2016 -2017 BIANNUAL REPORT - Department of Anesthesia, Critical Care, and Pain Medicine - Beth Israel Deaconess ...
←
→
Page content transcription
If your browser does not render page correctly, please read the page content below
2016 –2017 BIANNUAL REPORT
Department of Anesthesia,
Critical Care, and Pain Medicine
Our Mission:
Improve the quality of our patients’ lives by providing
compassionate, state-of-the-art care and relief of pain.
Advance the science of anesthesia by generating new knowledge.
Educate the next generation of leaders in anesthesia.
Support personal and professional fulfillment of our
departmental members.
Department of
Anesthesia, Critical Care, and Pain Medicine
BIANNUAL REPORT 2016 –2017
B I D M C. o r g 1
D EPA R T M E N T O F A N E S T H E S I A , CR I T I C A L C A R E, A N D PA I N M E D I CI N E
TABLE OF CONTENTS
Welcome...............................................................1
Harvard Faculty Roster.........................................4
CLINICAL ANESTHESIA.........................................6
BID – Milton........................................................8
BID – Needham.................................................10
BID – Plymouth..................................................12
CLINICAL ANESTHESIA DIVISIONS
Ambulatory and Pre-Admission Testing........16
Nurse Anesthesia.............................................18
Cardiac Anesthesia..........................................20
Neuroanesthesia..............................................24
Obstetric Anesthesia.......................................28
Orthopedic Anesthesia...................................34
Regional Anesthesia........................................38
Thoracic Anesthesia........................................42
Transplant Anesthesia.....................................46
Vascular Anesthesia.........................................48
CRITICAL CARE ...................................................50
PAIN MEDICINE...................................................54
RESEARCH...........................................................58
Center for Anesthesia Research Excellence....62
EDUCATION........................................................64
QUALITY, SAFETY, AND INNOVATION...............70
Residents and Fellows........................................78
Selected Publications.........................................80
By the Numbers..................................................89
Administrative, Technical and Nurse Staff........90
Publication Team
Editor’s Note
Executive Vice Chair Graphic Designer
This biannual report of the Department of Anesthesia, Alan Lisbon, MD Jennifer Luszcz
Critical Care, and Pain Medicine highlights the work and Director of Communications Photographers
and Special Projects James Dwyer
achievements of the department, and its faculty, residents, Heather Derocher Danielle Duffey
and staff for the academic years 2016 and 2017. I hope Section Editors Communications Intern
you find it interesting and informative. Sections were written by their Kassandra Primatello
respective division directors
– Alan Lisbon, MD
Data Analyst
Executive Vice Chair Aaron Banner-Goodspeed
B E T H I S R A E L D E ACO N E S S M E D I C A L CE N T E R
WELCOME
Welcome to the Department of Anesthesia, Critical Care, and Pain Medicine!
This biannual report documents just some of the many impressive accomplish
ments of the department over the past two years. These accomplishments
underscore the remarkable work of our team, working together to provide
skilled and compassionate clinical care, inspiring education, innovative
research, and leadership in the management and continuous improvement of
high quality, effective, patient-centered care. As chair and a longtime member
Daniel S. Talmor, MD, MPH
of the department, I offer my personal appreciation and admiration for the
Department Chair
expertise, collegiality, and dedication of this impressive team of physicians,
Edward Lowenstein
nurses, and support staff.
Professor of Anaesthesia
Our shared departmental vision is to:
• contribute significantly to the further development and success of Beth Israel
Deaconess Medical Center and its network of hospitals.
• deliver state-of-the-art and efficient service in perioperative anesthesia,
critical care, and pain management.
• lead the way to improving perioperative patient care through the
collaborative application of best practices.
• develop innovative training programs that attract the finest applicants from
Harvard Medical School and other top programs nationally.
• be recognized nationally and internationally as a leader in the advancement
of anesthesiology through education, research, innovation, and participation
in specialty societies.
• be accountable in a measurable way for the value the department brings to
our patients and the medical center.
The department has significant strengths. First and foremost, our faculty is
clinically excellent. They provide cutting-edge clinical care, supporting the most
complex surgical services. They are among the hardest working physicians
in the medical center. We take huge pride in our individual achievements,
our work as a department, and in the medical center. The intense loyalty and
dedication among our staff produces results. The clinical outcomes of our cases
are second to none across all three areas of service: operative anesthesia, critical
care medicine, and pain medicine.
Through our work over the last year, we are poised to ensure that these high
standards are extended across the Beth Israel Deaconess Medical Center
(Continued on page 2)
B I D M C. o r g 1
D EPA R T M E N T O F A N E S T H E S I A , CR I T I C A L C A R E, A N D PA I N M E D I CI N E
(BIDMC) network of hospitals. We have assumed responsibility for anesthesia
and pain medicine services at Beth Israel Deaconess – Milton and Beth Israel
Deaconess – Plymouth hospitals. The department is leading the way for the
integration of hospital-based clinical services throughout the network. As the
network expands, we will expand to provide high-quality and cost-effective
care at our new affiliates.
Our educational programs are nationally renowned and continue to attract
excellent candidates. Our clinical research programs have benefited greatly
from the formation of our Center for Anesthesia Research Excellence (CARE),
which has allowed us to grow clinical research across the department. Our
laboratory researchers in the field of pain medicine are nationally recognized,
and in both areas we have significant and increasing external funding.
The Division of Pain Medicine is one of the oldest and most respected
academic pain practices in the nation. Over the last year, we have also seen
an increase in services at our affiliates. The Pain Medicine Fellowship training
program is widely considered the best in the nation, and in 2015 was named
one of the top two training programs in the country by the American Academy
of Pain Medicine. The division has recruited several new physicians and
implemented a comprehensive plan to provide all of the nonsurgical care in the
Spine Center.
The Department of Anesthesia founded the first Intensive Care Unit (ICU)
at BIDMC in 1969. Since then, our department has provided stable and
responsible leadership for the surgical ICUs. Over the last two years we have
led development on the new BIDMC Neuro ICU, increased ICU services at
BID – Plymouth and begun to provide critical care coverage at BID – Milton.
Our Critical Care group continues to build on its research success with
multiple, ongoing clinical and translational research projects.
All academic clinical departments are challenged by a fourfold impact from
accountable care, declining clinical revenue, an evolving training environment,
and flat or contracting NIH budgets. Anesthesia is especially sensitive to all of
these. In the past, our specialty (and departments) pioneered the patient safety
495
95
2
495
3
95
93
128
OUR COMMUNITY SITES
2
190
We provide a full range of anesthesia, critical care, and pain
medicine — and oversee day-to-day operations of the ORs —
90
90
95
3
at our BIDMC Boston main campus, as well as our community
395
24
hospital partners, BID – Milton, and BID – Needham. We provide
oversight for Anesthesia and Critical Care at BID – Plymouth.
495
We also provide Pain Services our BID HealthCare© locations:
6
3
24
495
Lexington, Chestnut Hill, and Chelsea.
