Matthew Bret Weinger, M.D.

Faculty Appointments
Professor of Anesthesiology Professor of Civil and Environmental EngineeringNorman Ty Smith Chair in Patient Safety and Medical SimulationProfessor of Biomedical InformaticsProfessor of Medical Education & Administration (VUMC)
M.D., University of California, San Diego, CaliforniaM.S., Biological Sciences, Stanford University, Stanford, CaliforniaB.S., Electrical Engineering, Stanford University, Stanford, California
Office Address
1211 21st Ave N, Medical Arts Bldg, Suite 732
Nashville, TN 37212
Research Description
VUMC’s Center for Research and Innovation in Systems Safety (CRISS), directed by Matthew B. Weinger, MD, is a highly interdisciplinary and collaborative center, with projects spanning numerous clinical domains (from the medical home to the operating room and ICU) and disciplines (medicine, nursing and pharmacy). Using a range of human factors, usability and systems engineering, cognitive psychology, and implementation science techniques, CRISS studies performance during patient care and in realistic simulations to better understand how and why care deviates from optimal, then proposes interventions to improve the safety and quality of care.

CRISS investigators include anesthesiologists, PhD researchers, nursing and design staff, and faculty collaborators across Health Sciences and in the School of Engineering. They are particularly interested in designing and evaluating medical technologies (i.e., devices and information systems) with an emphasis on the effects of the introduction of new technologies on clinical care, and the use of electronically generated clinical data to identify evolving events and support decision-making. CRISS explores the nature of expertise, clinician-clinician communication, situational awareness, the workload and stress of individual clinicians and of teams, individual and group performance-shaping factors, human-technology interactions and novel methods of information presentation to generate practical benefits in terms of improved clinical care processes and outcomes.

Through 2017, our involvement with VUMC operational initiatives in quality improvement includes conducting formal usability testing of VUMC software applications and of medical devices being considered for purchase. CRISS was instrumental in projects that re-engineered blood transfusion processes, improved clinician handovers, redesigned clinical informatics tools, and enhanced compliance with perioperative timeouts and checklists. Recent projects include identifying opportunities for improvement for the new eStar (Epic) nursing medication administration application, improving the usability of the APD (provider directory) and contributing to the design and development of Hubbl, a new VUMC IT project management initiative.
Research Keywords
Patient Safety, Informatics, Simulation, Human Factors Engineering, Implementation Science, Usability Engineering, Human-Centered Design, Clinical Decision Support, Cognitive Science, Industrial Engineering, Anesthesiology, Perioperative Medicine, Patient-reported outcome
Slagle JM, Porterfield ES, Lorinc AN, Afshartous D, Shotwell MS, Weinger MB. Prevalence of Potentially Distracting Noncare Activities and Their Effects on Vigilance, Workload, and Nonroutine Events during Anesthesia Care. Anesthesiology [print-electronic]. 2017 Oct 10/16/2017; PMID: 29035894, DOI: 10.1097/ALN.0000000000001915, ISSN: 1528-1175.

Weinger MB, Banerjee A, Burden AR, McIvor WR, Boulet J, Cooper JB, Steadman R, Shotwell MS, Slagle JM, DeMaria S, Torsher L, Sinz E, Levine AI, Rask J, Davis F, Park C, Gaba DM. Simulation-based Assessment of the Management of Critical Events by Board-certified Anesthesiologists. Anesthesiology. 2017 Sep; 127(3): 475-89. PMID: 28671903, DOI: 10.1097/ALN.0000000000001739, ISSN: 1528-1175.

van Pelt M, Weinger MB. Distractions in the Anesthesia Work Environment: Impact on Patient Safety? Report of a Meeting Sponsored by the Anesthesia Patient Safety Foundation. Anesth. Analg [print-electronic]. 2017 Jun 6/9/2017; PMID: 28609339, DOI: 10.1213/ANE.0000000000002139, ISSN: 1526-7598.

Watkins SC, Roberts DA, Boulet JR, McEvoy MD, Weinger MB. Evaluation of a Simpler Tool to Assess Nontechnical Skills During Simulated Critical Events. Simul Healthc. 2017 Apr; 12(2): 69-75. PMID: 28704284, PII: 01266021-201704000-00002, DOI: 10.1097/SIH.0000000000000199, ISSN: 1559-713X.

