Publications
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Jun 30, 2025This multi-institutional study analyzed the readability of 120 breast radiology and pathology reports and 194 MedEd educational tools from the University of 麻豆传媒高清 and University of Miami. Findings revealed that most clinical reports exceeded a high school reading level, with surgical pathology reports being the most difficult to understand. While MedEd materials were more accessible, they still surpassed the recommended 6th-grade level. These results highlight a persistent gap in health literacy for breast cancer survivors. Future efforts, including AI integration and patient co-design, may help create more understandable materials that support empowerment and shared decision-making. -
May 29, 2025This Point-Counterpoint debate article explores whether secure messaging improves or hinders inpatient communication. Dr. Michelle Knees (IHQSE faculty) and co-authors examine the evidence behind this increasingly common communication tool. The "Point" argues that secure messaging supports collaboration and efficiency, while the "Counterpoint" raises concerns about cognitive load, interruptions, and patient safety. A shared rebuttal underscores the need for thoughtful implementation and institutional guidance. This balanced discussion reflects the evolving communication landscape in hospital medicine and highlights the need for evidence-based best practices. -
May 1, 2025To address rising opioid overdose rates, the study team developed and implemented an interruptive, electronic health record (EHR)-integrated clinical decision support (CDS) to increase buprenorphine treatment for opioid use disorder (OUD) in the emergency department. The CDS uses real-time EHR data to identify at-risk patients and guide clinicians through OUD evidence-based care pathways. This strategy significantly improved OUD treatment metrics and demonstrated high rates of adoption by providers. By balancing automation with clinician-driven decision-making, this approach offers a scalable, generalizable solution to address barriers in emergency department-initiated OUD care and supports a growing body of evidence for CDS as an effective implementation tool in high-acuity settings. -
Nov 13, 2024Clinical pathways translate best evidence into the local context through a structured multidisciplinary care plan. However, little is known about clinical pathway programs especially in pediatric settings. This study sought to determine the prevalence of clinical pathway programs in pediatric hospitals and describe similarities and differences. The team, led by IHQSE graduate, Dr. Leigh Anne Bakel, surveyed 81 of 111 Pediatric Research in Inpatient Settings (PRIS) network hospitals regarding the existence of a clinical pathway program, number, type, creation or revision of clinical pathways as well as other pathway program characteristics. More than half of respondents confirmed that clinical pathways were in place; however, nearly half of those programs were hindered by limited funding and an inability to measure pathway outcomes or improvements in care. -
Nov 11, 2024IHQSE faculty member, Dr. Katie Raffel, along with colleague Dr. Josu茅 Zapata, published a Leadership and Professional Development piece in Journal of Hospital Medicine, "Strategies to disagree productively: Persuasive DISNT". As providers, we often have experiences and insights that can improve how decisions are made within healthcare organizations. In expressing these perspectives, we may need to disagree. However, dissent is not always well-received. They discuss the need to: Determine value, Illustrate commitment, Show logic, Negotiate partnerships and Transform success into future impact in order to have the most success in disagreeing.
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Nov 7, 2024After observing a low but consistent rate of incorrect surgical line placement for pediatric cancer patients, IHQSE graduate Dr. Jonathan Roach and team implemented a new multi-factorial process to schedule and place surgical central lines. The intervention reduced the rate of incorrect line placement and near miss events to zero! IHQSE Faculty Dr. Tyler Anstett and Dr. Michael Tchou are coauthors of this publication in the Journal of the American College of Surgeons. -
Oct 31, 2024One of the greatest challenges in acute care is the ability to hire and retain nurses. With high turnover and a limited candidate pool, how do you build a highly reliable organization with fewer nurses? This advanced care setting calls for Bachelor-level nurses, but those can be hard to come by, and contract labor is expensive and unsustainable in the long term. IHQSE graduate, Stephanie Elston, MSN, and her team have built a model that optimizes support to the front-line staff, helping to relieve the disproportionate reliance on RNs. -
Oct 23, 2024Using patient-reported outcome measures to guide clinical care is associated with improved outcomes and widely regarded as a best practice in mental health. However, many systems have struggled to routinely adopt the practice. In an article in Psychiatric Services, IHQSE faculty, alumni, and members of the University of 麻豆传媒高清 Department of Psychiatry describe how they used technology to address major barriers to using this best practice in their design and implementation of the Measurement-Assisted Care (MAC) program. In MAC, patient-reported outcome measures are automatically attached to patient eCheck-in and clinician documentation templates nudge clinicians to view and discuss the responses during visits. MAC increased the availability of patient-reported outcome measures from 5% to 60%+ of patient visits with more than 90% of clinicians reporting the information was useful. -
Oct 14, 2024In-basket burden is frequently cited as a contributor to burnout. In a research letter published in JAMA Network Open, IHQSE graduate, Dr. Eden English, discusses her recent study of the use of large language models (LLMs) for drafting replies to patient messages within a large health system. -
Oct 2, 2024Secure messaging (SM) is becoming a common way for hospitalists to communicate, but most existing literature focuses on usage patterns and implementation science, without clear understanding of the benefits and challenges users may be encountering. IHQSE Faculty Michelle Knees, DO and team led a mixed methods study involving surveys and focus groups with hospitalists from 24 academic institutions, finding that, while SM enhances communication efficiency, it also increases multitasking, cognitive load, and alters interpersonal dynamics. The study underscores the need for clear institutional guidelines for SM use and emphasizes the importance of collaborating with frontline workers to improve communication practices.