At Spectrum Healthcare Partners, MaineHealth, Northern Light Mercy Hospital, and other Spectrum sites, collaboration is elevated through strong, site-wide partnerships that improve patient safety, satisfaction, and outcomes.
In the operating room, seamless communication between anesthesia and surgery can make all the difference – whether it is a planned procedure or an emergency. Either way, anesthesiologists must be ready to pivot in real time.
Eric Brown, MD, Spectrum anesthesiologist and medical director of anesthesiology at MaineHealth Maine Medical Center Biddeford, and Jared Hinrichs, MD, Spectrum anesthesiologist and anesthesiology medical director at Northern Light Mercy Hospital, are two of the physician leaders helping drive those efforts forward.
Anesthesia and surgical teams work closely together to support patients on surgery day – and to set them up for a smooth recovery.
“We coordinate and tailor the method of anesthesia to best benefit the patient based on the surgery and anticipated pain,” says Dr. Hinrichs. “That might include ultrasound-guided nerve blocks, local anesthesia, or multimodal techniques.”
In an ultrasound-guided nerve block, the anesthesiologist uses real-time imaging (the ultrasound) to guide an injection of pain-blocking medication precisely to the nerves responsible for sending pain signals from a specific region of the body. Nerve blocks are also known as “regional anesthesia.”
The patient might remain conscious for the procedure, or the nerve block might be paired with general anesthesia for surgeries requiring the patient to be unconscious.
Local anesthesia involves numbing a small area of the body (often through an injection) while a patient stays awake – such as numbing an area of skin before getting a mole biopsied or removed.
Multimodal anesthesia techniques are a type of general anesthesia; general anesthesia is when the patient is made fully unconscious. Multimodal techniques use a combination of anesthesia drugs at lower doses rather than just one drug. This increases beneficial effects, such as blocking pain and keeping the patient unconscious, and reduces the negative side effects that could occur by giving more of any one of the drugs involved to get the same benefits.
Related to general anesthesia is something called monitored anesthesia care (MAC), which some refer to as sedation or “twilight.” For both general anesthesia and MAC, medications are given to the patient through an IV to make them feel sleepy and relaxed, and the anesthesiology team carefully monitors the patient’s responses the entire time.
However, unlike general anesthesia, MAC will still allow the patient to breathe on their own (without a breathing tube and ventilator) even if they are not fully conscious. When only mild sedation is necessary, MAC will even allow the patient to stay awake and answer questions; during moderate MAC a patient may be asleep but can be awakened easily.
Spectrum anesthesiologists work with surgeons to coordinate these anesthesia options across both hospital and outpatient settings. “Our goal is to provide safe and efficient care – and that depends on location, surgery, and patient-specific needs,” says Dr. Hinrichs. “It’s a moving target that takes constant adjustment.”
Dr. Brown agrees and notes the value of aligning protocols across sites. “We’ve worked hard to establish uniform and rational exclusion criteria,” he says. Exclusion criteria are a checklist of factors used to determine when a patient is not a good fit for outpatient treatment.
“Sicker patients get more complex procedures at higher-acuity locations,” where there are resources for comprehensive or intensive inpatient care, explains Dr. Brown, “while others are best suited for ambulatory (outpatient) sites – all focused on the patient experience.”
Collaboration Drives System-Wide Improvements
Spectrum anesthesiologists work across multiple sites – sharing ideas, refining protocols, and bringing fresh perspectives to patient care.
“This diversity of past experiences and training helps enhance our care,” says Dr. Hinrichs. “We regularly meet as a physician group and engage in quality project meetings with representatives from all sites to discuss goals and strategies to help our patients.”
That collaboration helps improve everything from patient safety to system efficiency.
“We made substantial changes to our anesthesia protocol with enhanced standardization, and we’ve seen a marked improvement in post-anesthesia care unit length of stay,” says Dr. Brown. “It’s helped drive more rapid and comfortable recovery from anesthesia.”
“At Mercy Hospital, we’ve improved systems of communication between providers on call, strengthened staffing off-hours, and refined our perioperative review processes,” Dr. Hinrichs says.
“Perioperative” refers to the period of a patient’s surgery, including the care given before (preoperative), during (intraoperative), and after (postoperative). Spectrum offers more information here about what to expect before, during, and after getting anesthesia.
Regarding the improvements to anesthesiology-related systems and processes at Mercy Hospital, Dr. Hinrichs adds, “These kinds of challenges can involve multiple services, and collaboration is key.”