McIvor WR, Banerjee A, Boulet JR, Bekhuis T, Tseytlin E, Torsher L, DeMaria S, Rask JP, Shotwell MS, Burden A, Cooper JB, Gaba DM, Levine A, Park C, Sinz E, Steadman RH, Weinger MB. A Taxonomy of Delivery and Documentation Deviations During Delivery of High-Fidelity Simulations. Simul Healthc. 2017 Feb; 12(1): 1-8. PMID: 28146449, PII: 01266021-201702000-00001, DOI: 10.1097/SIH.0000000000000184, ISSN: 1559-713X.

Xu J, Reale C, Slagle JM, Anders S, Shotwell MS, Dresselhaus T, Weinger MB. Facilitated Nurse Medication-Related Event Reporting to Improve Medication Management Quality and Safety in Intensive Care Units. Nurs Res. 2016 Dec; 66(5): 337-49. PMID: 28858143, PMCID: PMC5679090, PII: 00006199-201709000-00001, DOI: 10.1097/NNR.0000000000000240, ISSN: 1538-9847.

Watkins SC, Anders S, Clebone A, Hughes E, Patel V, Zeigler L, Shi Y, Shotwell MS, McEvoy MD, Weinger MB. Mode of Information Delivery Does Not Effect Anesthesia Trainee Performance During Simulated Perioperative Pediatric Critical Events: A Trial of Paper Versus Electronic Cognitive Aids. Simul Healthc. 2016 Dec; 11(6): 385-93. PMID: 27922569, PII: 01266021-201612000-00003, DOI: 10.1097/SIH.0000000000000191, ISSN: 1559-713X.

Banerjee A, Slagle JM, Mercaldo ND, Booker R, Miller A, France DJ, Rawn L, Weinger MB. A simulation-based curriculum to introduce key teamwork principles to entering medical students. BMC Med Educ. 2016 Nov 11/16/2016; 16(1): 295. PMID: 27852293, PMCID: PMC5112730, PII: 10.1186/s12909-016-0808-9, DOI: 10.1186/s12909-016-0808-9, ISSN: 1472-6920.

Kappen TH, Wanderer JP, Ehrenfeld JM, Weinger MB. Is Intraoperative Hypotension Truly a Too Simple Problem for Useful Decision Support?. Anesth. Analg. 2016 Sep; 123(3): 792-3. PMID: 27331779, DOI: 10.1213/ANE.0000000000001364, ISSN: 1526-7598.

Watkins SC, Anders S, Clebone A, Hughes E, Zeigler L, Patel V, Shi Y, Shotwell MS, McEvoy M, Weinger MB. Paper or plastic? Simulation based evaluation of two versions of a cognitive aid for managing pediatric peri-operative critical events by anesthesia trainees: evaluation of the society for pediatric anesthesia emergency checklist [letter]. J Clin Monit Comput [print-electronic]. 2016 Jun; 30(3): 275-83. PMID: 26067401, PII: 10.1007/s10877-015-9714-7, DOI: 10.1007/s10877-015-9714-7, ISSN: 1573-2614.

France DJ, Levin S, Ding R, Hemphill R, Han J, Russ S, Aronsky D, Weinger M. Factors Influencing Time-Dependent Quality Indicators for Patients With Suspected Acute Coronary Syndrome. J Patient Saf [print-electronic]. 2016 Jan 1/11/2016; PMID: 26756723, PMCID: PMC4940339, DOI: 10.1097/PTS.0000000000000242, ISSN: 1549-8425.

Hanks CA, Weinger MB. Know Yourself, Know the System: Developing a Successful Career and Being Promoted as an Academic Anesthesiologist. Int Anesthesiol Clin. 2016; 54(3): 155-69. PMID: 27285078, PII: 00004311-201605430-00010, DOI: 10.1097/AIA.0000000000000104, ISSN: 1537-1913.

Slagle JM, Anders S, Porterfield E, Arnold A, Calderwood C, Weinger MB. Significant Physiological Disturbances Associated With Non-Routine Event Containing and Routine Anesthesia Cases. J Patient Saf. 2015 Dec; 11(4): 198-203. PMID: 24618643, DOI: 10.1097/PTS.0000000000000081, ISSN: 1549-8425.

Carayon P, Weinger MB, Brown R, Cartmill RS, Slagle J, Van Roy KS, Walker JM, Wood KE. How Do Residents Spend Their Time in the Intensive Care Unit?. Am. J. Med. Sci. 2015 Nov; 350(5): 403-8. PMID: 26171828, PMCID: PMC4626408, PII: S0002-9629(15)41332-1, DOI: 10.1097/MAJ.0000000000000520, ISSN: 1538-2990.

