15% reduction in operating theater availability helps address pandemic-induced hospital staffing shortages

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According to a study presented at the American Society of Anesthesiologists’ ADVANCE 2022, Anesthesiology Business Event, decreasing operating room (OR) availability by 15% helped a hospital address a 30% staffing shortage caused by the COVID-19 pandemic.

The Great Resignation had a disproportionate impact on healthcare at near crisis levels and we were able to address ongoing staffing shortages by methodically reducing available surgical times. By using a phased approach, including daily meetings to resolve scheduling issues, we were able to prioritize essential surgeries and care for the patients who need it most. »

Kimberly Cantees, MD, MBA, Clinical Director of Anesthesiology and Perioperative Services, UPMC Presbyterian Hospital, Pittsburgh

UPMC is a regional and national referral center for comprehensive quaternary care for many surgical specialties, including traumatology, transplantation, neurosurgery, cardiac surgery and surgical oncology. In the study, the hospital implemented a five-phase approach, which began in May 2021, to ensure it could continue to provide essential surgical care when its surgical technologist vacancy rate and nurse in the operating room has reached 30%. The phases included:

  • Phase I (May 2021): Restricted availability of operating theaters for less time-sensitive surgeries and relocation of some to other hospitals and surgery centers in the UPMC system; decreased operating room availability for surgeons with highly elective cases (eg, sports orthopedic procedures, some hand surgery cases, some plastic surgeries) and displacement of a small amount of surgical work at the bedside in the intensive care unit.
  • Phase II (July 2021): Formation of a multidisciplinary Surgical Services Capacity Committee that met daily to ensure that staffing matched the surgical schedule for the next two weeks. Values ​​for surgical care were identified and cases such as transplants and cancer surgeries were prioritized.
  • Phase III (October 2021): Reduced operating room time availability by 15% when surgeries could be scheduled and extended standard scheduling guidelines from three days to five days before surgery.
  • Phase IV (November 2021): Further reduction in OR schedule to address ongoing staffing shortages and reduction in OR time available for all surgical services by an additional 10%. Surgeons with two operating rooms saw their time reduced for all services except trauma patient care.
  • Phase V (January 2022): Implemented a UPMC system-wide review of surgical case prioritization and opened more ORs for booking, which allowed for greater flexibility to perform surgeries depending on staff availability.

During the phased approach, available ORs have been reduced from 36 to 31 (15%). This was enough to cope with the 30% reduction in surgical ward staff, Dr Cantees said. The hospital continued to use the approach to successfully address staffing challenges during the Omicron surge.

Dr. Cantees said the phased approach has received minimal pushback from surgeons, primarily due to clear communication of staffing barriers, as well as established surgical priorities. Communication occurs through regular meetings, emails and personal communications between members of the Multidisciplinary Surgical Services Capacity Committee and individual surgeons.

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