title: Perioperative use of beta-blocker in noncardiac surgery: a multicenter educational intervention to achieve best practice guidelines.
abstract: Perioperative cardiac ischemia and infarction are important causes of morbidity and mortality in patients undergoing noncardiac surgery. There is now significant evidence that the use of prophylactic beta-adrenergic antagonists among selected patients at risk for perioperative cardiovascular complications is associated with a reduction in myocardial ischemia and cardiac events. Furthermore, consensus guidelines have incorporated the findings of recent studies and provide recommendations for the appropriate utilization of beta-adrenergic antagonists among selected patients. Despite these guidelines, it is unknown to what extent these recommendations have become translated into clinical practice. After measuring perioperative beta-blocker use among participating hospitals within the New York Presbyterian Health Network, we developed a multicenter educational intervention to improve the overall utilization of beta-adrenergic prophylactic therapy in accordance with best practice guidelines. The literature supporting the development of this intervention is presented in this paper, along with the tools that are currently being used for decision support across an academic healthcare network.
authors.affiliation: Division of Outcomes, Effectiveness Research, Weill Medical College of Cornell, New York-Presbyterian Hospital, New York, NY 10021, USA. daq2002@med.cornell.edu
authors.forename: Debra A
authors.initials: DA
authors.lastname: Quinn
authors.forename: Jerry
authors.initials: J
authors.lastname: Balentine
authors.forename: Lawrence J
authors.initials: LJ
authors.lastname: Kadish
authors.forename: Steven
authors.initials: S
authors.lastname: Walerstein
authors.forename: Fredric
authors.initials: F
authors.lastname: Weinbaum
authors.forename: Mark
authors.initials: M
authors.lastname: Callahan
authors.forename: Antonia
authors.initials: A
authors.lastname: Novello
authors.forename: Eliot
authors.initials: E
authors.lastname: Lazaar
authors.forename: Mary
authors.initials: M
authors.lastname: Cooper