The Expanding Role of CRNAs: Advancing Anesthesia Access in Rural and Outpatient Settings

In many parts of the country, especially in rural areas and fast-growing outpatient surgical centers, access to anesthesia care is evolving. It’s no longer limited to large urban hospitals. Certified Registered Nurse Anesthetists (CRNAs) are stepping into vital roles, bringing safe, high-quality care to patients who might otherwise have limited options.

At Advanced Anesthesia Services, we are proud to be part of this shift. Our team of CRNAs is helping expand access, improve outcomes, and support healthcare systems across Washington and beyond.

Bringing Expertise Where It’s Needed Most

Rural hospitals and community clinics across the country face a common challenge: a shortage of physician anesthesiologists. CRNAs help close that gap. As highly trained and board-certified providers, CRNAs deliver the full spectrum of anesthesia services, including pre-op evaluations, anesthesia administration, pain control, and post-op monitoring.

In many rural hospitals and smaller surgical centers, CRNAs are the sole anesthesia provider. This allows patients to stay close to home for care, reducing travel time and eliminating delays. The result is better access to routine procedures, urgent surgeries, and pain management, without sacrificing quality or safety.

Supporting the Growth of Outpatient Surgery

The shift toward outpatient care is one of the biggest trends in modern healthcare. Ambulatory surgery centers and office-based practices are growing rapidly, and CRNAs are essential to that growth.

Outpatient settings demand efficiency, flexibility, and clinical expertise. CRNAs are well-suited for this work. Their ability to manage a high volume of cases safely and effectively makes them ideal for facilities that prioritize same-day procedures and fast patient recovery.

These environments often run with lean, multidisciplinary teams. CRNAs provide the level of independent decision-making and hands-on care that allows outpatient facilities to run smoothly while maintaining high standards of safety and patient satisfaction.

Long-Term Trends Shaping CRNA Practice

Several national trends are contributing to the growing presence of CRNAs in rural and outpatient settings.

Increased Autonomy
More states are expanding CRNA practice authority. In states where CRNAs can work independently, their role is even more impactful. This autonomy allows for flexible staffing and opens new possibilities in areas previously underserved by anesthesia providers.

Demand for Cost-Effective Care
CRNAs provide safe, effective care at a lower cost than traditional anesthesia models. Hospitals and outpatient facilities benefit from reduced overhead without compromising patient outcomes.

Expanded Clinical Scope
CRNAs are doing more than administering anesthesia. Their training now includes pain management, procedural sedation, and full-spectrum perioperative care. This expanded skill set allows them to support a wide range of clinical needs in both acute and ambulatory settings.

Commitment to Equity and Access
Healthcare equity is an urgent national priority. CRNAs are playing a key role in making sure patients in remote or historically overlooked communities get the surgical services they need. By embedding skilled anesthesia providers directly into these communities, we help close gaps in care.

Our Commitment to Washington Communities

At Advanced Anesthesia Services, we believe quality anesthesia care should be available to everyone—no matter their ZIP code. Our CRNA-led model brings flexible, expert care to facilities across Washington, including rural hospitals, outpatient surgery centers, and office-based practices.

We are proud to support our partners in Snoqualmie and beyond. By delivering high-level care with a personal, local touch, our CRNAs are helping build stronger communities and healthier outcomes—one patient at a time.

If your facility is exploring CRNA-led care or needs support for surgical or procedural growth, we’d love to connect. Let’s talk about how our model can fit your needs.

When surgery centers can’t find anesthesiologists, their operating rooms sit empty. We change that by delivering reliable anesthesia services to keep things moving. It leads to better patient care and no lost revenue.
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Thomas Nigro, Jr., Chief CRNA

Tom is a driven individual and supportive teammate. He received a Bachelor of Science degree in Biology from John Carroll University before completing his nursing training, Masters of Science, and Doctor of Nursing Practice degree from DePaul University. Tom’s CRNA training was through NorthShore University Health System School of Nurse Anesthesia. During his time at NorthShore he researched the topic of Substance Use Disorder and his work has subsequently been published. Tom recognizes that each person is unique. His careful examination of patient needs, and willingness to utilize progressive anesthesia practices provide for an individualized and excellent perioperative experience.
Christine Wilcock, Financial Officer

Christine Wilcock

Christine oversees the accounting and business development aspects of Advanced Anesthesia Services. She earned her accounting degree in 2010 and is experienced in all areas of medical accounting and billing. She is dedicated to our customers, ensuring the high-quality care our patients receive in the operating room continues through the billing and insurance payment process. Christine lives in Snoqualmie, Washington and has three children.
Allyn Wilcock, CEO

Allyn Wilcock

Allyn is the owner and oversees clinical operations at Advanced Anesthesia Services as well as Northwest Ketamine Clinics. He has worked in healthcare for over 20 years and earned his Master’s degree and anesthesia training from Texas Wesleyan University in 2004. He is experienced in all types of anesthesia. He is passionate about providing the best patient experience for all patients AAS serves. He was voted top CRNA in Washington State 2013, 2018, 2019, 2020 and 2023. Allyn lives with his wife and children in Snoqualmie, Washington.