Dec. 2013/Jan. 2014 Volume 4, Issue 4
Michaels wins pres gious Pillar Leader Award Damon Michaels, director of clinical trials research for the Periopera ve Clinical Research Ins tute for the Department of Anesthesiology, was honored as the December recipient of the Five Pillar Leader Award. The award is presented to an individual who shows leadership in service, quality, growth/finance, innova on and the promoon of staff and faculty sa sfac on and commitment. In his role as director of clinical trials research, Damon supports the en re Department of Anesthesiology’s clinical research mission, which is no small task. The department has more than 85 ac ve clinical trials, with many more in development. It is not, however, the magnitude of effort that brings Damon’s recogni on, but rather the professional and posi ve manner in which he handles the oversight Damon Michaels is a decade‐long Vanderbilt employee, and his com‐
of this work. See full story, page 2. mitment to excellence resulted in his recogni on as a Five Pillar Leader. New resident evalua on tool earns note
Drama c changes are coming to the way resident physicians in all medical special es are evaluated as they advance through training. Vanderbilt Department of Anesthesiology faculty have developed an automated tool to help more accurately assess residents’ performance as they meet educa onal goals and ul mately become be er doctors. See full story, page 3. At le , William Furman, MD; Dylan Snyder, BA; Jesse Ehrenfeld, MD, MPH; Warren Sandberg, MD, PhD; and Ma hew McEvoy, MD, developed an automated tool to be er evaluate residents and published a study on the new tool in the journal Anesthesiology. Evaluation Tool Earns Note, Page 3
Department Update, Pages 4-8
Holiday Open House, Page 9
Volume 4, Issue 4
Michaels recognized for outstanding leadership Damon Michaels, director of clinical trials research for the Periopera ve Clinical Research Ins tute for the Department of Anesthesiology, was honored as the recipient of the December Five Pillar Leader Award during the recent Clinical Enterprise Leadership Assembly. The award is given to an individual who shows leadership in service, quality, growth/
finance, innova on and the promo on of staff and faculty sa sfac on and commitment. Such leadership is evident in Damon’s achievements, as noted below: PEOPLE Damon’s leadership style is unfailingly enthusias c and passionate, and he encourages collabora on and mutual respect among his staff and the researchers they support. He has an open-door policy and encourages the ongoing educa on and development of his staff. For example, he created a career and promo on path for a team member who is pursuing a master’s degree in stas cs. Damon has become her advocate and champion as she builds the skills necessary to ensure her future employment at the top of her educa on. SERVICE Our Department is one of the most diverse at the Medical Center, and Damon collaborates daily and maintains highly posi ve rela onships with countless groups across the campus. His personal commitment to the best possible service sets the standard for his en re team. He is consistently respec ul, responsible, and professional. QUALITY Damon is con nually improving the quality of our research ini a ves. For example, he was instrumental in developing a formal ve ng process for poten al studies. This process gathers senior researchers, sta s cians, nurses, and administrators together to discuss a project’s feasibility well before research begins. By adding this step, our inves ga ons are be er refined and result in a higher output of ethically and scien fically sound research. 2
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GROWTH/FINANCE Damon con nually seeks more efficient and logical ways to pursue successful research. Over the past five years, our department’s scholarship and clinical research endeavors have grown tremendously, to the extent that we were forced to seri- Damon Michaels ously reorganize our data management. Damon stepped up and created a regulatory management structure for our research, as well as detailed standard opera ng procedures. Because of this, we now have a tremendously improved framework for our clinical research efforts. It is easy to correlate Damon’s efforts to the doubling of research publicaons produced by the Department of Anesthesiology in the past three years. INNOVATION Damon is a respected speaker at na onal conferences on the topics of innova ve approaches to assessing study feasibility, as well as team building. He is always seeking be er ways to perform tasks and improve processes. For example, Damon created a researcher quality assistance program that pairs a research nurse or study coordinator with an inves gator. This quality assistant supports the inves gator throughout his or her study. Then, a er the study’s comple on, an assessment is performed that reinforces the professional growth of the researcher. Through these examples and many more, Damon is the embodiment of a Five