National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Access to Care (3)
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- (-) Emergency Medical Services (EMS) (48)
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- Stroke (1)
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 48 Research Studies DisplayedChen SI, Wang Y, Dreyer R
Insurance and prehospital delay in patients </=55 years with acute myocardial infarction.
The authors assessed whether gender differences in health insurance help explain gender differences in delay in seeking care for patients with acute myocardial infarction (AMI) in the US and in Spain. They concluded that in the US, women were more likely than men to delay, although it was not explained by differences in insurance status. Further, the lack of gender differences in prehospital delays in Spain suggests that these differences may vary by health care system and culture.
AHRQ-funded; HS023000.
Citation: Chen SI, Wang Y, Dreyer R .
Insurance and prehospital delay in patients </=55 years with acute myocardial infarction.
Am J Cardiol 2015 Dec 15;116(12):1827-32. doi: 10.1016/j.amjcard.2015.09.018.
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Keywords: Healthcare Delivery, Emergency Medical Services (EMS), Health Insurance, Heart Disease and Health, Sex Factors
DeLia D, Wang HE, Kutzin J
Prehospital transportation to therapeutic hypothermia centers and survival from out-of-hospital cardiac arrest.
This study provides a real world evaluation of the effectiveness of post-arrest care in therapeutic hypothermia (TH) centers during a time of growing TH dissemination in the state of New Jersey. It concluded that post-arrest outcomes are more favorable at TH centers but these improved outcomes are not apparent until after hospital discharge.
AHRQ-funded; HS020097.
Citation: DeLia D, Wang HE, Kutzin J .
Prehospital transportation to therapeutic hypothermia centers and survival from out-of-hospital cardiac arrest.
BMC Health Serv Res 2015 Dec 2;15:533. doi: 10.1186/s12913-015-1199-z.
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Keywords: Cardiovascular Conditions, Comparative Effectiveness, Emergency Medical Services (EMS), Outcomes
McGeorge N, Hedge S, Berg RL
Assessment of innovative emergency department information displays in a clinical simulation center.
The authors assessed the functional utility of new display concepts for an emergency department information system created using cognitive systems engineering methods, by comparing them to similar displays currently in use. They found that participants using the new displays showed improved situation awareness, demonstrating that cognitive systems engineering methods can be used to create innovative displays that better support emergency medicine tasks, without increasing workload, compared to more standard displays.
AHRQ-funded; HS020433.
Citation: McGeorge N, Hedge S, Berg RL .
Assessment of innovative emergency department information displays in a clinical simulation center.
J Cogn Eng Decis Mak 2015 Dec;9(4):329-46. doi: 10.1177/1555343415613723.
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Keywords: Healthcare Delivery, Emergency Department, Emergency Medical Services (EMS), Health Information Technology (HIT)
Moore CL, Broder J, Gunn ML
Comparative effectiveness research: alternatives to "traditional" computed tomography use in the acute care setting.
The goal was to seek consensus in identifying and prioritizing research questions and themes that involve the comparative effectiveness of "traditional" computed tomography use versus alternative diagnostic strategies in the acute care setting. A modified Delphi technique was used that included input from emergency physicians, emergency radiologists, medical physicists, and an industry expert to achieve this.
AHRQ-funded; HS021271; HS023498.
Citation: Moore CL, Broder J, Gunn ML .
Comparative effectiveness research: alternatives to "traditional" computed tomography use in the acute care setting.
Acad Emerg Med 2015 Dec;22(12):1465-73. doi: 10.1111/acem.12831.
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Keywords: Comparative Effectiveness, Imaging, Critical Care, Emergency Medical Services (EMS)
McCabe AM, Kuppermann N
Generation of evidence and translation into practice: Lessons learned and future directions.
This article describes the experience of the Pediatric Emergency Care Applied Research Network (PECARN) in deriving and validating the traumatic brain injury prediction rules and how PECARN is translating these prediction rules into clinical practice. Furthermore, it discusses the potential for patient/parent shared decision-making with a focus on patient-centered outcomes in Emergency department research.
AHRQ-funded; HS023498.
Citation: McCabe AM, Kuppermann N .
Generation of evidence and translation into practice: Lessons learned and future directions.
Acad Emerg Med 2015 Dec;22(12):1372-9. doi: 10.1111/acem.12819.
