Permanently transitioning care from one anesthesia provider to another (not just covering brief breaks) during ambulatory surgery is associated with adverse events and mortality. Frank Dexter, MD, PhD, and colleagues from the University of Miami have come up with four strategies to reduce adverse events for ambulatory anesthesia:

1. Use statistical forecasts based on several months of historical data to determine optimal shift durations.

2. Consider assigning anesthesiologists who will work late to operating rooms that are expected to finish the earliest.

3. In the ORs with the latest scheduled end times, schedule cases with the shortest durations for last.

4. If a supervising anesthesiologist has to wrap up early for meetings or other administrative duties, assign that anesthesiologist to an OR finishing with shorter cases.

"The rationale for these recommendations is that such strategies provide multiple opportunities for a different anesthesia provider to assume responsibility for patients between cases, thus avoiding a handoff altogether," Dexter and his co-investigators wrote.

The recommendations were published in Dove Press. Access the abstract and the full article here.