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Children with a difficult airway are at high risk of decompensation in the setting of respiratory distress. Situational awareness among all team members, and a shared plan in case of an emergency, can reduce the chance of catastrophic outcomes.This study aimed to improve difficult airway situational awareness while minimizing alert burden in a quaternary care pediatric healthcare system through the application of clinical decision support (CDS).Three iterative designs were developed [...]

This study aims to tackle the critical challenge of adapting deep learning (DL) models for deployment in real-world healthcare settings, specifically focusing on catastrophic forgetting due to distribution shifts between hospital and non-hospital environments. Metabolic syndrome (MetS) is susceptible to misdiagnosis by DL models due to distribution shifts. This work demonstrates the potential of continual learning (CL) to enhance model performance in MetS identification across diverse settings.

The CONCERN Early Warning System (CONCERN EWS) is an artificial intelligence-based clinical decision support system (AI-CDSS) for the prediction of clinical deterioration, leveraging signals from nursing documentation patterns. While a recent multisite randomized controlled trial (RCT) demonstrated its effectiveness in reducing inpatient mortality and length of stay, evaluating implementation outcomes is essential to ensure equitable results across patient populations.This study aims to (1) assess whether clinicians' usage of the CONCERN [...]

The digitalization of health records stands to improve decision-making at clinical, administrative, and policy level. Efforts follow various paths and are closely intertwined with health system and organizational configurations. Problems persist in both uptake and use. This study explores the digitalization trajectories of academic health centers (AHCs) to understand tensions between organizational and government strategies and their impact on digital development.

To conduct a meta-ethnographic synthesis summarizing the overarching themes of the qualitative literature on nurse interaction with medication administration technologies (MAT) comprising electronic medication administration record (eMAR) and bar-coded medication administration (BCMA).

In dentistry, social determinants of health (SDoH) are potentially recorded in the clinical notes of electronic dental records. The objective of this study was to examine the availability of SDoH data in dental clinical notes and evaluate natural language processing methods to extract SDoH from dental clinical notes.A set of 1,000 dental clinical notes was sampled from a dataset of 105,311 patient visits to a dental clinic and manually annotated [...]

Inpatient hypoglycemia is associated with increased length of stay and mortality. There have been several models developed to predict a patient's risk of inpatient hypoglycemia.This study aimed to describe the barriers to implementing a model that we developed to predict inpatient hypoglycemic events informing a clinical decision support tool.A logistic regression model was trained on inpatient hospitalizations of diabetic patients receiving insulin at Atrium Health Wake Forest Baptist Medical Center [...]

Effective clinical decision support (CDS) interventions improve adherence to care guidelines, reduce prescribing errors, and, in some settings, decrease patient mortality. However, misalignment with the "Five Rights" framework, particularly regarding CDS timing in clinical workflows, can lead to implementation failures, alert fatigue, and physician burnout.This case series aimed to evaluate and redesign three interruptive CDS alerts at a large safety net health system to better align with clinician workflows, reduce [...]

Online healthcare portals provide access to electronic health information and support clinical communication. Almost no studies have examined perspectives on parental portal access. We aimed to characterize parental and adolescent perspectives on parental portal access.Semi-structured interviews with 51 dyads of parents and adolescents (102 total interviews). We stratified sampling for equal proportions of adolescents with and without chronic illnesses. We analyzed interview transcripts using thematic analysis.Parents and adolescents identified several [...]