Featured Doctor: Warren S. Sandberg
Dr. Warren Sandberg became an MGH resident in 1995, a staff member in 1998, and a clinical researcher in 2002. His background is in biochemistry, studying the molecular determinants of protein stability. His current research interests include perioperative systems design and operations research in the perioperative environment, anesthesia information management systems, and automated process monitoring and control during anesthesia. Dr. Sandberg is also a clinician, working as team leader of the Operating Room of the Future project sponsored by the Center for Integration of Medicine and Innovative Technology (CIMIT), as well as team leader for the Liver Transplantation Anesthesia Service.
“Transplantation is a completely separate, but vibrant, exciting part of my life as an anesthesiologist,” he said.
Sandberg has not always been a clinical researcher, however. He initially began a research career investigating the mechanisms of anesthesia in the laboratory of Dr. Keith Miller, but had a “crisis of identity,” he said, and then moved into full-time clinical work.
But, Dr. Sandberg said, “I couldn’t keep the researcher under wraps for long.”
In 2002, then-Anesthetist-in-Chief Dr. Warren Zapol offered Dr. Sandberg the opportunity to become the team leader of the anesthesia program for the innovative ORF project. Sandberg accepted and began studying perioperative systems design. In a paper published in Seminars in Laparoscopic Surgery, he defines perioperative systems design as “a rational approach to managing the convergent flow of patients having procedures from disparate physical and temporal starting points, frequently home, through the operating room and then to such a place and time for example, home or hospital bed where future events pertaining to the patient have no further impact on OR operations.”
The ORF perioperative system made qualitative improvements in workflow, according to Sandberg. For example, instead of working sequentially, the ORF team experimented with a parallel workflow process, so that more tasks could be accomplished at once.
“Instead of small quantitative changes, the ORF design team made big qualitative changes, so we can take on more cases,” he said. “I was lucky to join the project when I did the design team [link to Sims lab] had come up with this great system, and I got to implement it and analyze the results.”
The results, published in the August 2005 edition of Anesthesiology, were later replicated at other institutions in another OR environment at MGH and at the MetroHealth Medical Center and Cleveland Clinic in Cleveland, Ohio.
Dr. Sandberg’s more recent research focus is on “automated process monitoring and process control” in healthcare. According to Sandberg, process control involves several steps: collecting and integrating information with electronic data capture systems; creating a process model (how things are supposed to go); comparing actual events to expected events, based on the process model; and sending notifications to the process stakeholders when there are exceptions.
“The goal is to send information and notifications to people right before they’re needed, or at minimum, while they’re still engaged in the task at issue,” Sandberg said. “If you can reliably receive the reminders and information you need when you need them, it’s easier to focus on clinical work.”
The results of studies on process monitoring and control have either been published or are in press. Publications include Surgical Innovation, Anesthesia and Analgesia, and Anesthesiology.
Dr. Sandberg said Mass General is an excellent place to pursue his research interests and explore innovation in perioperative environments.
“It’s a great academic center overflowing with opportunities,” he said. “It’s an easy place to be.”
Faculty profile: Warren S. Sandberg
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