It is noon on a Friday and the head technician from radiology calls to schedule an MRI with anesthesia for 2 p.m. and says:“I really need YOU people to accommodate this patient and we have a busy schedule today so a long ANESTHESIA DELAY will be a big problem.”

Not long ago, this type of conversation would not have been unusual at the Children’s Hospital of Philadelphia. There are many challenges to providing anesthesia services outside the O.R. while maintaining the same safety and patient flow we enjoy in the O.R. complex. The comments by the technician in the quote highlight one of the most significant obstacles to success, namely a lack of a sense of teamwork when caring for patients in the non-O.R. anesthesia (NORA) environment. Comments such as “you people” and “anesthesia delay” underscore the notion...

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