Background: Hospital-acquired delirium is serious, leading to increased falls, pressure ulcers, length of stay (LOS), cost, patient institutionalization, and patient and caregiver distress. In addition, it is associated with mortality rates as high as 35-40% within one year in older patients who develop delirium. Because hospital-acquired delirium is often under-recognized and prevention and treatment involves [...]

Background: Digital bedside information displays can alert clinicians about patient safety hazards, but the unintended consequences of these interventions are not well understood. Introducing new digital interventions may have implications for clinician satisfaction with the electronic environment, clinical team communication, and patient-centered care. Toward greater understanding of these unintended consequences, we described the content, form, [...]

Background: In May 2022, Kaiser Permanente introduced “Enhanced Recovery Medical” (ERM). Modeled after “Enhanced Recovery After Surgery,” (ERAS), ERM aims to reduce hospital-acquired debility. Predefined ordersets and modified workflows help healthcare teams optimize elements key to recovery: nutrition, mobility, tethers, pain, sleep, and delirium. This ongoing quality improvement (QI) project examines how a resident-led initiative impacted co-resident [...]

Background: The prevalence of delirium among hospitalized patients ranges up to 56% and results in increased hospital mortality and duration of hospitalization. Symptoms of delirium may be subtle in early stages and may present clinically as hyperactive, hypoactive or mixed type. As such delirium often evades early detection. In addition, delirium in the hospital setting [...]

Background: Hospital-acquired venous thromboembolism (VTE) is a common complication that leads to prolonged hospitalizations 1 and increased morbidity and mortality 2. Data analyzed from the Computerized Registry of Patients with VTE (RIETE) suggests that 1 in every 3-4 patients with VTE develop this condition in the hospital 3. A study done using data collected from [...]

Background: As the day progresses, clinicians may experience decision fatigue that impairs clinical reasoning. Such impairment may exert its greatest effects on clinicians’ abilities to identify and effectively treat heterogeneous clinical syndromes with high diagnostic uncertainty, including sepsis. We therefore examined the association of time of day with antibiotic initiation among hospitalized ward patients with [...]