Whether your department is staffed with an anesthesiologist, only CRNAs, or a combination of the two, you should first understand what drives anesthesia costs in order to reduce costs.
The major driver is the cost of the anesthesia provider, and while this may seem easy enough to reduce, it’s not that simple. There is an art and science to efficiently matching anesthesia department staff to the utilization of the operating rooms they cover. Accounting for the inevitable is important—every facility will encounter a surgeon not utilizing block scheduling, delayed starts, pre-op processes or turnover snafus, call coverage requests, case cancellations, add-on cases, or other issues that can result in unnecessary expenses.
To effectively control costs, your anesthesia care team schedule should parallel the utilization of the ORs being covered. In essence, this means that if you staff one OR with a full-time CRNA, then your caseload volume for the day should span the entire time that CRNA is present. A facility analysis needs to be broken down to this level to properly control costs. Why would you pay a full-time CRNA when you have a half day of caseload volume? These inefficiencies are compounded by the number of ORs that your facility utilizes. You can quickly see the enormous amount of cash wasted if you have six to eight operating rooms that are not effectively managed in terms of anesthesia care.
Understanding OR utilization is key to effectively controlling the costs of your anesthesia care team. A quick way to understand this utilization is to divide the total anesthesia minutes by the minutes of anesthesia coverage for the day. For example, say we have one CRNA that works an eight hour shift and he performs two cases that are each 65 minutes in length. Then, we can analyze efficiency with the following calculation:
