National Healthcare Quality and Disparities Report
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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
751 to 775 of 795 Research Studies DisplayedCampbell LJ, Li Q, Li Y
Healthcare worker influenza vaccination in Oregon nursing homes: correlates of facility characteristics.
The authors identified nursing home (NH) characteristics that may be associated with employee influenza vaccination rates (EVRs). They concluded that, as NHs generally have low EVRs, it may be necessary to target low-performing facilities to achieve substantial improvements.
AHRQ-funded; HS000044.
Citation: Campbell LJ, Li Q, Li Y .
Healthcare worker influenza vaccination in Oregon nursing homes: correlates of facility characteristics.
J Am Med Dir Assoc 2014 Oct;15(10):768-72. doi: 10.1016/j.jamda.2014.06.005.
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Keywords: Provider: Health Personnel, Influenza, Nursing Homes, Prevention, Vaccination
Battles JB, Cleeman JI, Kahn KL
AHRQ Author: Battles JB
Introduction to "preventing healthcare-associated infections: results and lessons learned from AHRQ's HAI program".
This article introduces a special issue with 18 articles emanating from a synthesis of an AHRQ-funded healthcare-associated infections (HAI) project conducted by IMPAQ International and the RAND Corporation. The articles identify the major results and lessons learned from project documents including final reports, peer-reviewed literature, and HAI-prevention tool kits.
AHRQ-authored.
Citation: Battles JB, Cleeman JI, Kahn KL .
Introduction to "preventing healthcare-associated infections: results and lessons learned from AHRQ's HAI program".
Infect Control Hosp Epidemiol. 2014 Oct;35 Suppl 3:S1-2. doi: 10.1086/677817..
Keywords: Healthcare-Associated Infections (HAIs), Patient Safety, Prevention
Ali KJ, Farley DO, Speck K
Measurement of implementation components and contextual factors in a two-state healthcare quality initiative to reduce ventilator-associated pneumonia.
The authors sought to develop and field test an implementation assessment tool for assessing progress of hospital units in implementing improvements for the prevention of ventilator-associated pneumonia (VAP) in a two-state collaborative. They found that a relatively small number of barriers were found to have important negative effects on implementation progress, including barriers related to workload and time issues. They modified coaching provided to the unit teams to reinforce training in weak spots that the interviews identified.
AHRQ-funded; 290201000027I.
Citation: Ali KJ, Farley DO, Speck K .
Measurement of implementation components and contextual factors in a two-state healthcare quality initiative to reduce ventilator-associated pneumonia.
Infect Control Hosp Epidemiol 2014 Oct;35 Suppl 3:S116-23. doi: 10.1086/677832.
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Keywords: Healthcare-Associated Infections (HAIs), Patient Safety, Pneumonia, Prevention, Quality Improvement
Rosenman MB, Szucs KA, Finnell SM
Nascent regional system for alerting infection preventionists about patients with multidrug-resistant gram-negative bacteria: implementation and initial results.
The authors sought to build and to begin evaluating a regional automated system to notify infection preventionists (IPs) when a patient with a history of gram-negative rod multidrug-resistant organism (GNRMDRO) is admitted to an emergency department (ED) or inpatient setting. They found it feasible to create a regional microbiology-based alert system and observed substantial crossover between institutions. They concluded that this system, if it contributes to timely isolation, may help reduce the spread of GNRMDROs.
AHRQ-funded; HS020014.
Citation: Rosenman MB, Szucs KA, Finnell SM .
Nascent regional system for alerting infection preventionists about patients with multidrug-resistant gram-negative bacteria: implementation and initial results.
Infect Control Hosp Epidemiol 2014 Oct;35 Suppl 3:S40-7. doi: 10.1086/677833.
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Keywords: Emergency Department, Infectious Diseases, Inpatient Care, Patient Safety, Prevention
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
Chung S, Azar KM, Baek M
Reconsidering the age thresholds for type II diabetes screening in the U.S.
In order to examine the optimal age cut-point for opportunistic universal screening (as opposed to targeted screening), the researchers used a nationally representative sample from the National Health and Nutrition Examination Survey (2007-2010) and other resources. They found that opportunistic screening among individuals 35 years of age and older could greatly reduce the prevalence of undiagnosed diabetes or pre-diabetes.
AHRQ-funded; HS019815; HS019815.
Citation: Chung S, Azar KM, Baek M .
Reconsidering the age thresholds for type II diabetes screening in the U.S.
Am J Prev Med. 2014 Oct;47(4):375-81. doi: 10.1016/j.amepre.2014.05.012..
Keywords: Diabetes, Screening, Prevention, Chronic Conditions
Heintzman J, Marino M, Hoopes M
Using electronic health record data to evaluate preventive service utilization among uninsured safety net patients.
