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AHRQ Research Studies Date
Topics
- Behavioral Health (1)
- Care Coordination (2)
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- Children/Adolescents (3)
- Chronic Conditions (1)
- Clinician-Patient Communication (1)
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- Electronic Health Records (EHRs) (4)
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- (-) Health Information Technology (HIT) (14)
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- Rural Health (1)
- Simulation (1)
- Social Determinants of Health (1)
- Substance Abuse (1)
- (-) Teams (14)
- Telehealth (2)
- Tools & Toolkits (1)
- Transitions of Care (1)
- Trauma (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
1 to 14 of 14 Research Studies DisplayedBui LN, Knox M, Miller-Rosales C
Hospital capabilities associated with behavioral health integration within emergency departments.
The objective of this study was to identify hospital capabilities associated with behavioral health processes in emergency departments. Responses to the National Survey of Healthcare Organizations and Systems were linked American Hospital Association Annual Survey data. Most hospitals reported screening for behavioral health conditions and provided direct referrals to community-based clinicians. Approximately half the hospitals used team approaches to behavioral health. Hospitals that reported more barriers to care delivery innovations also reported less screening and usage of a team approach. The authors concluded that research and interventions which focus on removing barriers or adding processes to disseminate best practices offer a path to accelerate behavioral health integration in emergency departments.
AHRQ-funded; HS024075.
Citation: Bui LN, Knox M, Miller-Rosales C .
Hospital capabilities associated with behavioral health integration within emergency departments.
Med Care 2024 Mar; 62(3):170-74. doi: 10.1097/mlr.0000000000001973.
Keywords: Behavioral Health, Emergency Department, Hospitals, Substance Abuse, Teams, Telehealth, Health Information Technology (HIT)
Hose BZ, Carayon P, Hoonakker PLT
Work system barriers and facilitators of a team health information technology.
This study’s objective was to identify work design barriers and facilitators to the use of a team health IT that supports care transitions for pediatric trauma patients. The authors conducted an analysis on 36 interviews - representing 12 roles - collected from a scenario-based evaluation of T(3). They identified eight dimensions with both barriers and facilitators in all five work system elements: person (experience), task (task performance, workload/efficiency), technology (usability, specific features of T(3)), environment (space, location), and organization (communication/coordination). They concluded that designing technology that meets every role's needs is challenging; in particular, when trade-offs need to be managed, e.g., additional workload for one role or divergent perspectives regarding specific features.
AHRQ-funded; HS023837
Citation: Hose BZ, Carayon P, Hoonakker PLT .
Work system barriers and facilitators of a team health information technology.
Appl Ergon 2023 Nov; 113:104105. doi: 10.1016/j.apergo.2023.104105..
Keywords: Health Information Technology (HIT), Teams
Hose BZ, Carayon P, Hoonakker PLT
Managing multiple perspectives in the collaborative design process of a team health information technology.
The creation of technology that supports healthcare teams is crucial, and the development of such solutions should encompass various clinical roles. However, our understanding of the actual collaborative process in designing team-based care technologies is limited. The purpose of this study was to delve into the management of diverse perspectives during the development of a health IT solution geared towards meeting the informational needs of clinicians during pediatric trauma care transitions. The researcher’s analysis concentrated on four co-design sessions, which included multiple healthcare professionals involved in pediatric trauma patient care. Employing content analysis and process coding, the researchers analyzed the transcripts of the design sessions, drawing inspiration from Détienne's (2006) co-design framework. By expanding on Détienne's (2006) three collaborative activities, the researchers identified distinct themes and processes that characterized collaboration among care team members during the design process. The study found that the themes and processes showcase the collaborative nature of a team health IT design procedure, ultimately resulting in a highly functional technology.
AHRQ-funded; HS023837
Citation: Hose BZ, Carayon P, Hoonakker PLT .
Managing multiple perspectives in the collaborative design process of a team health information technology.
Appl Ergon 2023 Jan;106:103846. doi: 10.1016/j.apergo.2022.103846.
Keywords: Teams, Health Information Technology (HIT)
Durojaiye A, Fackler J, McGeorge N
Examining diurnal differences in multidisciplinary care teams at a pediatric trauma center using electronic health record data: social network analysis.