Pillar Leader. Thank you, Damon, for your posi ve example and leadership. Automated resident evalua on tool earns note Drama c changes are coming to the way resident physicians in all medical special es are evaluated as they advance through training. Department of Anesthesiology faculty have developed an automated tool to help more accurately assess residents’ performance as they meet educa onal goals and ul mately become be er doctors. “Assessing and repor ng resident performance on all Milestones and core competencies is quite challenging for faculty members,” said Warren Sandberg, MD, PhD, chair of the Department of Anesthesiology. “Having a tool that reduces the administra ve workload while also providing precise, reliable data, puts us at a tremendous advantage.” The changes are due to the Next Accredita on System (NAS) being implemented by the Accredita on Council for Graduate Medical Educa on (ACGME), a nonprofit organiza on that evaluates and accredits more than 9,000 medical residency programs throughout the United States. While developed ini ally to evaluate anesthesiology residents, the infrastructure exists for the automated case evalua on tool to be customized for use by other residency programs at VUSM. The tool has been presented by its developers to program directors of other special es at Vanderbilt, as well as to the American Medical Associa on’s Consor um to Accelerate Change in Medical Educa on. It will also be presented at a panel presenta on at the ACGME’s spring 2014 annual mee ng. New NAS requirements are intended to track learning ‘Milestones,’ and they take effect in July 2014 for anesthesiology residencies na onwide. To assist, anesthesiology faculty developed an automated case evalua on tool to provide immediate feedback on residents’ performance and track their progress. The case evalua on tool pulls data related to specific clinical tasks performed during pa ent cases and fulfills some of the new assessment requirements in ACGME’s Milestones system. “This near real- me, detailed feedback will be cri cal to help residents accurately evaluate their prac ce as they relate to the published guidelines and con nually improve the quality of care they deliver,” said Ma hew McEvoy, MD, vice chair for educa onal affairs and residency program director. “In light of the coming Milestones system, we decided to be proac ve and put our extensive data collec on systems to work for us.” A major concern of many residency program directors is that there will be a tremendous burden in documen ng residents’ progress through the mul -level Milestones system. For instance, there are 60 residents in the Vanderbilt Department of Anesthesiology training program, and there are 25 defined Milestones, or competency-based performance areas, that are to be demonstrated by residents from the beginning of their educa on through gradua on. Each Milestone has five possible levels of performance, and the ACGME requires that each resident is thoroughly assessed every six months on all of the Milestones. This translates into 1,500 data points that must be reported to the ACGME during each evalua on cycle, in addion to a report of personal performance for each resident. “We encourage our training programs to share best prac ces, and this tool is one of those,” said Donald Brady, MD, senior associate dean for GME and Con nuing Professional Development. “The anesthesiology residency, under the leadership of Dr. McEvoy, is at the forefront of helping residents use their own data for personal and systema c quality improvement. This project is a novel combina on of educa onal innova on and informa cs, the la er of which required partnership with the Vanderbilt Anesthesiology and Periopera ve Informa cs Research (VAPIR) Division, led by Dr. Jesse Ehrenfeld.” The evalua on tool is the focus of a study published by anesthesiology faculty in the January issue of Anesthesiology. The study shows that anesthesiology residents want frequent updates on their clinical performance, as well as evalua ons of their performance compared to that of faculty and their fellow residents as a whole. For the ini al study, data were collected from 24,154 completed anesthe c cases at Vanderbilt University Medical Center from February 2010 un l the end of March 2013. The data covered five measurable skill areas: an bio c administra on, glucose monitoring, temperature management, pain management and central line inser on. Addi onal metrics have been added to the evalua on tool, including the rate of postopera ve nausea and vomi ng, unan cipated ICU admission, and acute kidney injury. 3
Volume 4, Issue 4
Accomplishments of Note
As our department grows and we add members or as individuals assume new roles, these changes are announced via email, as well as in our newsle er. STAFF

Mary Beth Bauer, PhD, joined our department in November as a staff scien st in the laboratory of Kevin Currie, PhD, where she will be pursuing research in the regula on of calcium signaling and neuroendocrine secre on. 
