Learning health system research as a catalyst for promoting physician wellness: EHR InBasket Spring cleaning and team-based compassion practice.

Introduction: Addressing physician burnout is critical for healthcare systems. As electronic health record (EHR) workload and teamwork have been identified as major contributing factors to physician well-being, we aimed to mitigate burnout through EHR-based interventions and a compassion team practice (CTP), targeting EHR workload and team cohesion.

Methods: A modified stepped wedge-clustered randomized trial was conducted, involving specialties with heavy InBasket workloads.

Large Language Models for More Efficient Reporting of Hospital Quality Measures.

Hospital quality measures are a vital component of a learning health system, yet they can be costly to report, statistically underpowered, and inconsistent due to poor interrater reliability. Large language models (LLMs) have recently demonstrated impressive performance on health care-related tasks and offer a promising way to provide accurate abstraction of complete charts at scale. To evaluate this approach, we deployed an LLM-based system that ingests Fast Healthcare Interoperability Resources data and outputs a completed Severe Sepsis and Septic Shock Management Bundle (SEP-1) abstraction.

Leveraging Lean Methodology to Improve Compliance With Work-Hour Restrictions.

Importance: Since work-hour restrictions were instituted in 2003, sustainably complying with duty-hour regulations remains a challenge for general surgery residency programs across the nation.

Objective: To determine whether industry-based process improvement techniques could be leveraged to increase compliance with work-hour restrictions within a general surgery residency.

Design, Setting, And Participants: This quality improvement project using Lean methodology was conducted from October to November of the 2021 to 2022 academic year.

Antibody Levels from High-Throughput Variant-Specific SARS-CoV-2 Anti-Spike IgG and ACE2 Neutralization Assays Correlate with COVID Infection Risk in a Large Population.

Background: SARS-CoV-2 antibody levels have been proposed as a correlate of protection (CoP) from infection. Yet, large-scale prospective studies of cost-effective scalable antibody measures as predictors of infection under real-world conditions are limited. We examined whether antibody levels measured using high-throughput variant-specific SARS-CoV-2 anti-spike immunoglobulin G (IgG) and ACE2-neutralization assays correlate with cell-based neutralizing antibody (NAb) measurements, and whether they can serve as a reasonable CoP from SARS-CoV-2 infection.

Patient-Clinician Communication Interventions Across Multiple Primary Care Sites: A Cluster Randomized Clinical Trial.

Importance: Despite various attempts to improve patient-clinician communication, there has been limited head-to-head comparison of these efforts.

Objective: To assess whether clinician coaching (mobile application or in-person) is more effective than reminder posters in examination rooms and whether mobile app use is noninferior to in-person coaching.

Design, Setting, And Participants: A cluster randomized clinical trial with 3 arms.