Scheduling for anesthesia at geographic locations remote from the operating room.

Abstract

Providing general anesthesia at locations away from the operating room, called remote locations, poses many medical and scheduling challenges. This review discusses how to schedule procedures at remote locations to maximize anesthesia productivity (see Video, Supplemental Digital Content 1). Anesthesia labour productivity can be maximized by assigning one or more 8-h or 10-h periods of allocated time every 2 weeks dedicated specifically to each remote specialty that has enough cases to fill those periods. Remote specialties can then schedule their cases themselves into their own allocated time. Periods of allocated time (called open, unblocked or first come first served time) can be used by remote locations that do not have their own allocated time. Unless cases are scheduled sequentially into allocated time, there will be substantial extra underutilized time (time during which procedures are not being performed and personnel sit idle even though staffing has been planned) and a concomitant reduction in percent productivity. Allocated time should be calculated on the basis of usage. Remote locations with sufficient hours of cases should be allocated time reserved especially for them in which to schedule their cases, with a maximum waiting time of 2 weeks, to achieve an average wait of 1 week.