Dr Oakes is a Clinical Professor at Stanford School of Medicine with over 17 years of clinical experience in cardiothoracic anesthesiology. Dr. Oakes is Associate Dean of Post Graduate Medical Education and the Stanford Center of CME and Vice Chair of Clinical Educator Affairs in the Department of Anesthesiology.
The focus of her academic work has been the education and training of anesthesiologists at all levels of practice. In 2007 developed an education pathway for Stanford anesthesiology residents to learn perioperative echocardiography, one of the first programs of its kind nationally. She has since taught echocardiography to medical students, residents and fellows and lectures nationally on a range of topics related to transesophageal echocardiography, cardiothoracic anesthesiology, and medical education. In 2017, she was appointed Program Director of the Stanford Adult Cardiothoracic Anesthesiology Fellowship, and, under her 6 years of leadership, the program expanded from 4 fellows to 8 fellows and became widely recognized as one of the highest quality and most sought after programs nationally, consistently attracting a highly diverse group of fellowship candidates.
In 2018 Dr. Oakes was appointed Associate Dean of Postgraduate Medical Education and took over leadership of the Stanford Center of Continue Medical Education. Under her leadership the center has greatly expanded its programming and impact and Stanford CME is now universally regarded as the academic leader in continuing medical education. In addition to providing traditional meeting services and program accreditation, the office has taken the lead on several innovative educational programs including a statewide effort to that provided training to providers in over 1000 nursing homes on protecting their elderly residents from COVID, a virtual digital conference AI + Health reaching over 1000 participants, and several programs addressing health care disparities and justice, equity, diversity and inclusion efforts.
Dr. Oakes is a passionate mentor to both trainees and colleagues and has created multiple programs to support physician professional development including most recently, the Stanford CME Physician Leadership Certificate Program, a 6-month cohort-based leadership training for aspiring and developing physician leaders. She also co-founded and chairs the SCA Women in Cardiothoracic Anesthesiology (WICTA) Special Interest Group and has been recognized for her work supporting women medical professionals with the 2021Women in Medicine (WIM) #SheForShe Award and the 2023 WICTA “SHE LEADS” Award. Dr. Oakes is a recognized leader in her field and elected member of the Association of University Anesthesiologists (AUA).
- Cardiac Anesthesia
- Perioperative Transesophageal Echocardiography
Clinical Professor, Anesthesiology, Perioperative and Pain Medicine
Member, Cardiovascular Institute
Associate Dean, Post Graduate Medical Education and Continuing Medical Education, Stanford School of Medicine (2018 - Present)
Vice Chair, Clinician Educator Affairs, Department of Anesthesiology, Perioperative and Pain Medicine (2022 - Present)
Director, Perioperative Echocardiography Services and Education, Department of Anesthesiology, Critical Care, and Pain Medicine, Stanford School of Medicine (2013 - Present)
Member, Wellbeing Committee, Stanford Hospital and Clinics (2018 - Present)
Program Director, Adult Cardiothoracic Anesthesia, Department of Anesthesiology, Critical Care and Pain Medicine, Stanford School of Medicine (2017 - 2023)
Vice-Chief of Education, Division Cardiothoracic Anesthesia, Department of Anesthesia, Critical Care, and Pain Medicine, Stanford School of Medicine (2015 - Present)
Board Certification: National Board of Echocardiography, Perioperative Transesophageal Echocardiography (2018)
Residency: Brigham and Women's Hospital Harvard Medical School (2005) MA
Internship: Brigham and Women's Hospital Harvard Medical School (2002) MA
Board Certification: American Board of Anesthesiology, Anesthesia (2006)
Medical Education: Harvard Medical School (2001) MA
Graduate and Fellowship Programs
Cardiac Anesthesia (Fellowship Program)
The Women in Cardiothoracic Anesthesiology Special Interest Group: What Can the Lessons of One Anesthesiology Affinity Group Tell Us About How to Build Impactful Professional Communities?
