Dean Rose and his Pediatric surgical team have taken the practice of Peri-operative Nursing to the next level here at UF Health Shands. Dean has incorporated into his practice preoperative multidisciplinary patient care planning conferences. Dean identifies high risk procedures, complex high risk patients, and takes action to bring the entire patient care team around the table to plan the patient's care from admission to discharge. He also takes the next step of coordinating "dress rehearsals" for the team to ensure coordination of the steps of the procedure and availability of all necessary supplies/equipment. Dean and his team have demonstrated excellent outcomes utilizing this model of nursing care. Examples:

A 10 year old patient with congenital developmental delays/syndrome that impaired mobility and made the surgical procedure for correction a risk of 80% mortality related to anesthesia and infection. Dean brought PICU, anesthesia, respiratory, Peds nursing, Dr. B and the OR staff in for a conference. Dean and his team took the extra effort to bring the patient in before surgery to "visit" and get to know her and her mother, arrange for an earlier preop visit to ensure all preop work was completed, walked the OR staff through the set up and the procedure, and kept in contact with the patient and family prior to surgery. The team even had the patient's favorite doughnut in the room waiting for her after surgery. The first thing the patient asked for when she woke up was the doughnut. Her mother cried when she told me how much that meant to her and her daughter. The patient was discharged without signs of infection. The patient is now walking and did not present with infection. This is an exceptional outcome for this type of patient. At the time of the procedure, there had been 5 other procedures performed on children with this syndrome. 3 did not survive surgery and the other 2 were not walking. Dean and his team were instrumental in this positive outcome.

There was a baby to be born at Shands with a mass in atrium of heart. Dean reached out to L&D and pulled the team together to plan surgical care. He coordinated between cardiac surgery, GYN surgery, NICU, and Anesthesia. His team arranged for adjoining OR rooms, coordinated start times, and ensured that the teams were present at the correct times. The baby was successfully delivered and had heart surgery to repair the problem. Again, coordination was the key and Dean stepped up to the plate.

Dean coordinated GYN, ENT, Peds, and L&D to practice for an exit procedure to be performed on an infant with a neck mass. The day before the procedure the teams came together with all supplies/equipment and walked through the procedure. Adjustments were made to ensure all supplies were available. Dean went through many steps to get a specialized stapler that was on backorder for the procedure. This coordination adjusted start time for the procedure.

Under Dean's leadership the entire Pediatric team has moved their practice to an outstanding quality level.