Background: Complex non-pharmacologic interventions containing multiple, or bundled, components can successfully prevent and treat hospital-acquired delirium in older adults. However consistent implementation, and the measurement of compliance, of these bundled interventions can be challenging to sustain in hospital settings especially in presence of COVID-19. Developing workflows with a smaller sub-set of components that are feasible [...]

Background: Complex non-pharmacologic interventions containing multiple, or bundled, components can successfully prevent and treat hospital-acquired delirium in older adults. However consistent implementation, and the measurement of compliance, of these bundled interventions can be challenging to sustain in hospital settings especially in presence of COVID-19. Developing workflows with a smaller sub-set of components that are feasible [...]

Background: Hospital crowding and subsequent resource strain have been associated with worse patient outcomes and increased length of stay (1–3). As pediatric hospitals face an overwhelming respiratory illness surge in the wake of the COVID pandemic (4–6), improving hospital patient flow is all the more critical. Nonetheless, a substantial proportion of patients, nearly 1 in [...]

Background: Understanding patient readiness for discharge requires communication between the many disciplines who care for patients. Team members use different tools in the electronic health record (EHR) to document and communicate discharge-related information, which can result in inefficient communication, delays in discharge, and adverse patient outcomes. EHR-based discharge coordination tools have potential to improve discharge [...]

Background: Increased hospital capacity causes significant strain on medical institutions. Patients who are clinically ready for discharge but “stuck” awaiting post-acute resources are thought to contribute to this capacity strain. Here, we aim to provide a clinically relevant measurement of the prevalence (proportion of patients) and weight (proportion of days) for patients who have spent [...]

Background: Hospitals increasingly face capacity strain and challenges with patient flow, leading to emergency department (ED) crowding, ED boarding, and threats to patient safety and quality of care. ED boarding occurs from the time of the decision to admit until the patient arrives in an inpatient bed and is affected by many factors including discharge [...]

Background: Health information technology (HIT) systems were created with the intent to improve efficiency and streamline clinical workflows. However, evidence suggests HIT systems are a significant source of clinician burnout (Adler-Milstein 2020). A thorough understanding of clinicians’ frustrations is necessary to develop solutions to improve HIT systems. In doing so, efforts from the clinical informatics [...]

Background: Hospitals are facing increasing pressure to optimize throughput in order to reduce excess length of stay and improve emergency department (ED) boarding times. Improving coordination and throughput in complex organizations with multiple care sites can be particularly challenging. Health systems have implemented numerous initiatives to improve hospital throughput, but these efforts have mainly been [...]