PERIOPERATIVE MANAGEMENT A COURSE DESIGNED FOR PRACTITIONERS TO LIMIT RISK AND IMPROVE PATIENT OUTCOME BY PROPER PREOPERATIVE EVALUATION, INTRAOPERATIVE MANAGEMENT AND POSTOPERATIVE CARE From the Leader in Perioperative Medicine Now In its 26th Year Including up-to-date coverage of clinical controversies and guidelines, 15 Clinical Vignettes, and preparation for economic and legal challenges facing your practice Sunday - Wednesday March 14-17, 2010 MARCO ISLAND MARRIOTT Marco Island, Florida Jointly provided by The Institute for Johns Hopkins Nursing DESCRIPTION Thirty million patients undergo surgical procedures in the US each year, and the age and medical complexity of this patient population is increasing. All these patients require preoperative assessment, intraoperative management, and postoperative care. Every year the body of peer-reviewed literature on this topic increases and new guidelines on perioperative management are formulated. In addition, economic and regulatory forces are creating new challenges for health care professionals. As the established leader in perioperative medicine, this course aims to provide the practitioner with the most up-to-date knowledge necessary for delivery of effective clinical care. WHO SHOULD ATTEND This activity is intended for anesthesiologists, surgeons, internal medicine specialists, family practitioners, nurse anesthetists, nurse practitioners and physician assistants OBJECTIVES After attending this activity, the participant will demonstrate the ability to: 1. Describe current guidelines for preoperative cardiac and pulmonary risk assessment and how to prevent and/or minimize cardiac and pulmonary complications using cost-effective preoperative testing and specific intraoperative and postoperative interventions. 2. Describe the perioperative risks associated with diabetes, obesity, hepatic disease, and advanced age and management strategies to minimize complications in these patients. 3. Describe bleeding and thrombotic risks in surgical patients and how to reduce complications through evidence-based use of blood conservation strategies, transfusion, and management of anti-thrombotic drug therapies. 4. Recognize how to prevent and treat infectious complications in surgical patients. 5. Recognize the impact of health care delivery systems and culture on the quality and safety of perioperative care and describe ways to improve patient outcome through changes in system structure and culture. ACCREDITATION STATEMENT This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of The Johns Hopkins University School of Medicine and The Institute for Johns Hopkins Nursing. The Johns Hopkins University School of Medicine is accredited by the ACCME to provide continuing medical education for physicians. CREDIT DESIGNATION STATEMENT The Johns Hopkins University School of Medicine designates this educational activity for a maximum of 22.50 AMA PRA Category 1 CreditsTM. Physicians should only claim credit commensurate with the extent of their participation in the activity. NURSING CREDIT PENDING The Institute for Johns Hopkins Nursing is approved as a provider of nurse practitioner continuing education by the American Academy of Nurse Practitioners: AANP Provider Number 061216. OTHER CREDIT This activity has been reviewed and is acceptable for up to 22 prescribed credits by the American Academy of Family Physicians. This course has been approved by the American Association of Nurse Anesthetists for 22 credits; Code Number 32110; Expiration Date: March 17, 2010. American Academy of Physician Assistants accepts AMA Category 1 CME credit for the PRA from organizations accredited by ACCME. POLICY ON SPEAKER AND PROVIDER DISCLOSURE It is the policy of The Johns Hopkins University School of Medicine and the Institute for Johns Hopkins Nursing that the speaker and