The highly anticipated results of the Enhanced Peri-Operative Care for High-risk patients (EPOCH) trial, presented for the first time at EBPOM 2018. Were these results as expected? Can we make large scale quality improvement programmes work? Does this trial put 'the big questions' to bed?

This piece is introduced by Monty Mythen and presented by Professor Rupert Pearse, Professor of Intensive Care Medicine at Queen Mary, University of London and Carol Peden, Professor of Anesthesiology and Exec. Director of the Center for Health System Innovation, University of Southern California, University of Bath and the Institute for Healthcare Improvement (IHI).

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