DEPARTMENT OF ANESTHESIOLOGY ANNUAL REPORT

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2000 BUSINESS OFFICE ANNUAL REPORT Edward F. Cousineau, M.A., M.B.A. Business Manager Private Diagnostic Clinic At mid year 2000 the clinical case-loads for Anesthesiology began to fall off by about 10% as surgical volumes shifted away from Duke Hospital. By late in the year these volumes were again climbing a bit. The phenomenon resulted in the closure of several operating rooms at various times. By year’s end the Hospital was preparing to reopen these rooms to accommodate its still shifting volumes and to provide surgical specialties with needed time. The PDC’s implementation of a new cost allocation mechanism hit the department rather hard. Under these norms, the department was allocated a share in the PDC administrative costs of other clinical departments. This meant that these extra costs not usually borne by other anesthesiology groups and academic anesthesiology departments would be added on to our fair share of the operating and administrative burden. The establishment of a joint billing and collections service to be known, as the Professional Revenue Management Organization—the PRMO—in mid 2001 would further complicate the cost allocation process. There is some specula- tion that the Duke Health System will insist on true activity-based cost accounting for the PRMO. This would bolster the department’s contention over the last three years that PDC costs should be properly managed in a manner consistent with industry-wide practices. Only one other PDC department has consistently sided with this point of view. The PDC continued to provide improved financial information during calendar year 2000. A major initiative sought to accelerate collections for both Duke Hospital and the PDC. This resulted in the formation of a “Cash Acceleration Team” for Anesthesiology in July of 2000. Best estimates suggest that the department collected perhaps $800,000 in old accounts. Moreover, clearing the backlog enables better collection efforts to now be directed toward newer denials. Departmental Office space continued to be in extremely short supply throughout the department during the year. In-house chiefs were appointed for the Divisions of Women’s Anesthesia and Critical Care Medicine; Pain Management; and General, Vascular, Transplant Anesthesia and Critical Care Medicine. The new interdisciplinary pain clinic facility at Morreene Road was opened in late October. The facility makes patient access for chronic pain treatment much easier. Two dedicated block rooms designed for C-arm fluroscopy have been placed in use. Patient and procedural volumes are beginning to grow. However, the PDC has had some operational issues that must be addressed before the clinic will generate a positive revenue stream. The department's national ranking in NIH research awards has constantly remained in the top four over the past three years. During the 2000 NIH reporting period, the department's total NIH awards surpassed the amount reported by the number one institution in the previous 1999 reporting period. For calendar 2000 the department’s total external funding for research was over $6.1 million. Two key members of the business office staff received promotions outside of the department in autumn 2000. Steve Williams, former administrative manager, was made director of PDC Reimbursement. Mary W. Smith, former HR manager, was recruited back into the University Human Resources activity and was given a senior post within the university’s wage and salary function. Ms. Natalie Schneider and Mrs. Charlene Hundley assumed their respective positions at year’s end. Ms. Gloria Howard took over the role of staff specialist within the business manager’s office. Hospital The department now functions as a personnel records custodian for hospital employees in most instances. An increased role in management of the CRNA staff has fallen back into the department after resting exclusively with the hospital's peri-operative management team. The divisional chiefs have a much expanded role. The department continued to provide services for the selection and evaluation of anesthesia capital equipment to the hospital. Calendar 2000 saw the implementation of the new automated anesthesia record keepers, Saturn, from North American Drager. The review and purchase of other needed clinical equipment has slowed somewhat as Duke Hospital re-organizes its capital equipment request processes. The Departments of Anesthesiology, Surgery and Obstetric and Gynecology each began paying a share of the costs of the Physicians Assistants and Nurse Practitioners assigned to the pre-operative screening unit. These mid-level practitioners have added funding from Duke Hospital. Placing these positions within the PDC structure helps assure proper reporting relationships for compliance purposes. 2000 BUSINESS OFFICE ANNUAL REPORT 101
102 SUPPORT STAFF.. Anesthesia Clinical Research Staff First row left to right: Yung-Wei Hsu, M.D. Michele Ladd Suzanne Aycock, R.N. Scott McEwen Second row left to right: Lee McClurkin, R.N. Aaron Harrison Karen Ramsey, R.N. Not Pictured: Debbie Jones, R.N. Jolin Reeves SUPPORT STAFF Administrative Staff First Row left to right Natalie Schneider, B.B.A. Rosemary Cumbie, A.A. Patricia Cruse, A.A.S. Second Row left to right Edward Cousineau, M.A., M.B.A. Larry Dowell, A.A.S. Charlene Hundley, B.B.A. Not Pictured: Steve Williams, B.B.A. Mary Smith, B.S., M.Ed. Anesthesia Support Left to right Lessie Owens, MLPN Delmar Shelton, PA-C Allison Taylor, B.S., PA-C
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DEPARTMENT OF ANESTHESIOLOGY Duke U
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This issue is dedicated to the memo
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DUKE DEPARTMENT OF ANESTHESIOLOGY M
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FACULTY, RESIDENTS, FELLOWS, AND CR
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FACULTY Thomas E. Buchheit, M.D. Cl
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FACULTY Joel S. Goldberg, M.D. Assi
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FACULTY John C. Keifer, M.D. Associ
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FACULTY Joseph P. Mathew, M.D. Asso
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FACULTY Claude A. Piantadosi, M.D.
