title: Implications of National Anesthesia Workload on the Staffing of a Call Center: The Malignant Hyperthermia Consultant Hotline.
abstract: Recently, we analyzed data from the American Society of Anesthesiologist's (ASA) Anesthesia Quality Institute (AQI) to report the United States (U.S.) anesthesia workload by time of day and day of the week. The AQI data were reported using the Central Time zone. Times for the N = 613 calls to the Malignant Hyperthermia Association of the United States (MHAUS) Malignant Hyperthermia (MH) Hotline from August 1, 2012, through March 7, 2014, were adjusted similarly. The MH Hotline effectively provides at all times to each anesthesia group an additional board-certified anesthesiologist who has expertise in managing, diagnosing, and/or preventing MH crises. We compared the timing of calls with the MH Hotline consultants relative to times of most anesthesia workload nationally. The interval 6:30 AM to 6:30 PM Central Time on regular workdays accounted for most (P < 0.0001) calls to the MH Hotline (62.5% ± 2.0% [mean ± standard error]). However, the interval accounted for significantly less than the 82.2% of anesthesia minutes and 84.5% of general anesthesia minutes during that interval nationally (both P < 0.0001). Thus, most calls to the MH Hotline occurred when anesthesia groups nationwide were the busiest. Weekends accounted for 15.3% ± 1.5% of MH Hotline calls, significantly greater than the rates of 5.2% of anesthesia minutes and 4.3% of general anesthesia minutes during weekends nationally (both P < 0.0001). Thus, the MH Hotline was used proportionately more often when anesthesia providers have fewer colleagues present and available for consultation (all P < 0.0001). These findings may be expected of other (future) national support centers for anesthesia.
authors.affiliation: From the *Division of Management Consulting, Department of Anesthesia, University of Iowa, Iowa City, Iowa; †Malignant Hyperthermia Association of the United States, Sherburne, New York; ‡Department of Medical Education and Clinical Research, St. Barnabas Medical Center, Livingston, New Jersey; §Department of Anesthesiology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania; ∥Judith Jurin Semo, PLLC, Washington, DC; ¶Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Franklin
authors.initials: F
authors.lastname: Dexter
authors.forename: Henry
authors.initials: H
authors.lastname: Rosenberg
authors.forename: Richard H
authors.initials: RH
authors.lastname: Epstein
authors.forename: Judith Jurin
authors.initials: JJ
authors.lastname: Semo
authors.forename: Ronald S
authors.initials: RS
authors.lastname: Litman
mesh_terms: D000768:Anesthesia, General; D000776:Anesthesiology; D003253:Consultants; D015277:Hotlines; D006801:Humans; D008305:Malignant Hyperthermia; D014481:United States; D000078329:Workforce; D016526:Workload