Background: One of the widely reported benefits of electronic health records (EHRs) is the ability to alert clinicians, especially regarding medication-related safety issues. However, soon after the installation of EHRs, the phenomenon of “alert fatigue” was realized. The Agency for Healthcare Research and Quality has shown clinicians override the vast majority of computerized physician order [...]

Background: Use of stigmatizing language in clinical note documentation is a recognized problem, but such notes may be viewed disparately and irregularly. Whether such language is also used in highly visible behavioral alerts (BAs), which are presented forcefully through push notifications and viewed repeatedly whenever a chart is opened, is unknown. Further, whether BAs with [...]

Background: In order to reduce overuse, many hospitals have conducted studies and implemented protocols with the goal of reducing non-indicated telemetry monitoring. A common tool that institutions utilize for these changes are the clinical decision support systems (CDSS). In this report, we will present the telemetry protocol utilized by our hospital and review its effects [...]

Background: Early identification of sepsis is the main driver for patient survival. Roughly 30% of patients diagnosed with severe sepsis do not survive. To drive the desired clinical behavior, it is crucial to identify appropriate sensitivity and specificity of a sepsis early detection system. At our institution, we saw a 515% increase in Sepsis Alerts [...]

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: Advance care planning (ACP) conversations are essential for aligning care with patients’ values, particularly for high-risk hospitalized patients. However, there are limited tools in hospital medicine to identify and prompt clinicians to engage in ACP conversations effectively. Best Practice Alerts (BPAs) are commonly used in electronic medical records (EMRs) to streamline clinical workflows but [...]