Warner Mary E, Martin David P
Department of Anesthesiology & Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Curr Opin Anaesthesiol. 2018 Aug;31(4):492-497. doi: 10.1097/ACO.0000000000000611.
Nonoperating room anesthesia (NORA) and procedural services often are associated with dispersed geographic settings and small volumes of cases. These lead to scheduling challenges that, if not managed well, result in decreased patient and healthcare team satisfaction and reduced efficiency. This review describes recent studies and provides examples on how NORA scheduling issues have been addressed.
Increased use of blocked time for consolidated NORA services can lead to sufficiently large volumes of cases that allow improved scheduling and maintain patient and healthcare team satisfaction and better efficiency of care. In general, patients and proceduralists find that service blocks offered at least once every 2 weeks are acceptable. With the ability to perform the full scope of perioperative practices such as preoperative assessment and postoperative management, anesthesiologists are well positioned to lead NORA services. There is a rising expectation for both graduate medical education experiences and continuing education in quality improvement for NORA services.
Many factors play a role in successful scheduling of NORA services. Increasing consolidation of services, the use of block scheduling, and leadership by anesthesiologists can help improve patient and healthcare team satisfaction and practice efficiencies.
非手术室麻醉（NORA）和程序性服务通常与分散的地理环境和少量病例相关。这些导致了排班挑战，如果管理不善，会导致患者和医疗团队满意度下降以及效率降低。本综述描述了近期的研究，并举例说明了如何解决NORA排班问题。
增加使用整合的NORA服务的预留时间可以带来足够多的病例量，从而实现更好的排班，维持患者和医疗团队的满意度，并提高护理效率。总体而言，患者和手术医生认为每两周至少提供一次的服务时段是可以接受的。由于具备开展围手术期全部业务的能力，如术前评估和术后管理，麻醉医生非常适合领导NORA服务。对于毕业后医学教育经历以及NORA服务质量改进方面的继续教育的期望都在不断提高。
许多因素对NORA服务的成功排班起着作用。增加服务整合、采用时段排班以及麻醉医生发挥领导作用有助于提高患者和医疗团队的满意度以及医疗效率。
