- Founded and developed the regional anesthesiology and acute pain medicine program at the University of California, San Diego (UCSD), which included educational programs for trainees and physicians in practice, clinical services at 3 adult and pediatric hospitals, and a clinical research program
- Chaired the Perioperative Care Center Redesign Subcommittee at UCSD which resulted in a new process for preparing patients scheduled for elective surgery including a new staffing model, workflow, physical clinic plan, and technology support
- Established the first Perioperative Surgical Home (PSH) program within the Veterans Affairs (VA) health care system at VA Palo Alto in 2010 including a new 24/7 acute pain service and providing anesthesiology-led care coordination for surgical patients
- Appointed the first Associate Chief of Staff for Inpatient Surgical Services at VA Palo Alto Health Care System employing the PSH model to facilitate ongoing evidence-based change implementation in anesthesia and perioperative medicine clinical practices
- Received the Veterans Health Administration’s John D. Chase Award for Physician Executives Excellence
- Achieved Lean Six Sigma Green Belt certification
- Selected to serve on key national healthcare initiatives: The Joint Commission standards review panel on pain assessment and management in the acute care setting, Centers for Medicare and Medicaid Services MACRA Episode-Based Cost Measures Clinical Subcommittee (Musculoskeletal Disease, Non-Spine), FDA public workshop on regional anesthesia, and ASA-ASRA Technical Expert Panel on the Development of Quality Measures related to Pain Medicine, and the National Academy of Medicine Action Collaborative on Countering the U.S. Opioid Epidemic
- Chaired the first-ever multi-organizational Pain Summit, a two-year process involving 14 medical societies that culminated in the establishment of 7 guiding principles of acute perioperative pain management which were published in Regional Anesthesia and Pain Medicine in 2021 and will inform the development of future clinical practice recommendations as well as legislative and regulatory initiatives
- Founded the first Regional Anesthesiology and Acute Pain Medicine (RAAPM) Fellowship program in California (at UCSD) recognized by the national RAAPM fellowship directors group
- Co-founded the UCSD-NMCSD Intensive Regional Anesthesia Course in 2005, the first ACCME-accredited regional anesthesia course in California
- Led the task force to establish RAAPM as a new ACGME-accredited fellowship and subspecialty of anesthesiology which successfully achieved accreditation status in 2016
- Became the program director for the RAAPM fellowship at Stanford in 2016 and established Stanford as one of the first 9 ACGME-accredited RAAPM fellowship programs in the country
- Selected to serve as Chair of the committee charged with developing competency-based Milestones for ACGME-accredited RAAPM Fellowships
- American Society of Anesthesiologists: Chair of the Committee on Regional Anesthesia and Acute Pain Medicine; Delegate representing the California Society of Anesthesiologists
- California Society of Anesthesiologists: Elected officer since 2014 and currently President-Elect
- Association of Anesthesiology Subspecialty Program Directors: Council Member representing regional anesthesiology and acute pain medicine fellowship directors
- American Society of Regional Anesthesia and Pain Medicine: Director from 2015 to 2020; served as Chair of Communications which included website, social media, newsletter, and public relations; developed a social media strategy for the Society which included outreach through multiple social media platforms, starting the ASRA Blog, and supporting the launch of the ASRA RAPP podcast; converted the print newsletter to an electronic format, streamlined email communications with the ASRA Digest, and launched the expansion of patient education resources about surgical pain management options and opioid safety
Global Health and Global Surgery
Dr. Mariano has been working with the EQuIS Research Group and Ariadne Labs on the next phase of the World Health Organization Surgical Safety Checklist: modification, implementation, training, and evaluation.
Dr. Mariano has had an interest in global health and global surgery throughout his career. Since 2004, Dr. Mariano has worked with the Philippine American Group of Educators and Surgeons (PAGES) as a senior volunteer anesthesiologist.
Founded in 1981, PAGES is a non-profit volunteer organization that conducts its annual Operation HOPE mission for the underprivileged children of the Philippines who are afflicted with craniofacial birth defects and deformities related to burn injuries.
Dr. Mariano has volunteered his pediatric anesthesiology and acute pain medicine skills on multiple medical missions to the rural provinces of the Philippines and usually brings residents and fellows with him to expand their training with exposure to global health. So far he has completed mission trips with PAGES to Cavite City (Cavite), Bay City (Laguna), Trece Martires City (Cavite), Alaminos City (Pangasinan), Quezon City (Metro Manila), inner city Manila, Morong (Rizal), and Cabanatuan City (Nueva Ecija), with multiple trips to many of these locations. Unlike many medical mission groups, PAGES provides continuity of care and long-term follow-up for patients through collaborations with local health officials and our PAGES Philippines colleagues.
In 2006, Dr. Mariano was recruited by Project Perfect World (PPW) to participate in pediatric orthopedic surgery missions to Guayaquil, Ecuador. PPW is a humanitarian effort sponsored by the Association for Healthcare Resource & Materials Management that provides needed medical and surgical care that is otherwise unavailable to the children of low and middle income countries. PPW conducts regular missions to Ecuador to care for impoverished children who are afflicted with limb deformities.
Dr. Mariano has brought a regional anesthesiology and acute pain medicine fellow with him on each of these missions along with ultrasound and perineural catheter equipment in order to provide the highest quality pain control to these deserving patients.
To read Dr. Mariano’s blog about global health and medical missions, click here.