Background: Clinicians face an overwhelming volume of communication through various channels, including phone calls, text messages, emails, in-person interruptions, and secure messaging systems. This information overload is increasing[1] and poses significant challenges. Despite the availability of communication tools, failures in communication remain the leading cause of preventable medical errors [2]. Secure messaging systems, while essential, [...]

Background: Clinicians face an overwhelming volume of communication through various channels, including phone calls, text messages, emails, in-person interruptions, and secure messaging systems. This information overload is increasing[1] and poses significant challenges. Despite the availability of communication tools, failures in communication remain the leading cause of preventable medical errors [2]. Secure messaging systems, while essential, [...]

Background: Hospital reimbursement for medical necessity is based on the level of care a patient is receiving. In the electronic medical record (EMR), the level of care, inpatient or observation, is determined by a practitioner order or physician certification. The timeliness of this order is of utmost importance, as medical necessity is a dynamic status. [...]

Background: Hospitalist models have grown significantly since their inception in the mid-1990s. However, despite their widespread presence, hospitalists’ optimal workflows remain poorly studied and defined. This gap is particularly concerning given the increasing complexity of hospitalized patients. Without a clear understanding of optimal hospitalist work design, clinicians face an increased risk of unsafe workloads and [...]

Background: Effective discharge instructions are critical for safe patient transitions to outpatient care. However, patients may misunderstand the information they receive, particularly those with complex plans and limited English proficiency. The Institute for Healthcare Improvement and Solutions for Patient Safety recommend discharge instructions that outline the patient’s primary issue, care steps, signs of worsening, where [...]

Background: Hospitalists provide around-the-clock care for patients. There is a need to characterize the work and workflows of hospitalists during different times of the day in order to ensure that clinicians are tasked with workloads that enable safe patient care, alignment with quality goals, professional fulfillment, and efficient use of resources. While there are relatively [...]

Background: Traditional methods to elicit feedback on clinical decision support (CDS) tools lack specificity and actionable insights necessary to optimize hospitalist workflows and patient care (1,2). Alert fatigue—a significant issue among hospitalists—reduces provider satisfaction and jeopardizes patient safety by prompting clinicians to dismiss critical alerts (3). Purpose: This initiative aimed to implement and evaluate a [...]

Background: Secure text messaging platforms are increasingly replacing traditional paging systems for in-hospital communication1,2. At our institution, the number of secure texts per month nearly doubled from 4.4 million in September 2020 to 8.1 million in September 2023. This growing burden of automated notifications from secure texts without a framework to triage message urgency contributes [...]