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Keywords: Implementation, Evidence-Based Practice, Emergency Medical Services (EMS), Brain Injury, Children/Adolescents
Lewiss RE, Chan W, Sheng AY
Research priorities in the utilization and interpretation of diagnostic imaging: Education, assessment, and competency.
A group of radiologists, physicists, and emergency physicians convened at the 2015 Academic Emergency Medicine consensus conference to discuss and prioritize a research agenda related to education, assessment, and competency in ordering and interpreting diagnostic imaging. In this article, the authors review the supporting reliability and validity evidence and make specific recommendations for future research on the education, competency, and assessment of learning diagnostic imaging.
AHRQ-funded; HS023498.
Citation: Lewiss RE, Chan W, Sheng AY .
Research priorities in the utilization and interpretation of diagnostic imaging: Education, assessment, and competency.
Acad Emerg Med 2015 Dec;22(12):1447-54. doi: 10.1111/acem.12833.
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Keywords: Imaging, Education: Continuing Medical Education, Emergency Department, Emergency Medical Services (EMS), Healthcare Utilization, Health Services Research (HSR)
Lee DC, Carr BG, Smith TE
The impact of hospital closures and hospital and population characteristics on increasing emergency department volume: a geographic analysis.
The objective of this study was to test the association of hospital and population characteristics and the effect of hospital closures with increases in emergency department volume. Emergency volume increased nearly twice as fast at tertiary referral centers (4.8 percent) and nonurban hospitals (3.7 percent versus urban at 2.1 percent) after adjusting for other characteristics. The effect of hospital closures also strongly predicted variation in growth.
AHRQ-funded; HS018362; HS010914.
Citation: Lee DC, Carr BG, Smith TE .
The impact of hospital closures and hospital and population characteristics on increasing emergency department volume: a geographic analysis.
Popul Health Manag 2015 Dec;18(6):459-66. doi: 10.1089/pop.2014.0123.
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Keywords: Emergency Medical Services (EMS), Emergency Department, Hospitals, Access to Care
Melnick ER, Shafer K, Rodulfo N
Understanding overuse of computed tomography for minor head injury in the emergency department: a triangulated qualitative study.
The objective was to identify nonclinical, human factors that promote or inhibit the appropriate use of computed tomography (CT) in patients presenting to the emergency department (ED) with minor head injury. Five core domains emerged from the analysis: establishing trust, anxiety (patient and provider), constraints related to ED practice, the influence of others, and patient expectations.
AHRQ-funded; HS021271.
Citation: Melnick ER, Shafer K, Rodulfo N .
Understanding overuse of computed tomography for minor head injury in the emergency department: a triangulated qualitative study.
Acad Emerg Med 2015 Dec;22(12):1474-83. doi: 10.1111/acem.12824.
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Keywords: Emergency Medical Services (EMS), Imaging, Brain Injury, Shared Decision Making, Health Services Research (HSR)
Sanghavi P, Jena Newhouse, JP
Outcomes of basic versus advanced life support for out-of-hospital medical emergencies.
The researchers compared outcomes after advanced life support (ALS) and basic life support (BLS) in out-of-hospital medical emergencies. They found that advanced life support is associated with substantially higher mortality for several acute medical emergencies than BLS.
AHRQ-funded; HS022798.
Citation: Sanghavi P, Jena Newhouse, JP .
Outcomes of basic versus advanced life support for out-of-hospital medical emergencies.
Ann Intern Med 2015 Nov 3;163(9):681-90. doi: 10.7326/m15-0557..
Keywords: Elderly, Medicare, Emergency Medical Services (EMS), Outcomes
Stevens AD, Hernandez C, Jones S
Color-coded prefilled medication syringes decrease time to delivery and dosing errors in simulated prehospital pediatric resuscitations: a randomized crossover trial.
The study’s goal was to evaluate novel, prefilled medication syringes labeled with color-coded volumes corresponding to the weight-based dosing of the Broselow Tape, compared to conventional medication administration, in simulated prehospital pediatric resuscitation scenarios. It found that the novel syringes decreased time to medication administration and significantly reduced critical dosing errors by paramedics during simulated prehospital pediatric resuscitations.
AHRQ-funded; HS017526.
Citation: Stevens AD, Hernandez C, Jones S .
Color-coded prefilled medication syringes decrease time to delivery and dosing errors in simulated prehospital pediatric resuscitations: a randomized crossover trial.
Resuscitation 2015 Nov;96:85-91. doi: 10.1016/j.resuscitation.2015.07.035..
