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Publisher: Elsevier   (Total: 3177 journals)

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Showing 1 - 200 of 3177 Journals sorted alphabetically
A Practical Logic of Cognitive Systems     Full-text available via subscription   (Followers: 9)
AASRI Procedia     Open Access   (Followers: 14)
Academic Pediatrics     Hybrid Journal   (Followers: 28, SJR: 1.402, h-index: 51)
Academic Radiology     Hybrid Journal   (Followers: 22, SJR: 1.008, h-index: 75)
Accident Analysis & Prevention     Partially Free   (Followers: 90, SJR: 1.109, h-index: 94)
Accounting Forum     Hybrid Journal   (Followers: 25, SJR: 0.612, h-index: 27)
Accounting, Organizations and Society     Hybrid Journal   (Followers: 33, SJR: 2.515, h-index: 90)
Achievements in the Life Sciences     Open Access   (Followers: 5)
Acta Anaesthesiologica Taiwanica     Open Access   (Followers: 6, SJR: 0.338, h-index: 19)
Acta Astronautica     Hybrid Journal   (Followers: 378, SJR: 0.726, h-index: 43)
Acta Automatica Sinica     Full-text available via subscription   (Followers: 2)
Acta Biomaterialia     Hybrid Journal   (Followers: 27, SJR: 2.02, h-index: 104)
Acta Colombiana de Cuidado Intensivo     Full-text available via subscription   (Followers: 2)
Acta de Investigación Psicológica     Open Access   (Followers: 3)
Acta Ecologica Sinica     Open Access   (Followers: 8, SJR: 0.172, h-index: 29)
Acta Haematologica Polonica     Free   (Followers: 1, SJR: 0.123, h-index: 8)
Acta Histochemica     Hybrid Journal   (Followers: 3, SJR: 0.604, h-index: 38)
Acta Materialia     Hybrid Journal   (Followers: 237, SJR: 3.683, h-index: 202)
Acta Mathematica Scientia     Full-text available via subscription   (Followers: 5, SJR: 0.615, h-index: 21)
Acta Mechanica Solida Sinica     Full-text available via subscription   (Followers: 9, SJR: 0.442, h-index: 21)
Acta Oecologica     Hybrid Journal   (Followers: 10, SJR: 0.915, h-index: 53)
Acta Otorrinolaringologica (English Edition)     Full-text available via subscription  
Acta Otorrinolaringológica Española     Full-text available via subscription   (Followers: 2, SJR: 0.311, h-index: 16)
Acta Pharmaceutica Sinica B     Open Access   (Followers: 1)
Acta Poética     Open Access   (Followers: 4)
Acta Psychologica     Hybrid Journal   (Followers: 25, SJR: 1.365, h-index: 73)
Acta Sociológica     Open Access  
Acta Tropica     Hybrid Journal   (Followers: 6, SJR: 1.059, h-index: 77)
Acta Urológica Portuguesa     Open Access  
Actas Dermo-Sifiliograficas     Full-text available via subscription   (Followers: 3)
Actas Dermo-Sifiliográficas (English Edition)     Full-text available via subscription   (Followers: 2)
Actas Urológicas Españolas     Full-text available via subscription   (Followers: 3, SJR: 0.383, h-index: 19)
Actas Urológicas Españolas (English Edition)     Full-text available via subscription   (Followers: 1)
Actualites Pharmaceutiques     Full-text available via subscription   (Followers: 6, SJR: 0.141, h-index: 3)
Actualites Pharmaceutiques Hospitalieres     Full-text available via subscription   (Followers: 3, SJR: 0.112, h-index: 2)
Acupuncture and Related Therapies     Hybrid Journal   (Followers: 6)
Acute Pain     Full-text available via subscription   (Followers: 14)
Ad Hoc Networks     Hybrid Journal   (Followers: 11, SJR: 0.967, h-index: 57)
Addictive Behaviors     Hybrid Journal   (Followers: 15, SJR: 1.514, h-index: 92)
Addictive Behaviors Reports     Open Access   (Followers: 7)
Additive Manufacturing     Hybrid Journal   (Followers: 9, SJR: 1.039, h-index: 5)
Additives for Polymers     Full-text available via subscription   (Followers: 22)
Advanced Cement Based Materials     Full-text available via subscription   (Followers: 3)
Advanced Drug Delivery Reviews     Hybrid Journal   (Followers: 131, SJR: 5.2, h-index: 222)
Advanced Engineering Informatics     Hybrid Journal   (Followers: 11, SJR: 1.265, h-index: 53)
Advanced Powder Technology     Hybrid Journal   (Followers: 16, SJR: 0.739, h-index: 33)
Advances in Accounting     Hybrid Journal   (Followers: 8, SJR: 0.299, h-index: 15)
Advances in Agronomy     Full-text available via subscription   (Followers: 12, SJR: 2.071, h-index: 82)
Advances in Anesthesia     Full-text available via subscription   (Followers: 27, SJR: 0.169, h-index: 4)
Advances in Antiviral Drug Design     Full-text available via subscription   (Followers: 2)
Advances in Applied Mathematics     Full-text available via subscription   (Followers: 10, SJR: 1.054, h-index: 35)
Advances in Applied Mechanics     Full-text available via subscription   (Followers: 10, SJR: 0.801, h-index: 26)
Advances in Applied Microbiology     Full-text available via subscription   (Followers: 22, SJR: 1.286, h-index: 49)
Advances In Atomic, Molecular, and Optical Physics     Full-text available via subscription   (Followers: 14, SJR: 3.31, h-index: 42)
Advances in Biological Regulation     Hybrid Journal   (Followers: 4, SJR: 2.277, h-index: 43)
Advances in Botanical Research     Full-text available via subscription   (Followers: 2, SJR: 0.619, h-index: 48)
Advances in Cancer Research     Full-text available via subscription   (Followers: 28, SJR: 2.215, h-index: 78)
Advances in Carbohydrate Chemistry and Biochemistry     Full-text available via subscription   (Followers: 7, SJR: 0.9, h-index: 30)
Advances in Catalysis     Full-text available via subscription   (Followers: 5, SJR: 2.139, h-index: 42)
Advances in Cell Aging and Gerontology     Full-text available via subscription   (Followers: 3)
Advances in Cellular and Molecular Biology of Membranes and Organelles     Full-text available via subscription   (Followers: 12)
Advances in Chemical Engineering     Full-text available via subscription   (Followers: 27, SJR: 0.183, h-index: 23)
Advances in Child Development and Behavior     Full-text available via subscription   (Followers: 10, SJR: 0.665, h-index: 29)
Advances in Chronic Kidney Disease     Full-text available via subscription   (Followers: 10, SJR: 1.268, h-index: 45)
Advances in Clinical Chemistry     Full-text available via subscription   (Followers: 28, SJR: 0.938, h-index: 33)
Advances in Colloid and Interface Science     Full-text available via subscription   (Followers: 19, SJR: 2.314, h-index: 130)
