The USC Perioperative Brain Health Initiative is a quality improvement project at a major academic medical center to evaluate the impact of a multidisciplinary pathway to reduce perioperative neurocognitive disorder (PNCD) and improve outcomes in older adults undergoing elective, intermediate to high risk surgery. The most common perioperative complication to affect older adults is the development of PNCD-delirium, delayed neruocognitive recovery and minor/major NCD. Postoperative delirium events and delayed neurocognitive recovery - the "brain fog" and difficulty with concentration and memory that may occur in the postoperative setting can be distressing and life altering to both patients and their families.