195
2 BIANNUAL REPORT | 2 0 1 6 – 2 0 17
6
195
B E T H I S R A E L D E ACO N E S S M E D I C A L CE N T E R
movement, founded the specialties of critical care, and pain medicine,
introduced simulation to medicine, and led the integration of nonphysician
providers in the workforce. As a specialty and as a department, we will
continue to adapt and lead in this changing environment. Within the
medical center, the Anesthesia Department is recognized as a team player
that provides outstanding clinical service. We have taken the lead in
collaborative process improvements across the spectrum of perioperative
medicine, and in developing and improving patient care processes for
optimal outcomes. Outside the hospital, we are recognized as a national
leader in innovation, both in clinical care as well as in the science of
perioperative health care delivery.
The Beth Israel Deaconess Department of Anesthesia, Critical Care, and
Pain Medicine continues to provide world-class clinical care, training and
education, research, and leadership in an environment of collaboration and
collegiality. Whether you are an alumnus, colleague, potential applicant, or
interested friend, I hope that by perusing these pages you will learn more
about our diverse programs, activities, and accomplishments.
– Danny
B I D M C.org 3
D EPA R T M E N T O F A N E S T H E S I A , CR I T I C A L C A R E, A N D PA I N M E D I CI N E
HARVARD Faculty
Vimal K. Akhouri, MD, MBBS
Jeffrey K. Jankun, MD
Assistant Professor of Anaesthesia
Assistant Professor of Anaesthesia
FACULTY Amanda K. Anastasi, MD
Andrew J. Koropey, MD
Instructor in Anaesthesia
Assistant Professor of Anaesthesia
Galina V. Korsunsky, MD
M. Moris Aner, MD Instructor in Anaesthesia
Director, Chronic Inpatient Pain Services
Assistant Professor of Anaesthesia Megan L. Krajewski, MD
Instructor in Anaesthesia
Department Chair
M. Dustin Boone, MD
Daniel S. Talmor, MD, MPH Cindy M. Ku, MD
Director, Neuroanesthesia
Chair of Anesthesia, Critical Care, and Pain Medicine Associate Program Director, Anesthesia Residency
Program Director, Neuroanesthesia Fellowship
Edward Lowenstein Professor of Anaesthesia Instructor in Anaesthesia
Program Director, Neurocritical Care Fellowship
Co-director, Neuroscience Intensive Care Unit
Executive Vice Chair Assistant Professor of Anaesthesia Adrienne T. Kung, MD
Alan Lisbon, MD Instructor in Anaesthesia
Executive Vice Chair, Anesthesia Ruma R. Bose, MD, MBBS
Associate Professor of Anaesthesia Assistant Professor of Anaesthesia Lisa J. Kunze, MD, PhD
Director, Orthopedic Anesthesia
Somnath Bose, MD, MBBS Assistant Professor of Anaesthesia
Chief Administrative Officer
Instructor in Anaesthesia
Dawn M. Ferrazza, MA Rikante O. Kveraga, MD
Hyun Kee Chung, MD Site Chief, Needham
Vice Chairs Instructor in Anaesthesia Instructor in Anaesthesia
Sheila R. Barnett, MBBS, BSc
Rajiv R. Doshi, MD Robert S. Leckie, MD
Site Chief, Milton
Instructor in Anaesthesia Assistant Professor of Anaesthesia
Vice Chair, Perioperative Medicine
Associate Professor of Anaesthesia
David M. Feinstein, MD, MS Anthony C. Lee, MD
Director, Clinical Informatics Instructor in Anaesthesia
Rami Burstein, PhD
Vice Chair, Research and Neuroscience Program Director, Anesthesia Clinical
Informatics Fellowship Akiva Leibowitz, MD
John Hedley-Whyte Professor of Anaesthesia
Assistant Professor of Anaesthesia Instructor in Anaesthesia
Stephanie B. Jones, MD
Irina Fishman, MD Adam B. Lerner, MD
Vice Chair, Education and Faculty Development
Instructor in Anesthesia Director, Clinical Operations West Campus
Associate Professor of Anaesthesia
Assistant Professor of Anaesthesia
Peter J. Panzica, MD Brendan P. Garry, MBBCh BAO
Assistant Professor of Anaesthesia Dan Levy, PhD
Vice Chair, Clinical Anesthesia
Associate Professor of Anaesthesia
Assistant Professor of Anaesthesia
Jatinder S. Gill, MBBS, MD
Assistant Professor of Anaesthesia Lior Levy, MD
Satya Krishna Ramachandran, MD
Instructor in Anaesthesia
Vice Chair, Quality, Safety and Innovation
Randall S. Glidden, MD
Assistant Professor of Anaesthesia Yunping Li, MD
Associate Program Director, Obstetrical
Sapna Govindan, MD Anesthesia Fellowship
Instructor in Anaesthesia Assistant Professor of Anaesthesia
Philip E. Hess, MD Melanie R. Loberman, MD
Director, Obstetric Anesthesia Instructor in Anaesthesia
Program Director, Obstetrical Anesthesia Fellowship
Associate Professor of Anaesthesia Selina A. Long, MD
Assistant Professor of Anaesthesia
Bozena R. Jachna, MD
Director, Residency Mentor Program Stephen H. Loring, MD
Assistant Professor of Anaesthesia Professor of Anaesthesia
Cullen D. Jackson, PhD Haobo Ma, MD, MS
Director, Innovation Instructor in Anaesthesia
Instructor in Anaesthesia
Soumya Mahapatra, MD
Susie S. Jang, MD Instructor in Anaesthesia
Instructor in Anaesthesia
4 BIANNUAL REPORT | 2 0 1 6 – 2 0 17
B E T H I S R A E L D E ACO N E S S M E D I C A L CE N T E R
Feroze Mahmood, MD Christine G. Peeters-Asdourian, MD Andrew M. Strassman, PhD
Director, Cardiac and Vascular Anesthesia Program Director, Pain Medicine Fellowship Associate Professor of Anaesthesia
Director, Perioperative Echocardiography Assistant Professor of Anaesthesia
Professor of Anaesthesia Balachundhar Subramaniam, MD, MPH
John R. Pettinato, DO Director, Center for Anesthesia Research Excellence
Syed Hazique Mahmood, MD Instructor in Anaesthesia and Neurology Associate Professor of Anaesthesia
Instructor in Anaesthesia
Stephen D. Pratt, MD Eswar Sundar, MBBS
Jeffrey Martel, MD Director, Pre-Admission Testing Director, Clinical Operations-East Campus
Director, Medical Student Education (until 3/17) and Patient Experience Director of Anesthesia for GI Endoscopy
Instructor in Anaesthesia Assistant Professor of Anaesthesia Assistant Professor of Anaesthesia
Robina Matyal, MD Paragi H. Rana, MD Sugantha Sundar, MBBS
Associate Professor of Anaesthesia Associate Program Director, Pain Medicine Fellowship Assistant Director, Division of Quality and Safety
Instructor in Anaesthesia Assistant Professor of Anaesthesia
Caitlin McGinty-Froncek, MD
Instructor in Anaesthesia Joyson P. Ratnaraj, MD, MBBS M. Leo Tsay, MD
Assistant Professor of Anaesthesia Director, Physician Rotators in Anesthesia