Advances in Computers     Full-text available via subscription   (Followers: 14, SJR: 0.223, h-index: 22)
Advances in Dermatology     Full-text available via subscription   (Followers: 14)
Advances in Developmental Biology     Full-text available via subscription   (Followers: 10)
Advances in Digestive Medicine     Open Access   (Followers: 8)
Advances in DNA Sequence-Specific Agents     Full-text available via subscription   (Followers: 5)
Advances in Drug Research     Full-text available via subscription   (Followers: 21)
Advances in Ecological Research     Full-text available via subscription   (Followers: 42, SJR: 3.25, h-index: 43)
Advances in Engineering Software     Hybrid Journal   (Followers: 27, SJR: 0.486, h-index: 10)
Advances in Experimental Biology     Full-text available via subscription   (Followers: 6)
Advances in Experimental Social Psychology     Full-text available via subscription   (Followers: 42, SJR: 5.465, h-index: 64)
Advances in Exploration Geophysics     Full-text available via subscription   (Followers: 1)
Advances in Fluorine Science     Full-text available via subscription   (Followers: 7)
Advances in Food and Nutrition Research     Full-text available via subscription   (Followers: 53, SJR: 0.674, h-index: 38)
Advances in Fuel Cells     Full-text available via subscription   (Followers: 15)
Advances in Genetics     Full-text available via subscription   (Followers: 15, SJR: 2.558, h-index: 54)
Advances in Genome Biology     Full-text available via subscription   (Followers: 7)
Advances in Geophysics     Full-text available via subscription   (Followers: 6, SJR: 2.325, h-index: 20)
Advances in Heat Transfer     Full-text available via subscription   (Followers: 21, SJR: 0.906, h-index: 24)
Advances in Heterocyclic Chemistry     Full-text available via subscription   (Followers: 9, SJR: 0.497, h-index: 31)
Advances in Human Factors/Ergonomics     Full-text available via subscription   (Followers: 23)
Advances in Imaging and Electron Physics     Full-text available via subscription   (Followers: 2, SJR: 0.396, h-index: 27)
Advances in Immunology     Full-text available via subscription   (Followers: 36, SJR: 4.152, h-index: 85)
Advances in Inorganic Chemistry     Full-text available via subscription   (Followers: 8, SJR: 1.132, h-index: 42)
Advances in Insect Physiology     Full-text available via subscription   (Followers: 2, SJR: 1.274, h-index: 27)
Advances in Integrative Medicine     Hybrid Journal   (Followers: 6)
Advances in Intl. Accounting     Full-text available via subscription   (Followers: 3)
Advances in Life Course Research     Hybrid Journal   (Followers: 8, SJR: 0.764, h-index: 15)
Advances in Lipobiology     Full-text available via subscription   (Followers: 1)
Advances in Magnetic and Optical Resonance     Full-text available via subscription   (Followers: 9)
Advances in Marine Biology     Full-text available via subscription   (Followers: 15, SJR: 1.645, h-index: 45)
Advances in Mathematics     Full-text available via subscription   (Followers: 10, SJR: 3.261, h-index: 65)
Advances in Medical Sciences     Hybrid Journal   (Followers: 6, SJR: 0.489, h-index: 25)
Advances in Medicinal Chemistry     Full-text available via subscription   (Followers: 5)
Advances in Microbial Physiology     Full-text available via subscription   (Followers: 4, SJR: 1.44, h-index: 51)
Advances in Molecular and Cell Biology     Full-text available via subscription   (Followers: 21)
Advances in Molecular and Cellular Endocrinology     Full-text available via subscription   (Followers: 8)
Advances in Molecular Toxicology     Full-text available via subscription   (Followers: 7, SJR: 0.324, h-index: 8)
Advances in Nanoporous Materials     Full-text available via subscription   (Followers: 3)
Advances in Oncobiology     Full-text available via subscription   (Followers: 1)
Advances in Organ Biology     Full-text available via subscription   (Followers: 1)
Advances in Organometallic Chemistry     Full-text available via subscription   (Followers: 15, SJR: 2.885, h-index: 45)
Advances in Parallel Computing     Full-text available via subscription   (Followers: 6, SJR: 0.148, h-index: 11)
Advances in Parasitology     Full-text available via subscription   (Followers: 5, SJR: 2.37, h-index: 73)
Advances in Pediatrics     Full-text available via subscription   (Followers: 24, SJR: 0.4, h-index: 28)
Advances in Pharmaceutical Sciences     Full-text available via subscription   (Followers: 10)
Advances in Pharmacology     Full-text available via subscription   (Followers: 15, SJR: 1.718, h-index: 58)
Advances in Physical Organic Chemistry     Full-text available via subscription   (Followers: 8, SJR: 0.384, h-index: 26)
Advances in Phytomedicine     Full-text available via subscription  
Advances in Planar Lipid Bilayers and Liposomes     Full-text available via subscription   (Followers: 3, SJR: 0.248, h-index: 11)
Advances in Plant Biochemistry and Molecular Biology     Full-text available via subscription   (Followers: 7)
Advances in Plant Pathology     Full-text available via subscription   (Followers: 5)
Advances in Porous Media     Full-text available via subscription   (Followers: 5)
Advances in Protein Chemistry     Full-text available via subscription   (Followers: 17)
Advances in Protein Chemistry and Structural Biology     Full-text available via subscription   (Followers: 18, SJR: 1.5, h-index: 62)
Advances in Psychology     Full-text available via subscription   (Followers: 59)
Advances in Quantum Chemistry     Full-text available via subscription   (Followers: 6, SJR: 0.478, h-index: 32)
Advances in Radiation Oncology     Open Access  
Advances in Small Animal Medicine and Surgery     Hybrid Journal   (Followers: 3, SJR: 0.1, h-index: 2)
Advances in Space Biology and Medicine     Full-text available via subscription   (Followers: 5)
Advances in Space Research     Full-text available via subscription   (Followers: 378, SJR: 0.606, h-index: 65)
Advances in Structural Biology     Full-text available via subscription   (Followers: 5)
Advances in Surgery     Full-text available via subscription   (Followers: 9, SJR: 0.823, h-index: 27)
Advances in the Study of Behavior     Full-text available via subscription   (Followers: 29, SJR: 1.321, h-index: 56)
Advances in Veterinary Medicine     Full-text available via subscription   (Followers: 17)
