Efficiency and scheduling in the nonoperating room anesthesia suite: implications from patient satisfaction to increased revenue operating room: a common (Dollars and Sense) approach

Curr Opin Anaesthesiol. 2019 Aug;32(4):498-503. doi: 10.1097/ACO.0000000000000744.


Purpose of review: Although the NORA setting continues to outgrow the main operating room in cases, there are few studies addressing efficiency metrics, and even fewer studies addressing those of a single specialty outpatient gastroenterology facility. In order to capitalize on this growing trend, gastrointestinal endoscopies must be scheduled in a way that prevents lost potential revenue while maintaining patient convenience, comfort, safety, and satisfaction. By standardizing our scheduling for procedure block time among various endoscopists and converting our sedation practices from conscious sedation to solely Propofol sedation in a 4 : 1 CRNA to Anesthesiologist model, we increased revenue while maximizing physician efficiency and site utilization.

Recent findings: The commonly used main operating room efficiency benchmarks cannot effectively be applied in NORA as these two locations have widely different procedure times, turn-around-times, and recovery times. In fact, procedures in gastrointestinal endoscopy suites can be completed in less time than a typical operating room takes for turnover.

Summary: By adapting our sedation practices to solely Propofol sedation and by standardizing our procedural schedule times among all the endoscopists, we maximized the number of cases and revenue in our outpatient gastrointestinal endoscopy suite while increasing patient satisfaction through reduction in overall patient facility time and procedure to discharge time.

Publication types

  • Review

MeSH terms

  • Ambulatory Care Facilities / economics
  • Ambulatory Care Facilities / organization & administration*
  • Conscious Sedation / economics
  • Conscious Sedation / methods*
  • Efficiency, Organizational*
  • Endoscopy, Gastrointestinal / adverse effects
  • Endoscopy, Gastrointestinal / economics
  • Humans
  • Pain, Procedural / etiology
  • Pain, Procedural / prevention & control
  • Pain, Procedural / psychology
  • Patient Discharge
  • Patient Satisfaction*
  • Personnel Staffing and Scheduling / economics
  • Personnel Staffing and Scheduling / organization & administration*
  • Propofol / administration & dosage
  • Time Factors


  • Propofol