On the Design of Alternative Obstetric Anesthesia Team Configurations

Alternative ways to alleviate the shortage of anesthesiologists in obstetric services have been investigated in three study stages. These were (1) a survey and detailed analysis of the existing situation in one metropolitan region of the United States, (2) the construction and validation of a computer simulation model to study the consequences of alternative practice modes with speed, with economy and requiring no human experimentation, and (3) the establishment of a methodology for selecting an optimal anesthesia team configuration. This in turn should aid administrators in establishing future manpower needs and enable more efficient allocations of existing staff. The methodology, incorporating the simulation model, provides team design charts which enable decision makers to arrive at a basis for enlightened tradeoffs between personnel-associated costs and quality of service. Service quality is measured in terms of temporary unavailability of anesthesia personnel with the proper skills for performing certain tasks when needed. This article documents the overall project mission, the data base, the methodologies used, and the study results.