The news is filled with the latest high technology gizmos, gadgets and apps, but Anesthesia Technology is not often in the headlines. However, the July 2019 edition of the ASA Monitor has two articles devoted to these invaluable support professionals. In the first, an anesthesiologist and three leaders of the American Society of Anesthesia Technologists and Technicians (“ASATT”) describe the wide range of skills provided by the profession. ASATT members can offer a range of services including assistance with invasive procedures; maintenance of point of care testing devices; operation of cell savers; EMR setup; maintenance of QI records; and to ensure MRI compatibility of anesthesia equipment. Since many local facilities establish policies and procedures which limit the roles of anesthesia techs, ASATT is seeking to establish uniform state and federal scope of practice guidelines.
The second article is written by Dr. Alvin Head and our good friend Robert Johnson. Using their experience in numerous operating rooms, they observe that anesthesia techs are often laid off during periods of budget stress. They argue that this is in fact the wrong response and that valuable work provided “behind the scenes” by techs is then redistributed to far more expensive anesthesia clinicians. Thus, the attempt at reducing cost actually has the opposite effect. The authors provide a cost allocation analysis of supporting required steps during OR turnover with different provider classes. They find that in a 10 room OR a fully allocated annual cost for anesthesia techs is $16,640, for CRNA/AA’s $83,200 and for anesthesiologists $166,400. A helpful guide for the number of anesthesia techs per type of anesthetizing location is provided as well and shown below.
EHC NOTE: As we travel to operating rooms around the country, the issue of “inadequate support staff” – including anesthesia techs – is a frequent theme from surgeons, anesthesiologists, nurses and OR leaders. Operating room time is incredibly valuable, and it makes little sense to reduce operating room efficiency and utilization due to relatively affordable support staff. As the article by Head and Johnson points out, shifting functions appropriately performed by anesthesia techs to mid-level or physician providers will incur a 5 to 10-fold increase in expense for the same deliverables. It makes little sense in any business to utilize staff at levels below pay grade.
It also makes little sense to limit support staff in the roles they can fulfill in optimizing throughput and efficiency. This is the point of the article by the group including ASATT leadership. We concur with their proposals to seek uniform scope of practice guidelines for anesthesia techs. Facilities employing anesthesia technicians should always seek to maximize their contributions to the collective efforts for efficiency.
Expanding the discussion beyond techs, we feel that operating room leaders should carefully look at all support personnel including housekeeping, pharmacy techs, and the transport/orderly staff. If a minute of operating room time is worth over $100, it makes little sense to cut corners on affordable support staff who can make a lot more of those high-value minutes productive instead of dormant.