Background: Deep vein thrombosis (DVT) is typically diagnosed from ultrasound (US) Doppler evaluation and anticoagulation therapy is the standard treatment to prevent life threatening pulmonary embolism (PE). In our hospital, the treating provider is alerted to the positive test result by phone and/or text in the imaging result. There is an absence of clinical decision [...]

Background: Deep vein thrombosis (DVT) is typically diagnosed from ultrasound (US) Doppler evaluation and anticoagulation therapy is the standard treatment to prevent life threatening pulmonary embolism (PE). In our hospital, the treating provider is alerted to the positive test result by phone and/or text in the imaging result. There is an absence of clinical decision [...]

Background: Over-testing leads to inflated direct and indirect costs of care. Re-ordering tests prior to a given recommended interval, whether secondary to a lack of awareness of information in the patient’s chart or a lack of knowledge of the given recommended interval, most often increases costs without benefiting patients. Best Practice Advisory (BPA) pop-ups and [...]

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: Daily lab (DL) overuse in hospitalized patients leads to increased costs and resource utilization, iatrogenic anemia, and patient discomfort. Those awaiting discharge to post-acute care, who experience frequent non-medical delays in discharge, may represent an important group of patients at risk of receiving unnecessary DL, especially labs on day of discharge (LOD). Best Practice [...]

Background: Ensuring compliance with CMS requirements for inpatient admission orders and improving medication reconciliation at discharge are crucial aspects of patient safety and regulatory adherence. However, challenges such as missing admission orders and medication errors during transitions of care persist. In response, we implemented two strategic EHR interventions, Best Practice Advisories (BPAs), to enhance workflows, [...]

Case Presentation: A 19-year-old male presented with three days of fevers, cough, and pleuritic chest pain. He had a history of cystic fibrosis (CF) with lung and pancreatic involvement and allergic bronchiopulmonary aspergillosis (ABPA). Home medications were albuterol, dornase alfa, 3% normal saline, inhaled tobramycin, voriconazole, and pancrelipase. He was febrile, tachycardic, and had diminished [...]

Background: Transthoracic echocardiogram (TTE) is a frequently used cardiovascular imaging test for hospitalized patients especially those with chronic heart failure. Over the past two decades, TTE orders increased at a rate of about 5-8% per year. A large component of this is repeat TTE orders, defined as orders done within one year of a prior [...]