Tom Henthorn's Quasi Blog Spot

 

8/20/2013

It’s the end of the summer which means schools start anew.  For our department it is great to see a large number of of fresh, eager faces.  In addition to our new sRNAs (Amy Balmforth, Ashley Billing and Sara Sheets) we have our first class entering the AA school (Brandon Way, Dylan Hartley, Laura Knoblauch, Tyler Twardoski, William Thompson, Talia Cozzetta, Kelly Maas, and David Mitchell).

 

Congratulations to Stephanie May for taking first place in the poster session at this year’s AANA annual meeting in Las Vegas held last week.  This is impressive not only because there were over 70 other posters, but I believe this was Stephanie’s first ever poster presentation.  Below is shot of it with the big blue ribbon attached.  That’s not all the news from LV.  Stephanie also was awarded the National Advocate of the Year.  It’s really great to see excellence from our department so prominently displayed.

 

The current homepage of CU Denver | AMC features an article about an exciting new project from our clinical pharmacology group led by Uwe Christians.  This business/academic venture has taken a huge amount of work from a number of our faculty and administrative staff.  As the article points out, it’s now ready to go ‘prime time’.  Check it out and share the glow of accomplishment.

http://www.ucdenver.edu/about/WhoWeAre/spotlight/faculty/Pages/CU-Toxicology-creates-better-drug-test.aspx

 

 

 

8/6/2013

Today, Brian Davidson gave a presentation on our new Epic-linked adverse event reporting system at UCH’s Clinical Effectiveness and Patient Safety meeting.  More than two dozen key leaders from the hospital’s clinical operations were in attendance (they really care about this stuff), including the CEO (John Harney) and the Director of Risk Management (Sue West).  The presentation and the reaction to it were quite impressive from a number of standpoints.  First and foremost, everyone was astounded that we have 60% quality reporting on all of our cases in the database since inception.  This is a testament to the dedication of our providers to quality and safety.  Hats off to all of you for clicking the Quality button and entering data, even when nothing untoward happened.  It was also a testament to the simplicity and effectiveness of the IT tool that Bob Phelps and Ken Bullard built.  Finally, in just the couple of months this program has been in effect, Brian was able to give examples of how it has directly led to quality and safety improvements and how it has provided fertile ground for great topics for our departmental M&M conferences.  These conferences will increasingly become the mechanism by which practice standards are set and our performance is reported.  So, if you want to see what your ‘clicking’ of the Quality button on the Epic record results in, plan on attending M&M.

 

7/26/2013

University of Colorado Health, North, had their Epic go-live earlier this month.  North signifies Poudre Valley Hospital, Medical Center of the Rockies (Loveland), and various clinics and surgicenters in that area (by the way, UCH is now known as ‘Central’).  On completion, the entire system will be running virtually the same version of Epic so that patient records will be available system-wide.  South (Memorial in Colorado Springs) will go-live in November.

 

Not unexpectedly, the Epic anesthesiology module is one of the most complex and detailed portions of Epic.  Also expected, the anesthesia go-live was the smoothest and the ORs experienced the least workflow slowdown across the North hospitals.  The main reasons for this success are the great design of the Epic anesthesia module made possible by the input of our physicians and CRNAs, the coding of these design elements by Ken Bullard and Bob Phelps, and the tremendous instruction and go-live assistance and leadership provided by ‘Central’s’ super-users Leslie Jameson, Jacqueline Vasquez and Julie Negin.

 

This did not go unnoticed.  Here’s a photo from North’s newsletter, showing Leslie instructing Dr. Kelli Weiner (one of CU’s residency grads from the 1990’s) who is on the Board of Directors of Northern Colorado Anesthesia Professionals.  I received further go-live kudos last weekend during the Courage Classic from Drs. Bill Neff (Chief Medical Officer for the entire University of Colorado Health system) and Julio Salimbeni (Medical Director of PVH ORs and whose son ‘A.J.’ works as an orderly in our PACU); both of who further pointed out the tremendous help of Jacqueline and Julie.

 

For those interested, University of Colorado Health sponsors a team at the Courage Classic (3 day fund-raising bike tour in-and-around Summit County for CHCO) and we’re looking for more participation from ‘Central’ next year; A.J. and I were the only ones this year, so I’ll be sure to put the word out next spring.  To be fair there are other teams that our faculty and residents rode for this year.  It was great to see that Mario Villasenor, Glenn Merritt, Mark Twite, Richard Ing as well as Tom and Prairie Robinson were out there supporting their respective teams for the benefit of Children’s Hospital Foundation.

 

7/23/2013

The July issue of Anesthesiology has featured articles that touch on the activities of our faculty.  In an article highlighted as “This month in Anesthesiology” Ludmilla Khailova, a PRA in Paul Wischmeyer’s lab, et al., describe their work showing the importance of gut flora (i.e., the microbiome) on sepsis survival in a murine model.

http://journals.lww.com/anesthesiology/Abstract/2013/07000/Probiotic_Administration_Reduces_Mortality_and.28.aspx

Dr. Wischmeyer’s line of research aims to identify whether the diversity of a patient’s gut flora predicts the likelihood of perioperative morbidity and mortality and whether pre-operative replenishment of bacterial diversity could improve outcomes.

 

Several of our faculty are involved in retraining anesthesiologists who have been out of practice for 2 or more years.  The necessity and the associated issues of doing the retraining job well are described in an editorial by Steadman and Cole:

http://journals.lww.com/anesthesiology/Fulltext/2013/07000/Assessing_Competence_for_Reentry__What_Matters.10.aspx

In conjunction with CPEP (www.cpepdoc.org) Drs. Adrian Hendrickse, Marina Shindell and Gee Mei Tan are using the simulation lab for assessing skills and clinical management of anesthesiologists interested in reentry to active practice.  This aspect is well described in the featured article of a NYC reentry program by DeMaria et al.,

http://journals.lww.com/anesthesiology/Abstract/2013/07000/Simulation_based_Assessment_and_Retraining_for_the.35.aspx

Drs. Leslie Jameson, Alison Brainard and M.G. Lemley have taken the lead positions in putting together the actual clinical training programs for reentry docs along with CPEP (there are currently 2-3 potential reentry candidates in the pipeline).  Our department is the unique position of being a center of excellence for reentry activity partly because one of the leading physician assessment and retraining programs in the country (CPEP) is located in Denver.  An article by members of CPEP (Grace and Korinek), which included our own Lindsay Weitzel as a co-author, is featured in both the editorial and full article linked above.  In addition, the new version of Colorado’s medical practice act includes a provision for a temporary re-training status for physicians that otherwise had a ‘clean’ medical practice prior to their inactivity.  This provision is unique and might attract re-entry physicians to Colorado.

 

7/5/2013

July is the New Year in academic medicine so it feels right to exercise a new year’s resolution to make blog entries on a regular basis.  I saw something very cool in our ORs last week.  The new ‘Quality’ button on the Epic Intra-op electronic medical record (EMR) has scored its first major coup in only its first month of operation.  It seems several of our astute providers had recorded technical issues with certain ventilator settings that resulted in untoward functions, like complete apnea.  These occurrences were flagged via the quality reporting system that was created by Bob Phelps, Brian Davidson and Ken Bullard and lives outside the official EMR.  Our super-technicians (Russ Ingram and Johnny Lawrence) checked out several anesthesia machines.  Johnny then wrote the following email:

 

“The anesthesia machine in room 17 is pulled and is out of service. Jefferey Shoup (of biomedical engineering) came over this morning and took the anesthesia machine to his shop. There is a glitch in some of the anesthesia machines. Thanks again informing everybody.”

 

I’m glad to see that our department is embracing the use of the ‘Quality’ button on the Epic EMR.  By its use we can drive improvement in our processes and make the OR and perioperative care safer.

 

In the July ASA Newsletter three of our faculty are pictured as each having a different take on the proceedings at the ASA Legislative Conference held April 29 –May 3 in Washington.

 

 

3/13/2013

We have some good NIH funding news to report!  Sara Cheng has officially heard that her K23 funding is ‘set in stone’ (Title: Prognostic Risk Score for Post-Discharge VTE in Surgical Oncology Patients).  This marks the first of our own residents to become a junior faculty with us and obtain NIH funding.  This was articulated by the faculty as a strategic goal and to repeat this kind of success on a regular basis.  Thanks to Sara and Paul Wischmeyer for proving this goal was not pie-in-the-sky.

 

Congrats to Karen Jonscher who was awarded a 5-year K25 grant that begins funding immediately.  Karen’s grant exemplifies her unique approaches to proteomic analysis.  She’s working closely with Jed Friedman in the department of pediatrics, but our hope is that these techniques can be applied to research within our department as well.

 

Paco Herson’s R01 entitled, “CaMKII in global cerebral ischemia” received a score placing it in the 1st percentile and will soon be funded.  ‘Soon’ depends on how the country navigates the budget sequestration, however.

 

Holger Eltzschig continues to amaze.  In the past month we learned that his Program Project Grant (PPG) in conjunction with Mike Blackburn and Yang Xia from Houston, investigating adenosine-related mechanisms in a variety of organs, was awarded. This will bring over $700K/yr in direct funding to our department.  PPGs tend to fund at a higher level than R or K grants.  Yang Xia visited our campus from Houston this week and gave a dynamic research seminar on Monday afternoon showing how adenosine may hold the key to successfully treating Sickle Cell Disease (expect even more collaborative grants in this direction).  In addition, Holger learned that his 5th R01, this one examining proton pump inhibitors and renal ischemia, will be funded.  The amount of work it takes to get an R01 is huge.  Getting 5 R01s and a PPG represents a monumental effort and accomplishment.  In addition, many of Holger’s faculty mentees are having funding and publishing success (Eric Clamby, Tobias Eckle, Eoin McNamee, Almut Grenz, and Carole Ahearn to name a few).

 

As you know, departmental resources (time and dollars, mostly from clinical activity) have made these successes possible.  The entire department has permission to pat themselves on the back.  After deservedly patting your back, seek out the investigators for congrats and then give out pats to our administrative grants team (Jeanette Leeser, Sabrina Espinoza and Fanta Kuhlman) who have done yeoman’s work, meeting  many deadlines during an amazing flurry of grant submissions.

 

2/14/2013

Happy Valentine’s Day.  You may have noticed the big white tent to the southeast of the new parking structure at UCH last week.  It was placed there to house (or tent) the ‘Premier’ fundraising gala for the UCH Foundation.  Part of the festivities included appetizers served throughout the magnificent and enormous new ED (however, Dr. Richard Zane kept explaining to the amazed guests that it was just an ‘appropriately sized’ for our current volume).   The Denver Post had a nice article about it, including pictures of folks you may recognize.

http://www.denverpost.com/lifestyles/ci_22584337/premiere-raises-1million-university-hospitals-new-er-tower

 

2/6/2013

We were treated to a great ‘official’ start to the new combined Grand Rounds format.  Dr. Alex Evers, chair at Washington University’s Department of Anesthesiology, delivered a provocative talk on academic anesthesiology culture as well as a (too) short update on the GABA receptor.  If you missed it or, like me, would like to see it again, it’s available here:

mms://essvideo.ucdenver.edu/public/Anesthesia_Grand_Rounds_2_4_13.asf

 

Alex also delivered a fantastic Virtue lecture late in the afternoon on an alternative way of looking at post-operative cognitive function; could there actually be improvement rather than dysfunction?

 

I always get a kick out of the local media when they cover stories right out of our department.  It’s entertaining to see how things that you know very well get digested and then presented to the public.  Plus it’s great to know that what we’re all working hard at is also considered news worthy.  Here’s a nice article from the local paper about Drs. Eltzschig and Grenz, stemming from Holger’s recent NEJM article.

http://www.aurorasentinel.com/news/safer-sugery-cu-med-school-team-looks-at-ways-to-decrease-organ-damage-during-surgical-procedures/

 

1/18/2013

I received the grant application announcement from FAER yesterday.  Most interesting was the categorization of their flagship Mentored Research Training Grant (MTRG) into 3 separate categories: Healthcare Services, Basic Science and Clinical or Translational Research.   The deadline is February 15th.

 

FAER.org/research-grantsThe application website can be found here.

 

That the MTRGs grants lead to NIH funding, as FAER intends, is highlighted in their recent newsletter in an article featuring Tobias Eckle:

 

http://faer.org/news/mrtg-funding-leads-to-nih-grant/

 

Next week is National CRNA Week.  Kristen Van De Velde and her ‘elves’ are planning food events each day of the week as well as signage and posters in all our perioperative sites.  We have an amazing, completely essential cadre of CRNAs that we are proud to have as colleagues.  Let’s help them celebrate.

 

 

1/11/2013

One of the things that chairs fret about is NIH rankings.  How our various departments are ranked affects everything from hospital and medical school stature to recruitment of residents and faculty.  Yet, when I travel the corridors, I don’t hear others in the department asking me what I’m going to do about it.  The new rankings are out, based on 2012 numbers, and we’ve risen to #16 nationally – our first placement in the top 20.  Lot’s of people have put much effort into making this happen, mainly those doing cutting-edge research and writing and submitting grant applications like crazy.  However, I feel that everyone in the Department has contributed by doing important things such as generating clinical income to support our research, attending strategic planning and research retreats, supporting Virtue and FAER scholars, covering the ORs so research faculty can produce data, write and present their work, etc.  We couldn’t do this without everyone pitching in.  Now everyone should share in feeling a little pumped up, especially since the top 10 is within sight.

 

http://www.brimr.org/NIH_Awards/2012/NIH_Awards_2012.htm

 

When we saw the preliminary rankings a couple weeks ago we knew that a lot of our grants were somehow missing.  Fanta Kuhlman and Jeanette Leeser spent many hours with CU’s Grants and Contracts Office and with NIH getting the 60% of our grants that were missing-in-action properly credited.  To use Dick Traystman’s analogy, the bears will eat us if we don’t all row the boat together.  Thanks Fanta and Jeanette for your good hard oar pulls.

 

1/10/2013

Drs. Jason Brainard and Matt Rustici (Dept. of Pediatrics) received a Rymer Grant from the Academy of Medical Educators for the CU SOM. This grant was written so that a 2-week medical student elective could be developed and tested that will focus on critical care and procedural skills training.  A pilot elective is planned for this Spring.  If the course is successful an addition to the SOM curriculum will be proposed to the Dean as part of the formal education for all medical students.

 

The faculty for this elective will include Drs. Azam, Scott, and Sullivan from the ICU group as well as Dr. Ahlgren who will teach be teaching the curriculum on central line placement.

 

While on the subject of our top flight education efforts, we received a letter from the American Board of Anesthesiology just before the Holiday Season informing us that every single CU residency grad taking the 2012 ABA written exam passed, including all our recent grads and a couple who graduated awhile ago.   We used to say back in Chicago that results like these were proof that we were world-class educators; and when not so many passed, it was due to poor resident effort.  Actually, this great news reflects everyone’s focus and hard work.

 

1/4/2013

We recently learned that one of our stellar junior research faculty, Dr. Carol Aherne, received a prestigious Research Scholar Award from the American Gastroenterological Association.  The 3 that got this award last year were from the University of Chicago, MGH, and Northwestern.  This is quite the honor for Carol and will be a big help to our research programs.

 

Hats off to Dr. Susan Mandell.  She has been working steadily for almost a decade to get both UNOS and CMS to recognize that the anesthesiologists taking care of liver transplantation recipients, like surgeons require specialized experience.  Transplant programs now all need a qualified Director of Liver Transplantation Anesthesiology.  Susan just had an article accepted for the journal Liver Transplantation entitled, ‘Director Of Anesthesiology For Liver Transplantation:  Existing Practices And Recommendations By The United Network For Organ Sharing’, which demonstrates that requiring expertise would not unduly hurt transplantation programs.  Seems the opposite should have been the worry.

 

12/31/2012

As we head into the New Year I would like to mention a couple of the accomplishments of our faculty during the last parts of 2012.

 

Dr. Joy Hawkins was selected as one of the nine charter members of the FAER Academy of Education Mentors in Anesthesiology.  The goals of this academy are to:

  1. Generate enhanced education outcomes in anesthesiology.
  2. Promote the science and innovation of education in anesthesiology and perioperative 
medicine.
  3. Spur education mentor training and development.
  4. Provide assistance to anesthesiologists interested in education research.

Congratulations to Joy on this honor.  Being a member of this academy is meant to be the highest honor the specialty can bestow on an educator.  Being the very first to get the honor is something even more special.  Not like we didn’t already know.

 

For those who may have missed the December 13 New England Journal of Medicine there was a review article entitled, ‘Purinergic Signaling during Inflammation’ with Dr. Holger Eltzschig as the lead author:

http://www.nejm.org/doi/full/10.1056/NEJMra1205750

This marks the 3rd NEJM review article for our department in 2 years (to go with those Joy and Holger were invited to submit last year).  I know Denver has been focused on the records set this month by Peyton Manning, but our Department has hit the Anesthesiology record books as well.

 

11/27/2012

Sorry for the long hiatus.  However, it was partly for a good reason.  I had resolved a while back to get help with this blog so that the messages could be at least weekly.  To do this Kirstin Runa and I decided that my next administrative assistant would have writing skills.  Finding someone like that proved harder than it sounds.  Luckily and finally, we found Shannon Swan, who has among other administrative talents, a degree in anthropology (anesthesiologists are her new ‘subjects’).  Going forward, please send suggestions for blog content to Shannon, me, or both of us.  She has promised to keep me ‘on task’.

 

I was glad to see the terrific turnout for Grand Rounds on Monday morning.  I want to give a special shout out to everyone who braved the cold and the lack of provided directions from AO1, RC-2 and UCH to the Mt Oxford auditorium at CHCO.   Linda Watkins graced us with a dazzling, thought-proving presentation early Monday morning.  As was insisted on at the Research Retreat earlier this month and then seconded strongly at the UCH faculty meeting the following week, we will be moving to a Grand Rounds format (aiming for a January launch) that will include all the faculty at the AMC (UCH, CHCO and research) and each one will have some research content, even if only a 10 minute dose.  There are details to be worked out so stay tuned.

 

On the heels of Linda’s great presentation, it is wonderful to announce that her lab (in Boulder) along with Uwe Christians’ lab in our department was awarded a BioFrontiers grant by the State of Colorado’s Bioscience Discovery and Evaluation Grant Program.  The work is designed to move Linda’s exciting pain therapy candidates we heard about on Monday into clinical use.  Initially, Rachael Rzasa Lynn will be devoting much of her research time to this well-funded project.

 

Also of recent research funding note for other junior faculty are Eric Clamby’s American Heart Association grant and Hongyu Xue’s American Society for Parenteral and Enteral Nutrition’s Rhoads Research Foundation Grant.  These are big steps forward for both of them.

 

7/23/2012

The aftermath of the theatre shootings kept on through the weekend with several of the victims making return trips to the OR.  Of course, this also means lots of extraordinary care given in the SICU as well.  Here’s a note of recognition from Dr. Robert McIntyre, the President of the UCH Medical Board, who also spent a lot of time in the hospital this weekend.

 

The inevitable problem with pointing out the contribution of just one or two people in a situation like the one we have had around here for the past three days is that you do not point out the contribution of others (and believe me that everyone contributed). However, I feel compelled to point out the contributions of Matt Rowan and Amanda Wallace this weekend.  Both met with a group of surgery residents that I convened in the SICU very early Friday morning to coordinate efforts and they executed everything superbly. I think Sunday was the busiest ICU day I have experienced in my career. Matt handled it with a smooth confidence and excellent skill. All the patients had great care. And most of all he did it in the midst of the unbelievable circus that occurs when the President visits the ICU.

 

Robert McIntyre, Jr., MD

Professor of Surgery

University of Colorado School of Medicine

 

7/20/2012

I was able to witness firsthand the amazing response to last night’s events.  You hear this all the time; it is awe-inspiring to see everyone from housekeeping, to nurses, to hospital managers, to surgeons all kick it up a notch in terms of collegiality and focus when this sort of thing occurs.  The worst in people also brings out the best in people.

 

Our people were terrific.  I especially want to recognize the efforts of Ferenc Puskas for initiating the ‘mobilization’ and organizing our ‘mob’.  Our call team of John Armstrong, Heidi Green, Marshal Stafford, James Ryan and Jen Mauer were all in top form and beyond.  Also, the ‘responders’ were able to jump right in and do what was needed: kudos to Allison Rocco, Anne Rustemeyer, Matt Fiegel, Jonathan Mayles, and Mary Bidegary.  Jose Melendez also rushed in to help move patients and resources within the hospital to masterly direct the mass casualty situation.

 

I hope we never get a repeat of this sort of tragedy, but it’s good to know we’re ready when it does.

 

7/16/2012

This is my annual message to draw attention to Children’s Hospital’s annual Courage Classic, a bike ride in Summit County that raises money for the Children’s Hospital Foundation.  Again, the two top fund raising teams are the Gears of Courage (mainly healthcare professions from our AMC) and the Wheels of Justice (Denver-based attorneys)  This year, besides joint training rides, Dan Hyman from CHCO has produced a joint video where the two professional teams come together in the name of kids to drum up support for the Foundation.

