National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (9)
- (-) Adverse Events (44)
- Ambulatory Care and Surgery (1)
- Antibiotics (2)
- Blood Clots (4)
- Blood Thinners (2)
- Cancer (2)
- Cardiovascular Conditions (3)
- Catheter-Associated Urinary Tract Infection (CAUTI) (2)
- Children/Adolescents (2)
- Clinical Decision Support (CDS) (1)
- Colonoscopy (1)
- Comparative Effectiveness (3)
- Critical Care (1)
- Diagnostic Safety and Quality (3)
- Digestive Disease and Health (3)
- Education: Patient and Caregiver (1)
- Elderly (2)
- Electronic Health Records (EHRs) (4)
- Emergency Department (2)
- Evidence-Based Practice (1)
- Falls (7)
- Guidelines (4)
- Healthcare-Associated Infections (HAIs) (10)
- Healthcare Costs (2)
- Health Information Technology (HIT) (7)
- Health Promotion (1)
- Heart Disease and Health (1)
- Hospitalization (2)
- Hospital Readmissions (1)
- Hospitals (8)
- Injuries and Wounds (3)
- Inpatient Care (1)
- Intensive Care Unit (ICU) (2)
- Kidney Disease and Health (2)
- Medical Devices (1)
- Medical Errors (7)
- Medical Liability (1)
- Medication (12)
- Medication: Safety (6)
- Newborns/Infants (2)
- Outcomes (3)
- Patient-Centered Healthcare (1)
- Patient-Centered Outcomes Research (3)
- Patient and Family Engagement (2)
- Patient Safety (32)
- Pneumonia (1)
- Practice Patterns (1)
- (-) Prevention (44)
- Primary Care (1)
- Provider (1)
- Provider: Nurse (1)
- Provider: Pharmacist (1)
- Public Health (1)
- Quality Improvement (6)
- Quality Indicators (QIs) (1)
- Quality of Care (3)
- Respiratory Conditions (1)
- Risk (4)
- Screening (1)
- Shared Decision Making (1)
- Surgery (13)
- Teams (2)
- Telehealth (2)
- Tools & Toolkits (1)
- Urinary Tract Infection (UTI) (1)
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
26 to 44 of 44 Research Studies DisplayedOlsen MA, Nickel KB, Fraser VJ
Prevalence and predictors of postdischarge antibiotic use following mastectomy.
This study determined utilization, predictors, and outcomes of postdischarge prophylactic antibiotics after mastectomy with or without immediate breast reconstruction. The study conclude that prophylactic postdischarge antibiotics are commonly prescribed after mastectomy; immediate reconstruction is the strongest predictor. The authors recommended stewardship efforts in this population to limit continuation of prophylactic antibiotics after discharge are needed to limit antimicrobial resistance.
AHRQ-funded; HS019455.
Citation: Olsen MA, Nickel KB, Fraser VJ .
Prevalence and predictors of postdischarge antibiotic use following mastectomy.
Infect Control Hosp Epidemiol 2017 Sep;38(9):1048-54. doi: 10.1017/ice.2017.128.
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Keywords: Antibiotics, Healthcare-Associated Infections (HAIs), Medication, Patient Safety, Surgery, Injuries and Wounds, Prevention, Adverse Events, Risk
Costa DK, White MR, Ginier E
Identifying barriers to delivering the awakening and breathing coordination, delirium, and early exercise/mobility bundle to minimize adverse outcomes for mechanically ventilated patients: a systematic review.
The purpose of this review was to identify and catalog the barriers to the Awakening and Breathing Coordination, Delirium, and Early exercise/mobility bundle (ABCDE) delivery based on a widely used implementation framework, and to provide a resource to guide clinicians in overcoming barriers to implementation. It provides the first, to the authors’ knowledge, systematic differential diagnosis of barriers to ABCDE delivery, moving beyond the conventional focus on patient-level factors.
AHRQ-funded; HS024552.
Citation: Costa DK, White MR, Ginier E .
Identifying barriers to delivering the awakening and breathing coordination, delirium, and early exercise/mobility bundle to minimize adverse outcomes for mechanically ventilated patients: a systematic review.