Anesthesia and analgesia
2023; 137 (4): 763-771
The Women In Cardiothoracic Anesthesiology (WICTA), a special interest group of the Society of Cardiovascular Anesthesiologists, has been highly successful in mobilizing WICTA, a historically underrepresented and marginalized group in the subspecialty, and in supporting real and meaningful change in the professional community. The experience of WICTA as a professional affinity group in impacting a professional organization to diversify, evolve, and become more responsive to a wider professional audience has important lessons for other professional organizations. This article discusses the recent history of affinity organizations in anesthesiology, the benefits they offer professional organizations, and the strategies that have been used to effectively motivate change in professional communities. These strategies include engaging a strong advisory board, identifying the need of constituents, creating additional opportunities for networking and membership, addressing gaps in professional development, and aligning goals with those of the larger national organization. WICTA is just one example of the potential opportunities that affinity groups offer to professional societies and organizations for expanding their reach, enhancing their impact on physicians in their target audience, and achieving organizational missions.
View details for DOI 10.1213/ANE.0000000000006657
View details for PubMedID 37712467
Idees recues concernant les femmes en position de leadership en medecine universitaire.
Canadian journal of anaesthesia = Journal canadien d'anesthesie
Despite progress made over the past decade, women are under-represented in positions of leadership in academic medicine. Women physicians face numerous challenges throughout their careers. Despite achieving leadership positions, women in leadership continue to experience the impact of those challenges. In this review, we describe four misconceptions about women in leadership, along with their impact and recommendations. First, we describe differences between mentorship and sponsorship, as well as their impact on attaining leadership positions. Second, the gender pay gap persists throughout women's careers, regardless of leadership positions. Third, we explore the role of self-efficacy in leadership in the context of stereotype threats. Fourth, gendered expectations of leadership characteristics place an undue burden on women, detracting from their leadership effectiveness. Organizations can address the challenges women face by creating robust mentorship and sponsorship networks, establishing transparent and equitable pay policies, promoting and normalizing a broader range of leadership styles, and improving work flexibility and support structure. Ultimately, such changes serve all members of the organization through increased retention and engagement.
View details for DOI 10.1007/s12630-023-02458-7
View details for PubMedID 37193865
- A Call for Diversity: Women, Professional Development, and Work Experience in Cardiothoracic Anesthesiology. Journal of cardiothoracic and vascular anesthesia 2022
- Coming to Terms With a New Normal: Recovery, Resilience, and Opportunities in a Post-COVID-19 World. Journal of cardiothoracic and vascular anesthesia 2022
Perceptions of Gender Disparities Among Women in Cardiothoracic Anesthesiology.
Journal of cardiothoracic and vascular anesthesia
OBJECTIVE: In this study of women in cardiothoracic anesthesiology, the authors aimed to characterize demographics, roles in leadership, and perceived professional challenges.DESIGN: A prospective cross-sectional survey of female cardiothoracic anesthesiologists in the United States.SETTING: An internet-based survey of 43 questions was sent to women in cardiothoracic anesthesiology. The survey included questions on demographics, leadership, and perceptions of professional challenges including career advancement, compensation, promotion, harassment, and intimidation.PARTICIPANTS: A database of women in cardiothoracic anesthesiology was created via personal contacts and snowball sampling.INTERVENTIONS: None.MEASUREMENTS AND MAIN RESULTS: A total of 153 responses were analyzed, for a response rate of 65.1%. Most respondents were at the Clinical Instructor or Assistant Professor rank. Many women perceived that compensation, promotion, authorship, and career advancement were affected by gender. Furthermore, 67% of respondents identified having children as having a negative impact on career advancement. Many women reported experiencing derogatory comments (55.6%), intimidation (57.8%), microaggression (69.6%), sexual harassment (25.2%), verbal harassment (45.2%), and unwanted physical or sexual advances (24.4%). These behaviors were most often from a surgical attending, anesthesia attending, or patient.CONCLUSION: This survey study of women in cardiothoracic anesthesiology found that many women perceived inequities in financial compensation, authorship opportunities, and promotion; in addition, many felt that their career advancement was impacted negatively by having children. A striking finding was that the majority of women have experienced intimidation, derogatory comments, and microaggressions in the workplace.
View details for DOI 10.1053/j.jvca.2021.11.015
View details for PubMedID 34903458
Gender of Abstract Presenters at the Annual Meetings of the Society of Cardiovascular Anesthesiologists and American Society of Anesthesiologists: 2016 to 2020.
