Anesthesiology News Archive - VA Palo Alto Health Care System
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VA Palo Alto Health Care System


Anesthesiology News Archive

Dr. Geoffrey Lighthall Promoted

Dr. Geoffrey Lighthall Congratulations to Geoffrey Lighthall, MD, PhD, who has been promoted to Professor of Anesthesiology, Perioperative and Pain Medicine in the Medical Center Line!

Dr. Lighthall studied at the University of California at Santa Cruz and at San Diego and received his Md/PhD from University of Maryland Medical School. He served as chief resident during his anesthesia residency at Stanford and completed a fellowship in Critical Care Medicine in 2000. Board certified in both Anesthesiology and Critical Care Medicine, he provides cardiothoracic anesthesia and critical care services. He serves as the chair of the CPR committee and the Medical Director of the VA Palo Alto eTeam program.

His academic focus is on improving the performance and delivery of medical care to critically ill patients, including establishing better definitions of critical illness and creating means to better identify patients that benefit from ICU admission. In the past, this has led to studies on the prognostic value of vital signs in ward patients, creation of a medical emergency team, and establishment of improved systems to examine the origin and outcomes of critical events, such as codes, emergency team calls, and ICU admissions. Dr. Lighthall has promoted the use of simulation to introduce the concepts of teamwork to the ICU staff and trainees, and developed simulation-based metrics of performance in managing septic shock and improving ICU educational programs.

You can read more about Dr. Lighthall on our website.

Dr. Audrey Shafer Featured in Stanford Publications

Dr. Audrey ShaferStanford Medicine Magazine featured the Medicine and the Muse: Medical Humanities and the Arts Program directed by staff anesthesiologist, Audrey Shafer MD, in the winter 2017 issue. An article by Dr. Shafer describes not only the need for promoting the arts and humanities in medical education and practice, but also the direct link to her experiences providing anesthesia care at VAPAHCS. A post in Stanford Scopeblog highlights the important ways that medical humanities enlarge and deepen our understanding of the human condition.

Multiple Honors for Dr. David Gaba

Dr. David GabaDr. David Gaba was selected to be part of the inaugural class of fellows in the Society for Simulation in Healthcare Academy (SSHA). This inaugural class consists of 34 members of the simulation community selected from several countries.

In addition to being selected for the academy, Dr. Gaba also received the Pioneer in Simulation Award during the Society for Simulation in Healthcare’s (SSH) International Meeting on Simulation in Healthcare event in Orlando, Florida. This is the highest award that can be given through SSH. Dr. Gaba's contributions to simulation include inventing the modern patient simulator, adapting crew resource management from aviation to simulation-based crisis resource management in healthcare, and serving as the founding Editor-in-Chief of the peer-reviewed academic journal Simulation in Healthcare. Dr. Gaba was the active Editor-in-Chief for 11 years from the beginning of the journal until July 2016.

In addition, Dr. Gaba will be receiving a national award from the American Medical Women's Association (AMWA). AMWA will honor Dr. Gaba with the 2017 Dr. Larry Zaroff Man of Good Conscience Award at its 102nd annual meeting award luncheon on April 1, 2017. This award is presented to a male physician who has been a champion and supporter of women in medicine in the tradition established by Dr. Zaroff.

In the words of his nominator, Dr. Amanda Burden, “Dr. Gaba is truly a man of good conscience and is an ardent and steadfast supporter of women in medicine. He is extraordinarily generous with his knowledge, time, and support, and has served as a mentor and tremendous supporter for me and for many of my colleagues in education, research, and in practice in the fields of medicine, anesthesiology and simulation. I have had the opportunity to work on a number of projects with Dr. Gaba from the time I first met him in 2007. This relationship has grown stronger through his mentorship of my work on various studies, presentations, and federal grants. Throughout our relationship, Dr. Gaba has demonstrated extraordinary commitment and effectiveness as a mentor, especially of women in medicine, and remains constantly available to teach, counsel, and mentor all of us.”

Fifth Annual Faculty Development Retreat

Participants of the fifth anesthesiology annual faculty development retreat On July 7, 2016, we held the fifth annual one-day off-site faculty development retreat for the VA Palo Alto Anesthesiology and Perioperative Care Service physicians to discuss the topic: Designing the Future of Anesthesiology and Perioperative Medicine.

Dr. Mariano opened the retreat by reviewing the Service’s current mission, vision, and strategic plan. He also provided relevant context related to upcoming challenges facing VA, the specialty of anesthesiology, and healthcare in general. The Service’s activities in all four priority areas – Clinical Care, Education, Scholarship, and Leadership – have been expanding in volume and complexity. Dr. Mariano presented the concept that design thinking, process improvement, and medical training in diagnosis and treatment are closely aligned. Compared to published estimates of 17 years to change clinical practice, the Anesthesiology and Perioperative Care Service has successfully demonstrated the ability to rapidly implement clinical practice change and sustain these changes long-term. Brainstorming sessions in the morning and afternoon moderated by Drs. Walters, Harrison, and Howard generated some interesting ideas for future goals and projects.

Ramon Imai, Chief of Respiratory Therapy (RT), and Elayne Rodriguez, RT Clinical Supervisor, presented an update of activities involving RT. We currently have a couple of exciting collaborative projects involving RT and anesthesiology related to improving positive airway pressure therapy for patients with obstructive sleep apnea in the perioperative period and beyond.