The purpose of this study was to apply social network analysis to electronic health record (EHR) data to explore diurnal differences in the multidisciplinary teams caring for pediatric trauma patients. The researchers created an event log comprised of clinical activity metadata obtained from the EHR. The resulting event log was separated into 6 unique event logs, with content based on clinical activity shift (day shift or night shift) and location of the activities (divided by emergency department (ED), pediatric intensive care unit (PICU), and floor). For each event log, social networks were constructed and community overlap identified. The researchers utilized a comparison with qualitative care team data to compare and validate daytime and nighttime network structures for each care location. Validation was assessed via member-checking interviews with clinicians and qualitatively derived care team data, obtained through semi-structured interviews. The study found that of the 413 clinical encounters taking place within the 1-year study period, 65.9% began during the day shift and 34.1% began during the night shift. Multiple communities were identified in the ED and on the floor during the night shift, while a single community was identified in the ED and on the floor during the day shift, and in the PICU during the night shift. Qualitative data results indicated that the networks were accurate representations of the composition and interactions of the care teams. The researchers concluded that social network analysis was an effective method for utilization on EHR data at a pediatric trauma center to explore, identify, and describe diurnal differences in multidisciplinary care teams.
AHRQ-funded; HS023837.
Citation: Durojaiye A, Fackler J, McGeorge N .
Examining diurnal differences in multidisciplinary care teams at a pediatric trauma center using electronic health record data: social network analysis.
J Med Internet Res 2022 Feb 4;24(2):e30351. doi: 10.2196/30351..
Keywords: Children/Adolescents, Electronic Health Records (EHRs), Health Information Technology (HIT), Teams, Healthcare Delivery
Hoonakker PLT, Hose BZ, Carayon P
Scenario-based evaluation of team health information technology to support pediatric trauma care transitions.
This study’s objective was to examine if the Teamwork Transition Technology (T(3)) supports teams and team cognition. Using a scenario-based mock-up methodology with 36 clinicians and staff from the different units and departments who are involved in pediatric trauma to examine T(3), results showed that most participants agreed that the technology helped to achieve the goals set out in the design phase. Respondents thought that T(3) organized and presented information in a different way that was helpful to them. The authors concluded that the results of their evaluation showed that participants agreed that T(3) does support them in their work and increases their situation awareness.
AHRQ-funded; HS023837.
Citation: Hoonakker PLT, Hose BZ, Carayon P .
Scenario-based evaluation of team health information technology to support pediatric trauma care transitions.
Appl Clin Inform 2022 Jan;13(1):218-29. doi: 10.1055/s-0042-1742368.
AHRQ-funded; HS023837..
AHRQ-funded; HS023837..
Keywords: Children/Adolescents, Transitions of Care, Health Information Technology (HIT), Teams, Trauma
McAlearney AS, Hefner JL, MacEwan SR
Care Team perspectives about an inpatient portal: benefits and challenges of patients' portal use during hospitalization.
This study’s goal was to get care team member’s point of view on the benefits and challenges of inpatient portal implementation and use. Brief in-person interviews with 433 care team members across a six-hospital health system were held to explore opinions about patients’ use. The Inpatient Portal Evaluation Framework was used to characterize benefits and challenges of portal use that care team members reported affected patients, themselves, and the collaborative work of those care teams with their patients.
AHRQ-funded; HS024379; HS024091; HS024767.
Citation: McAlearney AS, Hefner JL, MacEwan SR .
Care Team perspectives about an inpatient portal: benefits and challenges of patients' portal use during hospitalization.
Med Care Res Rev 2021 Oct;78(5):537-47. doi: 10.1177/1077558720925296..
Keywords: Teams, Health Information Technology (HIT), Inpatient Care
Wang G, Wignall J, Kinard D
An implementation model for managing cloud-based longitudinal care plans for children with medical complexity.
In this study, the investigators aimed to iteratively refine an implementation model for managing cloud-based longitudinal care plans (LCPs) for children with medical complexity (CMC). They conducted iterative 1-on-1 design sessions with CMC caregivers (ie, parents/legal guardians) and providers between August 2017 and March 2019. The investigators concluded that utilizing the management strategies, described in the article, when implementing cloud-based LCPs had the potential to improve team-based care across settings.
AHRQ-funded; HS024299.
Citation: Wang G, Wignall J, Kinard D .
An implementation model for managing cloud-based longitudinal care plans for children with medical complexity.
J Am Med Inform Assoc 2021 Jan 15;28(1):23-32. doi: 10.1093/jamia/ocaa207..
Keywords: Children/Adolescents, Implementation, Chronic Conditions, Care Management, Care Coordination, Health Information Exchange (HIE), Health Information Technology (HIT), Teams
Cohen DJ, Wyte-Lake T, Dorr DA
Unmet information needs of clinical teams delivering care to complex patients and design strategies to address those needs.
The authors sought to identify the unmet information needs of clinical teams delivering care to patients with complex medical, social, and economic needs, and to propose principles for redesigning electronic health records (EHR) to address these needs. They concluded that developing EHR tools that are simple, accessible, easy to use, and able to be updated by a range of professionals is critical. They recommended that the identified information needs and design principles inform developers and implementers working in community health centers and other settings where complex patients receive care.
AHRQ-funded; HS023324.
Citation: Cohen DJ, Wyte-Lake T, Dorr DA .
