Background: Hospitalists often care for patients with serious illness and commonly review and discuss advance care planning (ACP). Documented ACP conversations can be difficult to access in the electronic health record (EHR) due to the lack of a centralized location for ACP documentation and individual clinician practice variation leading to ACP documentation existing in multiple [...]

Background: Implementing technology with the goal of eliminating preventable hospital-acquired conditions (e.g., CAUTI, CLABSI, etc.) in the acute care setting is an ongoing challenge, but it is crucial to creating a safer healthcare system. Increasingly, organizations are collaborating with systems engineering, human factors, and data analytic experts to ensure successful design, development, and implementation of [...]

Background: Failure to follow-up results of laboratory tests pending at discharge (TPADs) can lead to patient harm. Numerous interventions have been proposed to improve follow-up. The Laboratory Medicine Best Practices (LMBP™) workgroup, sponsored by the Centers for Disease Control, commissioned a systematic review to address the impact of various interventions on TPAD documentation, communication, and [...]

Background: Clinicians rely on physiologic monitor alarms to notify them of their patients’ changing vital signs. Currently, alarms occur very frequently and usually do not warrant clinical intervention. High alarm burden can lead to alarm fatigue, often observed as a slower response or unintentional ignoring of clinically important alarms. For this reason, alarm fatigue has [...]

Background: Health information technology (HIT) has the potential to decrease rates of hospital-acquired conditions. The Patient Safety Learning Lab (PSLL) developed a suite of HIT tools to engage patients, families, and providers in identifying, assessing, and reducing patient safety threats. The goal of this current evaluation is to quantify the effects of this intervention on [...]

Background: Adverse events (AEs) are a major concern in the inpatient setting, with many considered preventable. The Patient Safety Learning Lab implemented a Patient Safety Dashboard integrated with our electronic health record as part of a suite of health information technology tools to reduce inpatient AEs. The goals of this evaluation were to understand patterns [...]

Background: Thromboprophylaxis of hospitalized COVID-19 patients – including extended, post-discharge thromboprophylaxis in high-risk patients – has been evaluated in multiple randomized trials and incorporated into antithrombotic guidelines. Yet, provider adoption of best practices remains sub-optimal. Our aim was to assess whether an electronic health record (EHR)-agnostic clinical decision support (CDS) tool incorporating the validated IMPROVE-DD [...]

Background: Adverse drug events are common during transitions of care and often due to patient misunderstanding of the medication regimen or non-adherence. Challenges exist that may influence the ability of new interventions to address this issue. As part of the Smart Pillbox study, a randomized controlled trial of an electronic pillbox, we explored barriers and [...]

Background: Health information technology (HIT) systems were created with the intent to improve efficiency and streamline clinical workflows. However, evidence suggests HIT systems are a significant source of clinician burnout (Adler-Milstein 2020). A thorough understanding of clinicians’ frustrations is necessary to develop solutions to improve HIT systems. In doing so, efforts from the clinical informatics [...]

Background: Health information technology (HIT) systems, though designed to improve clinical workflow efficiency, have ironically contributed to clinician burnout, especially among hospitalists who depend on these systems for patient care and coordination (Adler-Milstein 2020). Addressing these challenges requires a detailed, resource-intensive process to identify workflow inefficiencies. Because this process is difficult, it is often performed [...]