 

http://www.youtube.com/watch?v=bEVkxRn5k5w&feature=youtu.be

 

Here’s the Gears of Courage website if you’re as interested as I think you are in making a donation of $10 or more to Courage Classic.  I’ll leave you on your own finding the Wheels of Justice website if you’d rather give fund-raising credit to lawyers.

 

http://www.couragetours.com/siteapps/teampage/ShowPage.aspx?c=8gLLK3MHLhIYF&b=7741033&teamid=4936816

 

 

7/3/2012

There have been several very nice scholarly products from our residents in the past week.  First, Carrie Stair is first author on an article entitled, “Sugammadex, The First Selective Relaxant Binding Agent For Neuromuscular Block Reversal” to be published in Drugs of Today 2012, 48(6): 405-413 with Ana Fernandez-Bustamante as the faculty author.  It’s amazing that Carrie managed this during a very busy CA-2 year.  Congrats to both!

 

Also, the ASA has accepted a slew of abstracts based on challenging cases from our residents:  Sarena Teng has two presentations, “"Can a Patient with Severe Pulmonary Hypertension and Eisenmenger’s Syndrome Be Sedated with Dexmedetomidine?" and "Anesthesia for a Malignant Hyperthemia-Susceptible Patient Presenting for Liver Transplantation".  Sukhbir (Suki) Walha will present “"Spurious Hypoxemia during Emergency Craniotomy".  And Shin Kamaya’s is, “Penetrating Trauma in a Peripartum Patient and Management with Massive Transfusion and Thrombelastography”.

 

We do some interesting and rigorously thought out clinical work in our program.  It’s terrific to see some of them presented at the ASA annual meeting in Washington, D.C.  Hats off to the residents who did the heavy lifting on these presentations as well as to the faculty who worked with them to manage the cases and push the outcome forward to an abstract.  I look forward to seeing a full manuscript accepted for publication on some or all of these.

 

Also Denver Health has named their new CEO who will replace Patti Gabow when she retires on September 5.  Hard to imagine the place without Dr. Gabow.  It sounds like Art Gonzalez is a very qualified choice.

 

http://www.denverpost.com/breakingnews/ci_20993217/denver-health-picks-new-ceo-replace-retiring-patricia?source=rss

 

 

6/25/2012

We had a terrific graduation dinner at the Grand Hyatt a week ago and I thought it apropos to list the awards that were given out.  Each award makes one stop to reflect on what an incredible group of dedicated professionals we have, at how many different stages of careers we all represent, and how big an effort everyone is willing to make in the name of patient care.  These awardees’ efforts have managed to stand out in the past year.

 

Outstanding Teachers of the Year Award

Children’s Hospital Colorado: Kim Weigers, M.D

University of Colorado Hospital: Breandan L. Sullivan, M.D.

Veterans Affairs Medical Center:  Aaron T. Murray, M.D.

Denver Health Medical Center: Greg Myers, M.D.

 

The “Unsung Hero” Award For Outstanding Resident Support

Peter Rowe, M.D.

 

Outstanding Resident of the Year Award

Kristin (Kit) Berger, M.D.

 

Outstanding Academic Achievement Award

David Abts, M.D.

 

“The Katie” Wood Memorial Award

Sarena Teng, M.D.

 

The “No Humbug” Award For Excellence in Medical Student Teaching

Angelo Dilullo, M.D.

           

 

6/5/2012

It’s not often that I report hospital-related as opposed to department-related items., but a few news stories about the hospitals on the AMC came out this week that I think are of interest.

 

The Denver Business journal reported that UCH was among the 25 best hospital to work at in the United States in a list compiled by HealthExecNews.

http://www.bizjournals.com/denver/news/2012/06/04/2-denver-area-hospitals-named-among.html

 

US News and World Report again rank CHC among the top children’s hospitals in the country.

http://www.bizjournals.com/denver/news/2012/06/04/2-denver-area-hospitals-named-among.html

 

And The Coloraoan has a very nice article about Rulon Stacey, the former CEO at Poudre Valley who is now ‘our leader’ of University of Colorado Health System.  It gives some nice background on Rulon and some insight why UCH jumped into the partnership with PVHS.

http://www.coloradoan.com/article/20120604/COLUMNISTS56/306040024/PVHS-s-Rulon-Stacey-star-health-care-industry?nclick_check=1

 

 

5/29/2012

Macintosh HD:private:var:folders:n6:9x7z7jfs3kz11rm0dkmdzdv80000gn:T:com.apple.mail.drag:12May_untitled_111-6.jpg

 

We received some very good news last week.  Ana Fernandez-Bustamante was awarded an FAER mentored research grant (MTG).  For those of you who follow this sort of thing, an MTG is a very big deal.  Typically the ASA research committee, which  reviews the applications, is very particular about these awards as they specifically target individuals and their mentoring environment with intent that they convert into NIH-funded labs and careers.  This is partly due to the limited funds available to FAER and to the diligence of the committee and the FAER board.  Our own FAER board member, Joy Hawkins, indicated that they were particularly stingy this year and awarded on 2 MTGs, despite receiving in excess of 3 dozen applications.  This makes Ana's achievement of getting this award on her very first submission amazingly spectacular.

 

Past FAER awardees in the department include Paul Wischmeyer, Holger Eltzschig, Sara Cheng, Tobias Eckle and myself.  It's important that we continue to show that we realize success from these investments.  If you remember, just last fall the FAER President, Denham Ward, visited our campus to interview past awardees and commented that for a small department we have a large concentration of them and they're all successful.

 

On that note, I should mention the media splash that Tobias Eckle enjoyed with his major new publication in Nature Medicine (see below).  The SOM's PR department, headed by Dan Meyer, put out a press release highlighting that Tobias' work showed how sunshine and/or bright lights might be protective against myocardial infarction.  The popular press came in droves.  Tobias told me that he was interviewed by over a dozen local and national publications and media outlets.  Most of you saw his interview on NBC's News9.  But if you didn't, here's the link:

 

http://www.9news.com/video/1587401683001/1/Study-Intense-light-could-minimize-heart-attack-damage

 

3/14/2012

It’s been some time since I made an entry.  Partly it’s my fault as a few things have stacked up.  The motivating event to unclog things was Tobias Eckle telling me yesterday that his manuscript was finally ‘fully’ accepted by Nature Medicine.  This was news I’ve been anticipating (and anticipating).  Getting a paper in Nature Medicine is about as good as it gets for a medical scientist and it’s really tough.  The revision process, alone, involved new experiments and new data and took well over a year.  The title of the paper is “Adora2b-elicited Per2 stabilization promotes a HIF-dependent metabolic switch critical for myocardial adaptation to ischemia.”  Uh, you’re going to have to ask Tobias or Holger to explain this to you; it’s deeply mechanistic.

 

Susan Mandell learned that her multi-institutional study of pain management for donor hepatectomy has been approved for funding by the NIH.  She will be heading to Washington soon for the planning meeting to kick this off.  Our UCH patients will be part of this study.

 

Paul Wischmeyer also heard this week that his NIH R34 multicenter glutamine for critically ill patients trial was approved for funding.  This could turn into a major multimillion dollar therapeutic trial, depending on the outcome of this still rather large pilot study.

 

Brian Davidson was featured in an article in the Denver Business Journal recently.  It talks about some of the efforts that almost everyone in the department has contributed to.  It’s great to see that others think that what we do to try to improve our clinical performance is worthy of coverage for a more general business readership.  Also, it takes Brian’s perseverance to keep this effort going.

 

http://www.bizjournals.com/denver/print-edition/2012/02/24/davidson-passionate-about-the-quality.html?page=all

 

1/17/2012

Congrats to Drs. Hendrickse and Tan for successfully getting certification from the ASA as an official simulation laboratory site for the Maintenance of Certification in Anesthesiology (MOCA) process.  They also successfully ran a training workshop to certify several of our faculty as additional simulation instructors so that MOCA courses can be offered at CAPE.  It’s terrific that we have the leadership and the faculty expertise to put something like this together.  Now the real work (and fun) begins.

 

Good news from the Department of Surgery.  First, they received a 5 year approval from the ACGME with no citations for their residency program.  This is a huge step as they were on probation last year, mostly due to duty hour violations.  In addition, we learned this week that Dr. Richard Schulick of Johns Hopkins University has accepted the position of Chair of the Department.  He was the top choice of the search committee as well as the top choice of virtually everyone he met while interviewing here.  His start date is May 1.  He will be on campus in the middle of February to take the new chair/division chief orientation course that the SOM now organizes.  I guess the school learned their lesson after throwing some of us into our multi-institutional environment of complex rules and regulations figuring that on-the-job-training would be fine.

 

1/5/2012

It’s fitting that on the first posting of the New Year, there’s something that’s really new to report on.  First, our newest faculty member Paco Herson and his wife Emily had a new baby boy last night at UCH.  Paco sent this picture and reported that mother and Levin Ross received amazing care.  Hope they remember that exact phrasing for the Press Ganey survey when it arrives.

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This morning the UCH brass, including the Board of Directors, were on hand for the ‘topping off’ ceremony on the new tower.  Even though it was January 5th, it felt more like August or September in the west parking lot/construction site.  The final beam got hoisted with the Scandinavian good luck offering to the Nordic gods of a small evergreen tree.  The whole thing made you appreciate what a terrific place we all work in and that it’s everyone’s intent to do something truly special here.  Check out the new beam with flag and tree next time you drive past when it’s not dark (even a warm front can’t fix the day/night cycle of January).

 

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Tomorrow will be the last day at UCH, but not the last one at the UCSOM, for Matthew Roberts.  He’s starting a new position at Denver Health on Monday.  Matthew has been one of the brightest lights at UCH for almost a decade and he’ll be greatly missed (sort of, as he won’t really be gone).  We’re going to have a lunch in his honor in the AIP lounge tomorrow, so be sure to stop by.  In addition, Matthew will be seeing off his old friends at the new Cedar Creek Pub (on campus in the Apartment Building at Ursula and Montview ) from 4 to 6 to hoist a few pints.

 

 

12/19/2011

Last week Bruce Schroffel, Jim Schmerling and Dick Krugman hosted a reception to mark the founding of the Colorado Institute for Maternal and Fetal Health.

 

http://www.childrenscolorado.org/conditions/newborn/MaternalFetal/highrisk.aspx

 

As the two hospital CEOs joked during their opening remarks, this took an inordinate amount of time to bring to fruition for something that has such obvious value to both the patient and medical communities.  Even with this collaboration barely out of the gate, I think the potential here is quite amazing.  Dr. Tim Crombleholme, the new pediatric Surgeon-in-Chief, commented that the Institute was a major reason he chose to bring his fetal surgery program to Denver.  Much was made of the amazing job done by our obstetrical anesthesiology team in making CHC safe for maternal emergencies and their steadfast support for the project.  The potential for pulling our department’s UCH and CHC faculties closer together and for clinical research collaborations also cannot be minimized.

 

Kudos to Sara Cheng for getting her manuscript, “Standard subcutaneous dosing of unfractionated heparin for VTE prophylaxis in surgical ICU patients leads to subtherapeutic factor Xa inhibition,” accepted for publication in Intensive Care Medicine.  This marks the completion of a long clinical investigative journey that Sara shouldered first as a resident, then as an FAER-sponsored fellow and now as a junior faculty.  Rigorous clinical trials are tough to do and even tougher to complete and get into the medical literature.   Good to know we have another ‘Jedi Knight’ we can call on for help in this area.

 

12/12/2011

It’s amazing how much holiday spirit is being generated by Cathe Cook and all of her ‘elves’ with the Salvation Army’s Angel Tree program This program provides underprivileged kids with their actual Christmas gift requests.  The tags Cathe offers have the child and the gift they most want on them.  Just buy the gift and bring it to Cathe for pick-up.  Cathe will also take a donation and she will then use her well-oiled system to convert cash into actual gifts.  There’s still time to make more kids happy.

 

The Department learned last week that our request to increase our residency class size from 12 to 15 received funding approval from UCH.  This was a major goal of our strategic plan and also a top recommendation of last year’s departmental Program Review, so this is a very big accomplishment.  Hats off to Joy Hawkins, Jose Melendez, Kay Oliver and Carlos Fernandez for their strong, effective efforts over the past several months to bring this to reality.  We plan to add 3 additional residents from outside the Match (the last year outside-the-Match selections will be allowed, by the way) to the CA-1 class that will start in July 2012.  The June 2015 graduation dinner is going either be very crowded or moved to a bigger venue.

 

Almut Grenz just learned that her paper describing work on the ENT1 transporter was accepted by JCI (The Journal of Clinical Investigation), a very big deal.  Of particular note is that two Colorado medical students (and former FAER student fellowship recipients) shared first authorship, Jessica Bauerle and Julee Dalton.  Besides making Jessica and Julee work very hard to earn their authorship position, Almut has provided these two budding anesthesiologists with an academic career starter package (a JCI paper) that very few could ever hope to match.

 

11/18/2011

Congratulations to Ana Fernandez-Bustamante et al. (Pierre Moine, Cristina Wood and Zung Tran) for having their manuscript accepted for publication in BMC Anesthesiology (Intraoperative ventilation: incidence and risk factors for receiving large tidal volumes during general anesthesia).  It’s so great to see activity from our operating rooms turned into published articles.  We generate a lot of abstract presentations from our clinical observations, but it takes a special effort to ‘push in a score from the red zone’ and get it published – sorry for the football analogy, but after the Bronco’s win last night I couldn’t resist.

 

In case you didn’t see Bruce Schroffel’s piece in the UCH Insider, here’s the latest about Ben Meyerfhoff:

 

“There has been a personal online "Care Calendar" for the Meyerhoff family set up where you can sign up to help with child care or to bring meals.  You can also purchase and donate gift cards the family can use at different restaurants.   To get started simply access the site http://carecalendar.org and enter the following information in the appropriate box: Calendar ID: 93421; Security Code: 5687.  Erin has also been so very generous with her time and energy by posting updates on Ben’s condition on Facebook at “Ben Meyerhoff Update.”

11/11/11

I received several wrong guesses to the quiz from Oct 28.  The correct answer was Tobias Eckle.  He was the recipient of a mentored research grant from FAER shortly after his arrival here in 2007.  The cover of Anesthesiology as part of the 25th anniversary of FAER showed the portraits of many of the past grant recipients (some when they had a fuller head of hair).  By any measure Tobias’ FAER grant was successful as he went on to get an NIH K08 award and will soon be submitting his first R01.  Also, Tobias just had a review accepted with Holger Eltzschig to Nature Medicine on mechanisms of ischemia/reperfusion (http://www.nature.com/nm/journal/v17/n11/full/nm.2507.html) and soon (we expect) the revision of his manuscript describing his discoveries of the importance of the period protein (regulating light/dark cycle) to myocardial protection will be accepted for publication to the same journal.  Being a cover-boy on Anesthesiology is nice, but getting two publications in Nature Medicine is a truly amazing accomplishment.

 

The current President of FAER Denham Ward (http://journals.lww.com/anesthesiology/Fulltext/2011/10000/What_Is_FAER___The_Foundation_for_Anesthesia.7.aspx) was on campus Wednesday.  He wanted to visit with our several past recipients of FAER awards to collect their ‘stories’ as part of an oral history project that he is working on.  He also wanted to understand what we were doing with the FAER funds that we had received as Colorado was in the top 5 recipients of FAER grants since 2006.  Denham left with some good material for his history project and a very positive impression of what we were doing.  Thanks to all who met with him.

 

 

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Please also help me welcome Paco Herson, PhD, who arrived here the first of the month to head up a new neuroscience laboratory.  Paco is an Associate Professor of Anesthesiology and will serve as Associate Chair for Neuroscience and Director of the Neural Injury Program. We expect the latter with the help of Dick Traystman will be a successful multidisciplinary effort, involving many departments.  Paco brought his lead post-doc, Nidia Quillinan, from Portland to help run his new laboratory.  I’ve heard they’ve managed to already a set of experiments already.  Not bad less than two weeks after arrival and it shows why Paco was so interested in recruiting Nidia to Denver.  Paco’s lab is located on the 8th floor of RC1-North, but he also has an office in AO1 in the Anesthesiology area on the 2nd floor so he can better meet with our faculty as well as those of other clinical departments.

 

Finally, congratulations to Ann-Kathrin Riegel, MD, PhD, for her recent publication in PLoS One, analyzing TEE data:  http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0026559

Ann-Kathrin will be finishing up her post-doc in Holger Eltzschig’s lab and will be joining the residency program in July as a CB-1.

 

11/8/2011

I’m very sad to report that our Chronic Pain Clinic Manager, Ben Meyerhof, sustained a severe cervical spine injury while riding his bike home on Monday night.  Those of you in the ORs on Monday night and Tuesday know of his spinal fusion surgery to stabilize his neck – thanks for the superb care you all provided for him.  Ben has a very long road ahead of him with a lot of work, regardless of what function he regains.  Given his athletic background and with everyone’s support he can make amazing progress and do amazing things during his rehab process.  We want Ben’s smiling face and dynamic presence back in the AOP as soon as he can do it.

 

10/28/2011

After an ‘Epic’ and traveling hiatus I’ll be back with several updates in the coming days and weeks.  As luck would have it, a month after the retirement of the institution’s most capable residency coordinator ever (Jan Ratterree, of course), the Department will be heading into its most intensive residency recruitment season in its history.  Joy Hawkins says that the 900 or so applications we received this fall was a record number.  We invited our usual 100 or so for interview, but this year almost all of them accepted, so it will be very busy around here on Mondays starting on November 7th.  Fortunately, Kay Oliver, our new coordinator, is more than up for the job and Jan has agreed to ride shotgun on Mondays as a part time employee.  Still, we’re going to need all your help to make this a successful recruitment season as this activity defines Team Sport.

 

Dirk Homann our newest research faculty, who’s based at Childrens’ and who’s spoken at a couple of our faculty meetings already, received an extraordinarily high score on his latest NIH grant submission, which placed it in the top 1 percent of all grants reviewed during the cycle, assuring funding.  Hats off to Dirk for the amazing work, to Randy Clark and Jeff Galinkin for the smart recruitment, and to Holger Eltzschig and his team for adding some of their key input to Dirk’s new proposed research plan.  If you go back and check through the blogs, you’ll see that this is the 3rd new NIH R01 grant in the last 4 months. 

 

Trivia Question: (1) Which faculty member has his/her picture on the cover of October’s Anesthesiology, not once, but twice?!

 

8/29/2011

Last time there was a post-doc research seminar I mentioned it only after the fact, mainly because I was floored at how good it was.  Well, even though this is late notice I would like to encourage folks to attend the research conference today at 3:30p in RC2’s Tri-visible room on the 2nd floor.  The ‘short’ topics will include a wide range of subjects of interest to both clinicians and basic scientists and two of the speakers are either residents (Tony Oliva) or soon to be residents (Ann-Kathrin Riegel), giving several reasons for this not to be missed.

 

The most recent Colorado Cancer Center newsletter/blog has an article about our own Dr. Natalie Serkova, which features her new publication reviewing the latest in cancer imaging techniques.

http://www.coloradocancerblogs.org/news/novel-imaging-techniques-show-effectiveness-of-new-targeted-cancer-drugs

 

Later today Dr Leslie Jameson will be speaking to a national audio conference of 1200 users and investigators of the National Surgical Quality Improvement Program (NSQIP) on the topic, “The perioperative role of the Anesthesiologist and the surgical encounter.”  This is important in several respects.  First, it appears that UCH will be entering the NSQIP program in the next year with general surgery, orthopedics, ENT and gynecologic cases.  Second, NSQIP currently does not utilize perioperative anesthesia data but the interest is high to do so, especially with the advent of the anesthesia EMRs and data repositories.  Third, Dr. Jameson could help draw attention to Colorado as a potential leader in this regard.  Leslie is advocating for our department’s involvement as the presence of COHO, the Department of Surgery’s past success with outcomes research and the extraordinary capabilities of our EMR team (Ken Bullard, Bob Phelps, et al) put us in a unique position to really succeed at this kind of research (as also noted by our external program reviewers in the spring).

 

8/5/2011

We’re coming up on (or just passed) the anniversaries of Jason and Alison Brainard joining our department.  Both have made quite significant marks in their short times here.  Alison has stepped up in a big way in medical student education, taking on a major leadership role and rolling out enhancements.  We just learned that Jason’s efforts to establish a Fundamentals Critical Care Support (FCCS) course at the University of Colorado will not only culminate in 3-day course the first week of October that will also utilize the simulation resources of the CAPE and Wells Center but has been chosen as one of the recipients of this year’s SOM/UCH-awarded grants in quality and safety (budget approx $20K).  The FCCS course is aimed as an introduction to the principles of critical care and is can be taught across various disciplines and professions.  The first targeted audience will be the ‘pre-arrest’ rapid response teams within UCH but Jason expects the venues to expand.  It’s great to see our team leading this effort and getting praise from the granting committee and from Dr. Robert McIntyre (President of the UCH medical staff) who said, “This is exciting and congratulations for making this happen.  You have learned that to get these things done you have to be a bulldozer, keep pushing the pile forward.”  I’m not sure I would characterize either Brainard as a bulldozer (gotta love how surgeons think) but it is certain that both have figured out in short order how to add tremendously to our missions and culture.

