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AHRQ Research Studies Date
Topics
- Arthritis (1)
- Behavioral Health (1)
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- (-) Children/Adolescents (5)
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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 5 of 5 Research Studies DisplayedBingham CA, Harris JG, Qui T
Pediatric Rheumatology Care and Outcomes Improvement Network's quality measure set to improve care of children with juvenile idiopathic arthritis.
The objective of this study was to describe the selection, development, and implementation of quality measures for juvenile idiopathic arthritis (JIA) by the Pediatric Rheumatology Care and Outcomes Improvement Network (PR-COIN), a multihospital learning health network. Clinicians in PR-COIN and parents of children with JIA collaboratively selected outcome quality measures and a committee of rheumatologists and data analysts developed operational definitions. Initial measures were clinical inactive disease, low pain score, and optimal physical functioning; the revised set included additional measures of disease activity, data quality, and a balancing measure. The authors concluded that PR-COIN's set of JIA quality measures is the first comprehensive set used at the point-of-care for a large cohort of JIA patients in a variety of pediatric rheumatology practice settings.
AHRQ-funded; HS021114.
Citation: Bingham CA, Harris JG, Qui T .
Pediatric Rheumatology Care and Outcomes Improvement Network's quality measure set to improve care of children with juvenile idiopathic arthritis.
Arthritis Care Res 2023 Dec; 75(12):2442-52. doi: 10.1002/acr.25168.
Keywords: Children/Adolescents, Arthritis, Quality Measures, Quality Improvement, Quality of Care, Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice
Woods-Hill CZ, Koontz DW, Colantuoni EA
Sustainability of the Bright STAR diagnostic stewardship program to reduce blood culture rates among critically ill children.
From 2017 to2020, 14 pediatric intensive care units (PICUs) participated in the Bright STAR (Testing Stewardship for Antibiotic Reduction) QI collaborative to reduce unnecessary blood cultures for PICU patients. The collaborative project found that 4 sites demonstrated a 33% decrease in blood culture rates and a 13% decrease in broad spectrum antibiotic use. The purpose of this current study was to assess whether sites sustained reduced blood culture rates after completion of the formal project. The study found that all sites had lower blood culture rates during the sustainability period when compared with the pre-implementation period. The blood culture rate increased 8% during the sustainability period compared with the postimplementation period but was 27% lower than during the pre-implementation period.
AHRQ-funded; HS025642.
Citation: Woods-Hill CZ, Koontz DW, Colantuoni EA .
Sustainability of the Bright STAR diagnostic stewardship program to reduce blood culture rates among critically ill children.
JAMA Pediatr 2023 Nov; 177(11):1234-37. doi: 10.1001/jamapediatrics.2023.3229..
Keywords: Children/Adolescents, Critical Care, Quality Improvement, Diagnostic Safety and Quality, Quality of Care
Xie A, Koontz DW, Colantuoni EA
Application of participatory ergonomics to the dissemination of a quality improvement program for optimizing blood culture use.
The overuse of blood cultures in pediatric ICUs (PICUs) may lead to the unnecessary utilization of antibiotics and related resistance to antibiotics. The purpose of this study was to utilize a participatory ergonomics (PE) approach to disseminate a quality improvement (QI) program for optimizing blood culture use in PICUs and assess the dissemination process and its impact on blood culture reduction. The study found that overall, the participating sites were able to implement the program successfully and reduce their blood culture rates from 149.4 blood cultures per 1,000 patient-days/month before implementation to 100.5 blood cultures per 1,000 patient-days/month after implementation. Differences in the dissemination process, as well as in local interventions and implementation strategies, were observed across sites. Site-specific variations in the rates of blood cultures were weakly negatively associated with the number of preintervention interactions with the coordinating team but not associated with their experiences with the six domains of the dissemination process or their interventions.
AHRQ-funded; HS025642; HS025238.
Citation: Xie A, Koontz DW, Colantuoni EA .
Application of participatory ergonomics to the dissemination of a quality improvement program for optimizing blood culture use.
Jt Comm J Qual Patient Saf 2023 Oct; 49(10):529-38. doi: 10.1016/j.jcjq.2023.06.004..
Keywords: Quality Improvement, Quality of Care, Children/Adolescents, Intensive Care Unit (ICU)
Hoffman JA, Pergjika A, Liu L
Standardizing and improving care for pediatric agitation management in the emergency department.
In the U.S., pediatric mental health emergency department (ED) visits are increasing, with a greater number of visits involving the prescription of medication for acute agitation. Well timed, consistent application of behavioral strategies and medications may decrease the need for physical restraint of pediatric patients. The purpose of this study was to standardize agitation management in a pediatric ED and decrease pediatric patient time in physical restraints. From September 2020 to August 2021, researchers implemented a quality improvement initiative followed by a 6-month maintenance period. A barrier evaluation discovered that agitation triggers were not adequately recognized, there were few activities provided for children during lengthy ED visits, ED staff did not have confidence in techniques for verbally deescalating events, choices for medication were not consistent, and medication administered took time to take effect. Consecutive interventions included the development of a pathway and order set for agitation care, optimization of workflows for child life and psychiatry, implementation of personalized de-escalation plans, and adding the medication droperidol to the ED formulary. The measures utilize din the study included standardization of medication choice for severe agitation and time in physical restraints. The study found that during the intervention and maintenance components, there were 129 ED visits with medication administered for severe agitation and 10 ED visits where physical restraints were used. Among ED visits with medication given for severe agitation, there was an increase from 8% to 88% in standardized medication choice (olanzapine or droperidol), and a decrease in mean minutes in physical restraints from 173 to 71.
AHRQ-funded; HS026385.
Citation: Hoffman JA, Pergjika A, Liu L .
Standardizing and improving care for pediatric agitation management in the emergency department.
Pediatrics 2023 Jul 1; 152(1). doi: 10.1542/peds.2022-059586..
Keywords: Children/Adolescents, Emergency Department, Behavioral Health, Quality Improvement, Quality of Care
Quigley DD, Slaughter ME, Qureshi N
Associations of pediatric nurse burnout with involvement in quality improvement.
The purpose of this study was to explore the relationships of inpatient pediatric nurse burnout with their perceptions on the importance of quality at the hospital, and with patient experience measurement, quality improvement (QI), unit culture, and staffing. The researchers implemented a cross-sectional study at an urban children's hospital and surveyed pediatric nurses about their perceptions including the Maslach Burnout Inventory. The study found that 27% of pediatric nurses reported burnout. Nurses who possessed greater confidence in patient experience measurement, received frequent patient experience performance reports, felt included in QI, and experienced QI efforts as integrated into patient care reported not being burned out when compared to those reporting burnout. Higher levels of open communication among nurses and unit-level teamwork were also related with lack of burnout, and a higher QI workload was related with burnout.
AHRQ-funded; HS025920.
Citation: Quigley DD, Slaughter ME, Qureshi N .
Associations of pediatric nurse burnout with involvement in quality improvement.
J Pediatr Nurs 2023 May-Jun; 70:e9-e16. doi: 10.1016/j.pedn.2022.11.001..
Keywords: Children/Adolescents, Burnout, Provider: Nurse, Quality Improvement, Quality of Care