Journal of cardiothoracic and vascular anesthesia
OBJECTIVE: The purpose of this study was to assess gender in abstract poster presentations at the Society of Cardiovascular Anesthesiologists (SCA) and American Society of Anesthesiologists (ASA) Annual Meetings from 2016 through 2020 to determine possible gender disparities in anesthesia overall as compared to cardiothoracic anesthesia.DESIGN: A bibliometric study SETTING: Publicly available data from the SCA and ASA websites.PARTICIPANTS: Presenting and senior authors of abstracts at the SCA and ASA Annual Meetings.INTERVENTIONS: None.MEASUREMENTS AND MAIN RESULTS: Abstract data on presenting and senior authors were collected for the years 2016 through 2020 for both annual meetings. Observed gender of abstract authors was compared to expected gender based on the gender distribution of cardiac anesthesiologists for the SCA or of all anesthesiologists for the ASA. From 2016 to 2020, the proportion of women senior authors on abstracts was significantly underrepresented (2016-2019, p < 0.05). At the SCA meetings, there was no significant difference in the observed versus expected proportion of women presenting and senior authors. The percentage of woman physicians' abstract-presenting authors at the ASA was overrepresented compared to the expected proportion for each year (2016-2020, p < 0.001).CONCLUSION: At the SCA, women were appropriately represented as both presenting and senior abstract authors. At the ASA, there was significant overrepresentation of women as presenting authors and underrepresentation of women as senior authors. These results suggested that abstract presentation is not a barrier to academic advancement.
View details for DOI 10.1053/j.jvca.2021.11.002
View details for PubMedID 34916140
A Call for Diversity: Underrepresented Minorities and Cardiothoracic Anesthesiology Fellowship Education.
Journal of cardiothoracic and vascular anesthesia
This paper is the first of a four-part series that details the current barriers to diversity in the field of adult cardiothoracic anesthesiology and outlines actionable programs that can be implemented to create change. Part I and Part II address the training experience of women and underrepresented minorities (URMs) in adult cardiothoracic anesthesiology (ACTA), respectively, and explore concrete opportunities to promote positive change. Part III and Part IV examine the professional experience of URMs and women in ACTA, respectively, and discuss interventions that can facilitate a more equitable and inclusive environment for both groups. Although these problems are complex, the authors here offer a detailed analysis of the challenges faced by each group both in the training phase and the professional practice phase of their careers. The authors also present meaningful and concrete actions that can be implemented to create a more diverse, equitable, and inclusive professional environment in cardiovascular and thoracic anesthesiology.
View details for DOI 10.1053/j.jvca.2021.09.028
View details for PubMedID 34696968
- A Call for Diversity: Women and Cardiothoracic Anesthesiology Fellowship Education. Journal of cardiothoracic and vascular anesthesia 2021
- Are anesthesiology societies at risk of becoming obsolete? Perspectives on challenges and opportunities for moving forward. International anesthesiology clinics 2020
- A Review of Perioperative Analgesic Strategies in Cardiac Surgery INTERNATIONAL ANESTHESIOLOGY CLINICS 2018; 56 (4): E56–E83
- Preface INTERNATIONAL ANESTHESIOLOGY CLINICS 2018; 56 (4): 1–2
A Review of Perioperative Analgesic Strategies in Cardiac Surgery.
International anesthesiology clinics
2018; 56 (4): e56–e83
View details for PubMedID 30204605
International anesthesiology clinics
2018; 56 (4): 1–2
View details for PubMedID 30204601
The Heart of the Matter: Increasing Quality and Charge Capture from Intraoperative Transesophageal Echocardiography.
A & A case reports
2016; 6 (8): 249-252
Although transesophageal echocardiography is routinely performed at our institution, there is no easy way to document the procedure in the electronic medical record and generate a bill compliant with reimbursement requirements. We present the results of a quality improvement project that used agile development methodology to incorporate intraoperative transesophageal echocardiography into the electronic medical record. We discuss improvements in the quality of clinical documentation, technical workflow challenges overcome, and cost and time to return on investment. Billing was increased from an average of 36% to 84.6% when compared with the same time period in the previous year. The expected recoupment of investment for this project is just 18 weeks.
