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This study aims to 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.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 [...]

The purpose of this systematic literature review is 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 emphasizes the critical need for quality enhancement in health care systems, with a specific focus on EDs.This review incorporates studies that have investigated the quality of care provided in ED settings, employing assorted mathematical and simulation [...]

Despite their potential, Clinical Decision Support (CDS) systems often lack alignment with clinicians' needs and are underutilized 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.This study aimed to explore the opportunities and challenges associated with the pilot [...]

Nursing documentation burden is a growing point of concern in the United States health care 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 aimed to evaluate whether flowsheet macros, a documentation efficiency tool in the EHR that consolidates documentation into a single click, reduces the time spent [...]

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 retrospective study was conducted at Chung-Ang University Gwangmyeong Hospital in South Korea (August 2022-January 2023). Turnaround times for the walk-in and mobile admission processes were compared. Patients were divided into mobile and walk-in groups based on their admission process. Collected timestamp data [...]

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.We partnered with Epic Systems to implement OpenAI's ChatGPT 4.0 for responding to patient messages. A pilot study was conducted from August 2023 to July 2024 across 13 ambulatory specialties involving 323 participants, including clinicians [...]

As healthcare delivery becomes increasingly digital, nursing informatics knowledge has become essential for nurses to participate effectively in digitally enabled healthcare environments. The Canadian Association of Schools of Nursing (CASN) released updated nursing informatics entry-to-practice competencies in 2025 to inform nursing education in Canada. However, the integration of informatics knowledge and content into nursing curricula and professional practice education remains inconsistent. Mapping the teaching strategies used by nursing educators to [...]

Electronic patient-reported outcome measures (ePROMs) can improve care for people with cancer, but effectiveness hinges on well-supported integration in clinical settings.We evaluated clinician use of specific clinical decision support (CDS) tools in the electronic health record (EHR) designed to facilitate timely, clinically appropriate responses to ePROM scores for six symptoms commonly experienced by cancer patients.The parent pragmatic trial, which took place at Mayo Clinic (Rochester, Minnesota, United States) and its [...]