Center for Perioperative Research (C.P.R)

The mission of the Center for Perioperative Research is to facilitate research projects designed to test strategies that promote high quality perioperative care. Our research can be grouped into the following categories:

  1. Clinical trials of new drugs and devices
  2. Using informatics tools and large clinical databases to study perioperative/periprocedural patient outcomes and management strategies
  3. Patient safety research
  4. Opioid-related complications and non-opioid management strategies

We created a unique and innovative collaborative model of clinical and translational research by engaging anesthesiologists, surgeons, and members of medicine and other departments designed to improve quality of perioperative care, realize cost savings, and foster education. Our funded research activities include clinical trials of new pharmaceutical agents, patient monitoring techniques, and novel devices. Other recent projects have focused on understanding clinical risk factors for post-discharge surgical readmissions and reoperations using hospital and national outcomes data. Some of the projects involve investigation of the efficacy of informatics-based clinical decision tools, efficacy of perioperative (OR and Non-OR) efficiency interventions, and enhanced recovery after surgery (ERAS) pathways. We have performed analysis of quality metrics and patient outcomes using national databases to study patient mortality, care patterns, complication rates, and healthcare utilization. Recent work has focused on using large clinical databases such as NSQIP, NIS, Medicare/Medicaid, NACOR and closed claims, to examine the impact of anesthetic and surgical factors on patient outcomes. Several recent projects examined the impact of regional anesthesia on short-term patient outcomes. Our patient safety-related research has been focused on the use of emergency manuals in the OR, including a recent multi-institutional study funded by the Anesthesia Patient Safety Foundation (APSF). There is also an ongoing study on the preoperative goals of care discussions and shared decision making funded by the Foundation for Anesthesia Education and Research (FAER). The Center is currently working on a collaborative project to identify risk factors for opioid-related complications in hospitalized surgical patients, discharge order sets to improve care transitions, and identify predictors of persistent opioid use and opioid-related complications.  (NIH funding under review). A recently completed multi-site PRODIGY study aims to establish the incidence of opioid-related respiratory events in hospitalized surgical patients. We are also collaborating on two federally funded grants. The first study is funded by the Agency for Healthcare Research and Quality (AHRQ, R01-HS025718-01A1) to adapt and evaluate measures of decision quality for common medical decisions. The measures and associated user guides with provide researchers and clinicians a clear means to evaluate shared decision making and compare different decision support strategies designed to improve the quality of medical decisions. The second study is funded by the National Science Foundation (NSF, Award #1838796) Smart and Connected Health Program to develop novel computational methods for continuous objective multimodal pain assessment sensing system (COMPASS). The goal is to develop deep learning algorithms for a pain classifier based on multimodal feature extraction, develop a clinical platform for algorithm application, and improve algorithm robustness and accuracy through clinical testing in chronic pain patients.

We are currently collaborating on a project investigating common and rare variant association of opioid addiction using the network-wide eMERGE (Electronic Medical Records and Genomics Network) Phase 3 cohort. This is an NIH-funded ongoing study (NIH; U01 HG008685) that uses Partners Healthcare and collaborator data. We hope to select opioid addiction phenotypes by temporal algorithms and identify major common and disease-specific opioid addition variants.

 Email: rurman@bwh.harvard.edu

Phone: (617) 732-8222

Web page: http://www.brighamandwomens.org/Departments_and_Services/anesthesiology/services/cpmmi.aspx

Publications:

https://www.ncbi.nlm.nih.gov/pubmed/?term=richard+urman

 Research Team

Richard D. Urman, MD, MBA, FASA

Richard D. Urman, MD, MBA, FASA

Principal Investigator - Anesthesia

Edward E. Whang, MD, FACS - Surgery

Edward E. Whang, MD, FACS - Surgery

Jason S. Gold, MD - Surgery

Jason S. Gold, MD - Surgery

Ethan Y. Brovman, MD - Anesthesia

Ethan Y. Brovman, MD - Anesthesia

Sergey Karamnov, MD - Anesthesia

Sergey Karamnov, MD - Anesthesia

Alexander B. Stone, MD - Anesthesia

Alexander B. Stone, MD - Anesthesia

Kelly Tankard, MD - Anesthesia

Kelly Tankard, MD - Anesthesia

Ramsey Saba, MD - Anesthesia

Ramsey Saba, MD - Anesthesia

James Gosnell, RN

James Gosnell, RN

Research Coordinator