Featured Service: Cambridge Health Alliance
Cambridge Health Alliance has a long-established relationship with Mass General.
In 1985, Mass General partnered with the then-Cambridge Hospital to provide anesthesia services. Cambridge Hospital later partnered with Somerville Hospital and Whidden Hospital to form CHA.
Dr. Jim Quinn served as chief of anesthesia from 1989 until February 2010. According to Interim Chief of Anesthesia Dr. Ronald Minter, Dr. Quinn grew the anesthesia group primarily from residents who were graduating from Mass General.
Now, one Mass General resident per month rotates through the service, Dr. Minter said, and some of those residents have gone on to become staff members. He estimates that half of the service's staff trained at Mass General.
CHA offers its residents a variety of cases, he said.
"You get a good mix of cases here, so that you can keep your skills in obstetrics, some pediatrics, vascular, general cases," he said. "It's a good mix between an academic setting and a small general hospital setting."
Residents also have the opportunity to gain experience in regional, interscalene, femoral nerve, and axillary nerve blocks.
The service sees 4,000 cases a year, plus 1500 deliveries in OB, he said. It operates six operating rooms at CHA, two at Whidden Hospital, and two at Somerville Hospital.
According to Dr. Minter, the alliance's patient population is unique because many patients don't speak English as a first language.
"For more than 50% of our patients, we need to involve interpretive services," he said. "So it's a very different culture here than at Mass General."
"A big part of what we do here is to try to understand cultural and language differences and make patient care as satisfying as possible," he said.
The alliance employs 50-60 interpreters, he said. It also tends to treat a higher portion of the uninsured and the underinsured than most hospital systems.
The service is currently working on several new projects, including implementing Metavision, Mass General's digital anesthesia recordkeeping system, Dr. Minter said.
In addition to keeping records, Metavision also links with several Partners applications.
"It's a very powerful bedside tool for the anesthesiologists at Mass General," Dr. Minter said. "It will be a big cultural change for us having digital recordkeeping in the OR."
The system should go live at CHA within a year, Minter said.
In addition, CHA recently implemented a modified version of the World Health Organization checklist to improve perioperative outcomes. Using modified WHO checklists, four staff members -- the pre-op nurse, anesthesiologist, surgeon, and scrub nurse -- confirm that they have the correct information about the patient and procedure.
For example, "before we go into the operating room, we make sure we know who the patient is, what the surgery is, if they have any allergies, if the side that the surgery is on is marked by the surgeon, if there's any anticipated problems, that everyone is present and available, and that we have no equipment issues in the room," Dr. Minter said.
The checklists have been effective at reducing errors, he said.
In another project, Dr. Minter is working to improve three areas: getting the first case of the day starts on time, improving turnover time between cases, and improving block utilization. The service has improved first-case start times by about 10% by matching staff members to early-morning patients and decreasing the delay in the first-case start, he said.
To improve turnover time, the service will also install large digital stopclocks just outside the operating room, Dr. Minter said.
The CHA anesthesia staff includes Drs. Minter, Aalok Agarwala, Stephen Campo, Shobhana Dalal, Kevin Dennehy, Kurt Dittrich, Lena Dohlman, Martha Gallagher, Ljiljana Grkovich, Grace Harrell, Deane Marchbein, Richard Miller, Meraj Mohiuddin, Suzanna Panitsas, David Pincus, James Quinn, Shanthala Shivananjappa, Dan Slatalla, James Thompson, John Wadlington, and Annie Woon.
The department CRNAs include Carol Hall, Erin O'Malley and Vicki Andrews. The administrative coordinator is Sandy Aurilio, and the anesthesia technicians include Noreen Feeney and Providencia Saez.
"It's a very strong department," Dr. Minter said.
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Featured Doctor: Ronald Minter
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