{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,6,15]],"date-time":"2024-06-15T20:33:15Z","timestamp":1718483595279},"reference-count":27,"publisher":"Georg Thieme Verlag KG","issue":"02","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Appl Clin Inform"],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2003Drug alerts are clinical decision support tools intended to prevent medication misadministration. In teaching hospitals, residents encounter the majority of the drug alerts while learning under variable workloads and responsibilities that may have an impact on drug-alert response rates.<\/jats:p><jats:p>\n          Objectives\u2003This study was aimed to explore drug-alert experience and salience among postgraduate year 1 (PGY-1), postgraduate year 2 (PGY-2), and postgraduate year 3 (PGY-3) internal medicine resident physicians at two different institutions.<\/jats:p><jats:p>\n          Methods\u2003Drug-alert information was queried from the electronic health record (EHR) for 47 internal medicine residents at the University of Pennsylvania Medical Center (UPMC) Pinnacle in Pennsylvania, and 79 internal medicine residents at the MetroHealth System (MHS) in Ohio from December 2018 through February 2019. Salience was defined as the percentage of drug alerts resulting in removal or modification of the triggering order. Comparisons were made across institutions, residency training year, and alert burden.<\/jats:p><jats:p>\n          Results\u2003A total of 126 residents were exposed to 52,624 alerts over a 3-month period. UPMC Pinnacle had 15,574 alerts with 47 residents and MHS had 37,050 alerts with 79 residents. At MHS, salience was 8.6% which was lower than UPMC Pinnacle with 15%. The relatively lower salience (42% lower) at MHS corresponded to a greater number of alerts-per-resident (41% higher) compared with UPMC Pinnacle. Overall, salience was 11.6% for PGY-1, 10.5% for PGY-2, and 8.9% for PGY-3 residents.<\/jats:p><jats:p>\n          Conclusion\u2003Our results are suggestive of long-term drug-alert desensitization during progressive residency training. A higher number of alerts-per-resident correlating with a lower salience suggests alert fatigue; however, other factors should also be considered including differences in workload and culture.<\/jats:p>","DOI":"10.1055\/s-0041-1729167","type":"journal-article","created":{"date-parts":[[2021,4,29]],"date-time":"2021-04-29T02:09:30Z","timestamp":1619662170000},"page":"355-361","source":"Crossref","is-referenced-by-count":4,"title":["Drug Alert Experience and Salience during Medical Residency at Two Healthcare Institutions"],"prefix":"10.1055","volume":"12","author":[{"given":"Kinjal","family":"Gadhiya","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Pittsburgh Medical Center Pinnacle Harrisburg, Pennsylvania, United States"}]},{"given":"Edgar","family":"Zamora","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Pittsburgh Medical Center Pinnacle Harrisburg, Pennsylvania, United States"}]},{"given":"Salim M.","family":"Saiyed","sequence":"additional","affiliation":[{"name":"Department of Clinical Informatics, University of Pittsburgh Medical Center Pinnacle, Harrisburg, Pennsylvania, United States"}]},{"given":"David","family":"Friedlander","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, The MetroHealth System, Case Western Reserve University, Cleveland, Ohio, United States"}]},{"given":"David C.","family":"Kaelber","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, MetroHealth System, Case Western Reserve University, Cleveland, Ohio, United States"},{"name":"Population and Quantitative Health Sciences, MetroHealth System, Case Western Reserve University, Cleveland, Ohio, United States"},{"name":"Center for Clinical Informatics Research and Education, MetroHealth System, Case Western Reserve University, Cleveland, Ohio, United 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