A strategy for deciding operating room assignments for second-shift anesthetists

We developed a relief strategy for assigning second-shift anesthetists to l ate-running operating rooms. The strategy relies on a statistical method wh ich analyzes historical case durations available from surgical services inf ormation systems to estimate the expected (mean) remaining hours in cases a fter they have begun. We tested our relief strategy by comparing the number of hours that first-shift anesthetists would work overtime if second-shift anesthetists were assigned using our strategy versus if the anesthesia coo rdinator knew in advance the exact amount of time remaining in each case. O ur relief strategy resulted in 3.4% to 4.9% more overtime hours for first-s hift anesthetists than the theoretical minimum, as would have been obtained had perfect retrospective knowledge been available. Few additional staff h ours would have been saved by supplementing our relief strategy with other methods to monitor case durations (e.g., real-time patient tracking systems or closed circuit cameras in operating rooms). Implications: A relief stra tegy that relies only on analyzing historical case durations from an operat ing room information system to predict the time remaining in cases performs well at minimizing anesthetist staffing costs.