BronxCare Health System

Dr. Dave Livingstone, Chairman, Anesthesiology (center), consulting with (L to R): Dr. Jung Eun Park, Attending, Anesthesiology, and Dr. David Frost, Attending, Anesthesiology.
Dr. Dave Livingstone, Chairman, Anesthesiology (center), consulting with (L to R): Dr. Jung Eun Park, Attending, Anesthesiology, and Dr. David Frost, Attending, Anesthesiology.

Anesthesiology

Crucial to the Surgical Process

Dr. Dave Livingstone, Chairman, Anesthesiology, is especially proud of the partnership between BronxCare and North American Partners in Anesthesia (NAPA), the largest single-specialty anesthesia and perioperative management company in the United States. This partnership provides BronxCare with an expanded level of anesthesia care and anesthesia-related management services. NAPA is widely recognized for its strong network of physicians and nurse anesthetists who utilize their extensive experience to meet the needs of hospitals served by them. In 2022, NAPA received the prestigious John M. Eisenberg Award for Innovation in Patient Safety and Quality at the National Level.

At BronxCare, NAPA has introduced its award-winning Anesthesia Risk Alert program (ARA) and various quality improvement projects, leveraging its ever-growing data from the large number of anesthesia cases managed by this single company. This unique position allows NAPA to learn from its extensive data and apply best practices at every site through practice advisories and weekly meetings led by Dr. Livingstone. It is an approach that keeps NAPA anesthesiologists and CRNAs ahead of the curve with respect to patient safety and outcomes. These areas, as well as value generation, continue to be of paramount importance to the Anesthesiology Department.

“We strive every day to provide our patients with exceptional anesthesia care. Our program improvements are ongoing and clearly visible, and we are continuing to move forward and excel."

—Dr. Dave Livingstone, Chairman, Anesthesiology

In addition to routine anesthesia services provided within the operating room and procedural suites, Dr. Livingstone’s clinical team offers a diverse array of leading techniques in regional anesthesia, point-of-care ultrasonography (POCUS), and acute pain management, providing a comprehensive and multimodal approach to treating and managing acute perioperative pain.

In the orthopaedic area, patients can undergo total joint replacement surgery using state-of-the-art ultrasound-guided peripheral nerve block techniques, with the benefits of improved pain control and increased patient satisfaction. This type of procedure is part of an evidence-based multimodal, narcotic-sparing approach to managing postoperative pain. These evidence-based ERAS (Enhanced Recovery After Surgery) protocols are also being introduced and expanded to other surgical services.

NAPA places a strong emphasis on fostering close relationships with surgical colleagues, creating a work culture of collaboration and efficiency. By working closely with surgeons and other medical and nursing professionals, NAPA ensures seamless coordination and communication in the operating room. This collaborative environment enhances patient care and also contributes to the well-being of the staff, reducing the risks of burnout and lack of engagement. Regular team-building activities, ongoing professional development opportunities, and a supportive work atmosphere are all part of NAPA’s strategy to maintain high levels of staff satisfaction and performance. “Our close-knit team approach allows us to provide high-quality care while ensuring that our staff remain motivated and engaged,” stated Dr. Livingstone.

Robinel Tongol, Nurse Anesthetist, preparing medication for patient.
Robinel Tongol, Nurse Anesthetist, preparing medication for patient.
Faith Uti, Nurse Anesthetist, preparing patient for anesthesia.
Faith Uti, Nurse Anesthetist, preparing patient for anesthesia.

An important endeavor involves the reorganization of the pre-surgical testing practice into the model of a perioperative surgical home. Working with medical, surgical, and nursing leadership, the department is developing a comprehensive goal-directed testing model. It will significantly enhance the quality of care provided to surgical patients and is expected to result in more accurate risk stratification, with improved and comprehensive preparation of surgical patients. This process is fundamental in effectively managing an operating room and optimizing patient outcomes.

“BronxCare is benefiting from our services, with collaboration being the key to our success. We are an integral part of a major teaching hospital that is providing much-needed high-level care to a diverse and vibrant community, and that is a strong motivating factor for us.”

—Dr. Dave Livingstone, Chairman, Anesthesiology

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