Considerations for Transgender Patients Perioperatively.

With a shift in the cultural, political, and social climate surrounding gender and gender identity, an increase in the acceptance and visibility of transgender individuals is expected. Anesthesiologists are thus more likely to encounter transgender and gender nonconforming patients in the perioperative setting. Anesthesiologists need to acquire an in-depth understanding of the transgender patient's medical and psychosocial needs. A thoughtful approach throughout the entirety of the perioperative period is key to the successful management of the transgender patient. This review provides anesthesiologists with a culturally relevant and evidence-based approach to transgender patients during the preoperative, intraoperative, and postoperative periods.

Real Time Locating Systems and sustainability of Perioperative Efficiency of Anesthesiologists.

OBJECTIVE: We determine if Real Time Locating Systems (RTLS) paired with automated notifications have a sustained effect on perioperative efficiency in anesthesiologists over a one-year period from the time of implementation. METHODS: A retrospective chart review of all outpatient and short-stay patients, who received general anesthesia at our ambulatory surgery center between July 1st, 2017 and December 31st, 2018 was performed. Patients included were over 18 years of age who presented for non-urgent cases with ASA classification of 1, 2, and 3. Additionally, only first cases of the day for individual anesthesiologists were included.Time was used as a measure of efficiency between three comparison groups: Anesthesiologists who use RTLS prior to implementation of automated notification pairing for the period of 1 July 2017 to 31 December 2017.Anesthesiologists who use RTLS paired with automated notifications for the period of 1 January 2018 to 30 June 2018.Anesthesiologists who use RTLS paired with automated notifications for the period of 1 July 2018 to 31 December 2018.The primary outcome measure duration (DUR) was collected from patient electronic records.DUR was defined as duration of time, in minutes, from patient arrival to the Operating Room (OR) and initiation of induction by the anesthesiologist (exclusively for first cases of the day). RESULTS: During the initial six months, DUR between time of OR admission and time of induction was significantly reduced to 6.0 minutes (5.0,8.0) post-implementation of automated notification pairing with RTLS. DUR then returned to pre-intervention baseline of 7.0 minutes (5.0, 9.0) during the subsequent six-month study period. CONCLUSION: Initial results indicate that implementation of integrated RTLS technology enabled anesthesiologists at our institution to be more efficient during the perioperative period. However, this perceived benefit was not sustained over a 1-year period as our measure of efficiency DUR ultimately returned to the pre-intervention baseline.