As a special treat, Arek Melkonian, a student in Stanford’s Medical Scientist Training Program, presented a guest lecture on etymology related to anesthesia, pain management, and cardiac and respiratory physiology. Mr. Melkonian currently teaches a medical school seminar on medical etymology and regularly posts blogs covering etymology and history on his website.

We ended the day with a hands-on point-of-care ultrasound workshop organized by Dr. Carlos Brun and Cynthia Shum. Dr. Brun presented some bedside ultrasound applications for anesthesiologists including transthoracic echocardiography, lung examination, and gastric volume assessment. Our Service recently increased our inventory of handheld portable ultrasound devices to allow each anesthesiologist with a clinical assignment to check one out per day. We envision ultrasound becoming a routine diagnostic and evaluation tool for the future anesthesiologist and perioperative physician and plan to train all of our physicians in this imaging modality.

New SAVE Volunteer Program through VAPAHCS Simulation Center

SimLab volunteers with dummy patient The first VAPAHCS simulation center student volunteer program, Student Anesthesiology Volunteer Educators (SAVE), began this past summer. The SAVE program was designed to give student volunteers an opportunity to explore the field of healthcare and gain knowledge in the use of simulation-based education. During this inaugural summer program, the students participated in numerous opportunities including:

  • Formal education and training in simulation methods
  • Participation as standardized patients in simulation scenarios
  • Set-up and operation of simulation equipment
  • Clinical observation rotations in multiple services and units
  • Simulation instruction and debriefing with student volunteers from other departments
  • Individual projects on an identified area of interest within healthcare and simulation

SAVE has been a highly rewarding program. In addition to providing extra help in the simulation center, the volunteers have shed light on untapped resources and have brought a new energy to the center. I look forward to continuing to work with student volunteers in the coming years and expanding the depth and breadth of the program. Some of the students have even committed to volunteering during the school year. Word seems to be spreading since I have already been contacted by other interested students! Stay tuned for more news from SAVE.

Cynthia Shum, DNP, MEd, RN, CHSE-A

Dr. Sesh Mudumbai Receives New Grant to Study Risks of Opioids

The Food and Drug Administration (FDA) has asked multiple researchers across 4 major healthcare systems (VHA, Kaiser Permanente, Group Health, and Clinical Director’s Network) to examine the risks of opioid use. Dr. Mudumbai is principal investigator for the VHA for FDA PMR Study 1 A (3033-1A): "A prospective investigation of the risks of opioid misuse, abuse, and addiction among patients treated with extended-release/long acting (ER/LA) opioids for the treatment of chronic pain.” The study will provide quantitative estimates of the serious risks of misuse, abuse, addiction, overdose, and death associated with ER/LA opioid use. The primary objective of FDA PMR Study 1A is to quantify these risks using both prospective and cross-sectional methods involving electronic, patient-reported, and genetic data. The project has received funding until 2020.

This is a particularly important and relevant study for VHA patients given the high burden of pain and prevalence of opioid use within the VHA. Prescription opioid misuse continues to represent a public health crisis across the country and especially for the VHA. Recent evidence indicates high rates of mental health disorders such as anxiety, depression, and post-traumatic stress disorder and co-existing high-risk opioid use within Veteran patient populations. Higher levels of opioid use generally may be related to higher rates of overdose, death, suicide, addiction, and other adverse outcomes such as motor vehicle accidents and falls. The results of this study will help inform policies for opioid use for the many VHA patients who take ER/LA opioids on a daily basis.

Congratulations to Dr. Jody Leng, 2016 Teacher of the Year!

Jody Cimbalo Leng At the resident graduation event held on June 18, 2016, for the Stanford Department of Anesthesiology, Perioperative and Pain Medicine, Dr. Jody Leng received the 2016 Teacher of the Year Award. Only one member of the faculty is selected per year among over 200 faculty physicians in the Department. This is an outstanding achievement for Dr. Leng who joined the medical staff of the VA Palo Alto Health Care System in 2014 after completing her fellowship in regional anesthesiology and acute pain medicine at Stanford. You can read Dr. Leng's full biography here.

Promotions to Clinical Assistant Professor

Congratulations to Drs. Megan Olejniczak, Jung Hong, and Milo Lochbaum, staff physician anesthesiologists, on their promotions to Clinical Assistant Professor at Stanford University School of Medicine!

Drs. Hong and Lochbaum joined the medical staff at VA Palo Alto Health Care System in 2013 after developing clinical expertise in private practice. They have been actively involved in resident education as well as clinical pathway improvement for complex patients having surgery. Dr. Olejniczak joined the medical staff in 2014 after completing fellowship in cardiothoracic and vascular anesthesiology fellowship and currently serves as our Director of this clinical subspecialty program at VA Palo Alto.

Read their full biographies.

The latest research article by Dr. Sesh Mudumbai and his team is featured on Forbes!

Anesthesiology Med Student Wins WGEA New Investigator Award

Emily Liu, a second year Stanford medical student under Anesthesiology Service, won the New Investigator Award for her oral presentation at the 2016 WGEA (Western Group on Educational Affairs) conference in Tuscon, AZ.

Her presentation was titled: “Practicing Well: Student Perspectives on a Bioethics and Medical Humanities Scholarly Concentration Program.”

Liu is working on a medical scholars research project under the mentoring of Dr. Audrey Shafer.

Dr. Ed Mariano Receives John D. Chase Award

Congratulations to Dr. Howard!

