weekends

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Reading about particular policies towards elective add-ons got me thinking about how other groups handle weekends:

I work at a large academic medical center that remains busy on the weekends. Our department is commited to running 2-4 OR rooms on the weekends during the daylight hours. It is not unusual to complete 10-15 procedures between 7 a.m. and 4 p.m. Some of these cases are truly emergent. Many, however, are semi-urgent or elective. (They could wait 24-28 hours without harming the patient.)

How do the rest of you arrange weekend coverage? What type of cases are you doing? Please comment on the size of your hospital or nature of your practice environment as well.

 

[rsgillmd]

Saturdays, a busy ortho surgeon has block time. You are guaranteed to be doing a couple of ortho cases. Likely some vascular cases as well, but mostly smaller ones. Generally the elective cases are done by 5-6 PM. Sundays is pretty much emergencies/uregent cases only, but that's because of the OR nursing issue -- they can't staff enough people to run more than one general OR. They have a separate team for cardiac. Usually no routine cardiac cases on the weekend, although the last couple of weeks there have been.

We have one attending and two residents to cover the main OR -- the senior resident is the cardiac resident. Additionally we have a similar team in OB (4 floors down).

We have one resident who moonlights each day -- Saturdays is from 7-3, Sundays is from 7-12.

The cardiac attending is the backup attending if there is no cardiac case -- he would come in for example two ORs running and now there is an emergency neuroradiology case.

There is a peds attending on call to come in and deal with kids who will need ICU care, and below some age (I forget what was agreed by the attendings).

That extra person is out of the picture if the general surgery attending is also one of the peds anesthesia attendings.

Hope this helps.

 

[jwk]

On Saturdays, we have four docs and seven anesthetists available. We have four OR's available for elective cases (one block room for ESWL, one block room for eyes) and one additional OR that we can open for urgent/emergent caes. Two of the anesthetists and two of the docs are assigned to OB.

We come down to two rooms only by 3pm - that's all the OR will staff. We still have capability for two rooms in OB on top of that.

Sundays and holidays there are two docs and four anesthetists available to run a maximum of four rooms overall. Sundays are for urgent/emergent cases only - and Sunday cases cannot be posted until after 8am on Saturday - they can't be posted several days ahead of time unless they're for recurring cases (I&D/dressing changes q2days, etc.).