Cullen D. Jackson, PhD
Director of Innovation
The Division of Innovation in the Department of Anesthesia, Critical Care & Pain Medicine spearheads research on systems-based practice to discover improvements that will positively impact health care delivery. Our work influences team and organization design, communication pathways and transitions of care, information management systems, and training and education across all aspects of the perioperative environment (before, during, and after surgery).
The goals of the Division are to improve the quality of perioperative care by enabling a safe and resilient environment, to improve the patient experience from before admission to after discharge, and to provide research and educational experiences that promote systems thinking. To achieve these goals, we utilize theories and methods from cognitive science and human factors engineering, data and statistical sciences, and modeling and simulation to study individual and team workload and decision-making; human-machine interfaces and interactions; and simulation-based training and assessment.
Because we focus on improvements within the perioperative system, we work with staff across the organization, including, but not limited to: Anesthesia, Surgery, Nursing, Social Work, Orthopaedics, Medicine, Gynecology and Obstetrics, and Information Systems. Some of the innovations our teams have accomplished include:
- Designed and implemented a curriculum and three scenarios using high-fidelity simulation to conduct 4- to 6-hour multidisciplinary team training for 12 groups of surgeons, anesthesiologists, and nurses.
- Designed, pilot tested, and implemented a process to have all patients prepared as close as possible to their assigned OR (total staff miles saved per year = 1,180 miles).
- Investigated root causes and designed a process to improve first case start time and reduce Holding Area holds in order to increase OR utilization. Monthly on-time starts were improved from mean 76.8% pre-intervention to 86.7% in the first 3 months post-intervention, and as a result of ongoing monitoring and continuous improvement loops, monthly percentage of on-time starts has risen to 90%.
- Defined processes and triggers for offering support to perioperative staff involved in adverse event situations, and established a process to train peer supporters.
- Designed and implemented a new standardized handoff process from OR to PACU and ICU on the BIDMC West Campus.
- Designed optimal workflows for staff to follow during OR turnovers and pilot tested the efficacy of the new processes, which will be rolled out to all ORs on the BIDMC West Campus over the coming months.