Document Detail

Analysis of operating room allocations to optimize scheduling of specialty rotations for anesthesia trainees.
MedLine Citation:
PMID:  20584873     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: Because specialty workloads and corresponding operating room (OR) allocations vary among days of the week, anesthesia residents and student nurse anesthetists are sometimes assigned to cases off rotation (e.g., scheduled for cardiac surgery but assigned to urology for the day). We describe a method to create hybrid rotations of two specialties (e.g., cardiac and vascular surgery), thereby reducing the numbers of days that trainees are "pulled" from their scheduled rotations. METHODS: Raw data were the number of hours of OR time used by each surgical specialty on each workday for the preceding 9 months. These OR workloads were converted to the number of ORs to be allocated to each specialty for each day of the week on the basis of maximization of the efficiency of use of OR time. We considered all potential hybrid rotations of pairwise combinations of specialties to which trainees could be assigned. Integer linear programming was used to calculate the maximum number of trainees who could be scheduled to hybrid rotations and receive daily assignments matching those rotations. RESULTS: Validity of the results was shown by using data from a small facility for which the optimal solution could be discerned by inspection. Validity (appropriateness) of the constraints was demonstrated by the exclusion of each constraint, resulting in answers that are obviously incorrect. Novelty and usefulness of the method was evidenced by its choosing from among hundreds of thousands of potential combinations of specialties and its identifying appropriate assignments that were substantively different from current rotations. CONCLUSIONS: We developed a methodology to determine rotations consisting of combinations of specialties to be paired for purposes of trainee scheduling to reduce the incidence of daily assignments off rotation. Practically, with this method, anesthesia residents and student nurse anesthetists can be assigned cases within their scheduled rotations as often as possible.
Franklin Dexter; Ruth E Wachtel; Richard H Epstein; Johannes Ledolter; Michael M Todd
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Publication Detail:
Type:  Journal Article     Date:  2010-06-28
Journal Detail:
Title:  Anesthesia and analgesia     Volume:  111     ISSN:  1526-7598     ISO Abbreviation:  Anesth. Analg.     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-28     Completed Date:  2010-08-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  1310650     Medline TA:  Anesth Analg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  520-4     Citation Subset:  AIM; IM    
Operations Research, Department of Anesthesia, University of Iowa, Iowa City, IA 52242, USA. Franklin-Dexter@UIowa.ed
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MeSH Terms
Anesthesiology / education*
Appointments and Schedules
Computer Simulation
Education, Medical, Graduate*
Efficiency, Organizational
Internship and Residency* / organization & administration
Models, Organizational
Numerical Analysis, Computer-Assisted
Nurse Anesthetists / education*,  organization & administration
Operating Room Information Systems / organization & administration*
Operating Rooms / organization & administration*
Personnel Staffing and Scheduling / organization & administration*
Personnel Staffing and Scheduling Information Systems / organization & administration*
Reproducibility of Results
Specialties, Surgical / education*,  organization & administration
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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