CSA’s Mariano Honored by US Department of Veterans Affairs

by
  • CSA Board of Directors
| Dec 21, 2015

We are delighted to congratulate Edward Mariano, MD, MAS, the CSA’s Vice-Speaker, on receiving the 2015 Chase Award for Executive Excellence from the Veterans Health Administration (VHA)!

Dr. Mariano received the award on December 3 in San Antonio at the annual meeting of the Association of Military Surgeons of the United States. He serves as Chief of the Anesthesiology and Perioperative Care Service, and Associate Chief of Staff of Inpatient Surgical Services, at the VA Palo Alto Health Care System. Dr. Mariano also holds the titles of Professor of Anesthesiology, Perioperative and Pain Medicine at Stanford University School of Medicine, and Co-Director of the Stanford Acute Pain Medicine and Regional Anesthesiology Fellowship Program.

Readers of our CSA Online First blogs and of KevinMD know Dr. Mariano as an accomplished writer who is passionate about the field of anesthesiology, about the practice of regional anesthesia, and about training the next generations of anesthesiologists to be the best possible physicians. He is also an accomplished speaker and educator, posts frequent blogs on his own website,www.edmariano.com, and maintains a lively Twitter presence: @EMARIANOMD.

IMG_50241The award was presented by Colonel (Ret.) Karen Malebranche, RN, MSN, CNS, Acting Chief Officer for Intergovernmental Affairs in the Veterans Health Administration (VHA), who was representing David Shulkin, MD, Under Secretary for Health in the Department of Veterans Affairs.

The Chase Award is presented each year to a physician who demonstrates sustained excellence in executive leadership and significant contributions and dedication in helping to accomplish the mission of the federal health agency.  John D. Chase, MD, for whom the award is named, served as the Chief Medical Director of the Veterans Administration from 1974 to 1978.  He served two years in the Navy and five years in the Army Reserve Medical Corps. The original award was established in 1992.

Col. Malebranche noted that while Dr. Mariano has only worked in the VHA since 2010, he exhibits a “passion for providing the highest quality of care, innovation, education, and leading his staff to continuously improve.” Malebranche noted that among his many achievements, Dr. Mariano and his team at Palo Alto have:

  • Markedly increased the number of cases in which physician anesthesiologists worked outside the operating room, including: perioperative evaluations, postoperative consultations, anesthesia provisions in other procedure locations, and pain management. In FY 2014, there were 16,000 of these cases, up from 6,000 in FY 2010. 
  • Implemented the Perioperative Surgical Home, an innovative patient-centered approach in which anesthesiologists work with surgeons and hospitalists in pre-op evaluations and post-op care, leading to improved patient outcomes.
  • Led Palo Alto Health Care System to a six-fold increase in post-op day-one ambulation of patients after total knee replacement.

Dr. Mariano’s services have received important new research grants, and their scientific publications grew from less than 15 peer-reviewed articles in 2010 to nearly 40 in 2014.  In addition, Dr. Mariano has volunteered his pediatric and regional anesthesiology services on multiple medical missions to rural provinces in Ecuador and the Philippines, often taking residents and fellows with him to expand their training and expose them to global health issues and the disparities in pain management in developing countries.

Dr. Mariano is also an active member of the VA Anesthesia Service Chiefs, who have strongly opposed the proposal to revise the VHA Nursing Handbook, which would establish independent practice for nurse anesthetists. This proposal directly conflicts with the Handbook of the National Anesthesia Service, which endorses a care team model with physician anesthesiologist supervision.  

“Anesthesiologists, working alone or in a care team model supervising other anesthesia providers, bring their expertise to the bedside to improve the patient experience. There has been growing pressure recently to abandon the team model and remove the need for nurse anesthetist supervision,” wrote Dr. Mariano in a recent blog. “Why are patients and surgeons being forced to choose between having a nurse anesthetist OR an anesthesiologist when they shouldn’t have to?  Given the choice, I think they will choose ‘AND.’”

safevaThe proposed VHA Nursing Handbook change is the subject of recent actions by ASA and CSA to encourage members to submit comments in opposition to the Federal Registry.  If you, a colleague or a member of your family would like to register your voice to ensure our nation’s veterans receive the best anesthesia care possible, please visit www.SafeVACare.org today.

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