Advances in Veterinary Science and Comparative Medicine     Full-text available via subscription   (Followers: 13)
Advances in Virus Research     Full-text available via subscription   (Followers: 5, SJR: 1.878, h-index: 68)
Advances in Water Resources     Hybrid Journal   (Followers: 46, SJR: 2.408, h-index: 94)
Aeolian Research     Hybrid Journal   (Followers: 6, SJR: 0.973, h-index: 22)
Aerospace Science and Technology     Hybrid Journal   (Followers: 333, SJR: 0.816, h-index: 49)
AEU - Intl. J. of Electronics and Communications     Hybrid Journal   (Followers: 8, SJR: 0.318, h-index: 36)
African J. of Emergency Medicine     Open Access   (Followers: 6, SJR: 0.344, h-index: 6)
Ageing Research Reviews     Hybrid Journal   (Followers: 9, SJR: 3.289, h-index: 78)
Aggression and Violent Behavior     Hybrid Journal   (Followers: 431, SJR: 1.385, h-index: 72)
Agri Gene     Hybrid Journal  
Agricultural and Forest Meteorology     Hybrid Journal   (Followers: 15, SJR: 2.18, h-index: 116)
Agricultural Systems     Hybrid Journal   (Followers: 31, SJR: 1.275, h-index: 74)
Agricultural Water Management     Hybrid Journal   (Followers: 43, SJR: 1.546, h-index: 79)
Agriculture and Agricultural Science Procedia     Open Access   (Followers: 1)
Agriculture and Natural Resources     Open Access   (Followers: 2)
Agriculture, Ecosystems & Environment     Hybrid Journal   (Followers: 56, SJR: 1.879, h-index: 120)
Ain Shams Engineering J.     Open Access   (Followers: 5, SJR: 0.434, h-index: 14)
Air Medical J.     Hybrid Journal   (Followers: 6, SJR: 0.234, h-index: 18)
AKCE Intl. J. of Graphs and Combinatorics     Open Access   (SJR: 0.285, h-index: 3)
Alcohol     Hybrid Journal   (Followers: 11, SJR: 0.922, h-index: 66)
Alcoholism and Drug Addiction     Open Access   (Followers: 9)
Alergologia Polska : Polish J. of Allergology     Full-text available via subscription   (Followers: 1)
Alexandria Engineering J.     Open Access   (Followers: 1, SJR: 0.436, h-index: 12)
Alexandria J. of Medicine     Open Access   (Followers: 1)
Algal Research     Partially Free   (Followers: 9, SJR: 2.05, h-index: 20)
Alkaloids: Chemical and Biological Perspectives     Full-text available via subscription   (Followers: 2)
Allergologia et Immunopathologia     Full-text available via subscription   (Followers: 1, SJR: 0.46, h-index: 29)
Allergology Intl.     Open Access   (Followers: 5, SJR: 0.776, h-index: 35)
Alpha Omegan     Full-text available via subscription   (SJR: 0.121, h-index: 9)
ALTER - European J. of Disability Research / Revue Européenne de Recherche sur le Handicap     Full-text available via subscription   (Followers: 9, SJR: 0.158, h-index: 9)
Alzheimer's & Dementia     Hybrid Journal   (Followers: 48, SJR: 4.289, h-index: 64)
Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring     Open Access   (Followers: 4)
Alzheimer's & Dementia: Translational Research & Clinical Interventions     Open Access   (Followers: 4)
Ambulatory Pediatrics     Hybrid Journal   (Followers: 6)
American Heart J.     Hybrid Journal   (Followers: 50, SJR: 3.157, h-index: 153)
American J. of Cardiology     Hybrid Journal   (Followers: 50, SJR: 2.063, h-index: 186)
American J. of Emergency Medicine     Hybrid Journal   (Followers: 43, SJR: 0.574, h-index: 65)
American J. of Geriatric Pharmacotherapy     Full-text available via subscription   (Followers: 10, SJR: 1.091, h-index: 45)
American J. of Geriatric Psychiatry     Hybrid Journal   (Followers: 14, SJR: 1.653, h-index: 93)
American J. of Human Genetics     Hybrid Journal   (Followers: 31, SJR: 8.769, h-index: 256)
American J. of Infection Control     Hybrid Journal   (Followers: 26, SJR: 1.259, h-index: 81)
American J. of Kidney Diseases     Hybrid Journal   (Followers: 32, SJR: 2.313, h-index: 172)
American J. of Medicine     Hybrid Journal   (Followers: 42, SJR: 2.023, h-index: 189)
American J. of Medicine Supplements     Full-text available via subscription   (Followers: 3)
American J. of Obstetrics and Gynecology     Hybrid Journal   (Followers: 190, SJR: 2.255, h-index: 171)
American J. of Ophthalmology     Hybrid Journal   (Followers: 62, SJR: 2.803, h-index: 148)
American J. of Ophthalmology Case Reports     Open Access   (Followers: 6)
American J. of Orthodontics and Dentofacial Orthopedics     Full-text available via subscription   (Followers: 6, SJR: 1.249, h-index: 88)
American J. of Otolaryngology     Hybrid Journal   (Followers: 25, SJR: 0.59, h-index: 45)
American J. of Pathology     Hybrid Journal   (Followers: 27, SJR: 2.653, h-index: 228)
American J. of Preventive Medicine     Hybrid Journal   (Followers: 27, SJR: 2.764, h-index: 154)
American J. of Surgery     Hybrid Journal   (Followers: 37, SJR: 1.286, h-index: 125)
American J. of the Medical Sciences     Hybrid Journal   (Followers: 12, SJR: 0.653, h-index: 70)
Ampersand : An Intl. J. of General and Applied Linguistics     Open Access   (Followers: 6)
Anaerobe     Hybrid Journal   (Followers: 4, SJR: 1.066, h-index: 51)
Anaesthesia & Intensive Care Medicine     Full-text available via subscription   (Followers: 61, SJR: 0.124, h-index: 9)
Anaesthesia Critical Care & Pain Medicine     Full-text available via subscription   (Followers: 14)
Anales de Cirugia Vascular     Full-text available via subscription  
Anales de Pediatría     Full-text available via subscription   (Followers: 2, SJR: 0.209, h-index: 27)
Anales de Pediatría (English Edition)     Full-text available via subscription  
Anales de Pediatría Continuada     Full-text available via subscription   (SJR: 0.104, h-index: 3)
Analytic Methods in Accident Research     Hybrid Journal   (Followers: 4, SJR: 2.577, h-index: 7)
Analytica Chimica Acta     Hybrid Journal   (Followers: 39, SJR: 1.548, h-index: 152)
Analytical Biochemistry     Hybrid Journal   (Followers: 164, SJR: 0.725, h-index: 154)
Analytical Chemistry Research     Open Access   (Followers: 10, SJR: 0.18, h-index: 2)
Analytical Spectroscopy Library     Full-text available via subscription   (Followers: 11)
Anesthésie & Réanimation     Full-text available via subscription   (Followers: 1)
Anesthesiology Clinics     Full-text available via subscription   (Followers: 22, SJR: 0.421, h-index: 40)
Angiología     Full-text available via subscription   (SJR: 0.124, h-index: 9)
Angiologia e Cirurgia Vascular     Open Access   (Followers: 1)

