These are exciting times for our Department and for the specialty as a whole. When I was a medical student the mortality rate associated with general anesthesia was 1/10,000 cases. It is now one tenth of that or less (≤ 1/100,000). This is a remarkable story and one that we need to continue to build upon by taking the significant improvements we have made in the operating room and applying them across the spectrum of perioperative care.
The American Society of Anesthesiology has called this concept the "Perioperative Surgical Home." This concept entails anesthesiologists taking responsibility for the entire continuum of patient care and utilizing their unique skills to improve patient outcomes and resource utilization. Our Department at BIDMC is one of the leaders of this process both at the medical center and nationally. In the last year we have already made significant progress towards this vision.
Our shared departmental vision is that the Department should:
Contribute significantly to the further development and success of Beth Israel Deaconess Medical Center and its network of hospitals.
Deliver state-of-the-art and efficient service in Perioperative Anesthesia, Critical Care and Pain Management.
Lead the way to improving perioperative patient care through the collaborative application of best practices.
Develop innovative training programs that attract the finest applicants from Harvard Medical School and other top programs nationally.
Be recognized nationally and internationally as a leader in the advancement of anesthesiology through education, research, innovation, and participation in specialty societies.
Be accountable in a measurable way for the value the department brings to our patients and to the medical center.
The Department has significant strengths. First and foremost, our faculty is clinically excellent. They provide cutting-edge clinical care, supporting the most complex surgical services. They are among the hardest working physicians in the medical center. Our retention rate is essentially 100 percent and we take huge pride in our individual achievements, our work as a department and in the Medical Center. The intense loyalty and dedication within the Department produces results. The clinical outcomes of our cases are second to none across all three areas of service: Operative Anesthesia, Critical Care Medicine and Pain Medicine.
Through our work over the last year, we are poised to ensure that these high standards are extended across the BIDMC network of hospitals. In the coming year we will take over Anesthesia and Pain Medicine services at Beth Israel Deaconess Hospital-Milton and Beth Israel Deaconess Hospital-Plymouth. The Department is leading the way for the integration of the hospital-based clinical services throughout the network. For instance, we have laid the framework to take our successful Preadmission Testing services model to the network and to deploy a network-wide anesthesia information system that will allow us to coordinate quality across the different hospitals. We have also taken a primary role in the redesign of Orthopedic services related to the New England Baptist Hospital joint venture. This work has already led to measurable improvements in patient outcomes as we have already seen a decrease in the number of joint patients discharged to SNIFs.
Our educational programs are nationally renowned and continue to attract excellent candidates. Our clinical research programs have benefited greatly from the formation this year of our Center for Anesthesia Research Excellence (CARE), which has allowed us to grow clinical research across the department. Our laboratory researchers in the field of Pain Medicine are nationally recognized and in both areas we have significant and increasing extra-mural funding.
The Division of Pain Medicine is one of the oldest and most respected academic pain practices in the nation. Over the last year we have seen an increase in volume of approximately 30 percent. The Pain fellowship training program is widely considered the best in the nation and in 2015 was named one of the top two training programs in the country by the American Academy of Pain Medicine. The Division has recruited several new physicians and implemented a comprehensive plan to provide all of the non-surgical care in the Spine Center.
The Department of Anesthesia founded the first ICU at BIDMC in 1969. Since then our department has provided stable and responsible leadership for the Surgical ICUs. Over the last two years we have added new services including a "float" intensivist position, designed to provide safe care for critically ill patients located outside of our traditional ICUs and have taken over direction of the ICU at Beth Israel Deaconess Hospital-Plymouth. Our Critical Care group continues build on its research success. Last year we were selected as the only Anesthesia based program in the new NIH network for the Prevention and Treatment of Acute Lung Injury.
All academic clinical departments are challenged by a four-fold impact from accountable care, declining clinical revenue, an evolving training environment and flat or contracting NIH budgets. Anesthesia is especially sensitive to all of these. In the past, our specialty pioneered the patient safety movement, founded the specialties of Critical Care and Pain Medicine, introduced simulation to medicine and led the integration of non-physician providers in the work force. As a specialty and as a Department, we will continue to adapt and lead in this changing environment.
In summary, within the medical center the Anesthesia Department is recognized as a well-run, financially stable, team player that provides outstanding clinical service. We have taken the lead in collaborative process improvements across the spectrum of perioperative medicine and continue to develop and improve patient care processes for optimal outcomes. Outside the hospital, we are recognized as a national leader in innovation, both in clinical care as well as in the science of perioperative health care delivery.
The Beth Israel Deaconess Medical Center Department of Anesthesia, Critical Care and Pain Medicine continues to provide world-class clinical care, training and education, research, and leadership in an environment of collaboration and collegiality.
Daniel S. Talmor, MD, MPH
Professor and Chair
Department of Anesthesia, Critical Care and Pain Medicine
Beth Israel Deaconess Medical Center
Harvard Medical School