The Montefiore Einstein Department of Anesthesiology has led the second phase of pediatric perioperative care expansion at the Hutchinson Ambulatory Surgery Center. As of March 10, 2025, the Hutchinson Campus now serves outpatient pediatric patients aged two years and older.
\r\n\r\nThis initiative has been led by Dr. Olubukola Nafiu, vice chair of Research and Pediatric Anesthesiology; Dr. Bill Jackson, pediatric anesthesiology division chief; Dr. Adela Aguirre-Alarcon, Hutchinson Ambulatory Surgery Center site director for Anesthesiology; and Dr. Majed Al Hassanieh, in collaboration with the Montefiore Einstein Department of Surgical Services. The Children’s Hospital at Montefiore (CHAM) Post-Anesthesia Care Unit (PACU) team has also played a critical role throughout both phases of implementation.
\r\n\r\nPrior to the launch of phase one, all Hutchinson Campus nurses completed training with the CHAM PACU nursing team to ensure readiness in caring for pediatric patients. Pediatric surgeries are now performed four days per week at the Hutchinson Ambulatory Surgery Center, with a fellowship-trained pediatric anesthesiologist always on site. Additional CHAM staff have served as on-site consultants to support a smooth transition.
\r\n\r\nThis phase represents a continued expansion of pediatric ambulatory care at the Hutchinson Campus. Before 2024, the center served adult patients only. In 2024, the minimum patient age was lowered from 14 to 8 years, and this most recent expansion further enhances access to high-quality pediatric surgical care for young patients and their families.
\r\n\r\nAs the Pediatric Anesthesiology service expands, the department continues to work closely with nursing and PACU colleagues. Pediatric patients may be less able to communicate early warning signs of complications, making vigilance and rapid intervention by the perioperative team essential to ensuring safe care.
\r\n\r\nMost pediatric surgical specialties are currently performed at the Hutchinson Ambulatory Surgery Center, including orthopedics, urology, ophthalmology, and otolaryngology. The preoperative evaluation team, led by Director of Preoperative Evaluation Dr. Carina Himes and pediatric nurse practitioner Jodi-Ann Williams, screens patients in advance to determine eligibility for surgery at the Hutchinson Campus.
\r\n\r\nPatients undergoing cardiac or neurological procedures are not treated at the Hutchinson Campus, as these surgeries typically require inpatient care. Children with medical conditions that may increase the risk of perioperative complications are also identified during the preoperative evaluation process and referred to CHAM for care.
\r\n\r\nFor pediatric patients who are eligible for surgery at the Hutchinson Campus, benefits include reduced fasting times, shorter lengths of stay, and higher patient and parent satisfaction. Providing pediatric ambulatory surgery at Hutchinson supports the department’s mission to deliver patient- and family-centered, equitable care across all Montefiore Einstein campuses.
\r\n\r\nIn addition to the expansion at the Hutchinson Campus, Montefiore Einstein pediatric anesthesiologists are supporting pediatric surgeries at Montefiore New Rochelle, which integrated into the Department of Anesthesiology in 2024. Pediatric surgeries at Montefiore New Rochelle are led by Montefiore Einstein otolaryngology surgeons and currently take place five days per month with strong outcomes. Discussions are underway to expand block time for additional service lines.
\r\n\r\nMontefiore Einstein continues to advance pediatric anesthesiology through innovation in both clinical care and research, offering surgical treatments for children in ambulatory settings that prioritize safety, family involvement, and improved patient experiences.
\r\n\r\nAligned with the Department of Anesthesiology’s mission to translate research into clinical practice, the Pediatric Anesthesiology Division has multiple research initiatives underway aimed at improving outcomes for pediatric patients.
\r\n\r\nA recent publication, “Development and validation of a score for prediction of postoperative respiratory complications in infants and children (SPORC-C),” published in the British Journal of Anaesthesia in January, supports efforts to identify pediatric patients at increased risk for postoperative respiratory complications. The tool is now used to help determine which patients can safely undergo surgery in freestanding ambulatory care facilities.
\r\n\r\nThe SPORC-C score was developed in collaboration with the Anesthesiology Digital Health Lab through analysis of data from more than 32,000 pediatric surgeries. Among these cases, 2.4 percent of patients experienced postoperative respiratory complications, leading researchers to identify 11 key risk factors.
\r\n\r\nBy applying this prediction tool, preoperative evaluation teams, pediatric anesthesiologists, and pediatric surgeons can collaboratively develop care plans that reduce risk. Adjustments to airway management strategies and anesthetic plans can be made proactively to enhance patient safety.
\r\n\r\nWork is currently underway to integrate this prediction instrument into the preoperative evaluation workflow using machine learning methods developed within the Digital Health Lab.
\r\n\r\nSince joining Montefiore Einstein in fall 2024, Dr. Nafiu has focused on expanding and supporting research across the Pediatric Anesthesiology Division and the broader Department of Anesthesiology. A key priority is integrating departmental research infrastructure with faculty and trainees interested in scholarly work.
\r\n\r\nThrough access to the Digital Health Lab’s large data sets and advanced statistical analysis capabilities, the department aims to provide resources that enable researchers to pursue impactful, collaborative projects that inform and improve clinical care.
\r\n\r\nBy fostering cross-divisional collaboration and reducing silos in research, the Department of Anesthesiology continues to strengthen the link between scientific discovery and high-quality patient care.
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