At this year’s presentation to the health system’s Quality Council, our department received accolades for innovative and value-added care throughout our perioperative services, ICUs and pain programs.
“The major theme was the collaboration we are doing with other departments,” says Nirav Kamdar, MD, MPP, MBA, our Director of Quality. “That’s what anesthesia is all about. We’re the one specialty that has a presence amongst all others. Our job is about orchestrating that collaboration.”
The presentation was prepared by Dr. Kamdar and Carol Lee, RN, BSN, and presented by Dr. Kamdar and our chair, Dr. Mahajan. It shared our successes in collaborating with the surgical departments including colorectal, urology, obstetrics and gynecology, and orthopedics, which have resulted in improved outcomes for patients and fewer complications.
Other innovations include comprehensive screenings in the Preoperative Evaluation and Planning Center (PEPC), led by Victor Duval, MD, which have reduced surgical cancellations and delays. The continued success of the efforts of the Complex Care Team (CCT) – developed by Anahat Dillion, MD, and Vadim Gudzenko, MD, and now led by Dr. Kamdar with the help of Lauren Beck, MD, our fellow in Perioperative Medicine – have reduced postoperative ICU admissions and length of stay.
The efforts of Siamak Rahman, MD, and Neesa Patel, MD, the directors of our Acute Pain Services, have improved patient satisfaction with pain management and reduced length of stay with the consistent use of regional blocks. The Enhanced Recovery after Surgery Collaborative, driven by Maxime Cannesson, MD, PhD, Aviva Regev, MD, MBA, Dr. Rahman, and Ms. Lee, has reduced postoperative nausea and vomiting and lessened the need for opioid prescriptions at discharge.
The presentation also showcased our informatics team, led by Ira Hofer, MD, Director of the Division of Bioinformatics and Analytics. We highlighted the team’s surgeon dashboards, which enable physicians to view the accuracy of scheduling time, operational variables, and readmission rates, among other statistics. “That kind of individual data feedback is huge in helping our colleagues inform their work,” says Dr. Kamdar.
The Electronic Anesthesia Reporting System (eARS), championed by Kenneth Kuchta, MD, Chair of Quality Improvement, and Emily Methangkool, MD, Co-Director of Quality Assurance and Quality Improvement, has greatly facilitated confidential reporting of complications or other adverse events.
Finally, we shared the progress of our peer support pilot program, which launched in mid-December. The program, which trains and provides peer supporters to physicians, nurses and administrators who’ve endured troubling events, is one of the initiatives spear-headed by Keren Ziv, MD, the chair of our Anesthesiology Wellness Committee.
The program ensures that department members receive the emotional support after challenging events needed to function optimally at work and in their personal lives. “It’s culture that makes hospitals safe,” notes Dr. Kamdar. “Anesthesia, as a specialty, is the prototype for patient safety. Dr. Ziv has taken a very active role in shaping the culture.”
While the Quality Council presentation allowed other departments to consider how our work might benefit them, it also provided us with new ideas to further innovate our hospital’s “complex adaptive system.”
“By listening to other departments’ successes and challenges, we were able to identify where we could collaborate in the future,” says Dr. Kamdar. One of the recurring topics was the readmission rate for pain, an area in which we are taking an active role in addressing.”