We’re running 6 ORs with add-ons pushing past 19:00 three nights a week, and I need to decide between a per diem CRNA pool or a full-time 12:00–20:30 provider to stabilize starts and keep anesthesia plans consistent… If you’ve made this switch, what impacted patient throughput and preop coordination most — reliability, cost, or flexibility?
Added a ‘90-second rule’ in Weave: if an assistant can’t resolve in that time, or sees the words pain/bleeding/new meds, it jumps to the tech line; we also do a 7:55 sweep so anything still open before doors at 8 escalates automatically. That took our 9:30 hold time to about 3 minutes, but we had to lock assistants out of med advice templates to prevent drift.
We went FT 12–20:30 and made that person the late-room lead who at 14:00 runs an add-on huddle with charge, locks regional vs GA, and calls preop/pharmacy for med clears; our after-17:30 starts improved about 20% and PACU holds eased, even with slightly higher labor cost. If your late cases aren’t mostly one service, per diem flexibility can still win — are your add-ons concentrated in ortho, @OP?