Cristin A. McMurray, MD Instructor in Anaesthesia
Instructor in Anaesthesia Deborah S. Reynolds, MD
Assistant Professor of Anaesthesia MaryAnn Vann, MD
Meredith W. Miller, MD, PhD Assistant Professor of Anaesthesia
Instructor in Anaesthesia Norma J. Sandrock, MD
Assistant Professor of Anaesthesia Jason S. Wakakuwa, MD
John D. Mitchell, MD Director, Transplant Anesthesia
Program Director, Anesthesia Residency Todd W. Sarge, MD Assistant Professor of Anaesthesia
Associate Professor of Anaesthesia Director, Critical Care Medicine
Assistant Professor of Anaesthesia Carol A. Warfield, MD
Joshua L. Mollov, MD Distinguished Lowenstein Professor of Anaesthesia
Instructor in Anaesthesia Aaron J. Schain, PhD
Instructor in Anaesthesia R. Joshua Wootton, MDiv, PhD
Renee A. Moran, DO Director, Pain Psychology
Instructor in Anaesthesia Shahzad Shaefi, MBBS Assistant Professor of Anaesthesia
Program Director, Anesthesia Critical Care
Jyotsna V. Nagda, MD Fellowship Cyrus A. Yazdi, MD
Assistant Professor of Anaesthesia Program Director, Adult Cardiothoracic Fellowship Instructor in Anaesthesia
Assistant Professor of Anaesthesia
Sara E. Neves, MD Scott D. Zimmer, MD
Associate Program Director, Anesthesia Critical Fred E. Shapiro, DO Director, Categorical Internship
Care Fellowship Assistant Professor of Anaesthesia Instructor in Anaesthesia
Instructor in Anaesthesia
Marc R. Shnider, MD
Anh L. Ngo, MD, MBA Director, Regional Anesthesia and Acute Pain APHMFP Faculty
Instructor in Anaesthesia Services John M. Connolly, MD
Assistant Professor of Anaesthesia Site Chief, Plymouth
Rodrigo Noseda, DVM, PhD
Assistant Professor of Anaesthesia Thomas T. Simopoulos, MD Erin Burns, MD
Interim Division Chief, Pain Medicine
Brian P. O’Gara, MD Interim Co-Director, Spine Clinic Benjamin Moor, MD
Instructor in Anaesthesia Assistant Professor of Anaesthesia
Neil W. Oliwa, MD
Achikam Oren-Grinberg, MD, MS Laura L. Sorabella, MD Sohrab Sidhwa, MD
Assistant Professor of Anaesthesia Instructor in Anaesthesia
Christopher Walters, MD
Nancy E. Oriol, MD Joan E. Spiegel, MD
Faculty Associate Dean for Community Assistant Professor of Anaesthesia Natallia Yaromenka, MD
Engagement in Medical Education
Associate Professor of Anaesthesia Richard A. Steinbrook, MD
Associate Professor of Anaesthesia
Qi C. Ott, MD
Instructor in Anaesthesia Justin K. Stiles, MD
Director, Medical Student Education (4/17- )
John B. Pawlowski, MD, PhD Instructor in Anaesthesia
Director, Thoracic Anesthesia
Assistant Professor of Anaesthesia
B I D M C. o r g 5
D EPA R T M E N T O F A N E S T H E S I A , CR I T I C A L C A R E, A N D PA I N M E D I CI N E
CLINICAL ANESTHESIA
The Clinical Anesthesia Program provides anesthesia services
for all operating rooms, labor and delivery, and non-operating
room procedural areas at Beth Israel Deaconess Medical Center.
Peter J. Panzica, MD
Vice Chair, Clinical Anesthesia
At BIDMC, we staff 40 operating rooms (ORs) between Boston’s East and
Assistant Professor of
Anaesthesia
West campuses, located in three main suites (19 on Main West, 11 in Feldberg-
East, and 10 in the Shapiro Ambulatory Suite-East). We recently opened a new
hybrid OR on the West Campus to care for the substantial increase in structur
al heart procedures over the past two years. Non-operating room procedural
areas include three sets of gastrointestinal endoscopy (GI) suites, three elec
trophysiology (EP) suites, two angiography suites, an endovascular procedure
suite, and CT, MRI and ECT suites.
Clinical Anesthesia Divisions include the Director of Perioperative Nursing
cardiac, vascular, thoracic, orthope (Dr. Peter Panzica, Dr. Mark Callery,
dic, neurosurgical, transplant, am and Elena Canacari, RN respectively).
bulatory, regional, GI, office-based, In 2016, we added clinical directors to
pre-admission testing, and obstetrics. the East (Dr. Eswar Sundar) and West
(Dr. Adam Lerner) Campuses. The
Governance of perioperative services
role and responsibility of the clinical
at BIDMC is by the Operating Room
Volume FY15 – FY17 directors is to manage the clinical op
Executive Committee (OREC), a
erations of their respective campuses.
subcommittee of the Medical Execu
50
48,738 48,135 tive Committee. OREC is responsible Our presence in the community
44,123 for strategic planning for the operat continues to grow as we provide
40 ing rooms and meets biweekly. This anesthesia care at BID – Needham
14,333 15,000 14,458 OR East committee is chaired by the Chiefs and BID – Milton, and oversight at
of Anesthesia and Surgery, and the BID – Plymouth. OR integration hap
cases in thousands
30 Director of Perioperative Nurs pens in concert with senior hospi
12,109 10,708 10,666 OR West ing (Dr. Danny Talmor, Dr. Elliot tal leadership to make the best use of
Chaikoff, and Elena Canacari, RN our systems OR resources—namely
20 respectively), with representation by driving lower-acuity care out to the
Remote members of the Anesthesia Depart community. We have helped create
11,811 16,907 17,051
Sites ment. A subcommittee of OREC—the effective OR governance in the com
10 Perioperative Operations Commit munity and connected their ORs to
tee—is responsible for the day-to-day the main campuses with a robust IT
4,870 4,938 4,762 OB
operations of the ORs and also meets system after creating common defini
1,000 1,185 1,198 TEE
0 biweekly. This committee is chaired tions and accountability for OR
FY15 FY16 FY17
PROJECTED by the Vice Chair of Clinical Anesthe metrics and efficiencies. BID – Need
sia, the Chief of General Surgery, and ham has six ORs—including two
6 BIANNUAL REPORT | 2 0 1 6 – 2 0 1770
B E T H I S R A E L D E A C O N E S S M E D I C A L THC E N T E R
BIDMC Anesthesia and
Hospital History
This year marks the 70th anniversary of anesthesia services at
Beth Israel Hospital, founded by Sam Gilman, MD, in 1937,
and evolving into the Department of Anesthesia, Critical
Care, and Pain Medicine. Our 70-year history depicts a story
of clinical and academic excellence, with deep roots in social
responsibility and patient care. We’re proud of our reputa-
tion, which has shaped who we are today, and continues
to guide us in providing compassionate and state-of-the art
care for our patients.
