Background: Complex non-pharmacologic interventions containing multiple, or bundled, components can successfully prevent and treat hospital-acquired delirium in older adults. However consistent implementation, and the measurement of compliance, of these bundled interventions can be challenging to sustain in hospital settings especially in presence of COVID-19. Developing workflows with a smaller sub-set of components that are feasible [...]

Background: Patient portal use has been associated with improved patient experience, safety, and health outcomes.1,2 To keep patients better connected to their providers, our institution aimed to expand MyChart utilization. We piloted a standard operating procedure (SOP) to enhance MyChart education and uptake among those admitted to an inpatient general medicine unit. Purpose: Our intervention [...]

Background: Clinicians face an overwhelming volume of communication through various channels, including phone calls, text messages, emails, in-person interruptions, and secure messaging systems. This information overload is increasing[1] and poses significant challenges. Despite the availability of communication tools, failures in communication remain the leading cause of preventable medical errors [2]. Secure messaging systems, while essential, [...]

Background: In hospital-based medicine, maintaining an open line of communication between inpatient teams and community pediatricians serves as an essential component of providing comprehensive patient care and ensuring continuity at time of discharge. At St. Louis Children’s Hospital, inpatient resident teams are responsible for providing timely communication with community pediatricians regarding major patient events. Despite [...]

Background:   Academic medical centers are complex healthcare delivery systems that are quickly adopting electronic health records (EHR) nationwide while still using alpha-numeric paging for physicians-in-training raised with cell phones, texting, messaging, and newer technologies.  Understanding workflow processes for these providers of patient care are key to finding solutions to improve healthcare quality and safety.   [...]

Background: Complex non-pharmacologic interventions containing multiple, or bundled, components can successfully prevent and treat hospital-acquired delirium in older adults. However consistent implementation, and the measurement of compliance, of these bundled interventions can be challenging to sustain in hospital settings especially in presence of COVID-19. Developing workflows with a smaller sub-set of components that are feasible [...]

Background: Despite widespread mandated use of Electronic Health Records (EHR), many residency programs struggle to find the best strategy to conduct EHR training. Traditional EHR training sessions are typically led by non-clinical IT staff and are often structured around software functionalities rather than clinical workflow. Furthermore, EHR training is often not customized to the needs [...]

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:  Most patient discharges(DC) from hospitals occur in the afternoons, thus creating patient flow and potentially patient safety issues. This creates increased ER boarding hours and delays interunit patient transfers between ICU, stepdown and medical units. Sick patients may not be getting the appropriate level of care due to lack of higher level of care beds. Purpose:  To increase [...]

Background: Acute Medical Assessment Units (AMAU) in the United Kingdom, Australia and New Zealand improve inpatient flow and quality. It is critical to spread such best practices. Qatar, a GCC state (Bahrain, Kuwait, Oman, Saudi Arabia, and UAE) has tremendous recent population growth stressing the healthcare system. Hamad General Hospital (HGH), the main national hospital, [...]