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: Venous thromboembolism (VTE) is a serious and all too frequent hospital complication, therefore assessing each patient’s individual risk of VTE is an important part of their care.  Multiple models are available for risk assessment, however most not only include multiple data points requiring redundant entry, but can be labor intensive and time-consuming to complete on [...]

Background: Surgical risk stratification tools have existed since Goldman created the cardiac risk index in 1977. Since then, there has been a proliferation of risk calculators: the three most notable being the Revised Cardiac Risk Index (RCRI), the American College of Surgeons-Surgical Risk Calculator (ACS-SRC), and the Gupta Myocardial Infarction and Cardiac Arrest calculator (MICA). [...]

Background: Rapid Response System (RRS) was designed as a safety tool for early detection and intervention of a deteriorating patient on a general floor in a hospital and Modified Early Warning System (MEWS) scores can be used to identify these patients. Obstructive Sleep Apnea (OSA) has been described as an independent risk factor for long [...]

Background: Risk assessment for venous thromboembolism (VTE) is a part of every hospital admission. The workflow of who completes the assessment varies between hospitals, but often it is carried out by trainees. VTE risk assessment is further complicated by the variety of methods to identify those patients who are appropriate for chemoprophylaxis, mechanical prophylaxis, or [...]

Background: It is widely accepted that hospitalized patients warrant risk assessment for venous thromboembolism (VTE) upon hospital admission. Although many VTE risk assessment models include a patient mobility element for calculating risk, a standardized method of determining mobility is lacking. We sought to determine if physician assessment of anticipated patient mobility upon hospital admission using [...]

Background: Delirium is an acute change in mental status affecting 10-64% of hospitalized patients, and may be preventable in 30-40% cases. There was no standardized protocol for delirium at our hospital prior to 2014. In October 2013, we formed a task force for delirium prevention and early identification across 18 medical-surgical units in our hospital. [...]

Background: An estimated 1 in 5 patients are at risk for being readmitted to the hospital within 30 days of discharge. Readmissions put a large financial strain on the United States healthcare system and increase risk for poor patient care outcomes. The Centers for Medicare/Medicaid Services publicly report readmission data and have financial penalties for [...]

Background: Mortality risk assessment is crucial for predicting patient outcomes, assessing patient care delivery, and improving healthcare quality. Although high-quality medical documentation is critical for mortality risk assessment tools, provider documentation may be inconsistent, relies on coding teams for support, and may not directly reflect provider orders. Complete and precise documentation and coding can improve [...]

Case Presentation: A 28-year-old, 447 lb man with hypothyroidism and depression was hospitalized for neurosurgical intervention for severe lumbar spinal stenosis. He had one risk factor from the Revised Cardiac Risk Index due to the spinal procedure, and his EKG, echocardiogram, and renal function were normal. He had no history of diabetes, TIA/CVA, or cardiac [...]