Slowing Down the Schedule to Put the Patient First
June 15, 2022
UH intensivist Angela Johnson, MD, recent “Dinner with the Doc” honoree, makes a difference for a family with a simple act of compassion
UH Clinical Update | June 2022
Putting the patient’s needs first is a core capability of University Hospitals, underpinning every encounter where we deliver care. It manifests itself in different ways in different venues. But in the fast-paced, tightly scheduled world of complex surgeries and procedures, sometimes putting the patient first means slowing down, abandoning the schedule and taking a step back.
UH anesthesiologist and critical care specialist Angela Johnson, MD, is a case in point. Dr. Johnson and the ICU team at UH Cleveland Medical Center were recently planning for a challenging afternoon surgery where a woman who’d struggled with health problems her entire life would be weaned off extracorporeal membrane oxygenation (ECMO).
“Planning for the procedure took the better part of two days,” Dr. Johnson says. “We had a big multidisciplinary team that was really just trying to make the best decisions for this woman that we could. Everybody was on board. We had a plan that we were going to do this on this particular day and we got everything teed up and ready to go.”
The surgery was scheduled for early afternoon. However, it was bumped to an earlier time slot when a morning case was canceled. The problem? The time for surgery was approaching, and the patient’s family was not with her in the room to support her, not having had time to make arrangements to accommodate the new schedule.
OR staff began to start making preparations at the patient’s bedside. The wheels were in motion. That’s when Dr. Johnson acted to put the patient first. She personally set up a FaceTime call for the patient with her husband and kids and convinced the OR team to wait until the patient’s mom arrived to finish their preparations.
“Her mom came and they chatted, with big hugs and kisses and all that, and she went to the OR,” Dr. Johnson says.
Those simple acts of compassion on Dr. Johnson’s part truly made a difference, as they made possible the patient’s last conversations she ever had with her family. After an encouraging post-op period, the patient took a turn for the worse and did not survive.
Because of the sad outcome in this high-risk case, Dr. Johnson says she’s glad she “dragged her feet” and put the patient first.
“I just I really felt strongly about her being able to see and talk to her family before the surgery because we had just changed plans super-quick,” she says. “The patient comes first. That has always just been so ingrained into me and how I practice medicine and how I do everything that I do for patients.”
Dr. Johnson was recently recognized by UH CEO Cliff Megerian, MD, FACS, with a “Dinner with the Doc” honor for this compassionate approach to patient care. Importantly, she’s now able to incorporate this approach beyond her own clinical practice, as new Medical Director of the Cardiothoracic Intensive Care Unit at UH Cleveland Medical Center.
Dr. Johnson says she’s energized by the new responsibility.
“We have people across disciplines, across specialties, and so it's really cool to be a part of,” she says. “Helping to plan the care, the care paths, the protocols, helping to manage all those teams together, coming up with what's the best strategy for our patients is rewarding, especially when there's so many specialists involved.”
Dr. Johnson had a bit of a circuitous path to anesthesiology and critical care medicine. She started out as a general surgery resident at Mayo Clinic, but ultimately decided that her primary interests were more in helping patients improve from a critical illness.
“I had a super-supportive surgical program,” she says. “I did a one-month elective in anesthesia and it was game over. It just clicked. It felt good. It felt like home.”
She completed her residency and fellowship at UH Cleveland Medical Center, and the rest is history.
“I decided to stay on staff because I love the people here and the department,” she says. “It's awesome.”
As she takes on her new leadership role in the Cardiothoracic ICU at UH Cleveland Medical Center and continues with the sometimes emotionally draining work of caring for critically ill patients, Dr. Johnson says that exercise and time with her family help her manage stress and find joy in her days. But she says it’s also the patient successes that keep her going.
“I could be on the phone with a patient’s cardiac surgeon, saying they're not doing great, I think we might have to put them on ECMO,” she says. “A week later they're sitting in a chair or sitting in bed waving at you, smiling. Those are the things that really just kind of help you get through and remind you why you're doing what you're doing.”
Congratulations to Dr. Johnson on her “Dinner with the Doc” honor.