Background: A single dose of dexamethasone is routinely given during general anesthesia for postoperative nausea and vomiting (PONV) prophylaxis, although the exact dosage and timing of administration may vary between practitioners. The authors aimed to standardize the dosage and timing of this medication when given to adult patients undergoing general anesthesia for elective surgery. Methods: Baseline data for 7,483 preintervention cases were analyzed. The researchers attempted to use a standard dose of 8 to 10 mg induction of anesthesia, which, based on a literature review, was effective for PONV prophylaxis, had a similar safety profile as a 4 to 5 mg dose (including in diabetic patients), and may confer additional benefits such as improved prophylaxis and quality of recover y. The inter ventions included standardizing the medication concentration vials, altering electronic health record quick-select button options, simplifying the intraoperative charting process, and educating the anesthesia providers. The research team then tracked compliance with the standard of care for 2,167 cases after the interventions. Results: Overall compliance with the standard of care increased from 21.2% preintervention to 53.7% postintervention. The number of patients not receiving dexamethasone was reduced from 29.7% to 19.4%. Patients receiving a compliant dose at a noncompliant time increased from 16.3% to 23.8%. Postanesthesia care unit antiemetic administration also decreased after the interventions. Conclusion: This study showed improvements in compliance with the dosage of medication with the interventions. However, compliance with the timing of administration remains challenging.

Academic anesthesiology department chairs face significant responsibilities, yet formal leadership pathways remain unclear. The purpose of this study was to characterize the educational backgrounds and career trajectories of current U.S. anesthesiology department chairs. Chair information was sought for all 192 Accreditation Council for Graduate Medical Education–accredited anesthesiology residency programs. During data collection, 40 were excluded due to absence of a designated chair or insufficient publicly available information, yielding a final sample of 152 chairs. The most common medical schools that the chairs attended were the University of Washington, the University of Chicago, and Johns Hopkins University (each, n = 4; 2.6%). Massachusetts General Hospital was the most frequent residency site (13/149; 8.7%) and fellowship site (9/84, 10.7%). Median time from residency to chair appointment was 21 yr (interquartile range [IQR], 15 to 27) and median tenure was 5 yr (IQR, 3 to 9). Most chairs had modest to moderate scholarship (Hirsch Index: 1 to 15 in 54.1%) with a median of 14 (IQR, 4 to 34). These findings suggest pathways to chair are frequently diverse, often non–research-intensive, and support the imperative for structured leadership development.

Objectives TAVR is a minimally invasive alternative to SAVR, offering a key treatment for high-risk patients with severe aortic stenosis, including those with advanced age or comorbidities. Its popularity has led to its use in lower volume institutions, where outcomes are comparable to higher volume centers. This study analyzes procedural volume and outcomes at our institution, compares them with the PARTNER III trial, and evaluates complications and patient selection criteria. Design This was a retrospective descriptive study. Setting This study was performed at a public, multi-institutional healthcare system featuring an acute care hospital with a Level I Adult Trauma and Burn Center. Participants We obtained retrospective data on 37 patients who underwent TAVR in our hospital system in 2022. Data was collected on their outcomes, including mortality, readmission rates, and cardiovascular and cerebrovascular complications at 30 days and 1 year. Interventions No interventions were performed on patients as this was a retrospective study. Measurements and Main Results Patient outcomes were compared with PARTNER III trial results. There was no 30-day mortality (versus 1% in the PARTNER III trial), and a 1-year mortality rate of 2.7% as compared to 8.5% in the PARTNER III trial. At 30 days, 0% of patients were readmitted for valve-related issues. Conclusions This study demonstrates that lower volume healthcare institutions can achieve outcomes comparable/similar to higher volume institutions in specialized procedures like TAVR, challenging the assumption that superior outcomes are tied to institutional size. Our findings highlight the importance of quality, teamwork, and individualized care in achieving excellent clinical outcomes, regardless of size.

Background: Mobile health (mHealth) apps are increasingly integrated into clinical workflows to support decision-making and adherence to best practices. Usability is a critical determinant of adoption, engagement, and long-term use. Objective: This study aimed to evaluate the usability of the C8 Health platform deployed in the Department of Anesthesiology at MetroHealth in 2024. Methods: A quality improvement initiative was conducted using the mHealth App Usability Questionnaire (MAUQ). A total of 142 anesthesiology clinicians participated by completing the questionnaire. This study was reported in accordance with the SQUIRE (Standards for Quality Improvement Reporting Excellence) guidelines for quality improvement reporting. Results: The overall MAUQ scores indicated high usability, with mean scores greater than 5.5 across core items (overall mean MAUQ score 5.73, SD 0.81). These findings suggest strong user satisfaction and positive engagement with the C8 Health platform among anesthesiology clinicians. Conclusions: The C8 Health platform demonstrated high usability in an anesthesiology setting. These results support its integration as a clinical decision support tool to enhance workflow efficiency and adherence to best practices.