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Defining Factors That Impact Obstetric Anesthesia Workload
Abstract Number: T1B-158
Abstract Type: Original Research
Optimal staffing of obstetric anesthesiology services for labor and delivery units has not been well defined, with widely varying staffing practices nationally. Staffing and economic concerns affect every hospital and type of practice. Staffing needs are complex and beyond single criteria such as deliveries/year. This is the first study to examine through expert consensus using the Delphi Method what constitutes adequate staffing for obstetric anesthesia and what factors should be considered including direct clinical, indirect clinical and non-clinical workloads of providing obstetric anesthesia services.
After IRB approval, we performed a modified three round Delphi survey to identify factors that impact the workload of the obstetric anesthesiologist. A list of factors that might influence obstetric anesthesia workload was generated by the authors, including direct clinical, indirect clinical and non-clinical workload. Ten experts were identified by membership on the SOAP Board of Directors or the ASA Committee on Obstetric Anesthesia with geographic and practice diversity. The experts were asked to rank each task according to importance on a seven-point Likert scale (1 = Strongly Disagree and 7 = Strongly Agree. Consensus was set a priori at ≥ 70% Likert score of ≥ 5. The result of the Delphi study is a list of agreed upon tasks that are deemed important in determining the workload for an obstetric anesthesiologist.
Nine experts completed the entire Delphi Study. See Table 1 for summary of factors that achieved consensus.
Expert consensus determined Obstetric Anesthesia workload comprises direct clinical, indirect clinical and non-clinical components, with varying levels of additional time needed. Staffing allocation for obstetric anesthesia services need to take theses components, which may vary by practice, into account. Single metrics like deliveries per year is not robust enough to solely determine staffing needs.