Leah Bergman, RN, BSN, MS, joined our department in December as a cer fied registered nurse anesthe st. Leah was previously a registered nurse in the pediatric emergency department at Monroe Carell Jr. Children’s Hospital at Vanderbilt. Items listed in the Department Update are self-reported by Division Chiefs and all department members, Any omission is not inten onal. Items include all ac vi es by department members since the last published newsle er. If you have an ac vity or accomplishment to list, please email informa on to Communica ons & Marke ng Coordinator Jill Clendening, jill.clendening@vanderbilt.edu. Monthly e-mail reminders are sent reques ng these updates. 
Lead Research Nurse Coordinator for the Periopera ve Clinical Research Ins tute (PCRI) Elizabeth Card, MSN, RN, CPAN, CCRP, was one of 352 students who graduated from Union University on Dec. 14. Card graduated with a Master of Science in Nursing Family Nurse Prac oner degree in Family Nurse Prac oner. 
Karen McCarthy, MS, joined our department in November as a database administrator in the Vanderbilt Anesthesiology & Periopera ve Informa cs Research (VAPIR) Division. 
Martha Tanner, BA, officially joined our department in December as an editorial assistant II. She had been providing editorial assistance to the department since July. Previously, she was employed by the Vanderbilt Department of Radiology, working for 12 years as an editorial assistant on the Journal of Magne c Resonance Imaging. 
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Julia Bohannon, PhD, was awarded an NIH F32 postdoctoral fellowship. Title: The effect of monophosphoryl lipid A on immune responses to infec on a er severe burns. Dr. Bohannon works in Dr. Ed Sherwood’s lab. Josh Billings, MD, has been invited to par cipate in a cri cal care panel at the next American Society of Anesthesiologists Annual Mee ng in New Orleans. His talk will focus on the pathophysiology and periopera ve management of rhabdomyolysis-induced kidney injury. 
A $3 million grant received by the Department of Anesthesiology from the GE Founda on’s Developing Health Globally program to fund interna onal medical educaon and research in Kenya and other low-resource regions of the world was the focus of a na onal press release issued in December by Vanderbilt University. The major focus of the grant is to develop training programs that can demonstrably lower surgical and obstetric mortality, as well as drama cally improve and expand educa on of anesthesia providers throughout these regions. Ray Booker, STP Educa onal Specialist; Arna Banerjee, MD; Sen. Bill Frist, MD; Jordan Halasz, STP Opera ons Manager, Ma Weinger, MD; and Nathan Ashby, MD, during the 2013 visit to CELA by Nash‐
ville Health Care Council Fellows. 
Dr. Arna Banerjee, Director of the Center for Experien al Learning and Assessment (CELA), as well as other members of the Division of Anesthesiology Cri cal Care Medicine, will host the Nashville Health Care Council’s second class of fellows at CELA on January 31, leading the group through a series of simula on exercises. The fellows include 32 senior health care leaders. The program is cochaired by former U.S. Senate Majority Leader Dr. Bill Frist and Larry Van Horn, a leading expert in health care management and economics, and professor at Vanderbilt University’s Owen Graduate School of Management. Media Notes 
An automated tool to assess residents’ progress was developed by the Anesthesiology Department, and the tool was featured both as a na onal American Society of Anesthesiologists’ media release and as a na onal media release issued by Vanderbilt University. The tool was the focus of a study published in Anesthesiology. The story was picked up by media outlets, including the Nashville Post: h p://nashvillepost.com/blogs/
postbusiness/2013/12/30/
