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>> Anesthesiology has changed tremendously in the last few years, and we've had to adapt
to the changes in what's required.
So the largest changes that have occurred are moving more peripherally in terms
of our anesthesia and pain management.
So we are now numbing smaller, and smaller nerves more distally,
and the advances in ultrasound guided imaging has allowed us to do that.
HSS is rated one of the top orthopedic hospitals,
if not the top orthopedic hospital in the world.
There are many reasons for that.
The biggest reason, I think, are our exceptional outcomes.
Our anesthesiologists focus on one thing: orthopedic and regional anesthesia.
The department is a mix of an academic and private group,
and we really have the best of both worlds.
We are completely focused on clinical care, academic excellence,
and administrative excellence as well.
>> HSS does several things that are really unique in terms of our clinical innovation.
One area is within pathway-based care, one is with opioid sparing techniques,
and the third is to incorporate regional anesthesia
and regional analgesia techniques wherever we can, and we embed each of those
into pathway-based care in order to improve patient outcomes,
as well as to advance the mission of the hospital and of the department,
which is excellence in clinical research, clinical practice,
and education of the next generation of practitioners.
Some of the key ways that our department is innovating with one eye
to the future surround moving more procedures to the ambulatory and same-day discharge setting,
optimizing medically complex patients so they will have better outcomes,
and using pathway-based care in order to standardize all of our processes.
So bundling each of these elements together is really a key way that we'll be able
to continue to innovate into the future.
>> One of the important things about research at Hospital for Special Surgery is
that we have a diverse group of investigators.
So these come from all types of backgrounds, and this really adds
to the interesting questions that we can ask.
The diversity in the investigators that we have really enhance the quality of our research.
One of the main important aspects is the opioid epidemic.
So we are attempting several avenues in trying to address this issue,
not only through multi-molo analgesia, but also preoperative decrease in opioids,
and also trying to change the habits of our physician prescribers after surgery.
We also have several educational initiatives in sort of opioid stewardship
that will hopefully improve outcomes.
>> We arrange a variety of programs to accommodate learning at all levels
within our department, for our attending faculty, for our fellows,
for our rotating residents, and for our visiting medical students.
We are very proud of our fellowship program.
It's probably considered the premier program in the country.
We have 10 fellows each year.
We select them from a very talented pool of applicants, and you know, we are really excited
to have them come join our institution.
They come from a variety of programs throughout the country, as well as internationally,
and we feel like we have really been able to pick the crème de la crème of applicants.
>> Our educational philosophy is more than just being a great clinician.
It's also about being a technician, but also a physician.
So part of that means that while you can certainly be good at what you do,
you also have to know all the different aspects of regional anesthesia,
and that includes education, it includes outcomes, it includes research
as to how we are moving this field forward,
and that's really what our educational philosophy is,
to be the best at what we do because that's what we do.
>> Musculoskeletal care, particularly trauma, is a huge burden of global disease.
Our expertise in musculoskeletal care is in line with that need.
So within our global health initiative in anesthesia, basically from 2012 to now,
we've held programs in Vietnam, Uganda, Malawi, India, and Ghana.
And so what typically happens is we run the programs, and once we are confident
that the local practitioners are self-sufficient and sort of mastered the skills we teach
and are able to teach each other, we then slowly exit that site.
We saw a lot of success in our anesthesia program,
and that's when basically we developed this program that is hospital wide
and includes all the disciplines we have here at HSS.
We will be, hopefully, rolling out our GMHED program,
the integrated musculoskeletal global health program in 2022 at our two current sites
in Kumasi, Ghana and Osmania Hospital in Hyderabad, India.
Essentially, what we hope to deliver is a full package that can try
to improve the musculoskeletal care in low resource settings.