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Journal Cover Anesthesiology Clinics
  [SJR: 0.421]   [H-I: 40]   [22 followers]  Follow
    
   Full-text available via subscription Subscription journal
   ISSN (Print) 1932-2275
   Published by Elsevier Homepage  [3177 journals]
  • Quality Improvement and Implementation Science
    • Authors: Meghan B. Lane-Fall; Lee A. Fleisher
      Abstract: Publication date: March 2018
      Source:Anesthesiology Clinics, Volume 36, Issue 1
      Author(s): Meghan B. Lane-Fall, Lee A. Fleisher


      PubDate: 2018-03-08T01:52:57Z
      DOI: 10.1016/s1932-2275(17)30126-x
       
  • Improving Perioperative Care: What Are the Tools That Lead
           to Sustainable Change'
    • Authors: Lee A. Fleisher
      Abstract: Publication date: March 2018
      Source:Anesthesiology Clinics, Volume 36, Issue 1
      Author(s): Lee A. Fleisher


      PubDate: 2018-03-08T01:52:57Z
      DOI: 10.1016/j.anclin.2017.12.002
       
  • Quality Improvement and Implementation Science: Different Fields with
           Aligned Goals
    • Authors: Meghan B. Lane-Fall; Lee A. Fleisher
      Abstract: Publication date: March 2018
      Source:Anesthesiology Clinics, Volume 36, Issue 1
      Author(s): Meghan B. Lane-Fall, Lee A. Fleisher


      PubDate: 2018-03-08T01:52:57Z
      DOI: 10.1016/j.anclin.2017.12.001
       
  • Implementation Science in Perioperative Care
    • Authors: Meghan B. Lane-Fall; Benjamin T. Cobb; Crystal Wiley Cené; Rinad S. Beidas
      Pages: 1 - 15
      Abstract: Publication date: March 2018
      Source:Anesthesiology Clinics, Volume 36, Issue 1
      Author(s): Meghan B. Lane-Fall, Benjamin T. Cobb, Crystal Wiley Cené, Rinad S. Beidas
      Teaser There is a 17-year gap between the initial publication of scientific evidence and its uptake into widespread practice in health care. The field of implementation science (IS) emerged in the 1990s as an answer to this “evidence-to-practice gap.” In this article, we present an overview of implementation science, focusing on the application of IS principles to perioperative care. We describe opportunities for additional training and discuss strategies for funding and publishing IS work. The objective is to demonstrate how IS can improve perioperative patient care, while highlighting perioperative IS studies and identifying areas in need of additional investigation.

      PubDate: 2018-03-08T01:52:57Z
      DOI: 10.1016/j.anclin.2017.10.004
       
  • Human Factors Applied to Perioperative Process Improvement
    • Authors: Joseph R. Keebler; Elizabeth H. Lazzara; Elizabeth Blickensderfer; Thomas D. Looke
      Pages: 17 - 29
      Abstract: Publication date: March 2018
      Source:Anesthesiology Clinics, Volume 36, Issue 1
      Author(s): Joseph R. Keebler, Elizabeth H. Lazzara, Elizabeth Blickensderfer, Thomas D. Looke
      Teaser This article discusses some of the major theories of the science of human factors/ergonomics (HF/E) in relation to perioperative medicine, with a focus on safety and errors within these systems. The discussion begins with human limitations based in cognition, decision making, stress, and fatigue. Given these limitations, the importance of measuring human performance is discussed. Finally, using the HF/E perspective on safety, high-level recommendations are provided for increasing safety within the perioperative environment.

      PubDate: 2018-03-08T01:52:57Z
      DOI: 10.1016/j.anclin.2017.10.005
       
  • Quality Improvement in Anesthesiology — Leveraging Data and
           Analytics to Optimize Outcomes
    • Authors: Elizabeth A. Valentine; Scott A. Falk
      Pages: 31 - 44
      Abstract: Publication date: March 2018
      Source:Anesthesiology Clinics, Volume 36, Issue 1
      Author(s): Elizabeth A. Valentine, Scott A. Falk
      Teaser Quality improvement is at the heart of practice of anesthesiology. Objective data are critical for any quality improvement initiative; when possible, a combination of process, outcome, and balancing metrics should be evaluated to gauge the value of an intervention. Quality improvement is an ongoing process; iterative reevaluation of data is required to maintain interventions, ensure continued effectiveness, and continually improve. Dashboards can facilitate rapid analysis of data and drive decision making. Large data sets can be useful to establish benchmarks and compare performance against other providers, practices, or institutions. Audit and feedback strategies are effective in facilitating positive change.

      PubDate: 2018-03-08T01:52:57Z
      DOI: 10.1016/j.anclin.2017.10.006
       
  • Emergency Manuals
    • Authors: Sara N. Goldhaber-Fiebert; Carl Macrae
      Pages: 45 - 62
      Abstract: Publication date: March 2018
      Source:Anesthesiology Clinics, Volume 36, Issue 1
      Author(s): Sara N. Goldhaber-Fiebert, Carl Macrae
      Teaser How can teams manage critical events more effectively' There are commonly gaps in performance during perioperative crises, and emergency manuals are recently available tools that can improve team performance under stress, via multiple mechanisms. This article examines how the principles of implementation science and quality improvement were applied by multiple teams in the development, testing, and systematic implementations of emergency manuals in perioperative care. The core principles of implementation have relevance for future patient safety innovations perioperatively and beyond, and the concepts of emergency manuals and interprofessional teamwork are applicable for diverse fields throughout health care.

      PubDate: 2018-03-08T01:52:57Z
      DOI: 10.1016/j.anclin.2017.10.003
       
  • Use of Simulation in Performance Improvement
    • Authors: Amanda Burden; Erin White Pukenas
      Pages: 63 - 74
      Abstract: Publication date: March 2018
      Source:Anesthesiology Clinics, Volume 36, Issue 1
      Author(s): Amanda Burden, Erin White Pukenas
      Teaser Human error and system failures continue to play a substantial role in preventable errors that lead to adverse patient outcomes or death. Many of these deaths are not the result of inadequate medical knowledge and skill, but occur because of problems involving communication and team management. Anesthesiologists pioneered the use of simulation for medical education in an effort to improve physician performance and patient safety. This article explores the use of simulation for performance improvement. Educational theories that underlie effective simulation programs are described as driving forces behind the advancement of simulation in performance improvement.

      PubDate: 2018-03-08T01:52:57Z
      DOI: 10.1016/j.anclin.2017.10.001
       
  • Developing Multicenter Registries to Advance Quality Science
    • Authors: Laura E. Schleelein; Kathleen A. Harris; Elizabeth M. Elliott
      Pages: 75 - 86
      Abstract: Publication date: March 2018
      Source:Anesthesiology Clinics, Volume 36, Issue 1
      Author(s): Laura E. Schleelein, Kathleen A. Harris, Elizabeth M. Elliott
      Teaser There are several benefits to clinical registries as an information repository tool, ultimately lending itself to the acquisition of new knowledge. Registries have the unique advantage of garnering much data quickly and are, therefore, especially helpful for niche populations or low-prevalence diseases. They can be used to inform on the ideal structure, process, or outcome involving an identified population. The data can be used in many ways, for example, as an observational tool to reveal associations or as a basis for framing future research studies or quality improvement projects.

      PubDate: 2018-03-08T01:52:57Z
      DOI: 10.1016/j.anclin.2017.10.002
       
  • Handovers in Perioperative Care
    • Authors: Atilio Barbeito; Aalok V. Agarwala; Amanda Lorinc
      Pages: 87 - 98
      Abstract: Publication date: March 2018
      Source:Anesthesiology Clinics, Volume 36, Issue 1
      Author(s): Atilio Barbeito, Aalok V. Agarwala, Amanda Lorinc
      Teaser Handovers around the time of surgery are common, yet complex and error prone. Interventions aimed at improving handovers have shown increased provider satisfaction and teamwork, improved efficiency, and improved communication and have been shown to reduce errors and improve clinical outcomes in some studies. Common recommendations in the literature include a standardized institutional process that allows flexibility among different units and settings, the completion of urgent tasks before information transfer, the presence of all members of the team for the duration of the handover, a structured conversation that uses a cognitive aid, and education in team skills and communication.