provider disclose real or apparent conflicts of interest relating to the topics of this educational activity, and also disclose discussions of unlabeled/unapproved uses of drugs or devices during their presentation(s). The Johns Hopkins University School of Medicine OCME has established policies in place that will identify and resolve all conflicts of interest prior to this educational activity. Detailed disclosure will be made in the activity handout materials. GENERAL INFORMATION REGISTRATION Saturday, March 13 - 5:00 - 7:00 p.m. - Capri Foyer Once registered, please join us for a reception at the Sunset Terrace South on Saturday from 5:00 - 7:00 p.m. Sunday, March 14 - 7:00 - 7:45 a.m. - Capri Foyer FEES REGISTRATION CUT-OFF DATE: March 9, 2010 Methods of Payment: Payment by check or credit card must accompany the registration form prior to the activity. On-site payments by credit card only. Foreign payments must be by credit card or with a U.S. Dollar World Money Order. The registration fee includes instructional materials, continental breakfasts, refreshment breaks, and welcome reception. Physicians $660 Residents*/Fellows*/Physician Assistants/ Nurse Anesthetists/ Nurse Practitioners/ Other Health Professionals $585 *with verification of status You will receive a confirmation by e-mail if you have provided your e-mail address. Otherwise confirmation will be sent by mail. If you have not received it by March 9, 2010, call (410) 502-9634 to confirm that you are registered. Certificates of attendance will be mailed by May 5, 2010. The Johns Hopkins University reserves the right to cancel or postpone any activity due to unforeseen circumstances. In this event, the University will refund the registration fee but is not responsible for travel expenses. Additionally, we reserve the right to change the venue to a comparable venue. Under such circumstances registrants will be notified as soon as possible. SYLLABUS There are three options available for obtaining the syllabus: CD All registrants will receive a CD with the lecture slides and paper for note taking. This is included in the cost of your registration. Hard Copy with Binder A hard copy of the syllabus can be ordered ahead of time and is available for an additional charge. (See Registration Page) Online Version available for download A link to the syllabus will be provided via email shortly before the activity, if you prefer to print the syllabus on your own. (There is a business center at the conference facility, however, computers/printers are limited and the Marriott levies a charge for this service.) LATE FEE AND REFUND POLICY A $50 late fee applies to registrations received after 5:00 p.m. EST on March 9, 2010. A handling fee of $50 will be deducted for cancellation. Refund requests must be received by fax or mail by March 9, 2010. No refunds will be made thereafter. Transfer of registration to another Johns Hopkins conference in lieu of cancellation is not possible. SOCIAL EVENT A complimentary welcome reception for registrants and faculty will be held on Saturday, March 13, from 5:00-7:00 p.m. on the Sunset Terrace South. Light snacks will be served. Pre-registration will also be available during that time. Please indicate your attendance on the registration form. HOTEL AND TRAVEL INFORMATION Marco Island Marriott (800) 438-4373 400 South Collier Boulevard (239) 394-2511 Marco Island, Florida 34145 Fax: (239) 642-2672 The newly renovated award winning Marco Island Marriott is scenically located directly on the Gulf of Mexico. Marco is easily accessible by car, and nearby Naples offers incredible shopping and dining opportunities. With March temperatures averaging 80 degrees, the Marco Island Marriott is truly the perfect winter getaway meeting location! HOTEL RESERVATION CUT-OFF DATE: FEBRUARY 13, 2010 Our special group room rate is $362, single or double, plus state and local taxes. If you intend to stay at the Marriott, please book early. The hotel is usually SOLD OUT by JANUARY 15 - before the hotel cut-off date. Check in time is 4:00 p.m. and check out time is 11:00 a.m. All reservation requests require a credit card guarantee of one night?s deposit. Deposits will be refunded for rooms cancelled more than seven days prior to arrival. Call United Airlines at (800) 521-4041 for discounted rates and refer to Meeting ID Number 549TJ. Avis Rent-A-Car For car rental discounts, call Avis at (800) 331-1600 and mention AWD number A101999. OUTCOMES SURVEY An Outcomes Survey will be sent to all physician attendees within three months post activity to assist us in determining what impact this activity had on the attendee?s practice. NEW SYLLABUS OPTIONS AVAILABLE HISTORICALLY, THE HOTEL SELLS OUT QUICKLY. PLEASE MAKE YOUR RESERVATIONS EARLY. Marco Island Marriott (800) 438-4373 Reservation Cut-Off Date: Saturday, February 13, 2010 AMERICANS WITH DISABILITIES ACT The Johns Hopkins University School of Medicine fully complies with the legal requirements of the ADA and the rules and regulations thereof. Please notify us if you have any special needs. ACKNOWLEDGEMENT Applications for commercial support from health care related industries are pending. A complete list of contributors will be provided in the syllabus. TO REGISTER or FOR FURTHER INFORMATION Register Online www.HopkinsCME.edu Register by Phone (410) 502-9634 Register by Fax (410) 955-0807 Confirmation/Certificates (410) 502-9634 General Information (410) 955-2959 E-mail the Office of CME cmenet@jhmi.edu SPEAKERS ACTIVITY DIRECTORS Nauder Faraday, MD Associate Professor of Anesthesiology/ Critical Care Medicine and Surgery Director, Perioperative Hemostasis and Thrombosis Research Laboratory Director, Perioperative Genomic Research Sean Berenholtz, MD, MHS, FCCM Associate Professor of Anesthesiology/ Critical Care Medicine and Surgery Director, ICU Performance Improvement Committee Co-Director, Johns Hopkins Quality and Safety Research Group JOHNS HOPKINS FACULTY Lauren Berkow, MD Assistant Professor of Anesthesiology/ Critical Care Medicine and Otolaryngology and Head and Neck Surgery Director, Airway Services David Bravos, MD Assistant Professor of Anesthesiology/ Critical Care Medicine Director, Regional Anesthesia Todd Dorman, MD, FCCM Professor of Anesthesiology/Critical Care Medicine, Surgery, and Nursing Associate Dean and Director of Continuing Medical Education Vice Chair, Dept. of Anesthesiology/ Critical Care Medicine Leonard Feldman, MD Assistant Professor of Medicine Division of General Internal Medicine Associate Residency Director Director of Education, Johns Hopkins Hospitalist Service Derek Fine, MD Associate Professor of Medicine Division of Nephrology Pamela Lipsett, MD, FACS, FCCM Professor of Surgery and Anesthesiology/ Critical Care Medicine Director, General Surgery and Surgical Critical Care Training Programs Co-Director, Surgical Intensive Care Elizabeth Martinez, MD, MHS Associate Professor of Anesthesiology/ Critical Care Medicine and Surgery Medical Director, Adult PACUs J. Bryan Sexton, PhD Associate Professor of Anesthesiology/ Critical Care Medicine Johns Hopkins Quality and Safety Research Group Frederick Sieber, MD Associate Professor of Anesthesiology/ Critical Care Medicine Clinical Director, Johns Hopkins Bayview Campus Tracey Stierer, MD Assistant Professor of Anesthesiology/ Critical Care Medicine Director, Division of Ambulatory Surgery Jerry Stonemetz, MD Staff Anesthesiologist Chief Billing and Compliance Officer Department of Anesthesiology/Critical Care Medicine Ilan Wittstein, MD Assistant Professor of Medicine Division of Cardiology GUEST FACULTY Peter Rock, MD, MBA, FCCM, FCCP Professor of Medicine, Surgery, and Anesthesiology