Dr. Steven Howard has been appointed to the Field Advisory Committee (FAC) for the VA National Anesthesia Service. In his role with this national level committee, Dr. Howard will be interacting directly with Dr. John Sum-Ping, the Director of the National Anesthesia Service. Here is a short description of the FAC from the VA Handbook:

The Field Advisory Committee, composed of four to eight field-based VA-employed Anesthesiologists and CRNAs, meets annually. It is responsible for providing:

a. Advice and recommendations to the National Anesthesia Service Director regarding:

(1) Program development,
(2) New clinical techniques and procedures,
(3) Clinical policy, and
(4) Program performance for anesthesia care.

b. Feedback on matters of importance to field-based practitioners.

To read more about Dr. Howard, please see his bio on our website.

Congratulations to Dr. Larry Siegel and Dr. Howard!

Congratulations to Dr. Larry Siegel who has been promoted to Clinical Professor of Anesthesiology, Perioperative and Pain Medicine effective in September!
Dr. Siegel is a graduate of the Massachusetts Institute for Technology and Harvard Medical School. He did his anesthesiology residency at the University of Pennsylvania and fellowship in cardiothoracic and vascular anesthesiology at Stanford. Before joining the staff at the VA Palo Alto Health Care System, Dr. Siegel served as Chief of Cardiothoracic and Vascular Anesthesiology at Stanford. In addition to his practice dedicated to clinical care, research, and teaching, Dr. Siegel has been actively involved in the world of pharmaceutical and medical device development. You can read more about Dr. Siegel on our website.

Congratulations to Dr. Steve Howard who has been promoted to Professor of Anesthesiology, Perioperative and Pain Medicine in the Medical Center Line!
Dr. Howard is a Northern California native. He ventured south to receive his undergraduate degree from UC Santa Barbara then to the midwest to earn his MD from Chicago Medical School before returning to Northern California for anesthesiology residency at Stanford. He is Co-Director of the VA Palo Alto simulation center, the west coast training site for the VA's national simulation program, SimLEARN. He serves as Director of our Service's Clinical Research program, and his research interests have included simulation as an educational intervention, fatigue and performance in health care personnel, cognitive aids for crisis management, and advanced techniques for perioperative pain control. You can read more about Dr. Howard on our website.

More News from the Service

Dr. Ed Bertaccini has been awarded a $50,000 grant from the Stanford Innovation Program through Stanford’s Office of Technology and Licensing to further pursue the development of a new class of anesthetic agents. You can read more about Dr. Bertaccini on our website.

Dr. Kyle Harrison has just been appointed to serve as the first Chair of the Clinical Assistant Professor Appointments and Promotions Committee for Stanford University School of Medicine. This committee will oversee the appointments and promotions to assistant professor for clinician educators across all departments of the school of medicine and affiliated institutions. You can read more about Dr. Harrison on our website.

Last but definitely not least, I am so happy to welcome back our anesthesia technician, Mike Buenaflor, who has been deployed with the Navy for nearly a year. We have missed having him here, but I know his family has missed him more.

Congratulations to Drs. Bertaccini and Harrison and welcome back Mike!

Dr. Peter Barelka Wins Excellence in Teaching Award

Peter Barelka Please congratulate Dr. Peter Barelka for winning the 2015 Excellence in Teaching Award from the Division of Pain Medicine at Stanford. This award originated over a decade ago, and the recipient is selected by the pain medicine fellows from a large group of outstanding educators who take part in the Stanford pain medicine fellowship program. This ACGME-accredited fellowship program focuses on comprehensive, interdisciplinary, collaborative training in and treatment of acute, chronic, and cancer pain. Fellows learn and practice the medical, interventional, physical and behavioral aspects of pain medicine so that upon graduation, they will be successful pain medicine physicians in both academic and community practices.

For those of you who may not know, Dr. Barelka is also a Veteran who currently serves our Veterans as a pain medicine specialist and anesthesiologist. Congratulations, Dr. Barelka! To read more about his education and accomplishments, please see his bio on our website.

2015 Anesthesiology Faculty Development Retreat

On July 14, 2015, we held the fourth annual one-day off-site faculty development retreat for the VA Palo Alto Anesthesiology and Perioperative Care Service physicians to discuss the topic: “How People See Anesthesiology and Anesthesiologists: Public Perception and Professional Reputation.”
Participants of the 2015 Anesthesiology Faculty Development Retreat

Congratulations Dr. Ed Bertaccini on "Best Abstract"

Please join us in congratulating Dr. Ed Bertaccini whose scientific abstract "Molecular Modeling Leads to a New Class of Intravenous Anesthetics" was selected for oral presentation in the Best of Abstracts (Basic Science) session at the upcoming American Society of Anesthesiologists (ASA) annual meeting to be held in San Diego this October. The ASA annual meeting is the premier anesthesiology-focused scientific conference, attracting approximately 20,000 attendees from around the world. Dr. Bertaccini's abstract is one of 12 that were selected for this session out of a pool of 1400 submissions based on its scientific rigor and broad implications for the practice of anesthesiology.

Two Physician Anesthesiologists Receive 2015 Department of Medicine Chief Residents Award

Congratulations to Drs. Geoff Lighthall and Kyle Harrison, who received this year's Chief Residents Award from the Department of Medicine. This award from the Chief Residents is given to faculty outside the Department of Medicine who have demonstrated an outstanding contribution to medical resident education.

Drs. Lighthall and Harrison were recognized for their work on the development and teaching of monthly courses to the medical residents on leadership and teamwork during cardiac arrest situations (the "SOS" course) and the management of other medical emergencies in critically ill patients (the "SCARED" course).

