A5031401002- Cardiac, Anesthesia and Surgical Outcomes
- Healthcare Operations and Scheduling Optimization
- Hospital Admissions and Outcomes
- Nausea and vomiting management
- Patient Safety and Medication Errors
- Anesthesia and Pain Management
- Simulation-Based Education in Healthcare
- Family and Patient Care in Intensive Care Units
- Maternal and Perinatal Health Interventions
- Global Health Workforce Issues
- Gallbladder and Bile Duct Disorders
- Artificial Intelligence in Healthcare and Education
- Healthcare Policy and Management
- Colorectal Cancer Screening and Detection
- Cerebrospinal fluid and hydrocephalus
- Healthcare Systems and Challenges
- Global Maternal and Child Health
- Neonatal and fetal brain pathology
- Traumatic Brain Injury and Neurovascular Disturbances
- Clinical Reasoning and Diagnostic Skills
- Birth, Development, and Health
- Healthcare professionals’ stress and burnout
- Minimally Invasive Surgical Techniques
- Migration, Health and Trauma
- Interprofessional Education and Collaboration
University of Iowa Hospitals and Clinics
2000-2024
University of Iowa
2002-2024
University of Miami
2022
Lanka Hospitals
2007
Marymount University
2002
( Anesth Analg . 2024;139(5):931–939. doi:10.1213/ANE.0000000000006883) The closure of rural obstetric (OB) units has created maternal care deserts, requiring expectant mothers in areas to travel long distances for essential maternity care. This situation also poses challenges emergency departments (EDs) hospitals without OB units, which must ensure that their staff regularly train maintain skills. Similarly, level-1 with low volumes cases struggle provide comprehensive training. To address...
Background Mannitol and furosemide are used to reduce increased intracranial pressure (ICP) brain bulk during neurosurgery. One mechanism by which these changes might occur is via a reduction in water content. Although mannitol commonly combination, there has been no formal evaluation of the interactive effects two drugs on water. The effect alone combination content normal rat was examined. Methods lungs rats anesthetized with halothane were mechanically ventilated maintain physiologic...
BACKGROUND: Closure of rural obstetric (OB) units has led to maternal care deserts, causing mothers travel long distances for maternity care. Emergency departments (EDs) in hospitals where OB have closed require regular training personnel maintain skills, as do Level-1 with low volumes cases. We used a federal grant develop an mobile simulation program bring simulation-based providers. Our goal was improve skills and standardize through the framework Alliance Innovation Maternal Health (AIM)...
Prolonged times to tracheal extubation are those from end of surgery (dressing on the patient) 15 minutes or longer. They so long that others in operating room (OR) generally have exhausted whatever activities can be done. cause delays starts surgeons' to-follow cases and associated with longer duration workdays. Anesthesiologists rate them as being inferior quality. We compare prolonged between a teaching hospital United States phase I postanesthesia care unit (PACU) Japan without PACU. Our...
Multiple previous studies have shown that having a large diversity of procedures has substantial impact on quality management hospital surgical suites. At hospitals with diversity, unless sophisticated statistical methods suitable for rare events are used, anesthesiologists working in suites will inaccurate predictions blood usage, case durations, cost accounting and price transparency, times remaining late running cases, use intraoperative equipment. What is unknown whether feature only few...
Introduction Whenever a department implements the evaluation of professionals, reasonable operational goal is to request as few evaluations possible. In anesthesiology, anesthesiologists (by trainees) and nurse anesthetists anesthesiologists) with valid psychometrically reliable scales have been made by requesting daily ratee’s performance on immediately preceding day. However, some trainees or are paired same anesthesiologist for multiple days week. Multiple from rater during given week may...
Rural obstetric providers have differing educational needs, compared with those in large urban settings based on challenges faced when delivering maternal health care. There are 2 groups of rural providers, and without previous training, which dictates for each group, goals skills improvement maintenance. Training hospitals should focus infrequent high-risk events, constrained by systems deficiencies, all ideally addressed in-situ simulation. Using a mobile simulation approach, visiting...
Department of Anesthesia, University Iowa Hospitals and Clinics, City, IA Departmental funding was received for this article. The author has no conflicts interest to disclose.
Hyperbaric bupivacaine, the local anesthetic routinely selected for single-injection spinal anesthesia cesarean delivery (CD), was in short supply 2018. Hospital stocks were significantly less than before and after shortage period. We developed a contingency plan to communicate with pharmacy retrieve, restrict, reallocate remaining of drug continue performing CD under neuraxial anesthesia, specifically emergency CD, when time appropriate. Retrospective chart review revealed that elective CDs...
Introduction Many obstetrical patients from rural areas in the United States lack hospitals that provide labor and delivery care. Our objective was to examine effects of such on caseloads cesarean deliveries at Iowa with level III maternal care, as defined by Department Public Health (e.g., obstetric anesthesiologists). Methods This retrospective longitudinal study included every discharge state October 2015 through June 2021. There were N=60,534 76 hospitals, which three III, rest I or II....
Obstetric surgical suites differ from most inpatient suites, serving one specialty, and often small. We evaluated long-term capacity planning for these operating rooms. The retrospective cohort study included all caesarean births in three rooms over 28 years, 1994 through 2021, plus other obstetric procedures the latter 19 years. calculated anaesthesia activity index, 0.5 × neuraxial labour analgesia placement + 1.0 births. Annual year to next had a Pearson linear correlation coefficient of...
Obesity in pregnancy is an increasing problem the United States. can result dangerous complications such as premature birth, cesarean delivery, gestational diabetes, and preeclampsia. Little currently known about outcomes morbidly (body mass index (BMI) ≥40 kg/m2 ) super obese (BMI ≥50 pregnant patients. Consequently, it difficult to adequately counsel patients plan for delivery care. Most current data groups general, however, some aspects reductions hormone concentrations vary markedly with...