Operating Room Management and the Business of Anesthesia: Innovative Solutions to Bridge the Educational Gap in Residency Training Programs

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In the ever-changing health care environment, anesthesiologists are becoming tasked with the challenges of a broadened scope of practice. This is evident by the expansion of resident education to cover the Perioperative Surgical Home domains of pre-, intra-, and postoperative patient care. As we transition from residency into the workforce, however, we will be expected to have some degree of understanding of operating room (OR) management, health care finances, and administrative medicine. Unfortunately, the clinical landscape of most anesthesiology training programs remains such that education in this area is lacking. Long days in the OR coupled with late nights reading and planning for your next day’s cases leave little time for additional studies. Equally restrictive are the mandatory case volumes and specific rotation requirements that provide limited flexibility in structured curriculums. Together, these constraints make standardized lectures and dedicated OR management rotations frequently unfeasible.
Perhaps, then, that is why I found the Web-based module “OR Management Basics: Right Case, Right Time, Right Cost” developed by Tsai et al1 to be a great option for an already very full educational curriculum. In an effort to fill in this educational gap, this roughly 1-hour module introduces residents to the basics of accounting, finance, and OR management. And, despite this module being free for all anesthesia residents who are members of the American Society of Anesthesiologists, I suspect few residents are aware of its existence. This module was extremely easy to locate on the Web site of American Society of Anesthesiologists and can be found under the “My Learning” section of the American Society of Anesthesiologists Education Center. The module was exceptionally user-friendly and does an outstanding job of introducing the reader to the “business of anesthesia.” Particularly helpful are discussions on operational metrics, including contribution margin, adjusted utilization, OR block allocations, and the costs of OR inefficiency. For those of us fortunate enough to spend time on an OR management rotation, the “three scheduling rules” are particularly poignant in helping to effectively “run the board.” Finally, the interactive examples of operational decision-making serve to solidify the residents’ understanding of the material while the cited research articles allow for further independent study.
The reality of our profession today assumes that all graduating anesthesia residents have a basic understanding of managerial information. With the results of their study and through this writer’s personal experience, it seems as though online Web-based tools can be used effectively in residency education to teach the basic tenets of OR management. Creating a collection of such modules that subsequently can be shared and modified by residency programs across the country is a possible way we can begin to standardize resident education to improve our understanding of the “business” of anesthesia. Moving forward, these types of curricula will be vital in preparing us for the future practice of our specialty.

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