Anesthesiology’s Expanding Role in Patient Care
“Anesthesia touches nearly every patient population and most services,” Dr. Hinrichs says. “We help drive safety and efficiency by staying closely connected with nursing teams, perioperative staff, hospitalists, surgeons, intensivists, and ER colleagues.”
While anesthesiology is often seen as a behind-the-scenes specialty, it plays a central and collaborative role.
“A lot happens that patients may not see,” says Dr. Brown. “Even though you may only remember meeting your anesthesiologist before surgery, we’re involved at every level – from helping your surgeon choose the right operative setting for your procedure to managing complications and ensuring a smooth recovery.”
Built for What Is Next
As more procedures shift to outpatient settings, anesthesiology is playing a larger role in patient-centered care.
“We’re now involved in more procedures that used to be done with moderate, or ‘conscious,’ sedation,” says Dr. Brown. “Short-acting but effective medications like Propofol offer a smoother, more comfortable experience – and having anesthesiologists involved adds a layer of safety.”
It is just one example of how integration between surgical and anesthesiology teams benefits from solid communication.
“We’re having these conversations constantly – not just within our department, but across nearly every service we work with,” says Dr. Hinrichs. “The goal is the same – we want to give every patient the best chance for a safe procedure and smooth recovery.”
Looking ahead, both physicians agree the future of care depends on staying connected – and committed.
“Anesthesiology will continue to be an essential resource for our communities,” says Dr. Hinrichs. “That only works when everyone involved shares the same pride, purpose, and focus on the patient.”
“As physicians, we’re lucky to have such a deep team backing us up,” says Dr. Brown. “From the Spectrum office staff to prep and perioperative nurses and our CRNAs, who help deliver anesthesia to patients, these strong partnerships help guide where we go next.”
Key Takeaways:
- Anesthesiologists are the doctors who determine and coordinate the method of anesthesia to best benefit a patient during surgery.
- Anesthesiologists base their decisions on the patient’s health, the type of surgery, and other factors such as the anticipated level of pain, in collaboration with the surgeon.
- Anesthesiologists and specially trained nurses called CRNAs are the people who deliver and adjust anesthesia to patients during surgery.
- CRNA stands for “Certified Registered Nurse Anesthetist.”
- Anesthesiology and surgical teams work closely together to support patients on surgery day.
- Seamless communication is essential between the doctors providing anesthesia and the doctors performing surgery, both in planned procedures and emergency procedures.
- Spectrum anesthesiologists collaborate with surgeons to coordinate a variety of anesthesia methods in both hospital and outpatient settings.
- The four main methods of anesthesia include:
- General anesthesia: when a patient is fully unconscious during a procedure and requires a breathing tube connected to a ventilator to keep them breathing.
- Ultrasound-guided nerve blocks, also known as regional anesthesia: when pain-numbing medication is delivered to a specific nerve or group of nerves to block pain in a particular region of the body.
- Monitored anesthesia care, or MAC: when a patient is sedated but awake and can answer questions, or is unconscious but can easily be awakened. A patient receiving MAC can also breathe on their own.
- Local anesthesia: when only a small area of the body is numbed, often through an injection, while a patient stays fully awake.
- Multimodal anesthesia is a form of general anesthesia that involves the use of multiple drugs to increase beneficial effects and reduce side effects.
- Spectrum’s anesthesiologists work across a variety of outpatient and hospital sites in Maine through MaineHealth and Northern Light Mercy Hospital.
- By creating a uniform set of criteria and protocols used at all sites of service, Spectrum’s anesthesiologists help to ensure all patients receive safe and efficient care at hospitals and outpatient facilities – and help determine which setting is best for each procedure.
- Spectrum anesthesiologists regularly meet with representatives from all sites to collaborate on strategies to help patients.
- Spectrum’s enhanced standardization of protocols is resulting in more rapid and comfortable recovery from anesthesia for patients.
- “Perioperative” refers to the period of a patient’s surgery, including the care given before (preoperative), during (intraoperative), and after (postoperative).
- Anesthesiologists are involved at every level of surgical care, from helping surgeons choose the right operative setting for a patient’s procedure to managing complications during surgery and ensuring a smooth recovery.
- Experienced Spectrum anesthesiologists are actively involved in mentoring newer anesthesiologists stepping into leadership roles.
- As more procedures shift to outpatient settings, anesthesiology is playing a bigger role in patient-centered care using moderate or “conscious” sedation.
