Computer simulation to determine how rapid anesthetic recovery protocols to decrease the time for emergence or increase the phase I postanesthesia care unit bypass rate affect staffing of an ambulatory surgery center

Franklin Dexter, Alex Macario, Paul J. Manberg, David Lubarsky

Research output: Contribution to journalArticle

93 Citations (Scopus)

Abstract

Ambulatory surgery centers (ASC) are implementing new anesthetic techniques and rapid recovery protocols in the postanesthesia care unit (PACU) to achieve earlier discharge after general anesthesia. Using computer simulation, we addressed two questions. First, what is the decrease in an ASC's operating room (OR) staff if the time from which the surgery is finished to the time the patient leaves the OR is decreased? Second, what is the decrease in PACU nursing staffing if patients bypass phase I PACU (i.e:, proceed from the OR directly to the phase II PACU)? The decrease in labor costs from rapid emergence or fast-tracking depends on how staff are compensated, how many ORs routinely run concurrently, and what percentage of patients undergo general anesthesia. The results show potential decreases in ASCs' labor costs ($7.39 per case) from technologies (e.g., new anesthetics or Bispectral Index(TM) [Aspect Medical Systems, Natick, MA] monitoring) to decrease emergence times or increase the phase I by: pass rates. Implications: Decreases in operating room and postanesthesia care unit labor costs resulting from faster emergence and phase I postanesthesia care unit bypass vary depending on the amount of routine overtime, how the staff are compensated, and how many patients are routinely anesthetized each day.

Original languageEnglish (US)
Pages (from-to)1053-1063
Number of pages11
JournalAnesthesia and Analgesia
Volume88
Issue number5
DOIs
StatePublished - May 17 1999
Externally publishedYes

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Operating Rooms
Ambulatory Surgical Procedures
Computer Simulation
Anesthetics
Costs and Cost Analysis
General Anesthesia
Nursing Care
Technology

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

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abstract = "Ambulatory surgery centers (ASC) are implementing new anesthetic techniques and rapid recovery protocols in the postanesthesia care unit (PACU) to achieve earlier discharge after general anesthesia. Using computer simulation, we addressed two questions. First, what is the decrease in an ASC's operating room (OR) staff if the time from which the surgery is finished to the time the patient leaves the OR is decreased? Second, what is the decrease in PACU nursing staffing if patients bypass phase I PACU (i.e:, proceed from the OR directly to the phase II PACU)? The decrease in labor costs from rapid emergence or fast-tracking depends on how staff are compensated, how many ORs routinely run concurrently, and what percentage of patients undergo general anesthesia. The results show potential decreases in ASCs' labor costs ($7.39 per case) from technologies (e.g., new anesthetics or Bispectral Index(TM) [Aspect Medical Systems, Natick, MA] monitoring) to decrease emergence times or increase the phase I by: pass rates. Implications: Decreases in operating room and postanesthesia care unit labor costs resulting from faster emergence and phase I postanesthesia care unit bypass vary depending on the amount of routine overtime, how the staff are compensated, and how many patients are routinely anesthetized each day.",
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