1896
New England Deacon-
ess Hospital (NEDH) is
established by the New
England Conference of Methodists, opening 14 patient
beds in a residential brownstone on Mass. Ave. From
its founding, NEDH maintained a reputation as an out-
new ORs and a post-anesthesia Several Faculty Hour chartered teams standing tertiary-care hospital, developing many of the
care unit (PACU) and holding area. were centered around OR improve techniques used in cardiac, and vascular surgery.
BID – Milton has six ORs, as well as a ment and involved departmental
1907
high-volume GI suite, with future OR members collaborating with our
expansion being planned. BID – Plym surgical and nursing colleagues. These
outh has eight ORs, along included eliminating blood
with a labor and delivery bank waste (essentially NEDH builds a 50-bed
suite (L&D), and a GI eliminated); improving hospital and relocates to
suite. We will soon have PACU length of stay (with the Longwood area near
Harvard Medical School.
a common electronic the addition of patient
anesthesia record in our pathways and multimodal
community sites. analgesia in many subspe
Adam Lerner, MD
Clinical Director, West Campus cialty areas); and improving
Case volume at
cath lab efficiency.
BID – Needham and
BID – Milton has con The only constant is change.
tinued to increase over It is an exciting time to be
the past two years. The at BIDMC, with the ac
1916
Anesthesia Department celerated consolidation of
is expanding to support health care systems in the
additional space and Eswar Sundar, MD
Clinical Director, East Campus
Boston area. Ours is the
growing volume at our fastest- growing system in Beth Israel Hospital (BIH)
opens on Townsend Street,
Boston campus and our community the region, and this brings on certain
Roxbury, with 45 patient
hospitals. With the addition of 10 challenges and opportunities. Our beds. A Jewish-sponsored
new staff to our department, we have Anesthesia Department is well posi hospital, BIH was founded
a total of 205 clinicians—91 attend tioned and trusted to help guide these to care for the medical needs of Boston’s immigrant
Jewish community and to provide residency training
ings, 40 CRNAs, house staff of 55 changes and create our own successful
opportunities for the area’s Jewish doctors. The hospital
residents, and 19 fellows (with new future through clinical excellence, in developed a strong reputation for social responsibility,
fellowships in neuroanesthesia and novation, collaboration, and value- for taking care of the poor, and for academic excellence.
Beth Israel earned a place as one of the premier hospi-
neurocritical care). based care.
tals in the Harvard system.
B I D M C. o r g 7D EPA R T M E N T O F A N E S T H E S I A , CR I T I C A L C A R E, A N D PA I N M E D I CI N E
CLINICAL ANESTHESIA – MILTON
Andrew J. Koropey, MD Joshua L. Mollov, MD Nurse Anesthetists
Associate Chief, Anesthesiology, Milton Instructor in Anaesthesia Dan Marriggi, CRNA
Instructor in Anaesthesia Sara E. Neves, MD* Chief CRNA
Faculty Instructor in Anaesthesia Claudia Ambrus, CRNA
Vimal K. Akhouri, MD, MBBS Anh L. Ngo, MD, MBA Joan Botelho, CRNA
Assistant Professor of Anaesthesia Instructor in Anaesthesia
Sheila R. Barnett, MBBS, BSc Traci Brown, CRNA
Somnath Bose, MD, MBBS* Peter J. Panzica, MD
Vice Chair, Perioperative Medicine Assistant Professor of Anaesthesia Katherine Canina, CRNA
Instructor in Anaesthesia
Site Chief, Milton Scott D. Zimmer, MD Lori Cetrino, CRNA
Jeffrey K. Jankun, MD
Associate Professor of Anaesthesia Assistant Professor of Anaesthesia Instructor in Anaesthesia Elizabeth Demartini, CRNA
Megan L. Krajewski, MD* *ICU Erin Herrmann, CRNA
Instructor in Anaesthesia Pain Medicine Hope Mangili, CRNA
Lior Levy, MD Paragi H. Rana, MD Darcy McCabe, CRNA
Instructor in Anaesthesia Instructor in Anaesthesia
Marybeth Sabeti, CRNA
Haobo Ma, MD, MS Cyrus A. Yazdi, MD
Instructor in Anaesthesia Elizabeth Stansberry, CRNA
Instructor in Anaesthesia
Beth Israel Deaconess Hospital adults in multiple specialties, includ pedic surgery volume, especially for
Milton (BID – Milton) is an 88-bed ing orthopedics, hand, spine, general knee and hip joint replacements,
acute care community hospital with surgery, ENT, urology, gynecology, continues to be a major contribu
24-hour emergency services, an and plastics. This past year, several tor to operating room volume and it
eight-bed ICU, and more than 250 surgical services have joined or ex is not uncommon to perform six to
physicians on staff. The hospital has panded coverage at Milton, leading eight joint replacements in a single
been affiliated with BIDMC since to exciting new opportunities. This day. Volume is likely to continue to
2005. In 2015, the BIDMC Anesthe includes the introduction of a new increase next year with the addition
sia Department took over anesthesia robotic surgery program—allowing of more orthopedic surgeons. To
services, including pain management surgeons to decant cases from down accommodate the expanding surgical
and shared coverage of the ICU. We town BIDMC to the community. This volume, a seventh operating room
staff five to six operating rooms as year Milton also became a bariatric and a new 12-bed inpatient unit are
well as one to three endoscopy suites center of excellence, and we observe expected to open in early 2018. The
daily. BID – Milton offers surgery for steady growth in this service. Ortho increase in services and surgeons
operating at Milton is met with great
enthusiasm from patients and provid
ers since the community setting is
often easier for patients and families
to navigate—avoiding the stresses of
downtown traffic, costly parking, and
crowded clinics.
