Risk Consulting

The Edge of Risk Series combines emerging risk management issues with the view of leading industry experts and world-renowned Stanford faculty clinicians who work at the sharp end of care.

High Risk Surgery: What is Best for the Patient?

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Date Recorded: Wednesday, Janurary 23, 2013
Time: 12pm-1pm (PST)
Duration: 1 hour including Q&A session (PST)
Technology: Streaming media via your web browser
Speakers: John Morton, MD, MPH, FACS, FASMBS, Associate Professor; Section Chief, Minimally Invasive Surgery; Director, Bariatric Surgery & Surgical Quality, Stanford School of Medicine
  Robert R. Cima, MD, Professor of Surgery and Consultant; Colorectal Surgery, Mayo Clinic Rochester, MN
  John Celona, JD, Senior Director, Advanced Risk Analytics, Stanford University Medical Network Risk Authority, LLC
Moderator: Dana M. Welle, DO, JD, FACOG, FACS, Physician Risk Consultant, Stanford University Medical Network Risk Authority, LLC
CE Credits:

Approved: 1 hour of CE credit from the American Society for Healthcare Risk Management (ASHRM)

You must be the registered viewer of the live or recorded webinar, or attest to your attendance, to demonstrate your attendance for credit.

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Developing the best care plan for patients facing surgery who are considered high risk based on their individual profile or for patients undergoing a high risk procedure can pose significant challenges. Medical and ethical considerations need to balance the chance for improved quality of life while considering the full impact to the patient in terms of physical, emotional and financial health. Additionally, the impact to the healthcare organization should be considered as resources become increasingly scarce. What once was a narrow discussion surrounding risks, benefits and alternatives to the patient now requires a more complete analysis of all the interests involved for patients to make a fully informed decision whether to proceed with high risk surgery.

Stanford University Medical Network Risk Authority and a panel of experts will explore this complex medical issue and provide an overview of the concept of high risk surgery as it exists in the current medical-economic environment and in light of today's healthcare consumer. It will provide a framework within which an organization can better assist a patient to make a fully informed decision while assessing its opportunities to reduce risk of loss and create value for the benefit of the medical community it serves.

Learning Objectives:

Attendees will learn to...

Registered Attendees also Receive the High Risk Surgery White Paper.

This comprehensive paper provides an overview of the latest information and can be distributed as a learning tool within your organization.


About the Speakers:

Dr. John M. Morton is Associate Professor of Surgery at Stanford University serving as Section Chief of Minimally Invasive Surgery and Director of both Bariatric Surgery and Surgical Quality. He has published over 80 peer-reviewed articles, edited two books on bariatric surgery and quality improvement and written 20 book chapters with over 200 national and international oral presentations.

Dr. Morton received undergraduate, Masters in Public Health, and Medical Doctor Degrees from Tulane University and a Masters in Health Administration from University of Washington. He was the first surgical resident to receive a Robert Wood Johnson Clinical Scholar Fellowship in the program's history at University of Washington and also completed an advanced laparoscopic fellowship at University of North Carolina, Chapel Hill. He served on Capitol Hill as Senator Bill Frist's Health Policy Intern.

As a teacher, Dr. Morton has received four teaching awards at Stanford University in 7 years including the 2008 Arthur Bloomfield Clinical Teacher of the Year. As Director of Surgical Quality at Stanford University Medical Center, Dr. Morton led efforts to impove the Department of Surgery's University Health Consortium's annual ranking from 24/98 to 1/98 and their Annual NSQIP mortality ranking from Average to Exemplary. He chairs the monthly Surgical Champions forum for the American College of Surgeons. He has been an invited speaker on surgical quality and bariatric surgery by the American College of Surgeons, Agency for Healthcare Research and Quality, National Patient Safety Foundation, and American Society for Metabolic and Bariatric Surgery. He serves as President of the California chapter of the American Society for Metabolic and Bariatric Surgery (ASMBS) and is currently the National Chairman for Acess to Care for ASMBS.


