Background: Hospital-acquired C. difficile colitis is associated with increased length of stay (LOS) and significant morbidity and mortality. During hospitalization, patients visit many procedural, diagnostic, and treatment areas throughout the hospital, presenting opportunities for spore contamination of surfaces and nosocomial disease transmission. We developed a novel methodology using electronic health record (EHR) data to map [...]

Background: There has been ample speculation about potential future applications of natural language processing and related technologies for clinical documentation, and yet the mechanics of clinical documentation have changed very little since the passage of the HITECH Act in 2009. Purpose: While awaiting the integration of more advanced technologies into electronic health records (EHRs), we [...]

Background: Frailty is linked to poor outcomes in older patients, especially those with multiple conditions. The electronic frailty index (eFI) is a validated tool based on the cumulative deficit model used to screen hospitalized patients at risk for poor outcomes1. The eFI relies on 35 ICD-10 codes associated with encounters across four domains (morbidity, sensory, [...]

Background: Hospitalized patients and their families often face challenges in accessing and understanding developments in care plans, test results, and interdisciplinary decisions made during their stay. This knowledge gap causes anxiety, confusion, and missed opportunities for shared decision-making. Enhanced interdisciplinary communication and transparency with patients positively impacts patient satisfaction, readmission rates, patient safety and adherence [...]

Background: Despite the widespread use of technology across our daily lives, many processes in the hospital remain manual and labor-intensive. As hospital medicine divisions grow, there is an increasing need for automated and scalable solutions. While many hospitals look to external vendors to provide automated solutions, these often lack customizability and gaps remain. Purpose: To [...]

Background: Hospital-acquired C. difficile colitis is associated with increased length of stay (LOS) and significant morbidity and mortality. During hospitalization, patients visit many procedural, diagnostic, and treatment areas throughout the hospital, presenting opportunities for spore contamination of surfaces and nosocomial disease transmission. We developed a novel methodology using electronic health record (EHR) data to map [...]

Background: Communicating to physicians about electronic health record (EHR) software updates is important for maintaining clinical workflow and preserving patient safety. However, reaching providers with mass e-mails is challenging; the optimal strategy for educating providers about EHR updates remains unclear. Purpose: Modify our communication strategy to improve inpatient physicians’ understanding of EHR software updates. Description: [...]

Background: One target for improvement of effective patient centered care on the inpatient medical ward is the mechanism for communication among the multidisciplinary care team (MCT).  The medical service at Stanford Hospital and Clinics recently implemented morning “team care rounds” (TCRs) that provided space for the MCT members, including the physician (MD), nurse (RN), case [...]

Background: In sepsis, every hour of delay in antibiotic administration after the onset of hypotension is associated with 4-7% increase in mortality, but little is known about the characteristics of patients with treatment delays. Our objective was to determine if septic adults presenting to the Emergency Department (ED) who receive antibiotics more than 60 minutes [...]

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: [...]