View details for DOI 10.1213/XAA.0000000000000169
View details for PubMedID 27082233
Factors Contributing to Adverse Perioperative Events in Adults with Congenital Heart Disease: A Structured Analysis of Cases from the Closed Claims Project
CONGENITAL HEART DISEASE
2015; 10 (1): 21-29
Prior investigations have suggested that the rapidly growing population of adults with congenital heart disease is at increased risk of perioperative morbidity and mortality, but information is limited on the nature of those perioperative factors that may relate to adverse outcomes. We sought to use a national claims database to describe the contribution of perioperative factors to adverse outcomes and compare contributing factors in cardiac vs. noncardiac operations.The study is a retrospective in-depth structured analysis of cases from the Anesthesia Closed Claims Project database.We examined the largest national anesthesia malpractice claims database.We included all claims cases involving adult patients with congenital heart disease (CHD).Patients in this retrospective analysis were classified by type of surgery (cardiac or noncardiac).Perioperative factors contributing to an adverse event were assessed by an expert panel of cardiac anesthesiologists.Of 21 confirmed cases, 11 (52%) involved cardiac procedures and 10 (48%) noncardiac procedures. The most common factors contributing to the adverse event in cardiac cases were surgical technique (73% of cases) and intraoperative anesthetic care (55%), whereas in noncardiac cases, postoperative monitoring/care (50%), CHD (50%) and preoperative assessment or optimization (40%) were most common. The factors contributing to the patient injury differed similarly: in cardiac cases, the most common factors were intraoperative anesthetic care (55%) and surgical technique (45%) compared with postoperative monitoring/care (50%) and CHD (50%) in noncardiac cases.Within the limitations of a small number of events in a claims-based database, this study offers advantages of being a national, structured analysis of real cases to provide detailed information on phenomena that are otherwise abstract and hypothesized by expert opinion. These results should help affirm the role of anesthesiologists in acquiring and executing expertise as consultants in perioperative medicine for adults with congenital heart disease patients.
View details for DOI 10.1111/chd.12188
View details for Web of Science ID 000349462600010
View details for PubMedID 24869762
Factor VIII Inhibitor Bypass Activity and Recombinant Activated Factor VII in Cardiac Surgery
JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA
2014; 28 (5): 1221-1226
Postcardiopulmonary bypass hemorrhage remains a serious complication of cardiac surgery. Given concerns regarding adverse effects of blood product transfusion and limited efficacy of current antifibrinolytics, procoagulant medications, including recombinant factor VIIa (rFVIIa) and factor eight inhibitor bypass activity (FEIBA), increasingly have been used in managing refractory bleeding. While effective, these medications are associated with thromboembolic complications. This study compared the efficacy and risk of adverse events of rFVIIa and FEIBA in cardiac surgical patients with refractory bleeding.This retrospective study evaluated 168 patients who underwent cardiac surgery and received either FEIBA or rFVIIa to manage postbypass hemorrhage. Demographic, clinical, and outcomes data were collected and statistical analysis performed to compare thromboembolic event rates, relative efficacy, and 30-day mortality following administration of these medications.Single university hospital.Patients undergoing cardiac surgery.None.Sixty-one patients received rFVIIa, and 107 received FEIBA. Demographics, surgical procedures, and preoperative anticoagulation were similar between the cohorts; however, the rFVIIa cohort had longer durations of cardiopulmonary bypass (305.1 v 243.8 min, p<0.01). There were no significant differences in the number of thromboembolic events, 30-day mortality, or rates of revision surgery. Neither group demonstrated a clear relationship between dosage and occurrence of thromboembolic events. The rFVIIa cohort received more platelets than the FEIBA cohort (3.13 v 1.67 units, p = 0.01), but transfusion rates of other blood products were similar.This study suggests that rFVIIa and FEIBA have similar efficacy and adverse event profiles in managing intractable postbypass hemorrhage in cardiac surgical patients. Further prospective studies are required.
View details for DOI 10.1053/j.jvca.2014.04.015
View details for Web of Science ID 000343188500009
Perioperative management of combined carotid and coronary artery bypass grafting procedures.