 

7/18/2011

This coming weekend is Children’s Hospital Colorado’s Courage Classic.  This is a bicycle tour/fundraiser for their research foundation and I have signed up to participate and already made my pledge amount.  This weekend I went on a training ride with my medical campus-based team Gears of Courage (mostly nurses and doctors) and our arch rivals in terms of pledge support Wheels of Justice (mostly lawyers).  Guess who usually wins?  Well, this year we are leading them with a week to go.  Don’t let this be another ‘Lucy pulling the teed-up football away from Charlie Brown at the last second’ situation.  It would be great if you could click on my link and pledge a buck or two.  All the money goes to pediatric research and the Courage Classic funds have a terrific track record of support.  Also, it would great to finally beat the attorneys at something.

 

http://www.couragetours.com/2011/tomhenthorn

 

 

7/14/2011 (Bastille Day Edition)

Thanks to Marina and Anatoly for hosting a terrific new resident welcome party Sunday evening.  It’s always a treat to see a new class of residents so eager to jump into the specialty and this may just be our best CA-1 class yet.

 

Congrats to Almut Grenz (again).  On the last blog installment I announced her being awarded an American Heart Association grant and yesterday she received notice from the Juvenile Diabetes Research Foundation for a research award of $110K (first year) to study A2BAR as Novel Therapeutic Target during Diabetic Nephropathy.  She also has a strong RO1 submitted to the NIH, so we have fingers crossed on that one as well.

 

We scored a double publicity coup yesterday on Channel 7 (ABC).  They had a health story that featured Dr. Jason Krutsch using Botox to treat the migraine headaches of another of our faculty Dr. Lindsay Weitzel who works in our research labs.  It’s a nicely done story and the Weizel dog plays a very strong supporting role.

 

http://www.thedenverchannel.com/health/28517128/detail.html

 

 

6/14/2011 (Flag Day Edition)

Thanks to all for a terrific resident and fellow graduation dinner on Saturday.  It was quite the send off.  It was also a little sobering to realize that after organizing about 25 of these events, Jan Ratterree will not be the one in the background pulling all the strings anymore.  I’m missing her already and it’s not even October yet (when Jan’s retirement begins).

 

Dr. Nathaen Weitzel will soon have the first issue of Seminars in Cardiothoracic and Vascular Anesthesia released in which he is Editor in Chief.  This is a big undertaking and he says he’s able to do this with the help and advice of several of our faculty.  His focus and hard work has a lot to do with it too.

 

Also of editorial note, Dr. Tobias Eckle has been named an Academic Editor for PLoS One, one the highest impact factor journals in biomedical science.  This is quite an honor.

 

We’ve got our fingers tightly crossed that Dr. Uwe Christians’ RO1, examining In Vivo Assessment of Calcineurin Inhibitor Toxicity in Children, will be funded soon.  The application was the highest scored grant in its study section and the NIH has requested just-in-time info, which usually comes before the award announcement.  This study represents the new collaboration between the clinical pharmacology group and pediatrics.  His co-PI will be Josh Thurman of the Renal Division and the Barbara Davis Center.

 

Also just in (as I was writing this, in fact), Dr. Almut Grenz learned this morning that her Mentored Scientist Development Grant from the American Heart Association entitled “Netrin-1 during Renal Ischemia” is funded!  Almut is doing some really exciting science that will very soon have a translational component that many of you will be seeing in a study involving our living kidney donor program.  Keep an eye out for upcoming research conferences to hear about this potential clinical breakthrough.

 

Finally, after months and months of preparation, simulation, regulatory work, credentialing, and more, the first infant will be delivered by cesarean section at Childrens’ tomorrow morning.  Big kudos to Drs. Hawkins, Bucklin, Fuller, Fiegel and Wood for their work on this project!

 

5/25/2011

This month’s ‘Anesthesiology’ has an intriguing article about an epidural needle with an ultrasound crystal at its tip that allows the clinician to see where the needle is going and when it reaches the epidural space.  One of the authors is Dr. Susan Mandell who helped coordinate the activities of the engineering group with the clinical study group and, as is quite evident to those who have read Susan’s prose, basically wrote the entire article. 

http://journals.lww.com/anesthesiology/Abstract/2011/06000/Eyes_in_the_Needle__Novel_Epidural_Needle_with.18.aspx

 

The article was significant enough to be featured with an editorial and it was also promoted as one of the 3 top public-interest articles by the journal with a press release to through the ASA.

http://journals.lww.com/anesthesiology/Fulltext/2011/06000/The_All_seeing_Eye___Ultrasound_Technologies_for.10.aspx

 

We recently learned that the Department will receive two more significant grants from the Crohn's & Colitis Foundation of America (CCFA).  One is a fellowship grant that was awarded to Dr. Eoin McNamee, a post-doc in the Eltzschig lab.  This is the same 3 year fellowship worth about $60K/yr that Carol Aherne received, but what is really cool about this one is that Eoin is the first person from the entire Mucosal Inflammation Program to get a fellowship grant from the CCFA on the first submission!  Also, Dr. Holger Eltzschig will be receiving the very prestigious Senior Research Award from the CCFA with the same July 1 start date.

 

5/ 12/2011

Text Box: More than Numbing up and Knocking Out
As a liver transplant patient teetered on the brink of death, two anesthesiologists stepped in with a demonstration of just how cool their specialty has become.

https://imgssl.constantcontact.com/letters/images/1101116784221/UCHMkting_UCHI_Logo.gif

 

This week’s issue of the UCH Insider has a very nice article about the amazing work that our faculty and residents do.  It is written from a true head-of-the-table perspective about a liver transplant case (patient named Tom or Bob or something – at least he didn’t mix up ‘numbing out and …’).

 

http://r20.rs6.net/tn.jsp?llr=o7lraccab&et=1105390995087&s=62663&e=001qSvhmu85htLlPnQ57R0T2_J3XG0wqBOt4HCyyGFECkS_ctn2gOlkqLdV16eJKEXmTIJIkEsgQee_LBcGl4jlOfOaI2siMKw4zbEMp3w3ugui_dd4ZT3DNZ5vt_TSv1cXWr8uuQLRHbuqDO-CypBgAh_xzJUm04lSNWueka7sGU2Ss_OPvTsE4g==

 

All I can say is that it is very cool to see the hard work and dedication that our faculty, trainees, nurses and staff put in at such at high level 24/7/365 get noticed.  Thanks to Susan Mandell for grabbing the attention of our PR folks, bringing one to the OR, and just showing him what it’s all about.

 

5/2/2011

I feel like I’ve been away quite a lot during the past several weeks with vacation, meetings, jet lag, reviewing FAER grant submissions, etc., but I feel about ready to settle back in for awhile.  The meeting that I attended this last weekend was the 2011 WARC (western anesthesia residents conference) which was held in probably the nicest setting yet for a WARC, the Paloma Resort in Tucson (2 days of perfect weather definitely helped the cause).  Quinn Stevens and Jeremy Hansen also attended and presented posters.  Here’s Quinn during his formal presentation:

IMG_0143.jpg

The attendance and interactions were both terrific at this year’s meeting and next year’s may even be better with UCLA hosting WARC’s 50th anniversary meeting at Marina del Rey.

 

If you’ve been wondering what our OB team has been up to when they tell us that they’re off for a simulation day at TCH, this very nice write-up describes how they used progressive simulations to design and test the processes for the maternal-fetal medicine program at TCH.  Through simulation they found several systems issues where a pediatric hospital would have problems caring for an obstetric patient in an emergency.

http://www3.uch.edu/uchinsider/maternal%20fetal%20medicine%20simulations.pdf

 

Finally, while asking for advice from Tobias Eckle on some aspects of an FAER grant application I was reviewing that involved ischemia/reperfusion of the myocardium in animal models, Tobias shared his latest ‘publication’ with me.  It’s from an online journal that publishes methods videos so other investigators can truly grasp the nuance of some new, technically challenging, but important techniques.  I had only been vaguely aware of this sort of communication and when I looked at Tobias’ work, found it to be truly amazing and valuable.  Take a look:

http://www.jove.com/details.php?ID=2526

 

 

4/5/2011

I am especially pleased to note that that James Ryan and Sarena Teng  were two of 23 residents from throughout the entire University of Colorado system nominated by the Humanism and Excellence in Teaching Committee at the University of Colorado School of Medicine for the prestigious Humanism and Excellence in Teaching Award, which is awarded annually by the Arnold P. Gold Foundation.  James and Sarena were nominated by medical students based on experiences in their third-year clerkships.  Nominees are selected for the following qualities: as a role model for compassionate, relationship-centered care; as one who exhibits sensitivity and respect for others, including patients and fellow caregivers; and for demonstration of particularly strong teaching skills.  This is a great honor and reflects on the culture of teaching that permeates throughout the whole department.  Way to go guys!!

 

If you haven’t seen it already, you might want to check out the article in today’s Denver Post about Tom Hornbein’s mount climbing adventures.  Besides being a famous mountaineer, Dr. Hornbein was also a long time professor and then chair of anesthesiology at the University of Washington.  Since moving to Estes Park in retirement, he has been a frequent visitor to our campus and department.  The article is about his being inducted into Hall of Mountaineering Excellence on Saturday at the American Mountaineering Museum in Golden.

 

http://www.denverpost.com/extremes/ci_17772098#ixzz1IfQtwpxU

 

3/25/2011

I want to thank the faculty and staff for their wonderful response in support of Phyllis Tuller’s family this past week.  It was a hard week for all of us.  I am sure that the funds being sent in to the Memorial Fund are as greatly appreciated as the sympathy and emotional support that was shown.

 

As I reported at the faculty meeting last night the External Review that occurred on Wednesday and Thursday went very well.   Thanks to everyone for taking the time to attend the many meetings and for covering for others so that they could attend.  Some of the comments coming from the committee reflected spectacularly on all aspects of our mission.  In their interviews with hospital leadership from UCH, TCH and DH as well as chairs of clinical departments there were zero (none) complaints or perceived shortcomings of the services that we provide.  That doesn’t mean we should be complacent, rather everyone should continue their stellar efforts to stay in front of the curve.  Obviously, it’s working.  Similar kudos came for our education efforts of both students and residents.  However, they did note that we have one of the smallest resident class size to department size ratios in the country and that we should strongly consider expanding.  In addition, we are an outlier among top anesthesiology programs in not have a critical care fellowship as well as having an open SICU.  Recommendations from the reviewers along both of these lines could be very useful.  In addition, they were impressed with the production and topical relevance of our research efforts.  They believed the core programs we have established are especially well poised to get us to our strategic goal of reaching the top 10 in NIH funding, but will need continued investment to get there.  Ways to better engage junior faculty, especially those more focused clinically, in research efforts were discussed at the exit session as well.  Other recommendations on how to bolster mentoring for our faculty will also be made. Despite the imperfect process of the review, I believe the results will ultimately serve to propel us along the course that the faculty outlined at the Retreat this last fall.  Now we just have to roll up our sleeves and get to it.

 

3/2/2011

Thanks go out to all that have stayed in Denver ‘manning the fort’ to ensure that CRASH is successful.  As you may have noticed, CRASH has moved from a mainly invited ‘national’ speaker meeting to one where is it 95% composed of our own faculty (only one outside speaker each of the last two years), while improving its content and popularity.  This says volumes about our faculty, particularly the junior ones, and their ability to communicate the latest-and-greatest material to their peers.  This, of course, puts increased demands on the department to maintain clinical care while CRASH is underway.  Thanks again to those making the sacrifice.

 

Mindy Cohen has a new first authored research paper published in Anesthesia and Analgesia.  It’s a great example of the type of clinical research that Jeff Galinkin, Uwe Christians and their group are spearheading.  We have the resources to do much more of this kind of clinical pharmacology research in both pediatric and adult perioperative care.

 

https://files.me.com/tkhenthorn/95z688

 

Dick Traystman (who is jointly appointed in our Department) put a nice write-up of our own Almut Grenz in his weekly blog.  Yes, it’s kind of beating his own drum in this regard, but it is great that he puts the activities of our faculty out to the rest of the University on occasion.

 

https://files.me.com/tkhenthorn/ada0n4

 

2/24/2011

It’s seems hard to believe, but we now have two faculty in one year with major review articles in the NEJM.  Holger Eltzschig’s article on the link between hypoxia and inflammation was published in last week’s issue and it comes less than one year since Joy Hawkins’ NEJM article on labor epidural analgesia.  Congrats to Holger (and again to Joy) and congrats to everyone in the Department for fostering the culture that makes these sorts of significant contributions possible.

 

http://www.nejm.org/doi/full/10.1056/NEJMra0910283

 

Also of interest is that many science-oriented news outlets ran with the CU SOM press release from Dan Meyers (UCD’s PR specialist) about Holger’s NEJM article (a few are listed below).  It’s an avenue we often don’t think of but is one that can boost awareness of what we do.

http://esciencenews.com/articles/2011/02/18/study.links.hypoxia.and.inflammation.many.diseases, http://www.bio-medicine.org/medicine-news-1/Study-links-hypoxia-and-inflammation-in-many-diseases-79391-1/, http://www.sciencedaily.com/releases/2011/02/110218132317.htm,

 

After reading about QI from Peter Pronovost earlier in the week, you can now look at two recent editorials, one from JAMA and another from the NEJM, indicating that ‘Quality’ is now passé and is being replaced by ‘Value’ as the concept most likely to drive changes in healthcare.  Again, we need to focus on what Anesthesiology brings to the table in terms of expertise and opportunity to add both quality and value to our patients and the health of the population we serve.

 

http://www.nejm.org/doi/full/10.1056/NEJMp1013111

http://jama.ama-assn.org/content/304/16/1831.full.pdf+html

 

2/21/2011

Sorry for the long hiatus.  There were many contributing factors, including the Program Review Self-Study and loss of my VPN connection for a couple of weeks, but the main blame was my inattention.  I will endeavor to stay on track with at least a couple entries per week.   One of the cool things that happened in February was the UCH Medical Staff Dinner in which Leslie Jameson received the Extraordinary Service Award.   One of the most remarkable things about the award was that she was nominated for it by our surgical colleagues.  Leslie’s dedication to her patients is extraordinary and evident to everyone.  Below is Leslie with her award in hand:

Macintosh HD:private:var:folders:eN:eNDHzD3qFmy2C8+P8XThqU+++TI:-Tmp-:com.apple.mail.drag-T0x10051ffd0.tmp.X4o1W2:IMG_0133.JPG

 

As some of you may have noticed, the SOM  and our AMC hospital partners have begun serious discussions about how we will go about readjusting our healthcare delivery focus to make it more oriented to value, quality, safety and patient-centeredness.  This will require a much more team-oriented approach to healthcare than we’ve seen heretofore; one that integrates clinical departments, hospitals, and other professionals.  There are many layers to this discussion, beginning with what is driving this change and going on to how to implement these changes, to how to teach it, to what it means to our specialty and to all of us.  To that end I will begin to include links to articles that relate to the layers of this rapidly growing movement so that we can begin a dialog about it in several department forums.  I’ll start with one authored by Peter Pronovost, an anesthesiologist at Johns Hopkins, who has led the modern Quality Improvement movement.  His Commentary, which appeared earlier this month in JAMA , is a very well-stated case for part of what is needed.

 

http://jama.ama-assn.org/content/305/5/500.full.pdf+html

 

 

1/3/2011

Hope all had a great Holidays and that no one is writing 2010 anymore.  A very important paper was published since my last entry.  Joy Hawkins was the lead author on an article in this month’s Obstetrics and Gynecology:

http://journals.lww.com/greenjournal/Abstract/2011/01000/Anesthesia_Related_Maternal_Mortality_in_the.11.aspx

(the full article can be viewed by clicking the view in OvidSP link-it’s well worth reading as the discussion reads like a concise review).  This is the latest in a series of maternal mortality reports that was originated here by Joy and former illustrious UCSOM faculty Charlie Gibbs and Susan Palmer.  The article was also covered quite well in the lay press, complete with quotes from Joy.

http://www.reuters.com/article/idUSTRE6BN2B820101224

 

So if that makes you think that spinal/epidural anesthesia is getting too dangerous, you might want to take a look at the latest review article in the NEJM:

http://www.nejm.org/doi/full/10.1056/NEJMra0808281

 

Perhaps not all that reassuring for our patients, but this review does cast light on the fact that the perioperative interval still contains long term risks that merit further research.

 

12/19/2010

Today’s Denver Post named Bruce Schroffel as the Post’s Business Person of the year:

http://www.denverpost.com/business/ci_16889835

 

 

We all believe he has done a terrific job as President and CEO of UCH, but the hospital’s business success has been in no small part due to the year-over-year increases in surgical and procedural volume, which our faculty, residents, CRNAs and staff have taken on all the while improving the depth and quality of care and services.  This honor belongs to all of us!  The article makes mention of two important elements that our department is at the center of.  One is the strengthening alliance of UCH with TCH and the other is the looming pressure to improve quality, likely with less revenue.  It so nice to see a positive article about our medical center in the local media.

 

Speaking of honors, Dr. Holger Eltzschig just became the fourth anesthesiologist to be a member of the American Society of Clinical Investigation, an honorary society at the top of medical science.  The other three are Daniel Sessler, Jeff Balser, and John Severinghaus.  As amazing and wonderful such a personal achievement is, it is another honor that belongs to all of us as the successes of Holger’s lab were made possible by the support of the entire department, especially those faculty, residents, students, post-docs and PRAs that generate all the data.

 

Also of note is the receipt of the second terrific letter in a week from the ACGME.  This one gave the residency program the maximum 5 years of approval and also gave special commendation to the department for fully addressing concerns raised during the last review.  Congratulations to everyone for making this happen!

 

12/13/2010

Good news on the educational front today.  Ferenc Puskas received a letter from the ACGME that not only gave the Cardiothoracic Anesthesiology Fellowship the maximum 5 years of approval, it also commended the program for the ‘outstanding’ quality of the educational experience and the support given to the fellows.  The letter even went so far as to say how well written and complete the application was.  Kudos to the cardiac team and to our GME ‘gurus’ Jan Ratterree and Joy Hawkins for making this new fellowship a high flying one so quickly.

 

Brenda Bucklin also was just notified that she has been selected to be a member of the Association of University Anesthesiogists (AUA) Educational Advisory Board.  The term is for 3 years.  The AUA has two advisory boards, one for education and one for research, that are charged with arranging the program in each area for the annual meeting and thus pointing out to the specialty what the latest, most important topics of consideration are.  I am also pretty sure that Brenda will be the first Colorado faculty to serve the AUA in this way (at least while a faculty member here).  Congratulations!

 

12/3/2010

Congratulations to our most recent student CRNA  graduates, Meghan Wampold and John Howerte.  An informal luncheon was held in their honor on Wednesday, beautifully arranged by Stephanie May (note the mortarboard on the cake) .  Both will be practicing in Greeley, starting in January.

 

Also of note is the selection of Dr. Sara Cheng to be the University of Colorado’s candidate for Doris Duke Clinical Scientist Development Award.  Each institution is allowed to put forward only one candidate for this award to the Doris Duke Charitable Trust each year.  Congrats to Sara and good luck on the national competition!

 

11/29/2010

Hope everyone had a great Thanksgiving Holiday.  Thanksgiving Day saw the publication in the NEJM, regarding the lack of progress towards patient safety since the Institute of Medicine report, “To Err Is Human.”

http://www.nejm.org/doi/full/10.1056/NEJMsa1004404

There was a follow-up article in the NY Times as well.

http://www.nytimes.com/2010/11/25/health/research/25patient.html?_r=2&ref=todayspaper

 

This topic was well covered in last week’s Grand Rounds by Brian Davidson.  He outlined initiatives we could take in our own department.  According to the articles above, improved safety and quality care do not happen by awareness alone.

 

11/19/2010

We have two research successes that just have to be noted.  First, is we learned this week that Holger Eltzschig was awarded his 3rd RO1 grant from the NIH to study, “Mucosal Hypoxia Inducible Factor in Acute Lung Injury.”  The number of anesthesiologists in existence with 3 RO1s could easily be counted on my right hand.  Holger says that he is busy working on a 4th RO1, his best one yet.  This amazing, developing story is truly a departmental success as the Eltzschig lab (acronym: CHaIR) has received most of its funding to this point from funds that were generated from everyone’s clinical efforts, whether from departmental or dean’s AEF.  As important as the financial support is the fact that you all contribute to the environment that helps fuel CHaIR and our other successful labs with ideas, encouragement, administrative support, students, trainees, colleagues and so much more.  It’s so great when we see such tangible (and almost mythic) evidence of success for efforts that have so many moving parts.  We can all be proud of this.

 

The other research success is that of our newest post-doc fellow, Ann-Kathrin Riegel.  Ann-Kathrin joined us from Tübingen, Germany, in July 2010 for a year of research before starting her residency here at UCD as a CB-1 in July, 2011.  She just received an acceptance letter for her article (as sole first author), in the prestigious journal Blood entitled, “Selective induction of the endothelial P2Y6 nucleotide receptor promotes vascular inflammation,” and co-authored by Faigle, Zug, Rosenberger, Robaye, Boeynaems, Idzko, and Eltzschig.  Welcome and congratulations to Ann-Kathrin!