This is the second year in a row that VA Palo Alto Anesthesiology and Perioperative Care staff have received the Chief Residents Award from the Department of Medicine (Dr. Carlos Brun, 2014). We are very grateful to the residents of the Department of Medicine for recognizing our staff physicians for their dedication to teaching and look forward to more opportunities to collaborate and innovate.

To read more about our staff anesthesiologists, visit the Anesthesiology & Perioperative Care Service website

Congratulations to Drs. Wagner and Lochbaum, Winners of the 13th Annual Stanford Anesthesiology Department Golf Tournament!

On April 4, 2015, a beautiful day at Stanford University Golf Course, Drs. Michael Wagner and Milo Lochbaum (staff anesthesiologists at VA Palo Alto Health Care System) along with their two teammates squared off against six other rival teams from the Department of Anesthesiology, Perioperative and Pain Medicine.

Although the competition was fierce, the VA Palo Alto team led by Drs. Wagner and Lochbaum was triumphant with a final score of 61 (9 under par). Each member of the winning team received a commemorative trophy of a golfer swinging a golf club that stands nearly a foot tall with the inscription “Stanford Anesthesia Golf Scramble 2015 Champion.”

VAPAHCS Drs. Wagner and Lochbaum and their two teammates holding a golf trophy, smiling into the camera

Congratulations to Dr. Nate Kelly, Clinical Assistant Professor!

April 22, 2015 - Congratulations to Dr. Nate Kelly who was just promoted to Clinical Assistant Professor of Anesthesiology, Perioperative and Pain Medicine!

Dr. Kelly joined the Anesthesiology and Perioperative Care Service staff in 2010 and serves as Director of the Cardiothoracic and Vascular Anesthesiology program. In the past few years, Dr. Kelly has been recognized for his excellence in teaching by the Stanford anesthesiology residents, and under his leadership the clinical cardiothoracic and vascular anesthesiology program has grown to provide life-saving care to critically-ill patients receiving care in the operating rooms and interventional cardiology suites. He is board-certified in anesthesiology and perioperative echocardiography.

Read about Dr. Kelly and the rest of our staff on our website.

Read the latest blog by by Dr. Ed Mariano, Chief of Anesthesiology and Perioperative Care at VAPAHCS: 5 Tips for Future Physician Leaders.

Funding for Women Veterans Pain Clinic Approved

Congratulations to Erica Stary, MD, and her colleagues, Elizabeth Manning, PhD, and Jennifer Lee, MD, PhD, whose innovative proposal was accepted for funding by the Office of Women's Health Services! Their project "Comprehensive, Multidisciplinary Clinic for the Treatment of Chronic Musculoskeletal Pain in Aging Women Veterans" aims to establish a comprehensive pain clinic where an integrated, multi-specialty team provides effective and patient-centered treatment for aging women Veterans with chronic musculoskeletal pain. According to Dr. Stary, "This clinic will incorporate medical and pharmacologic support, psychological interventions, physical therapy, patient-centered group classes, health coaching, patient education, and complementary and alternative medicine modalities. This initiative establishes a unique and efficient model of health care delivery for such patients, allowing us to further meet a critical need within our healthcare system. Our careful approach to developing, evaluating, and refining the model is expected to increase its suitability for future sharing with other Veterans Health Administration hospitals.

Congratulations to Dr. Carlos Brun

Congratulations to Dr. Carlos Brun who was just promoted to Clinical Assistant Professor of Anesthesiology, Perioperative and Pain Medicine!

In the past two years, Dr. Brun has received the Teacher of the Year Award from the Department of Anesthesiology, Perioperative and Pain Medicine and the Chief Residents’ Award from the Department of Medicine.

Read about Dr. Brun and the rest of our staff on our website.

Third Annual Anesthesiology and Perioperative Care Service Faculty Development Retreat

Members of the Anesthesiology and Perioperative Care Service On July 15, 2014, the Crowne Plaza Cabana Hotel was the site of the third annual faculty development retreat for the Anesthesiology and Perioperative Care Service. This year the retreat was organized by Drs. Tessa Walters, Kyle Harrison, and Ed Mariano, and guests included Drs. Geoffrey Abrams from Orthopedic Surgery and Dan Eisenberg from General Surgery. The major theme of the retreat was Enhancing Recovery after Surgery (ERAS) and the Perioperative Surgical Home (PSH). This event emphasizes the ongoing commitment of our Service to increase collaboration with other clinical services and continually improve the care of our Veteran patients.


Congratulations to Dr. Eddie Kim who was recently promoted to Clinical Assistant Professor!

July 16, 2014 - Since joining the Anesthesiology and Perioperative Care Service staff as Director of Acute Pain Medicine and Regional Anesthesiology in 2010, Dr. Kim has led tremendous change in the way we manage patients’ perioperative pain. His introduction of continuous nerve blocks using local anesthetics has decreased patients’ dependence on opioid pain medications after surgery, and his leadership in hospital fall prevention demonstrates his ongoing commitment to patient safety. He has received a Teaching Scholar award from the Stanford Department of Anesthesiology, Perioperative and Pain Medicine for his basic ultrasound curriculum for new residents and nationally recognized as annual meeting faculty for the American Society of Regional Anesthesia and Pain Medicine (ASRA).

