Background: The 2014 ACC/AHA Perioperative Guidelines suggest using the Revised Cardiac Risk Index (RCRI), myocardial infarction or cardiac arrest (MICA), or American College of Surgeons (ACS)-NSQIP calculators for combined patient-surgical risk assessment. However, there is no published data comparing their performance. Methods: We retrospectively reviewed records of 663 patients seen in our preop clinic who [...]

Background: The Joint Commission’s Surgical Care Improvement Project (SCIP)-9 recommended removing indwelling urinary catheters (IUC) before postoperative day 2 to decrease urinary infection (UTI) risk. Our center implemented a best practice alert (BPA) in the electronic health record to enforce SCIP-9 with near-100% compliance.  We sought to study the effect of the BPA on catheter [...]

Background: The emergence of hospitalists over the last 25 years as leaders in quality, safety, and value-based care has resulted in improvements in hospital throughput and reduction of in-hospital complications (1). The keys to success are standardizing clinical pathways and interdisciplinary collaboration. At Tampa General Hospital (TGH), our hospitalist team observed significant variability in the [...]

Case Presentation: 72-year-old male with h/o HTN, DM, obesity, polymyalgia rheumatica (on steroids), CKD stage IV, ankylosing spondylitis, and HFrEF (LVEF 45-50%) underwent total knee arthroplasty with removal of prior implant and distal femur replacement for osteosarcoma. Cut to close time was 9 hours. Intraoperatively, the SBP dipped to 90s for about 10-15 minutes after [...]

Case Presentation: A 69-year-old woman presented for an elective multi-level lumbar laminotomy for the treatment of chronic back pain secondary to spinal canal stenosis. Her medical history included hypertension and hypercholesterolemia. She reported a history of depression, which was well controlled on paroxetine. She denied using drugs, stated she quit tobacco decades prior, and reported [...]