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FACULTY Mark Stafford-Smith, M.D.,
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FACULTY Christopher C. Young, M.D.,
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20 FACULTY DUKE UNIVERSITY HEALTH S
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AFFILIATED FACULTY Scott T. Howell,
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Edmond C. Bloch, M.B., Ch.B. Associ
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INTERNS Atilio Barbeito, M.D. Abiga
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RESIDENTS John D. Mitchell, M.D. CA
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RESIDENTS CA-3 Tarsha V. Garvin, M.
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Paula D. Alford, B.A., CRNA Beatric
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CRNA Deborah J. Ferrero-Conover, CR
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CRNA Carolyn C. Knoop, CRNA, MSN Da
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CRNA Kena B. Sigman, CRNA, MSN Tede
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40 DUKE ANESTHESIA FACULTY WHO BECA
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CLINICAL ACTIVITIES Infraclavicular
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CLINICAL ACTIVITIES CARDIOTHORACIC
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CLINICAL ACTIVITIES Goals for 2000
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CLINICAL ACTIVITIES Narda D. Crough
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Page 61 and 62: CLINICAL ACTIVITIES Molecular Biolo
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Page 65 and 66: CLINICAL ACTIVITIES OTOLARYNGOLOGY,
Page 67 and 68: CLINICAL ACTIVITIES PAIN MANAGEMENT
Page 69 and 70: CLINICAL ACTIVITIES therapy. This y
Page 71 and 72: CLINICAL ACTIVITIES Regional Anesth
Page 73 and 74: CLINICAL ACTIVITIES thesiology Pain
Page 75 and 76: CLINICAL ACTIVITIES WOMEN’S ANEST
Page 77 and 78: BIOSTATISTICS AND CLINICAL OUTCOME
Page 79 and 80: DIVERS ALERT NETWORK extended to Co
Page 81 and 82: DEPARTMENTAL COMMITTEES David B. Sc
Page 83: 80 Thirteenth Annual ASA Duke Anest
Page 86 and 87: Several advances in the residency c
Page 88 and 89: The Annual Resident Graduation and
Page 90 and 91: Lectures, Conferences and Didactics
Page 106 and 107: Anesthesia Technician Staff Sitting
Page 108 and 109: Hyperbaric Center Left to right Eri
Page 110 and 111: Molecular Pharmacology Laboratory F
Page 112 and 113: Signal Transduction Laboratory Fron
Page 114 and 115: The determination of the MAC reduct
Page 116 and 117: Magnesium neuroprotection in cardia
Page 118 and 119: Active Institutional Animal Care an
Page 120 and 121: Mackensen, George B., M.D. Peri-Isc
Page 122 and 123: A Randomized, Double-Blind, Paralle
Page 124 and 125: Cardiac surgery in infants and chil
Page 126 and 127: An exciting development is the esta
Page 128 and 129: services to pharmaceutical companie
Page 130 and 131: Gerontological Research in Anesthes
Page 132 and 133: Masaya Kudo, M.D. Daniel Morris, Ph
Page 134 and 135: RESEARCH ASSISTANT Amy L. Kondyra V
Page 136 and 137: Gan TJ, Apfelbaum J, Chen C. Instit
Page 138 and 139: Pineda JA, Lynch JR, Laskowitz DT,
Page 140 and 141: East CJ, Clements F, Mathew J, Slau
Page 142 and 143: Mackensen GB, Stanley TO, Grocott H
Page 144 and 145: Taekman JM, Web alert. Current Anes
Page 146 and 147: Robertson KM. Donor management. Pro
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Page 150 and 151: Rosemary W. Cumbie Special Assistan
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DEPARTMENT OF ANESTHESIOLOGY ANNUAL REPORT

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