干旱区生态环境知识资源中心(Arid): Obstetric anesthesia services in Israel snapshot (OASIS) study: a 72 hour cross-sectional observational study of workforce supply and demand

Arid

DOI	10.1186/s13584-021-00460-2
	Obstetric anesthesia services in Israel snapshot (OASIS) study: a 72 hour cross-sectional observational study of workforce supply and demand
	Schtrechman-Levi, Gal; Ioscovich, Alexander; Hart, Jacob; Bar, Jacob; Calderon-Margalit, Ronit; Nir, Eshel A.; Ginosar, Yehuda
通讯作者	Nir, EA (corresponding author), Hebrew Univ Jerusalem, Fac Med, Jerusalem, Israel. ; Nir, EA (corresponding author), Kaplan Med Ctr, Dept Anesthesia & Operating Rooms, Rehovot, Israel.
来源期刊	ISRAEL JOURNAL OF HEALTH POLICY RESEARCH
ISSN	2045-4015
出版年	2021
卷号	10 期号:1
英文摘要	BackgroundWe planned an observational study to assess obstetric anesthesia services nationwide. We aimed to assess the effect of the anesthesia workload/workforce ratio on quality and safety outcomes of obstetric anesthesia care.MethodsObservers prospectively collected data from labor units over 72h (Wednesday, Thursday and Friday). Independent variables were workload (WL) and workforce (WF). WL was assessed by the Obstetric Anesthesia Activity Index (OAAI), which is the estimated time in a 24-h period spent on epidurals and all cesarean deliveries. Workforce (WF) was assessed by the number of anesthesiologists dedicated to the labor ward per week. Dependent variables were the time until anesthesiologist arrival for epidural (quality measure) and the occurrence of general anesthesia for urgent Cesarean section, CS, (safety measure). This census included vaginal deliveries and unscheduled (but not elective) CS.ResultsData on 575 deliveries are from 12 maternity units only, primarily because a major hospital chain chose not to participate; eight other hospitals lacked institutional review board approval. The epidural response rate was 94.4%; 321 of 340 parturients who requested epidural analgesia (EA) received it. Of the 19 women who requested EA but gave birth without it, 14 (77%) were due to late arrival of the anesthesiologist. Median waiting times for anesthesiologist arrival ranged from 5 to 28min. The OAAI varied from 4.6 to 25.1 and WF ranged from 0 to 2 per shift. Request rates for EA in hospitals serving predominantly orthodox Jewish communities and in peripheral hospitals were similar to those of the entire sample. More than a fifth (13/62; 21%) of the unscheduled CS received general anesthesia, and of these almost a quarter (3/13; 23%) were attributed to delayed anesthesiologist arrival.ConclusionsInadequate WF allocations may impair quality and safety outcomes in obstetric anesthesia services. OAAI is a better predictor of WL than delivery numbers alone, especially concerning WF shortage. To assess the quality and safety of anesthetic services to labor units nationally, observational data on workforce, workload, and clinical outcomes should be collected prospectively in all labor units in Israel.
英文关键词	Obstetric anesthesia Health service Workload Workforce Epidural analgesia Cesarean section
类型	Article
语种	英语
开放获取类型	DOAJ Gold, Green Published
收录类别	SSCI
WOS记录号	WOS:000629373800002
WOS类目	Health Policy & Services ; Public, Environmental & Occupational Health
WOS研究方向	Health Care Sciences & Services ; Public, Environmental & Occupational Health
来源机构	Hebrew University of Jerusalem
资源类型	期刊论文
条目标识符	http://119.78.100.177/qdio/handle/2XILL650/350625
作者单位	[Schtrechman-Levi, Gal; Hart, Jacob] Tel Aviv Univ, Sch Publ Hlth, Sackler Sch Med, Dept Epidemiol & Prevent Med, Tel Aviv, Israel; [Schtrechman-Levi, Gal] Haim Sheba Med Ctr, Dept Gen & Oncol Surg Surg C, Ramat Gan, Israel; [Ioscovich, Alexander] Shaare Zedek Med Ctr, Dept Anesthesiol Perioperat Med & Pain Treatment, Jerusalem, Israel; [Hart, Jacob] Netanya Acad Coll, Hlth Serv Management Sch, Netanya, Israel; [Bar, Jacob] Wolfson Med Ctr, Dept Obstet & Gynecol, Holon, Israel; [Calderon-Margalit, Ronit] Hadassah Hebrew Univ, Braun Sch Publ Hlth, Jerusalem, Israel; [Nir, Eshel A.] Hebrew Univ Jerusalem, Fac Med, Jerusalem, Israel; [Nir, Eshel A.] Kaplan Med Ctr, Dept Anesthesia & Operating Rooms, Rehovot, Israel; [Ginosar, Yehuda] Hadassah Hebrew Univ Med Ctr, Wohl Inst Translat Med, Dept Anesthesiol & Crit Care Med, Jerusalem, Israel; [Ginosar, Yehuda] Washington Univ, Sch Med, Dept Anesthesiol, St Louis, MO 63110 USA
推荐引用方式 GB/T 7714	Schtrechman-Levi, Gal,Ioscovich, Alexander,Hart, Jacob,et al. Obstetric anesthesia services in Israel snapshot (OASIS) study: a 72 hour cross-sectional observational study of workforce supply and demand[J]. Hebrew University of Jerusalem,2021,10(1).
APA	Schtrechman-Levi, Gal.,Ioscovich, Alexander.,Hart, Jacob.,Bar, Jacob.,Calderon-Margalit, Ronit.,...&Ginosar, Yehuda.(2021).Obstetric anesthesia services in Israel snapshot (OASIS) study: a 72 hour cross-sectional observational study of workforce supply and demand.ISRAEL JOURNAL OF HEALTH POLICY RESEARCH,10(1).
MLA	Schtrechman-Levi, Gal,et al."Obstetric anesthesia services in Israel snapshot (OASIS) study: a 72 hour cross-sectional observational study of workforce supply and demand".ISRAEL JOURNAL OF HEALTH POLICY RESEARCH 10.1(2021).