This study used EHR data to compare the preventive service utilization of uninsured patients receiving care at Oregon community health centers (CHCs) in 2008 through 2011 with that of continuously insured patients at the same CHCs in the same period. The results showed that CHCs provided many preventive services to uninsured patients, but that uninsured patients were less likely than continuously insured patients to receive 5 of 11 preventive services. The authors concluded that lack of insurance is a barrier to preventive service utilization, even in patients who can access care at a CHC.
AHRQ-funded; HS021522.
Citation: Heintzman J, Marino M, Hoopes M .
Using electronic health record data to evaluate preventive service utilization among uninsured safety net patients.
Prev Med 2014 Oct;67:306-10. doi: 10.1016/j.ypmed.2014.08.006.
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Keywords: Community-Based Practice, Electronic Health Records (EHRs), Healthcare Utilization, Prevention, Uninsured
Arling PA, Abrahamson K, Miech EJ
Communication and effectiveness in a US nursing home quality-improvement collaborative.
The investigators explored the relationship between changes in resident health outcomes, practitioner communication patterns, and practitioner perceptions of group effectiveness within a quality-improvement collaborative of nursing home clinicians. They found that reductions in fall rates were highest in facilities where respondents experienced the highest levels of communication with collaborative members outside of scheduled meetings. Clinician and practitioner observations were discussed.
AHRQ-funded; HS018464.
Citation: Arling PA, Abrahamson K, Miech EJ .
Communication and effectiveness in a US nursing home quality-improvement collaborative.
Nurs Health Sci 2014 Sep;16(3):291-7. doi: 10.1111/nhs.12098.
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Keywords: Communication, Falls, Nursing Homes, Quality of Care, Prevention, Quality Improvement
Barnes SL, Morgan DJ, Harris AD
Preventing the transmission of multidrug-resistant organisms: modeling the relative importance of hand hygiene and environmental cleaning interventions.
The authors investigated the relative impact of hand hygiene and environmental cleaning in order to assess resource allocation. They concluded that hand hygiene should remain a priority for infection control programs, but environmental cleaning can have significant benefit for hospitals or individual hospital units that have either high hand hygiene compliance levels or low terminal cleaning thoroughness.
AHRQ-funded; HS018111.
Citation: Barnes SL, Morgan DJ, Harris AD .
Preventing the transmission of multidrug-resistant organisms: modeling the relative importance of hand hygiene and environmental cleaning interventions.
Infect Control Hosp Epidemiol 2014 Sep;35(9):1156-62. doi: 10.1086/677632.
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Keywords: Healthcare-Associated Infections (HAIs), Methicillin-Resistant Staphylococcus aureus (MRSA), Prevention
Goldsweig AM, Reid KJ, Gosch K
Contemporary use of dual antiplatelet therapy for preventing cardiovascular events.
The authors examined dual antiplatelet therapy (DAPT) use in contemporary clinical practice after publication of the results of the landmark randomized clinical trial CHARISMA. They found that use of DAPT is modest in patients with established cardiovascular disease, for whom the CHARISMA trial suggested decreased major adverse cardiovascular events (MACEs), and prescription rates have remained stable over time; use of DAPT in patients with multiple risk factors only, for whom CHARISMA suggested that DAPT may lead to increased MACEs, was low and decreased over time.
AHRQ-funded; HS018781.
Citation: Goldsweig AM, Reid KJ, Gosch K .
Contemporary use of dual antiplatelet therapy for preventing cardiovascular events.
Am J Manag Care 2014 Aug;20(8):659-65.
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Keywords: Cardiovascular Conditions, Medication, Prevention, Practice Patterns, Risk
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
Perry LM, Winthrop KL, Curtis JR
Vaccinations for rheumatoid arthritis.
The goal of this paper is to highlight the most recent literature on the key vaccines and the specific considerations for the rheumatologist and their rheumatoid arthritis (RA) patients, with a particular focus on influenza, pneumococcal, and herpes zoster vaccines. It is important for rheumatologists to understand which vaccines are live and what potential contraindications exist for giving vaccines to RA patients.
AHRQ-funded; HS018517
Citation: Perry LM, Winthrop KL, Curtis JR .
Vaccinations for rheumatoid arthritis.
Curr Rheumatol Rep. 2014 Aug;16(8):431. doi: 10.1007/s11926-014-0431-x..
Keywords: Arthritis, Vaccination, Prevention
Heintzman J, Bailey SR, Hoopes MJ
Agreement of Medicaid claims and electronic health records for assessing preventive care quality among adults.
The researchers sought to compare the agreement of electronic health records (EHR) data versus Medicaid claims data in documenting adult preventive care. For services performed in the primary care setting, EHR data compared favorably to Medicaid claims in documenting the percentage of patients with service receipt; services that were referred out were less frequently observed in the EHR.