      PubDate: 2018-03-08T01:52:57Z
      DOI: 10.1016/j.anclin.2017.10.007
       
  • Rethinking Clinical Workflow
    • Authors: Joseph J. Schlesinger; Kendall Burdick; Sarah Baum; Melissa Bellomy; Dorothee Mueller; Alistair MacDonald; Alex Chern; Kristin Chrouser; Christie Burger
      Pages: 99 - 116
      Abstract: Publication date: March 2018
      Source:Anesthesiology Clinics, Volume 36, Issue 1
      Author(s): Joseph J. Schlesinger, Kendall Burdick, Sarah Baum, Melissa Bellomy, Dorothee Mueller, Alistair MacDonald, Alex Chern, Kristin Chrouser, Christie Burger
      Teaser The concept of clinical workflow borrows from management and leadership principles outside of medicine. The only way to rethink clinical workflow is to understand the neuroscience principles that underlie attention and vigilance. With any implementation to improve practice, there are human factors that can promote or impede progress. Modulating the environment and working as a team to take care of patients is paramount. Clinicians must continually rethink clinical workflow, evaluate progress, and understand that other industries have something to offer. Then, novel approaches can be implemented to take the best care of patients.

      PubDate: 2018-03-08T01:52:57Z
      DOI: 10.1016/j.anclin.2017.10.008
       
  • Developing Capacity to Do Improvement Science Work
    • Authors: Irene McGhee; Yehoshua Gleicher
      Pages: 117 - 126
      Abstract: Publication date: March 2018
      Source:Anesthesiology Clinics, Volume 36, Issue 1
      Author(s): Irene McGhee, Yehoshua Gleicher
      Teaser Developing capacity to do improvement science starts with prioritizing quality improvement training in all health professions curricula so that a common knowledge base and understanding are created. Educational programs should include opportunities for colearning with patients, health professionals, and leaders. In this way, knowledge translation (also called implementation) is more effective and better coordinated when applied across organizations. Key factors that enable and drive behavior change are reviewed, as is the importance of influence and leadership. A comprehensive approach that accounts for these factors hardwires quality improvement into the health care systems and creates a culture that enables its ongoing development.

      PubDate: 2018-03-08T01:52:57Z
      DOI: 10.1016/j.anclin.2017.11.001
       
  • Diffusing Innovation and Best Practice in Health Care
    • Authors: Philip E. Greilich; Mary Eleanor Phelps; William Daniel
      Pages: 127 - 141
      Abstract: Publication date: March 2018
      Source:Anesthesiology Clinics, Volume 36, Issue 1
      Author(s): Philip E. Greilich, Mary Eleanor Phelps, William Daniel
      Teaser Diffusing innovation and best practices in healthcare are among the most challenging aspects of advancing patient safety and quality improvement. Recommendations from the Baldrige Foundation, Institute for Healthcare Improvement, and The Joint Commission provide guidance on the principles for successful diffusion. Perioperative leaders are encouraged to applying these principles to high priority areas such as handovers, enhanced recovery and patient blood management. Completing a successful pilot project can be exciting, however, effective diffusion is essential to achieving meaningful and lasting impact on the service line and health system.

      PubDate: 2018-03-08T01:52:57Z
      DOI: 10.1016/j.anclin.2017.10.009
       
  • Integrating Academic and Private Practices
    • Authors: Aviva Regev; Aman Mahajan
      Abstract: Publication date: Available online 9 April 2018
      Source:Anesthesiology Clinics
      Author(s): Aviva Regev, Aman Mahajan
      Teaser As health care reform shifts toward value over volume, academic medical centers, known for highly specialized, high-cost care, will suffer from erosion of their traditional funding sources. Academic medical centers have undertaken mergers and partnerships with community medical centers, to maintain a more diversified, cost-effective, and competitive presence in their markets. These consolidations have seen varying results. Cultural factors are frequently cited as a cause of dysfunction and disintegration. Anesthesiology groups integrating academic and private practice physicians are likely to face many of the same challenges. Appropriate attention to culture and other key issues may help realize numerous benefits.

      PubDate: 2018-04-12T07:29:05Z
      DOI: 10.1016/j.anclin.2018.01.012
       
  • Anesthesiology’s Future with Specialists in Population Health
    • Authors: Mike Schweitzer
      Abstract: Publication date: Available online 9 April 2018
      Source:Anesthesiology Clinics
      Author(s): Mike Schweitzer
      Teaser In population health medicine, often it is not primary care, but rather the specialists’ care teams that are responsible for the most overall spending for health care. Engaging specialists in population health medicine is a prerequisite to be successful in improving the quality of care by reducing complications, unnecessary utilization, avoidable Emergency Department visits/readmissions, and total cost of care. Creating patient-centric, physician-lead, interdisciplinary care teams to redesign the delivery of care across the continuum of the episode of care (eg, shadow bundle) is a successful approach to commercial or Centers for Medicare and Medicaid Services value-based payments.

      PubDate: 2018-04-12T07:29:05Z
      DOI: 10.1016/j.anclin.2018.01.008
       
  • Perioperative Surgical Home for the Patient with Chronic Pain
    • Authors: Talal W. Khan; Smith Manion
      Abstract: Publication date: Available online 9 April 2018
      Source:Anesthesiology Clinics
      Author(s): Talal W. Khan, Smith Manion
      Teaser The management of acute pain for the phenotypically different patient who suffers from chronic pain is challenging. The care of these patients is expensive and siloed. The physician-led, multidisciplinary, patient-centric, care coordination framework of the perioperative surgical home is an optimal vehicle for the management of these patients. The engagement of physician anesthesiologists in the optimization, in-hospital management, and postdischarge care of the patient with chronic pain will lead to improved outcomes, reduced health care expenditures, and improve the health of this challenging population.

      PubDate: 2018-04-12T07:29:05Z
      DOI: 10.1016/j.anclin.2018.01.011
       
  • Challenges in Outcome Reporting
    • Authors: Avery Tung
      Abstract: Publication date: Available online 9 April 2018
      Source:Anesthesiology Clinics
      Author(s): Avery Tung
      Teaser Although measuring outcomes is an integral part of medical quality improvement, large-scale outcome reporting efforts face several challenges. Among these are difficulties in establishing consensus definitions for outcome measurement; classifying gray outcomes, such as postoperative respiratory failure; and adequately adjusting for patient comorbidities and severity of illness. Unintended consequences of outcome reporting can also distort care in undesirable ways, and clinician reluctance to care for high-risk patients may occur with reporting programs. Ultimately, clinicians need not compare outcomes to improve and should recognize that even outcomes that cannot be precisely quantitated can still be improved.

      PubDate: 2018-04-12T07:29:05Z
      DOI: 10.1016/j.anclin.2018.01.004
       
  • Bundled Payments and Hidden Costs
    • Authors: Stanley W. Stead; Sharon K. Merrick
      Abstract: Publication date: Available online 9 April 2018
      Source:Anesthesiology Clinics
      Author(s): Stanley W. Stead, Sharon K. Merrick
      Teaser In a fee-for-service environment, anesthesiologists are paid for the volume of services billed, with little relation to the cost of delivering the services. In bundled payments, anesthesiologists are paid a set fee for an episode of care inclusive of all the anesthesia, pain medicine, and related services for the surgical episode and a period of time after the initial procedure to cover complications and redo procedures. When calculating a bundled payment, all the services typically used by a patient must be counted when calculating both the costs and expected payment.

