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
- 1 May 1999
- journal article
- Published by Wolters Kluwer Health in Anesthesia & Analgesia
- Vol. 88 (5), 1053-1063
- https://doi.org/10.1213/00000539-199905000-00016
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[trade mark sign] [Aspect Medical Systems, Natick, MA] monitoring) to decrease emergence times or increase the phase I bypass 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. (Anesth Analg 1999;88:1053-63)Keywords
This publication has 10 references indexed in Scilit:
- Is the Bispectral Index Useful in Predicting Fast-Track Eligibility After Ambulatory Anesthesia with Propofol and Desflurane?Anesthesia & Analgesia, 1998
- Fast-Track Eligibility After Ambulatory AnesthesiaAnesthesia & Analgesia, 1998
- Titration of Volatile Anesthetics Using Bispectral Index Facilitates Recovery after Ambulatory AnesthesiaAnesthesiology, 1997
- Bispectral Index Monitoring Allows Faster Emergence and Improved Recovery from Propofol, Alfentanil, and Nitrous Oxide AnesthesiaAnesthesiology, 1997
- A963 BENCHMARKING DATA TO MODIFY PRACTICE REDUCES AMBULATORY SURGICAL CENTER EXPENSESAnesthesiology, 1997
- A32 BYPASSING THE PACU-A NEW PARADIGM IN AMBULATORY SURGERYAnesthesiology, 1997
- A Statistical Method for Predicting Postanesthesia Care Unit Staffing NeedsAORN Journal, 1997
- Quantification of phase I postanesthesia nursing activities in the phase II postanesthesia care unitNursing Outlook, 1997
- Recovery Pattern and Home-Readiness After Ambulatory SurgeryAnesthesia & Analgesia, 1995
- Analysis of Strategies to Decrease Postanesthesia Care Unit CostsAnesthesiology, 1995