The operating rooms at Milton are
now a hive of activity, and this is
an exciting time for our anesthesia
group. Over the last 12 months, our
team has steered the way on major
efforts to improved operating room
8 BIANNUAL REPORT | 2 0 1 6 – 2 0 17efficiencies and the perioperative care cases—both cases associated with ad
1923
Frank H. Lahey, MD, a member of the NEDH surgical
of our patients. This has led to con verse events, and also those that are staff since 1914, founds the Lahey Clinic, a pioneering
sistent on-time starts in the operating interesting cases for education. Addi multispecialty group medical practice. Lahey was NEDH
room, efficient use of rooms during tionally, we regularly review data on surgeon-in-chief for many years.
the day, less overtime for late rooms, case volume and anesthetic types. We
and an increase in surgical capacity. have also added the ability to stream
While intraoperative anesthetic excel
lence is always our goal, in the last 12
months we have also turned increas
grand rounds from the main campus
and host teleconferences for staff
meetings. We serve on several major
1928
BIH dedicates its new facility at 330 Brookline Ave
ing attention to the perioperative care committees for the hospital includ (our East Campus).
of our patients. Our preoperative ing Medical Staff, Operating Room
assessment system is modeled after Executive, Surgical Steering, and ICU
BIDMC – Boston, and patients with committee. We have been working
complex medical histories are evalu with other community partners on
ated in person by our nurse practi shared operating room governance
tioner in the preoperative assessment through PowerHealth, an operat
clinic in advance of surgery. Postop ing room data collection tool, and
erative pain control is also a major is streamlining our electronic record
sue for patients, and we have worked within Meditech.
closely with our orthopedic partners
in particular to create streamlined The community setting
carepaths, including multimodal an
algesia for joint-replacement patients.
This effort has led to the ability to
Working in a community setting
brings different challenges compared
with a major academic hospital, and
1928
BIH and Harvard Medical
send patients home the morning after School form a teaching and
we continue to learn from our com research partnership, with Her-
their surgery, sometimes even the day
munity partners. The importance of rman L. Blumgart, MD, named
of surgery.
teamwork in the community setting Director of Medical Research and
head of the Harvard Teaching
Within our own group, we continue cannot be overemphasized. To run
Service.
to look for opportunities to improve nine locations efficiently and safely,
patient care and the quality of our every member of the team makes
anesthetic care. For example, as a
group we have increased the num
ber of members performing regional
invaluable contributions every day—
whether by demonstrating clinical
excellence, efficiently setting up for
1937
Samuel Gilman, MD, founds
anesthetics, and spinal anesthesia the next case, or simply entering the anesthesia services and
is routine for all joint-replacement orders on time. It all counts. becomes head of anesthesiol-
patients. This year we introduced ogy at BIH. He remains chair of
As chief of our Milton service, I feel anesthesiology until 1967.
regular quality meetings to review
fortunate to have an enthusiastic and
talented team of anesthesiologists
1952
BID–Milton Volume FY16 – FY17
and nurse anesthetists who come in
10,000 every day ready and prepared to
8,000 give it their all. In the coming year, The transthoracic pacer, a
9,101 9,198 I look forward to continuing to noninvasive method for
6,000
cases
work together to provide the best jump-starting the heart, is
4,000 developed by Paul Zoll, MD,
patient care as safely and efficiently and his team at BIH. Zoll be-
2,000 as possible. comes known as the father
of modern cardiac therapy.
0
FY16 FY17
PROJECTED
B I D M C. o r g 9D EPA R T M E N T O F A N E S T H E S I A , CR I T I C A L C A R E, A N D PA I N M E D I CI N E
CLINICAL ANESTHESIA – NEEDHAM
Vimal K. Akhouri, MD Cindy M. Ku, MD Pain Medicine
Assistant Professor of Anaesthesia Instructor in Anaesthesia M. Moris Aner, MD
Amanda K. Anastasi, MD Lisa J. Kunze, MD, PhD Assistant Professor of Anaesthesia
Assistant Professor of Anaesthesia Assistant Professor of Anaesthesia Jatinder S. Gill, MBBS, MD
Hyun Kee Chung, MD Robert S. Leckie, MD Assistant Professor of Anaesthesia
Instructor in Anaesthesia Assistant Professor of Anaesthesia Susie S. Jang, MD
Rikante O. Kveraga, MD Rajiv R. Doshi, MD Soumya Mahapatra, MD Instructor in Anaesthesia
Instructor in Anaesthesia Instructor in Anaesthesia Cyrus A. Yazdi, MD
Site Chief, Needham
Galina V. Korsunsky, MD Instructor in Anaesthesia
Instructor in Anaesthesia Instructor in Anaesthesia
Beth Israel Deaconess Hospital in Pre-admission testing managing a fast-paced OR, and
Needham (BID – Needham) is a 58- learning more about the intricacies
bed community satellite hospital af BID–Needham uses a pre-admission of running an efficient OR similar to
filiated with BIDMC in Boston. The system that enables patients to pre- that found in private practice.
surgical pavilion has a state-of-the- enter relevant health information.
art “open concept” pre-anesthesia This encourages active patient partici Quality and safety innovations
holding area, a post-anesthesia care pation and engagement in the devel
opment of perioperative care plans. The Department of Anesthesia at
unit, six ORs with two new operat
BID–Needham has developed several
ing suites added recently to accom
modate growing surgical volume. Patient satisfaction innovative programs in recent years,
including:
One OR Suite is a dedicated We have implemented a variety of
Cystoscopy room, and two are • multimodal analgesia for patients
subspecialty-specific multimodal
laparoscopic suites. having laparoscopic surgery and
analgesia pathways. These include
uro-gynecological procedures.
In an effort to distribute volume a number of innovative peripheral
nerve blocks that enhance the entire • postoperative care pathways for
appropriately within the system, in
post-surgery recovery. In the area of major joint replacements
2015, a Clinical Integration Commit
tee, with members from BIDMC and patient satisfaction with ambulatory • innovative iPad–based electronic
BID – Needham, worked to offload surgery, month after month, greater health records
lower-acuity volume from BIDMC to than 95% of patients coming to
In addition, the department has
BID – Needham, leading to consis BID – Needham would be very likely
received recognition. A poster titled
tently increasing volume year after to recommend having surgery here.
“Improving Pain Management by Fo
year. Volume at BID – Needham has cusing on Causes of PACU Discharge
increased 15% since the committee
Training
Delays and Preoperative Medications”
was formed. The high percentage of orthopedics received third place at the Foundation
at BID – Needham offers an excellent for Anesthesia Education and Research
Anesthesia providers who manage
opportunity to develop a rotating poster presentation contest at the 2017
complex and high-acuity patients
Regional Anesthesia Fellowship in American Society of Anesthesiologists
at BIDMC bring their expertise to
combination with BIDMC – Boston. Practice Management conference.
the community, but tailored to the
Currently there is a practice manage We’ve accomplished all this while
needs of a fast-paced outpatient
ment rotation for residents nearing experiencing significant growth: from
setting.
graduation at BID – Needham. They 2014 to 2016, the Needham OR
gain experience supervising CRNAs, volume increased by 26 percent.
10 B I A N N U A L R E P O R T | 2 0 1 6 – 2 0 17B E T H I S R A E L D E ACO N E S S M E D I C A L CE N T E R
1967John Hedley-Whyte, MD, moves from MGH to BIH
to found a new independent academic department of
anesthesia. Joining Hedley-Whyte from MGH was Leonard
Bushnell, MD, to head the ICU at BIH. The department’s
key role in critical care at Beth Israel and now at BIDMC
SERVICES PROVIDED
has continued over the decades.