      PubDate: 2018-04-12T07:29:05Z
      DOI: 10.1016/j.anclin.2018.01.005
       
  • Measuring Clinical Productivity
    • Authors: Mark E. Hudson; Evan E. Lebovitz
      Abstract: Publication date: Available online 9 April 2018
      Source:Anesthesiology Clinics
      Author(s): Mark E. Hudson, Evan E. Lebovitz
      Teaser Productivity measurements have been used to evaluate and compare physicians and physician practices. Anesthesiology is unique in that factors outside anesthesiologist control impact opportunity for revenue generation and make comparisons between providers and facilities challenging. This article uses data from the multicenter University of Pittsburgh Physicians Department of Anesthesiology to demonstrate factors influencing productivity opportunity by surgical facility, between department divisions and subspecialties within multispecialty divisions, and by individuals within divisions. The complexities of benchmarking anesthesiology productivity are demonstrated, and the potential value of creating a productivity profile for facilities and groups is illustrated.

      PubDate: 2018-04-12T07:29:05Z
      DOI: 10.1016/j.anclin.2018.01.001
       
  • Measuring Quality for Individual Anesthesia Clinicians
    • Authors: John Allyn; Craig Curry
      Abstract: Publication date: Available online 9 April 2018
      Source:Anesthesiology Clinics
      Author(s): John Allyn, Craig Curry
      Teaser A robust quality management system (QMS) will provide value to patients, providers, and hospitals or systems by focusing on system performance. The QMS must remain independent of provider-specific measures used for privileging. Some outcome measures may be used to assess system performance; they must not be used to assess individual provider performance. All anesthesia providers, especially leaders, must be guardians of an organization’s safety culture.

      PubDate: 2018-04-12T07:29:05Z
      DOI: 10.1016/j.anclin.2018.01.003
       
  • Value Proposition and Anesthesiology
    • Authors: Joseph W. Szokol; Keith J. Chamberlin
      Abstract: Publication date: Available online 9 April 2018
      Source:Anesthesiology Clinics
      Author(s): Joseph W. Szokol, Keith J. Chamberlin
      Teaser Health care in general and anesthesia in particular have seen dramatic changes in the economic landscape. It is vital if anesthesia groups wish to survive and prosper in this new environment to understand the changes occurring in health care and be flexible and proactive in taking on these challenges. More than ever anesthesia groups must be good corporate citizens and seek ways in which to enhance their value to the organization, whether in the operating room or out of operating room locations, and be a proactive partner with the hospital.

      PubDate: 2018-04-12T07:29:05Z
      DOI: 10.1016/j.anclin.2018.02.001
       
  • Comprehensive Acute Pain Management in the Perioperative Surgical Home
    • Authors: John-Paul J. Pozek; Martin De Ruyter; Talal W. Khan
      Abstract: Publication date: Available online 7 April 2018
      Source:Anesthesiology Clinics
      Author(s): John-Paul J. Pozek, Martin De Ruyter, Talal W. Khan
      Teaser The careful coordination of care throughout the perioperative continuum offered by the perioperative surgical home (PSH) is important in the treatment of postoperative pain. Physician anesthesiologists have expertise in acute pain management, pharmacology, and regional and neuraxial anesthetic techniques, making them ideal leaders for managing perioperative analgesia within the PSH. Severe postoperative pain is one of many patient- and surgery-specific factors in the development of chronic postsurgical pain. Delivering adequate perioperative analgesia is important to avoid this development, to decrease perioperative morbidity, and to improve patient satisfaction.

      PubDate: 2018-04-12T07:29:05Z
      DOI: 10.1016/j.anclin.2018.01.007
       
  • Quality and the Health System
    • Authors: Monaliza Gaw; Frank Rosina; Thomas Diller
      Abstract: Publication date: Available online 7 April 2018
      Source:Anesthesiology Clinics
      Author(s): Monaliza Gaw, Frank Rosina, Thomas Diller
      Teaser Since the publication of “To Err is Human” in 1999, substantial efforts have been made within the health care industry to improve quality and patient safety. Although improvements have been made, recent estimates continue to indicate the need for a marked change in approach. In this article, the authors discuss the concepts and characteristics of high reliability organizations, safety culture, and clinical microsystems. The health care delivery system must move beyond current quality and patient safety approaches and fully engage in these new concepts to transform health care system performance.

      PubDate: 2018-04-12T07:29:05Z
      DOI: 10.1016/j.anclin.2018.01.010
       
  • Practice Management: Successfully Guiding Your Group into the Future
    • Authors: Lee A. Fleisher
      Abstract: Publication date: Available online 7 April 2018
      Source:Anesthesiology Clinics
      Author(s): Lee A. Fleisher


      PubDate: 2018-04-12T07:29:05Z
      DOI: 10.1016/j.anclin.2018.02.003
       
  • Managing Your Anesthesiology Practice for the Future
    • Authors: Amr E. Abouleish; Stanley W. Stead
      Abstract: Publication date: Available online 9 March 2018
      Source:Anesthesiology Clinics
      Author(s): Amr E. Abouleish, Stanley W. Stead


      PubDate: 2018-03-20T04:04:26Z
      DOI: 10.1016/j.anclin.2018.02.002
       
  • Forthcoming Issues
    • Abstract: Publication date: March 2018
      Source:Anesthesiology Clinics, Volume 36, Issue 1


      PubDate: 2018-03-08T01:52:57Z
       
  • Anesthesia Outside the Operating Room
    • Authors: Mark S. Weiss; Wendy L. Gross
      Abstract: Publication date: December 2017
      Source:Anesthesiology Clinics, Volume 35, Issue 4
      Author(s): Mark S. Weiss, Wendy L. Gross


      PubDate: 2017-11-05T07:26:36Z
      DOI: 10.1016/j.anclin.2017.09.001
       
  • Anesthesia Outside of the Operating Room: The Wild West or the New
           Frontier'
    • Authors: Lee A. Fleisher
      Abstract: Publication date: December 2017
      Source:Anesthesiology Clinics, Volume 35, Issue 4
      Author(s): Lee A. Fleisher


      PubDate: 2017-11-05T07:26:36Z
      DOI: 10.1016/j.anclin.2017.09.002
       
  • Anesthesia Outside the Operating Room
    • Authors: Mark S. Weiss; Wendy L. Gross
      Abstract: Publication date: December 2017
      Source:Anesthesiology Clinics, Volume 35, Issue 4
      Author(s): Mark S. Weiss, Wendy L. Gross


      PubDate: 2017-11-05T07:26:36Z
      DOI: 10.1016/j.anclin.2017.09.001
       
  • Demands of Integrated Care Delivery in Interventional Medicine and
           Anesthesiology
    • Authors: Wendy L. Gross; Lebron Cooper; Steven Boggs
      Pages: 555 - 558
      Abstract: Publication date: December 2017
      Source:Anesthesiology Clinics, Volume 35, Issue 4
      Author(s): Wendy L. Gross, Lebron Cooper, Steven Boggs
      Teaser Evolving financial and medical constraints fueled by the increasing repertoire of nonoperating room cases and widening scope of patient comorbidities are discussed. The need to integrate finances and care approaches is detailed, and strategic suggestions for broader collaborative practice are suggested.