Martin Helrich Professor Chair, Dept. of Anesthesiology, University of Maryland School of Medicine Chief of Anesthesiology, University of Maryland Medical Center Baltimore, Maryland Brett Simon, MD, PhD Professor and Chair Department of Anesthesia, Critical Care, and Pain Medicine Beth Israel Deaconess Medical Center Boston, Massachusetts PROGRAM Sunday, March 14, 2010 7:00 - 7:45 Registration/Continental Breakfast 7:45 - 8:00 Conference Goals 8:00 - 8:30 The Perioperative Stress Response Todd Dorman, MD, FCCM 8:30 - 9:00 Preoperative Cardiac Risk Assessment and Testing Ilan Wittstein, MD 9:00 - 9:30 Mechanisms, Monitoring, and Management of Patients with Coronary Artery Disease Nauder Faraday, MD 9:30 - 9:45 Preoperative Evaluation: Optimized, Not Cleared Leonard Feldman, MD 9:45 - 10:00 Evidence-Based Preoperative Testing Sean Berenholtz, MD, MHS, FCCM 10:00 - 10:15 Questions and Answers 10:15 - 10:30 Case Discussion with Faculty/Refreshment Break 10:30 - 11:00 Surgical Site Infections Pamela Lipsett, MD, FACS, FCCM 11:00 - 12:00 Controversial Clinical Vignettes Management of the Patient with both Coronary and Cerebrovascular Disease Nauder Faraday, MD The Pre-Op Patient with a New Left Bundle Branch Block Peter Rock, MD, MBA, FCCM, FCCP The Preoperative Patient with a Pacemaker or AICD Ilan Wittstein, MD Perioperative Management of the Hypertensive Patient Todd Dorman, MD, FCCM 12:00 - 12:30 Perioperative Risks and Management of Pulmonary Hypertension Brett Simon, MD, PhD 12:30 - 12:45 Question and Answers Monday, March 15, 2010 7:00 - 7:30 Continental Breakfast and Case Discussion with Faculty 7:30 - 7:45 Questions and Answers 7:45 - 8:15 Preoperative Pulmonary Risk Assessment and Testing Peter Rock, MD, MBA, FCCM, FCCP 8:15 - 8:45 Perioperative Management of Patients with Cardiomyopathy Todd Dorman, MD, FCCM 8:45 - 9:15 Mechanisms and Management of Patients with Pulmonary Disease Peter Rock, MD, MBA, FCCM, FCCP 9:15 - 9:45 Perioperative Management of Patients on Chronic Antithrombotic Therapy Nauder Faraday, MD 9:45 - 10:00 Questions and Answers 10:00 - 10:15 Case Discussion with Faculty/Refreshment Break 10:15 - 10:45 Preventing, Identifying and Managing Common Nosocomial Infections Pamela Lipsett, MD, FACS, FCCM 10:45 - 11:15 Management of Perioperative Bleeding Nauder Faraday, MD 11:15 - 11:45 The Preoperative Patient with Obstructive Sleep Apnea Peter Rock, MD, MBA, FCCM, FCCP 11:45 - 12:30 Controversial Clinical Vignettes: Perioperative Management of the Obese Patient Lauren Berkow, MD Regional vs. General Anesthesia: Does It Change Outcome? Elizabeth Martinez, MD, MHS Managing the Difficult Airway Lauren Berkow, MD 12:30 - 12:45 Questions and Answers Tuesday, March 16, 2010 7:00 - 7:30 Continental Breakfast and Case Discussion with Faculty 7:30 - 7:45 Questions and Answers 7:45 - 8:15 Perioperative Fluid Management Pamela Lipsett, MD, FACS, FCCM 8:15 - 8:45 Perioperative Renal Dysfunction Derek Fine, MD 8:45 - 9:15 Perioperative Management of Diabetes and Hyperglycemia Leonard Feldman, MD 9:15 - 9:45 Post-Operative Delirium, Cognitive Decline, and Depression Frederick Sieber, MD 9:45 - 10:00 Questions and Answers 10:00 - 10:15 Case Discussion with Faculty/Refreshment Break 10:15 - 10:45 Perioperative Risks and Management of the Elderly Patient Frederick Sieber, MD 10:45 - 11:15 Essentials of Acute Pain Management David Bravos, MD 11:15 - 12:15 Controversial Clinical Vignettes: Allergy and Anaphylaxis Todd Dorman, MD Perioperative Management of Steroids and Adrenal Insufficiency Derek Fine, MD Pain Management in the Opioid-Tolerant Patient: A Case-Based Discussion David Bravos, MD 12:15 - 12:45 Perioperative Management of the Patient with Hepatic Disease Brett Simon, MD, PhD 12:45 - 1:00 Questions and Answers Wednesday, March 17, 2010 7:00 - 7:30 Continental Breakfast and Case