• Cancer surgery • Minimal-access laparoscopic surgery,
Plastics and reconstructive procedures including colorectal surgery
1983
•
• Women’s health and gynecology procedures • Adult otolaryngology
• Orthopedic sports medicine • Limited pediatric otolaryngology
• Total and complex joint replacements • Urological procedures for men and women
• Hand, ankle, and podiatry sports medicine
NEDH performs the first successful liver trans-
plant in New England.
1985 Ellison “Jeep”
Pierce, MD, chair
of anesthesiology at
NEDH, founds the
Anesthesia Patient
Safety Foundation.
(Pierce served as
president of the
American Society of
Anesthesiologists in 1982). In the 1980s, residents were
taught the mortality rate from general anesthesia was
1/10,000. Now it’s closer to 1/250,000.
1990Ed Lowenstein, MD, is
named chair and remains
in this position until 1997.
Considered one of the found-
ers of the field of cardiac
BID–Needham Volume FY15 – FY17
anesthesia, his seminal paper
in NEJM, “Cardiovascular
8,000 responses to large doses of
morphine,” was the basis
6,000 for the use of high-dose
cases
4,000 opioid anesthetics in cardiac
4,796 surgery.
2,000 3,868
3,321
0
FY15 FY16 FY17 B I D M C. o r g 11
PROJECTEDD EPA R T M E N T O F A N E S T H E S I A , CR I T I C A L C A R E, A N D PA I N M E D I CI N E
CLINICAL ANESTHESIA – PLYMOUTH
Erin Burns, MD Randy Barnhard, CRNA Kristen Hogan, CRNA
Benjamin Moor, MD John Cona, CRNA Barbara Quirk, CRNA
Neil W. Oliwa, MD Shirley Czaja, CRNA Amy Townsend, CRNA
Sohrab Sidhwa, MD Kevin Doherty, CRNA Tara Traczyk, CRNA
Christopher Walters, MD Jos Foley, CRNA Peter Tsinzo, CRNA
John M. Connolly, MD
Natallia Yaromenka, MD Penne Traci Greer, CRNA Maria Vaz, CRNA
Site Chief, Plymouth
The Beth Israel Deaconess Hospital meet the needs of patients while opti
in Plymouth (BID – Plymouth) is a mizing clinical outcomes and promot
153-bed community hospital, located ing an exceptional patient experience.
43 miles south of Boston. BID –
Plymouth was chosen as a Leapfrog Department statistics
Top General Hospital in 2016.
We perform about 6,500 operative
The BID – Plymouth Anesthesia De procedures annually in eight ORs,
partment is a division of the HMFP along with staffing three endoscopy
Department of Anesthesia and works rooms performing approximately
under the auspices of Harvard Medi 5,500 cases. The Obstetric Depart
cal Faculty Practice Affiliates. The ment manages about 770 deliveries,
Plymouth Division is comprised of and our Pain Management Center has
seven anesthesiologists, 11 CRNAs, a about 4,000 patient encounters annu
nurse practitioner, and a pain manage ally. We provide extensive use of nerve
ment physician’s assistant, all of whom blocks to facilitate enhanced patient
are dedicated to providing the safest recovery and patient satisfaction.
anesthetic care possible to our patients.
Accomplishments
Anesthesia services are provided in
the operating rooms, OB suites, Pain Anesthesia Department members,
Management Center, cardiovascular along with surgeons, peri-op nursing
lab, endoscopy suites, Radiology, representatives, OR technicians and
and emergency room. Anesthesiolo ancillary health professionals, met
gists are available in the hospital 24 off site at a “Patient Experience”
hours a day, 7 days a week to meet deep-dive event to identify opportu
any emergent medical needs of the nities to improve the patient experi
patients in our expanding community. ence. Ideas in development include
creating a “What to expect” video
Our anesthesia care team is proud to for patients, perioperative status
serve all of the patients in Southeastern updates for waiting family members,
Massachusetts. We are committed to and a campaign for increased aware
developing and implementing patient ness of professional conduct in the
safety and quality initiatives to best perioperative area.
12 B I A N N U A L R E P O R T | 2 0 1 6 – 2 0 171996
Beth Israel Hospital and New England Deaconess Hospital
merge to form Beth Israel Deaconess Medical Center
(BIDMC). The traditions of the two hospitals melded to cre-
ate a medical center with outstanding surgery, attention to
patient safety, academic excellence, and a continued sense
of social responsibility.
2002
BIDMC expands our network of care. Deaconess Glover
Hospital in Needham becomes the first community hospi-
tal affiliate of Beth Israel Deaconess Medical Center, where
we run the Anesthesia Department and Pain Services.
2012
Milton Hospital officially becomes Beth Israel Deacon-
ess Hospital-Milton, solidifying a relationship that
began nearly a decade earlier.
BID–Plymouth Volume FY15 – FY17
2015
The 114-year-old Jordan
Hospital is renamed Beth
Israel Deaconess Hospital-
8,000
Plymouth, extending the BID
6,000 system of integrated care into
6,384 southeastern Massachusetts.
cases
4,000 5,804 6,041
2,000
0
FY15 FY16 FY17
PROJECTED B I D M C. o r g 13D EPA R T M E N T O F A N E S T H E S I A , CR I T I C A L C A R E, A N D PA I N M E D I CI N E
FACULTY HOUR
Faculty Hour projects are one of the primary methods 1. First, it provides all the relevant stakeholders with a
we use for improving health care delivery in the periop- “seat at the table.”
erative environment. The Faculty Hour Chartered Team 2. Second, it increases the knowledge and experience
portfolio is managed by the Quality, Safety, and Innova- base with which to consider issues and conceive of
tion Division. possible solutions.
These projects are comprised of multidisciplinary teams 3. And finally, it helps build a culture of collegiality and
with staff from the Departments of Anesthesiology, Sur- collaboration outside of the clinical setting, which
gery, Nursing, Orthopedics, Obstetrics and Gynecology, can persist back at the bedside.
and others, to rigorously study and develop methods for
All of these factors contribute to developing a more
improving our care delivery system.
robust shared mental model within the group, which
Collaborating across departments on shared issues in enhances the “stickiness” of proposed solutions, and
this way facilitates a number of benefits: increases the probability of the success of intervention.