 

Last, but not least, I want to recognize the 2010 UCH EXCEPTIONAL PARTNERSHIP IN LEADERSHIP AWARD winners.  This award recognizes a team of a UCH manager/director and a physician who have partnered together to lead or manage a team.   This year the winners were:  Ashley Nassau and Brian Davidson, MD.  They collaborated on the creation the new OR block time utilization reports as well as setting up the OR on-time start and turnover project (yet another example of a success that we all share in - is there another kind?).  Special congrats are in order to Brian and Ashley as they add their names to a short but illustrious group as the past winners were:

2009       Denise Snuttjer/Janet Durham, MD

2008       Katie Borgstrom/Yang Chen, MD

 

 

11/5/2010

Surprisingly I had an anesthesiology encounter while on vacation in Uruguay.  The Spanish word ‘Anestestistas’ was on the banner headline of the Sunday El Pais the day we arrived and remained somewhere on page one of most of the daily newspapers throughout our 4 days we were there.  Here’s a sample from La Republica:

http://www.larepublica.com.uy/politica/428856-mujica-pidio-a-los-anestesistas-una-mano-para-la-gente-mas-necesitada

 

If you’re like me, you’ll have to use Google-Translate to get the full meaning of the article.  But the short version is that the national anesthesiology society is at odds with the government and even the national medical society about provision of care to ‘public’ (as opposed to privately insured) patients, resulting a public relations nightmare for everyone in which dozens of women with breast cancer not able to have surgery (no pink ribbons for these guys).  If you go deeper you’ll find that there has been a (perhaps) systematic restriction in anesthesia residency class size, resulting in a relative shortage of anesthesiologists in Uruguay, and other issues as well.

 

To me this represents an extreme example of what the sociologist Eliot Freidson wrote about in his landmark study, Profession of Medicine, where he first defines a profession as a work group that reserves to itself the authority to judge the quality of its own work.  He then points out that “after becoming autonomous the profession has less and less come to reflect what the public asks of it and more and more come to assert what the public should get from it.”  He even went on to say  “so far as the terms of work go, professions differ from trade unions only in their sanctimoniousness.”  Freidson’s words have remained in the ear of organized medicine in the US for some decades now, but a graphic reminder of what the larger meaning of ‘profession’ means is worth considering, even when it comes from a small, largely rural country like Uruguay.

 

10/22/2010

On Tuesday afternoon in San Diego at the Medical Student Anesthesia Research Fellowship Symposium, our two FAER student fellows presented their research along with the other 30 student fellows from around the country.  Scott Bluth from UT Houston worked this summer with Natalie Serkova on a project that tracked the progression of experimental Multiple Sclerosis in rat spinal cords with MRI.  Julee Dalton was selected as one of 14 students who also presented their work during an oral session.  Julee gave easily the most stellar presentation of the session, which included answering some really in depth questions, on her work on renal ischemic protection with Almut Grenz and Holger Eltzschig.  Congrats to all the students from across the country as well as to the respective faculty and PRAs who provided such stimulating  and diverse investigational environments to these young professionals.  FAER is doing a great job making this sort of activity possible.  It is truly seeding our specialty’s future (hint: consider making a donation to FAER, yearly).

 

Speaking of future anesthesiologist-scientists, I am pleased to announce that Drs. Tony Oliva and Jen Appleman have been selected to be the Virtue Scholars from our CA-1 class.  They will be exploring research opportunities with potential research mentor this year with  the expectation that during their CA-2 year an actual proposal will be delineated.  We’re very excited about the potential of these two individuals.  Also, Rachael Rzasa-Lynn will begin her Virtue Scholar research project this academic year.  Rachael will be working with a very well known pain scientist from Boulder, Linda R. Watkins (check her out on pubmed).   Rachael’s project is to begin in Boulder, but then become established in our department’s lab shortly after that.  I am very thrilled that Rachael has taken on this ambitious project and especially since she is (practically singlehandedly) establishing a bridge to this world-class pain research lab.  Bravo!

 

10/18/2010

Just a quick update to say that our department has had a very large profile at this year’s ASA.   The feedback has been tremendous. Congrats go out to all the residents and faculty for their stellar involvement and presentations.  Brian Davidson garnered much attention from the clinical quality improvement community at a well-attended poster discussion session (impressing Amr Abouleish on the right, but driving Henry Acosta to his iPhone during his talk).

 

 

          Tom Henthorn's Quasi Blog Spot

 

 

 

2/14/2013

          Tom Henthorn's Quasi Blog Spot

 

7/26/2013

University of Colorado Health, North, had their Epic go-live earlier this month.  North signifies Poudre Valley Hospital, Medical Center of the Rockies (Loveland), and various clinics and surgicenters in that area (by the way, UCH is now known as ‘Central’).  On completion, the entire system will be running virtually the same version of Epic so that patient records will be available system-wide.  South (Memorial in Colorado Springs) will go-live in November.

 

Not unexpectedly, the Epic anesthesiology module is one of the most complex and detailed portions of Epic.  Also expected, the anesthesia go-live was the smoothest and the ORs experienced the least workflow slowdown across the North hospitals.  The main reasons for this success are the great design of the Epic anesthesia module made possible by the input of our physicians and CRNAs, the coding of these design elements by Ken Bullard and Bob Phelps, and the tremendous instruction and go-live assistance and leadership provided by ‘Central’s’ super-users Leslie Jameson, Jacqueline Vasquez and Julie Negin.

 

This did not go unnoticed.  Here’s a photo from North’s newsletter, showing Leslie instructing Dr. Kelli Weiner (one of CU’s residency grads from the 1990’s) who is on the Board of Directors of Northern Colorado Anesthesia Professionals.  I received further go-live kudos last weekend during the Courage Classic from Drs. Bill Neff (Chief Medical Officer for the entire University of Colorado Health system) and Julio Salimbeni (Medical Director of PVH ORs and whose son ‘A.J.’ works as an orderly in our PACU); both of who further pointed out the tremendous help of Jacqueline and Julie.

 

For those interested, University of Colorado Health sponsors a team at the Courage Classic (3 day fund-raising bike tour in-and-around Summit County for CHCO) and we’re looking for more participation from ‘Central’ next year; A.J. and I were the only ones this year, so I’ll be sure to put the word out next spring.  To be fair there are other teams that our faculty and residents rode for this year.  It was great to see that Mario Villasenor, Glenn Merritt, Mark Twite, Richard Ing as well as Tom and Prairie Robinson were out there supporting their respective teams for the benefit of Children’s Hospital Foundation.

 

7/23/2013

The July issue of Anesthesiology has featured articles that touch on the activities of our faculty.  In an article highlighted as “This month in Anesthesiology” Ludmilla Khailova, a PRA in Paul Wischmeyer’s lab, et al., describe their work showing the importance of gut flora (i.e., the microbiome) on sepsis survival in a murine model.

http://journals.lww.com/anesthesiology/Abstract/2013/07000/Probiotic_Administration_Reduces_Mortality_and.28.aspx

Dr. Wischmeyer’s line of research aims to identify whether the diversity of a patient’s gut flora predicts the likelihood of perioperative morbidity and mortality and whether pre-operative replenishment of bacterial diversity could improve outcomes.

 

Several of our faculty are involved in retraining anesthesiologists who have been out of practice for 2 or more years.  The necessity and the associated issues of doing the retraining job well are described in an editorial by Steadman and Cole:

http://journals.lww.com/anesthesiology/Fulltext/2013/07000/Assessing_Competence_for_Reentry__What_Matters.10.aspx

          Tom Henthorn's Quasi Blog Spot

 

8/6/2013

Today, Brian Davidson gave a presentation on our new Epic-linked adverse event reporting system at UCH’s Clinical Effectiveness and Patient Safety meeting.  More than two dozen key leaders from the hospital’s clinical operations were in attendance (they really care about this stuff), including the CEO (John Harney) and the Director of Risk Management (Sue West).  The presentation and the reaction to it were quite impressive from a number of standpoints.  First and foremost, everyone was astounded that we have 60% quality reporting on all of our cases in the database since inception.  This is a testament to the dedication of our providers to quality and safety.  Hats off to all of you for clicking the Quality button and entering data, even when nothing untoward happened.  It was also a testament to the simplicity and effectiveness of the IT tool that Bob Phelps and Ken Bullard built.  Finally, in just the couple of months this program has been in effect, Brian was able to give examples of how it has directly led to quality and safety improvements and how it has provided fertile ground for great topics for our departmental M&M conferences.  These conferences will increasingly become the mechanism by which practice standards are set and our performance is reported.  So, if you want to see what your ‘clicking’ of the Quality button on the Epic record results in, plan on attending M&M.

 

7/26/2013

University of Colorado Health, North, had their Epic go-live earlier this month.  North signifies Poudre Valley Hospital, Medical Center of the Rockies (Loveland), and various clinics and surgicenters in that area (by the way, UCH is now known as ‘Central’).  On completion, the entire system will be running virtually the same version of Epic so that patient records will be available system-wide.  South (Memorial in Colorado Springs) will go-live in November.

 

Not unexpectedly, the Epic anesthesiology module is one of the most complex and detailed portions of Epic.  Also expected, the anesthesia go-live was the smoothest and the ORs experienced the least workflow slowdown across the North hospitals.  The main reasons for this success are the great design of the Epic anesthesia module made possible by the input of our physicians and CRNAs, the coding of these design elements by Ken Bullard and Bob Phelps, and the tremendous instruction and go-live assistance and leadership provided by ‘Central’s’ super-users Leslie Jameson, Jacqueline Vasquez and Julie Negin.

 

This did not go unnoticed.  Here’s a photo from North’s newsletter, showing Leslie instructing Dr. Kelli Weiner (one of CU’s residency grads from the 1990’s) who is on the Board of Directors of Northern Colorado Anesthesia Professionals.  I received further go-live kudos last weekend during the Courage Classic from Drs. Bill Neff (Chief Medical Officer for the entire University of Colorado Health system) and Julio Salimbeni (Medical Director of PVH ORs and whose son ‘A.J.’ works as an orderly in our PACU); both of who further pointed out the tremendous help of Jacqueline and Julie.

 

For those interested, University of Colorado Health sponsors a team at the Courage Classic (3 day fund-raising bike tour in-and-around Summit County for CHCO) and we’re looking for more participation from ‘Central’ next year; A.J. and I were the only ones this year, so I’ll be sure to put the word out next spring.  To be fair there are other teams that our faculty and residents rode for this year.  It was great to see that Mario Villasenor, Glenn Merritt, Mark Twite, Richard Ing as well as Tom and Prairie Robinson were out there supporting their respective teams for the benefit of Children’s Hospital Foundation.

 

7/23/2013

The July issue of Anesthesiology has featured articles that touch on the activities of our faculty.  In an article highlighted as “This month in Anesthesiology” Ludmilla Khailova, a PRA in Paul Wischmeyer’s lab, et al., describe their work showing the importance of gut flora (i.e., the microbiome) on sepsis survival in a murine model.

http://journals.lww.com/anesthesiology/Abstract/2013/07000/Probiotic_Administration_Reduces_Mortality_and.28.aspx

Dr. Wischmeyer’s line of research aims to identify whether the diversity of a patient’s gut flora predicts the likelihood of perioperative morbidity and mortality and whether pre-operative replenishment of bacterial diversity could improve outcomes.

 

Several of our faculty are involved in retraining anesthesiologists who have been out of practice for 2 or more years.  The necessity and the associated issues of doing the retraining job well are described in an editorial by Steadman and Cole:

http://journals.lww.com/anesthesiology/Fulltext/2013/07000/Assessing_Competence_for_Reentry__What_Matters.10.aspx

In conjunction with CPEP (www.cpepdoc.org) Drs. Adrian Hendrickse, Marina Shindell and Gee Mei Tan are using the simulation lab for assessing skills and clinical management of anesthesiologists interested in reentry to active practice.  This aspect is well described in the featured article of a NYC reentry program by DeMaria et al.,

http://journals.lww.com/anesthesiology/Abstract/2013/07000/Simulation_based_Assessment_and_Retraining_for_the.35.aspx

Drs. Leslie Jameson, Alison Brainard and M.G. Lemley have taken the lead positions in putting together the actual clinical training programs for reentry docs along with CPEP (there are currently 2-3 potential reentry candidates in the pipeline).  Our department is the unique position of being a center of excellence for reentry activity partly because one of the leading physician assessment and retraining programs in the country (CPEP) is located in Denver.  An article by members of CPEP (Grace and Korinek), which included our own Lindsay Weitzel as a co-author, is featured in both the editorial and full article linked above.  In addition, the new version of Colorado’s medical practice act includes a provision for a temporary re-training status for physicians that otherwise had a ‘clean’ medical practice prior to their inactivity.  This provision is unique and might attract re-entry physicians to Colorado.

 

7/5/2013

July is the New Year in academic medicine so it feels right to exercise a new year’s resolution to make blog entries on a regular basis.  I saw something very cool in our ORs last week.  The new ‘Quality’ button on the Epic Intra-op electronic medical record (EMR) has scored its first major coup in only its first month of operation.  It seems several of our astute providers had recorded technical issues with certain ventilator settings that resulted in untoward functions, like complete apnea.  These occurrences were flagged via the quality reporting system that was created by Bob Phelps, Brian Davidson and Ken Bullard and lives outside the official EMR.  Our super-technicians (Russ Ingram and Johnny Lawrence) checked out several anesthesia machines.  Johnny then wrote the following email:

 

“The anesthesia machine in room 17 is pulled and is out of service. Jefferey Shoup (of biomedical engineering) came over this morning and took the anesthesia machine to his shop. There is a glitch in some of the anesthesia machines. Thanks again informing everybody.”

 

I’m glad to see that our department is embracing the use of the ‘Quality’ button on the Epic EMR.  By its use we can drive improvement in our processes and make the OR and perioperative care safer.

 

In the July ASA Newsletter three of our faculty are pictured as each having a different take on the proceedings at the ASA Legislative Conference held April 29 –May 3 in Washington.

 

 

3/13/2013

We have some good NIH funding news to report!  Sara Cheng has officially heard that her K23 funding is ‘set in stone’ (Title: Prognostic Risk Score for Post-Discharge VTE in Surgical Oncology Patients).  This marks the first of our own residents to become a junior faculty with us and obtain NIH funding.  This was articulated by the faculty as a strategic goal and to repeat this kind of success on a regular basis.  Thanks to Sara and Paul Wischmeyer for proving this goal was not pie-in-the-sky.

 

Congrats to Karen Jonscher who was awarded a 5-year K25 grant that begins funding immediately.  Karen’s grant exemplifies her unique approaches to proteomic analysis.  She’s working closely with Jed Friedman in the department of pediatrics, but our hope is that these techniques can be applied to research within our department as well.

 

Paco Herson’s R01 entitled, “CaMKII in global cerebral ischemia” received a score placing it in the 1st percentile and will soon be funded.  ‘Soon’ depends on how the country navigates the budget sequestration, however.

 

Holger Eltzschig continues to amaze.  In the past month we learned that his Program Project Grant (PPG) in conjunction with Mike Blackburn and Yang Xia from Houston, investigating adenosine-related mechanisms in a variety of organs, was awarded. This will bring over $700K/yr in direct funding to our department.  PPGs tend to fund at a higher level than R or K grants.  Yang Xia visited our campus from Houston this week and gave a dynamic research seminar on Monday afternoon showing how adenosine may hold the key to successfully treating Sickle Cell Disease (expect even more collaborative grants in this direction).  In addition, Holger learned that his 5th R01, this one examining proton pump inhibitors and renal ischemia, will be funded.  The amount of work it takes to get an R01 is huge.  Getting 5 R01s and a PPG represents a monumental effort and accomplishment.  In addition, many of Holger’s faculty mentees are having funding and publishing success (Eric Clamby, Tobias Eckle, Eoin McNamee, Almut Grenz, and Carole Ahearn to name a few).

 

As you know, departmental resources (time and dollars, mostly from clinical activity) have made these successes possible.  The entire department has permission to pat themselves on the back.  After deservedly patting your back, seek out the investigators for congrats and then give out pats to our administrative grants team (Jeanette Leeser, Sabrina Espinoza and Fanta Kuhlman) who have done yeoman’s work, meeting  many deadlines during an amazing flurry of grant submissions.

 

2/14/2013

Happy Valentine’s Day.  You may have noticed the big white tent to the southeast of the new parking structure at UCH last week.  It was placed there to house (or tent) the ‘Premier’ fundraising gala for the UCH Foundation.  Part of the festivities included appetizers served throughout the magnificent and enormous new ED (however, Dr. Richard Zane kept explaining to the amazed guests that it was just an ‘appropriately sized’ for our current volume).   The Denver Post had a nice article about it, including pictures of folks you may recognize.

http://www.denverpost.com/lifestyles/ci_22584337/premiere-raises-1million-university-hospitals-new-er-tower

 

2/6/2013

We were treated to a great ‘official’ start to the new combined Grand Rounds format.  Dr. Alex Evers, chair at Washington University’s Department of Anesthesiology, delivered a provocative talk on academic anesthesiology culture as well as a (too) short update on the GABA receptor.  If you missed it or, like me, would like to see it again, it’s available here:

mms://essvideo.ucdenver.edu/public/Anesthesia_Grand_Rounds_2_4_13.asf

 

Alex also delivered a fantastic Virtue lecture late in the afternoon on an alternative way of looking at post-operative cognitive function; could there actually be improvement rather than dysfunction?

 

I always get a kick out of the local media when they cover stories right out of our department.  It’s entertaining to see how things that you know very well get digested and then presented to the public.  Plus it’s great to know that what we’re all working hard at is also considered news worthy.  Here’s a nice article from the local paper about Drs. Eltzschig and Grenz, stemming from Holger’s recent NEJM article.

http://www.aurorasentinel.com/news/safer-sugery-cu-med-school-team-looks-at-ways-to-decrease-organ-damage-during-surgical-procedures/

 

1/18/2013

I received the grant application announcement from FAER yesterday.  Most interesting was the categorization of their flagship Mentored Research Training Grant (MTRG) into 3 separate categories: Healthcare Services, Basic Science and Clinical or Translational Research.   The deadline is February 15th.

 

FAER.org/research-grantsThe application website can be found here.

 

That the MTRGs grants lead to NIH funding, as FAER intends, is highlighted in their recent newsletter in an article featuring Tobias Eckle:

 

http://faer.org/news/mrtg-funding-leads-to-nih-grant/

 

Next week is National CRNA Week.  Kristen Van De Velde and her ‘elves’ are planning food events each day of the week as well as signage and posters in all our perioperative sites.  We have an amazing, completely essential cadre of CRNAs that we are proud to have as colleagues.  Let’s help them celebrate.

 

 

1/11/2013

One of the things that chairs fret about is NIH rankings.  How our various departments are ranked affects everything from hospital and medical school stature to recruitment of residents and faculty.  Yet, when I travel the corridors, I don’t hear others in the department asking me what I’m going to do about it.  The new rankings are out, based on 2012 numbers, and we’ve risen to #16 nationally – our first placement in the top 20.  Lot’s of people have put much effort into making this happen, mainly those doing cutting-edge research and writing and submitting grant applications like crazy.  However, I feel that everyone in the Department has contributed by doing important things such as generating clinical income to support our research, attending strategic planning and research retreats, supporting Virtue and FAER scholars, covering the ORs so research faculty can produce data, write and present their work, etc.  We couldn’t do this without everyone pitching in.  Now everyone should share in feeling a little pumped up, especially since the top 10 is within sight.

 

http://www.brimr.org/NIH_Awards/2012/NIH_Awards_2012.htm

 

When we saw the preliminary rankings a couple weeks ago we knew that a lot of our grants were somehow missing.  Fanta Kuhlman and Jeanette Leeser spent many hours with CU’s Grants and Contracts Office and with NIH getting the 60% of our grants that were missing-in-action properly credited.  To use Dick Traystman’s analogy, the bears will eat us if we don’t all row the boat together.  Thanks Fanta and Jeanette for your good hard oar pulls.

 

1/10/2013

Drs. Jason Brainard and Matt Rustici (Dept. of Pediatrics) received a Rymer Grant from the Academy of Medical Educators for the CU SOM. This grant was written so that a 2-week medical student elective could be developed and tested that will focus on critical care and procedural skills training.  A pilot elective is planned for this Spring.  If the course is successful an addition to the SOM curriculum will be proposed to the Dean as part of the formal education for all medical students.

 

The faculty for this elective will include Drs. Azam, Scott, and Sullivan from the ICU group as well as Dr. Ahlgren who will teach be teaching the curriculum on central line placement.

 

While on the subject of our top flight education efforts, we received a letter from the American Board of Anesthesiology just before the Holiday Season informing us that every single CU residency grad taking the 2012 ABA written exam passed, including all our recent grads and a couple who graduated awhile ago.   We used to say back in Chicago that results like these were proof that we were world-class educators; and when not so many passed, it was due to poor resident effort.  Actually, this great news reflects everyone’s focus and hard work.

 

1/4/2013

We recently learned that one of our stellar junior research faculty, Dr. Carol Aherne, received a prestigious Research Scholar Award from the American Gastroenterological Association.  The 3 that got this award last year were from the University of Chicago, MGH, and Northwestern.  This is quite the honor for Carol and will be a big help to our research programs.

