Quality Assessment of Acute Inpatient Pain Management in an Academic Health Center.

The quality of acute inpatient pain management remains suboptimal and poorly understood. In this retrospective study, we analyze acute pain management practice in a large academic health center using several quality indicators. Not surprisingly, despite high rate of pain assessment, many patients still have frequent, prolonged, and unrelieved severe pain episodes.

The Barriers to High-Quality Inpatient Pain Management: A Qualitative Study.

The current literature suggests deficiencies in the quality of acute pain management among general medical inpatients. The aim of this qualitative study is to identify potential barriers to high-quality acute pain management among general medical inpatients at an urban academic medical center during a 2-year period. Data are collected using retrospective chart reviews, survey questionnaires, and semistructured, open-ended interviews of 40 general medical inpatients who have experienced pain during their hospitalization.

Anemia in general medical inpatients prolongs length of stay and increases 30-day unplanned readmission rate.

Objectives: Anemia, either chronic or newly developed in the hospital as a result of underlying disease and/or phlebotomy, is seen commonly among general medical inpatients, and its impact on the quality and efficiency of care is unknown.

Methods: This study investigated the relation among hemoglobin level, length of stay, and 30-day unplanned readmission rates in a cohort of 314 general medical inpatients 18 years old and older admitted to a teaching hospital during a period of 4 months in a large urban academic medical center, using retrospective chart review of the electronic health record.

Results: Anemia was common among this cohort of general medical inpatients (44.

Frequency and types of alerts for antibiotic prescribing in a neonatal ICU.

Sepsis in neonates is a significant problem that carries with it severe morbidity and mortality. Managing antibiotics in this population is therefore an important issue. We studied clinical alerts currently in place to support antibiotic prescribing in a neonatal intensive care unit in order to ensure that appropriate information is being provided in a way that is consistent with current recommendations.

Automated knowledge acquisition from clinical narrative reports.

Knowledge of associations between biomedical entities, such as disease-symptoms, is critical for many automated biomedical applications. In this work, we develop automated methods for acquisition and discovery of medical knowledge embedded in clinical narrative reports. MedLEE, a Natural Language Processing (NLP) system, is applied to extract and encode clinical entities from narrative clinical reports obtained from New York-Presbyterian Hospital (NYPH), and associations between the clinical entities are determined based on statistical methods adjusted by volume tests.

Alert override reasons: a failure to communicate.

In 2007, the Leapfrog CPOE standard required that all clinical alert overrides be accompanied by an override reason. We wanted to know how many of the free text comments left by clinicians were actually override reasons, and how many were other types of communication. We reviewed 3583 free text comments left voluntarily by clinicians while responding to an alert in a CPOE system.

Novel techniques for survey and classification studies to improve patient centered websites.

There is great interest in ascertaining patient perceptions in order to create more patient-friendly web resources. The recent proliferation of inexpensive web based data collection systems can facilitate this. Many quite sophisticated tools are commercially available.