Issue link: https://beckershealthcare.uberflip.com/i/1543897
6 ASC MANAGEMENT independently to the fullest extent of their licensure. By granting CRNAs the autonomy to make clinical decisions, healthcare facilities can enhance satisfaction, efficiency and patient outcomes. Most importantly, they can reduce facility anesthesia financial supplement cost. is independence not only acknowledges their expertise, but also fosters a more collaborative healthcare environment, ultimately benefiting both providers and patients alike. Evan Lebovitz, MD. Anesthesiologist in Alexandria (Va.): In anesthesiology, staffing to average demand is a false economy. Surgical schedules fluctuate, emergencies are inevitable and clinician absences are predictable, even if modeled as anomalies. Any system run consistently at maximal utilization is not efficient; it is brittle. High- reliability industries recognize the necessity of slack capacity: deliberate, protected excess staffing that absorbs variability and prevents cascading delays, burnout and compromised patient care. What may appear as "bloat" on paper is, in reality, the margin that preserves patient safety, case throughput and provider stability. Anesthesia services cannot be optimized to the mean; they must be built to withstand variability. Penny Liu, MD. Vice Chair for Clinical Affairs and Director of Neuroanesthesia at Tus Medical Center (Boston): If I could make one change to improve workforce retention, it would be to intentionally invest in the steady, mission-driven clinicians who consistently deliver excellent care without fanfare. ese "quiet high performers" are the cultural backbone of our departments. ey create psychological safety, model professionalism and carry operational reliability. Creating formal pathways for mentorship, leadership development and recognition for these steady contributors sends a powerful signal as to how we truly define excellence. When organizations recognize and develop these individuals, they reinforce that integrity, consistency and patient-centered mastery truly matter. Organizations that recognize quiet excellence don't just retain talent, they build resilient cultures. Rick Middleton, MSN, CRNA. Director of Anesthesia Services at UNC Wayne (Goldsboro, N.C.): e one thing that would immediately improve anesthesia workforce retention would be the advent of routine retention bonuses. Since the loss of pensions for retirement savings, facility commitment has all but disappeared. e advent of the 1099 and locum CRNA prevents CRNAs from building a true commitment to their local facility or place of employment. True multiyear performance- based retention bonuses would go a long way to help to secure facility CRNA employment commitment and also help to establish local workforce commitment. Michael Nurok, MD, PhD. Professor and Co-Chair in the Department of Anesthesiology at Cedars-Sinai Medical Center (Los Angeles): Too oen, the anesthesia workforce are treated as interchangeable and nameless bodies at the head of the OR table. Retention requires institutional culture and leadership that truly value their anesthesiologists, foster purpose- driven work and provide meaningful opportunities for professional growth and development. Michelle Reilly, DNP, CRNA. Chief CRNA, Anesthesia Co.-Frederick Division at Frederick (Md.) Health: e most impactful change would be building anesthesia staffing models that prioritize operational sustainability, not just minimum daily coverage. In many perioperative settings, teams are structured to meet scheduled case volume, not the predictable variability of add-ons, prolonged cases, trauma activations, ICU transfers and PACU support. When there is no margin for surge, providers absorb the strain through missed breaks, late relief, heavier call intensity and schedule volatility. Retention improves when organizations staff to expected variability, distribute call burden equitably, align coverage with acuity and service line growth and include anesthesia leadership in block time and throughput planning. Anesthesia workforce retention ultimately depends on designing sustainable practice models that utilize providers efficiently, deploy them to the top of their training and balance productivity with long- term operational resilience. Gregory Rendelman, CRNA. Department of Veterans Affairs (Lancaster, Pa.): When I was a kid, we had "camper counselor day," where the kids got to be counselors, and the counselors were kids, just for a day! It was a fantastic way to see things from another angle. Imagine if those who make big decisions took a little nap with propofol, along with a full set of anesthesia drugs and breathing equipment for that patient. We could call it "Anesthesia / Administrator Day" or "Surgeon/Anesthetist Day." We'd be there as their safety net, ready to fix any problems instantly. Steven Schaefer, MD. Anesthesiologist at Legacy Mount Hood Medical Center (Gresham, Ore.): e single most impactful change to improve anesthesia workforce retention would be providing individuals with greater agency over their time. is means ensuring predictable, regular hours and the ability to schedule time off effectively to achieve a satisfying work-life balance. Nick Schiavoni, MD. Locum Anesthesiologist: e single change that would most improve anesthesia workforce retention is giving clinicians predictable control over their schedules. Attrition is oen driven by unpredictable call burden, last- minute schedule changes and cumulative workload creep. Until departments redesign staffing structures around schedule transparency and autonomy, instability will persist regardless of pay increases. Samuel Smith, MSN. CRNA at Richmond (Va.) VA Medical Center: Effective leadership is the cornerstone of workforce retention in the anesthesia field. Retaining providers is significantly improved by cultivating a supportive workplace culture that makes them feel appreciated and provides access to professional development and mentorship. Furthermore, addressing the need for better work-life balance through flexible scheduling is a consistent strategy shown in labor force statistics to reduce turnover intentions and combat burnout across various practice environments. e most successful retention strategies identified in the literature share several key characteristics: they empower providers with autonomy and control over their schedules, utilize technology for efficient supply-and- demand matching, systematically integrate individual preferences and strategically balance the simultaneous needs for both flexibility and predictability. Adam Spiegel. CEO of NorthStar Anesthesia (Irving, Texas): A greater emphasis and development of clinical leadership would have the largest impact on workforce retention. Knowing how to balance and navigate the complex demands and unpredictable schedules of the operating room allows strong clinical leaders to cultivate trust and cohesion across the team. With this foundation, leaders can empower administrators and clinicians to advance their skills and expertise, while maintaining an appropriate workload balance. Ruth Waterman, MD. Chair of the Department of Anesthesiology at UC San Diego Health: e single change that would most improve anesthesia workforce retention is creating a culture of genuine respect, backed by operational support, from colleagues and hospital administration. Respect must be visible in daily practice: involving anesthesia