Background: Accurate, high-quality data is critical for work in quality improvement, research, and clinical operations. With an electronic health record (EHR), vast amounts of observational data are collected on patients every day. This data can provide actionable knowledge if an institution can successfully extract and analyze it. At our institution, which adopted the Epic EHR [...]

Background: Over the past fifty years, remote cardiac monitoring (“telemetry”) has become routine for many patients admitted to the hospital. Telemetry has many clinical benefits and is recommended by the American Heart Association for a limited set of indications, but is often inappropriately used. Overutilization of telemetry can lead to unnecessary tests and procedures, may [...]

Background: Reducing length of stay to improve access, minimize hospital-associated morbidity, and reduce cost is a top priority at many hospitals. Information about barriers and delays impacting discharge (i.e., arranging subacute nursing facility placement, setting up a new dialysis seat, receiving consult recommendations for discharge) is rarely documented and often obtained anecdotally or qualitatively. This [...]

Background: HEART and TIMI risk scores that include 12-lead electrocardiogram (ECG) changes and troponin I (cTnI) have been used to stratify patients presenting with chest pain that may indicate the presence of an acute coronary syndrome (ACS). It has been shown that the 12-lead electrocardiogram (ECG) can be derived (dECG) from 3 measured leads displayed [...]

Background: Medication alerts are one of the touted safety features with the electronic health record (EHR). With time, users tend to override the alerts, which leads to patient harm. The phenomenon of “alert fatigue” is well known to any practicing clinician. Frequent interruptions of little value train physicians to disregard alerts in favor of efficiency. [...]

Background: Deployment of Electronic Medical Records (EMR) consumes significant enterprise-wide resources. Hospitals may be reluctant to introduce further changes during the same year, including patient experience improvement initiatives. Deployment efforts may stretch clinical leaders who provide oversight on patient experience efforts. Lastly, EMR is noted to be a major source of provider burnout and deployment [...]

Background: Physicians are increasingly using the social media outlet, Twitter, as a medium to connect and engage. Specifically, Twitter-based journal clubs have created a space for clinicians, educators and researchers to disseminate and discuss recent research. Recognizing this developing landscape, the Journal of Hospital Medicine (JHM) began producing a CME-accredited Twitter-based journal club, called #JHMChat [...]

Background: Heart failure (HF) is a major public health concern that affects over 5 million adults in the US. HF is among the most common reasons for hospital admissions and presents a considerable cost burden to the medical system. Patients are stabilized and carefully monitored at the hospital but often go home without adequate follow-up [...]

Background: Healthcare research has traditionally relied upon data collected from clinical trials and data generated from patient registries and insurance claims to drive analyses. As electronic health records (EHR) and computerized physician order entry have proliferated, large quantities of healthcare data is being generated daily through their routine use. A form of “big data,” this [...]

Background: Centers for Medicare & Medicaid Services (CMS) reimbursement increasingly depends on patient satisfaction scores and readmission rates to incentivize high-quality inpatient hospital care. Providers are continuously implementing complementary interventions to improve patient satisfaction and reduce hospital readmissions. Post-discharge phone calls are a relatively simple intervention to implement that can potentially improve continuity of care [...]