      PubDate: 2017-11-05T07:26:36Z
      DOI: 10.1016/j.anclin.2017.08.001
       
  • Building and Maintaining Organizational Infrastructure to Attain Clinical
           Excellence
    • Authors: Kelly Lebak; Jason Lane; Richard Taus; Hansol Kim; Michael S. Stecker; Michael Hall; Meghan B. Lane-Fall; Mark S. Weiss
      Pages: 559 - 568
      Abstract: Publication date: December 2017
      Source:Anesthesiology Clinics, Volume 35, Issue 4
      Author(s): Kelly Lebak, Jason Lane, Richard Taus, Hansol Kim, Michael S. Stecker, Michael Hall, Meghan B. Lane-Fall, Mark S. Weiss
      Teaser Active maintenance of highly functional teams is critical to ensuring safe, efficient patient care in the non–operating room anesthesia (NORA) suite. In addition to developing collaborative relationships and patient care protocols, individual and team training is needed. For anesthesiologists, this training must begin during residency. The training should be supplemented with continuing education in this field for providers who find themselves working in the NORA space. As NORA continues to grow, robust NORA-specific quality assurance and improvement programs will empower anesthesiologists with the tools they need to best care for these patients.

      PubDate: 2017-11-05T07:26:36Z
      DOI: 10.1016/j.anclin.2017.07.002
       
  • Safety of Non–Operating Room Anesthesia
    • Authors: Zachary G. Woodward; Richard D. Urman; Karen B. Domino
      Pages: 569 - 581
      Abstract: Publication date: December 2017
      Source:Anesthesiology Clinics, Volume 35, Issue 4
      Author(s): Zachary G. Woodward, Richard D. Urman, Karen B. Domino
      Teaser Malpractice claims for non–operating room anesthesia care (NORA) had a higher proportion of claims for death than claims in operating rooms (ORs). NORA claims most frequently involved monitored anesthesia care. Inadequate oxygenation/ventilation was responsible for one-third of NORA claims, often judged probably preventable by better monitoring. Fewer malpractice claims for NORA occurred than for OR anesthesia as assessed by the relative numbers of in NORA versus OR procedures. The proportion of claims in cardiology and radiology NORA locations were increased compared with estimates of cases in these locations. Although NORA is safe, adherence to safe clinical practice is important.

      PubDate: 2017-11-05T07:26:36Z
      DOI: 10.1016/j.anclin.2017.07.003
       
  • Implementation and Use of Anesthesia Information Management Systems for
           Non–operating Room Locations
    • Authors: Jason T. Bouhenguel; David A. Preiss; Richard D. Urman
      Pages: 583 - 590
      Abstract: Publication date: December 2017
      Source:Anesthesiology Clinics, Volume 35, Issue 4
      Author(s): Jason T. Bouhenguel, David A. Preiss, Richard D. Urman
      Teaser Non–operating room anesthesia (NORA) encounters comprise a significant fraction of contemporary anesthesia practice. With the implemention of an aneshtesia information management system (AIMS), anesthesia practitioners can better streamline preoperative assessment, intraoperative automated documentation, real-time decision support, and remote surveillance. Despite the large personal and financial commitments involved in adoption and implementation of AIMS and other electronic health records in these settings, the benefits to safety, efficacy, and efficiency are far too great to be ignored. Continued future innovation of AIMS technology only promises to further improve on our NORA experience and improve care quality and safety.

      PubDate: 2017-11-05T07:26:36Z
      DOI: 10.1016/j.anclin.2017.07.001
       
  • Monitoring for Nonoperating Room Anesthesia
    • Authors: Stylianos Voulgarelis; John P. Scott
      Pages: 591 - 599
      Abstract: Publication date: December 2017
      Source:Anesthesiology Clinics, Volume 35, Issue 4
      Author(s): Stylianos Voulgarelis, John P. Scott
      Teaser Procedures requiring nonoperating room anesthesia (NORA) continue to increase in quantity and complexity. The roles of anesthesiologists as members of care teams in nonoperating room locations continue to evolve. The safe provision of NORA requires strict adherence to standardized monitoring guidelines including pulse oximetry, capnography, electrocardiogram, and noninvasive blood pressure ampliflier. Body temperature should also be measured in appropriate scenarios. High-risk anesthetics require advanced preparation and monitoring.

      PubDate: 2017-11-05T07:26:36Z
      DOI: 10.1016/j.anclin.2017.07.004
       
  • Use of Anesthesiology Services in Radiology
    • Authors: Hansol Kim; Jason Lane; Rolf Schlichter; Michael S. Stecker; Richard Taus
      Pages: 601 - 610
      Abstract: Publication date: December 2017
      Source:Anesthesiology Clinics, Volume 35, Issue 4
      Author(s): Hansol Kim, Jason Lane, Rolf Schlichter, Michael S. Stecker, Richard Taus
      Teaser In the setting of technological advancements in imaging and intervention with concomitant rise in the use of non–operating room anesthesia (NORA) care, it has become even more critical for anesthesiologists to be aware of the needs and limitations of interventional procedures performed outside of the operating room. This article addresses the use of NORA services from the interventional radiologist’s point of view and provides specific examples of preprocedural, intraprocedural, and postprocedural care patients may need for optimal outcome.

      PubDate: 2017-11-05T07:26:36Z
      DOI: 10.1016/j.anclin.2017.07.005
       
  • An Anesthesiologist’s View of Tumor Ablation in the Radiology Suite
    • Authors: Annie Amin; Jason Lane; Thomas Cutter
      Pages: 611 - 615
      Abstract: Publication date: December 2017
      Source:Anesthesiology Clinics, Volume 35, Issue 4
      Author(s): Annie Amin, Jason Lane, Thomas Cutter
      Teaser The advent of radiology image–guided tumor ablation procedures has opened up a new era in minimally invasive procedures. Using CT, MRI, ultrasound, and other modalities, radiologists and surgeons can now ablate a tumor through percutaneous entry sites. What traditionally was done in an operating room via large open incisions, with multiple days in the hospital recovering, is now becoming an outpatient procedure via these new techniques. Anesthesiologists play a critical role in optimizing outcome in these patients. Knowledge by anesthesiologists of procedural goals, technology used, and inherit safety concerns of anesthetizing patients in the radiology suite are all critical to patients and proceduralists.

      PubDate: 2017-11-05T07:26:36Z
      DOI: 10.1016/j.anclin.2017.07.006
       
  • A Radiologist’s View of Tumor Ablation in the Radiology Suite
    • Authors: Sharath K. Bhagavatula; Jason Lane; Paul Shyn
      Pages: 617 - 626
      Abstract: Publication date: December 2017
      Source:Anesthesiology Clinics, Volume 35, Issue 4
      Author(s): Sharath K. Bhagavatula, Jason Lane, Paul Shyn
      Teaser Image-guided percutaneous, minimally invasive ablation techniques offer a wide variety of new modalities to treat tumors in some of the most medically complicated patients coming to our hospitals. The use of computed tomography, PET, ultrasound imaging, and MRI to guide radiofrequency ablation, microwave ablation, and cryoablation techniques now makes it possible to treat patients on a short stay or outpatient basis with very good immediate outcomes. This rapid expansion of new tumor ablation techniques often presents challenges for the non–operating room anesthesia team. Collaboration and communication between the radiologist and anesthesiologist are key to safety and excellent patient outcomes.

