Background: Bedside nurses often communicate via alphanumeric (text) paging with hospitalists and other providers. To help the nurse and provider triage the urgency of these messages, our institution has implemented a tiered paging labeling system based on message priority, but the use of this labeling system and the concordance between provider perception and nurse perception [...]

Background: Early warning scores are clinical decision support tools that incorporate multiple physiologic variables to detect patient deterioration. Previous studies have highlighted the value of integrating measures of provider intuition into predictive models. (1-3) For example, incorporating the Patient Acuity Rating, a Likert-based measure of nurse worry, into the six-variable Modified Early Warning Score (MEWS) [...]

Background: The volume of opioid prescriptions in the US has increased dramatically over the last two decades, and strong evidence suggests that this has perpetuated opioid misuse, addiction, overdose, and drug-related deaths. We aimed to learn if there are differences in opioid prescribing among generalist physicians, NPs, and PAs to Medicare beneficiaries. Methods: We performed [...]

Background: Few studies have demonstrated effective hospital mobility programs, despite the overwhelming evidence that hospital mobility leads to better patient outcomes. The objective of this study was to explore factors that contribute to whether or not patients move their recommended amounts while in the hospital. Methods: A convenience sample of 6 acute care nurses completed [...]

Background: The nature of the Advanced Practice Provider (APP) and attending physician (MD) relationship is that of trust, mutual respect, and delegation. In U.S. territories where MD supervision or oversight of APP practice is required by law, MDs are left to trust and delegate patient care tasks and authority to their collaborating APPs while sharing [...]

Background: We observed that clinical pages in our institution on both medical and surgical services do not always reach the primary inpatient provider. Because we use pagers to communicate critical, time-sensitive information, delayed or misdirected communication can adversely impact patient care. Purpose: Our goal was to quantify the frequency with which pages did not reach [...]

Background: Patient safety assistants (PSAs), or “sitters,” observe patients at bedside considered at “high risk” for in-hospital events [1] such as falls or elopements. While studies suggest PSAs do not impact safety outcomes,[2-4] they are widely utilized without formal guidelines.[2, 5, 6] With increasing healthcare costs and limited resources, efficient care models are sought.[1, 2, [...]

Background: The placement of peripherally inserted central catheters (PICCs) is increasingly performed primarily by vascular access nurses (VAN) in United States hospitals1. Despite the increased use of these specially trained clinicians, little is known about the patient and device characteristics of the PICCs they placed compared to those placed by interventional radiology (IR) providers. While [...]

Background: In the hospital care setting, clinician groups employ a range of staffing models utilizing physicians as well as advanced practice providers (APPs), to meet patient care needs. Models have evolved in recent years in part due to pandemic related staffing constraints; proposed policy changes to billing practices may also be contributing. The Centers for [...]

Background: It is challenging for patients to navigate through complex healthcare systems after-hours. This leads to delays in patient care, patient/provider dissatisfaction, inappropriate resource utilization, readmissions, and higher healthcare costs. Prior to August 2015, non-medical staff at external call centers with invalidated standard work, poor work cell co-location, and inadequate active daily management addressed the [...]