2. Beginning January 1, 2012 the beta blocker measure will be expanded. To pass this measure, patients on beta blocker therapy at home, must receive one on the day before surgery or the day of surgery AND on POD 1 or POD2.

3. Withdrawal of beta blocker therapy is associated with increased mortality.

4. Reasons for not Administering A Beta Blocker Bradycardia (heart rate less than 50) Bradycardia (heart rate less than 50) Hypotension (systolic less than 100) Hypotension (systolic less than 100) Concurrent use of IV inotropics Concurrent use of IV inotropics during each period of interest Other reasons documented by physician Other reasons documented by physician ex: “not indicated, rate and BP controlled” ex: “not indicated, rate and BP controlled”

5. Rivaroxaban (Xarelto) is now listed as an appropriate choice for VTE prophylaxis on total hips and knees.

6. Crohn’s Disease and Ulcerative Colitis added to “stand alone” infection list. If documented prior to anesthesia, no further documentation regarding antibiotic choice, timing or duration will be required.

7. Infection prior to Anesthesia Abscess Abscess Acute abdomen Acute abdomen Aspiration pneumonia Aspiration pneumonia Bloodstream infection Bloodstream infection Bone infection Bone infection Cellulitis Cellulitis Crohn’s Disease Crohn’s Disease Endometritis Endometritis Fecal Contamination Fecal Contamination Free air in abdomen Free air in abdomen Gangrene Gangrene H. pylori H. pylori Necrosis Necrosis Necrotic/ischemic/infarcted bowel Necrotic/ischemic/infarcted bowel Osteomyelitis Osteomyelitis Other documented infection Other documented infection Penetrating abdominal trauma Penetrating abdominal trauma Perforation of bowel Perforation of bowel Pneumonia or other lung infection Pneumonia or other lung infection Purulence/pus Purulence/pus Sepsis Sepsis Surgical site or wound infection Surgical site or wound infection Ulcerative colitis Ulcerative colitis Urinary tract infection (UTI) Urinary tract infection (UTI)