Ruminating on soil carbon: Applying current understanding to inform grazing management.

Among options for atmospheric CO2 removal, sequestering soil organic carbon (SOC) via improved grazing management is a rare opportunity because it is scalable across millions of globally grazed acres, low cost, and has high technical potential. Decades of scientific research on grazing and SOC has failed to form a cohesive understanding of how grazing management affects SOC stocks and their distribution between particulate (POM) and mineral-associated organic matter (MAOM)-characterized by different formation and stabilization pathways-across different climatic contexts. As we increasingly look to grazing management for SOC sequestration on grazinglands to bolster our climate change mitigation efforts, we need a clear and collective understanding of grazing management's impact on pathways of SOC change to inform on-the-ground management decisions. We set out to review the effects of grazing management on SOC through a unified plant ecophysiology and soil biogeochemistry conceptual framework, where elements such as productivity, input quality, soil mineral capacity, and climate variables such as aridity co-govern SOC accumulation and distribution into POM and MAOM. To maximize applicability to grazingland managers, we discuss how common management levers that drive overall grazing pattern, including timing, intensity, duration, and frequency can be used to optimize mechanistic pathways of SOC sequestration. We discuss important research needs and measurement challenges, and highlight how our conceptual framework can inform more robust research with greater applicability for maximizing the use of grazing management to sequester SOC.

Navigating Alert Fatigue: A Case Study in Electronic Health Record Alert Design Optimization.

Clinical decision support (CDS) systems play a crucial role in enhancing patient outcomes, but inadequate design contributes to alert fatigue, inundating clinicians with disruptive alerts that lack clinical relevance. This case study delves into a quality improvement (QI) project addressing nursing electronic health record (EHR) alert fatigue by strategically redesigning four high-firing/low action alerts. Employing a mixed-methods approach, including quantitative analysis, empathy mapping sessions, and user feedback, the project sought to understand and alleviate the challenges posed by these alerts. Virtual empathy mapping sessions with clinical nurses provided valuable insights into user experiences. Qualitative findings, CDS design principles, and organizational practice expectations informed the redesign process, resulting in the removal of all four identified disruptive alerts and redesign of passive alerts. This initiative released 877 unactionable disruptive nursing hours, emphasizing the significance of proper alert design and the necessity for organizational structures ensuring sustained governance in healthcare system optimization.