Johns Hopkins Perioperative Management-In Its 40th Year 2025

Over 300 million patients undergo surgical procedures worldwide, and the age and medical complexity of this patient population continues to increase. Higher risk patients are now having surgery in ambulatory and non-OR settings. All these patients require preoperative assessment, intraoperative management, and postoperative care. Every year the body of peer-reviewed literature on this topic increases and new guidelines on clinical management are formulated. The curriculum for this course was specifically created to address the needs of clinicians who provide care for patients before, during, and after surgery based on examination of the evidence-based peer-reviewed literature, recent research, feedback from course participants, and input from expert colleagues inside and outside Johns Hopkins. As the established leader in perioperative medicine, this course aims to provide practitioners with the most up-to-date knowledge necessary to deliver effective, evidence-based care by affecting healthcare practices at the level of the individual and the larger health system.

1. Describe current guidelines for preoperative cardiac and pulmonary risk assessment and list several ways to predict and prevent cardiac and pulmonary complications using preoperative testing and intraoperative and postoperative interventions.
2. Recognize the risks of perioperative anemia and transfusion as well as the risks and benefits of perioperative anti-thrombotic therapies, and list several strategies to reduce bleeding and thrombotic complications through evidence-based approaches to anemia management, transfusion, coagulation testing, and pharmacologic interventions with anti-thrombotic and anti-fibrinolytic agents.
3. Describe the perioperative complications associated with diabetes, renal insufficiency, liver disease, delirium, and frailty, and list current management strategies to optimize outcomes in patients with these medical conditions.
4. Describe strategies to control acute postoperative pain, including in patients who chronically use opioids or cannabis.
5. Recognize how to prevent, diagnose, and treat common healthcare associated infections that complicate surgical procedures.
6. Recognize the perioperative implications of the growing use of newer pharmacologic therapies for diabetes, obesity, heart failure, and immunomodulators and the pros/cons of emerging physiologic monitoring technologies for use in the OR, PACU, and wards.
7. Recognize the impact of burnout, and its relation to gender, race, and micro-aggressions, on clinician wellbeing and patient safety, and describe strategies to improve work-force wellbeing, communication, and the quality/safety of clinical care for of individual healthcare worker, patients, and the health system.
8. Recognize basic views for real-time ultrasound guided vascular access and perform vascular access on simulation equipment using ultrasound (optional POCUS Workshop).
9. Recognize and interpret basic transthoracic ultrasound views of cardiac and lung structures (optional POCUS Workshop).
10. Apply basic ultrasound algorithms to diagnose and manage an unstable perioperative patient (optional POCUS Workshop).
11. Recognize and interpret ultrasound views of peripheral nerve structures and how ultrasound can facilitate performance of peripheral nerve blocks for upper and lower extremity surgery (optional POCUS Workshop).
12. Recognize the causal role of gratitude in well-being (optional Wellness Workshop).
13. Perform a brief gratitude intervention in real time (optional Wellness Workshop).
14. List several wellbeing improvements associated with awe and wonder interventions (optional Wellness Workshop).
15. Perform a brief awe intervention in real time (optional Wellness Workshop).

The Johns Hopkins Perioperative Management—In Its 40th Year (2025) course is designed for physicians and healthcare professionals involved in perioperative care, surgery, and anesthesia.

This course is particularly beneficial for:

• Anesthesiologists managing perioperative pain and sedation.
• Critical Care Physicians overseeing high-risk surgical patients.
• Family Medicine & Internal Medicine Physicians involved in preoperative assessments.
• General & Orthopedic Surgeons optimizing surgical outcomes.
• Hospitalists & Physician Assistants coordinating perioperative care.
• Nurse Anesthetists & Nurse Practitioners supporting surgical teams.
• Urologists & Pain Medicine Specialists addressing surgical complications.

The program covers preoperative assessment, intraoperative management, and postoperative care, ensuring participants stay updated on evidence-based perioperative practices