Background: Nebraska Medicine is dedicated to the continuous, goal-directed improvement of: 1. Central venous catheter (CVC) duration 2. Indwelling urinary catheter (IUC) duration 3. Telemetry duration 4. VTE prophylaxis 5. Non-violent restraint order renewal Clinical decision support (CDS) is a cornerstone of quality improvement efforts despite historically sub-optimal response rates. After 2 years of improvements [...]

Background: Inpatient physicians often discharge patients while diagnostic tests are still pending. The discharging attending is responsible for following-up these results, even if they have rotated off service. This can lead to delayed and/or missed detection of results, which impacts patient safety. It also creates a burden on physicians to check for results during time [...]

Background: Hospitalists balance efficiency and quality in their daily practice. How a physician’s time management affects care quality is unknown. Accordingly, we aimed to compare the EHR efficiency of hospitalists, as measured by their time spent within the EHR per day, with quality of care, as measured by readmission rates and patient satisfaction. Methods: Data [...]

Background: Hospitalized patients are often disrupted at night for routine medical care, some of which is unnecessary. These sleep disruptions have implications for patient satisfaction, delirium, mobility, immune status, as well as hospital outcomes such as length of stay and readmissions. Interventions to improve inpatient sleep would benefit from the ability to objectively measure sleep, [...]

Background: A somewhat under-discussed topic in EHR implementation is the safety and efficiency consequences of their lengthy build and implementation. After multiple years of stalled clinical innovation while IT staff dedicate their focus to EHR builds, hospital systems undergo an 8 – 16 hour downtime often followed by multiple planned and unplanned downtimes that can [...]

Background: In recent years, in large part due to reimbursement incentives, the healthcare industry has shifted focus from volume to quality of care, with patient satisfaction being a crucial part of the evaluation. There is growing recognition that patient satisfaction is at least in part linked to clinician satisfaction and burnout(1). Thus, there is a [...]

Background: As of 2017, 96% of non-federal acute care hospitals had an electronic health record (EHR). Hospitalists interact with the EHR for several hours each day. Many studies have suggested a direct correlation between physician burnout and frustrations with the EHR. Data has been published regarding physician time studies in the outpatient setting, but there [...]

Background: Cognitive load (CL) is increasing in healthcare leading to provider frustration and poor performance. Human factors design principles like cognitive load theory (CLT) may mitigate the negative impacts of CL. This study examined the impact of a post-hospital dashboard (PHD) designed using CLT on provider performance and perceptions of workload in the post-hospitalization visit. [...]