Clinical Affairs

Moffitt Long (ML) Hospital with the ML ORs, ML NORA as well as Cath/Electrophysiology Labs and Endoscopy remains our busiest site for anesthesia and critical care, routinely staffing between 30 and 39 anesthetizing locations per day.  

Everyone working in the ML ORs has felt the impact of construction projects to provide necessary upgrades and repairs to our facility. Some of the more important projects include electrical upgrades to many of our ORs as well as the installation of new surgical lights along with repairs. OR26, our first hybrid room, has been offline for an extended period while undergoing a complete rebuild including new Xray equipment. It will be back online in the second half of June.  

Despite the impact of construction projects, with up to three rooms closed at a time, surgical volume at ML has increased by 3.7% during the current fiscal year when compared to the previous one. 

Many of our most complex patients are cared for at Moffitt Long due to a variety of factors such as highest intensive care capacity, the better availability of consult services like cardiology and neurology, and the availability of interventional cardiology as well as cardiothoracic and vascular surgery. These patients often also undergo complex surgeries frequently involving multiple surgeons from multiple surgical services. 

This complex and busy environment provides an enormous potential for learning and teaching which is especially appreciated by our senior residents and fellows. 

Neurosurgery, including their division of spine surgery, is the busiest department by case numbers and total OR time. The spine surgery divisions of the departments of neurosurgery and orthopaedic surgery taken together represent the busiest service at ML. The anesthesia service for spine surgery is now led by Marc Buren, MD who took over the service from Jeremy Lieberman, MD. Marc has been expanding the team to meet the growing demand for specialized anesthesia care.  

Other busy surgical services include general surgery, transplant surgery, urology, as well as cardiac and vascular surgery. The transplant services have been busy and growing significantly in case volume which has put a burden on the cardiac and liver transplant anesthesia teams. While there is a growing number of transplanted organs that are preserved involving some form of machine perfusion, there is still a large percentage of transplant surgeries that are done during evening and night hours. The cardiac and liver transplant anesthesia teams have also been expanding to meet the growing demand. 

Thromboelastography with TEG 6S is finally available for the busy cardiothoracic surgery and liver transplant surgery services. Dieter Adelmann, MD, PhD from the liver transplant anesthesia team played a big role in making this happen by not giving up and keeping the pressure on the clinical lab to bring the machines online.  

We are continuing our efforts to improve the work experience for our anesthesia providers working at ML. The E1am team (Seema Gandhi, MD; Christy Inglis-Arkell, MD; Nicholas Mendez, MD; Nichlesh Patel, MD; John Turnbull, MD; Tyler Chernin, MD; Lee-lynn Chen, MD; Helge Eilers, MD) is working hard to make the optimal assignments to balance safe patient care, education, and workload.  

The teamwork and mutual support within the anesthesia team at Moffitt Long is exceptional and is demonstrated on a regular basis when we take care of complex and critically ill patients that often require several of our team members to work together to provide the care needed. 

Despite the high workload and the large number of add-on cases, the average length of the work day at ML is on par with our other sites with the median leave time before 5pm. 

With the upcoming opening of the Bayfront ambulatory surgery center and construction ramping up for the new hospital at Parnassus, we expect surgical volume and services to shift between campuses, but ML will remain busy with complex cases.  

Among other priorities identified by our anesthesia team, we will continue to adapt our staffing to ensure the highest quality care and improve satisfaction by rotating less frequently between sites. 

Helge Eilers, MD
Vice Chair for Clinical Affairs, UCSF Health