      PubDate: 2017-11-05T07:26:36Z
      DOI: 10.1016/j.anclin.2017.07.007
       
  • Catheterization Laboratory
    • Authors: Paul N. Fiorilli; Saif Anwaruddin; Elizabeth Zhou; Ronak Shah
      Pages: 627 - 639
      Abstract: Publication date: December 2017
      Source:Anesthesiology Clinics, Volume 35, Issue 4
      Author(s): Paul N. Fiorilli, Saif Anwaruddin, Elizabeth Zhou, Ronak Shah
      Teaser The cardiac catheterization laboratory is advancing medicine by performing procedures on patients who would usually require sternotomy and cardiopulmonary bypass. These procedures are done percutaneously, allowing them to be performed on patients considered inoperable. Patients have compromised cardiovascular function or advanced age. An anesthesiologist is essential for these procedures in case of hemodynamic compromise. Interventionalists are becoming more familiar with transcatheter aortic valve replacement and the device has become smaller, both contributing to less complications. Left atrial occlusion and the endovascular edge-to-edge mitral valve repair devices were approved. Although these devices require general anesthesia, an invasive surgery and cardiopulmonary bypass machine are not necessary for deployment.

      PubDate: 2017-11-05T07:26:36Z
      DOI: 10.1016/j.anclin.2017.07.008
       
  • Anesthesia in the Electrophysiology Laboratory
    • Authors: Jeff E. Mandel; William G. Stevenson; David S. Frankel
      Pages: 641 - 654
      Abstract: Publication date: December 2017
      Source:Anesthesiology Clinics, Volume 35, Issue 4
      Author(s): Jeff E. Mandel, William G. Stevenson, David S. Frankel
      Teaser The electrophysiology suite is a foreign location to many anesthesiologists. The initial experience was with shorter procedures under conscious sedation, and the value of greater tailoring of the sedation/anesthesia by anesthesiologists was not perceived until practice patterns had already been established. Although better control of ventilation with general anesthesia may be expected, suppression of arrhythmias, blunting of the hemodynamic adaptation to induced arrhythmias, and interference by muscle relaxants with identification of the phrenic nerve may be seen. We review a range of electrophysiology procedures and discuss anesthetic approaches that balance patient safety and favorable outcomes.

      PubDate: 2017-11-05T07:26:36Z
      DOI: 10.1016/j.anclin.2017.07.009
       
  • Cardioversions and Transthoracic Echocardiography
    • Authors: Ronak Shah; Elizabeth Zhou
      Pages: 655 - 667
      Abstract: Publication date: December 2017
      Source:Anesthesiology Clinics, Volume 35, Issue 4
      Author(s): Ronak Shah, Elizabeth Zhou
      Teaser Patients with atrial fibrillation and flutter routinely require transesophageal echocardiography with cardioversion. It is not uncommon to encounter patients with reduced ejection fractions, coronary artery disease, prior cardiac surgery, or obstructive sleep apnea. The anesthesiologist must carefully evaluate the patient and any available laboratory and study findings to assess for potential complications after anesthesia. Appropriate anesthetics must be chosen based on the preoperative evaluation. Additionally, because most of these cases are done without a secured airway, emergency medications and airway equipment must be readily available.

      PubDate: 2017-11-05T07:26:36Z
      DOI: 10.1016/j.anclin.2017.08.002
       
  • Anesthesia for Routine and Advanced Upper Gastrointestinal Endoscopic
           Procedures
    • Authors: Christopher D. Sharp; Ezekiel Tayler; Gregory G. Ginsberg
      Pages: 669 - 677
      Abstract: Publication date: December 2017
      Source:Anesthesiology Clinics, Volume 35, Issue 4
      Author(s): Christopher D. Sharp, Ezekiel Tayler, Gregory G. Ginsberg
      Teaser This article aims to detail the breadth and depth of advanced upper gastrointestinal endoscopic procedures. It will focus on sedation and airway management concerns pertaining to this emerged and emerging class of minimally invasive interventions. The article will also cover endoscopic hemostasis, endoscopic resection, stenting and Barrett eradication therapy plus endoscopic ultrasound. It additionally will address the nuances of endoscopic retrograde cholangiopancreatography and new natural orifice transluminal endoscopic surgery procedures including endoscopic cystgastrostomy and the per-oral endoscopic myotomy procedure.

      PubDate: 2017-11-05T07:26:36Z
      DOI: 10.1016/j.anclin.2017.08.006
       
  • Anesthesia for Colonoscopy and Lower Endoscopic Procedures
    • Authors: John Michael Trummel; Vinay Chandrasekhara; Michael L. Kochman
      Pages: 679 - 686
      Abstract: Publication date: December 2017
      Source:Anesthesiology Clinics, Volume 35, Issue 4
      Author(s): John Michael Trummel, Vinay Chandrasekhara, Michael L. Kochman
      Teaser Demand for anesthesiologist-assisted sedation is expanding for gastrointestinal lower endoscopic procedures and may add to the cost of these procedures. Most lower endoscopy can be accomplished with either no, moderate, or deep sedation; general anesthesia and active airway management are rarely needed. Propofol-based sedation has advantages in terms of satisfaction and recovery over other modalities, but moderate sedation using benzodiazepines and opiates work well for low-risk patients and procedures. No sedation for routine colonoscopy works well for selected patients and eliminates sedation-related risks. There is no difference in outcome measures based on sedation received.

      PubDate: 2017-11-05T07:26:36Z
      DOI: 10.1016/j.anclin.2017.08.007
       
  • Interventional Pulmonology
    • Authors: David M. DiBardino; Andrew R. Haas; Richard C. Month
      Pages: 687 - 699
      Abstract: Publication date: December 2017
      Source:Anesthesiology Clinics, Volume 35, Issue 4
      Author(s): David M. DiBardino, Andrew R. Haas, Richard C. Month
      Teaser Bronchoscopy presents a unique challenge and need for collaboration between anesthesia providers and bronchoscopists. The approach to topical anesthesia, analgesia, and sedation must be customized based on complexity, duration, and setting. The bronchoscopy team must work together in each phase of the procedure to ensure patient safety and allow completion of a quality bronchoscopy. Airway access may change depending on the type of procedure planned and must be discussed before each case. Intraprocedural difficulties with ventilation, airway pressure, and sedation may arise that must be addressed together. This review highlights an approach to these common challenges.

      PubDate: 2017-11-05T07:26:36Z
      DOI: 10.1016/j.anclin.2017.08.004
       
  • Forthcoming Issues
    • Abstract: Publication date: December 2017
      Source:Anesthesiology Clinics, Volume 35, Issue 4


      PubDate: 2017-11-05T07:26:36Z
       
 
 
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