Todd Schlosser sat down with Ed DeLaney, the Director of Perfusion at Northwell Health, and Dr. Derek Brinster, a cardiovascular thoracic surgeon and Director of Aortic Surgery at Northwell Health, on a recent episode of SpecialtyCare’s Checking the Vitals. They discussed how perfusionists and surgeons work together to provide excellent patient care during heart surgery, how critical communication is in the operating room, and how innovations occur and are shared with other surgery teams.
About Ed Delaney
Ed Delaney is currently the Director of Cardiac Perfusion for Northwell Health, residing at Lennox Hill Hospital. Delaney oversees Lennox Hill Hospital, Staten Island University Hospital, and the perfusion school at Hofstra. He’s also the Co-Director of Hofstra’s Cardiovascular Science and Perfusion Medicine Program.
Ed Delaney has a 12-year background in the American Order Cardiovascular Perfusion. Additionally, he’s on the Perfusion Program Director’s Council, the Accreditation Committee for Perfusion Education, a long-standing member of AMEC, a member of the academy, and a Director of the New York State Society.
About Dr. Derek Brinster
Dr. Derek Brinster has worked in cardiovascular and thoracic surgery for 20 years. He started his practice at the Medical College of Virginia in Richmond, Virginia. He was the Director of Aortic Surgery in the Heart Valve Program before joining Northwell Health in New York City about seven years ago. Dr. Brinster’s passion and training have focused heavily on complex aortic surgery.
Northwell Health is one of the largest healthcare enterprises in the United States, with 30 healthcare systems. Four of those 30 healthcare systems currently do cardiovascular and thoracic surgery. Northwell has one of the most prominent aortic dissections in North America, rapidly growing over the last seven years.
Providing Excellent Patient Care
Surgeons can collaborate on various approaches to provide the highest quality patient care. These procedures are very repetitive, so there’s more opportunity to make improvements and improve outcomes. There’s always an open forum of trust and communication that encourages teams to pose different ways of doing things or alternate solutions. As a result, everyone is coming together to provide more excellent patient care. Delaney and Dr. Brinster credit the collaborative model between the surgical team and perfusionists as unique. Significant advancements are discussed at monthly conferences throughout the healthcare system. Additionally, they strive to ensure that these procedures remain consistent.
Communication in the Operating Room
Ed Delaney and Dr. Derek Brinster discussed the importance of closed-loop communication in the operating room. Closed-loop communication is when a surgeon gives a command, and the other person repeats it back or offers additional information the surgeon will affirm and vice versa. This is a critical way of ensuring that everyone is on the same page and minimizes the risk of error. They strive to teach the young perfusionists about what they’re telling the surgeon and how they’re saying it. They focus on ensuring they don’t use too much verbiage, resulting in confusion or error.
Many surgeons do a lot of student teaching on their complex cases, so they strive to get students to mimic and learn what they do. Surgeons use this same process for educating students on proper feedback. Feedback is given amongst the anesthesiologist, surgeon, and perfusion, encompassing the entire team to emphasize the importance of this during surgery.
Delaney also notes that a critical component of closed-loop communication is the tone of voice. This allows perfusionists to understand when a surgeon’s tone is more serious when they’re struggling with a procedure or when silence in the operating room is necessary. Good perfusionists pick up on those cues and allow them to understand when they’re at a critical part of surgery and when it’s more relaxed. Surgeons train up on this, especially during more challenging cases.
Many advancements in technology have improved cardiac procedures over the last five to ten years. Nowadays, surgeons are doing third and fourth re-operations on the aorta. Technology, capabilities, and protections have advanced, allowing surgeons to perform more complex procedures.
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