Background: An estimated 20-30% of inpatient standing labs are medically unnecessary1, contributing to iatrogenic anemia2, sleep disruption3, and increased healthcare costs. The Society of Hospital Medicine identified routine repetitive complete blood count (CBC) and chemistry (BMP) as a common wasteful inpatient practice4. At our institution, repetitive inpatient CBC, BMP, magnesium, and phosphorus account for 500,000 [...]

Background: Opioid overdose is a well-established cause of morbidity and mortality in the United States1. Naloxone is an opioid antagonist and harm-reducing treatment with a complex history of prescribing behaviors, attitudes, availability and reimbursement2. Interventions to increase appropriate co-prescription of naloxone include government mandates3 and Electronic Health Record (EHR) clinical decision support4. Our institution used [...]

Background: Delirium is an acute, fluctuating confusional state that commonly develops in older and acutely ill hospitalized patients. This condition contributes to patient morbidity and mortality and substantial financial burden to the healthcare system through prolonged hospitalization and increased resource utilization. Clinical decision support within the electronic medical record (EMR) has shown potential to improve [...]

Background: In 2023, UVA Health’s Catheter-Associated Urinary Tract Infection (CAUTI) Coalition identified diagnostic stewardship as a contributing factor in 57% of all CAUTI events. An independent review of all CAUTIs involving hospitalist physicians from 2022-2023 found that diagnostic stewardship was a key driver. Inappropriate urine testing can lead to treating asymptomatic bacteriuria with antibiotics, which [...]

Background: Traditional methods to elicit feedback on clinical decision support (CDS) tools lack specificity and actionable insights necessary to optimize hospitalist workflows and patient care (1,2). Alert fatigue—a significant issue among hospitalists—reduces provider satisfaction and jeopardizes patient safety by prompting clinicians to dismiss critical alerts (3). Purpose: This initiative aimed to implement and evaluate a [...]