title: The impact of anaesthetic trainees on elective caesarean section procedural times: a prospective observational study.
abstract: Operating room efficiency is an important concern in hospitals today both in the public and private sectors. Currently, a paucity of literature exists to evaluate the impact of anaesthetic training on operating room efficiency in the Australian health system. At Monash Medical Centre, Clayton, private consultant operating sessions and public teaching operating sessions use the same operating theatres, nursing and technical staff. Consultant anaesthetists and obstetricians perform all tasks during private sessions, whereas anaesthetic and obstetric trainees perform many tasks during public sessions. In this prospective observational study, total case time, anaesthesia controlled time and the surgical time were measured for elective caesarean section under spinal anaesthesia in 59 patients (private consultant n = 29, public teaching n = 30). Increases in total case time (24 minutes, P < 0.001), anaesthesia controlled time (5.2 minutes, P < 0.015) and surgical time (19.25 minutes, P < 0.001) were observed in the public teaching group compared with the private consultant group. The participation of anesthetic trainees in caesarean sections results in a modest increase in anaesthetic controlled time of approximately five minutes per case or 16 minutes in an operative session with three cases scheduled. Elimination of anaesthetic 'training' time does not allow scheduling of an extra elective caesarean section. Reduced operating theatre throughput is unlikely to be a consequence of training specialist anaesthetists in this clinical setting.
authors.affiliation: Department of Anaesthesia and Perioperative Medicine, Monash Medical Centre, Clayton, Victoria, Australia.
authors.forename: W
authors.initials: W
authors.lastname: Browne
authors.forename: L W L
authors.initials: LW
authors.lastname: Siu
authors.forename: J P
authors.initials: JP
authors.lastname: Monagle
mesh_terms: D000328:Adult; D000773:Anesthesia, Obstetrical; D000775:Anesthesia, Spinal; D000776:Anesthesiology / Q000193:education*; D001315:Australia; D002585:Cesarean Section; D002983:Clinical Competence; D003253:Consultants; D017598:Efficiency, Organizational / Q000706:statistics & numerical data*; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D009873:Operating Rooms / Q000458:organization & administration; D011247:Pregnancy; D011446:Prospective Studies; D013337:Students, Medical; D013997:Time Factors