JMIR Perioperative Medicine

Total knee arthroplasty (TKA) is the primary treatment for advanced knee osteoarthritis. Despite its clinical success and favorable patient-reported outcome measures (PROMs), approximately 20% to 30% of patients continue to experience persistent functional limitations and muscle weakness. This highlights the need for a comprehensive evaluation of recovery parameters beyond pain and range of motion. Given the wide range of methods available for assessing TKA outcomes, clinicians often select tools based on personal preference and understanding, which may affect accuracy and consistency; for example, the Knee Injury and Osteoarthritis Outcome Score may overestimate function compared to gait analysis studies.

Traditional statistical models often fail to capture the complex dynamics influencing survival outcomes in patients with bladder cancer after radical cystectomy, a procedure where approximately 50% of patients develop metastases within 2 years. The integration of artificial intelligence (AI) offers a promising avenue for enhancing prognostic accuracy and personalizing treatment strategies.

Enhanced Recovery After Surgery (ERAS) programs bundle evidence-based interventions to standardize care, expedite recovery, and improve outcomes. As ERAS programs have expanded it has become clear that a major challenge is monitoring compliance of bundle elements and outcomes to feedback performance to stakeholders and guide changes. Manual data abstraction is onerous and not feasible. Reliance on receiving new reports from busy health system information technology (IT) groups is challenging. Therefore, we sought to address this unmet need at our hospital by developing a novel ERAS Datamart system.

Hypothermia, defined as a core body temperature below 36°C, is a common postoperative complication associated with adverse outcomes such as delayed wound healing, infections, and increased bleeding.

Perioperative patient-reported outcomes (PROs) allow patients to share their experiences of surgical procedures with their healthcare teams using standardized measures. Despite increasing recognition of their value, PROs are not routinely used in clinical practice, partly due to limited evidence of their impact on traditional clinical outcomes and uncertainty among clinicians about their utility. Digital health tools offer a promising way to integrate PROs into clinical workflows and enhance patient-clinician interaction, but their success depends on person-centered design to ensure usability and relevance. Safe Surgery South Africa, a non-profit organization, developed the Perioperative Shared Health Record (PSHR), a secure web-based tool that enables patients to share personal health information and PROs with their anaesthetist and surgeon before and after surgery. Initial implementation revealed significant user experience challenges, which contributed to poor uptake.

As electronic patient portals (EPPs) continue to gain popularity and systems transition to online tools for scheduling, communication, and telehealth, patients without access or skills to utilize these tools may be overlooked.

Anesthesia residents experience nonroutine clinical events during perioperative patient care, including workplace stressors or adverse incidents that may cause physical and emotional stress. These events can lead to burnout and negative mental health outcomes. Burnout and depression rates are lower when residents have adequate support systems within their workplace. Better REsident Wellness (BREW) rounds are a weekly one-hour peer discussion for anesthesia residents, facilitated by a registered psychologist at our institution. Although shown to improve residents’ wellbeing, a deeper understanding of the benefits of such programs may support their expansion to other residency programs.

Health care provider burnout worsened during the COVID-19 pandemic.

Background: The perioperative environment is complex and may be challenging for patients and guardians to navigate. The emotional burden and stressors inherent to the perioperative process commonly result in preoperative anxiety. Many studies have demonstrated the usefulness of virtual reality (VR) in various patient populations.

Reducing the time to surgery for patients requiring cholecystectomy may lessen the risk of adverse outcomes. Dedicated day-surgery lists supported by out-of-hospital remote monitoring have been explored as a potential solution; however, the cost-effectiveness of such innovative care models remains largely unexplored.

Preoperative anxiety is a common psychological condition, and many patients express a need for more information before surgery. Understanding the prevalence and associated factors of both can improve patient care.

Rising arthroplasty volumes are testing capacity, budgets, and workforce resilience. Clinical pathways (CPWs) provide a practical, evidence-based structure that aligns perioperative actions from preparation through follow-up. In this review, we treat three aims as co-primary: quality (patient outcomes and adherence to best practice); resource management/efficiency at the episode level (e.g., length of stay, perioperative flow, direct costs); and sustainability, defined as the ability to maintain high-quality services over time by optimising financial, human, and environmental resources while safeguarding equitable access.