AHRQ-funded; HS021522
Citation: Heintzman J, Bailey SR, Hoopes MJ .
Agreement of Medicaid claims and electronic health records for assessing preventive care quality among adults.
J Am Med Inform Assoc. 2014 Jul-Aug;21(4):720-4. doi: 10.1136/amiajnl-2013-002333..
Keywords: Electronic Health Records (EHRs), Health Insurance, Medicaid, Prevention, Primary Care
Raebel MA, Ellis JL, Schroeder EB
Intensification of antihyperglycemic therapy among patients with incident diabetes: a Surveillance Prevention and Management of Diabetes Mellitus (SUPREME-DM) study.
The aim of this study was to characterize antihyperglycemic intensification during the first year after initiating oral antihyperglycemic therapy among adult patients with incident diabetes. The researchers found that 43.5 percent of patients with diabetes had treatment intensified within 1 year of starting antihyperglycemic medication. HbA1c of less than 7 percent was achieved in a very high proportion of patients (65.1 percent).
AHRQ-funded; HS019859
Citation: Raebel MA, Ellis JL, Schroeder EB .
Intensification of antihyperglycemic therapy among patients with incident diabetes: a Surveillance Prevention and Management of Diabetes Mellitus (SUPREME-DM) study.
Pharmacoepidemiol Drug Saf, 2014 Jul;23(7):699-710. doi: 10.1002/pds.3610..
Keywords: Diabetes, Prevention, Medication
Atlas SJ, Zai AH, Ashburner JM
Non-visit-based cancer screening using a novel population management system.
The authors evaluated whether involving primary care providers (PCPs) in a visit-independent population management IT application led to more effective cancer screening. They found that involving PCPs in a visit-independent population management IT application resulted in similar cancer screening rates compared with an automated reminder system, but fewer patients were sent reminder letters, suggesting that PCPs were able to identify and exclude from contact patients who would have received automated reminder letters but not undergone screening.
AHRQ-funded; HS018161.
Citation: Atlas SJ, Zai AH, Ashburner JM .
Non-visit-based cancer screening using a novel population management system.
J Am Board Fam Med 2014 Jul-Aug;27(4):474-85. doi: 10.3122/jabfm.2014.04.130319.
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Keywords: Cancer, Health Information Technology (HIT), Prevention, Primary Care, Screening
Kranz AM, Rozier RG, Preisser JS
Preventive services by medical and dental providers and treatment outcomes.
The researchers compared the association between the provider of preventive services (PCP, dentist, or both) with Medicaid-enrolled children before their third birthday and subsequent dental caries-related treatment (CRT) and CRT payment. They concluded that, due to children's increased opportunity to receive multiple visits in medical offices during well-child visits, preventive oral health services provided by PCPs may lead to a greater reduction in CRT than dentist visits alone.
AHRQ-funded; HS000032.
Citation: Kranz AM, Rozier RG, Preisser JS .
Preventive services by medical and dental providers and treatment outcomes.
J Dent Res 2014 Jul;93(7):633-8. doi: 10.1177/0022034514536731.
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Keywords: Children/Adolescents, Dental and Oral Health, Patient-Centered Outcomes Research, Prevention, Primary Care
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
Kappagoda S, Ioannidis JP
Prevention and control of neglected tropical diseases: overview of randomized trials, systematic reviews and meta-analyses.
The purpose of this review was to analyze evidence from randomized controlled trials (RCTs) on the prevention and control of neglected tropical diseases (NTDs) and to identify areas where evidence is lacking. The most studied diseases were geohelminth infection (51 RCTs) and leishmaniasis (46 RCTs). Vaccines, chemoprophylaxis and interventions targeting insect vectors were evaluated in 113, 99 and 39 RCTs, respectively. Few addressed how best to deliver preventive chemotherapy.
AHRQ-funded; HS000028.
Citation: Kappagoda S, Ioannidis JP .
Prevention and control of neglected tropical diseases: overview of randomized trials, systematic reviews and meta-analyses.
Bull World Health Organ 2014 May;92(5):356-66c. doi: 10.2471/blt.13.129601..
Keywords: Prevention, Infectious Diseases, Evidence-Based Practice
Ant Ozok A, Wu H, Garrido M
Usability and perceived usefulness of personal health records for preventive health care: a case study focusing on patients' and primary care providers' perspectives.
The purpose of this study was to evaluate the usefulness of a specific patient-centered information technology (Personal Health Record) in improving awareness (for the patients) and compliance with (for both patients and providers) preventive care guidelines. The results were that patients found the tailored health recommendations useful and the PHR easy to understand and use.
AHRQ-funded; HS018762
Citation: Ant Ozok A, Wu H, Garrido M .
