Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Aug;49(4):292-297.
doi: 10.5152/TJAR.2021.924.

Estimating Obstetric Anaesthesia Workload: Number of Deliveries Compared to Time-Based Workload

John J Kowalczyk  1 , Steven S Lipman  2 , Brendan Carvalho  2
Affiliations

Estimating Obstetric Anaesthesia Workload: Number of Deliveries Compared to Time-Based Workload

John J Kowalczyk et al. Turk J Anaesthesiol Reanim. 2021 Aug.

Abstract

Background: Number of deliveries is utilised to estimate obstetric anaesthesiologist workload; however, this may not reflect true workload. The goal of this analysis was to assess if including type of procedure, time required and length of each shift would better predict clinical workloads.

Methods: We queried the electronic medical records at a high volume, academic centre for 12 consecutive months of maternal deliveries. Data extracted included delivery type, analgesic/anaesthetic procedure and whether delivery occurred during weekday, weeknight or weekend shifts. To generate an hourly comparison of shifts of varying duration, procedures were divided by the number of hours per shift. To calculate obstetric anaesthesiology time-based workload, delivery type was multiplied by estimated time associated with the analgesic/anaesthetic procedure.

Results: A total of 4,598 deliveries occurred in the 12-month study period. The caesarean delivery rate was 32%, and labour epidural rate was 85%. 1,564 anaesthetic procedures occurred during weekdays and 2,557 occurred during the weeknights and weekends. After accounting for the duration of each procedure and hours per shift, mean 6 standard deviation time-based workload ratio was 0.68 6 0.12 on weekdays versus 0.36 6 0.07 on weeknights and weekends.

Conclusion: Relative workload based on deliveries alone suggests 41% less workload during the weekday, whereas accounting for duration of each procedure and hours per shift resulted in an 89% greater workload on weekday shifts. The study highlights the importance of considering analgesic/anaesthetic procedures and estimates of time taken to perform them, not just number of deliveries when considering obstetric anaesthesiology workload.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1.
Figure 1.
Deliveries occurring on day and night and weekend shifts during the 12-month study period
Figure 2.
Figure 2.
Number of deliveries per hour on day and night and weekend shifts during the 12-month study period
Figure 3.
Figure 3.
Number of analgesic/anaesthetic procedure per hour on day and night and weekend shifts during the 12-month study period
Figure 4.
Figure 4.
Time-based workload on day and night and weekend shifts during the 12-month study period Time-based workload was calculated as time (in hours) spent performing analgesic/anaesthetic procedures and related activities per hour. A ratio of 1.0 is equivalent to one person spending all their time in that hour doing analgesic/anaesthetic procedures, a ratio of 0.5 equivalent to spending half their time in the hour doing analgesic/anaesthetic procedures
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Kalogiannidis I, Margioula-Siarkou C, Petousis S, Goutzioulis M, Prapas N, Agorastos T. Infant births during the internal night are at increased risk for operative delivery and NICU admission. Arch Gynecol Obstet. 2011;284:65–71.. 10.1007/s00404-010-1602-2 - DOI - PubMed
    1. Wu YW, Pham TN, Danielsen B, Towner D, Smith L, Johnston SC. Nighttime delivery and risk of neonatal encephalopathy. Am J Obstet Gynecol. 2011;204:37e1–6.. 10.1016/j.ajog.2010.09.022 - DOI - PubMed
    1. Gijsen R, Hukkelhoven CW, Schipper CM, Ogbu UC, de Bruin-Kooistra M, Westert GP. Effects of hospital delivery during off-hours on perinatal outcome in several subgroups: A retrospective cohort study. BMC Pregnancy Childbirth. 2012;12:92. 10.1186/1471-2393-12-92 - DOI - PMC - PubMed
    1. Pasupathy D, Wood AM, Pell JP, Fleming M, Smith GC. Time of birth and risk of neonatal death at term: Retrospective cohort study. BMJ. 2010;341:C3498. 10.1136/bmj.c3498 - DOI - PMC - PubMed
    1. Cuckler GA, Sisko AM, Poisal JA.et al. National health expenditure projections, 2017-26: Despite uncertainty, fundamentals primarily drive spending growth. Health Aff (Millwood). 2018;37:482–492.. 10.1377/hlthaff.2017.1655 - DOI - PubMed

LinkOut - more resources