Keywords: Medication, Emergency Medical Services (EMS), Children/Adolescents, Medical Errors, Comparative Effectiveness
Wexler R, Hefner JL, Sieck C
Connecting emergency department patients to primary care.
The researchers developed and evaluated a system change innovation designed to remove system barriers to primary care access for Medicaid patients. The intervention did not decrease ED visits nor increase primary care use over the 12 months of the study period. The qualitative results provide insight into nonurgent ED utilization by patients with Medicaid, suggesting potential future interventions.
AHRQ-funded; HS020693.
Citation: Wexler R, Hefner JL, Sieck C .
Connecting emergency department patients to primary care.
J Am Board Fam Med 2015 Nov-Dec;28(6):722-32. doi: 10.3122/jabfm.2015.06.150044.
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Keywords: Emergency Department, Emergency Medical Services (EMS), Primary Care, Health Information Technology (HIT), Healthcare Utilization
Gabayan GZ, Derose SF, Chiu VY
Emergency department crowding and outcomes after emergency department discharge.
The researchers assess whether a panel of emergency department (ED) crowding measures, including 2 reported by the Centers for Medicare & Medicaid Services (CMS), is associated with inpatient admission and death within 7 days of ED discharge. Their findings suggest that ED length of stay is a proxy for unmeasured differences in case mix and challenge the validity of the CMS metric as a safety measure for discharged patients.
AHRQ-funded; HS018098.
Citation: Gabayan GZ, Derose SF, Chiu VY .
Emergency department crowding and outcomes after emergency department discharge.
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Keywords: Emergency Department, Emergency Medical Services (EMS), Hospital Discharge, Outcomes, Hospitalization
Werner NE, Holden RJ
Interruptions in the wild: development of a sociotechnical systems model of interruptions in the emergency department through a systematic review.
After a systematic review and synthesis of the literature and drawing on ergonomic concepts, the authors present a sociotechnical model of interruptions in complex settings that motivates new directions in research and design. The model conceptualizes interruptions as a process, not a single event, that occurs within and is shaped by an interacting socio-technical system and that results in a variety of interrelated outcomes.
AHRQ-funded; HS022916.
Citation: Werner NE, Holden RJ .
Interruptions in the wild: development of a sociotechnical systems model of interruptions in the emergency department through a systematic review.
Appl Ergon 2015 Nov;51:244-54. doi: 10.1016/j.apergo.2015.05.010..
Keywords: Emergency Department, Emergency Medical Services (EMS)
Tataris KL, Mercer MP, Govindarajan P
Prehospital aspirin administration for acute coronary syndrome (ACS) in the USA: an EMS quality assessment using the NEMSIS 2011 database.
The researchers sought to determine (1) the proportion of patients with suspected cardiac ischaemia who received aspirin and (2) patient and prehospital characteristics that independently predicted administration of aspirin. Patients living in the Southern region of the USA and patients with governmental (federally administered such as Veteran's Health Care, but not Medicare or Medicaid) insurance had the lowest odds of receiving aspirin.
AHRQ-funded; HS017965.
Citation: Tataris KL, Mercer MP, Govindarajan P .
Prehospital aspirin administration for acute coronary syndrome (ACS) in the USA: an EMS quality assessment using the NEMSIS 2011 database.
Emerg Med J 2015 Nov;32(11):876-81. doi: 10.1136/emermed-2014-204299.
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Keywords: Cardiovascular Conditions, Care Management, Emergency Medical Services (EMS), Heart Disease and Health, Healthcare Delivery, Medication
Vogel JA, Seleno N, Hopkins E
Denver ED Trauma Organ Failure Score outperforms traditional methods of risk stratification in trauma.
The objective of this study was to compare prognostic accuracies of the Denver Emergency Department (ED) Trauma Organ Failure (TOF) Score, ED Sequential Organ Failure Assessment (SOFA) score, and ED base deficit and ED lactate for inhospital mortality in adult trauma patients. It concluded that The Denver ED TOF Score more accurately predicts inhospital mortality in adult trauma patients compared to the other three.
AHRQ-funded; HS017526.
Citation: Vogel JA, Seleno N, Hopkins E .
Denver ED Trauma Organ Failure Score outperforms traditional methods of risk stratification in trauma.
Am J Emerg Med 2015 Oct;33(10):1440-4. doi: 10.1016/j.ajem.2015.07.006..