Usability and perceived usefulness of personal health records for preventive health care: a case study focusing on patients' and primary care providers' perspectives.
Appl Ergon. 2014 May;45(3):613-28. doi: 10.1016/j.apergo.2013.09.005..
Keywords: Electronic Health Records (EHRs), Quality of Care, Prevention, Primary Care, Web-Based
Jackson DJ, Hartert TV, Martinez FD
Asthma: NHLBI workshop on the primary prevention of chronic lung diseases.
This article reports on the state of primary prevention research in asthma, with emphasis on specific recommendations for research priorities and interventions that could be undertaken now. The emphasis of this work was on prevention of disease onset, and because the majority of asthma begins during preschool years, this document focuses on childhood asthma.
AHRQ-funded; HS018454, HS022093
Citation: Jackson DJ, Hartert TV, Martinez FD .
Asthma: NHLBI workshop on the primary prevention of chronic lung diseases.
Ann Am Thorac Soc. 2014 Apr;11 Suppl 3:S139-45. doi: 10.1513/AnnalsATS.201312-448LD..
Keywords: Asthma, Prevention, Children/Adolescents, Chronic Conditions
Meddings J, Rogers MA, Krein SL
Reducing unnecessary urinary catheter use and other strategies to prevent catheter-associated urinary tract infection: an integrative review.
The authors updated a prior systematic review and a meta-analysis regarding interventions prompting urinary catheter (UC) removal by reminders or stop orders. They found that UC reminders and stop orders appear to reduce catheter-associated urinary tract infection rates and should be used to improve patient safety.
AHRQ-funded; 290200710062I; HS019767; HS018344.
Citation: Meddings J, Rogers MA, Krein SL .
Reducing unnecessary urinary catheter use and other strategies to prevent catheter-associated urinary tract infection: an integrative review.
BMJ Qual Saf 2014 Apr;23(4):277-89. doi: 10.1136/bmjqs-2012-001774.
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Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Healthcare-Associated Infections (HAIs), Patient Safety, Patient-Centered Outcomes Research, Prevention, Quality Improvement, Urinary Tract Infection (UTI)
Streiff MB, Brady JP, Grant AM
AHRQ Author: Brady JP
CDC Grand Rounds: preventing hospital-associated venous thromboembolism.
Approximately half of new venous thromboembolism (VTE) cases occur during a hospital stay or within 90 days of an inpatient admission or surgical procedure, and many are not diagnosed until after discharge. Prevention of VTE can be complicated as physicians must balance the risk for thrombosis with the risk for bleeding from anticoagulants. A collaborative, team-based approach to care is needed for significant and sustained improvement, and it also offers efficiency and capacity to tackle other patient safety problems.
AHRQ-authored.
Citation: Streiff MB, Brady JP, Grant AM .
CDC Grand Rounds: preventing hospital-associated venous thromboembolism.
MMWR Morb Mortal Wkly Rep 2014 Mar 7;63(9):190-3.
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Keywords: Blood Clots, Healthcare-Associated Infections (HAIs), Hospitalization, Prevention, Teams
Olsho LE, Spector WD, Williams CS
AHRQ Author: Spector WD
Evaluation of AHRQ's on-time pressure ulcer prevention program: a facilitator-assisted clinical decision support intervention for nursing homes.
The researchers evaluated the effectiveness of the On-Time Quality Improvement for Long Term Care (On-Time) program in reducing the rate of in-house-acquired pressure ulcers among nursing home residents. They found that On-Time implementation is associated with sizable reductions in pressure ulcer incidence.
AHRQ-authored; AHRQ-funded; 290200600011I.
Citation: Olsho LE, Spector WD, Williams CS .
Evaluation of AHRQ's on-time pressure ulcer prevention program: a facilitator-assisted clinical decision support intervention for nursing homes.
Med Care 2014 Mar;52(3):258-66. doi: 10.1097/mlr.0000000000000080.
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Keywords: Clinical Decision Support (CDS), Long-Term Care, Nursing Homes, Pressure Ulcers, Prevention
Lau BD, Haut ER
Practices to prevent venous thromboembolism: a brief review.
The purpose of this review is to provide an update on the most effective interventions aimed at improving adherence to guidelines on the use of venous thromboembolism (VTE) prevention strategies. After reviewing sixteen studies, the researchers concluded that the greatest and most sustained improvements were those that combined education with computerised tools.
AHRQ-funded; 290200710.
Citation: Lau BD, Haut ER .
Practices to prevent venous thromboembolism: a brief review.
BMJ Qual Saf 2014 Mar;23(3):187-95. doi: 10.1136/bmjqs-2012-001782..
Keywords: Comparative Effectiveness, Blood Clots, Prevention, Shared Decision Making, Guidelines