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What’s New in the Patient Safety World

September 2022

Anesthesia Staffing Levels and Patient Outcomes

 

We’ve done many columns on the relationship between nursing staffing levels and patient outcomes. But what about other staffing levels? A new study (Burns 2022) has looked at the relationship between anesthesia staffing levels and patient outcomes.

 

Burns and colleagues looked at major noncardiac inpatient surgical procedures performed in 23 US academic and private hospitals from 2010 to 2017. They used propensity score–matching methods to create balanced sample groups with respect to patient-, operative-, and hospital-level confounders. They then examined 30-day mortality and 6 major surgical morbidities (cardiac, respiratory, gastrointestinal, urinary, bleeding, and infectious complications) across groups by the number of overlapping cases an anesthesiologist was supervising. (Note: cases with involvement of residents were excluded.)

 

Increasing anesthesiologist coverage responsibilities was associated with an increase in risk-adjusted surgical patient morbidity and mortality. Compared with patients in the group supervising 1-2 cases, those in the group supervising 2-3 cases had a 4%relative increase in risk-adjusted mortality and morbidity (5.06% vs 5.25%) and those in the group supervising 3-4 cases had a 14% increase in risk-adjusted mortality and morbidity (5.06%vs 5.75%).

 

Despite some limitations noted by the authors, the message to hospitals should be clear – stretching anesthesiologists too thinly can have adverse impacts on patient outcomes.

 

 

References:

 

 

Burns ML, Saager L, Cassidy RB, Mentz G, Mashour GA, Kheterpal S. Association of Anesthesiologist Staffing Ratio With Surgical Patient Morbidity and Mortality. JAMA Surg 2022; Published online July 20, 2022

https://jamanetwork.com/journals/jamasurgery/fullarticle/2794450

 

 

 

 

 

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