Keywords: Emergency Medical Services (EMS), Risk, Mortality, Comparative Effectiveness, Emergency Department
Le Grand Rogers R, Narvaez Y, Venkatesh AK
Improving emergency physician performance using audit and feedback: a systematic review.
The objective of the review was to assess the effect of audit and feedback on emergency physician performance and identify features critical to success. It concluded that the literature on audit and feedback in the ED reports positive results for interventions across numerous clinical conditions but without the standardized reporting sufficient for meta-analysis.
AHRQ-funded; HS021271.
Citation: Le Grand Rogers R, Narvaez Y, Venkatesh AK .
Improving emergency physician performance using audit and feedback: a systematic review.
Am J Emerg Med 2015 Oct;33(10):1505-14. doi: 10.1016/j.ajem.2015.07.039..
Keywords: Provider Performance, Emergency Medical Services (EMS), Emergency Department
Yanagizawa-Drott L, Kurland L, Schuur JD
Infection prevention practices in Swedish emergency departments: results from a cross-sectional survey.
This study aimed to estimate the extent to which Swedish EDs have adopted evidence-based measures to prevent healthcare-associated infections (HAIs). It found that thirty-nine percent of EDs participate in a project to improve hand hygiene compliance. Staff hand hygiene compliance rates were audited at least monthly in 45 percent of EDs. Forty-three percent reported a compliance rate of 80 percent or more.
AHRQ-funded; HS021616; HS020013.
Citation: Yanagizawa-Drott L, Kurland L, Schuur JD .
Infection prevention practices in Swedish emergency departments: results from a cross-sectional survey.
Eur J Emerg Med 2015 Oct;22(5):338-42. doi: 10.1097/mej.0000000000000159..
Keywords: Emergency Department, Emergency Medical Services (EMS), Healthcare-Associated Infections (HAIs), Prevention, Risk
Marin JR, Wang L, Winger DG
Variation in computed tomography imaging for pediatric injury-related emergency visits.
This study assessed variation in the use of computed tomography (CT) for pediatric injury-related emergency department (ED) visits. It found wide variation in CT imaging for pediatric injury-related visits not attributable solely to case mix. In multivariable analysis of nonpediatric EDs, trauma centers and nonacademic EDs were associated with CT use. Higher pediatric volume was associated with any CT use.
AHRQ-funded; HS023498.
Citation: Marin JR, Wang L, Winger DG .
Variation in computed tomography imaging for pediatric injury-related emergency visits.
J Pediatr 2015 Oct;167(4):897-904.e3. doi: 10.1016/j.jpeds.2015.06.052..
Keywords: Emergency Medical Services (EMS), Children/Adolescents, Children/Adolescents, Emergency Department, Imaging
Moreira ME, Hernandez C, Stevens AD
Color-coded prefilled medication syringes decrease time to delivery and dosing error in simulated emergency department pediatric resuscitations.
The study objective was to evaluate novel, prefilled medication syringes labeled with color-coded volumes corresponding to the weight-based dosing of the Broselow Tape, compared with conventional medication administration, in simulated pediatric emergency department (ED) resuscitation scenarios. It found that a novel color-coded, prefilled syringe decreased time to medication administration and significantly reduced critical dosing errors by emergency physician and nurse teams during simulated pediatric ED resuscitations.
AHRQ-funded; HS017526.
Citation: Moreira ME, Hernandez C, Stevens AD .
Color-coded prefilled medication syringes decrease time to delivery and dosing error in simulated emergency department pediatric resuscitations.
Ann Emerg Med 2015 Aug;66(2):97-106.e3. doi: 10.1016/j.annemergmed.2014.12.035..
Keywords: Emergency Medical Services (EMS), Adverse Drug Events (ADE), Medication, Children/Adolescents, Patient Safety
Smith-Bindman R, Moghadassi M, Griffey RT
Computed tomography radiation dose in patients with suspected urolithiasis.
The researchers determined the radiation doses of CT scans for suspected urolithiasis in the emergency department setting. They found that less than 8 percent of patients received appropriately low-dose CT for suspected urolithiasis. Furthermore, they found a 200-fold variation in dose between patients and a 5-fold variation in median dose across hospitals.
AHRQ-funded; HS019312.
Citation: Smith-Bindman R, Moghadassi M, Griffey RT .
Computed tomography radiation dose in patients with suspected urolithiasis.
JAMA Intern Med 2015 Aug;175(8):1413-6. doi: 10.1001/jamainternmed.2015.2697..
