When It Rains, It Pours: Obstetric Anesthesia Workload

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In this issue of Anesthesia & Analgesia, Im and colleagues offer the results of a survey aimed at characterizing the workload of obstetric anesthesiologists. The authors targeted Society of Obstetric Anesthesia and Perinatology (SOAP) Centers of Excellence (COE) designated institutions. This designation is achieved when standards are met for obstetric anesthesia trained staff, dedicated in-house OB anesthesia coverage, and sufficient resources/personnel for unanticipated emergency and/or high-risk management. Obstetric anesthesia activity was estimated at these institutions using a time-based workload ratio (Stanford Work Index or SWI, 1.0 = clinically working every minute of every hour on duty) during weekday, weeknight, and weekend shifts. The average workload was higher during daytime weekday shifts compared with evenings and weekends. Additionally, the SWI was similar between academic and non-academic anesthesiology attendings. Obstetric anesthesia clinical activity was calculated using the Obstetric Anesthesia Activity Index​ (OAAI) which was defined as the number of cesarean sections and neuraxial analgesia​ procedures multiplied by the time estimated for the​ respective procedure. The survey results offer insight into obstetric anesthesiology staffing balances at a variety of institutions. An accompanying editorial recognizes that mean workloads often do not reflect the fluctuations in clinical demands that frequently result in an abundance or deficit of resources. The reader is strongly encouraged to review the cited article and editorial for an in-depth understanding of the concepts summarized in this infographic.

1. Im M, Riley ET, Hoang D, Lim G, Zakowski M, Carvalho B. Obstetric anesthesia procedure-based workload and facility utilization of Society of Obstetric Anesthesia and Perinatology Centers of Excellence designated institutions obstetric anesthesia procedure-based workload and facility Utilization of Society of Obstetric Anesthesia and Perinatology Centers of Excellence Designated Institutions. Anesth Analg. 2022;135:1142–1150. 2. Ginosar Y, Wimpfheimer A, Weissman C. Using mean anesthesia workload to plan anesthesia workforce allocation: the “flaw of averages” Using mean anesthesia workload to plan anesthesia workforce allocations: the “flaw of averages”. Anesth Analg. 2022;135:1138–1141.

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