Background: Common hospitalist workflow includes hospitalists balancing inpatient care and discharges with new Emergency Department (ED) admissions. This model can strain hospitalist efficiency. We hence introduced a Double ED Admitter (DEDA) Model, where we designated two hospitalist physicians exclusively for ED admissions during peak hours, allowing rounding hospitalists to focus on inpatient care and timely [...]

Background: Medical emergencies present a major challenge to outpatient clinics. The University of Colorado Hospital (UCHA), a quaternary referral hospital with more than 1.4 million outpatient visits per year, previously relied on Emergency Medical Services (EMS) for patient evaluation and transport to the Emergency Department (ED), leading to prolonged response times, poor utilization of community [...]

Background: The rigid architecture of electronic health records (EHRs) is inherently at odds with the dynamic environment of clinical practice, creating a widening gap between EHR workflows and frontline needs.(1) Although digital health solutions are available from external vendors, their implementation is often prolonged by legal and governance requirements, as well as architectural integration challenges, [...]

Background: Health systems are rapidly piloting Large Language Model (LLM)-enabled tools within the Electronic Health Record (EHR) [1–4], but there is limited guidance on how to evaluate these tools during early deployment [5]. Qualitative clinician feedback is essential for understanding real-world usability, identifying safety concerns, and guiding iterative improvement of novel technologies [6]. Traditional qualitative [...]

Background: Our health care system includes two academic medical centers (AMC) and community hospital locations. Occupancy at our AMC often exceeds 100%. Identifying patients while in the Emergency Department (ED) whose care needs can be safely and appropriately managed in a community hospital setting is a key priority. This approach helps preserved AMC capacity for [...]

Background: Prolonged hospitalizations for patients medically ready for discharge can increase healthcare costs, risk of complications, and strain on hospital capacity. Therefore, identifying and mitigating modifiable barriers to discharge that extend length of stay (LOS) is critical for improving quality of care. Purpose: To address this challenge, the UNC Health Care Management Physician Advisor team [...]

Background: Code status discussions (CSDs) are essential but often inadequate in routine clinical practice. Simulation with standardized patients (SPs) can address CSD skills, but is resource-intensive and not widely available. As a result, many learners lack sufficient training in these difficult conversations. This study examined how artificial intelligence (AI)-driven simulation might enhance CSD training. Methods: [...]

Background: For many inpatient wards teams, morning rounds remain the primary time many attendings use to engage learners in clinical decision making and education. Literature supports the use of bedside rounds to improve learner communication and patient engagement. However, many institutional, learner, and patient factors may impact attending choice in how they round with learners. [...]

Background: Alcohol Use Disorder (AUD) is prevalent among hospitalized Veterans and is associated with increased mortality.[1] AUD contributes to both morbidity and mortality through its direct physiological effects and its association with various medical, psychiatric, and social consequences. The World Health Organization estimates that alcohol use accounts for approximately 4.7% of all deaths in 2019 [...]

Background: Early warning scores are used with increasing frequency, but little data exist on the impact of these scores on clinical outcomes. Our health system’s experience with two prior early warning scores was associated with complaints of alarm fatigue and no demonstrable improvement in clinical outcomes. After performing a retrospective validation comparing six early warning [...]