Third Annual Arts and Anesthesia Soiree

June 20, 2014 - The 3rd Annual Arts and Anesthesia Soiree hosted by the Stanford Department of Anesthesiology, Perioperative and Pain Medicine on May 28, 2014 featured works and performances by members of the VAPAHCS Anesthesiology and Perioperative Care Service. The event is designed to encourage community and connection throughout the department via the arts. VAPAHCS contributions included photography by Dr. Ed Mariano, Service Chief, and Dr. Jack Kan, alumnus attending, fellow and resident; artwork by Sarah and Hannah Hammons (daughters of Ana Hammons, Administrative Officer); a poem by Dr. Audrey Shafer, staff anesthesiologist; and chamber pieces by staff anesthesiologist Dr. Tessa Walters, her husband Dr. Mike MacAvoy, and their daughters.

Photos and art exhibits A woman and four girls playing the violin

Click images to see large version

Congratulations, Dr. Brun!

June 13, 2014 - Tonight, our very own Dr. Carlos Brun will be honored by the residents of the Department of Medicine at their graduation ceremony.

In the words of Chief Resident, Dr. Ilana Richman:
“The award we're giving is called the Chief Residents' Award, which is given every year to a person outside the Department of Medicine who has made a significant contribution to the internal medicine residents' education.”

Please join me in congratulating Carlos!

Congratulations, Dr. Hong!

June 17, 2014 - Dr. Jung Hong has been selected as one of the upcoming academic year’s Faculty Teaching Scholars for his project entitled “Basic Guideline for Private Practice — Practice Management Curriculum.” A limited number of Scholars and projects are selected each year from the pool of faculty in the Department of Anesthesiology, Perioperative and Pain Medicine at Stanford.

Annual Symposium of Stanford Medicine and Muse Program

May 2, 2014 - Over 400 people attended the annual symposium of the Stanford Medicine and the Muse Program, directed by Dr. Audrey Shafer, on April 16, 2014. The event featured medical student presentations, performances and art, and a conversation with physician-author Khaled Hosseini, whose works include The Kite Runner. The event was covered by Stanford Scopeblog and The Stanford Daily.

Stanford medical student Grace Xiong presents a surprise award to Dr. Audrey Shafer to express appreciation from the medical students for founding the symposium.
Stanford medical student Grace Xiong presents a surprise award to Dr. Audrey Shafer to express appreciation from the medical students for founding the symposium.


Physicians specializing in the patient experience - a blog by Dr. Ed Mariano



Chicago Spring Annual Meeting Awards

Spring Annual Meeting in Chicago

April 22, 2014 - Our Anesthesiology faculty at the VA Palo Alto had a very strong presence at the American Society of Regional Anesthesia and Pain Medicine Spring Annual Meeting in Chicago this April 2014. One of our abstracts was selected for oral presentation as 1 of 3 Best of Meeting Abstracts for the second year in a row and was presented by our research assistant, Toni Ganaway. Another abstract was selected as 1 of 3 Best Abstracts by a Resident or Fellow and was presented by Dr. Mike Rasmussen.

Our other two abstract submissions were accepted for moderated poster discussion sessions. Drs. Steve Howard, Kyle Harrison, and Ankeet Udani, and simulation nurse educator Cynthia Shum conducted their Crisis Management for the Regional Anesthesiologist Workshop again this year. Drs. Eddie Kim and Ed Mariano also represented VA Palo Alto as ASRA meeting faculty, teaching workshops and moderating poster discussions.

Participants of the Crisis Management for the Regional Anesthesiologist Workshop

Dr. Steven Howard new Chair of Anesthesia Patient Safety Foundation's Scientific Evaluation Committee

Oct 4, 2013 - Big news! Our very own Dr. Steven Howard has been announced as the new Chair of the Anesthesia Patient Safety Foundation's Scientific Evaluation Committee!
See announcement >>

Dr. Kyle Harrison promoted to rank of Clinical Associate Professor at Stanford

Sep 24, 2013 - Dr. Kyle Harrison was promoted to the rank of Clinical Associate Professor of Anesthesiology, Perioperative and Pain Medicine (Affiliated) at Stanford University School of Medicine. Dr. Harrison has been a staff anesthesiologist at VA Palo Alto since 2003 and is an integral part of the Stanford Anesthesiology residency program, serving as an Associate Residency Program Director. He is also a member of our internationally-recognized simulation team.

The most significant news from the Anesthesiology and Perioperative Care Service at the VA Palo Alto is that we had our second annual faculty development retreat on July 22, 2013, at the Li Ka Shing Center on Stanford campus. Continuing the theme of faculty development from last year's retreat and the mid-year retreat focused on the perioperative surgical home, this year's retreat operationalized the concept of "teaching the teachers." Many many thanks go to Drs. Carlos Brun, Allegra Lobell, and Steve Howard for their hard work organizing this year's event which opened with guest lectures by Drs. Alex Macario and Larry Chu and featured hands-on interactive workshops on transthoracic echocardiography with live models and high-fidelity simulators, a crisis management simulation session, and updates from section leaders on various specialties that make up the Anesthesiology and Perioperative Care Service.

Dr. Larry Chu, one of our guest speakers
Dr. Larry Chu, one of our guest speakers.

Dr. Carlos Brun teaches bedside echocardiography
Dr. Carlos Brun teaches bedside echocardiography.

Dr. Edward J. Bertaccini, Cardiac Anesthesiologist and Intensive Care Specialist, has been promoted to Professor within the Medical Center Line Professoriate of the Stanford University School of Medicine

July 10, 2013 - Dr. Bertaccini is a native of San Jose, California. He is a descendant of a long line of teachers in the San Francisco Bay Area and is proud to carry on the family tradition of educators with this new promotion. He is a Cardinal Bellarmine Award-winning graduate of Bellarmine College Preparatory in San Jose. He completed his undergraduate training in Biochemistry and Quantum Physics at the University of California, Davis, where he graduated Summa Cum Laude. He subsequently attended the St. Louis University School of Medicine in St. Louis, MO.

