Background: Joint Commission has identified “communication” as the third most frequent root cause of sentinel events.1 Alpha-numeric pagers are common for communication among healthcare professionals. Pagers are not HIPAA compliant and communication through pagers often lacks sufficient information for effective communication.2 Because pager communication is one-way, closed loop communication requires a return telephone call, disrupting [...]

Background: Physician handoffs between inpatient shifts influence safety and care quality. Handoffs are also at risk for communication failures. Poor care coordination and miscommunication cause 80% of sentinel events nationwide. The rise of the electronic medical record (EMR) presented an opportunity to standardize communication during handoffs. Unfortunately, this potential has thus far gone largely unrealized, [...]

Background: Treating alcohol withdrawal in the inpatient medical setting requires timely identification of the severity of alcohol withdrawal so appropriate treatment can be administered. Delayed or missed diagnosis can lead to increased morbidity and mortality, increased cost and length of stay, and ICU admissions. CIWA-Ar is the most commonly used scale, but it is lengthy [...]

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: Many efforts to improve bed availability in hospitals with high occupancy focus on encouraging providers to discharge patients earlier in the day without making substantial changes to workflows or to address barriers to patient care progression. Unfortunately, when this is most needed is often when teams are at their busiest with high census and [...]

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: 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 [...]