Estimating Obstetric Anaesthesia Workload: Number of Deliveries Compared to Time-Based Workload.

BACKGROUND

Number of deliveries is utilised to estimate obstetric anaesthesiologist workload; however, this may not reflect true workload. The goal of this analysis was to assess if including type of procedure, time required and length of each shift would better predict clinical workloads.

METHODS

We queried the electronic medical records at a high volume, academic centre for 12 consecutive months of maternal deliveries. Data extracted included delivery type, analgesic/anaesthetic procedure and whether delivery occurred during weekday, weeknight or weekend shifts. To generate an hourly comparison of shifts of varying duration, procedures were divided by the number of hours per shift. To calculate obstetric anaesthesiology time-based workload, delivery type was multiplied by estimated time associated with the analgesic/anaesthetic procedure.

RESULTS

A total of 4,598 deliveries occurred in the 12-month study period. The caesarean delivery rate was 32%, and labour epidural rate was 85%. 1,564 anaesthetic procedures occurred during weekdays and 2,557 occurred during the weeknights and weekends. After accounting for the duration of each procedure and hours per shift, mean 6 standard deviation time-based workload ratio was 0.68 6 0.12 on weekdays versus 0.36 6 0.07 on weeknights and weekends.

CONCLUSION

Relative workload based on deliveries alone suggests 41% less workload during the weekday, whereas accounting for duration of each procedure and hours per shift resulted in an 89% greater workload on weekday shifts. The study highlights the importance of considering analgesic/anaesthetic procedures and estimates of time taken to perform them, not just number of deliveries when considering obstetric anaesthesiology workload.