 

Hats off to Dr. Susan Mandell.  She has been working steadily for almost a decade to get both UNOS and CMS to recognize that the anesthesiologists taking care of liver transplantation recipients, like surgeons require specialized experience.  Transplant programs now all need a qualified Director of Liver Transplantation Anesthesiology.  Susan just had an article accepted for the journal Liver Transplantation entitled, ‘Director Of Anesthesiology For Liver Transplantation:  Existing Practices And Recommendations By The United Network For Organ Sharing’, which demonstrates that requiring expertise would not unduly hurt transplantation programs.  Seems the opposite should have been the worry.

 

12/31/2012

As we head into the New Year I would like to mention a couple of the accomplishments of our faculty during the last parts of 2012.

 

Dr. Joy Hawkins was selected as one of the nine charter members of the FAER Academy of Education Mentors in Anesthesiology.  The goals of this academy are to:

  1. Generate enhanced education outcomes in anesthesiology.
  2. Promote the science and innovation of education in anesthesiology and perioperative 
medicine.
  3. Spur education mentor training and development.
  4. Provide assistance to anesthesiologists interested in education research.

Congratulations to Joy on this honor.  Being a member of this academy is meant to be the highest honor the specialty can bestow on an educator.  Being the very first to get the honor is something even more special.  Not like we didn’t already know.

 

For those who may have missed the December 13 New England Journal of Medicine there was a review article entitled, ‘Purinergic Signaling during Inflammation’ with Dr. Holger Eltzschig as the lead author:

http://www.nejm.org/doi/full/10.1056/NEJMra1205750

This marks the 3rd NEJM review article for our department in 2 years (to go with those Joy and Holger were invited to submit last year).  I know Denver has been focused on the records set this month by Peyton Manning, but our Department has hit the Anesthesiology record books as well.

 

11/27/2012

Sorry for the long hiatus.  However, it was partly for a good reason.  I had resolved a while back to get help with this blog so that the messages could be at least weekly.  To do this Kirstin Runa and I decided that my next administrative assistant would have writing skills.  Finding someone like that proved harder than it sounds.  Luckily and finally, we found Shannon Swan, who has among other administrative talents, a degree in anthropology (anesthesiologists are her new ‘subjects’).  Going forward, please send suggestions for blog content to Shannon, me, or both of us.  She has promised to keep me ‘on task’.

 

I was glad to see the terrific turnout for Grand Rounds on Monday morning.  I want to give a special shout out to everyone who braved the cold and the lack of provided directions from AO1, RC-2 and UCH to the Mt Oxford auditorium at CHCO.   Linda Watkins graced us with a dazzling, thought-proving presentation early Monday morning.  As was insisted on at the Research Retreat earlier this month and then seconded strongly at the UCH faculty meeting the following week, we will be moving to a Grand Rounds format (aiming for a January launch) that will include all the faculty at the AMC (UCH, CHCO and research) and each one will have some research content, even if only a 10 minute dose.  There are details to be worked out so stay tuned.

 

On the heels of Linda’s great presentation, it is wonderful to announce that her lab (in Boulder) along with Uwe Christians’ lab in our department was awarded a BioFrontiers grant by the State of Colorado’s Bioscience Discovery and Evaluation Grant Program.  The work is designed to move Linda’s exciting pain therapy candidates we heard about on Monday into clinical use.  Initially, Rachael Rzasa Lynn will be devoting much of her research time to this well-funded project.

 

Also of recent research funding note for other junior faculty are Eric Clamby’s American Heart Association grant and Hongyu Xue’s American Society for Parenteral and Enteral Nutrition’s Rhoads Research Foundation Grant.  These are big steps forward for both of them.

 

7/23/2012

The aftermath of the theatre shootings kept on through the weekend with several of the victims making return trips to the OR.  Of course, this also means lots of extraordinary care given in the SICU as well.  Here’s a note of recognition from Dr. Robert McIntyre, the President of the UCH Medical Board, who also spent a lot of time in the hospital this weekend.

 

The inevitable problem with pointing out the contribution of just one or two people in a situation like the one we have had around here for the past three days is that you do not point out the contribution of others (and believe me that everyone contributed). However, I feel compelled to point out the contributions of Matt Rowan and Amanda Wallace this weekend.  Both met with a group of surgery residents that I convened in the SICU very early Friday morning to coordinate efforts and they executed everything superbly. I think Sunday was the busiest ICU day I have experienced in my career. Matt handled it with a smooth confidence and excellent skill. All the patients had great care. And most of all he did it in the midst of the unbelievable circus that occurs when the President visits the ICU.

 

Robert McIntyre, Jr., MD

Professor of Surgery

University of Colorado School of Medicine

 

7/20/2012

I was able to witness firsthand the amazing response to last night’s events.  You hear this all the time; it is awe-inspiring to see everyone from housekeeping, to nurses, to hospital managers, to surgeons all kick it up a notch in terms of collegiality and focus when this sort of thing occurs.  The worst in people also brings out the best in people.

 

Our people were terrific.  I especially want to recognize the efforts of Ferenc Puskas for initiating the ‘mobilization’ and organizing our ‘mob’.  Our call team of John Armstrong, Heidi Green, Marshal Stafford, James Ryan and Jen Mauer were all in top form and beyond.  Also, the ‘responders’ were able to jump right in and do what was needed: kudos to Allison Rocco, Anne Rustemeyer, Matt Fiegel, Jonathan Mayles, and Mary Bidegary.  Jose Melendez also rushed in to help move patients and resources within the hospital to masterly direct the mass casualty situation.

 

I hope we never get a repeat of this sort of tragedy, but it’s good to know we’re ready when it does.

 

7/16/2012

This is my annual message to draw attention to Children’s Hospital’s annual Courage Classic, a bike ride in Summit County that raises money for the Children’s Hospital Foundation.  Again, the two top fund raising teams are the Gears of Courage (mainly healthcare professions from our AMC) and the Wheels of Justice (Denver-based attorneys)  This year, besides joint training rides, Dan Hyman from CHCO has produced a joint video where the two professional teams come together in the name of kids to drum up support for the Foundation.

 

http://www.youtube.com/watch?v=bEVkxRn5k5w&feature=youtu.be

 

Here’s the Gears of Courage website if you’re as interested as I think you are in making a donation of $10 or more to Courage Classic.  I’ll leave you on your own finding the Wheels of Justice website if you’d rather give fund-raising credit to lawyers.

 

http://www.couragetours.com/siteapps/teampage/ShowPage.aspx?c=8gLLK3MHLhIYF&b=7741033&teamid=4936816

 

 

7/3/2012

There have been several very nice scholarly products from our residents in the past week.  First, Carrie Stair is first author on an article entitled, “Sugammadex, The First Selective Relaxant Binding Agent For Neuromuscular Block Reversal” to be published in Drugs of Today 2012, 48(6): 405-413 with Ana Fernandez-Bustamante as the faculty author.  It’s amazing that Carrie managed this during a very busy CA-2 year.  Congrats to both!

 

Also, the ASA has accepted a slew of abstracts based on challenging cases from our residents:  Sarena Teng has two presentations, “"Can a Patient with Severe Pulmonary Hypertension and Eisenmenger’s Syndrome Be Sedated with Dexmedetomidine?" and "Anesthesia for a Malignant Hyperthemia-Susceptible Patient Presenting for Liver Transplantation".  Sukhbir (Suki) Walha will present “"Spurious Hypoxemia during Emergency Craniotomy".  And Shin Kamaya’s is, “Penetrating Trauma in a Peripartum Patient and Management with Massive Transfusion and Thrombelastography”.

 

We do some interesting and rigorously thought out clinical work in our program.  It’s terrific to see some of them presented at the ASA annual meeting in Washington, D.C.  Hats off to the residents who did the heavy lifting on these presentations as well as to the faculty who worked with them to manage the cases and push the outcome forward to an abstract.  I look forward to seeing a full manuscript accepted for publication on some or all of these.

 

Also Denver Health has named their new CEO who will replace Patti Gabow when she retires on September 5.  Hard to imagine the place without Dr. Gabow.  It sounds like Art Gonzalez is a very qualified choice.

 

http://www.denverpost.com/breakingnews/ci_20993217/denver-health-picks-new-ceo-replace-retiring-patricia?source=rss

 

 

6/25/2012

We had a terrific graduation dinner at the Grand Hyatt a week ago and I thought it apropos to list the awards that were given out.  Each award makes one stop to reflect on what an incredible group of dedicated professionals we have, at how many different stages of careers we all represent, and how big an effort everyone is willing to make in the name of patient care.  These awardees’ efforts have managed to stand out in the past year.

 

Outstanding Teachers of the Year Award

Children’s Hospital Colorado: Kim Weigers, M.D

University of Colorado Hospital: Breandan L. Sullivan, M.D.

Veterans Affairs Medical Center:  Aaron T. Murray, M.D.

Denver Health Medical Center: Greg Myers, M.D.

 

The “Unsung Hero” Award For Outstanding Resident Support

Peter Rowe, M.D.

 

Outstanding Resident of the Year Award

Kristin (Kit) Berger, M.D.

 

Outstanding Academic Achievement Award

David Abts, M.D.

 

“The Katie” Wood Memorial Award

Sarena Teng, M.D.

 

The “No Humbug” Award For Excellence in Medical Student Teaching

Angelo Dilullo, M.D.

           

 

6/5/2012

It’s not often that I report hospital-related as opposed to department-related items., but a few news stories about the hospitals on the AMC came out this week that I think are of interest.

 

The Denver Business journal reported that UCH was among the 25 best hospital to work at in the United States in a list compiled by HealthExecNews.

http://www.bizjournals.com/denver/news/2012/06/04/2-denver-area-hospitals-named-among.html

 

US News and World Report again rank CHC among the top children’s hospitals in the country.

http://www.bizjournals.com/denver/news/2012/06/04/2-denver-area-hospitals-named-among.html

 

And The Coloraoan has a very nice article about Rulon Stacey, the former CEO at Poudre Valley who is now ‘our leader’ of University of Colorado Health System.  It gives some nice background on Rulon and some insight why UCH jumped into the partnership with PVHS.

http://www.coloradoan.com/article/20120604/COLUMNISTS56/306040024/PVHS-s-Rulon-Stacey-star-health-care-industry?nclick_check=1

 

 

5/29/2012

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We received some very good news last week.  Ana Fernandez-Bustamante was awarded an FAER mentored research grant (MTG).  For those of you who follow this sort of thing, an MTG is a very big deal.  Typically the ASA research committee, which  reviews the applications, is very particular about these awards as they specifically target individuals and their mentoring environment with intent that they convert into NIH-funded labs and careers.  This is partly due to the limited funds available to FAER and to the diligence of the committee and the FAER board.  Our own FAER board member, Joy Hawkins, indicated that they were particularly stingy this year and awarded on 2 MTGs, despite receiving in excess of 3 dozen applications.  This makes Ana's achievement of getting this award on her very first submission amazingly spectacular.

 

Past FAER awardees in the department include Paul Wischmeyer, Holger Eltzschig, Sara Cheng, Tobias Eckle and myself.  It's important that we continue to show that we realize success from these investments.  If you remember, just last fall the FAER President, Denham Ward, visited our campus to interview past awardees and commented that for a small department we have a large concentration of them and they're all successful.

 

On that note, I should mention the media splash that Tobias Eckle enjoyed with his major new publication in Nature Medicine (see below).  The SOM's PR department, headed by Dan Meyer, put out a press release highlighting that Tobias' work showed how sunshine and/or bright lights might be protective against myocardial infarction.  The popular press came in droves.  Tobias told me that he was interviewed by over a dozen local and national publications and media outlets.  Most of you saw his interview on NBC's News9.  But if you didn't, here's the link:

 

http://www.9news.com/video/1587401683001/1/Study-Intense-light-could-minimize-heart-attack-damage

 

3/14/2012

It’s been some time since I made an entry.  Partly it’s my fault as a few things have stacked up.  The motivating event to unclog things was Tobias Eckle telling me yesterday that his manuscript was finally ‘fully’ accepted by Nature Medicine.  This was news I’ve been anticipating (and anticipating).  Getting a paper in Nature Medicine is about as good as it gets for a medical scientist and it’s really tough.  The revision process, alone, involved new experiments and new data and took well over a year.  The title of the paper is “Adora2b-elicited Per2 stabilization promotes a HIF-dependent metabolic switch critical for myocardial adaptation to ischemia.”  Uh, you’re going to have to ask Tobias or Holger to explain this to you; it’s deeply mechanistic.

 

Susan Mandell learned that her multi-institutional study of pain management for donor hepatectomy has been approved for funding by the NIH.  She will be heading to Washington soon for the planning meeting to kick this off.  Our UCH patients will be part of this study.

 

Paul Wischmeyer also heard this week that his NIH R34 multicenter glutamine for critically ill patients trial was approved for funding.  This could turn into a major multimillion dollar therapeutic trial, depending on the outcome of this still rather large pilot study.

 

Brian Davidson was featured in an article in the Denver Business Journal recently.  It talks about some of the efforts that almost everyone in the department has contributed to.  It’s great to see that others think that what we do to try to improve our clinical performance is worthy of coverage for a more general business readership.  Also, it takes Brian’s perseverance to keep this effort going.

 

http://www.bizjournals.com/denver/print-edition/2012/02/24/davidson-passionate-about-the-quality.html?page=all

 

1/17/2012

Congrats to Drs. Hendrickse and Tan for successfully getting certification from the ASA as an official simulation laboratory site for the Maintenance of Certification in Anesthesiology (MOCA) process.  They also successfully ran a training workshop to certify several of our faculty as additional simulation instructors so that MOCA courses can be offered at CAPE.  It’s terrific that we have the leadership and the faculty expertise to put something like this together.  Now the real work (and fun) begins.

 

Good news from the Department of Surgery.  First, they received a 5 year approval from the ACGME with no citations for their residency program.  This is a huge step as they were on probation last year, mostly due to duty hour violations.  In addition, we learned this week that Dr. Richard Schulick of Johns Hopkins University has accepted the position of Chair of the Department.  He was the top choice of the search committee as well as the top choice of virtually everyone he met while interviewing here.  His start date is May 1.  He will be on campus in the middle of February to take the new chair/division chief orientation course that the SOM now organizes.  I guess the school learned their lesson after throwing some of us into our multi-institutional environment of complex rules and regulations figuring that on-the-job-training would be fine.

 

1/5/2012

It’s fitting that on the first posting of the New Year, there’s something that’s really new to report on.  First, our newest faculty member Paco Herson and his wife Emily had a new baby boy last night at UCH.  Paco sent this picture and reported that mother and Levin Ross received amazing care.  Hope they remember that exact phrasing for the Press Ganey survey when it arrives.

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This morning the UCH brass, including the Board of Directors, were on hand for the ‘topping off’ ceremony on the new tower.  Even though it was January 5th, it felt more like August or September in the west parking lot/construction site.  The final beam got hoisted with the Scandinavian good luck offering to the Nordic gods of a small evergreen tree.  The whole thing made you appreciate what a terrific place we all work in and that it’s everyone’s intent to do something truly special here.  Check out the new beam with flag and tree next time you drive past when it’s not dark (even a warm front can’t fix the day/night cycle of January).

 

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Tomorrow will be the last day at UCH, but not the last one at the UCSOM, for Matthew Roberts.  He’s starting a new position at Denver Health on Monday.  Matthew has been one of the brightest lights at UCH for almost a decade and he’ll be greatly missed (sort of, as he won’t really be gone).  We’re going to have a lunch in his honor in the AIP lounge tomorrow, so be sure to stop by.  In addition, Matthew will be seeing off his old friends at the new Cedar Creek Pub (on campus in the Apartment Building at Ursula and Montview ) from 4 to 6 to hoist a few pints.

 

 

12/19/2011

Last week Bruce Schroffel, Jim Schmerling and Dick Krugman hosted a reception to mark the founding of the Colorado Institute for Maternal and Fetal Health.

 

http://www.childrenscolorado.org/conditions/newborn/MaternalFetal/highrisk.aspx

 

As the two hospital CEOs joked during their opening remarks, this took an inordinate amount of time to bring to fruition for something that has such obvious value to both the patient and medical communities.  Even with this collaboration barely out of the gate, I think the potential here is quite amazing.  Dr. Tim Crombleholme, the new pediatric Surgeon-in-Chief, commented that the Institute was a major reason he chose to bring his fetal surgery program to Denver.  Much was made of the amazing job done by our obstetrical anesthesiology team in making CHC safe for maternal emergencies and their steadfast support for the project.  The potential for pulling our department’s UCH and CHC faculties closer together and for clinical research collaborations also cannot be minimized.

 

Kudos to Sara Cheng for getting her manuscript, “Standard subcutaneous dosing of unfractionated heparin for VTE prophylaxis in surgical ICU patients leads to subtherapeutic factor Xa inhibition,” accepted for publication in Intensive Care Medicine.  This marks the completion of a long clinical investigative journey that Sara shouldered first as a resident, then as an FAER-sponsored fellow and now as a junior faculty.  Rigorous clinical trials are tough to do and even tougher to complete and get into the medical literature.   Good to know we have another ‘Jedi Knight’ we can call on for help in this area.

 

12/12/2011

It’s amazing how much holiday spirit is being generated by Cathe Cook and all of her ‘elves’ with the Salvation Army’s Angel Tree program This program provides underprivileged kids with their actual Christmas gift requests.  The tags Cathe offers have the child and the gift they most want on them.  Just buy the gift and bring it to Cathe for pick-up.  Cathe will also take a donation and she will then use her well-oiled system to convert cash into actual gifts.  There’s still time to make more kids happy.

 

The Department learned last week that our request to increase our residency class size from 12 to 15 received funding approval from UCH.  This was a major goal of our strategic plan and also a top recommendation of last year’s departmental Program Review, so this is a very big accomplishment.  Hats off to Joy Hawkins, Jose Melendez, Kay Oliver and Carlos Fernandez for their strong, effective efforts over the past several months to bring this to reality.  We plan to add 3 additional residents from outside the Match (the last year outside-the-Match selections will be allowed, by the way) to the CA-1 class that will start in July 2012.  The June 2015 graduation dinner is going either be very crowded or moved to a bigger venue.

 

Almut Grenz just learned that her paper describing work on the ENT1 transporter was accepted by JCI (The Journal of Clinical Investigation), a very big deal.  Of particular note is that two Colorado medical students (and former FAER student fellowship recipients) shared first authorship, Jessica Bauerle and Julee Dalton.  Besides making Jessica and Julee work very hard to earn their authorship position, Almut has provided these two budding anesthesiologists with an academic career starter package (a JCI paper) that very few could ever hope to match.

 

11/18/2011

Congratulations to Ana Fernandez-Bustamante et al. (Pierre Moine, Cristina Wood and Zung Tran) for having their manuscript accepted for publication in BMC Anesthesiology (Intraoperative ventilation: incidence and risk factors for receiving large tidal volumes during general anesthesia).  It’s so great to see activity from our operating rooms turned into published articles.  We generate a lot of abstract presentations from our clinical observations, but it takes a special effort to ‘push in a score from the red zone’ and get it published – sorry for the football analogy, but after the Bronco’s win last night I couldn’t resist.

 

In case you didn’t see Bruce Schroffel’s piece in the UCH Insider, here’s the latest about Ben Meyerfhoff:

 

“There has been a personal online "Care Calendar" for the Meyerhoff family set up where you can sign up to help with child care or to bring meals.  You can also purchase and donate gift cards the family can use at different restaurants.   To get started simply access the site http://carecalendar.org and enter the following information in the appropriate box: Calendar ID: 93421; Security Code: 5687.  Erin has also been so very generous with her time and energy by posting updates on Ben’s condition on Facebook at “Ben Meyerhoff Update.”

11/11/11

I received several wrong guesses to the quiz from Oct 28.  The correct answer was Tobias Eckle.  He was the recipient of a mentored research grant from FAER shortly after his arrival here in 2007.  The cover of Anesthesiology as part of the 25th anniversary of FAER showed the portraits of many of the past grant recipients (some when they had a fuller head of hair).  By any measure Tobias’ FAER grant was successful as he went on to get an NIH K08 award and will soon be submitting his first R01.  Also, Tobias just had a review accepted with Holger Eltzschig to Nature Medicine on mechanisms of ischemia/reperfusion (http://www.nature.com/nm/journal/v17/n11/full/nm.2507.html) and soon (we expect) the revision of his manuscript describing his discoveries of the importance of the period protein (regulating light/dark cycle) to myocardial protection will be accepted for publication to the same journal.  Being a cover-boy on Anesthesiology is nice, but getting two publications in Nature Medicine is a truly amazing accomplishment.

 

The current President of FAER Denham Ward (http://journals.lww.com/anesthesiology/Fulltext/2011/10000/What_Is_FAER___The_Foundation_for_Anesthesia.7.aspx) was on campus Wednesday.  He wanted to visit with our several past recipients of FAER awards to collect their ‘stories’ as part of an oral history project that he is working on.  He also wanted to understand what we were doing with the FAER funds that we had received as Colorado was in the top 5 recipients of FAER grants since 2006.  Denham left with some good material for his history project and a very positive impression of what we were doing.  Thanks to all who met with him.

