"The Infinite Game"
In order to understand the vision of Infinite Anesthesia, we must first reflect on notions explained by James P. Carse ("Finite and Infinite Games: A Vision of Life as Play and Possibility") and Simon Sinek ("The Infinite Game"). Carse writes that, "A finite game is played for the purpose of winning, an infinite game for the purpose of continuing the play." Sinek elaborates on the idea stating, “In a finite game, the game ends when the time is up and the players live on to play another day... In an infinite game, it’s the opposite. It is the game that lives on, and it is the players whose time runs out.”
How does this translate to health care and the clinical setting? The authors of the "The Infinite Game: One Possible Future of Anesthesia in the United States"— including our department Chair Dr. Dan Berkowitz and Dr. Matt Sherrer—challenge clinicians to apply Sinek's five essential practices for adopting an infinite game mindset, and then build a new anesthesia approach, "Infinite Anesthesia," with these five practices as its core values.
Lead Infinitely: Framework Resources
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1. Advance a just cause.
1. Advance a just cause.
“The just cause pursued by Infinite Anesthesia is the creation of a mutually supportive workspace that maximizes patient care with every encounter—in a way that appreciates every team member.”
- The Infinite Game: One Possible Future of Anesthesia in the United StatesThe Infinite Game: One Possible Future of Anesthesia in the United States
Sherrer, D. Matthew MD, MBA, FASA, FAACD*; Dutton, Richard P. MD, MBA†; Kamdar, Nirav MD, MPP, MBA‡; Reede, Lynn DNP, MBA, CRNA, FNAP§; Tsai, Mitchell H. MD, MMM, FASA, FAACD∥; Berkowitz, Dan E. MB BCh*; Vetter, Thomas R. MD, MPH, MFA
Anesthesia & Analgesia 137(6):p 1179-1185, December 2023. | DOI: 10.1213/ANE.0000000000006628UAB Anesthesia Care Team Optimization Committee (ACTOC)
ACTOC Mission: Optimize the perioperative care of our patients by building and promoting an inclusive, respectful, and fulfilling anesthesia care team. -
2. Build trusting teams.
2. Build trusting teams.
“Rather than allowing a toxic culture to continue to impact patient care and provider wellness, [ACTOC leaders] elected to address these issues intentionally and civilly. By bringing in outside experts to facilitate respectful dialogue and discuss the undiscussable, [UAB ACTOC] shifted away from antagonistic stakeholder positions to focus on respectful interactions, accountability, and trust—and replaced the toxic culture with a culture of safety and wellness.”
UAB Anesthesia Care Team Optimization Committee (ACTOC)
ACTOC Mission: Optimize the perioperative care of our patients by building and promoting an inclusive, respectful, and fulfilling anesthesia care teamThe Infinite Game: One Possible Future of Anesthesia in the United States
Sherrer, D. Matthew MD, MBA, FASA, FAACD*; Dutton, Richard P. MD, MBA†; Kamdar, Nirav MD, MPP, MBA‡; Reede, Lynn DNP, MBA, CRNA, FNAP§; Tsai, Mitchell H. MD, MMM, FASA, FAACD∥; Berkowitz, Dan E. MB BCh*; Vetter, Thomas R. MD, MPH, MFA
Anesthesia & Analgesia 137(6):p 1179-1185, December 2023. | DOI: 10.1213/ANE.0000000000006628Recognizing the Awe in Anesthesia
Berkowitz, Dan E. MB, BCh*; Sherrer, D. Matthew MD, MBA*; Vetter, Thomas R. MD, MPH, MFA*,†
Anesthesia & Analgesia ():10.1213/ANE.0000000000007050, May 10, 2024. | DOI: 10.1213/ANE.0000000000007050“As practicing anesthesiologists, we ought to pause more often to witness our colleagues’ quiet courage, kindness, strength, and resilience—and to embrace its moral beauty and our attendant awe. This awe can serve as a pathway to better mental and physical health, and hence an antidote to professional burnout. Indeed, recent data on learning from excellence shows that prosocial behaviors such as kindness, generosity, and compassion are frequently cited as not only contributing to improved patient care but also as directly impacting the well-being of colleagues.13 Intentionally encountering such prosocial behavior can also promote greater prosocial behavior by us all in the anesthesiology community, thereby ameliorating the recent, demoralizing commoditization of anesthesiology.”
Audiobook: Dr. Matthew Sherrer | An Infinite Game Mindset for Enhanced Cooperation in Anesthesia
Anesthesia Leadership News: 19 graduate from UAB Medicine’s High Performing Care Collaborative Spring 2024 programThe team quotient: Becoming expert teams
"We can’t just be a team of experts—we need to be expert teams. Therefore, we have to improve our team quotient... Without team skills, each of these specializations can often create unintentional friction, not only on our systems but also on our outcomes."Collectively Intelligent Anesthesia Care Teams
D. Matthew Sherrer, MD, MBA, FASA, FAACD; Melissa Mines Ramsey, DNP, CRNA; Kesha Thurston, DNP, MSHQS, CRNA“With the collaborative support of and guidance from the UAB ACTOC, our team has shown that civility in the workplace and an understanding and practice of collectively intelligent teamwork can thrive, benefitting patients and providers alike.”
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3. Study your worthy rivals.
3. Study your worthy rivals.
“The default situation is for anesthesiologists and nurse anesthetists to see each other as mutually worthy rivals in the perioperative marketplace. However, in Infinite Anesthesia, we see each other as fellow players in an infinite game, jointly competing against the status quo of bipartisan rivalry. In other words, rather than seeing each other as the opponent, Infinite Anesthesia emphasizes collaboration and mutual respect. We thus compete to overcome microaggressions, to alleviate stress and to minimize burnout, and to rise above political animus, name calling, and bickering—as we build toward a better future state.”
- The Infinite Game: One Possible Future of Anesthesia in the United StatesThe Infinite Game: One Possible Future of Anesthesia in the United States
Sherrer, D. Matthew MD, MBA, FASA, FAACD*; Dutton, Richard P. MD, MBA†; Kamdar, Nirav MD, MPP, MBA‡; Reede, Lynn DNP, MBA, CRNA, FNAP§; Tsai, Mitchell H. MD, MMM, FASA, FAACD∥; Berkowitz, Dan E. MB BCh*; Vetter, Thomas R. MD, MPH, MFA
Anesthesia & Analgesia 137(6):p 1179-1185, December 2023. | DOI: 10.1213/ANE.0000000000006628 -
4. Prepare for existential flexibility.
4. Prepare for existential flexibility.
The Icarus Paradox and the Future of Anesthesiology
Sherrer, D. Matthew MD, MBA, FASA, FAACD*; Franklin, Andrew D. MD, MBA, FASA, FAACD†; Kimatian, Stephen J. MD‡; Black, Ian H. MD, FASA§,∥,; Tsai, Mitchell H. MD, MMM, FASA, FAACD#
Anesthesia & Analgesia 136(1):p 185-189, January 2023. | DOI: 10.1213/ANE.0000000000006253“We could choose to embrace the status quo and continue to be complacent with our current models and financial position. Undoubtedly, many anesthesiologists would prefer this option over a path of continued exploration, iteration, and innovation that places us in new models that offer none of the comfort and familiarity with which we have grown accustomed. However, some would see this as an opportunity to embrace uncertainty, to leave the predictability of our daily routines, and to tinker with new and exciting ideas.”
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5. Demonstrate the courage to lead.
5. Demonstrate the courage to lead.
UAB Leadership Development Office
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Perioperative Leadership Fellowship at UAB
