The Agency for Healthcare Research and Quality (AHRQ) recently published an important evidence-based report entitled Making Health Care Safer: A Critical Analysis of Patient Safety Practices.

The text of this report is available at: http://www.ahrq.gov/clinic/ptsafety.

Included in this report was a recommendation for use of perioperative beta-blockers in appropriate patients to prevent perioperative morbidity and mortality and a recommendation for the use of real-time ultrasound guidance during central venous line placement to prevent complications. Both of these recommendations have been discussed in recent issues of the APSF Newsletter. In the Fall 2001 issue, Dr. Prielipp reviewed the top 11 AHRQ recommendations, in the Fall 2002 issue, Drs. Webster and Blitt expressed their opinions in support of real-time ultrasound guidance for central venous access, and in the Summer 2002 issue, Dr. Royster reviewed the recommendations for perioperative beta blockade. The APSF Newsletter has received a number of letters to the editor questioning the details and strength of these recommendations and expressing concern over their extrapolation into “standards of care.” Several of these letters follow, along with Dr. Royster’s practical suggestions for implementation of perioperative beta-blockade and a thoughtful response from authors of the AHRQ report.