Flexing some anesthesia department muscle?

[Iso4ane]

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So traditionally (and except for pain), anesthesia usually doesn't bring patients to the hospital. But, I figure that anesthesia provides many services to the rest of the hospital. Additionally, the anesthesia department (by a rough estimate), should be one of the larger departments in many institutions (in terms of number of personnel/attendings). I feel like we should have more sway, instead of being overlooked. Or am I just too early in my training to see all the dealings.

/rant The reason I bring this up, is that the hospital had remodeled recently, and some genius thought it was better decision to move the preoperative bays to a different floor (from the ORs), because it would mess up with the work flow of another department (although that entire department could fit where the pre-op bays are.) I guess they don't see 20 patients waiting on three elevators as a work flow problem. Or the fact that the pre-op bays are not quite set up well or blocks/thoracic epidurals, so those patient have to make another stop prior to entering the OR. /end_rant

 

[Mr Medschool Money]

So traditionally (and except for pain), anesthesia usually doesn't bring patients to the hospital. But, I figure that anesthesia provides many services to the rest of the hospital. Additionally, the anesthesia department (by a rough estimate), should be one of the larger departments in many institutions (in terms of number of personnel/attendings). I feel like we should have more sway, instead of being overlooked. Or am I just too early in my training to see all the dealings.

/rant The reason I bring this up, is that the hospital had remodeled recently, and some genius thought it was better decision to move the preoperative bays to a different floor (from the ORs), because it would mess up with the work flow of another department (although that entire department could fit where the pre-op bays are.) I guess they don't see 20 patients waiting on three elevators as a work flow problem. Or the fact that the pre-op bays are not quite set up well or blocks/thoracic epidurals, so those patient have to make another stop prior to entering the OR. /end_rant

that is ridiculous hahaha.

 

[WashMe]

So traditionally (and except for pain), anesthesia usually doesn't bring patients to the hospital. But, I figure that anesthesia provides many services to the rest of the hospital. Additionally, the anesthesia department (by a rough estimate), should be one of the larger departments in many institutions (in terms of number of personnel/attendings). I feel like we should have more sway, instead of being overlooked. Or am I just too early in my training to see all the dealings.

/rant The reason I bring this up, is that the hospital had remodeled recently, and some genius thought it was better decision to move the preoperative bays to a different floor (from the ORs), because it would mess up with the work flow of another department (although that entire department could fit where the pre-op bays are.) I guess they don't see 20 patients waiting on three elevators as a work flow problem. Or the fact that the pre-op bays are not quite set up well or blocks/thoracic epidurals, so those patient have to make another stop prior to entering the OR. /end_rant

I know who you are! Ninja skills

 

[pjl]

This is why you get involved in committees. Someone from the anesthesia department should have been attending those very boring and long meetings for the construction committee. You get invited to those meetings by being active in other committees.

There is always a clutch minute or two in those hours that you are wasting where you have to speak up. Doing so can save you years of annoyances like rapidly hitting the up button on the elevator as you try to get your case moving.

Or, you can save yourself the time and just go with the flow. Nobody can blame anesthesia for the delay if you are stuck waiting for an elevator.


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[sigrhoillusion]

"Nobody can blame anesthesia for the delay if you are stuck waiting for an elevator."

Oh I'm sure they can, and will... lol

 

[Timeoutofmind]

So traditionally (and except for pain), anesthesia usually doesn't bring patients to the hospital. But, I figure that anesthesia provides many services to the rest of the hospital. Additionally, the anesthesia department (by a rough estimate), should be one of the larger departments in many institutions (in terms of number of personnel/attendings). I feel like we should have more sway, instead of being overlooked. Or am I just too early in my training to see all the dealings.

/rant The reason I bring this up, is that the hospital had remodeled recently, and some genius thought it was better decision to move the preoperative bays to a different floor (from the ORs), because it would mess up with the work flow of another department (although that entire department could fit where the pre-op bays are.) I guess they don't see 20 patients waiting on three elevators as a work flow problem. Or the fact that the pre-op bays are not quite set up well or blocks/thoracic epidurals, so those patient have to make another stop prior to entering the OR. /end_rant

Lol reminds me of The Office

 

[sigrhoillusion]

Yeah, the best bet is to have an anesthesiologist at some of these committee meetings.

Where I did residency between CA1 and CA2 year they moved the cardiac ICU (CCU) to a different location which happened to be the floor above the cardiac OR when before it was down the hall. An extra elevator ride for a very sick cardiac patient often with lots of poles, lines, LVAD equipment, etc...

Where I work now they recently moved all the anesthesia offices to pretty much the furthest part of the hospital away from the ORs. I say pretty much, because the actual furthest part would probably be the NICU which is far more annoying...

 

[IlDestriero]

Every major committee needs representation by all of the major departments, and certainly any affected departments, even if it's just an empty seat at the table/calling in/agenda and minutes review. Your hospital leadership is a joke and your group leadership is suspect as well if they didn't know all this was going on. That change will cause you and your patients decades of headaches and delays. They won't stop the OR engine from turning, but those constant delays add up and I bet they will add a lot more time than anyone thinks. Not to mention the disruption of constantly calling for patient transport elevators.
Hopefully it's not too late to change the plan. Have the building geeks run flow models and you can kill that fast. Efficiency is an issue we try to keep at the forefront of any changes and model everything. Remember that and you can all work hard and go home early.
BTW it's certainly possible that a member of your group WAS at those planning meetings or at least was made aware of the planned changes and couldn't convince them that it was a horrendous idea. That's also useful info as that person shouldn't be trusted with that kind of responsibility again. We've rolled back policies, flow changes, etc. before and after they went into effect because they made no sense to us or added roadblocks to flow and efficiency and later found we had representatives there...
You don't need some suck up yes man there, you need an independent out of the box thinker that can screen these kinds of changes and work out some of the unintended consequences.
That idea was so dumb there's no way that people didn't see the impact on anesthesia. That's also telling. You're time and flow are not valued by the hospital in any way. And the decision makers have probably never been in the OR or understand how it works there.

--
Il Destriero

 

[San Marzano]

One of our hospitals has the outpatient preop area one floor up and across the street via underground tunnel from the main OR.

 

[abolt18]

One of our hospitals has the outpatient preop area one floor up and across the street via underground tunnel from the main OR.

😕

 

[sigrhoillusion]

😕

Might as well have the preop center at the local train station...

 

[ZzzPlz]

Our pharmacy tubes drugs to the OR all the time. Maybe we could design a tubing system for patients? Problem solved

 

[MoMoGesiologist]

The Mayo Clinic is trialing such a system right now!

http://gomerblog.com/2014/08/pneumatic-tube/

 

[San Marzano]

😕

For first case starts there's a person standing at the elevator pushing the button and holding the door while we all wait in line with stretchers loading on one by one... insanity is not a strong enough word.

 

[turnupthegas]

WTF. Crazy!


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[Planktonmd]

Let me put it for you in very simple terms:
The general lack of respect anesthesia departments have is a direct reflection of the belief that we are a bunch of hacks who could be easily replaced by nurses.
This belief is always there (openly or secretly), and is shared by all administrators and other specialists.
Anyone who cannot tolerate this simple fact or live with it for the next 30 years or so should not go to anesthesia.

 

[chocomorsel]

Plankton's baaacckk!!!!

 

[Outrigger]

I've seen some ghetto ORs but to not have the preop floor at the same level as the ORs? And then they expect close supervision while the attending is stuck in preop all day on a different floor? You have some seriously weak leadership in the department.