EXAMPLES OF FACULTY HOUR PROJECTS: 2015 – PRESENT
• Carepath for Ambulatory Orthopaedic Sports Medicine Surgery to Improve PACU Length of Stay
• Implementation of Enhanced Recovery After Surgery (ERAS) for Colorectal Surgery
• Carepath for Ambulatory Breast and Plastic Surgery to Improve PACU Length of Stay
• Carepath for Outpatient Cystoscopy Surgery to Improve PACU Length of Stay
• Revising ICU Notes Creation and Rounding Process in the Surgical ICUs
• Improving Access and Preventing Waste of Blood Bank Products
• Developing Neuraxial Anesthesia PACU Discharge Guidelines
• Reducing the Incidence of Unplanned Intubation for General, Thoracic, Vascular Surgical Services
• Development of Preoperative Anemia Guidelines for Orthopedic Surgery
• Development of Protocols for Emergency Aortic Ruptures (“Code Aortic Rupture”)
• Design and Development of Processes to Improve Catheterization Lab Efficiency
• Implementing Anesthesia Interventions for Controlling Unplanned Intubation
14 B I A N N U A L R E P O R T | 2 0 1 6 – 2 0 17B E T H I S R A E L D E ACO N E S S M E D I C A L CE N T E R
B I D M C. o r g 15AMBULATORY AND
PRE-ADMISSION TESTING
Completely redesigned in 2014, the most importantly, an introduction to
Stephen D. Pratt, MD BIDMC Pre-Admission Testing (PAT) the medical center to maximize the
Director, Pre-Admission Testing unit is a state-of-the-art clinic that patient-friendly experience.
and Patient Experience provides a private, patient-centered
Assistant Professor of Anaesthesia Patients can be assessed in one of three
atmosphere, with resources for blood
ways. All patients receive a telephone
drawing, electrocardiogram testing,
“Witnessing the complete physical evaluations, and
call from an experienced nurse in
phenomenal targeted physical therapy assess
PAT to review health issues, confirm
medications, and review preoperative
teamwork and ments. The multidisciplinary PAT
instructions. For many, this is the only
team includes dedicated anesthesiolo
collaboration of gists, perioperative advanced practice
preoperative assessment that is needed.
our entire staff to Those with a more complex medical
nurses, nurses, case managers, physi
history will be seen in the PAT clinic
prepare each patient cal therapists, medical assistants,
by an experienced nurse practitioner
and administrative staff. The pri
for a successful, mary mission of the PAT clinic is to
or physician anesthesiologist. During
this visit, we perform a complete pre-
comfortable experience ensure that all patients are optimally
anesthesia assessment, a history and
prepared for their planned anesthe
is very satisfying and physical exam, and obtain appropriate
sia and procedure. This preparation
rewarding.” includes management of complex
testing (blood work, echocardiogram).
If indicated, a physical therapist or
medical conditions, patient educa
case manager might also see the pa
tion, coordination of appropriate
tient. The medical staff spends hours
laboratory or other testing, collec
ensuring that these complex patients
tion of required chart elements, and,
16 B I A N N U A L R E P O R T | 2 0 1 6 – 2 0 17Sheila R. Barnett, MBBS, BSc Nurse Practitioners
Associate Professor of Anaesthesia
Norine M. Gentner, NP
Lisa J. Kunze, MD, PhD Brian A. Hoell, NP
Assistant Professor of Anaesthesia
TEAM
Joyce Larson, NP
Brendan P. Garry, MBBCh BAO
Assistant Professor of Anaesthesia Mary-Ellin Moore, NP
Randall S. Glidden, MD Norma Osborn, NP
Assistant Professor of Anaesthesia Yolanda Perez-Schulman, NP
Joyson P. Ratnaraj, MD, MBBS Eileen Pimentel-Smalling, NP
Assistant Professor of Anaesthesia
Virginia A. Sheppard, NP
Deborah S. Reynolds, MD Eileen M. Stuart-Shor, NP
Assistant Professor of Anaesthesia
Bethany W. Thomas, NP
Richard A. Steinbrook, MD
Associate Professor of Anaesthesia
are optimally prepared. They might viewed by the PAT attending anesthe
contact a medical specialist to obtain siologist and appropriate recommen
records, arrange additional assess dations made when necessary.
ment of a significant condition, or
The BIDMC PAT clinic is a new, open,
create a plan for issues like periopera
bright, and patient-centered environ
tive management of anticoagulant have input from the cardiology device
ment. It is also a very busy clinic. In
medications or an implanted cardiac clinic regarding management of the
2016 we performed more than 24,000
device. They might discuss the appro device. We are working on a more
RN telephone assessments, saw more
priateness of the planned procedure standard approach to perioperative
than 8,100 patients in the clinic, per
with the surgeon in light of a high management of anticoagulant medica
formed more than 7,000 history and
anesthesia risk. The final preoperative tions. The nurse practitioners actively
physical exams, and waived nearly
assessment is a “waive.” These are engage in a self-education program
2,400.
complex patients who would gener with regularly scheduled lectures on
ally come for a PAT visit, but this Despite the busy clinical load, the PAT relevant topics. Multiple academic
visit is waived because they have had group is continually trying to improve publications have arisen from the
a recent anesthesia assessment, or the care we provide. We have worked work done in PAT, and the group was
they live far away, or there are other to improve the workflow for several awarded a grant for assessing periop
extenuating circumstances. The charts specific patient groups. Patients with erative cognitive dysfunction in the
of these patients are thoroughly re an implanted cardiac device now geriatric population.
Anesthesia Pre-Admission Testing
October 2016 to May 2017
Total operating room cases booked
14,321
RN telephone assessments
11,981
Pre-admission testing visits
5,062
PAT histories and physicals performed
4,298
B I D M C. o r g 17D EPA R T M E N T O F A N E S T H E S I A , CR I T I C A L C A R E, A N D PA I N M E D I CI N E
NURSE ANESTHESIA
The nurse anesthetists primarily experience with an average of 20 years
practice in a clinical role within the of anesthesia practice. CRNAs provide
Department of Anesthesia, Critical mentoring and shadowing opportuni
Beth A. Coolidge, CRNA Care, and Pain Medicine. Certi ties for BIDMC RNs hoping to gain
Chief Nurse Anesthetist fied Registered Nurse Anesthetists admission to nurse anesthesia gradu
(CRNAs) work within a care-team ate programs. Such opportunities have
“I am inspired by model providing perioperative an enabled graduates of nurse anesthe
the commitment of esthesia care for most of the depart sia programs to return to BIDMC
our nurse anesthetists ments and subspecialties throughout and practice as nurse anesthetists in
the medical center, both in Boston our department. The CRNAs have
to provide the best care and at BID–Needham, Milton, and prescriptive authority, which enables
to our patients. Plymouth. A secondary, yet impor them to provide immediate pre- and
tant, role of our CRNA team is to postoperative order completion. This
They are all dedicated
actively assist with resident, medical improves efficiency and quality of pain
and hard-working student, nursing, and nursing student management to our patients during
team members of training. CRNAs also participate in a their entire surgical experience.
wide variety of hospital and depart
our outstanding The Division of Nurse Anesthesia is
ment committees, including the
department.” multidisciplinary Faculty Hour and
committed to — and takes pride in deliv
ering high-quality, safe anesthesia care
Advanced Practice Nursing Com
to the BIDMC and affiliate populations.
mittees. The division at the medical
I am inspired by the commitment of our
center currently includes 23 highly-
nurse anesthetists to provide the best
trained and dedicated CRNAs,
care to our patients. They are all dedi
with an additional four new hires
cated and hard-working team members
onboarding this fall. Overall, the
of our outstanding department.