Dr. Bertaccini returned home to complete his internship at the Santa Clara Valley Medical Center, and finally joined the Stanford community for his anesthesiology residency with subsequent critical care medicine fellowship. This was particularly meaningful to him since he was originally accepted to Stanford University as an undergraduate student but could not afford to attend. Upon completion of his training in 1994, he joined the faculty at the Stanford University School of Medicine Department of Anesthesia and clinical staff at the VA Palo Alto Health Care System (VAPAHCS), serving Veterans, as an anesthesiologist and critical care medicine specialist and continues this dedication to clinical care today.

Now a Stanford Professor, Dr. Bertaccini maintains an internationally-recognized research program in the molecular modeling of anesthetic action. He hopes to further enhance our understanding of how anesthetics work, possibly design new anesthetics for patients, and shed light on the nature of human consciousness itself. In his years of service to VAPAHCS, he has served as both the director of the operating room and the acting co-director of the intensive care unit. His clinical efforts have played an integral part of teams that have achieved national recognition for both cardiac surgery as well as intensive care outcomes. Over the last 20 years, he considers himself very fortunate to have been involved in the education of hundreds of medical students and residents in the fields of anesthesiology, medicine and surgery, as well as to have been honored to care for thousands of America's Veteran heroes.

Dr. Edward Bertaccini meets with Admiral Mike Mullins
Dr. Edward Bertaccini meets with Admiral Mike Mullins, Chairman of the Joint Chiefs of Staff, at the Palo Alto VA Hospital on September 23, 2008.

Dr. Carlos Brun Receives Teacher of the Year Award

June 17, 2013 - Dr. Carlos Brun received the Teacher of the Year Award from the Stanford Department of Anesthesiology, Perioperative and Pain Medicine this past weekend. The announcement was made at the graduation ceremony for the Stanford Anesthesiology residents, and one attending anesthesiologist is selected per year by the graduating class. This is truly a remarkable achievement by Dr. Brun who only joined our staff at VAPAHCS in 2011 and was chosen among over 200 Stanford anesthesiology faculty including affiliates. He is a rising star in the Anesthesiology and Perioperative Care Service at VAPAHCS, serving as a staff anesthesiologist and critical care physician as well as Associate Medical Director of our Intensive Care Unit.

Miscellaneous Honors and Awards

May 6, 2013 - The VA Palo Alto Anesthesiology and Perioperative Care Service had a busy weekend at national and international conferences. Dr. David M. Gaba was honored at the 2013 International Anesthesia Research Society's Annual Meeting in San Diego as the Dr. T.H. Seldon Memorial Lecturer. The topic of his talk was: "Simulation -- another (unsung) gift to medicine from anesthesiology."

At the 2013 American Society of Regional Anesthesia and Pain Medicine (ASRA) Spring Annual Meeting in Boston, Ms. Cynthia Shum and Drs. Steve Howard, Edward Kim and Kyle Harrison provided their teaching expertise to innovative workshop and lecture sessions. Stanford anesthesiology resident, Dr. Ankeet Udani, was honored as the ASRA Resident of the Year. Stanford Regional Anesthesia and Acute Pain Medicine fellow, Dr. Justin Workman, presented one of the three "Best of Meeting" abstracts on the topic: "Replacing continuous femoral nerve blocks with continuous adductor canal blocks within a clinical pathway for total knee arthroplasty: a case-control study of postoperative ambulation."

Pictured below (from left to right): Dr. Steve Howard, Dr. Michael Mulroy (Virginia Mason), Dr. Kyle Harrison, Dr. Lisa Warren (Massachusetts General Hospital), Ms. Cynthia Shum, Dr. Guy Weinberg (University of Illinois, Chicago).

Dr. Steve Howard, Dr. Michael Mulroy (Virginia Mason), Dr. Kyle Harrison, Dr. Lisa Warren (Massachusetts General Hospital), Ms. Cynthia Shum, Dr. Guy Weinberg (University of Illinois, Chicago)

Dr. Ankeet Udani Awarded Research Fellowship Grant

April 29, 2013 - Dr. Ankeet Udani, CA-3 anesthesia resident and Fellow in Stanford’s Anesthesia and Research in Medicine (FARM) program, was awarded a Research Fellowship Grant from the Foundation for Anesthesia Education and Research titled: "The effectiveness of simulation-based deliberate practice versus a standard didactic curriculum on learning regional anesthesia."

The aim of his group's study is to determine the efficacy of simulation-based deliberate practice on novice residents’ performance of ultrasound-guided peripheral nerve blocks. Deliberate practice training entails 1) focused and repetitive practice, 2) informative realtime feedback, 3) precise measurements of performance, 4) a motivated learner, and 5) well-defined learning objectives. They hypothesize that simulation-based deliberate practice will significantly increase resident assessment scores and self-confidence in performing ultrasound-guided peripheral nerve blocks versus a standard didactic curriculum. Future deliberate practice studies will translate its impact on clinical performance and patient safety, and detail cognitive characteristics of practitioners who benefit most from it.

