Why healthcare leaders should look beyond staffing and operations when anesthesiology performance declines
SUNRISE, Fla., Aug. 13, 2026 /PRNewswire/ — When an anesthesiology department struggles with turnover, staffing instability, or inconsistent results, healthcare leaders often respond with familiar operational solutions: revise the schedule, adjust staffing ratios, change coverage models, or recruit more clinicians.
Those interventions may be necessary. But when the problems reoccur, the issue may be deeper than operations.
A new white paper from North American Partners in Anesthesia (NAPA), When Operations Struggle, Culture Is Often a Root Cause, challenges healthcare leaders to consider an overlooked driver of anesthesiology performance: the relationship between leadership, culture, and the way clinicians work together.
“Operational problems are highly visible, so naturally that is where leaders tend to focus first,” said Clavio Ascari, MD, NAPA’s Chief Clinical Officer. “But turnover, disengagement, and inconsistent performance may signal something happening beneath the operating model. If leaders only address the symptom, the same challenges are likely to return.”
In the paper, Dr. Ascari argues that anesthesiology departments rarely struggle because they lack processes. More often, the question is whether those processes are supported by a culture that creates trust, accountability, and ownership of outcomes.
That distinction matters because cultural problems frequently present themselves as operational ones, such as:
- Persistent turnover
- Growing reliance on locums
- Clinicians who approach their role as “clock in, clock out”
- Surgeons and nursing teams who no longer view anesthesiology as a responsive, integrated partner
Individually, each can trigger an operational response. Taken together, they may point to a broader breakdown in how the department is led and how the team functions.
That is the point at which healthcare leaders may need to ask a different question…not simply, “How do we fix our operations?” but “What is happening within the culture of this department?”
Seemingly routine leadership choices—such as scheduling, clinician engagement, or communication with surgical stakeholders—can either strengthen or weaken culture over time. Even something as operational as a schedule can be an expression of culture. When schedules are perceived as inconsistent or inequitable, dissatisfaction can grow. When they are transparent, fair, and informed by clinician input, they can reinforce respect and collective ownership.
Leadership structure matters, too. Traditional top-down approaches may fall short in complex anesthesiology environments. Instead, collaborative dyad leadership structures can help create stronger clinician engagement, representation, and shared accountability.
“Culture isn’t separate from performance,” said Dr. Ascari. “It’s what makes performance sustainable.”
The white paper encourages healthcare leaders who face persistent staffing or performance issues to reconsider where they begin the search for solutions. The cultural and leadership dynamics may be what’s hiding beneath their operational indicators.
About North American Partners in Anesthesia
As a clinician-led organization, North American Partners in Anesthesia (NAPA) continues to redefine healthcare, delivering industry-leading excellence nationwide to its partners and patients. With 40 years of clinical services experience, we serve millions of patients annually at hundreds of healthcare facilities. This expertise informs our managed services in anesthesia-driven revenue cycle solutions, talent and workforce strategies, and perioperative advising. For more information, please visit NAPAanesthesia.com.
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SOURCE NAPA Management Services Corporation