division has an impressive depth of
18 B I A N N U A L R E P O R T | 2 0 1 6 – 2 0 17B E T H I S R A E L D E ACO N E S S M E D I C A L CE N T E R
Judy Akpan, CRNA Judith B. Hurley, CRNA
Carolyn H. Bruce, CRNA Tawnya Lopez, CRNA
TEAM
Donnell Carter, CRNA Eileen Lyons, CRNA
Timothy J. DeGuzman, CRNA Arpana Miller, CRNA
Patricia A. Demiglio, CRNA Patricia M. O’Connor, CRNA
Florence M. Egan, CRNA Rebecca J. Peyev, CRNA
Cary Endozo, CRNA Jennifer L. Phelan, CRNA
Nicole Grahm, CRNA William G. Rice, CRNA
Donna M. Greene, CRNA Brian Sim, CRNA
H. Rita Han, CRNA Ashley Vaughn, CRNA
Sarah E. Hayden, CRNA Genevieve E. Wright, CRNA
B I D M C.org 19CARDIAC ANESTHESIA
The scope, case mix, and complexity ous Amplatzer® device closures of
of the cases for cardiac anesthesia atrial and ventricular septal defects
has continued to evolve over the past and other complex intracardiac
Feroze Mahmood, MD two years. Our hospital volume for interventions. Our staff members
Director, Cardiac and Vascular Anesthesia open cardiac surgical procedures provide a very high level of real-time
Director, Perioperative Echocardiography remains stable. Almost a thousand three-dimensional (3D) imaging to
Professor of Anaesthesia cases were performed in the last assess suitability and procedural
fiscal year that required cardiopul guidance, thereby establishing suc
“Our division is monary bypass support. Importantly, cess and excluding complications.
considered the many transcutaneous aortic valve re This unique skill set has expanded
placements (TAVRs) were performed our role beyond the traditional heart
national leader in
this year with an expected marginal rooms into the cardiac catheteriza
3D imaging and reduction in the number of surgical tion laboratories and has established
research.” aortic valve replacements. Our medi our staff members as integral mem
cal center remains one of the busiest bers of the “structural heart” team.
centers in Boston for TAVRs. There Therefore, our role as perioperative
was also a significant increase in the physicians is well established. With
number of percutaneous interven the approval and accreditation of
tions on mitral and tricuspid valves our medical center as a heart failure
that included Mitraclip® procedure program by the Joint Commission,
and valve-in-valve therapy. Addition the ventricular assist device (VAD)
ally our interventional cardiologists volume has consistently increased
have started performing percutane over the last year. Our division
20 B I A N N UA L R EP O RT | 2 0 1 6 – 2 0 17Ruma R. Bose, MD, MBBS Qi C. Ott, MD
Assistant Professor of Anaesthesia Instructor in Anaesthesia
TEAM
Megan L. Krajewski, MD Peter J. Panzica, MD
Instructor in Anaesthesia Assistant Professor of Anaesthesia
Robert S. Leckie, MD Shahzad Shaefi, MBBS
Assistant Professor of Anaesthesia Assistant Professor of Anaesthesia
Adam B. Lerner, MD Bala Subramaniam, MBBS, MPH
Assistant Professor of Anaesthesia Associate Professor of Anaesthesia
John D. Mitchell, MD Sugantha Sundar, MBBS
Associate Professor of Anaesthesia Assistant Professor of Anaesthesia
members are involved in clinical care beta-blockers, reducing allogeneic cases. Drs. Panzica and Lerner have
of patients on various kinds of VADs transfusions, and facilitating early worked on a project to reduce blood
for cardiac and noncardiac surgery. extubation times have all translated component wastage, streamlining of
into a demonstrable shorter length of ordering, and availability of blood
Quality stay for our patients — a benchmark products. Dr. Lerner is also the leader
of program quality. In the last fiscal of the group working to develop a
According to the Society of Thoracic
year, members of the division have protocol for management of aortic
Surgeons data, our cardiac surgi
served on various hospital com emergencies. Ongoing faculty educa
cal outcomes data has enjoyed the
mittees for process improvement. tional projects include introduction
highest star rating in the majority of
Notably, Drs. Panzica, Mahmood, of a new echocardiography reporting
outcome metrics, and, is above the
and Ott spearheaded the cardiac system, educational in-service of mul
national average in others. Vigi
catheterization laboratory efficiency tiple VAD devices, and introduction
lance of division members in timely
project to ensure on-time start of to structural heart interventions.
administration of antibiotics and
B I D M C. o r g 21D EPA R T M E N T O F A N E S T H E S I A , CR I T I C A L C A R E, A N D PA I N M E D I CI N E
grant, Dr. Shahzad Shaefi has been
investigating the role of hyperoxia in
postoperative delirium. Dr. Qi Cui
Ott has initiated a research project on
the changes in cerebral oximetry with
initiation of cardiopulmonary bypass.
As part of his National Institute
of Health grant, Dr. Balachundhar
Subramaniam has been investigating
predictive value of pulse pressure vari
ability during cardiac surgery. Under
the auspices of the multidisciplinary
Valve Research Group division mem
bers have been conducting multiple
3D imaging-based projects that range
from valve modeling to 3D printing
of intracardiac valves. Our division
Fellowship and education division members are rated as some
of the best clinical teachers in the has been recognized and granted the
Our cardiothoracic (CT) anesthesia department, with Dr. Robert Leckie status of hospital “core laboratory”
fellowship program is one of the selected by the residents as the 2016 for 3D printing. We have established
most competitive programs in the Clinical Teacher of the Year. a state-of-the-art 3D printing labora
country. We had more than 150 ap tory and offer these services to the en
plicants for only two spots last year. Research and innovation tire medical center. Additionally, our
In this context we are excited to re division possesses multiple echocar
port that our CT fellowship program In addition to their clinical respon diography simulators and a dedicated
was approved for a third spot by the sibilities, our division members have simulation laboratory. Echocardiog
Accreditation Council for Graduate participated in basic science, clinical, raphy education curricula developed
Medical Education (ACGME), and educational, and database research. in our laboratory are shared with
in July 2017, we started three fellows As part of his Foundation for An multiple national and international
for our 12-month accredited CT fel esthesia Education and Research universities, and we conduct multiple
lowship. In the coming year, we plan
to offer an additional (fourth) spot
of a Structural Heart Fellowship for
fellows who have completed the ac
credited CT fellowship. We envision
this one-year fellowship dedicated to
developing expertise in multimodal
ity perioperative imaging to provide
procedural guidance. Trainees’
experience during cardiac rotations
continues to improve, and cardiac
electives during senior year are con
sistently oversubscribed. The division
also offers a very popular one-month
TEE elective to senior residents and
to trainees of sister institutions. Our
22 B I A N N UA L R EP O R T | 2 0 1 6 – 2 0 17You can also read