 

 

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Please also help me welcome Paco Herson, PhD, who arrived here the first of the month to head up a new neuroscience laboratory.  Paco is an Associate Professor of Anesthesiology and will serve as Associate Chair for Neuroscience and Director of the Neural Injury Program. We expect the latter with the help of Dick Traystman will be a successful multidisciplinary effort, involving many departments.  Paco brought his lead post-doc, Nidia Quillinan, from Portland to help run his new laboratory.  I’ve heard they’ve managed to already a set of experiments already.  Not bad less than two weeks after arrival and it shows why Paco was so interested in recruiting Nidia to Denver.  Paco’s lab is located on the 8th floor of RC1-North, but he also has an office in AO1 in the Anesthesiology area on the 2nd floor so he can better meet with our faculty as well as those of other clinical departments.

 

Finally, congratulations to Ann-Kathrin Riegel, MD, PhD, for her recent publication in PLoS One, analyzing TEE data:  http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0026559

Ann-Kathrin will be finishing up her post-doc in Holger Eltzschig’s lab and will be joining the residency program in July as a CB-1.

 

11/8/2011

I’m very sad to report that our Chronic Pain Clinic Manager, Ben Meyerhof, sustained a severe cervical spine injury while riding his bike home on Monday night.  Those of you in the ORs on Monday night and Tuesday know of his spinal fusion surgery to stabilize his neck – thanks for the superb care you all provided for him.  Ben has a very long road ahead of him with a lot of work, regardless of what function he regains.  Given his athletic background and with everyone’s support he can make amazing progress and do amazing things during his rehab process.  We want Ben’s smiling face and dynamic presence back in the AOP as soon as he can do it.

 

10/28/2011

After an ‘Epic’ and traveling hiatus I’ll be back with several updates in the coming days and weeks.  As luck would have it, a month after the retirement of the institution’s most capable residency coordinator ever (Jan Ratterree, of course), the Department will be heading into its most intensive residency recruitment season in its history.  Joy Hawkins says that the 900 or so applications we received this fall was a record number.  We invited our usual 100 or so for interview, but this year almost all of them accepted, so it will be very busy around here on Mondays starting on November 7th.  Fortunately, Kay Oliver, our new coordinator, is more than up for the job and Jan has agreed to ride shotgun on Mondays as a part time employee.  Still, we’re going to need all your help to make this a successful recruitment season as this activity defines Team Sport.

 

Dirk Homann our newest research faculty, who’s based at Childrens’ and who’s spoken at a couple of our faculty meetings already, received an extraordinarily high score on his latest NIH grant submission, which placed it in the top 1 percent of all grants reviewed during the cycle, assuring funding.  Hats off to Dirk for the amazing work, to Randy Clark and Jeff Galinkin for the smart recruitment, and to Holger Eltzschig and his team for adding some of their key input to Dirk’s new proposed research plan.  If you go back and check through the blogs, you’ll see that this is the 3rd new NIH R01 grant in the last 4 months. 

 

Trivia Question: (1) Which faculty member has his/her picture on the cover of October’s Anesthesiology, not once, but twice?!

 

8/29/2011

Last time there was a post-doc research seminar I mentioned it only after the fact, mainly because I was floored at how good it was.  Well, even though this is late notice I would like to encourage folks to attend the research conference today at 3:30p in RC2’s Tri-visible room on the 2nd floor.  The ‘short’ topics will include a wide range of subjects of interest to both clinicians and basic scientists and two of the speakers are either residents (Tony Oliva) or soon to be residents (Ann-Kathrin Riegel), giving several reasons for this not to be missed.

 

The most recent Colorado Cancer Center newsletter/blog has an article about our own Dr. Natalie Serkova, which features her new publication reviewing the latest in cancer imaging techniques.

http://www.coloradocancerblogs.org/news/novel-imaging-techniques-show-effectiveness-of-new-targeted-cancer-drugs

 

Later today Dr Leslie Jameson will be speaking to a national audio conference of 1200 users and investigators of the National Surgical Quality Improvement Program (NSQIP) on the topic, “The perioperative role of the Anesthesiologist and the surgical encounter.”  This is important in several respects.  First, it appears that UCH will be entering the NSQIP program in the next year with general surgery, orthopedics, ENT and gynecologic cases.  Second, NSQIP currently does not utilize perioperative anesthesia data but the interest is high to do so, especially with the advent of the anesthesia EMRs and data repositories.  Third, Dr. Jameson could help draw attention to Colorado as a potential leader in this regard.  Leslie is advocating for our department’s involvement as the presence of COHO, the Department of Surgery’s past success with outcomes research and the extraordinary capabilities of our EMR team (Ken Bullard, Bob Phelps, et al) put us in a unique position to really succeed at this kind of research (as also noted by our external program reviewers in the spring).

 

8/5/2011

We’re coming up on (or just passed) the anniversaries of Jason and Alison Brainard joining our department.  Both have made quite significant marks in their short times here.  Alison has stepped up in a big way in medical student education, taking on a major leadership role and rolling out enhancements.  We just learned that Jason’s efforts to establish a Fundamentals Critical Care Support (FCCS) course at the University of Colorado will not only culminate in 3-day course the first week of October that will also utilize the simulation resources of the CAPE and Wells Center but has been chosen as one of the recipients of this year’s SOM/UCH-awarded grants in quality and safety (budget approx $20K).  The FCCS course is aimed as an introduction to the principles of critical care and is can be taught across various disciplines and professions.  The first targeted audience will be the ‘pre-arrest’ rapid response teams within UCH but Jason expects the venues to expand.  It’s great to see our team leading this effort and getting praise from the granting committee and from Dr. Robert McIntyre (President of the UCH medical staff) who said, “This is exciting and congratulations for making this happen.  You have learned that to get these things done you have to be a bulldozer, keep pushing the pile forward.”  I’m not sure I would characterize either Brainard as a bulldozer (gotta love how surgeons think) but it is certain that both have figured out in short order how to add tremendously to our missions and culture.

 

7/18/2011

This coming weekend is Children’s Hospital Colorado’s Courage Classic.  This is a bicycle tour/fundraiser for their research foundation and I have signed up to participate and already made my pledge amount.  This weekend I went on a training ride with my medical campus-based team Gears of Courage (mostly nurses and doctors) and our arch rivals in terms of pledge support Wheels of Justice (mostly lawyers).  Guess who usually wins?  Well, this year we are leading them with a week to go.  Don’t let this be another ‘Lucy pulling the teed-up football away from Charlie Brown at the last second’ situation.  It would be great if you could click on my link and pledge a buck or two.  All the money goes to pediatric research and the Courage Classic funds have a terrific track record of support.  Also, it would great to finally beat the attorneys at something.

 

http://www.couragetours.com/2011/tomhenthorn

 

 

7/14/2011 (Bastille Day Edition)

Thanks to Marina and Anatoly for hosting a terrific new resident welcome party Sunday evening.  It’s always a treat to see a new class of residents so eager to jump into the specialty and this may just be our best CA-1 class yet.

 

Congrats to Almut Grenz (again).  On the last blog installment I announced her being awarded an American Heart Association grant and yesterday she received notice from the Juvenile Diabetes Research Foundation for a research award of $110K (first year) to study A2BAR as Novel Therapeutic Target during Diabetic Nephropathy.  She also has a strong RO1 submitted to the NIH, so we have fingers crossed on that one as well.

 

We scored a double publicity coup yesterday on Channel 7 (ABC).  They had a health story that featured Dr. Jason Krutsch using Botox to treat the migraine headaches of another of our faculty Dr. Lindsay Weitzel who works in our research labs.  It’s a nicely done story and the Weizel dog plays a very strong supporting role.

 

http://www.thedenverchannel.com/health/28517128/detail.html

 

 

6/14/2011 (Flag Day Edition)

Thanks to all for a terrific resident and fellow graduation dinner on Saturday.  It was quite the send off.  It was also a little sobering to realize that after organizing about 25 of these events, Jan Ratterree will not be the one in the background pulling all the strings anymore.  I’m missing her already and it’s not even October yet (when Jan’s retirement begins).

 

Dr. Nathaen Weitzel will soon have the first issue of Seminars in Cardiothoracic and Vascular Anesthesia released in which he is Editor in Chief.  This is a big undertaking and he says he’s able to do this with the help and advice of several of our faculty.  His focus and hard work has a lot to do with it too.

 

Also of editorial note, Dr. Tobias Eckle has been named an Academic Editor for PLoS One, one the highest impact factor journals in biomedical science.  This is quite an honor.

 

We’ve got our fingers tightly crossed that Dr. Uwe Christians’ RO1, examining In Vivo Assessment of Calcineurin Inhibitor Toxicity in Children, will be funded soon.  The application was the highest scored grant in its study section and the NIH has requested just-in-time info, which usually comes before the award announcement.  This study represents the new collaboration between the clinical pharmacology group and pediatrics.  His co-PI will be Josh Thurman of the Renal Division and the Barbara Davis Center.

 

Also just in (as I was writing this, in fact), Dr. Almut Grenz learned this morning that her Mentored Scientist Development Grant from the American Heart Association entitled “Netrin-1 during Renal Ischemia” is funded!  Almut is doing some really exciting science that will very soon have a translational component that many of you will be seeing in a study involving our living kidney donor program.  Keep an eye out for upcoming research conferences to hear about this potential clinical breakthrough.

 

Finally, after months and months of preparation, simulation, regulatory work, credentialing, and more, the first infant will be delivered by cesarean section at Childrens’ tomorrow morning.  Big kudos to Drs. Hawkins, Bucklin, Fuller, Fiegel and Wood for their work on this project!

 

5/25/2011

This month’s ‘Anesthesiology’ has an intriguing article about an epidural needle with an ultrasound crystal at its tip that allows the clinician to see where the needle is going and when it reaches the epidural space.  One of the authors is Dr. Susan Mandell who helped coordinate the activities of the engineering group with the clinical study group and, as is quite evident to those who have read Susan’s prose, basically wrote the entire article. 

http://journals.lww.com/anesthesiology/Abstract/2011/06000/Eyes_in_the_Needle__Novel_Epidural_Needle_with.18.aspx

 

The article was significant enough to be featured with an editorial and it was also promoted as one of the 3 top public-interest articles by the journal with a press release to through the ASA.

http://journals.lww.com/anesthesiology/Fulltext/2011/06000/The_All_seeing_Eye___Ultrasound_Technologies_for.10.aspx

 

We recently learned that the Department will receive two more significant grants from the Crohn's & Colitis Foundation of America (CCFA).  One is a fellowship grant that was awarded to Dr. Eoin McNamee, a post-doc in the Eltzschig lab.  This is the same 3 year fellowship worth about $60K/yr that Carol Aherne received, but what is really cool about this one is that Eoin is the first person from the entire Mucosal Inflammation Program to get a fellowship grant from the CCFA on the first submission!  Also, Dr. Holger Eltzschig will be receiving the very prestigious Senior Research Award from the CCFA with the same July 1 start date.

 

5/ 12/2011

Text Box: More than Numbing up and Knocking Out
As a liver transplant patient teetered on the brink of death, two anesthesiologists stepped in with a demonstration of just how cool their specialty has become.

https://imgssl.constantcontact.com/letters/images/1101116784221/UCHMkting_UCHI_Logo.gif

 

This week’s issue of the UCH Insider has a very nice article about the amazing work that our faculty and residents do.  It is written from a true head-of-the-table perspective about a liver transplant case (patient named Tom or Bob or something – at least he didn’t mix up ‘numbing out and …’).

 

http://r20.rs6.net/tn.jsp?llr=o7lraccab&et=1105390995087&s=62663&e=001qSvhmu85htLlPnQ57R0T2_J3XG0wqBOt4HCyyGFECkS_ctn2gOlkqLdV16eJKEXmTIJIkEsgQee_LBcGl4jlOfOaI2siMKw4zbEMp3w3ugui_dd4ZT3DNZ5vt_TSv1cXWr8uuQLRHbuqDO-CypBgAh_xzJUm04lSNWueka7sGU2Ss_OPvTsE4g==

 

All I can say is that it is very cool to see the hard work and dedication that our faculty, trainees, nurses and staff put in at such at high level 24/7/365 get noticed.  Thanks to Susan Mandell for grabbing the attention of our PR folks, bringing one to the OR, and just showing him what it’s all about.

 

5/2/2011

I feel like I’ve been away quite a lot during the past several weeks with vacation, meetings, jet lag, reviewing FAER grant submissions, etc., but I feel about ready to settle back in for awhile.  The meeting that I attended this last weekend was the 2011 WARC (western anesthesia residents conference) which was held in probably the nicest setting yet for a WARC, the Paloma Resort in Tucson (2 days of perfect weather definitely helped the cause).  Quinn Stevens and Jeremy Hansen also attended and presented posters.  Here’s Quinn during his formal presentation:

IMG_0143.jpg

The attendance and interactions were both terrific at this year’s meeting and next year’s may even be better with UCLA hosting WARC’s 50th anniversary meeting at Marina del Rey.

 

If you’ve been wondering what our OB team has been up to when they tell us that they’re off for a simulation day at TCH, this very nice write-up describes how they used progressive simulations to design and test the processes for the maternal-fetal medicine program at TCH.  Through simulation they found several systems issues where a pediatric hospital would have problems caring for an obstetric patient in an emergency.

http://www3.uch.edu/uchinsider/maternal%20fetal%20medicine%20simulations.pdf

 

Finally, while asking for advice from Tobias Eckle on some aspects of an FAER grant application I was reviewing that involved ischemia/reperfusion of the myocardium in animal models, Tobias shared his latest ‘publication’ with me.  It’s from an online journal that publishes methods videos so other investigators can truly grasp the nuance of some new, technically challenging, but important techniques.  I had only been vaguely aware of this sort of communication and when I looked at Tobias’ work, found it to be truly amazing and valuable.  Take a look:

http://www.jove.com/details.php?ID=2526

 

 

4/5/2011

I am especially pleased to note that that James Ryan and Sarena Teng  were two of 23 residents from throughout the entire University of Colorado system nominated by the Humanism and Excellence in Teaching Committee at the University of Colorado School of Medicine for the prestigious Humanism and Excellence in Teaching Award, which is awarded annually by the Arnold P. Gold Foundation.  James and Sarena were nominated by medical students based on experiences in their third-year clerkships.  Nominees are selected for the following qualities: as a role model for compassionate, relationship-centered care; as one who exhibits sensitivity and respect for others, including patients and fellow caregivers; and for demonstration of particularly strong teaching skills.  This is a great honor and reflects on the culture of teaching that permeates throughout the whole department.  Way to go guys!!

 

If you haven’t seen it already, you might want to check out the article in today’s Denver Post about Tom Hornbein’s mount climbing adventures.  Besides being a famous mountaineer, Dr. Hornbein was also a long time professor and then chair of anesthesiology at the University of Washington.  Since moving to Estes Park in retirement, he has been a frequent visitor to our campus and department.  The article is about his being inducted into Hall of Mountaineering Excellence on Saturday at the American Mountaineering Museum in Golden.

 

http://www.denverpost.com/extremes/ci_17772098#ixzz1IfQtwpxU

 

3/25/2011

I want to thank the faculty and staff for their wonderful response in support of Phyllis Tuller’s family this past week.  It was a hard week for all of us.  I am sure that the funds being sent in to the Memorial Fund are as greatly appreciated as the sympathy and emotional support that was shown.

 

As I reported at the faculty meeting last night the External Review that occurred on Wednesday and Thursday went very well.   Thanks to everyone for taking the time to attend the many meetings and for covering for others so that they could attend.  Some of the comments coming from the committee reflected spectacularly on all aspects of our mission.  In their interviews with hospital leadership from UCH, TCH and DH as well as chairs of clinical departments there were zero (none) complaints or perceived shortcomings of the services that we provide.  That doesn’t mean we should be complacent, rather everyone should continue their stellar efforts to stay in front of the curve.  Obviously, it’s working.  Similar kudos came for our education efforts of both students and residents.  However, they did note that we have one of the smallest resident class size to department size ratios in the country and that we should strongly consider expanding.  In addition, we are an outlier among top anesthesiology programs in not have a critical care fellowship as well as having an open SICU.  Recommendations from the reviewers along both of these lines could be very useful.  In addition, they were impressed with the production and topical relevance of our research efforts.  They believed the core programs we have established are especially well poised to get us to our strategic goal of reaching the top 10 in NIH funding, but will need continued investment to get there.  Ways to better engage junior faculty, especially those more focused clinically, in research efforts were discussed at the exit session as well.  Other recommendations on how to bolster mentoring for our faculty will also be made. Despite the imperfect process of the review, I believe the results will ultimately serve to propel us along the course that the faculty outlined at the Retreat this last fall.  Now we just have to roll up our sleeves and get to it.

 

3/2/2011

Thanks go out to all that have stayed in Denver ‘manning the fort’ to ensure that CRASH is successful.  As you may have noticed, CRASH has moved from a mainly invited ‘national’ speaker meeting to one where is it 95% composed of our own faculty (only one outside speaker each of the last two years), while improving its content and popularity.  This says volumes about our faculty, particularly the junior ones, and their ability to communicate the latest-and-greatest material to their peers.  This, of course, puts increased demands on the department to maintain clinical care while CRASH is underway.  Thanks again to those making the sacrifice.

 

Mindy Cohen has a new first authored research paper published in Anesthesia and Analgesia.  It’s a great example of the type of clinical research that Jeff Galinkin, Uwe Christians and their group are spearheading.  We have the resources to do much more of this kind of clinical pharmacology research in both pediatric and adult perioperative care.

 

https://files.me.com/tkhenthorn/95z688

 

Dick Traystman (who is jointly appointed in our Department) put a nice write-up of our own Almut Grenz in his weekly blog.  Yes, it’s kind of beating his own drum in this regard, but it is great that he puts the activities of our faculty out to the rest of the University on occasion.

 

https://files.me.com/tkhenthorn/ada0n4

 

2/24/2011

It’s seems hard to believe, but we now have two faculty in one year with major review articles in the NEJM.  Holger Eltzschig’s article on the link between hypoxia and inflammation was published in last week’s issue and it comes less than one year since Joy Hawkins’ NEJM article on labor epidural analgesia.  Congrats to Holger (and again to Joy) and congrats to everyone in the Department for fostering the culture that makes these sorts of significant contributions possible.

 

http://www.nejm.org/doi/full/10.1056/NEJMra0910283

 

Also of interest is that many science-oriented news outlets ran with the CU SOM press release from Dan Meyers (UCD’s PR specialist) about Holger’s NEJM article (a few are listed below).  It’s an avenue we often don’t think of but is one that can boost awareness of what we do.

http://esciencenews.com/articles/2011/02/18/study.links.hypoxia.and.inflammation.many.diseases, http://www.bio-medicine.org/medicine-news-1/Study-links-hypoxia-and-inflammation-in-many-diseases-79391-1/, http://www.sciencedaily.com/releases/2011/02/110218132317.htm,

 

After reading about QI from Peter Pronovost earlier in the week, you can now look at two recent editorials, one from JAMA and another from the NEJM, indicating that ‘Quality’ is now passé and is being replaced by ‘Value’ as the concept most likely to drive changes in healthcare.  Again, we need to focus on what Anesthesiology brings to the table in terms of expertise and opportunity to add both quality and value to our patients and the health of the population we serve.

 

http://www.nejm.org/doi/full/10.1056/NEJMp1013111

http://jama.ama-assn.org/content/304/16/1831.full.pdf+html

 

2/21/2011

Sorry for the long hiatus.  There were many contributing factors, including the Program Review Self-Study and loss of my VPN connection for a couple of weeks, but the main blame was my inattention.  I will endeavor to stay on track with at least a couple entries per week.   One of the cool things that happened in February was the UCH Medical Staff Dinner in which Leslie Jameson received the Extraordinary Service Award.   One of the most remarkable things about the award was that she was nominated for it by our surgical colleagues.  Leslie’s dedication to her patients is extraordinary and evident to everyone.  Below is Leslie with her award in hand:

Macintosh HD:private:var:folders:eN:eNDHzD3qFmy2C8+P8XThqU+++TI:-Tmp-:com.apple.mail.drag-T0x10051ffd0.tmp.X4o1W2:IMG_0133.JPG

 

As some of you may have noticed, the SOM  and our AMC hospital partners have begun serious discussions about how we will go about readjusting our healthcare delivery focus to make it more oriented to value, quality, safety and patient-centeredness.  This will require a much more team-oriented approach to healthcare than we’ve seen heretofore; one that integrates clinical departments, hospitals, and other professionals.  There are many layers to this discussion, beginning with what is driving this change and going on to how to implement these changes, to how to teach it, to what it means to our specialty and to all of us.  To that end I will begin to include links to articles that relate to the layers of this rapidly growing movement so that we can begin a dialog about it in several department forums.  I’ll start with one authored by Peter Pronovost, an anesthesiologist at Johns Hopkins, who has led the modern Quality Improvement movement.  His Commentary, which appeared earlier this month in JAMA , is a very well-stated case for part of what is needed.