Chest 2017 Aug;152(2):304-11. doi: 10.1016/j.chest.2017.03.054.
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Keywords: Respiratory Conditions, Adverse Events, Prevention, Outcomes
Rawat N, Yang T, Ali KJ
Two-state collaborative study of a multifaceted intervention to decrease ventilator-associated events.
Given strong national interest in improving ventilated patient care, the National Institute of Health and AHRQ funded a two-state collaborative to reduce ventilator-associated events. The researchers described the collaborative's impact on ventilator-associated event rates in 56 ICUs. They found that compliance with all evidence-based interventions improved over the course of the collaborative. This study is the largest to date affirming that best practices can prevent ventilator-associated events.
AHRQ-funded; 29032002T.
Citation: Rawat N, Yang T, Ali KJ .
Two-state collaborative study of a multifaceted intervention to decrease ventilator-associated events.
Crit Care Med 2017 Jul;45(7):1208-15. doi: 10.1097/ccm.0000000000002463.
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Keywords: Healthcare-Associated Infections (HAIs), Intensive Care Unit (ICU), Adverse Events, Patient Safety, Prevention
Shaw CA, Steelman VM, DeBerg J
Effectiveness of active and passive warming for the prevention of inadvertent hypothermia in patients receiving neuraxial anesthesia: a systematic review and meta-analysis of randomized controlled trials.
The purpose of this review is to answer the question: Does the type of warming intervention influence the frequency or severity of inadvertent perioperative hypothermia (IPH) in surgical patients receiving neuraxial anesthesia? The review concluded that during neuraxial anesthesia, active warming (AW) reduces IPH more effectively than passive warming. Even with AW, IPH persists in some patients.
AHRQ-funded; HS021422.
Citation: Shaw CA, Steelman VM, DeBerg J .
Effectiveness of active and passive warming for the prevention of inadvertent hypothermia in patients receiving neuraxial anesthesia: a systematic review and meta-analysis of randomized controlled trials.
J Clin Anesth 2017 May;38:93-104. doi: 10.1016/j.jclinane.2017.01.005.
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Keywords: Comparative Effectiveness, Prevention, Outcomes, Adverse Events, Patient Safety
Obremskey WT, Schmidt AH, O'Toole RV
A prospective randomized trial to assess oral versus intravenous antibiotics for the treatment of postoperative wound infection after extremity fractures (POvIV study).
The POvIV study is a prospective, multicenter, randomized trial to compare oral (PO) with intravenous (IV) antibiotic therapy in patients with postoperative wound infections after extremity fractures. This study will be the largest prospective randomized trial to evaluate the safety and effectiveness of PO antibiotic use for treatment of postoperative wound infections. Results will inform clinician decisions on antibiotic delivery in patients with postoperative wound infections.
AHRQ-funded; HS000029.
Citation: Obremskey WT, Schmidt AH, O'Toole RV .
A prospective randomized trial to assess oral versus intravenous antibiotics for the treatment of postoperative wound infection after extremity fractures (POvIV study).
J Orthop Trauma 2017 Apr;31 Suppl 1:S32-s38. doi: 10.1097/bot.0000000000000802.
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Keywords: Antibiotics, Surgery, Injuries and Wounds, Healthcare-Associated Infections (HAIs), Comparative Effectiveness, Medication, Patient Safety, Adverse Events, Prevention, Patient-Centered Outcomes Research, Outcomes
O'Toole RV, Joshi M, Carlini AR
Supplemental perioperative oxygen to reduce surgical site infection after high-energy fracture surgery (OXYGEN study).
This study is a clinical trial with a primary goal of assessing the efficacy of 2 different concentrations of perioperative oxygen in the prevention of surgical site infection (SSI) in adults with tibial plateau, pilon (tibial plafond), or calcaneus fractures at higher risk of infection and definitively treated with plate and screw fixation.
AHRQ-funded; HS000029.
Citation: O'Toole RV, Joshi M, Carlini AR .
Supplemental perioperative oxygen to reduce surgical site infection after high-energy fracture surgery (OXYGEN study).
J Orthop Trauma 2017 Apr;31 Suppl 1:S25-s31. doi: 10.1097/bot.0000000000000803.