Keywords: Emergency Department, Guidelines, Imaging, Emergency Medical Services (EMS)
Peng J, Wheeler K, Shi J
Trauma with Injury Severity Score of 75: are these unsurvivable injuries?
This study aimed to assess the true mortality among patients with an ISS=75, and to examine the characteristics and primary diagnoses of these patients. Its results revealed that at least half of patients with an ISS=75 survived, demonstrating that the rationale for excluding patients with an ISS=75 from analysis is not always justified.
AHRQ-funded; HS022277.
Citation: Peng J, Wheeler K, Shi J .
Trauma with Injury Severity Score of 75: are these unsurvivable injuries?
PLoS One 2015 Jul 31;10(7):e0134821. doi: 10.1371/journal.pone.0134821..
Keywords: Mortality, Healthcare Cost and Utilization Project (HCUP), Trauma, Emergency Medical Services (EMS), Emergency Department
Eckerle MD, Namde M, Holland CK
Opportunities for earlier HIV diagnosis in a pediatric ED.
The researchers sought to determine whether there were opportunities for earlier HIV diagnosis in the PED for a cohort of young adults diagnosed with HIV. They concluded that there are opportunities for earlier diagnosis of HIV in PEDs, affirming the importance of HIV screening implementation in these settings. However, PEDs are unlikely to have the same frequency of contact with undiagnosed individuals as do adult EDs.
AHRQ-funded; HS021749.
Citation: Eckerle MD, Namde M, Holland CK .
Opportunities for earlier HIV diagnosis in a pediatric ED.
Am J Emerg Med 2015 Jul;33(7):917-9. doi: 10.1016/j.ajem.2015.04.006..
Keywords: Human Immunodeficiency Virus (HIV), Diagnostic Safety and Quality, Screening, Children/Adolescents, Emergency Medical Services (EMS)
Melnick ER, Keegan J, Taylor RA
Redefining overuse to include costs: a decision analysis for computed tomography in minor head injury.
This study was conducted to (1) determine the testing threshold for head computed tomography (CT) in minor head injury in the emergency department using decision analysis with and without costs included in the analysis. If only effectiveness is considered, current clinical decision rules might not provide a sufficient degree of certainty to ensure identification of all patients for whom the benefits of CT outweigh its risks.
AHRQ-funded; HS021271.
Citation: Melnick ER, Keegan J, Taylor RA .
Redefining overuse to include costs: a decision analysis for computed tomography in minor head injury.
Jt Comm J Qual Patient Saf 2015 Jul;41(7):313-22..
Keywords: Clinical Decision Support (CDS), Shared Decision Making, Imaging, Emergency Medical Services (EMS)
Akosa Antwi Y, Moriya AS, Simon K
AHRQ Author: Moriya AS
Changes in emergency department use among young adults after the Patient Protection and Affordable Care Act's dependent coverage provision.
The researchers evaluated the effect of the Patient Protection and Affordable Care Act insurance expansion on ED use among young adults. They found a modest decrease in ED use of young adults aged 19 to 25 years compared with those aged 27 to 29 years, particularly for less urgent conditions.
AHRQ-authored.
Citation: Akosa Antwi Y, Moriya AS, Simon K .
Changes in emergency department use among young adults after the Patient Protection and Affordable Care Act's dependent coverage provision.
Ann Emerg Med 2015 Jun;65(6):664-72.e2. doi: 10.1016/j.annemergmed.2015.01.010..
Keywords: Emergency Department, Emergency Medical Services (EMS), Health Insurance
Kim HS, Anderson JD, Saghafi O
Cyclic vomiting presentations following marijuana liberalization in Colorado.
This paper's primary objective was to determine the prevalence of patients presenting with cyclic vomiting before and after the liberalization of medical marijuana in Colorado in 2009. Its secondary objective was to describe the odds of marijuana use among cyclic vomiting visits in these same time periods. The researchers found that the prevalence of cyclic vomiting presentations nearly doubled after the liberalization of medical marijuana, with said patients more likely to endorse marijuana use.
AHRQ-funded; HS000078.
Citation: Kim HS, Anderson JD, Saghafi O .
Cyclic vomiting presentations following marijuana liberalization in Colorado.
Acad Emerg Med 2015 Jun;22(6):694-9. doi: 10.1111/acem.12655.
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Keywords: Adverse Drug Events (ADE), Complementary and Alternative Medicine, Emergency Medical Services (EMS), Policy, Substance Abuse