vusm_develops_tool_to_assess_resident_performance The grant news was featured prominently on the
Vanderbilt University Medical Center home page www.mc.vanderbilt.edu (the first page everyone sees when visi ng), as well as the home page for Vanderbilt University Research: h p://research.vanderbilt.edu/ Other media hits: 
Becker’s Hospital Review: h p://
www.beckershospitalreview.com/anesthesia/
vanderbilt-university-receives-3m-to-expandanesthesia-training-program-in-kenya.html 
Nashville Public Radio: h p://
nashvillepublicradio.org/blog/2013/12/26/
nashville-medical-school-tries-to-improve-oddsfor-african-surgeries/ 
Associated Press coverage in these areas: Nashville, TN; San Francisco, CA; Boise, ID; Lake Wylie, SC; Cha anooga, TN; Knoxville, TN; Anchorage, AK; Huntsville, AL; Belleville, IL; Greenfield, IN; Palm Beach, FL.; Memphis, TN.; Bradenton, FL.; South Carolina (the State); Rock Hill, SC; Colorado Springs, CO; Raleigh, NC; Sacramento, CA; Columbia, WA; Bellingham, WA; Olympia, WA; Tampa, FL; Oklahoma (NewsOK.com); Columbus, OH; Johnson City, TN; Columbus, GA; Boston, MA (NECN); Biloxi/
Gulfport, MS; State College, PA 5
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Accomplishments of Note
ing the use of a rapid response team by surgical services Vanderbilt Interna onal at a ter ary care hospital. J Am Coll Surg. 2014 Jan;218
Anesthesia (VIA) and the (1):66-72. doi: 10.1016/j.jamcollsurg.2013.09.011. Epub Regional Anesthesia and 2013 Nov 23. Acute Pain Management Program in Kenya spear Brummel NE, Girard TD, Ely EW, Pandharipande PP, Moheaded by Dr. Randall randi A, Hughes CG, Graves AJ, Shintani A, Murphy E, Malchow were featured in Work B, Pun BT, Boehm L, Gill TM, Di us RS, Jackson JC. the November 2013 newsFeasibility and safety of early combined cogni ve and le er of the American physical therapy for cri cally ill medical and surgical paSociety of Regional Anesthesia and Pain Medicine. ents: the Ac vity and Cogni ve Therapy in ICU (ACTThe mul -page ar cle ICU) trial. Intensive Care Med. 2013 Nov 21. [Epub ahead focused on the efforts to of print] increase regional anesthesiology educa on and access  Burjek NE, Wagner CE, Hollenbeck RD, Wang L, Yu C, to regional anesthesiology McPherson JA, Billings FT 4th. Early Bispectral Index and equipment. Seda on Requirements During Therapeu c Hypothermia Predict Neurologic Recovery Following Cardiac Arrest. Crit Care Med. 2013 Dec 20. 
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Benzon HT, Huntoon MA. Do we need new guidelines for interven onal pain procedures in pa ents on an coagulants? Reg Anesth Pain Med. 2014 Jan-Feb;39(1):1-3. 
Bohannon JK, Hernandez A, Enkhbaatar P, Adams WL, Sherwood ER. The immunobiology of toll-like receptor 4 agonists: from endotoxin tolerance to immunoadjuvants. Shock. 2013 Dec;40(6):451-62. 
Bruehl S, Denton JS, Lonergan D, Koran ME, Chont M, Sobey C, Fernando S, Bush WS, Mishra P, ThorntonWells TA. Associa ons between KCNJ6 (GIRK2) gene polymorphisms and pain-related phenotypes. Pain. 2013 Dec;154(12):2853-9. 
Coburn M, Pandharipande PP, Sanders RD. Are we o rack using propofol for seda on a er trauma c brain injury?. Crit Care Med. 2014 Jan;42(1):211-2. 
Dewaay DJ, McEvoy MD, Kern DH, Alexander LA, Nietert PJ. A Targeted Simula on Curriculum Can Improve Medical Student Assessment and Management of Acute Coro-
Note: This list includes publica ons from November through early
January, as submi ed by authors or as published in PubMed. 
Agarwal HS, Wolfram KB, Saville BR, Donahue BS, Bichell DP. Postopera ve complica ons and associa on with outcomes in pediatric cardiac surgery. J Thorac Cardiovasc Surg. 2013 Nov 23. 
Agarwal HS, Hardison DC, Saville BR, Donahue BS, Lamb FS, Bichell DP, Harris ZL. Residual lesions in postoperave pediatric cardiac surgery pa ents receiving extracorporeal membrane oxygena on support. J Thorac Cardiovasc Surg. 2014 Jan;147(1):434-41. 