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Keywords: Injuries and Wounds, Surgery, Healthcare-Associated Infections (HAIs), Prevention, Patient Safety, Adverse Events
Jones CE, Hollis RH, Gullick AA
Venous thromboembolic events: how low can you go?
This study evaluated postoperative venous thromboembolism (VTE) chemical prophylaxis adherence to assess the preventability of VTEs. It found that nearly half of patients who experienced postoperative VTEs received appropriate guideline-driven care. Most interruptions in chemical prophylaxis were justified medically. This further questions the preventability of postoperative VTEs and the utility of this outcome as a valid measure of hospital quality.
AHRQ-funded; HS013852.
Citation: Jones CE, Hollis RH, Gullick AA .
Venous thromboembolic events: how low can you go?
Am J Surg 2017 Apr;213(4):706-10. doi: 10.1016/j.amjsurg.2016.10.037.
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Keywords: Adverse Events, Blood Clots, Blood Thinners, Patient-Centered Outcomes Research, Prevention
Battles JB, Reback KA, Azam I
AHRQ Author: Battles JB, Reback KA, Azam I
Paving the way for progress: the Agency for Healthcare Research and Quality Patient Safety and Medical Liability Demonstration Initiative.
AHRQ launched the Patient Safety and Medical Liability (PSML) initiative in 2009. The papers in this issue cover a breadth of topics related to the PSML initiative. Members of the individual Demonstration project teams have authored the majority of the papers. Seven of these papers report outcomes associated with the individual Demonstrations and another four describe tools generated as a part of the interventions.
AHRQ-funded; 233201500029P.
Citation: Battles JB, Reback KA, Azam I .
Paving the way for progress: the Agency for Healthcare Research and Quality Patient Safety and Medical Liability Demonstration Initiative.
Health Serv Res 2016 Dec;51 Suppl 3:2401-13. doi: 10.1111/1475-6773.12632.
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Keywords: Adverse Events, Medical Errors, Medical Liability, Patient Safety, Prevention
Beckman MG, Abe K, Barnes K
AHRQ Author: Brady PJ
Strategies and partnerships toward prevention of healthcare-associated venous thromboembolism.
This issue of the Journal of Hospital Medicine showcases the initiatives of several of the CDC’s healthcare-associated venous thromboembolism (HA-VTE) prevention champions. The CDC and AHRQ are partnering to disseminate and promote these best practices. In addition to this challenge, the CDC, AHRQ and the Joint Commission Center for Transforming Healthcare are working on activities and programs dedicated to improving prevention of HA-VTE. They are summarized in the article.
AHRQ-authored.
Citation: Beckman MG, Abe K, Barnes K .
Strategies and partnerships toward prevention of healthcare-associated venous thromboembolism.
J Hosp Med 2016 Dec;11 Suppl 2:S5-s7. doi: 10.1002/jhm.2659.
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Keywords: Prevention, Blood Clots, Quality Improvement, Guidelines, Adverse Events
Subramaniam RM, Suarez-Cuervo C, Wilson RF
Effectiveness of prevention strategies for contrast-induced nephropathy: a systematic review and meta-analysis.
N-acetylcysteine, sodium bicarbonate, statins, and ascorbic acid have been studied for reducing contrast-induced nephropathy (CIN). This study evaluated the comparative effectiveness of interventions to reduce CIN in adults receiving contrast media. It concluded that the greatest reduction in CIN was seen with N-acetylcysteine plus IV saline in patients receiving LOCM and with statins plus N-acetylcysteine plus IV saline.
AHRQ-funded; 290201200007I.
Citation: Subramaniam RM, Suarez-Cuervo C, Wilson RF .
Effectiveness of prevention strategies for contrast-induced nephropathy: a systematic review and meta-analysis.
Ann Intern Med 2016 Mar 15;164(6):406-16. doi: 10.7326/m15-1456.
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Keywords: Adverse Events, Comparative Effectiveness, Kidney Disease and Health, Patient-Centered Outcomes Research, Prevention
Croft LD, Liquori M, Ladd J
The effect of contact precautions on frequency of hospital adverse events.
