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Objectives Improve concordance between patient end-of-life preferences and code status orders by incorporating data from a state registry with Clinical Decision Support (CDS) within the electronic health record (EHR) to preserve patient autonomy and ensure that patients receive care that aligns with their wishes. Methods Leveraging a Health Information exchange (HIE) interface between the New York State Medical Orders for Life-Sustaining Treatment (eMOLST) registry and the EHR of our academic [...]

This systematic literature review aims to critically evaluate the use of mathematical and simulation models within emergency departments (EDs) and assess their potential to improve the quality of care. This review emphasises the critical need for quality enhancement in healthcare systems, specifically focusing on EDs. This review incorporates studies investigating the quality of care provided in ED settings, employing assorted mathematical and simulation models for adult populations. Based on the [...]

Despite their potential, Clinical Decision Support (CDS) systems often lack alignment with clinicians' needs and are underutilised in practice. Pilot implementations can help to improve the fit between systems and local needs by engaging users in real-world testing and refinement. Although pilot implementations of CDS have been reported, limited evidence has explored the factors contributing to pilot success.

Nursing documentation burden is a growing point of concern in the United States healthcare system. Documentation in the electronic health record (EHR) is a contributor to perceptions of burden. Efficiency tools like flowsheet macros are one development intended to ease the burden of documentation.

This study compared the time efficiency of the hospital admission process using personal mobile devices to traditional walk-in methods, thereby assessing the effectiveness of the mobile admission process.

This study aims to evaluate the impact of using a large language model (LLM) for generating draft responses to patient messages in the electronic health record (EHR) system on clinicians and support staff workload and efficiency.

Interruptive alerts in clinical decision support (CDS) systems are intended to guide clinicians in making informed decisions and adhering to best practices. However, these alerts can often become a source of frustration, contributing to alert fatigue and clinician burnout. Traditionally, alert burden is often assessed by evaluating total firing counts, which can overlook the true impact of highly interruptive workflows. This study demonstrates how an alert burden metric was used [...]

Patient portals bridge patient and provider communications but exacerbate physician and nursing burnout. Large language models (LLMs) can generate message responses that are viewed favorably by healthcare professionals; however, these studies have not included diverse message types or new prompt-engineering strategies. Our goal is to investigate and compare the quality and precision GPT-generated message responses versus real doctor responses across the spectrum of message types within a patient portal.

Introduction While computerized provider order entry (CPOE) has become standard for medication, laboratory, referral, and imaging ordering, use in surgical case requests is not well described. Our many surgical clinics used varying workflows for case requests, leading to data duplication and data storage outside of the electronic health record (EHR). We hypothesized that a provider-entered order-based case request (OBCR) tool would improve data entry efficiency and provide a more comprehensive [...]

Registered nurses increasingly work in remote care and digital interaction roles, offering flexibility and expansion of their scope of practice. These roles may expose nurses to digital compassion fatigue, a phenomenon proposed to be characterized by the negative psychological and emotional impact of caring for patients remotely through the use technology.