Big brother or big opportunity? Utilization of EHR use metadata in the inpatient setting: A mixed methods study at 16 organizations.

Background: Clinician electronic actions within the electronic health record (EHR) are captured seamlessly in real-time during regular work activities in all major EHRs. Analysis of this EHR use metadata, such as audit log data, is increasingly used to understand the impact of work design on critical patient, workforce, and organizational outcomes.

Objective: Understand experiences and perspectives influencing the use and implementation of audit log data into practice.

Characterizing electronic messaging use among hospitalists and its association with patient volumes.

Background: Secure electronic messaging is increasingly being utilized for communications in healthcare settings. While it likely increases efficiency, it has also been associated with interruptions, high message volumes, and risk of errors due to multitasking.

Objectives: We aimed to characterize patterns of secure messaging among hospitalists to understand the volume of messages, message patterns, and impact on hospitalist workload.

Attention Among Health Care Professionals : A Scoping Review.

Background: The concept of attention can provide insight into the needs of clinicians and how health systems design can impact patient care quality and medical errors.

Purpose: To conduct a scoping review to 1) identify and characterize literature relevant to clinician attention; 2) compile metrics used to measure attention; and 3) create a framework of key concepts.

Data Sources: Cumulated Index to Nursing and Allied Health Literature (CINAHL), Medline (PubMed), and Embase (Ovid) from 2001 to 26 February 2024.

Virtual hospital care development and deployment: A rapid qualitative study of frontline clinicians and leaders.

Background: Virtual hospitalist programs are rapidly growing in popularity due to worsening clinician shortages and increased pressure for flexible work options. These programs also have the potential to establish sustainable staffing models across multiple hospitals optimizing cost. We aimed to explore the current state of virtual hospitalist services at various health systems, challenges and opportunities that exist in providing virtual care, and future opportunities for these types of services.

Decreasing Inappropriate Telemetry Use via Nursing-Driven Checklist and Electronic Health Record Order Set.

Introduction: Telemetry is ubiquitous in many hospitals despite widely acknowledged limitations, waste, and potential harm associated with inappropriate use. To curb overuse, guidelines such as the 2017 American Heart Association/American College of Cardiology (AHA/ACC) continuous telemetry monitoring practice standards have outlined appropriate telemetry use standards. This study aimed to perform two "plan-do-study-act" (PDSA) cycles and assess whether a nursing (RN)-driven checklist addressing appropriate telemetry use, combined with just-in-time education delivered via an electronic health record (EHR) order set modification, was efficacious in reducing inappropriate telemetry use within a level 1a Veterans Health Administration hospital.

Pain Control Disparities in Acute Pancreatitis.

Background and objective Patient treatments and outcomes have historically differed based on age, sex, race/ethnicity, and social factors, and there is a growing awareness that such disparities still exist. While prior studies have found that patients belonging to minority groups have their pain undertreated, few studies have evaluated pain control based on age, sex, body mass index (BMI), or presence of a substance use disorder (SUD). The studies that do exist have inconsistent results.

Does Osteopathic Manipulative Treatment Make a Neuropsychological Difference in Adults With Pain? A Rationale for a New Approach.

Cognitive impairment is common in patients with pain. While symptoms of pain are effectively treated with osteopathic manipulative treatment (OMT), the cognitive complaint is vastly ignored. Pain-induced cognitive dysfunction can be severe and is particularly apparent in working memory and attention.

Gram-Negative Pyomyositis in an Immunocompetent Patient.

Pyomyositis is an acute or sub-acute primary infection of the striated muscles. It is commonly misdiagnosed in its early stages due to its nonspecific presentation and lower suspicion among physicians when it comes to diagnosis. It has been historically associated with tropical climates but is being seen with increasing incidence in temperate regions.