Bala G. Nair (right), acting assistant professor of anesthesiology and pain medicine, and Karen L. Posner (left), research professor of anesthesiology and holder of the Laura Cheney Professorship in Anesthesia Patient Safety, demonstrate the Smart Anesthesia Messenger at UW Medical Center’s surgery pavilion. The professorship is supporting Nair’s work through an annual award to junior faculty.
“She was a supervisor, and I was an orderly, and she was very good at giving orders,” says Professor Emeritus Frederick W. Cheney, Jr., Fel. ’67.
The former chair of UW Medicine’s Department of Anesthesiology & Pain Medicine is not just describing a summer job after his first year of college. He’s also describing his mother in the 1950s, when she was a nurse at New England Deaconess Hospital in Boston, Mass.
Cheney and his friends and family es-tablished the Laura Cheney Professorship in Anesthesia Patient Safety to honor the woman who inspired his career in medicine. They also established the professorship to continue Cheney’s career-long goal: making patients safer in the operating room and during their hospital stay.
Medicine has always concerned itself with health and safety, says Debra A. Schwinn, the current chair of UW Medicine’s Department of Anesthesiology & Pain Medicine, but anesthesiology was ahead of the curve. “In terms of examining safety scientifically, especially patient outcomes, anesthesiology was one of the first disciplines,” says Schwinn. “This is partly because in anesthesiology, if you have a bad outcome, it’s really bad.”
If anesthesiology was ahead of the curve, Cheney led that curve as one of the founders of the American Society of Anesthesiology’s Closed Claims Project (CCP), begun in 1985. Cheney and his colleagues decided to use national data from patient lawsuits to do a broad analysis of patient-safety issues.
Having a large data sample is really helpful, explains Karen L. Posner, research professor of anesthesiology, the first holder of the Laura Cheney Professorship, and Cheney’s long-time research partner. “When you collect [data] in a large group, you can investigate patterns that might lead you to possible causes,” says Posner.
Over time, the CCP’s findings led to significant steps forward in patient safety, including improvements in intubation, as well as the use of a pulse oximeter in the OR and during recovery. (The pulse oximeter, which clips on to a patient’s finger, measures oxygen level in the blood.) There are other benefits to this type of research. “Often, major advances in surgery can only occur as anesthesia is made safer,” says Schwinn.
With the department’s decision to use the professorship to promote the careers of junior faculty researchers, the endowment has begun to build on Cheney’s legacy. Bala G. Nair, acting assistant professor of anesthesiology and pain medicine, is creating a tool — the Smart Anesthesia Messenger (SAM) — that will help anesthesiologists remember complicated procedures in the OR and alert them to situations that may affect patient safety.
Nair already has built a prototype of SAM that reminds anesthesiologists precisely when to administer antibiotics during surgery. “The SAM prompts have helped us achieve near 100-percent compliance on antibiotic administration. That’s an important step in preventing post-surgical infections and complications,” Nair says.
And with the Laura Cheney Professorship supporting dedicated research time, says Nair, the department is developing a foundation for future progress. “With the help of this professorship, we’ll have a good software platform. We’ll also have a prototype of a decision-support module that can work with the Anesthesia Information Management System,” he says.
That will help the department gather the data necessary to apply for grants to expand SAM’s reach. And it will, as Nair, Cheney, and their colleagues recognize, help their department and their field achieve still greater levels of patient safety.