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Barocas DA, Kulahalli CS, Ehrenfeld JM, Kapu AN, Penson DF, You CC, Weavind L, Dmochowski R. Benchmark-
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nary Syndrome in the Se ng of a Clinical Performance Examina on. Am J Med Sci. 2013 Nov 25. [Epub ahead of print] 

Ehrenfeld JM. Systems, technology and the cri cal need for rigorous evalua on. J Med Syst. 2014 Jan;38(1):9998. Ehrenfeld JM, Dexter F, Rothman BS, Minton BS, Johnson D, Sandberg WS, Epstein RH. Lack of u lity of a decision support system to mi gate delays in admission from the opera ng room to the postanesthesia care unit. Anesth Analg. 2013 Dec;117(6):1444-52. 
McDonald MR, Sathiyakumar V, Apfeld JC, Hooe B, Eh‐
renfeld J, Obremskey WT, Sethi MK. Predic ve factors of hospital length of stay in pa ents with opera vely treated ankle fractures. J Orthop Traumatol. 2013 Dec 14. 
McQueen KA. Editorial perspec ve: global surgery: measuring the impact. World J Surg. 2013 Nov;37
(11):2505-6. 
McQueen KA. The global anesthesia crisis and con nuous quality improvement. Int Anesthesiol Clin. 2014 Winter;52(1):109-19. 
Ges IA, Brindley RL, Currie KP, Baudenbacher FJ. A microfluidic pla orm for chemical s mula on and real me analysis of catecholamine secre on from neuroendocrine cells. Lab Chip. 2013 Dec 7;13(23):4663-73. 
Novak LL, Holden RJ, Anders SH, Hong JY, Karsh BT. Using a sociotechnical framework to understand adaptaons in health IT implementa on. Int J Med Inform. 2013 Dec;82(12):e331-44. 
Holden RJ, Carayon P, Gurses AP, Hoonakker P, Hundt AS, Ozok AA, Rivera-Rodriguez AJ. SEIPS 2.0: a human factors framework for studying and improving the work of healthcare professionals and pa ents. Ergonomics. 2013 Nov;56(11):1669-86. 
Patel MB, Laudanski K, Pandharipande PP. An Internaonal Career Development Survey of Cri cal Care Prac oners. Crit Care Med. 2013 Dec 11. [Epub ahead of print] 
Phitayakorn R, Morales-Garcia D, Wanderer J, Lubitz CC, Gaz RD, Stephen AE, Ehrenfeld JM, Daniels GH, Hodin RA, Parangi S. Surgery for Graves' disease: a 25-year perspec ve. Am J Surg. 2013 Nov;206(5):669-73. 
Karsh BT, Waterson P, Holden RJ. Crossing levels in systems ergonomics: a framework to support 'mesoergonomic' inquiry. Appl Ergon. 2014 Jan;45(1):45-54. Raphemot R, Kadakia RJ, Olsen ML, Banerjee S, Days E, Smith SS, Weaver CD, Denton JS. Development and valida on of fluorescence-based and automated patch clamp-based func onal assays for the inward rec fier potassium channel kir4.1. Assay Drug Dev Technol. 2013 Nov-Dec;11(9-10):532-43. Epub 2013 Nov 22. 
Likis FE, Andrews JC, Collins MR, Lewis RM, Seroogy JJ, Starr SA, Walden RR, McPheeters ML. Nitrous oxide for the management of labor pain: a systema c review. Anesth Analg. 2014 Jan;118(1):153-67. Sanders RD, Coburn M, Pandharipande PP. Neural and immune consequences of trauma c brain injury: does propofol reduce the impact? Anesthesiology. 2013 Dec;119(6):1241-3. 
Schumann R, Mandell MS, Mercaldo N, Michaels D, Rob‐
ertson A, Banerjee A, Pai R, Klinck J, Pandharipande P, 
Huntoon MA. Daring discourse: a new sec on for readers. Reg Anesth Pain Med. 2013 Nov-Dec;38(6):469-70. 
Jeff JM, Donahue BS, Brown-Gentry K, Roden DM, Crawford DC, Stein CM, Kurnik D. Gene c varia on in the β1adrenergic receptor is associated with the risk of atrial fibrilla on a er cardiac surgery. Am Heart J. 2014 Jan;167(1):101-108.e1. 