 

http://jama.ama-assn.org/content/305/5/500.full.pdf+html

 

 

1/3/2011

Hope all had a great Holidays and that no one is writing 2010 anymore.  A very important paper was published since my last entry.  Joy Hawkins was the lead author on an article in this month’s Obstetrics and Gynecology:

http://journals.lww.com/greenjournal/Abstract/2011/01000/Anesthesia_Related_Maternal_Mortality_in_the.11.aspx

(the full article can be viewed by clicking the view in OvidSP link-it’s well worth reading as the discussion reads like a concise review).  This is the latest in a series of maternal mortality reports that was originated here by Joy and former illustrious UCSOM faculty Charlie Gibbs and Susan Palmer.  The article was also covered quite well in the lay press, complete with quotes from Joy.

http://www.reuters.com/article/idUSTRE6BN2B820101224

 

So if that makes you think that spinal/epidural anesthesia is getting too dangerous, you might want to take a look at the latest review article in the NEJM:

http://www.nejm.org/doi/full/10.1056/NEJMra0808281

 

Perhaps not all that reassuring for our patients, but this review does cast light on the fact that the perioperative interval still contains long term risks that merit further research.

 

12/19/2010

Today’s Denver Post named Bruce Schroffel as the Post’s Business Person of the year:

http://www.denverpost.com/business/ci_16889835

 

 

We all believe he has done a terrific job as President and CEO of UCH, but the hospital’s business success has been in no small part due to the year-over-year increases in surgical and procedural volume, which our faculty, residents, CRNAs and staff have taken on all the while improving the depth and quality of care and services.  This honor belongs to all of us!  The article makes mention of two important elements that our department is at the center of.  One is the strengthening alliance of UCH with TCH and the other is the looming pressure to improve quality, likely with less revenue.  It so nice to see a positive article about our medical center in the local media.

 

Speaking of honors, Dr. Holger Eltzschig just became the fourth anesthesiologist to be a member of the American Society of Clinical Investigation, an honorary society at the top of medical science.  The other three are Daniel Sessler, Jeff Balser, and John Severinghaus.  As amazing and wonderful such a personal achievement is, it is another honor that belongs to all of us as the successes of Holger’s lab were made possible by the support of the entire department, especially those faculty, residents, students, post-docs and PRAs that generate all the data.

 

Also of note is the receipt of the second terrific letter in a week from the ACGME.  This one gave the residency program the maximum 5 years of approval and also gave special commendation to the department for fully addressing concerns raised during the last review.  Congratulations to everyone for making this happen!

 

12/13/2010

Good news on the educational front today.  Ferenc Puskas received a letter from the ACGME that not only gave the Cardiothoracic Anesthesiology Fellowship the maximum 5 years of approval, it also commended the program for the ‘outstanding’ quality of the educational experience and the support given to the fellows.  The letter even went so far as to say how well written and complete the application was.  Kudos to the cardiac team and to our GME ‘gurus’ Jan Ratterree and Joy Hawkins for making this new fellowship a high flying one so quickly.

 

Brenda Bucklin also was just notified that she has been selected to be a member of the Association of University Anesthesiogists (AUA) Educational Advisory Board.  The term is for 3 years.  The AUA has two advisory boards, one for education and one for research, that are charged with arranging the program in each area for the annual meeting and thus pointing out to the specialty what the latest, most important topics of consideration are.  I am also pretty sure that Brenda will be the first Colorado faculty to serve the AUA in this way (at least while a faculty member here).  Congratulations!

 

12/3/2010

Congratulations to our most recent student CRNA  graduates, Meghan Wampold and John Howerte.  An informal luncheon was held in their honor on Wednesday, beautifully arranged by Stephanie May (note the mortarboard on the cake) .  Both will be practicing in Greeley, starting in January.

 

Also of note is the selection of Dr. Sara Cheng to be the University of Colorado’s candidate for Doris Duke Clinical Scientist Development Award.  Each institution is allowed to put forward only one candidate for this award to the Doris Duke Charitable Trust each year.  Congrats to Sara and good luck on the national competition!

 

11/29/2010

Hope everyone had a great Thanksgiving Holiday.  Thanksgiving Day saw the publication in the NEJM, regarding the lack of progress towards patient safety since the Institute of Medicine report, “To Err Is Human.”

http://www.nejm.org/doi/full/10.1056/NEJMsa1004404

There was a follow-up article in the NY Times as well.

http://www.nytimes.com/2010/11/25/health/research/25patient.html?_r=2&ref=todayspaper

 

This topic was well covered in last week’s Grand Rounds by Brian Davidson.  He outlined initiatives we could take in our own department.  According to the articles above, improved safety and quality care do not happen by awareness alone.

 

11/19/2010

We have two research successes that just have to be noted.  First, is we learned this week that Holger Eltzschig was awarded his 3rd RO1 grant from the NIH to study, “Mucosal Hypoxia Inducible Factor in Acute Lung Injury.”  The number of anesthesiologists in existence with 3 RO1s could easily be counted on my right hand.  Holger says that he is busy working on a 4th RO1, his best one yet.  This amazing, developing story is truly a departmental success as the Eltzschig lab (acronym: CHaIR) has received most of its funding to this point from funds that were generated from everyone’s clinical efforts, whether from departmental or dean’s AEF.  As important as the financial support is the fact that you all contribute to the environment that helps fuel CHaIR and our other successful labs with ideas, encouragement, administrative support, students, trainees, colleagues and so much more.  It’s so great when we see such tangible (and almost mythic) evidence of success for efforts that have so many moving parts.  We can all be proud of this.

 

The other research success is that of our newest post-doc fellow, Ann-Kathrin Riegel.  Ann-Kathrin joined us from Tübingen, Germany, in July 2010 for a year of research before starting her residency here at UCD as a CB-1 in July, 2011.  She just received an acceptance letter for her article (as sole first author), in the prestigious journal Blood entitled, “Selective induction of the endothelial P2Y6 nucleotide receptor promotes vascular inflammation,” and co-authored by Faigle, Zug, Rosenberger, Robaye, Boeynaems, Idzko, and Eltzschig.  Welcome and congratulations to Ann-Kathrin!

 

Last, but not least, I want to recognize the 2010 UCH EXCEPTIONAL PARTNERSHIP IN LEADERSHIP AWARD winners.  This award recognizes a team of a UCH manager/director and a physician who have partnered together to lead or manage a team.   This year the winners were:  Ashley Nassau and Brian Davidson, MD.  They collaborated on the creation the new OR block time utilization reports as well as setting up the OR on-time start and turnover project (yet another example of a success that we all share in - is there another kind?).  Special congrats are in order to Brian and Ashley as they add their names to a short but illustrious group as the past winners were:

2009       Denise Snuttjer/Janet Durham, MD

2008       Katie Borgstrom/Yang Chen, MD

 

 

11/5/2010

Surprisingly I had an anesthesiology encounter while on vacation in Uruguay.  The Spanish word ‘Anestestistas’ was on the banner headline of the Sunday El Pais the day we arrived and remained somewhere on page one of most of the daily newspapers throughout our 4 days we were there.  Here’s a sample from La Republica:

http://www.larepublica.com.uy/politica/428856-mujica-pidio-a-los-anestesistas-una-mano-para-la-gente-mas-necesitada

 

If you’re like me, you’ll have to use Google-Translate to get the full meaning of the article.  But the short version is that the national anesthesiology society is at odds with the government and even the national medical society about provision of care to ‘public’ (as opposed to privately insured) patients, resulting a public relations nightmare for everyone in which dozens of women with breast cancer not able to have surgery (no pink ribbons for these guys).  If you go deeper you’ll find that there has been a (perhaps) systematic restriction in anesthesia residency class size, resulting in a relative shortage of anesthesiologists in Uruguay, and other issues as well.

 

To me this represents an extreme example of what the sociologist Eliot Freidson wrote about in his landmark study, Profession of Medicine, where he first defines a profession as a work group that reserves to itself the authority to judge the quality of its own work.  He then points out that “after becoming autonomous the profession has less and less come to reflect what the public asks of it and more and more come to assert what the public should get from it.”  He even went on to say  “so far as the terms of work go, professions differ from trade unions only in their sanctimoniousness.”  Freidson’s words have remained in the ear of organized medicine in the US for some decades now, but a graphic reminder of what the larger meaning of ‘profession’ means is worth considering, even when it comes from a small, largely rural country like Uruguay.

 

10/22/2010

On Tuesday afternoon in San Diego at the Medical Student Anesthesia Research Fellowship Symposium, our two FAER student fellows presented their research along with the other 30 student fellows from around the country.  Scott Bluth from UT Houston worked this summer with Natalie Serkova on a project that tracked the progression of experimental Multiple Sclerosis in rat spinal cords with MRI.  Julee Dalton was selected as one of 14 students who also presented their work during an oral session.  Julee gave easily the most stellar presentation of the session, which included answering some really in depth questions, on her work on renal ischemic protection with Almut Grenz and Holger Eltzschig.  Congrats to all the students from across the country as well as to the respective faculty and PRAs who provided such stimulating  and diverse investigational environments to these young professionals.  FAER is doing a great job making this sort of activity possible.  It is truly seeding our specialty’s future (hint: consider making a donation to FAER, yearly).

 

Speaking of future anesthesiologist-scientists, I am pleased to announce that Drs. Tony Oliva and Jen Appleman have been selected to be the Virtue Scholars from our CA-1 class.  They will be exploring research opportunities with potential research mentor this year with  the expectation that during their CA-2 year an actual proposal will be delineated.  We’re very excited about the potential of these two individuals.  Also, Rachael Rzasa-Lynn will begin her Virtue Scholar research project this academic year.  Rachael will be working with a very well known pain scientist from Boulder, Linda R. Watkins (check her out on pubmed).   Rachael’s project is to begin in Boulder, but then become established in our department’s lab shortly after that.  I am very thrilled that Rachael has taken on this ambitious project and especially since she is (practically singlehandedly) establishing a bridge to this world-class pain research lab.  Bravo!

 

10/18/2010

Just a quick update to say that our department has had a very large profile at this year’s ASA.   The feedback has been tremendous. Congrats go out to all the residents and faculty for their stellar involvement and presentations.  Brian Davidson garnered much attention from the clinical quality improvement community at a well-attended poster discussion session (impressing Amr Abouleish on the right, but driving Henry Acosta to his iPhone during his talk).

 

 

          Tom Henthorn's Quasi Blog Spot

 

 

 

2/14/2013

          Tom Henthorn's Quasi Blog Spot

 

7/26/2013

University of Colorado Health, North, had their Epic go-live earlier this month.  North signifies Poudre Valley Hospital, Medical Center of the Rockies (Loveland), and various clinics and surgicenters in that area (by the way, UCH is now known as ‘Central’).  On completion, the entire system will be running virtually the same version of Epic so that patient records will be available system-wide.  South (Memorial in Colorado Springs) will go-live in November.

 

Not unexpectedly, the Epic anesthesiology module is one of the most complex and detailed portions of Epic.  Also expected, the anesthesia go-live was the smoothest and the ORs experienced the least workflow slowdown across the North hospitals.  The main reasons for this success are the great design of the Epic anesthesia module made possible by the input of our physicians and CRNAs, the coding of these design elements by Ken Bullard and Bob Phelps, and the tremendous instruction and go-live assistance and leadership provided by ‘Central’s’ super-users Leslie Jameson, Jacqueline Vasquez and Julie Negin.

 

This did not go unnoticed.  Here’s a photo from North’s newsletter, showing Leslie instructing Dr. Kelli Weiner (one of CU’s residency grads from the 1990’s) who is on the Board of Directors of Northern Colorado Anesthesia Professionals.  I received further go-live kudos last weekend during the Courage Classic from Drs. Bill Neff (Chief Medical Officer for the entire University of Colorado Health system) and Julio Salimbeni (Medical Director of PVH ORs and whose son ‘A.J.’ works as an orderly in our PACU); both of who further pointed out the tremendous help of Jacqueline and Julie.

 

For those interested, University of Colorado Health sponsors a team at the Courage Classic (3 day fund-raising bike tour in-and-around Summit County for CHCO) and we’re looking for more participation from ‘Central’ next year; A.J. and I were the only ones this year, so I’ll be sure to put the word out next spring.  To be fair there are other teams that our faculty and residents rode for this year.  It was great to see that Mario Villasenor, Glenn Merritt, Mark Twite, Richard Ing as well as Tom and Prairie Robinson were out there supporting their respective teams for the benefit of Children’s Hospital Foundation.

 

7/23/2013

The July issue of Anesthesiology has featured articles that touch on the activities of our faculty.  In an article highlighted as “This month in Anesthesiology” Ludmilla Khailova, a PRA in Paul Wischmeyer’s lab, et al., describe their work showing the importance of gut flora (i.e., the microbiome) on sepsis survival in a murine model.

http://journals.lww.com/anesthesiology/Abstract/2013/07000/Probiotic_Administration_Reduces_Mortality_and.28.aspx

Dr. Wischmeyer’s line of research aims to identify whether the diversity of a patient’s gut flora predicts the likelihood of perioperative morbidity and mortality and whether pre-operative replenishment of bacterial diversity could improve outcomes.

 

Several of our faculty are involved in retraining anesthesiologists who have been out of practice for 2 or more years.  The necessity and the associated issues of doing the retraining job well are described in an editorial by Steadman and Cole:

http://journals.lww.com/anesthesiology/Fulltext/2013/07000/Assessing_Competence_for_Reentry__What_Matters.10.aspx

In conjunction with CPEP (www.cpepdoc.org) Drs. Adrian Hendrickse, Marina Shindell and Gee Mei Tan are using the simulation lab for assessing skills and clinical management of anesthesiologists interested in reentry to active practice.  This aspect is well described in the featured article of a NYC reentry program by DeMaria et al.,

http://journals.lww.com/anesthesiology/Abstract/2013/07000/Simulation_based_Assessment_and_Retraining_for_the.35.aspx

Drs. Leslie Jameson, Alison Brainard and M.G. Lemley have taken the lead positions in putting together the actual clinical training programs for reentry docs along with CPEP (there are currently 2-3 potential reentry candidates in the pipeline).  Our department is the unique position of being a center of excellence for reentry activity partly because one of the leading physician assessment and retraining programs in the country (CPEP) is located in Denver.  An article by members of CPEP (Grace and Korinek), which included our own Lindsay Weitzel as a co-author, is featured in both the editorial and full article linked above.  In addition, the new version of Colorado’s medical practice act includes a provision for a temporary re-training status for physicians that otherwise had a ‘clean’ medical practice prior to their inactivity.  This provision is unique and might attract re-entry physicians to Colorado.

 

7/5/2013

July is the New Year in academic medicine so it feels right to exercise a new year’s resolution to make blog entries on a regular basis.  I saw something very cool in our ORs last week.  The new ‘Quality’ button on the Epic Intra-op electronic medical record (EMR) has scored its first major coup in only its first month of operation.  It seems several of our astute providers had recorded technical issues with certain ventilator settings that resulted in untoward functions, like complete apnea.  These occurrences were flagged via the quality reporting system that was created by Bob Phelps, Brian Davidson and Ken Bullard and lives outside the official EMR.  Our super-technicians (Russ Ingram and Johnny Lawrence) checked out several anesthesia machines.  Johnny then wrote the following email:

 

“The anesthesia machine in room 17 is pulled and is out of service. Jefferey Shoup (of biomedical engineering) came over this morning and took the anesthesia machine to his shop. There is a glitch in some of the anesthesia machines. Thanks again informing everybody.”

 

I’m glad to see that our department is embracing the use of the ‘Quality’ button on the Epic EMR.  By its use we can drive improvement in our processes and make the OR and perioperative care safer.

 

In the July ASA Newsletter three of our faculty are pictured as each having a different take on the proceedings at the ASA Legislative Conference held April 29 –May 3 in Washington.

 

 

3/13/2013

We have some good NIH funding news to report!  Sara Cheng has officially heard that her K23 funding is ‘set in stone’ (Title: Prognostic Risk Score for Post-Discharge VTE in Surgical Oncology Patients).  This marks the first of our own residents to become a junior faculty with us and obtain NIH funding.  This was articulated by the faculty as a strategic goal and to repeat this kind of success on a regular basis.  Thanks to Sara and Paul Wischmeyer for proving this goal was not pie-in-the-sky.

 

Congrats to Karen Jonscher who was awarded a 5-year K25 grant that begins funding immediately.  Karen’s grant exemplifies her unique approaches to proteomic analysis.  She’s working closely with Jed Friedman in the department of pediatrics, but our hope is that these techniques can be applied to research within our department as well.

 

Paco Herson’s R01 entitled, “CaMKII in global cerebral ischemia” received a score placing it in the 1st percentile and will soon be funded.  ‘Soon’ depends on how the country navigates the budget sequestration, however.

 

Holger Eltzschig continues to amaze.  In the past month we learned that his Program Project Grant (PPG) in conjunction with Mike Blackburn and Yang Xia from Houston, investigating adenosine-related mechanisms in a variety of organs, was awarded. This will bring over $700K/yr in direct funding to our department.  PPGs tend to fund at a higher level than R or K grants.  Yang Xia visited our campus from Houston this week and gave a dynamic research seminar on Monday afternoon showing how adenosine may hold the key to successfully treating Sickle Cell Disease (expect even more collaborative grants in this direction).  In addition, Holger learned that his 5th R01, this one examining proton pump inhibitors and renal ischemia, will be funded.  The amount of work it takes to get an R01 is huge.  Getting 5 R01s and a PPG represents a monumental effort and accomplishment.  In addition, many of Holger’s faculty mentees are having funding and publishing success (Eric Clamby, Tobias Eckle, Eoin McNamee, Almut Grenz, and Carole Ahearn to name a few).

 

As you know, departmental resources (time and dollars, mostly from clinical activity) have made these successes possible.  The entire department has permission to pat themselves on the back.  After deservedly patting your back, seek out the investigators for congrats and then give out pats to our administrative grants team (Jeanette Leeser, Sabrina Espinoza and Fanta Kuhlman) who have done yeoman’s work, meeting  many deadlines during an amazing flurry of grant submissions.

 

2/14/2013

Happy Valentine’s Day.  You may have noticed the big white tent to the southeast of the new parking structure at UCH last week.  It was placed there to house (or tent) the ‘Premier’ fundraising gala for the UCH Foundation.  Part of the festivities included appetizers served throughout the magnificent and enormous new ED (however, Dr. Richard Zane kept explaining to the amazed guests that it was just an ‘appropriately sized’ for our current volume).   The Denver Post had a nice article about it, including pictures of folks you may recognize.

http://www.denverpost.com/lifestyles/ci_22584337/premiere-raises-1million-university-hospitals-new-er-tower

 

2/6/2013

We were treated to a great ‘official’ start to the new combined Grand Rounds format.  Dr. Alex Evers, chair at Washington University’s Department of Anesthesiology, delivered a provocative talk on academic anesthesiology culture as well as a (too) short update on the GABA receptor.  If you missed it or, like me, would like to see it again, it’s available here:

mms://essvideo.ucdenver.edu/public/Anesthesia_Grand_Rounds_2_4_13.asf

 

Alex also delivered a fantastic Virtue lecture late in the afternoon on an alternative way of looking at post-operative cognitive function; could there actually be improvement rather than dysfunction?

 

I always get a kick out of the local media when they cover stories right out of our department.  It’s entertaining to see how things that you know very well get digested and then presented to the public.  Plus it’s great to know that what we’re all working hard at is also considered news worthy.  Here’s a nice article from the local paper about Drs. Eltzschig and Grenz, stemming from Holger’s recent NEJM article.

http://www.aurorasentinel.com/news/safer-sugery-cu-med-school-team-looks-at-ways-to-decrease-organ-damage-during-surgical-procedures/

 

1/18/2013

I received the grant application announcement from FAER yesterday.  Most interesting was the categorization of their flagship Mentored Research Training Grant (MTRG) into 3 separate categories: Healthcare Services, Basic Science and Clinical or Translational Research.   The deadline is February 15th.

 

FAER.org/research-grantsThe application website can be found here.

 

That the MTRGs grants lead to NIH funding, as FAER intends, is highlighted in their recent newsletter in an article featuring Tobias Eckle:

 

http://faer.org/news/mrtg-funding-leads-to-nih-grant/

 

Next week is National CRNA Week.  Kristen Van De Velde and her ‘elves’ are planning food events each day of the week as well as signage and posters in all our perioperative sites.  We have an amazing, completely essential cadre of CRNAs that we are proud to have as colleagues.  Let’s help them celebrate.

 

 

1/11/2013

One of the things that chairs fret about is NIH rankings.  How our various departments are ranked affects everything from hospital and medical school stature to recruitment of residents and faculty.  Yet, when I travel the corridors, I don’t hear others in the department asking me what I’m going to do about it.  The new rankings are out, based on 2012 numbers, and we’ve risen to #16 nationally – our first placement in the top 20.  Lot’s of people have put much effort into making this happen, mainly those doing cutting-edge research and writing and submitting grant applications like crazy.  However, I feel that everyone in the Department has contributed by doing important things such as generating clinical income to support our research, attending strategic planning and research retreats, supporting Virtue and FAER scholars, covering the ORs so research faculty can produce data, write and present their work, etc.  We couldn’t do this without everyone pitching in.  Now everyone should share in feeling a little pumped up, especially since the top 10 is within sight.