Mentors: Dr. Steve Howard, Dr. David Gaba, Dr. Edward Mariano, Dr. Clarence Braddock, and Dr. Kelley Skeff
Mentors: Dr. Steve Howard, Dr. David Gaba, Dr. Edward Mariano, Dr. Clarence Braddock, and Dr. Kelley Skeff

Dr. Mudumbai Awarded Best in Category Award

At the 2012 International Anesthesia Research Society meeting held in Boston, MA, May 18-21, 2012, Dr. Mudumbai was awarded a Best in Category award for his study entitled, "Epidemiology and Risks of Transfusion among Different Age Strata in ICU Patients." Dr. Mudumbai was the first author for a group that included a multi-disciplinary set of physicians and researchers from VA Palo Alto and VA San Francisco. His mentor on this study was Dr. Todd Wagner of VA Palo Alto’s Health Economics Resource Center (HERC).

The objective of this study was to determine whether intensive care unit (ICU) patients over age 80 had decreased survival at one-year after receipt of packed red blood cell (PRBC) transfusions. The risk of PRBC transfusions for the elderly VA patient is an urgent question because there is data indicating that the elderly as a group have a disproportionately high rate of PRBC transfusions. Furthermore, the proportion of the very old - age over 80 years - among ICU patients is expected to dramatically increase. The results of this study indicate that age is not an independent risk factor for reduced survival associated with PRBC transfusions and should not preclude PRBC transfusions in ICU patients' age over 80 years.

First Annual Faculty Development Retreat

On July 25, 2012, faculty from the Anesthesiology and Perioperative Care Service engaged in their first annual faculty development retreat held at the Crowne Plaza Cabana Hotel in Palo Alto, CA. Drs. Richard Mazze, Edward Mariano, and Steve Howard organized the event that was titled “Defining a Successful Academic Career and Achieving It.”

The genesis of the retreat developed after many discussions about how to mentor “junior” faculty members early in their academic career. Successful leaders from the VA and Stanford participated in the event by engaging current VA anesthesiologists in discussions about how to achieve clinical, research, education and leadership success in an academic environment. Other than the organizers, guest speakers included: Drs. Frank Sarnquist, David Gaba, Kevin Fish, Brendan Carvalho, and Stephen Ezeji-Okoye, the Deputy Chief of Staff for VA Palo Alto Health Care System.

The majority of VA faculty were able to participate in the gathering which was uniformly enjoyed by the participants. Thanks go to the faculty and per diem anesthesiologists who took care of the clinical work on the day of the retreat.

We look forward to hosting more of these types of events on a regular basis.

Some photos of the event:

Anesthesiology Team at the first annual retreat
From left to right: Dr. Richard Mazze, Dr. Jeffrey Baden, Dr. Kevin Fish, Dr. Audrey Shafer, Dr. Kyle Harrison, Dr. Natasha Funck, Dr. David Gaba, Dr. Sesh Mudumbai, Dr. Geoff Lighthall, Dr. Peter Barelka, Dr. Mike Wagner, Dr. Nate Kelly, Dr. Carlos Brun, Dr. Eddie Kim, Ana Hammons, Dr. Tessa Walters, Dr. Edward Mariano, Dr. Steve Howard

Anesthesiology Chiefs
From left to right: VA Chiefs – Dr. Audrey Shafer, Dr. Richard Mazze, Dr. Jeffrey Baden, Dr. Kevin Fish, Dr. Edward Mariano

Dr. Edward Mariano Awarded FAER Research in Education Grant

August 13, 2012 - Dr. Edward Mariano, Chief of the Anesthesiology and Perioperative Care Service, was awarded a Research in Education Grant from the Foundation for Anesthesia Education and Research titled: "An Efficacy Study of Simulation-based Training on Practicing Anesthesiologists’ Acquisition of Ultrasound-Guided Perineural Catheter Insertion Skills."

The study will determine the efficacy of conventional training methods (e.g., didactic lectures and model scanning) and immersive learning (e.g., hybrid simulation) in teaching ultrasound-guided perineural catheter insertion to anesthesiologists in practice without prior formal regional anesthesia training.

Since anesthesiologists are rarely studied after the end of residency training, we hope this methodology will be a model for the introduction of new techniques and technologies throughout the career of the practicing anesthesiologist.

For this IRB-approved study, we will recruit 32 board-certified anesthesiologists who have been in practice for more than 10 years. Surveys and interviews will be used to assess experience with perineural catheter placement before and after receiving standardized curricula. Routine follow-up will occur for 12 months after training to assess successful implementation and barriers to instituting perineural catheter insertion into clinical practice.

Mentor: Dr. Steve Howard; Collaborators: Dr. Edward Kim, Dr. Kyle Harrison, Dr. Jack Kan; Research Assistant: Toni Ganaway.

Congratulations to Dr. Carlos Brun

Dr. Carlos Brun was selected by the Stanford Anesthesia residents as Faculty Teacher of the Month from over 100 department faculty. He joins Dr. Nate Kelly as our second VA Palo Alto anesthesiologist to win this award since its inception four months ago.

Dr. Brun joined the Anesthesiology and Perioperative Care Service in July of last year after completing his residency in anesthesiology. Prior to his anesthesiology training, Dr. Brun had already completed internal medicine residency and critical care medicine fellowship; so despite being a “new grad,” Dr. Brun is now eligible for board certification in his third medical specialty! His unique combination of skills make him an extremely well-rounded perioperative physician, caring for our Veteran patients before, during, and after surgery in the intensive care unit or on the wards, and his enthusiasm for teaching has already left a big impression on the Stanford residents. In their own words:

"He has an evidence-based answer to every question I've ever asked of him, from the kinetics of remifentanil to how fast we should run to an E-team. Despite his great breadth of anesthesia and intensive care knowledge, he always treats residents with respect and gives us ownership of our anesthetic plans. He is very detail-oriented and inspires me to be a better, more vigilant, more well-read anesthesiologist. ...I have never met anyone in the hospital who was not a fan of Carlos Brun."