2014; 32 (3): 699-721
The objective of this review is to provide a high level overview on current thinking for treatment of patients with combined carotid and coronary artery disease given that these patients are at higher risk of adverse cardiac events, stroke, and death. This review discusses (1) the current literature addressing perioperative stroke risk in the setting of coronary artery bypass graft, (2) the literature regarding different surgical approaches when both carotid and coronary revascularization are being considered, and (3) the data available to guide optimal management of this complex patient population to minimize complications regardless of the surgical approach taken.
View details for DOI 10.1016/j.anclin.2014.05.005
View details for PubMedID 25113728
Congenital anomalies of the aortic arch in acute type-a aortic dissection: implications for monitoring, perfusion strategy, and surgical repair.
Journal of cardiothoracic and vascular anesthesia
2014; 28 (3): 467-472
To assess whether management of acute Stanford type-A aortic dissection differs in patients with congenital anomalies of the aortic arch compared with standard institutional practice.Retrospective analysis of all consecutive patients from 2001 through 2011.Quaternary referral center for surgical management of thoracic aortic disease.All patients with arch anomalies who underwent surgery for acute Stanford type-A aortic dissection during the study period (n = 43).Surgical management, anesthetic monitoring, and perfusion strategy were analyzed in a retrospective fashion. No new interventions were undertaken as part of this study.Management differed most in patients with an aberrant right subclavian artery (n = 5), because the institutional standard of right axillary artery cannulation with left upper extremity arterial pressure monitoring was not possible. In patients with one of two "bovine" arch patterns (n = 32), management differed in the conduct of selective antegrade cerebral perfusion, which could include clamping above or below the takeoff of the left common carotid artery (and, therefore, produced unilateral or bilateral antegrade cerebral perfusion). All patients with a connective tissue disorder exhibited a bovine arch pattern. Management of patients with a right arch (n = 3) reflected the opposite of management for normal anatomy (for patients with traditional mirror-image branching) or opposite that of the aberrant right subclavian group (for patients who had a corresponding aberrant left subclavian artery).Rational management reflected the anatomic variations observed. These results support the importance of interdisciplinary planning, especially in an emergency, to optimize outcome.
View details for DOI 10.1053/j.jvca.2013.12.001
View details for PubMedID 24731741
- Tricuspid regurgitation jet velocity suggestive of severe pulmonary hypertension. Journal of cardiothoracic and vascular anesthesia 2014; 28 (2): 433-434
Comparative Study of Factor Eight Inhibitor Bypass Activity and Recombinant Activated Factor VII in Refractory Post-Cardiopulmonary Bypass Bleeding
Scientific Sessions of the American-Heart-Association/Resuscitation Science Symposium
LIPPINCOTT WILLIAMS & WILKINS. 2011
View details for Web of Science ID 000299738708362
Safety of Transesophageal Echocardiography
JOURNAL OF THE AMERICAN SOCIETY OF ECHOCARDIOGRAPHY
2010; 23 (11): 1115-1127
Since its introduction into the operating room in the early 1980s, transesophageal echocardiography (TEE) has gained widespread use during cardiac, major vascular, and transplantation surgery, as well as in emergency and intensive care medicine. Moreover, TEE has become an invaluable diagnostic tool for the management of patients with cardiovascular disease in a nonoperative setting. In comparison with other diagnostic modalities, TEE is relatively safe and noninvasive. However, the insertion and manipulation of the ultrasound probe can cause oropharyngeal, esophageal, or gastric trauma. Here, the authors review the safety profile of TEE by identifying complications and propose a set of relative and absolute contraindications to probe placement. In addition, alternative echocardiographic modalities (e.g., epicardial echocardiography) that may be considered when TEE probe placement is contraindicated or not feasible are discussed.
View details for DOI 10.1016/j.echo.2010.08.013
View details for Web of Science ID 000283437300001
View details for PubMedID 20864313
- Cardiopulmonary Bypass in 2009: Achieving and Circulating Best Practices ANESTHESIA AND ANALGESIA 2009; 108 (5): 1368-1370
- Intraoperative monitoring of elephant trunk kinking with transesophageal echocardiography JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA 2007; 21 (4): 584-586