 

http://www.brimr.org/NIH_Awards/2012/NIH_Awards_2012.htm

 

When we saw the preliminary rankings a couple weeks ago we knew that a lot of our grants were somehow missing.  Fanta Kuhlman and Jeanette Leeser spent many hours with CU’s Grants and Contracts Office and with NIH getting the 60% of our grants that were missing-in-action properly credited.  To use Dick Traystman’s analogy, the bears will eat us if we don’t all row the boat together.  Thanks Fanta and Jeanette for your good hard oar pulls.

 

1/10/2013

Drs. Jason Brainard and Matt Rustici (Dept. of Pediatrics) received a Rymer Grant from the Academy of Medical Educators for the CU SOM. This grant was written so that a 2-week medical student elective could be developed and tested that will focus on critical care and procedural skills training.  A pilot elective is planned for this Spring.  If the course is successful an addition to the SOM curriculum will be proposed to the Dean as part of the formal education for all medical students.

 

The faculty for this elective will include Drs. Azam, Scott, and Sullivan from the ICU group as well as Dr. Ahlgren who will teach be teaching the curriculum on central line placement.

 

While on the subject of our top flight education efforts, we received a letter from the American Board of Anesthesiology just before the Holiday Season informing us that every single CU residency grad taking the 2012 ABA written exam passed, including all our recent grads and a couple who graduated awhile ago.   We used to say back in Chicago that results like these were proof that we were world-class educators; and when not so many passed, it was due to poor resident effort.  Actually, this great news reflects everyone’s focus and hard work.

 

1/4/2013

We recently learned that one of our stellar junior research faculty, Dr. Carol Aherne, received a prestigious Research Scholar Award from the American Gastroenterological Association.  The 3 that got this award last year were from the University of Chicago, MGH, and Northwestern.  This is quite the honor for Carol and will be a big help to our research programs.

 

Hats off to Dr. Susan Mandell.  She has been working steadily for almost a decade to get both UNOS and CMS to recognize that the anesthesiologists taking care of liver transplantation recipients, like surgeons require specialized experience.  Transplant programs now all need a qualified Director of Liver Transplantation Anesthesiology.  Susan just had an article accepted for the journal Liver Transplantation entitled, ‘Director Of Anesthesiology For Liver Transplantation:  Existing Practices And Recommendations By The United Network For Organ Sharing’, which demonstrates that requiring expertise would not unduly hurt transplantation programs.  Seems the opposite should have been the worry.

 

12/31/2012

As we head into the New Year I would like to mention a couple of the accomplishments of our faculty during the last parts of 2012.

 

Dr. Joy Hawkins was selected as one of the nine charter members of the FAER Academy of Education Mentors in Anesthesiology.  The goals of this academy are to:

  1. Generate enhanced education outcomes in anesthesiology.
  2. Promote the science and innovation of education in anesthesiology and perioperative 
medicine.
  3. Spur education mentor training and development.
  4. Provide assistance to anesthesiologists interested in education research.

Congratulations to Joy on this honor.  Being a member of this academy is meant to be the highest honor the specialty can bestow on an educator.  Being the very first to get the honor is something even more special.  Not like we didn’t already know.

 

For those who may have missed the December 13 New England Journal of Medicine there was a review article entitled, ‘Purinergic Signaling during Inflammation’ with Dr. Holger Eltzschig as the lead author:

http://www.nejm.org/doi/full/10.1056/NEJMra1205750

This marks the 3rd NEJM review article for our department in 2 years (to go with those Joy and Holger were invited to submit last year).  I know Denver has been focused on the records set this month by Peyton Manning, but our Department has hit the Anesthesiology record books as well.

 

11/27/2012

Sorry for the long hiatus.  However, it was partly for a good reason.  I had resolved a while back to get help with this blog so that the messages could be at least weekly.  To do this Kirstin Runa and I decided that my next administrative assistant would have writing skills.  Finding someone like that proved harder than it sounds.  Luckily and finally, we found Shannon Swan, who has among other administrative talents, a degree in anthropology (anesthesiologists are her new ‘subjects’).  Going forward, please send suggestions for blog content to Shannon, me, or both of us.  She has promised to keep me ‘on task’.

 

I was glad to see the terrific turnout for Grand Rounds on Monday morning.  I want to give a special shout out to everyone who braved the cold and the lack of provided directions from AO1, RC-2 and UCH to the Mt Oxford auditorium at CHCO.   Linda Watkins graced us with a dazzling, thought-proving presentation early Monday morning.  As was insisted on at the Research Retreat earlier this month and then seconded strongly at the UCH faculty meeting the following week, we will be moving to a Grand Rounds format (aiming for a January launch) that will include all the faculty at the AMC (UCH, CHCO and research) and each one will have some research content, even if only a 10 minute dose.  There are details to be worked out so stay tuned.

 

On the heels of Linda’s great presentation, it is wonderful to announce that her lab (in Boulder) along with Uwe Christians’ lab in our department was awarded a BioFrontiers grant by the State of Colorado’s Bioscience Discovery and Evaluation Grant Program.  The work is designed to move Linda’s exciting pain therapy candidates we heard about on Monday into clinical use.  Initially, Rachael Rzasa Lynn will be devoting much of her research time to this well-funded project.

 

Also of recent research funding note for other junior faculty are Eric Clamby’s American Heart Association grant and Hongyu Xue’s American Society for Parenteral and Enteral Nutrition’s Rhoads Research Foundation Grant.  These are big steps forward for both of them.

 

7/23/2012

The aftermath of the theatre shootings kept on through the weekend with several of the victims making return trips to the OR.  Of course, this also means lots of extraordinary care given in the SICU as well.  Here’s a note of recognition from Dr. Robert McIntyre, the President of the UCH Medical Board, who also spent a lot of time in the hospital this weekend.

 

The inevitable problem with pointing out the contribution of just one or two people in a situation like the one we have had around here for the past three days is that you do not point out the contribution of others (and believe me that everyone contributed). However, I feel compelled to point out the contributions of Matt Rowan and Amanda Wallace this weekend.  Both met with a group of surgery residents that I convened in the SICU very early Friday morning to coordinate efforts and they executed everything superbly. I think Sunday was the busiest ICU day I have experienced in my career. Matt handled it with a smooth confidence and excellent skill. All the patients had great care. And most of all he did it in the midst of the unbelievable circus that occurs when the President visits the ICU.

 

Robert McIntyre, Jr., MD

Professor of Surgery

University of Colorado School of Medicine

 

7/20/2012

I was able to witness firsthand the amazing response to last night’s events.  You hear this all the time; it is awe-inspiring to see everyone from housekeeping, to nurses, to hospital managers, to surgeons all kick it up a notch in terms of collegiality and focus when this sort of thing occurs.  The worst in people also brings out the best in people.

 

Our people were terrific.  I especially want to recognize the efforts of Ferenc Puskas for initiating the ‘mobilization’ and organizing our ‘mob’.  Our call team of John Armstrong, Heidi Green, Marshal Stafford, James Ryan and Jen Mauer were all in top form and beyond.  Also, the ‘responders’ were able to jump right in and do what was needed: kudos to Allison Rocco, Anne Rustemeyer, Matt Fiegel, Jonathan Mayles, and Mary Bidegary.  Jose Melendez also rushed in to help move patients and resources within the hospital to masterly direct the mass casualty situation.

 

I hope we never get a repeat of this sort of tragedy, but it’s good to know we’re ready when it does.

 

7/16/2012

This is my annual message to draw attention to Children’s Hospital’s annual Courage Classic, a bike ride in Summit County that raises money for the Children’s Hospital Foundation.  Again, the two top fund raising teams are the Gears of Courage (mainly healthcare professions from our AMC) and the Wheels of Justice (Denver-based attorneys)  This year, besides joint training rides, Dan Hyman from CHCO has produced a joint video where the two professional teams come together in the name of kids to drum up support for the Foundation.

 

http://www.youtube.com/watch?v=bEVkxRn5k5w&feature=youtu.be

 

Here’s the Gears of Courage website if you’re as interested as I think you are in making a donation of $10 or more to Courage Classic.  I’ll leave you on your own finding the Wheels of Justice website if you’d rather give fund-raising credit to lawyers.

 

http://www.couragetours.com/siteapps/teampage/ShowPage.aspx?c=8gLLK3MHLhIYF&b=7741033&teamid=4936816

 

 

7/3/2012

There have been several very nice scholarly products from our residents in the past week.  First, Carrie Stair is first author on an article entitled, “Sugammadex, The First Selective Relaxant Binding Agent For Neuromuscular Block Reversal” to be published in Drugs of Today 2012, 48(6): 405-413 with Ana Fernandez-Bustamante as the faculty author.  It’s amazing that Carrie managed this during a very busy CA-2 year.  Congrats to both!

 

Also, the ASA has accepted a slew of abstracts based on challenging cases from our residents:  Sarena Teng has two presentations, “"Can a Patient with Severe Pulmonary Hypertension and Eisenmenger’s Syndrome Be Sedated with Dexmedetomidine?" and "Anesthesia for a Malignant Hyperthemia-Susceptible Patient Presenting for Liver Transplantation".  Sukhbir (Suki) Walha will present “"Spurious Hypoxemia during Emergency Craniotomy".  And Shin Kamaya’s is, “Penetrating Trauma in a Peripartum Patient and Management with Massive Transfusion and Thrombelastography”.

 

We do some interesting and rigorously thought out clinical work in our program.  It’s terrific to see some of them presented at the ASA annual meeting in Washington, D.C.  Hats off to the residents who did the heavy lifting on these presentations as well as to the faculty who worked with them to manage the cases and push the outcome forward to an abstract.  I look forward to seeing a full manuscript accepted for publication on some or all of these.

 

Also Denver Health has named their new CEO who will replace Patti Gabow when she retires on September 5.  Hard to imagine the place without Dr. Gabow.  It sounds like Art Gonzalez is a very qualified choice.

 

http://www.denverpost.com/breakingnews/ci_20993217/denver-health-picks-new-ceo-replace-retiring-patricia?source=rss

 

 

6/25/2012

We had a terrific graduation dinner at the Grand Hyatt a week ago and I thought it apropos to list the awards that were given out.  Each award makes one stop to reflect on what an incredible group of dedicated professionals we have, at how many different stages of careers we all represent, and how big an effort everyone is willing to make in the name of patient care.  These awardees’ efforts have managed to stand out in the past year.

 

Outstanding Teachers of the Year Award

Children’s Hospital Colorado: Kim Weigers, M.D

University of Colorado Hospital: Breandan L. Sullivan, M.D.

Veterans Affairs Medical Center:  Aaron T. Murray, M.D.

Denver Health Medical Center: Greg Myers, M.D.

 

The “Unsung Hero” Award For Outstanding Resident Support

Peter Rowe, M.D.

 

Outstanding Resident of the Year Award

Kristin (Kit) Berger, M.D.

 

Outstanding Academic Achievement Award

David Abts, M.D.

 

“The Katie” Wood Memorial Award

Sarena Teng, M.D.

 

The “No Humbug” Award For Excellence in Medical Student Teaching

Angelo Dilullo, M.D.

           

 

6/5/2012

It’s not often that I report hospital-related as opposed to department-related items., but a few news stories about the hospitals on the AMC came out this week that I think are of interest.

 

The Denver Business journal reported that UCH was among the 25 best hospital to work at in the United States in a list compiled by HealthExecNews.

http://www.bizjournals.com/denver/news/2012/06/04/2-denver-area-hospitals-named-among.html

 

US News and World Report again rank CHC among the top children’s hospitals in the country.

http://www.bizjournals.com/denver/news/2012/06/04/2-denver-area-hospitals-named-among.html

 

And The Coloraoan has a very nice article about Rulon Stacey, the former CEO at Poudre Valley who is now ‘our leader’ of University of Colorado Health System.  It gives some nice background on Rulon and some insight why UCH jumped into the partnership with PVHS.

http://www.coloradoan.com/article/20120604/COLUMNISTS56/306040024/PVHS-s-Rulon-Stacey-star-health-care-industry?nclick_check=1

 

 

5/29/2012

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We received some very good news last week.  Ana Fernandez-Bustamante was awarded an FAER mentored research grant (MTG).  For those of you who follow this sort of thing, an MTG is a very big deal.  Typically the ASA research committee, which  reviews the applications, is very particular about these awards as they specifically target individuals and their mentoring environment with intent that they convert into NIH-funded labs and careers.  This is partly due to the limited funds available to FAER and to the diligence of the committee and the FAER board.  Our own FAER board member, Joy Hawkins, indicated that they were particularly stingy this year and awarded on 2 MTGs, despite receiving in excess of 3 dozen applications.  This makes Ana's achievement of getting this award on her very first submission amazingly spectacular.

 

Past FAER awardees in the department include Paul Wischmeyer, Holger Eltzschig, Sara Cheng, Tobias Eckle and myself.  It's important that we continue to show that we realize success from these investments.  If you remember, just last fall the FAER President, Denham Ward, visited our campus to interview past awardees and commented that for a small department we have a large concentration of them and they're all successful.

 

On that note, I should mention the media splash that Tobias Eckle enjoyed with his major new publication in Nature Medicine (see below).  The SOM's PR department, headed by Dan Meyer, put out a press release highlighting that Tobias' work showed how sunshine and/or bright lights might be protective against myocardial infarction.  The popular press came in droves.  Tobias told me that he was interviewed by over a dozen local and national publications and media outlets.  Most of you saw his interview on NBC's News9.  But if you didn't, here's the link:

 

http://www.9news.com/video/1587401683001/1/Study-Intense-light-could-minimize-heart-attack-damage

 

3/14/2012

It’s been some time since I made an entry.  Partly it’s my fault as a few things have stacked up.  The motivating event to unclog things was Tobias Eckle telling me yesterday that his manuscript was finally ‘fully’ accepted by Nature Medicine.  This was news I’ve been anticipating (and anticipating).  Getting a paper in Nature Medicine is about as good as it gets for a medical scientist and it’s really tough.  The revision process, alone, involved new experiments and new data and took well over a year.  The title of the paper is “Adora2b-elicited Per2 stabilization promotes a HIF-dependent metabolic switch critical for myocardial adaptation to ischemia.”  Uh, you’re going to have to ask Tobias or Holger to explain this to you; it’s deeply mechanistic.

 

Susan Mandell learned that her multi-institutional study of pain management for donor hepatectomy has been approved for funding by the NIH.  She will be heading to Washington soon for the planning meeting to kick this off.  Our UCH patients will be part of this study.

 

Paul Wischmeyer also heard this week that his NIH R34 multicenter glutamine for critically ill patients trial was approved for funding.  This could turn into a major multimillion dollar therapeutic trial, depending on the outcome of this still rather large pilot study.

 

Brian Davidson was featured in an article in the Denver Business Journal recently.  It talks about some of the efforts that almost everyone in the department has contributed to.  It’s great to see that others think that what we do to try to improve our clinical performance is worthy of coverage for a more general business readership.  Also, it takes Brian’s perseverance to keep this effort going.

 

http://www.bizjournals.com/denver/print-edition/2012/02/24/davidson-passionate-about-the-quality.html?page=all

 

1/17/2012

Congrats to Drs. Hendrickse and Tan for successfully getting certification from the ASA as an official simulation laboratory site for the Maintenance of Certification in Anesthesiology (MOCA) process.  They also successfully ran a training workshop to certify several of our faculty as additional simulation instructors so that MOCA courses can be offered at CAPE.  It’s terrific that we have the leadership and the faculty expertise to put something like this together.  Now the real work (and fun) begins.

 

Good news from the Department of Surgery.  First, they received a 5 year approval from the ACGME with no citations for their residency program.  This is a huge step as they were on probation last year, mostly due to duty hour violations.  In addition, we learned this week that Dr. Richard Schulick of Johns Hopkins University has accepted the position of Chair of the Department.  He was the top choice of the search committee as well as the top choice of virtually everyone he met while interviewing here.  His start date is May 1.  He will be on campus in the middle of February to take the new chair/division chief orientation course that the SOM now organizes.  I guess the school learned their lesson after throwing some of us into our multi-institutional environment of complex rules and regulations figuring that on-the-job-training would be fine.

 

1/5/2012

It’s fitting that on the first posting of the New Year, there’s something that’s really new to report on.  First, our newest faculty member Paco Herson and his wife Emily had a new baby boy last night at UCH.  Paco sent this picture and reported that mother and Levin Ross received amazing care.  Hope they remember that exact phrasing for the Press Ganey survey when it arrives.

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This morning the UCH brass, including the Board of Directors, were on hand for the ‘topping off’ ceremony on the new tower.  Even though it was January 5th, it felt more like August or September in the west parking lot/construction site.  The final beam got hoisted with the Scandinavian good luck offering to the Nordic gods of a small evergreen tree.  The whole thing made you appreciate what a terrific place we all work in and that it’s everyone’s intent to do something truly special here.  Check out the new beam with flag and tree next time you drive past when it’s not dark (even a warm front can’t fix the day/night cycle of January).

 

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Tomorrow will be the last day at UCH, but not the last one at the UCSOM, for Matthew Roberts.  He’s starting a new position at Denver Health on Monday.  Matthew has been one of the brightest lights at UCH for almost a decade and he’ll be greatly missed (sort of, as he won’t really be gone).  We’re going to have a lunch in his honor in the AIP lounge tomorrow, so be sure to stop by.  In addition, Matthew will be seeing off his old friends at the new Cedar Creek Pub (on campus in the Apartment Building at Ursula and Montview ) from 4 to 6 to hoist a few pints.

 

 

12/19/2011

Last week Bruce Schroffel, Jim Schmerling and Dick Krugman hosted a reception to mark the founding of the Colorado Institute for Maternal and Fetal Health.

 

http://www.childrenscolorado.org/conditions/newborn/MaternalFetal/highrisk.aspx

 

As the two hospital CEOs joked during their opening remarks, this took an inordinate amount of time to bring to fruition for something that has such obvious value to both the patient and medical communities.  Even with this collaboration barely out of the gate, I think the potential here is quite amazing.  Dr. Tim Crombleholme, the new pediatric Surgeon-in-Chief, commented that the Institute was a major reason he chose to bring his fetal surgery program to Denver.  Much was made of the amazing job done by our obstetrical anesthesiology team in making CHC safe for maternal emergencies and their steadfast support for the project.  The potential for pulling our department’s UCH and CHC faculties closer together and for clinical research collaborations also cannot be minimized.

 

Kudos to Sara Cheng for getting her manuscript, “Standard subcutaneous dosing of unfractionated heparin for VTE prophylaxis in surgical ICU patients leads to subtherapeutic factor Xa inhibition,” accepted for publication in Intensive Care Medicine.  This marks the completion of a long clinical investigative journey that Sara shouldered first as a resident, then as an FAER-sponsored fellow and now as a junior faculty.  Rigorous clinical trials are tough to do and even tougher to complete and get into the medical literature.   Good to know we have another ‘Jedi Knight’ we can call on for help in this area.

 

12/12/2011

It’s amazing how much holiday spirit is being generated by Cathe Cook and all of her ‘elves’ with the Salvation Army’s Angel Tree program This program provides underprivileged kids with their actual Christmas gift requests.  The tags Cathe offers have the child and the gift they most want on them.  Just buy the gift and bring it to Cathe for pick-up.  Cathe will also take a donation and she will then use her well-oiled system to convert cash into actual gifts.  There’s still time to make more kids happy.

 

The Department learned last week that our request to increase our residency class size from 12 to 15 received funding approval from UCH.  This was a major goal of our strategic plan and also a top recommendation of last year’s departmental Program Review, so this is a very big accomplishment.  Hats off to Joy Hawkins, Jose Melendez, Kay Oliver and Carlos Fernandez for their strong, effective efforts over the past several months to bring this to reality.  We plan to add 3 additional residents from outside the Match (the last year outside-the-Match selections will be allowed, by the way) to the CA-1 class that will start in July 2012.  The June 2015 graduation dinner is going either be very crowded or moved to a bigger venue.

 

Almut Grenz just learned that her paper describing work on the ENT1 transporter was accepted by JCI (The Journal of Clinical Investigation), a very big deal.  Of particular note is that two Colorado medical students (and former FAER student fellowship recipients) shared first authorship, Jessica Bauerle and Julee Dalton.  Besides making Jessica and Julee work very hard to earn their authorship position, Almut has provided these two budding anesthesiologists with an academic career starter package (a JCI paper) that very few could ever hope to match.

 

11/18/2011

Congratulations to Ana Fernandez-Bustamante et al. (Pierre Moine, Cristina Wood and Zung Tran) for having their manuscript accepted for publication in BMC Anesthesiology (Intraoperative ventilation: incidence and risk factors for receiving large tidal volumes during general anesthesia).  It’s so great to see activity from our operating rooms turned into published articles.  We generate a lot of abstract presentations from our clinical observations, but it takes a special effort to ‘push in a score from the red zone’ and get it published – sorry for the football analogy, but after the Bronco’s win last night I couldn’t resist.

 

In case you didn’t see Bruce Schroffel’s piece in the UCH Insider, here’s the latest about Ben Meyerfhoff:

 

“There has been a personal online "Care Calendar" for the Meyerhoff family set up where you can sign up to help with child care or to bring meals.  You can also purchase and donate gift cards the family can use at different restaurants.   To get started simply access the site http://carecalendar.org and enter the following information in the appropriate box: Calendar ID: 93421; Security Code: 5687.  Erin has also been so very generous w