Dr. Robert Cima is a professor of surgery and a consultant in Colorectal Surgery at the Mayo Clinic in Rochester, Minnesota. He has been at the Mayo Clinic since 2003. A California native, he completed his undergraduate work and medical school in Calfiornia, obtaining his medical degree from Stanford University. He completed his general surgery training and a research fellowship at Harvard Medical School, Brigham and Women's Hospital. After his residency he completed a fellowship in Colon and Rectal Surgery at the Mayo Clinic, Rochester, Minnesota. He returned to the Brigham and Women's Hospital, Harvard Medical School, as an associate surgeon for two years before returning to Mayo Clinic as a Senior Associate Consultant in Colon and Rectal Surgery. His clinical interests include minimally invasive surgery, inflammatory bowel disease, in particular complex Crohn's disease, and complex abdominal wall and parastomal hernia issues. His academic intersts include minimally invasive surgery and patient related outcomes from surgery. He is also very active in the surgical quality and safety programs both in the Mayo Foundation as well as nationally.

He has served for 6 years as the vice-chairman of surgery for quality and safety. Currently, he is the chairman of the Quality and Safety Committee for the entire Rochester surgical practice. He served on the National Quality Forum (NQF) Surgical measures Committee until 2012. Dr. Cima is actively engaged in research related to systems approach to improving patient safety and outcomes.


John Celona has experience in healthcare, pharmaceuticals, and biotechnology and many other industries ranging from A (automobiles) to Z (zinc mines). He also specializes in litigation risk analysis. In addition, Mr. Celona is a frequent conference speaker and teaches decision and risk analysis in the Stanford School of Engineering, Stanford Center for Professional Development, and in the American Course on Drug Development and Regulatory Sciences. Mr. Celona is co-author of Decision Analysis for the Porfessional, first published in 1986 and now in its fourth edition.

John currently serves as senior director of Advanced Risk Analytics (ARA) for Stanford University Medical Center. John's work focuses on applying decision analysis methodologies to risk management at Stanford and bringing those cutting-edge solutions, like the safe patient handling program, to other leading healthcare organizations such as the Veteran's Administration (VA) healthcare system. Stanford's Safe Patient Handling work has already been awarded the prestigious Melinda S. Mitchell Quality and Service Award and incorporated into the 2010 Guidelines for the Design and Construction of Healthcare Facilities published by the American Society for Healthcare Engineers.

John is a graduate of the Stanford School of Engineering and Hastings College of Law, University of California.



Dana Welle has more than 16 years of clinical experience as an obstetrician-gynocologist. After completing her residency in a large tertiary academic medical center, she began private practice where she continued to manage high risk obstetric cases as well as perform complicated gynecological surgery. She is a fellow in the American College of Obstetrics and Gynecology (ACOG) and also a fellow in the American College of Surgeons (ACS). Although she is no longer directly involved in patient care, she continues her pursuit of medical knowledge and remains active in both ACOG and ACS.

Dana currently serves as the physician risk consultant for Stanford Hospital and Clinics and Lucile Packard Children's Hospital. Her responsibilies include conducting risk assessments, consulting with and educating healthcare providers and staff, and investigating potential claims at both facilities. She serves on the Committee for Professionalism and the Physician Wellness Committee at Stanford Hospital and Clinics, as well as on the Care Improvement Committee for both hospitals, and the Patient Safety Oversight Committee for Lucile Packard Children's Hospital.

Dana's combined educational degrees, coupled with her clincial background, places Dana in a unique position. She is able to use both her medical and legal insight to strengthen the relationship between the medical staff and the risk management team and bring a different perspective to addressing risk management issues.

Dana received her BS in Kinesology from the University of California at Los Angeles, her DO degree from the Western University of Health Sciences and her JD degree from Santa Clara University School of Law. She is a member of the state bar of California.


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