Stanford Team Reduces VAP in TBI patients by 50%

June 27, 2025

A Stanford Surgery team has reduced the odds of ventilator-associated pneumonia (VAP) in severe traumatic brain injury (TBI) patients by 50% in the SICU.

The team, led by Surgical Critical Care Fellow Dr. Harrison Chau and supported by nurse coordinators/educators Emily Zwissig, Shelby Murphy, and Felix Navarro from Stanford’s SICU K4 unit was part of the Spring Realizing Improvement through Team Empowerment (RITE) program. According to their research, there was a steady increase in VAP cases since Spring 2023.

The team implemented targeted interventions including a process map for severe TBI patients and a TBI VAP prevention checklist reducing VAP usage from 14% to 7%. This reduction in VAP translates to 1-2 fewer patients of VAP per six months and ~$50,000 in health care cost savings.

“This amazing team brought tremendous resilience, energy, and commitment to the work. We’re proud of their accomplishments and excited to see the positive impact on patient outcomes,” said Amin Etemad Rezai, who served as the team’s coach. “Special kudos and gratitude to our sponsors, Dr. Joe Forrester, and Dr. Lisa Knowlton, for their steadfast support and dedication to continuous improvement.”

The team’s next steps include exploring prophylactic antibiotics, the EPIC admission order set, and EOLAS protocol. By Spring 2026 they hope to reduce the odds ratio of VAP in severe TBI patients to below 1.

Media Contact

Director of Communications

(650) 723-2301

rebaker@stanford.edu

Bio

As the Director of Communications for Stanford Surgery, Rachel Baker tells the stories of her department's faculty, staff, and trainees. With the help of an amazing team of content creators, she produces and curates original articles, photos, videos, graphics, and podcasts. She works with each division, center, program, and lab within her purview to define their audience and reach their goals while maintaining a consistent brand voice. She also offers both 1:1 and group education on a variety of topics including media training, using social media to advantage, and presentation refinement. Rachel holds a Bachelor's degree in journalism with a focus on photography from Syracuse University's S.I. Newhouse School of Public Communications and is currently pursuing a Master's Degree in Strategic Communications from the University of Maryland.

About Stanford Surgery

The Stanford University Department of Surgery is dedicated to inventing the future of surgical care through:

• pioneering cutting-edge research,
• developing the next generation of leaders, and
• healing through incomparable surgical skills and compassion.

To learn more, please visit surgery.stanford.edu

The Latest

– Surgery

SurgIQ Celebrates First Graduation

General Surgery Resident Dr. Dong Hur and team are the first to graduate from SurgIQ; a resident- and OR staff–driven quality improvement initiative designed to turn frontline insight into meaningful change.
– Surgery

Stanford/ReSurge Hand Surgery Workshop in Kampala, Uganda

Plastic surgery faculty from Stanford and ReSurge delivered a 2-day, hands-on hand surgery and cadaver dissection course for surgeons as part of the COSECSA Annual Meeting in Kampala, Uganda this past December.
– Surgery

INSIDE: PCSA2026

Two general surgery residents won awards at the Pacific Coast Surgical Association's 97th annual meeting this year in Oahu, Hawaii.
– Surgery

INSIDE: ASC2026

Stanford Surgery trainees from across several disciplines presented at the 21st annual Academic Surgical Congress held in Orlando, Florida last week.
– Surgery

Exploring the Intersection of Surgery and Cancer Research with Dr. Dan Delitto

Dr. Dan Delitto is an assistant professor of surgery at Stanford University specializes in surgical oncology and holds a PhD in immunology. On this episode, Dr. Delitto reflects on his decision to pursue an MD-PhD pathway during residency and discusses the recent advancements in single-cell RNA sequencing technology that his lab has acquired. He explains the complex role of fibroblasts in cancer development, particularly in pancreatic ductal carcinoma, highlighting how these cells can both promote and hinder tumor growth.