Key Takeaways

Disconnect between hospital operating room schedules and anesthesia demand is driving inefficiency and higher costs.
Expanded operating room capacity in the morning and shorter surgical days are increasing anesthesia coverage costs.
Hospitals can counter rising costs by using predictive and prescriptive analytics to forecast demand and optimize operating room scheduling.
Predictive AI can help increase productivity, prevent burnout, and eliminate the illusion of a staffing shortfall.

I recently read an article by Franklin Dexter and colleagues in the Journal of Clinical Anesthesia¹, and I found the results fascinating. The data showed that more than 61% of anesthetics nationwide occur before 1:00 PM, and nearly 80% wrap up by 3:30 PM. Yet, in many hospitals, anesthesia providers are still scheduled until 3, 5, or even 7 PM.

That mismatch was eye-opening, and it helps explain why so many leaders describe what feels like a staffing crisis. A closer look at the numbers reveals that while demand has shifted earlier in the day, schedules haven’t kept pace.

Even more striking, the article found that the number of anesthesia clinicians in the U.S. has grown by more than 40% between 2013 and 2023, outpacing the growth in surgical case volume. In other words, the workforce has expanded, but the timing of when those clinicians are needed has shifted in ways that create the perception of a shortage.

So why does it still feel like we’re short-staffed? Because more clinicians are working mornings, fewer are working afternoons, and hospitals are opening more rooms for first-case starts, only to close earlier in the day. That means you need more people to cover the same total number of cases, driving up costs and creating the impression of scarcity.

Think of it this way: it’s like opening five Starbucks stores to serve the same number of morning customers you used to serve with three. Sure, everyone gets their latte at 7:30 AM, but you’re paying for more baristas, and you’re closing by 2 PM.

The Cost of “More Rooms, Shorter Days”

This national trend – opening more rooms for first-case starts, but ending the day earlier – has consequences that go far beyond scheduling headaches:

Rising costs of institutional support: In California, hospital subsidies for anesthesia have ballooned from $36/hour in 2002 to $160/hour in 2021².
Burnout and frustration: Clinicians are pulled in heavily during morning surges, then watch rooms sit empty in the afternoon.
Inefficient use of staff: The system is designed to handle the peak morning surge, which drives headcount needs, not the total number of hours worked.

In other words, we’re paying more for anesthesia coverage than ever before, while getting shorter workdays and reduced productivity in return.

How Hospitals Can Flip the Script

This is where hospitals and health system leaders have a choice. You can keep adding more rooms, hiring more staff, and shortening the day, or you can run tighter, smarter schedules that maximize the resources you already have.

Predictive analytics and smart operating room scheduling software provide the lever to do just that. By forecasting demand, consolidating cases, and aligning staffing with reality, leaders can avoid being swept along by the “more rooms, shorter days” trend.

Consolidate and plan ahead: Predictive AI can recommend how to pack cases efficiently – delivering the first starts surgeons want without leaving empty rooms midday.
Set and track the right goals: Metrics like Staffed Room Utilization (SRU) should be north-star measures. Hospitals using predictive analytics often see 5–15% increases in SRU and prime time utilization, which translates into 1–2 additional cases per OR per month without adding staff.
Align staffing with true demand: Forecasting modules can project coverage needs in advance, automate assignments, and highlight gaps before they turn into morning crises.

In Better Healthcare Through Math³, co-authored by LeanTaaS CEO and Founder, Mohan Giridharadas, he states, “By upgrading to software systems built on better math, health systems can enable staff to make data-based decisions to flatten peaks of demand and create smoother patient flow.”

A Challenge for Healthcare Leaders

If the national trend continues unchecked, costs will keep climbing, providers will keep burning out, and hospitals will keep chasing a solution that doesn’t address the root problem. But it doesn’t have to be that way.

With predictive AI platforms that optimize operating room scheduling, like iQueue for Operating Rooms, hospitals can flip the script: run full, productive days, protect their staff, and unlock growth, without hiring armies of additional clinicians.

So here’s the challenge: Do you want to follow the national trend – more rooms, shorter days, higher costs – or do you want to take the smarter path?

Let’s stop talking about the anesthesia “shortage.” Let’s solve the real problem: the inefficient use of the clinicians we already have.

Schedule a demo today.

Jonathan Turner and Zetong Li also contributed to this blog.

References

¹Dexter, F., Epstein, R. H., & Dutton, R. P. (2025). United States’ anesthesia workdays in 2022–2023–Implications for national workforce assessments. Journal of Clinical Anesthesia, 107, 111988.

²Duffy E, Green S, Trish E. Stipends from hospitals to emergency medicine and

anesthesiology clinicians increased In California, 2002–21. Health Aff 2025;44:

754–60. https://doi.org/10.1377/hlthaff.2024.01220.

³Agrawal, S., & Giridharadas, M. (2020). Better Healthcare Through Math: Bending the Access and Cost Curves. Forbes Books