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Enhancing the efficiency of family-centered rounds (FCRs) while ensuring timely patient care has been a focus of study over the past decade. We employed an Operations Research technique (i.e., simulation) to identify opportunities for improving rounding efficiency on our inpatient cardiology unit at Nationwide Children's Hospital (NCH).Through simulation of schedule-based rounds, our aims were to reduce the length of stay (LOS) and subsequent healthcare costs via (1) prioritizing rounds for [...]

Patient decompensation necessitating rapid response team (RRT) care in the hospital setting involves complex medical decision making, strong leadership skills, and precise communication where every second matters. However, RRT outcomes can vary based on leader training, knowledge, and experience. We designed five digital, condition-specific, guided algorithms to improve RRT care and compared user survey data among three physician cohorts across the clinical training spectrum to assess the practicality of real-world [...]

Clinical decision support systems (CDSS) have been suggested to be helpful in detecting and preventing drug-related problems such as adverse drug events (ADEs). However, patient participation systems monitoring self-reported data, such as symptoms, are still sparsely described in the literature.This study aimed to investigate if the use of a patient participating CDSS (PCDSS) can facilitate early detection of ADEs, thereby contributing to safer drug treatment in older adults.A 1-year prospective [...]

This study aimed to assess the effect of a passive, opt-in electronic health record (EHR)-based clinical decision support (CDS), the Chronic Pain OneSheet, on guideline-recommended chronic pain management in primary care.A pragmatic randomized controlled trial with a parallel group design was conducted between October 2020 and May 2022. Participants were 137 primary care clinicians (PCCs) treating qualifying patients with chronic pain at 25 primary care clinics within two academic health [...]

Electronic health records (EHRs) are intended to improve clinical practice, but excessive alerts can be counterproductive, leading to workarounds. The Mortality Surprise Question (MSQ), a tool for identifying patients who might benefit from early end-of-life discussions, was integrated into the Emergency Department (ED) EHR admission process.This study investigated how the staged implementation of a clinical decision support tool at the point of admission order entry affected ED clinician admission order [...]

Sepsis is a heterogeneous syndrome with high morbidity and mortality. Despite extensive clinical trials, therapeutic progress remains limited, in part due to the absence of actionable sepsis subtypes.This study aimed to evaluate the feasibility of using HL7 Fast Healthcare Interoperability Resources (FHIR) for prerandomization sepsis subtyping to support clinical trial enrichment across multiple health systems.Data from 765 encounters at two academic medical centers were analyzed. FHIR-based resources were extracted from [...]

Digital health tools, such as artificial intelligence scribes, offer significant potential to alleviate physician burnout and reduce administrative burdens associated with electronic health records. Despite their promise, Canadian health care organizations face challenges in establishing cohesive strategies for their effective implementation and evaluation.This paper explores actionable, organizational strategies to enhance physician wellness through digital health tools. It examines systemic barriers, promising practices, and infrastructure needs, culminating in five key recommendations [...]

End-of-life care (EoLC), such as advance care planning, advance directives, hospice, and palliative care consults, can improve patient quality of life and reduce costs, yet such interventions are underused. Machine learning-based prediction models show promise in identifying patients who may be candidates for EoLC based on increased risk of short-term (less than 1 year) mortality. Clinical decision support systems using these models can identify candidate patients at a time during [...]

Falls among adults over 60 are a global health concern, including Australia.This study aimed to investigate temporospatial fall alert patterns-across time and location-detected by ambient fall detection sensors in three Australian aged care settings, to inform fall prevention strategies.A mixed-methods approach was used to analyze fall alert patterns and fall risks. Ambient fall detection sensors collected data from three care settings (residential aged care facilities [RACFs], retirement villages [RVs], and [...]

The effective operation of magnetic resonance imaging (MRI) systems relies on physical interactions with complex imaging environments, equipment, and user interfaces (UIs). However, there is limited empirical data evaluating how physical interactions with MRI equipment and accessories, workspace configuration, MRI UI design, and technical proficiency influence clinical workflow.In this study, a cross-sectional survey was conducted among MRI end-users, across public and private health facilities (n = 13), using a structured questionnaire to [...]