title: Introduction of anesthesia resident trainees to the operating room does not lead to changes in anesthesia-controlled times for efficiency measures.
abstract: BACKGROUND
  Operating room efficiency is an important concern in most hospitals today. Little work has been reported to evaluate the contribution of anesthesia residents to changes in anesthesia-controlled time-related efficiencies in the operating room. The goal of this study was to measure the impact of the initiation of new residents to the operating room on anesthesia-related time measures of operating room efficiency.
  
  
  METHODS
  Using the computerized operating room information systems, specific data regarding anesthesia-controlled times were extracted over three distinct 2-week periods over the course of 1 academic year. These included the first 2 weeks of July, when most of the operating rooms were staffed by attending physicians working alone; 2 weeks in September when new anesthesia residents were working in a 2:1 ratio with staff; and 2 weeks in May. The induction times, emergence times, and room turnover times were compared over these three periods for first-year anesthesia residents. Standard descriptive statistics were computed. Analysis of variance testing was then conducted comparing each of these time periods. Significance was set at P < 0.05.
  
  
  RESULTS
  A total of 3,004 surgical procedures were performed during the 2-week study periods in July, September, and May, respectively. For the July, September, and May groups, the mean anesthesia induction times were 17.3, 19.0, and 20.8 min (P = 0.047); the emergence times were 8.7, 9.7, and 10.0 min, (P = 0.024); and the corresponding mean room turnover times were 47.6, 48.5, and 48.6 min (P = 0.907), respectively.
  
  
  CONCLUSIONS
  Although statistically significant time differences were found, these data strongly suggest that the initiation of anesthesia trainees to the operating room has no clinically or economically meaningful adverse effect on the anesthesia-controlled time component of operating room efficiency.
authors.affiliation: Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA. seappen@partners.org
authors.forename: Sunil
authors.initials: S
authors.lastname: Eappen
authors.forename: Hugh
authors.initials: H
authors.lastname: Flanagan
authors.forename: Neil
authors.initials: N
authors.lastname: Bhattacharyya
mesh_terms: D000758:Anesthesia / Q000009:adverse effects; D000776:Anesthesiology / Q000193:education*; D003953:Diagnosis-Related Groups; D006751:Hospital Information Systems; D006801:Humans; D007396:Internship and Residency; D009873:Operating Rooms / Q000458:organization & administration*; D018907:Privacy; D013514:Surgical Procedures, Operative; D013997:Time Factors; D014481:United States