Today's Solutions to Operational Variability Lead Overstaffing 

Scheduling is complex in any setting, but anesthesia scheduling poses a uniquely difficult challenge. Leaders must plan coverage around fluctuating surgical volume while responding to events that can change the day in an instant. Among the realities anesthesia groups face:

  • Anesthesia resources are scarce and in high demand

  • Emergent or urgent cases often account for up to 30% of daily volume

  • Many cases are scheduled into surgical “block time” without enough detail to accurately predict case duration

  • Daily variability is often caused by add-on cases, OR overruns and delays, staff changes, vendor complications, and shifts in case mix 

Given these pressures, most organizations arrive at the same conclusion: overstaff to avoid being caught short. 

The result is predictable. To safeguard against uncertainty, teams add extra anesthesia coverage “just in case,” especially in late afternoons, after hours, and in NORA locations. While understandable, this approach creates systematic overstaffing.  While understandable, this approach creates systematic overstaffing. It is expensive, inefficient, and increasingly unsustainable as margins per case continue to erode. 

More importantly, overstaffing often fails to solve the underlying problem. Even with excess coverage, many groups still experience the perception of being understaffed. Add-on cases compete for limited resources, forcing anesthesia teams to make real-time prioritization decisions. In practice, care often flows to the “squeakiest wheel,” frustrating surgeons and delaying cases for patients with equally urgent needs. Simply adding more clinicians no longer resolves these tensions. 

 

Tomorrow's Schedule is a Poor Predictor of Reality

Many attempts to fix anesthesia utilization have focused on improving per-case duration prediction. In theory, if every case length were known, staffing would be simpler. In practice, the data required to do this accurately does not exist. 

While some organizations attempt to solve this by layering in more data, healthcare delivery in the United States remains highly fragmented. Until significant structural changes occur, even the best case-level data will continue to fall short of producing consistently accurate predictions. 

Scheduling is plagued by several real drivers of variability. Every day brings differences in:

  • the patient

  • the clinical team

  • available equipment

  • unexpected add-ons and urgent cases 

Trying to build staffing plans from the bottom up (or case by case) is time-consuming, costly, and still produces imperfect answers. Tomorrow’s schedule rarely unfolds as written.


Historical Patterns Can Accurately Predict Tomorrow's Schedule


A more effective approach is to recognize that while individual cases are unpredictable, patterns of demand are not. 

The first step in anesthesia optimization is to establish a new staffing baseline that meaningfully reduces over-coverage. Medaxion combines a facility’s historical data with operational experience from more than 15 million cases across 7,000+ ORs to remove guesswork from staffing decisions. 

Rather than attempting case-by-case precision, Medaxion models minute-by-minute demand and builds probability-based staffing plans with appropriate safety margins. 

In most environments, this approach consistently identifies opportunities to reduce daily staffing, often by one to two CRNAs per day. In more severely misaligned environments, the impact can be even greater. These staffing adjustments frequently translate into physician savings as well, amplifying the overall financial benefit. 

For a 10-OR hospital, this typically represents $1–$2 million in annual financial impact, with larger facilities often realizing even greater savings due to embedded inefficiencies. Improvements are commonly visible within the first three months, with gains concentrated in afternoons, after-hours coverage, and NORA locations. 

For anesthesia professionals, this means delivering the same clinical workload with fewer disruptive staffing swings, less idle time, and a more predictable workday. The result is improved productivity and a more sustainable clinical environment.

 

Moving from More Bodies to Better Insight

If your organization is struggling with daily variability, afternoon overstaffing, or growing NORA demand, the answer is rarely to add more clinicians. The solution is better intelligence. 

Medaxion’s Anesthesia Manager transforms historical patterns into actionable staffing models that right-size coverage while protecting patient care, clinician well-being, and hospital margin.