Background: Routine patient care including vital signs checks, lab draws, medication administration, during the night contributes to the already disturbed sleep of inpatients. This study aimed to assess the performance of automated risk scores to stratify the risk of an overnight deterioration to better inform letting low-risk patients sleep and more intensively monitoring and/or intervening [...]

Background: Evidence-based guidelines/protocols for electrolyte replacement that safely encourage oral (PO) and/or intravenous (IV) dosing attain goal levels more successfully than standard care.1-17 PO is generally more comfortable and less dangerous than IV. Between 5/2017-11/2017, Jefferson dosed ~300,000 doses of potassium (K) and magnesium (Mg), with 30% and 19% of doses being PO, respectively. Guiding [...]

Background: Social determinants of health (SDOH) are thought to account for up to half of modifiable outcomes related to health. Children from minority groups and/or lower socioeconomic backgrounds are at higher risk for hospitalization. Efforts have been made to screen for social risk factors in the outpatient setting. However, few studies describe inpatient SDOH screening [...]

Background: Venous thromboembolism (VTE) is a prevalent and costly medical condition in hospitalized patients. Risk assessment tools like the Padua Predictive Score aim to differentiate low-risk and high-risk patients for targeted pharmaceutical prophylaxis (pPPX) administration. However, widespread adoption of risk assessment remains suboptimal. This study investigates HA VTE prophylaxis use in medicine inpatients within a [...]

Background: Sepsis is a major cause of mortality in hospitalized patients, and early treatment is critical to survival. However, there is a paucity of research on methods to assist real-time clinical decision-making for sepsis treatment. Utilizing data on patients who had sepsis in the ICU, we propose a novel data-driven framework for recommending treatments by [...]

Background: Thromboprophylaxis of hospitalized COVID-19 patients – including extended, post-discharge thromboprophylaxis in high-risk patients – has been evaluated in multiple randomized trials and incorporated into antithrombotic guidelines. Yet, provider adoption of best practices remains sub-optimal. Our aim was to assess whether an electronic health record (EHR)-agnostic clinical decision support (CDS) tool incorporating the validated IMPROVE-DD [...]

Background: Inadequate assessment and recognition of barriers to discharge at time of admission leads to delays in the discharge process and prolongation of hospital admissions. These delays are associated with multiple negative outcomes such as increased length of stay, decreased patient satisfaction, strain on hospital bed capacity, and higher readmission rates. Prior studies have shown [...]

Background: In-hospital patient deterioration, often unpredictable and multifaceted, presents a significant challenge in hospital medicine. Despite existing measures like illness severity scoring systems and rapid response teams (RRT), patient outcomes remain suboptimal. Delays in recognizing and treating worsening conditions lead to adverse effects and increased healthcare costs. Purpose: In our large healthcare system, covering two [...]

Background: Care of hospitalized patients with Sickle Cell Disease (SCD) presents unique challenges due to variability in care, the interplay of acute and chronic pain, and the complex social determinants of health among patients with SCD. Despite comprising only a small percentage of admissions at our academic medical center, admissions for acute SCD-related illnesses have [...]