Production pressure in operating theatres endangers patients

A common experience by clinical anaesthesiologists is an operation schedule that is incompatible with the staff available and the necessary rescheduling - compliance with reality - often leads to conflict due to "production pressure" - a potentially dangerous situation for patients. With many health care providers in financial strait dangerous situations are most likely to arise when safety considerations (e.g. employment of fully qualified anaesthesiologists) are left unconsidered in order to meet production targets (case load, theatre capacity utilisation and changeover times). This article describes critical events that demonstrate how acute danger to patients becomes when priority is given to meeting a target (eg. completing the OR schedule) over the safety of the patient. The article also identifies those answerable in the event of possibly resulting malpractice litigation, as well as those who - though also equally responsible have not previously been called to account. Current laws that that apply to medical malpractice lawsuits, tend to obfuscate recognition and evaluation of the responsibility of the decision-taking physician and non-physician managers with no direct patient contact. The possibility of being publicly sued and charged increases in direct proportion to patient contact - the doctor is always in trouble, the "no-patient-contact" managers probably never. The preventative effect of such lawsuits is largely non-existent. Since they are still very unlikely to be personally - and publicly - held responsible for the consequences of their decisions, health care providers are even encouraged to retain or even introduce dangerous but cost-effective organisational structures.