Preoperative Optimization
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Preoperative Optimization Doctors William Manson, MD, Stuart Lowson, MD, & Lee Heffner, MD are ready to greet patients.
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Preoperative Optimization Anesthesiologists William Manson, MD, Stuart Lowson, MD, & Lee Heffner, MD, confer about a patient.
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William Manson, MD
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William Manson, MD, consults with a patient.
About
The Preoperative Optimization at the University of Virginia (UVA) concerns the care of patients preparing for, undergoing and recovering from surgery. The Preoperative Anesthesia Clinic (PAC) has both a clinical and an educational focus. The clinical focus is to perform a comprehensive evaluation of perioperative patients with the goal of reducing procedure cancellation and reducing perioperative length of stay. The educational focus is to educate anesthesia residents in the field of perioperative medicine.
Members of the Preoperative Optimization team evaluate and optimize patients prior to surgery and interventional procedures. The goals are to prepare patients for surgery in order to decrease same-day surgery cancellations and reduce perioperative morbidity and mortality. The team includes members from multiple subspecialties of anesthesia. Patients are evaluated over the phone, in-person and via telemedicine. This team coordinates care with multiple subspecialties including pain medicine, cardiology, pulmonology, and other clinicians.
A Message from the Medical Director
Tyler Johnson, MD
Medical Director of Perioperative Medicine
The Preoperative Optimization Team is currently in an exciting growth period. We are planning a major reorganization of the system to provide evaluation of all patients that receive anesthesia in the UVA System. We have begun work on optimization efforts to manage patients with chronic comorbidities.
The faculty in the Preoperative Optimization Team have a wide array of experience in Anesthesiology. Dr. Heffner has over 10 years of experience in Perioperative Medicine. She was the prior Medical Director of the Preoperative Anesthesia Clinic (PAC) at UVA Health. She brings her wealth of knowledge to the Team. She leads education efforts in Preoperative Optimization. Dr. Lowson has over 15 years’ experience in critical care medicine and anesthesiology. He leads the effort to review guidelines and policies in the Preoperative Optimization Team. Dr. Vizzini is trained as a pediatric cardiac anesthesiologist. She directs the care of pediatric patients in Preoperative Optimization Team. Dr. Lesh is trained in both internal medicine and anesthesiology. He has practiced in both private practice and major academic medical centers. Dr. Chiao completed her residency in anesthesiology here at UVA followed by a fellowship in Quality at UVA Health.
Our Team
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Tyler J. Johnson, MD
Neuroanesthesia
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Lliam Brannigan, MBBCH
Critical Care, Liver Transplant
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Geir Følling Elgjo, MD, PhD
Adult Multi-Specialty
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Erin Hennessey, MD
Critical Care
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William Manson, MD
Regional
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Kathleen Valenzuela, MD
Critical Care
The Preoperative Optimization Team strives for excellent patient care and constant improvement. Over the next few years, there will be a significant revision of the operational process of preoperative optimization. The reorganization will allow the perioperative medicine team to screen the roughly 200 patient anesthetics that occur each day. The screening will focus our efforts towards optimizing outcomes for patients that are at high risk for perioperative morbidity and prolonged length of stay.
Education
The Preoperative Optimization Team has a robust ultrasound education in POCUS for the regional anesthesiology fellows.
William Manson, MD is our faculty in perioperative point of care ultrasound at the Perioperative Medicine Summit for the Society of Perioperative Assessment and Quality Improvement (SPAQI).
All CA1 Residents do a one month rotation in our Preoperative Anesthesia Clinic (PAC) evaluating patients and creating pre-op plans prior to surgery.