Projects and Initiatives
- Clinical Pathway for Adult Patients with Epidermolysis Bullosa undergoing General Anesthesia
- Removing desflurane vaporizer and usage reduction of desflurane
- Buying reusable laryngoscopes and pulse oximeters and reducing use of disposables
- Perioperative Management of Hyperglycemia
- COVID-19 Common Critical and Practical Questions
- Online CME Module: Anesthesiology Workflows for COVID-19 Pandemic
- Perioperative Mental Health Screening Program
- InterCEPT (Interprofessional Communication Education Program for Teamwork; simulation-based in real settings with full clinical teams)
- Does spiking of intravenous bags cause microbial contamination?
- Implementation of a Stanford Anesthesiology Anemia Management Clinic to reduce RBC transfusion and hospital length of stay
- Perioperative and ERAS initiatives with:
- • Bariatrics pathway
- • Colorectal pathway
- • Pancreatic resection pathway
- • Liver resection pathway
- • Spine pathway
- • Gynecology pathway
- • Orthopedic joints
- • Glycemic control pathway
- • Delirium pathway
New epidural pathway
New ERAS pathway for sport medicine (Dr. Sherman is our champion)
New Rib fracture protocol with ED-ICU-RAAPMS-APS
Nr-Fit project to start ASAP: legal and safety improvement
- Complete data submission for cases covered by each cardiac anesthesia faculty to the Society of Thoracic Surgeons (STS) Adult Cardiac Surgery Database (ACSD), the world’s premier clinical outcomes registry for adult cardiac surgery.
- Leading multidisciplinary efforts to improve lung transplant recipient analgesia and outcomes.
- Broad division participation in Stanford Cardiovascular Institute (CVI) efforts to streamline ICU bed workflow and availability to reduce holds and delays in patient transfers.
- Improving analgesia for BVATS/hybrid ablation patients by multimodal analgesia and fascial plane blocks.
- Adult cardiothoracic anesthesia fellow annual participation ("ownership") of a quality project with faculty-led QI didactic sessions. Projects in 2019-20 were 500P CVOR setup, blood conservation in CVICU, intraoperative glucose management, COVID-19 airway protocols, hybrid ablation analgesia.
- CSRP Selected Project (Geriatrics, Trauma and Anesthesia) – Rib Fracture Pathway.
- ALS PEG Pathway – NCC/Neuromuscular/Anesthesia/Surgery.
- Peripheral Vasopressor Policy Update.
- Updating End of Life Care orders and policy.
- CODE Banner Update.
- Weekly QA review and quarterly QI review for OB division.
- OB Safety Committee
- LPCH Baby Friendly Committee
- Multidisciplinary Cardiac Disease Obstetric Patients Monthly Meeting
- Joint OB/OB Anesthesia M&M meetings (3x/year)
- Multidisciplinary COVID-19 obstetric task force
- Maternal early warning system in the Epic L&D platform
- Multidisciplinary Obstetric Simulation
- California Maternal Quality Care Collaborative
- Obstetric Anesthesia Emergency Manual
- Revision and streamlining of intrathecal pain pump patient flows in clinic and inpatient service
- Development of patient center CHOIR report for clinic patient
- Development of podcasts regarding business of pain medicine for Association of Pain Program Directors
- Development of neurology resources for pain medicine fellows for Association of Pain Program Directors
- Development of new pain education website
- Mitigating Intraoperative Hypothermia.
- Epidural pain management on wards - RN education on catheter management and troubleshooting, orderset and policy change.
- Medication warning visual aids for anesthesiologists - specifically: interaction between glycopyrrolate and dexmedetomidine.
- Intraoperative Codes - Simulations for staff, Crowd control process, Post-code debrief process for staff.
- LPCH clinical pathway guidelines for perioperative stress dose steroids.
- Formal debrief process between regional team and surgeons and anesthesiologist following block placement and prior to start of surgery.
- Review of LPCH NPO times and hypoglycemia perioperatively.