New
research findings highlight "the large amount of 'out-of-OR' tasks that
supervising anesthesiologists must regularly handle," according to a
commentary by Dr Patricia A. Kapur of David Geffen School of Medicine at
UCLA. Communication with other areas of the hospital—particularly
where other patients are being prepared for surgery—"must be addressed
as part of the considerations if technologically assisted, remote
supervision tele-anesthesiology is to be adopted as part of an overall
staffing paradigm in the future," Dr Kapur adds.
Patterns of Communication with Supervising Anesthesiologists
The
study by Dr Bettina Smallman of State University of New York Upstate,
Syracuse, and colleagues examined the types of messages sent to
anesthesiologists supervising ORs in two hospitals using different kinds
of communication systems. The analysis included more than 13,000 pages
sent through an internal text paging system at hospital A, and about
900 calls made through an internal wireless audio system at hospital B.
The
researchers were particularly interested in where the messages were
originating. If anesthesiologists are supervising, rather than
personally providing care in the OR, then they should receive about as
many messages from outside of ORs as from inside the ORs they are
supervising.
The results suggested that was the case. At hospital
A, at least 45 percent of pages came from outside the OR—the largest
group was messages from the holding area alerting the anesthesiologist
that the next patient was ready. At hospital B, at least 56 percent of
calls came from outside the OR.
At both hospitals, providers in
the OR made few urgent calls to the supervising anesthesiologist. That
suggested that the situation in the OR was under control and that the
supervising anesthesiologist was free to coordinate other activities to
keep all ORs running efficiently. Dr Smallman and coauthors conclude,
"From the perspective of increasing anesthesia productivity, activities
performed by anesthesia providers outside of ORs should be a focus of
[communication] systems, not activities related to intraoperative
workload."
Tele-Anesthesia Has Potential to Make OR Care More Efficient
Tele-anesthesia
refers to emerging systems in which supervising anesthesiologists use
technology to monitor activities from outside the OR—similar to the
tele-monitoring approaches already widely used in intensive care units.
In addition to video images and patient monitoring data, supervising
anesthesiologists would also have access to software decision-support
systems. In theory, this might allow them to identify developing
problems more promptly than the busy providers working in the OR.
These
monitoring and communication systems have the potential to help ORs
work more productively and efficiently. As tele-anesthesiology systems
are introduced, they may allow senior anesthesiologists to provide
"knowledge input" almost immediately, and to supervise activities in
more ORs than they could if they had to be physically present.
Full article available at Anesthesia & Analgesia Journal
Source:International Anesthesia Research Society (IARS) via Newswise