Discussion with Faculty 7:30 - 7:45 Questions and Answers 7:45 - 8:15 Perioperative DVT and Pulmonary Embolism Nauder Faraday, MD 8:15 - 8:45 Management of Patients for Procedures in Ambulatory and Non-OR Locations Tracey Stierer, MD 8:45 - 9:15 Improving Perioperative Quality and Safety through System and Culture Change Sean Berenholtz, MD, MHS, FCCM 9:15 - 9:45 Health Care Provider Stress: Recognition and Management to Improve Patient Outcomes J. Bryan Sexton, PhD 9:45 - 10:00 Questions and Answers 10:00 - 10:15 Case Discussion with Faculty/Refreshment Break 10:15 - 10:45 Establishing an Effective Preoperative Evaluation Center: Practical Considerations for You and Your Institution Jerry Stonemetz, MD 10:45 - 11:15 Pay-for-Performance in Perioperative Medicine Elizabeth Martinez, MD, MHS 11:15 - 12:30 Controversial Clinical Vignettes: Postoperative Nausea and Vomiting Tracey Stierer, MD Monitoring Intraoperative Awareness and CNS Function Frederick Sieber, MD Improving the Quality of Sepsis Care Sean Berenholtz, MD, MHS, FCCM Regulatory Compliance and Pay-for-Performance: Financial Implications for Your Practice and Institution Jerry Stonemetz, MD Medico-Legal Liability in Perioperative Medicine: Common Pitfalls and How to Avoid Them Jerry Stonemetz, MD 12:30 - 12:45 Questions and Answers 12:45 Summary Adjourn - Please complete and return the Evaluation and Credit Report Forms. The Johns Hopkins University School of Medicine and the Institute for Johns Hopkins Nursing take responsibility for the content, quality and scientific integrity of this CME activity. This schedule is subject to change. MARK YOUR CALENDAR Future date for Perioperative Management at the Marriott Marco Island March 13-16, 2011 REGISTRATION FORM Course Number 80020789 Perioperative Management - In Its 26th Year March 14-17, 2010 To Register:??Online: www.HopkinsCME.edu??By fax: (866) 510-7088 By phone (credit card only): (410) 502-9634 Or mail this form to The Johns Hopkins University, Office of Continuing Medical Education, P.O. Box 64128, Baltimore, Maryland 21264-4128. Include check payable to HOPKINS/80020789 or include credit card information below. PAYMENT MUST ACCOMPANY FORM TO CONFIRM YOUR REGISTRATION. Please type or print clearly: last name first name middle initial primary degree (for name badge) primary specialty preferred mailing address city state ZIP + 4 code country daytime telephone fax number e-mail / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / You will receive confirmation notice by e-mail if you provide your e-mail address. M Check here if you wish to receive e-mail and/or fax notices about upcoming CME activities. M I will attend the complimentary pre-conference reception on Saturday evening. What do you hope to learn by attending this activity? Please notify us if you have any special needs. Registration Fees: M Physicians $660 M Residents*/Fellows*/Physician Assistants/Nurse Anesthetists/Nurse Practitioners/ Other Health Professionals $585 *with verification of status M Hard Copy of Syllabus (a CD/electronic copy of the syllabus is included in the registration fee) $?35 For registrations received after 5:00 p.m. EST on March 9, 2010, include a $50 late fee. On-site registrations are payable only by credit card. Total amount enclosed $ Payment Type: JHU Faculty/Staff Only: Complete registration form and return with appropriate form below to OCME, Turner 20. M Internal Order Number: The ION Data Request Form, can be found online at http://www.hopkinscme.edu/pdfs/IonRequest.pdf. M Tuition Remission: To apply for TR, go to http://benefits.jhu.edu/EduBenefits/tuitionRemission.cfm. This is a non-credit professional development activity. M Check (See instructions on top of form.) M Credit Card:????M VISA????M MASTERCARD????M DISCOVER????M AMEX Card # - - - Exp. Date Name on Card Signature & Date