Making the Schedule

Twice a day, I sit with the main operating room scheduler and go over the cases and staffing. It feels like a logic puzzle trying to fit everything in. Case 1 can go after case 2 but only if case 3 is done and case 4 doesn't go too long. A lot about scheduling is understanding patients, surgeons, and anesthesiologists. For example, I will try to schedule pediatric cases first thing in the morning because I don't want a child to be fasting too long. But I also have to keep in mind that only some anesthesiologists are willing to do pediatric cases. Some surgeons run two operating rooms, and we have to stagger them so one doesn't delay the other. Some surgeons have a half-day clinic. Other surgeons have a full schedule of cases but want to follow with an add-on. Some surgeons request particular anesthesiologists, and some anesthesiologists like to focus on particular surgeries. For the most part, we use historical data to plan our rooms; what worked last Tuesday is liable to work this Tuesday, but it still feels like a mess of moving parts.

Despite our intricate planning, everything gets jumbled on the day of surgery. We try to slot in any urgent or add-on cases. I review them to make sure they are appropriate for the ambulatory surgery center. Add-ons change the late rooms which can affect nursing and call staff. I also realized that everything takes longer than expected. If I have an hour gap in the day, I cannot schedule an hour-long add-on; things never fit that snugly, and the add-on will delay everything that follows. Not only do I need the surgeons, anesthesiologists, and nurses, but I also have to account for the time it takes for the patient to come from the floor or emergency department, the equipment needed, the recovery room staffing, and the paperwork. As the day proceeds, some rooms run early and some run late. Patients may be stuck in traffic or surgeons may have a long clinic. I deal with equipment delays and mediate conflicts. I learn to be fluid and dynamic in running the operating room because even the best-laid plans get wrecked by an unanticipated minor change.