Déjà Vu? How Might Lessons Learned from Electronic Health Record Implementation Apply to Artificial Intelligence?

Background: The US healthcare system is currently facing significant challenges in quality, affordability, and labor shortages. Artificial intelligence (AI) promises to transform healthcare delivery by making it safer, more effective, less wasteful, and more patient-centered. With more than $30 billion invested in healthcare AI companies in the past three years, the proliferation of AI solutions is expected to bring much-needed relief to the strained healthcare industry.

How can artificial intelligence decrease cognitive and work burden for front line practitioners?

Artificial intelligence (AI) has tremendous potential to improve the cognitive and work burden of clinicians across a range of clinical activities, which could lead to reduced burnout and better clinical care. The recent explosion of generative AI nicely illustrates this potential. Developers and organizations deploying AI have a responsibility to ensure AI is designed and implemented with end-user input, has mechanisms to identify and potentially reduce bias, and that the impact on cognitive and work burden is measured, monitored, and improved.

Use of Hospital Capacity Command Centers to Improve Patient Flow and Safety: A Scoping Review.

Objectives: Delayed emergency department (ED) and hospital patient throughput is recognized as a critical threat to patient safety. Increasingly, hospitals are investing significantly in deploying command centers, long used in airlines and the military, to proactively manage hospital-wide patient flow. This scoping review characterizes the evidence related to hospital capacity command centers (CCCs) and synthesizes current data regarding their implementation.

Impact of multidisciplinary team huddles on patient safety: a systematic review and proposed taxonomy.

Background: Despite significant advances, patient safety remains a critical public health concern. Daily huddles-discussions to identify and respond to safety risks-have been credited with enhancing safety culture in operationally complex industries including aviation and nuclear power. More recently, huddles have been endorsed as a mechanism to improve patient safety in healthcare.

Transforming concepts in patient safety: a progress report.

In 2009, the National Patient Safety Foundation's Lucian Leape Institute (LLI) published a paper identifying five areas of healthcare that require system-level attention and action to advance patient safety.The authors argued that to truly transform the safety of healthcare, there was a need to address medical education reform; care integration; restoring joy and meaning in work and ensuring the safety of the healthcare workforce; consumer engagement in healthcare and transparency across the continuum of care. In the ensuing years, the LLI convened a series of expert roundtables to address each concept, look at obstacles to implementation, assess potential for improvement, identify potential implementation partners and issue recommendations for action.

Enhancing problem list documentation in electronic health records using two methods: the example of prior splenectomy.

Background: Quality improvement professionals often choose between patient-specific interventions, like clinical decision support (CDS), and population-based interventions, like registries or care management. In this paper, we explore the synergy of these two strategies, targeting the problem of procedure documentation for patients with a history of splenectomy.

Methods: We developed a population health documentation (PHD) intervention and a CDS intervention to improve splenectomy documentation within our electronic health record.

Closing the Gap and Raising the Bar: Assessing Board Competency in Quality and Safety.

Background: Despite recognition of the important role that governance and executive leaders play in ensuring patient safety and quality, little research has examined leaders' involvement in these areas beyond surveys that assess higher-level knowledge and understanding of patient and workforce safety concepts.

Methods: A survey was sent to a convenience sample of board members and CEOs, as well as unpaired safety and quality leaders (SQLs). The survey included approximately 36 questions asking board members and other non-CEO executives their knowledge, understanding, and board activities related to safety and quality, and SQLs their perceptions of their own boards' knowledge, understanding, and activities related to safety and quality.

Effect of Pharmacist Counseling Intervention on Health Care Utilization Following Hospital Discharge: A Randomized Control Trial.

Background: Reduction in 30-day readmission rates following hospitalization for acute coronary syndrome (ACS) and acute decompensated heart failure (ADHF) is a national goal.

Objective: The aim of this study was to determine the effect of a tailored, pharmacist-delivered, health literacy intervention on unplanned health care utilization, including hospital readmission or emergency room (ER) visit, following discharge.

Design: Randomized, controlled trial with concealed allocation and blinded outcome assessors

Setting: Two tertiary care academic medical centers

Participants: Adults hospitalized with a diagnosis of ACS and/or ADHF.

Ambulatory Computerized Prescribing and Preventable Adverse Drug Events.

Background: Adverse drug events (ADEs) represent a significant cause of injury in the ambulatory care setting. Computerized physician order entry reduces rates of serious medication errors that can lead to ADEs in the inpatient setting, but few studies have evaluated whether computerized prescribing in the ambulatory setting reduces preventable ADE rates in ambulatory care.

Objective: To determine the rates of preventable ADEs before and after the implementation of computerized prescribing with basic clinical decision support for ordering medications.