Today’s healthcare landscape is demanding more from hospitals than ever before. A good anesthesia partner could make all the difference, but all too often new care models face skepticism.
Collaborative team models are the backbone of Sound Anesthesia programs and help hospitals thrive by keeping service local to deliver the exceptional care communities deserve. We sat down with Sound Anesthesia CEO Dr. David Leachman and Chief Anesthetist Noele Morse, CRNA, to learn more about what operational excellence looks like for anesthesia teams—and the important groundwork that must be laid ahead of introducing the new, flexible team models.
What are the three most important things a program needs to keep anesthesia services strong and sustainable over time?
David: Before we break this down, I want to give one reminder: collaborative anesthesia services can’t work without the culture and service pieces. Anesthesia is a relationship-driven service line. Surgeons feel reliability, nurses feel communication, patients feel the team dynamic.
First, optimize the workforce paradigm. That means staffing physicians and certified registered nurse anesthetists (CRNAs) who are highly trained and ready to work at the top of their licensure. Clinician ratios can be flexible based on acuity and case mix to reduce labor cost and dependence on locums. Every model we create covers a hospital’s workload—the only thing that changes is how we mix physicians and CRNAs.
Staffing choices drive very different labor cost structures. When labor expense rises above what professional collections can support, the difference usually shows up as subsidy. The point is there is no “universally best” model—we have multiple levers to design a safe and efficient model best suited for that hospital.
Noele: Second, align with the broader hospital system. When anesthesia operates in a silo, the flexibility that surgeries often require is a lot harder. Dyad leadership between physicians and CRNAs promotes a shared governance, and transparent scheduling creates the predictability and stability that helps build clinician well-being and trust.
David: Third, get the cost structure and operational efficiency right. Standardized protocols, data-driven scheduling, and disciplined staffing all help with throughput and cost.
Noele: When you get these three imperatives right—workforce ratio, alignment, and efficiency—teams don’t just “cover cases.” They protect access, reduce costs, and make the operating room (OR) experience better for everyone.
How does Sound Anesthesia help hospitals build effective collaborative staffing models to increase OR efficiency?
David: Building an effective anesthesia staffing model is complex. There is no one-size-fits-all solution. Every hospital, case mix, and OR environment is different, so building buy-in that fits the culture and norms of each team is critical.
Noele: That’s why hospitals need to look at the staffing model, OR design and a hospital’s unique data when creating a custom care team model. Information on case counts, locations, specialties, and patient acuity are just the start of what’s needed to define clinical demand.
High-performing anesthesia teams don’t happen by accident. Fully understanding this data creates teams that deliver safe care, communicate well, adapt to changes in real time, and support throughput. It takes intentional leadership development and strong physician–CRNA dyads to make them work.
David: Seeing collaborative care models in person can be incredibly powerful as well. Arranging visits to view high-performing sites provides a baseline for teams and helps them visualize success.
Noele: Piloting is another great way to build buy-in with clinicians who may be new to these care models. Building confidence with low-risk cases grows a pool of data that encourages expansion. Regular forums and feedback on quality metrics seal the deal. Oh, and don’t forget to celebrate success!
How do you work through resistance when applying a new care model to an anesthesia team?
David: In any major transition, resistance is normal. And most of it isn’t philosophical—it’s emotional. It’s rooted in identity and fear of loss: loss of autonomy, status, familiar patterns, or control. Recognizing and affirming this for clinicians makes it easier to lead them through it. If we don’t acknowledge the microcultures upfront, they show up later as friction. Mapping stakeholders early—like the champions, skeptics, and quiet influencers—tells us where to focus our energy.
Noele: Clarity and sharing information are also critical. When people understand what’s changing, why it’s different, and how they’ll be supported, resistance softens. It’s essential to recognize that you’re stepping into an environment with layered relationships—surgeons, anesthesia, nursing, and administration—each with its own priorities and fears. Before proposing a new care model or staffing structure, we listen. We can’t design a functional model without understanding the lived experience. From there, we measure, adjust, and scale what works.