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Wanderer JP, Ehrenfeld JM. Clinical decision support for periopera ve informa on management systems. Semin Cardiothorac Vasc Anesth. 2013 Dec;17(4):288-93 
On December 28th, at 11:41 pm, Jacob Henry Allen was born to Dr. Brian and Sara Allen, their second son. He weighed 7 lbs., 14 oz. and was 21.5 inches long. Both mother and baby are doing well. Special thanks from the family to Drs. Ben Johnson, Adam Kingeter, and Brent McNew for their excellent anesthesia care. Congratula ons, Allen family! Walia A. Anesthesia for liver transplantation in United States academic centers: intraoperative practice. J Clin Anesth. 2013 Nov;25(7):542-50. 
Sherwood ER, Hotchkiss RS. BTLA as a biomarker and mediator of sepsis-induced immunosuppression. Crit Care. 2013 Dec 9;17(6):1022. 
Varughese AM, Rampersad SE, Whitney GM, Flick RP, Anton B, Heitmiller ES. Quality and safety in pediatric anesthesia. Anesth Analg. 2013 Dec;117(6):1408-18. 
Wagner CE, Bick JS, Johnson D, Ahmad R, Han X, Ehren‐
feld JM, Schildcrout JS, Pretorius M. Etomidate Use and Postopera ve Outcomes among Cardiac Surgery Pa ents. Anesthesiology. 2013 Nov 27. [Epub ahead of print] 
Wanderer JP, Blum JM, Ehrenfeld JM. Intraopera ve low- dal-volume ven la on. N Engl J Med. 2013 Nov 7;369(19):1861-1863. Save These Important Dates  The Bradley E. Smith Endowed Lectureship on Medical Professionalism is February 7, 2014. Dr. Charles “Chuck” Whi en, Margaret Milam McDer‐
mo Dis nguished Chair in Anesthesiology and Pain Management and professor at University of Texas Southwestern Medical Center, is the guest speaker. Dr. Chuck Whi en 14
Dr. Lena Sun Volume 4, Issue 4
 The Dr. James Phythyon Memorial Lectureship in Pediatric Anesthesiolo‐
gy is April 18, 2014. Dr. Lena Sun, E.M. Papper Professor of Pediatric Anesthesiology, Professor of Anesthesiology & Pediatrics, and Chief of Division of Pediatric Anesthesiol‐
ogy at Columbia University Medical Center, is our guest lecturer. Dr. Sun is the principal inves gator of the mul ‐site PANDA (Pediatric Anesthesia and Neuro‐Development As‐
sessment) Study on the ques on of anesthe c neurotoxicity in the developing human brain. She recently received NIH funding for an R34 to support the planning of the full PANDA study. Families, Friends Re‐connect at Holiday Event
The Holiday Open House at the
home of Dr. Warren and
Elisabeth Sandberg provided the
perfect opportunity for
fellowship and re-connection for
our Department members and
families. Enjoy a few images
captured during the event.
Here’s looking forward to a
healthy, happy, and highly
productive 2014!
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Do You Have A VU Portrait?? Please note, if you are a new Anesthesiology Department faculty member and have not yet scheduled a professional Vanderbilt University portrait, please contact your division’s administrative assistant to schedule a portrait. These photos are used on our Department website, and they are important to have on file for possible news events, as well as for professional activities such as speaking engagements and promotion of educational activities. Not seeing your
news? The Anesthesia Monitor, the Vanderbilt Department of Anesthesiology newsle er, is a reflecon of the ac vi es and successes of our faculty, staff, and alumni. We would love to share what’s going on in your division, as well as the significant milestones in your life. News can include anything from recent publica ons and professional awards/achievements to personal news and accomplishments. If you have a photo or two to go along with your news, that’s even be er! Please send all details and photos to Communica ons & Marke ng Coordinator Jill Clendening at jill.clendening@vanderbilt.edu . Please send us your news to share with other Vanderbilt alumni and faculty. News can include personal news, accomplishments, and achievements. In addition, send us your mailing address, e‐mail address and other current contact information so we can keep you updated on all the latest news and upcoming events. Please send news via e‐mail to Communications & Marketing Coordinator Jill Clendening at: jill.clendening@vanderbilt.edu , by calling 615‐322‐4841, or by mail to: Vanderbilt University Department of Anesthesiology 1211 21st Avenue South 722 Medical Arts Building Nashville, TN 37212 24
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