Residual neuromuscular blockade can be avoided with quantitative neuromuscular monitoring. In this issue of Anesthesiology, Weigel et al. detail a professional practice initiative they conducted to attain documented train-of-four ratios greater than or equal to 0.90 in all patients to improve patient outcomes through reducing residual paralysis. In an accompanying editorial, Lane-Fall tells us how this new article demonstrates much about what anesthesiology has to learn from implementation science and quality improvement. Cover Illustration: A. Johnson, Vivo Visuals Studio.

  • Weigel et al.: Quantitative Neuromuscular Monitoring in Clinical Practice: A Professional Practice Change Initiative, p. 901

  • Lane-Fall: What Anesthesiology Has to Learn from Implementation Science and Quality Improvement, p. 875