Operating Room Schedules

According to hospital administrators in the United States, surgeons say they order preoperative tests to satisfy anesthesiologists: surgeons find it easier just to order all the tests and let the anesthesiologist sort them out (also see Chapter 86 ). Surgeons also believe that it is much more efficient to order batteries of tests than to have an anesthesiologist, who sees the patient the night before or the morning of surgery, obtain the tests on an emergency basis. This line of reasoning overlooks the fact that abnormalities arising from tests performed in the battery fashion are usually not discovered until the night before or the morning of surgery, if at all. Then, the discovery of abnormal results delays or postpones OR schedules, as effort and time are wasted to obtain consultant review of false-positive or slightly abnormal results. Also, data show clear cost reductions from delegating test selection to anesthesiologists,^{[26] [27] [28] [29] [30]} as well as other benefits from educational practices that are discussed later in this chapter.^{[5] [31] [32] [33] [34] [35] [36] [37] [38] [39] [40] [54] [55] [56] [57] [58] [59] [60] [61] [62] [63] [64] [65] [66] [67] [68] [69] [70] [71] [72] [169]}