Background: Team-based approaches have been broadly promoted to improve healthcare delivery in the U.S. However, few studies have analyzed the complexities of team-based communication in the current healthcare delivery landscape of increasing electronic health record (EHR) use and the rapidly evolving EHR functionalities. Major hurdles to studying effective communication within and between healthcare teams include: [...]

Background: Electronic Health Records (EHR) systems are broadly used to support the delivery of patient care and to facilitate communication and coordination among providers.  The use of EHR has been demonstrated to improve health care quality and efficiency. However, the impact of how providers utilize EHRs and communicate information in care delivery remains unclear. Specifically, how do [...]

Background: Serious Illness Conversations (SICs) lead to a better understanding of patient values and preferences, improved patient and family satisfaction, and other benefits. Prognostic awareness and early identification of patients who may benefit from an SIC remains a challenge. Epic’s Risk of Unplanned Readmission (Readmission Risk Score), a composite score (0-100) that includes clinical factors [...]

Background: Hospitalized patients receiving direct oral anticoagulants (DOACs) sometimes require bridging with unfractionated heparin (UFH). Monitoring UFH with anti-Xa assays has been shown to correlate with better outcomes. However, DOACs interfere with anti-Xa assays resulting in inappropriate UFH dose adjustments that can negatively impact patient care. In 2015, we deployed an electronic health record (EHR) [...]

Background: Hospitalists spend a significant part of their workday interacting with the electronic medical record (EMR). Less is known regarding the details of the tasks that are performed during this interaction. In considering aspects of workflow and EMR usability, we sought to characterize how hospitalists spend time within the EMR, in terms of number of [...]

Background: Confidentiality within adolescent medicine is imperative in establishing a trusting patient-physician relationship. In April 2021, the 21st Century Cures Act granted patients’ guardians immediate access to select patient electronic medical records. Whereas Pediatric Hospital Medicine (PHM) history and physical (H&P) notes are visible to guardians, adolescent sensitive notes (ASN) remain confidential. At our institution, [...]

Background: As surgical and anesthetic practices have advanced, an increasing population of older adults with increased medical complexity are undergoing surgery. A significant portion of these patients may present to the hospital requiring urgent surgical intervention and there is an evolving and expanding role for hospitalists in preoperative risk assessment. However, there remains variable exposure [...]