Background: Mobile health and health related applications have largely focused on outpatient tools with little development intended for an inpatient setting where the acute need for timely and easy to access information may be greater. An easy to use mobile application for hospitalized patients could meet this need by providing a central repository of information [...]

Background: Mobile phones enable efficient communication between healthcare providers. These devices also have the advantage of providing faster information retrieval at the point of care. Many hospitals still rely on outdated pager technology that allows only for unidirectional communication. If text messaging contains decisions about patient care both forms of communication technologies must ensure adequate [...]

Background:  Recent Center for Medicare and Medicaid Services (CMS) rules require hospitals to have their physicians submit inpatient admission orders and certification prior to a patient’s discharge in order to justify hospitalization reimbursement; however, CMS does not specify how hospitals are to achieve this regulation. Use of Health Information Technology (HIT) tools has significantly expanded, [...]

Background: Severe sepsis is the number one cause of hospital mortality. Despite decades of bench and clinical research on sepsis, the only intervention that consistently decreases mortality is early recognition of the disease and antibiotic administration. We surveyed 136 house officers and 280 nurses and found that they were able to recognize sepsis in clinical [...]

Background: Multidisciplinary rounds, geared toward reviewing patients’ readiness for discharge, are performed daily throughout our large academic medical center. Standardization of these rounds was made a priority in order to promote patient safety and efficiency. As hospitals become more complex and teams become larger, it is more important than ever to ensure all providers are [...]

Background: Accurate problem lists linked to electronic medical record (EMR) clinical data can be useful for chart review by clinicians for patient care, clinical decision support design, and data extraction for clinical research.  The EMR at Stanford Hospital allows the problem list to be modified in several ways: adding and deleting problems, and designating problems [...]

Background: Medication reconciliation at patient care transition points is a requirement of multiple regulatory bodies in medicine. In 2005 it was rated as the #8 National Patient Safety Goal by the Joint Commission and subsequently as the #3 goal in 2011. The Center for Medicare and Medicaid made medication reconciliation part of its Meaningful Use [...]

Background: About 209,000 adults experience an in-hospital cardio-pulmonary arrest (IHCA) every year in the US. Known early warning scoring systems (e.g., MEWS, eCART) have shown low efficiency in predicting a patient’s risk of deterioration. We assessed the possibility of using the Rothman Index (RI) as such a tool. Methods: We conducted a retrospective case-control study with 248 adult inpatients at Yale-New [...]

Background: Heparin-Induced Thrombocytopenia (HIT) is a rare (0.1-1% of heparinized medical patients) but devastating (up to 10% mortality) side-effect of heparin administration[1].  In thrombocytopenic patients, the pre-test probability of HIT is estimated by the validated “4Ts Score”, which is used to risk-stratify patients into Low (0-3 points), Intermediate (4-5 points), and High (6-8 points) likelihoods [...]

Background: Cardiac telemetry was originally designed to help detect and provide early intervention in arrhythmic complications of myocardial infarction. Today, however, telemetry use continues to expand beyond the critical and coronary care units, despite adequate research displaying questionable benefit. Our study seeks to assess the utility of telemetry in identifying decompensation in patients with documented [...]