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More is being discovered about the patterns leading to a retained sponge. Multidisciplinary approaches and new technologies may help reduce this low frequency but clinically significant event. However, given the complexity of surgical care, eliminating retained sponges may prove elusive.

Despite substantial investments in health information technology (HIT), the nation's goals of reducing cost and improving outcomes through HIT remain elusive. This period of transition, with new Office of National Coordinator for HIT leadership, upcoming Meaningful Use Stage III definitions, and increasing congressional oversight, is opportune to consider needed course corrections in HIT strategy. This article describes current problems and recommended changes in HIT policy, including approaches to usability, interoperability, and quality measurement. Recommendations refrain from interim measures, such as electronic health record adoption rates, and instead focus on measurable national value to benefit the economy, to reduce healthcare costs, and to improve clinical efficiency and care quality.

In their early years of implementation, external quality assessment programs have already had significant consequences in the healthcare system. As new tools become available, their full impact on care and caregivers must be thoroughly evaluated. Careful consideration of clinical practice implications and an understanding of the risks are critical before accepting and implementing new assessment paradigms. The substantial and widespread effects of these programs should prompt further evaluation from the medical community.

This chapter discusses the critical role of anesthesia information management systems (AIMS) in clinical tracking and operating room information management. It begins by reviewing the history and implementation of such systems and examines their current abilities and utilities. The current known benefits of AIMS, as documented by peer-reviewed literature, are examined. Possible additional benefits, both future and current, and the potential role of AIMS in future healthcare information management are discussed. Though AIMS vary greatly between individual systems and will continue to evolve over time, this chapter aims to highlight fundamental system features. The goal of this chapter is to broaden understanding of AIMS and their clinical utility, as they have an essential part of modern operative care.