Improving efficiency and workflows in the nonoperating room anesthesia setting

PURPOSE OF REVIEW: Nonoperating room anesthesia (NORA) services are rapidly expanding and now represent a substantial proportion of anesthetic care. Efficient systems are critical to enable limited anesthesia resources to meet this increased demand. Traditional operating room efficiency metrics are poorly suited to these complex and heterogeneous environments. Efficiency in NORA should be viewed not merely as throughput but through the 'Triple Aim' framework of improving access, reducing cost, and enhancing quality. RECENT FINDINGS: Recent literature highlights the importance of preprocedural optimization, safety-focused procedural management, and artificial intelligence modeling to address variability in NORA workflows. Emerging data supports the use of real-time dashboards and artificial intelligence tools to enhance scheduling accuracy and resource allocation. SUMMARY: Improving NORA efficiency requires integrated operational, financial, and workforce strategies rather than isolated interventions. Adoption of systematic preprocedural triage, data-driven scheduling and case routing, standardized intraprocedural workflows, effective recovery pathways, and continuous performance metrics are key elements needed to achieve the Triple Aim. Future research should focus on harnessing rapidly evolving technology, including artificial intelligence tools, to create and refine NORA-specific benchmarks and scalable analytic tools to support continued improvement of distributed procedural care.