The researchers sought to determine whether use of contact precautions on hospital ward patients is associated with patient adverse events. They concluded that hospital ward patients on contact precautions were less likely to experience noninfectious adverse events during their hospital stay than patients not on contact precautions.
AHRQ-funded; HS018111.
Citation: Croft LD, Liquori M, Ladd J .
The effect of contact precautions on frequency of hospital adverse events.
Infect Control Hosp Epidemiol 2015 Nov;36(11):1268-74. doi: 10.1017/ice.2015.192.
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Keywords: Adverse Events, Patient Safety, Prevention, Hospitals
Thompson DA, Marsteller JA, Pronovost PJ
Locating errors through networked surveillance: A multimethod approach to peer assessment, hazard identification, and prioritization of patient safety efforts in cardiac surgery.
The objectives of the study were to develop a scientifically sound and feasible peer-to-peer assessment model that allows health-care organizations to evaluate patient safety in cardiovascular operating rooms and to establish safety priorities for improvement. It identified 6 top priority hazard themes: safety culture, teamwork and communication, infection prevention, transitions of care, failure to adhere to practices or policies, and operating room layout and equipment.
AHRQ-funded; HS013904.
Citation: Thompson DA, Marsteller JA, Pronovost PJ .
Locating errors through networked surveillance: A multimethod approach to peer assessment, hazard identification, and prioritization of patient safety efforts in cardiac surgery.
J Patient Saf 2015 Sep;11(3):143-51. doi: 10.1097/pts.0000000000000059..
Keywords: Patient Safety, Medical Errors, Adverse Events, Surgery, Cardiovascular Conditions, Prevention
Young RS, Gobel BH, Schumacher M
Use of the modified early warning score and serum lactate to prevent cardiopulmonary arrest in hematology-oncology patients: a quality improvement study.
The authors aimed to improve the early identification of clinically deteriorating hematology-oncology patients in order to prevent the development of critical illness and to facilitate timely intensive care unit (ICU) transfers. They used a protocol employing the Modified Early Warning Score and found that implementation of this protocol reduced codes and preventable codes without an associated increase in ICU transfers.
AHRQ-funded; HS000078.
Citation: Young RS, Gobel BH, Schumacher M .
Use of the modified early warning score and serum lactate to prevent cardiopulmonary arrest in hematology-oncology patients: a quality improvement study.
Am J Med Qual 2014 Nov-Dec;29(6):530-7. doi: 10.1177/1062860613508305.
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Keywords: Adverse Events, Cancer, Diagnostic Safety and Quality, Prevention, Quality Improvement
Fakih MG, Krein SL, Edson B
AHRQ Author: Battles JB
Engaging health care workers to prevent catheter-associated urinary tract infection and avert patient harm.
This article discusses catheter-associated urinary tract infection (CAUTI) prevention efforts, describes the national collaboration between different organizations, briefly reviews the technical and socio-adaptive components of the program, and specifically describes an approach to engaging health care workers as an essential part of CAUTI prevention and averting patient harm.
AHRQ-authored; AHRQ-funded; 290201000025I; 29032001T
Citation: Fakih MG, Krein SL, Edson B .
Engaging health care workers to prevent catheter-associated urinary tract infection and avert patient harm.
Am J Infect Control. 2014 Oct;42(10 Suppl):S223-9. doi: 10.1016/j.ajic.2014.03.355..
Keywords: Adverse Events, Catheter-Associated Urinary Tract Infection (CAUTI), Healthcare-Associated Infections (HAIs), Patient Safety, Prevention, Practice Patterns, Quality Improvement
Freedman JL, Faerber JI, Kang TI
Predictors of antiemetic alteration in pediatric acute myeloid leukemia.
The purpose of this study was to gain better knowledge of patient and cancer treatment factors associated with nausea/vomiting (NV) in order to enhance prophylaxis in children being treated for acute myeloid leukemia (AML). It found that treatment-related NV, as evidenced by antiemetic alterations, is more prevalent with increasing age.
AHRQ-funded; HS018425
Citation: Freedman JL, Faerber JI, Kang TI .
