This issue of Anesthesiology Clinics focuses on Anesthesia Out of the Operating Room. Editors Mark Weiss and Wendy Gross have assembled an expert team of authors on topics such as: A Changing Landscape: Demands of Integrated Care Delivery: Interventional Medicine and Anesthesiology: Engineering Challenges and Interdisciplinary Teamwork; Organizational Infrastructure: Attaining and Teaching Clinical Excellence. Improvement across specialties by implementing an "Institute” mentality in the clinical arena; Quality: Who's rules apply?; Electronic Health Records; Monitoring; Interventional Radiology (NOT RADIATION): (Safety/Tumor Ablation/Adult radiology/ equipment); Approaches to Vascular Disease; Cath Lab: Structural Heart Disease, Devices and TAVR; EP Lab; Cardioversions and TEEs; Upper GI EGD and new procedures; Colonoscopy and new procedures anesthesiologist and GI person; Endoscopic Surgery, repair of surgical procedures, bariatric procedures; Interventional Pulmonology; Pediatrics; Market Evaluation; Finances, Bundled Payments and ACOs; Competitive Strategy or Joint Venture Finance: potential threats and likely future scenarios.