Weinger MB, Slagle JM, Kuntz AH, Schildcrout JS, Banerjee A, Mercaldo ND, Bills JL, Wallston KA, Speroff T, Patterson ES, France DJ. A Multimodal Intervention Improves Postanesthesia Care Unit Handovers. Anesth. Analg. 2015 Oct; 121(4): 957-71. PMID: 25806398, DOI: 10.1213/ANE.0000000000000670, ISSN: 1526-7598.

Carayon P, Wetterneck TB, Alyousef B, Brown RL, Cartmill RS, McGuire K, Hoonakker PL, Slagle J, Van Roy KS, Walker JM, Weinger MB, Xie A, Wood KE. Impact of electronic health record technology on the work and workflow of physicians in the intensive care unit. Int J Med Inform [print-electronic]. 2015 Aug; 84(8): 578-94. PMID: 25910685, PMCID: PMC4490834, PII: S1386-5056(15)00079-9, DOI: 10.1016/j.ijmedinf.2015.04.002, ISSN: 1872-8243.

Weinger MB, Burden AR, Steadman RH, Gaba DM. This is not a test!: Misconceptions surrounding the maintenance of certification in anesthesiology simulation course [editorial]. Anesthesiology. 2014 Sep; 121(3): 655-9. PMID: 24821072, DOI: 10.1097/ALN.0000000000000303, ISSN: 1528-1175.

Miller A, Wagner CE, Song Y, Burns K, Ahmad R, Lee Parmley C, Weinger MB. Implementing goal-directed protocols reduces length of stay after cardiac surgery. J. Cardiothorac. Vasc. Anesth [print-electronic]. 2014 Jun; 28(3): 441-7. PMID: 24746336, PII: S1053-0770(14)00015-9, DOI: 10.1053/j.jvca.2014.01.010, ISSN: 1532-8422.

Weinger MB, Gaba DM. Human factors engineering in patient safety [editorial]. Anesthesiology. 2014 Apr; 120(4): 801-6. PMID: 24481419, DOI: 10.1097/ALN.0000000000000144, ISSN: 1528-1175.

Xie M, Weinger MB, Gregg WM, Johnson KB. Presenting multiple drug alerts in an ambulatory electronic prescribing system: a usability study of novel prototypes. Appl Clin Inform. 2014; 5(2): 334-48. PMID: 25024753, PMCID: PMC4081740, DOI: 10.4338/ACI-2013-10-RA-0092, ISSN: 1869-0327.

Anders S, Albert R, Miller A, Weinger MB, Doig AK, Behrens M, Agutter J. Evaluation of an integrated graphical display to promote acute change detection in ICU patients. Int J Med Inform [print-electronic]. 2012 Dec; 81(12): 842-51. PMID: 22534099, PMCID: PMC3414670, PII: S1386-5056(12)00071-8, DOI: 10.1016/j.ijmedinf.2012.04.004, ISSN: 1872-8243.

Saied N, Booker R, Weinger M. Misassembled bellows housing leading to failure of mechanical ventilation during general anesthesia. Simul Healthc. 2012 Dec; 7(6): 380-9. PMID: 22228283, DOI: 10.1097/SIH.0b013e3182306033, ISSN: 1559-713X.

Walia A, Mandell MS, Mercaldo N, Michaels D, Robertson A, Banerjee A, Pai R, Klinck J, Weinger M, Pandharipande P, Schumann R. Anesthesia for liver transplantation in US academic centers: institutional structure and perioperative care. Liver Transpl. 2012 Jun; 18(6): 737-43. PMID: 22407934, DOI: 10.1002/lt.23427, ISSN: 1527-6473.

Minnick AF, Donaghey B, Slagle J, Weinger MB. Operating room team members' views of workload, case difficulty, and nonroutine events. J Healthc Qual [print-electronic]. 2012 May; 34(3): 16-24. PMID: 22059640, DOI: 10.1111/j.1945-1474.2011.00142.x, ISSN: 1945-1474.

Anders S, Miller A, Joseph P, Fortenberry T, Woods M, Booker R, Slaughter J, Weinger MB, France D. Blood product positive patient identification: comparative simulation-based usability test of two commercial products. Transfusion [print-electronic]. 2011 Nov; 51(11): 2311-8. PMID: 21599676, DOI: 10.1111/j.1537-2995.2011.03185.x, ISSN: 1537-2995.

Speroff T, Ely EW, Greevy R, Weinger MB, Talbot TR, Wall RJ, Deshpande JK, France DJ, Nwosu S, Burgess H, Englebright J, Williams MV, Dittus RS. Quality improvement projects targeting health care-associated infections: comparing Virtual Collaborative and Toolkit approaches. J Hosp Med [print-electronic]. 2011 May; 6(5): 271-8. PMID: 21312329, DOI: 10.1002/jhm.873, ISSN: 1553-5606.