Predictors of antiemetic alteration in pediatric acute myeloid leukemia.
Pediatr Blood Cancer. 2014 Oct;61(10):1798-805. doi: 10.1002/pbc.25108..
Keywords: Adverse Drug Events (ADE), Adverse Events, Cancer, Children/Adolescents, Medication, Prevention
Huang LC, Conley D, Lipsitz S
The Surgical Safety Checklist and teamwork coaching tools: a study of inter-rater reliability.
The authors assessed the inter-rater reliability (IRR) of two novel observation tools for measuring surgical safety checklist performance and teamwork. They found that both the Checklist Coaching Tool and the Surgical Teamwork Tool demonstrated substantial IRR and required limited training to use, indicating that both instruments may be used to observe checklist performance and teamwork in the operating room. They recommended that further refinement and calibration of observer expectations, particularly in rating teamwork, could improve the utility of the tools.
AHRQ-funded; HS019631.
Citation: Huang LC, Conley D, Lipsitz S .
The Surgical Safety Checklist and teamwork coaching tools: a study of inter-rater reliability.
BMJ Qual Saf 2014 Aug;23(8):639-50. doi: 10.1136/bmjqs-2013-002446.
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Keywords: Patient Safety, Surgery, Tools & Toolkits, Teams, Adverse Events, Medical Errors, Prevention
Berger Z, Flickinger TE, Pfoh E
Promoting engagement by patients and families to reduce adverse events in acute care settings: a systematic review.
This review examined how interventions encouraging patient and family engagement have been implemented in controlled trials. Among 12 identified studies, the authors noted that definitions of patient and family engagement were lacking. They found insufficient high-quality evidence to inform real-world implementation and provided recommendations for further study.
AHRQ-funded; 290200710062I.
Citation: Berger Z, Flickinger TE, Pfoh E .
Promoting engagement by patients and families to reduce adverse events in acute care settings: a systematic review.
BMJ Qual Saf 2014 Jul;23(7):548-55. doi: 10.1136/bmjqs-2012-001769.
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Keywords: Adverse Events, Health Promotion, Patient and Family Engagement, Patient Safety, Prevention
Forrester SH, Hepp Z, Roth JA
Cost-effectiveness of a computerized provider order entry system in improving medication safety ambulatory care.
The study objective was to estimate the cost-effectiveness of computerized provider order entry versus traditional paper-based prescribing in reducing medications errors and adverse drug events in the ambulatory setting of mid-sized medical group. Using a decision-analytic model, the researchers found that the adoption of CPOE in the ambulatory setting provides excellent value for the investment.
AHRQ-funded; HS014739
Citation: Forrester SH, Hepp Z, Roth JA .
Cost-effectiveness of a computerized provider order entry system in improving medication safety ambulatory care.
Value Health. 2014 Jun;17(4):340-9. doi: 10.1016/j.jval.2014.01.009..
Keywords: Health Information Technology (HIT), Adverse Drug Events (ADE), Adverse Events, Medical Errors, Medication, Patient Safety, Healthcare Costs, Ambulatory Care and Surgery, Prevention
Hempel S, Newberry S, Wang Z
AHRQ Author: Spector WD
Hospital fall prevention: a systematic review of implementation, components, adherence, and effectiveness.
The authors sought to document systematically the implementation, components, comparators, adherence, and effectiveness of published fall prevention approaches in U.S. acute care hospitals. They found that most interventions included multiple components, and the pooled postintervention incidence rate ratio (IRR) was 0.77. They found no systematic association between implementation intensity, intervention complexity, comparator information, or adherence levels and IRR. They concluded that promising approaches exist, but better reporting of outcomes, implementation, adherence, intervention components, and comparison group information is necessary to establish evidence on how hospitals can successfully prevent falls.
AHRQ-authored; AHRQ-funded; 290201000017I.
Citation: Hempel S, Newberry S, Wang Z .
Hospital fall prevention: a systematic review of implementation, components, adherence, and effectiveness.
J Am Geriatr Soc 2013 Apr;61(4):483-94. doi: 10.1111/jgs.12169.
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Keywords: Adverse Events, Falls, Hospitals, Patient Safety, Prevention