"I learned more from him in one day than most attendings in one month."

25-Year Service Award for Ana Hammons

On February 17, 2012, Ana Hammons received her 25-year service award at the Director's Staff Meeting. Ana was joined by her two daughters, her sister, and many friends and fans. She has been the Administrative Officer in the Anesthesiology Service since 1994 and continues to be a leader, advocate, and resource for staff throughout the health care system. Read Ana's full biography.

Anesthesia group photo

Congratulations to Dr. Richard Mazze

...for his many years of service to the VA Palo Alto Health Care System. The entire operating room staff and long-time friends and colleagues celebrated the conclusion of Dr. Mazze's clinical work on October 19, 2011.

Anesthesia group photo
Pictured are (from left to right): Dr. Audrey Shafer, Dr. Richard Mazze, Ana Hammons, Dr. Kevin Fish, and Dr. Edward Mariano, Chief of the Anesthesiology and Perioperative Care Service.

Dr. Nate Kelly Recognized as Outstanding Teacher

Congratulations to Dr. Nate Kelly for being selected by the Stanford Anesthesia residents as the first Teacher of the Month from over 100 department faculty.

“Dr. Kelly joined us last year in the Anesthesiology and Perioperative Care Service, following the completion of his cardiothoracic anesthesiology fellowship. Since that time, Dr. Kelly has established himself as a superb clinician and educator with special expertise in perioperative echocardiography,” said Dr. Edward Mariano, Chief, Anesthesiology and Perioperative Care Service.

Here are some of the comments from the announcement by the Chief Residents:

"Nate Kelly consistently goes the extra mile just because of his passion for teaching residents and improving their experience in working with him. Even as a relatively junior attending, he somehow manages to strike that elusive balance between competence and easygoing demeanor that every resident is hoping for when they see their assignment for the next day. With Nate, you never feel condescended to or belittled, and you have no reservations about asking a question or speaking up about a concern. But you have the comfort of a safety net; you can also be almost guaranteed that you aren't going to be allowed to do anything dangerous to your patient, and if a correction or criticism is to be levied, it will be with a gentle and constructive tone, without any hint of panic or annoyance. He is hard to stump when it comes to questions in the OR, but the things he can't quote off the top of his head become points for learning and exploration, not areas of defensiveness or avoidance. He always makes you feel like your contribution was valued, even if it was your first day as a medical student and you did nothing but grab supplies, and yet always makes you realize you can learn from and improve upon each day's experience. We're lucky to have him as a teacher."

"He keeps a level head, communicates extremely well with all OR members, and represents the best qualities of a team player that we can hope for in residency education."

"Keeps an active presence in the operating room and provides evidence based discussions regarding anesthesia techniques and plans."

"Nate always conveys positive energy... his demeanor encourages an environment of learning and helped me develop confidence in my clinical decisions."

Dr. Carlos Brun Joins Anesthesiology Service Staff

Dr. Carlos Brun was presented with the Resident of the Year award by Dr. Ronald Pearl, chair of the Stanford Department of Anesthesiology at an award and graduation ceremony in June, 2011. This award, voted on by faculty, is given to the most outstanding resident in the department and is an exceedingly high honor in a very competitive field. Dr. Brun, who has trained in Portland Oregon, the Montreal Heart Institute, and Cleveland Clinic, also completed a Critical Care fellowship at Stanford prior to joining the anesthesia residency program. He served as a chief resident for the VAPAHCS Anesthesiology Service during his senior year and we are delighted to welcome him to the Anesthesiology Service as staff anesthesiologist and intensivist.
Dr. Carlos Brun
Pictured is Carlos Brun, MD, staff anesthesiologist, Anesthesiology Service

VAPAHCS Doctor Receives National Award for Excellence

Dr. Gaba and Dr. Robert A. Petzel Department of Veterans Affairs (VA) employee Dr. David M. Gaba was named the first-ever recipient of the Under Secretary for Health’s Award for Excellence in Clinical Simulation Training, Education and Research, and presented with the award at the International Meeting of Simulation in Healthcare in New Orleans on Jan. 24, 2011.

"This award honors individuals who have made a national impact through the direct provision of innovative clinical simulation training, education and research in VA," said VA Under Secretary for Health Dr. Robert A. Petzel. "Dr. Gaba's influence on the skills of clinical staff throughout VA has benefited the millions of Veterans cared for in our health care system."

Dr. Gaba was recognized with the 2011 Excellence in Clinical Simulation Training, Education and Research Practice Award for his numerous contributions to the field of clinical simulation over the past two decades. He created the first modern mannequin-based fully interactive simulator, which has since been commercialized and, along with his curricula, is in use in thousands of simulation training and education programs around the world. He has also conducted ground-breaking research in Crisis Resource Management (CRM) in clinical care settings and has designed CRM-oriented simulation instructor training designed to improve patient safety outcomes.

Gaba is staff anesthesiologist at the VA Palo Alto Health Care System and Associate Dean for Immersive and Simulation-based Learning and Director of the Center for Immersive and Simulation Based Learning (CISL) at Stanford University School of Medicine in California. He is also editor-in-chief of "Simulation in Healthcare," the official journal of the Society for Simulation in Healthcare. Read News Story>>