Hyman SA, Michaels DR, Berry JM, Schildcrout JS, Mercaldo ND, Weinger MB. Risk of burnout in perioperative clinicians: a survey study and literature review. Anesthesiology. 2011 Jan; 114(1): 194-204. PMID: 21178675, PII: 00000542-201101000-00039, DOI: 10.1097/ALN.0b013e318201ce9a, ISSN: 1528-1175.

Speroff T, Nwosu S, Greevy R, Weinger MB, Talbot TR, Wall RJ, Deshpande JK, France DJ, Ely EW, Burgess H, Englebright J, Williams MV, Dittus RS. Organisational culture: variation across hospitals and connection to patient safety climate. Qual Saf Health Care. 2010 Dec; 19(6): 592-6. PMID: 21127115, PII: 19/6/592, DOI: 10.1136/qshc.2009.039511, ISSN: 1475-3901.

Miller A, Weinger MB, Buerhaus P, Dietrich MS. Care coordination in intensive care units: communicating across information spaces. Hum Factors. 2010 Apr; 52(2): 147-61. PMID: 20942247, DOI: 10.1177/0018720810369149, ISSN: 0018-7208.

France DJ, Greevy RA, Liu X, Burgess H, Dittus RS, Weinger MB, Speroff T. Measuring and comparing safety climate in intensive care units. Med Care. 2010 Mar; 48(3): 279-84. PMID: 20125046, DOI: 10.1097/MLR.0b013e3181c162d6, ISSN: 1537-1948.

Weinger MB. The pharmacology of simulation: a conceptual framework to inform progress in simulation research. Simul Healthc. 2010 Feb; 5(1): 8-15. PMID: 20383084, PII: 01266021-201002000-00003, DOI: 10.1097/SIH.0b013e3181c91d4a, ISSN: 1559-713X.

Slagle JM, Weinger MB. Effects of intraoperative reading on vigilance and workload during anesthesia care in an academic medical center. Anesthesiology. 2009 Feb; 110(2): 275-83. PMID: 19194155, PII: 00000542-200902000-00016, DOI: 10.1097/ALN.0b013e318194b1fc, ISSN: 1528-1175.

Bayley R, Weinger M, Meador S, Slovis C. Impact of ambulance crew configuration on simulated cardiac arrest resuscitation. Prehosp Emerg Care. 2008 Jan; 12(1): 62-8. PMID: 18189180, PII: 789525825, DOI: 10.1080/10903120701708011, ISSN: 1545-0066.

Oken A, Rasmussen MD, Slagle JM, Jain S, Kuykendall T, Ordonez N, Weinger MB. A facilitated survey instrument captures significantly more anesthesia events than does traditional voluntary event reporting. Anesthesiology. 2007 Dec; 107(6): 909-22. PMID: 18043059, PII: 00000542-200712000-00010, DOI: 10.1097/01.anes.0000291440.08068.21, ISSN: 1528-1175.

Talbot TR, Tejedor SC, Greevy RA, Burgess H, Williams MV, Deshpande JK, McFadden P, Weinger MB, Englebright J, Dittus RS, Speroff T. Survey of infection control programs in a large national healthcare system. Infect Control Hosp Epidemiol [print-electronic]. 2007 Dec; 28(12): 1401-3. PMID: 17994522, PII: S0195941700026424, DOI: 10.1086/523867, ISSN: 0899-823X.

Unertl KM, Weinger MB. Modeling workflow and information flow in chronic disease care. AMIA Annu Symp Proc. 2007 Oct 10/11/2007; 1140. PMID: 18694236, ISSN: 1942-597X.

Unertl KM, Weinger M, Johnson K. Variation in use of informatics tools among providers in a diabetes clinic. AMIA Annu Symp Proc. 2007 Oct 10/11/2007; 756-60. PMID: 18693938, PMCID: PMC2655904, ISSN: 1942-597X.

Harris B, Weinger MB. An insidious failure of an oxygen analyzer. Anesth. Analg. 2006 May; 102(5): 1468-72. PMID: 16632828, PII: 102/5/1468, DOI: 10.1213/01.ane.0000205814.47841.16, ISSN: 1526-7598.

Unertl KM, Weinger MB, Johnson KB. Applying direct observation to model workflow and assess adoption. AMIA Annu Symp Proc. 2006; 794-8. PMID: 17238450, PMCID: PMC1839698, PII: 86281, ISSN: 1942-597X.