TSA Statement on Staffing Models in the Setting of Systemic Workforce Supply and Demand Imbalance

The importance of risk stratification in determining models of sedation and anesthesia is vital to patient safety. Anesthesiologists are physicians trained specifically to minimize perioperative risk. Their training and expertise emphasizes patient safety in the pre-operative, intra-operative and post-operative environments. The type of sedation or anesthesia that is optimal for any given procedure can vary significantly from one patient to another depending on a multitude of factors including patient co-morbidities, proceduralist skillset, procedure modality, and facility resources or limitations. As the only physicians specialized in assessing and managing anesthetic risk across the wide expanse of procedural fields, facility types and patient variables, an Anesthesiologist must always be consulted when a facility is determining how and where sedation and anesthesia is being provided.

Medcare conditions of participation require that an anesthesiologist who is the director of anesthesia services oversees moderate and deep sedation services within a facility. In the current environment of workforce supply and demand imbalance it may be possible to use non-traditional staffing models for moderate and deep sedation if an expert analysis of the variables is undertaken. Patient characteristics, procedural risk, and facility resources including staff and equipment vary significantly. A one size fits all approach is insufficient to maintain patient safety. In the current setting of workforce imbalance, utilization of a Consultant Anesthesiologist is necessary to develop innovative staffing arrangements and is essential for ensuring that a facility maximizes both patient safety and operational efficiency when crafting policies on minimal and moderate sedation.`

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