Unmet information needs of clinical teams delivering care to complex patients and design strategies to address those needs.
J Am Med Inform Assoc 2020 May;27(5):690-99. doi: 10.1093/jamia/ocaa010..
Keywords: Healthcare Delivery, Teams, Electronic Health Records (EHRs), Health Information Technology (HIT), Social Determinants of Health, Community-Based Practice, Primary Care
Mastrianni A, Kulp L, Mapelli E
Understanding digital checklist use through team communication.
Introducing technology support in a complex, team-based work setting requires a study of teamwork effects on technology use. In this paper, the investigators present their initial analysis of team communications in a trauma resuscitation setting, where they deployed a digital checklist to support trauma team leaders in guiding patient care. They discuss design implications for checklist design for dynamic, team-based activities.
AHRQ-funded; HS026057.
Citation: Mastrianni A, Kulp L, Mapelli E .
Understanding digital checklist use through team communication.
Ext Abstr Hum Factors Computing Syst 2020 Apr;2020. doi: 10.1145/3334480.3382817.
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Keywords: Teams, Communication, Health Information Technology (HIT)
McAlearney AS, Gaughan A, MacEwan SR
Improving acceptance of inpatient portals: patients' and care team members' perspectives.
Inpatient portals are gaining interest as a means to increase patient-centered care during hospitalization. However, acceptance of a new technology such as the inpatient portal relies on perceptions of both its usefulness and ease of use. These factors have not been studied in the context of inpatient portal implementation. In this study, the investigators interviewed patients and care team members about their experiences using an inpatient portal that had been implemented across a large, academic medical center.
AHRQ-funded; HS024379; HS024091.
Citation: McAlearney AS, Gaughan A, MacEwan SR .
Improving acceptance of inpatient portals: patients' and care team members' perspectives.
Telemed J E Health 2020 Mar;26(3):310-26. doi: 10.1089/tmj.2019.0026..
Keywords: Health Information Technology (HIT), Patient-Centered Healthcare, Teams
Bond WF, Barker LT, Cooley KL
A simple low-cost method to integrate telehealth interprofessional team members during in situ simulation.
This article describes the integration of remote telehealth electronic intensive care unit (eICU) personnel into in situ simulations with rural emergency department (ED) care teams and the technical challenges of creating shared awareness of the patient's condition and the care team's progress among the care team, the eICU, and those running the simulation. The purpose of the simulations was to introduce telehealth technology and new processes of engaging the eICU via telehealth during sepsis care in rural EDs; development of the scenarios included experts in sepsis, telehealth, and emergency medicine. A shared in situ simulation clinical actions observational checklist was created using an off-the-shelf survey software program. The checklist was completed during the simulations by an onsite observer, and shared with the eICU team via teleconferencing software to and cue eICU nurse engagement. Staff from the two EDs were engaged and an eICU nurse participated in debriefing via the telehealth video system.
AHRQ-funded; HS024027.
Citation: Bond WF, Barker LT, Cooley KL .
A simple low-cost method to integrate telehealth interprofessional team members during in situ simulation.
Simul Healthc 2019 Apr;14(2):129-36. doi: 10.1097/sih.0000000000000357..
Keywords: Critical Care, Electronic Health Records (EHRs), Emergency Department, Health Information Technology (HIT), Rural Health, Simulation, Teams, Telehealth
Artis KA, Dyer E, Mohan V
Accuracy of laboratory data communication on ICU daily rounds using an electronic health record.
The researchers created a robust but simple methodology to measure the prevalence of inaccurately communicated (misrepresented) data and to characterize data communication failures by type. They found that clinician laboratory data retrieval and communication during ICU rounds at their institution was poor, prone to omissions and inaccuracies, yet largely unrecognized by the rounding team.
AHRQ-funded; HS023793.
Citation: Artis KA, Dyer E, Mohan V .
Accuracy of laboratory data communication on ICU daily rounds using an electronic health record.
Crit Care Med 2017 Feb;45(2):179-86. doi: 10.1097/ccm.0000000000002060.
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Keywords: Communication, Electronic Health Records (EHRs), Health Information Technology (HIT), Intensive Care Unit (ICU), Teams
Abraham J, Kannampallil TG, Patel VL
Impact of structured rounding tools on time allocation during multidisciplinary rounds: an observational study.
The aim of this study was to investigate whether disproportionate time allocation effects during multidisciplinary rounds (MDRs) persist with the use of structured rounding tools. It concluded that the use of structured rounding tools potentially mitigates disproportionate time allocation and communication breakdowns during rounds with the more structured system-based Handoff Intervention Tool (HAND-IT), almost completely eliminating such effects.
AHRQ-funded; HS017586.
Citation: Abraham J, Kannampallil TG, Patel VL .
Impact of structured rounding tools on time allocation during multidisciplinary rounds: an observational study.
JMIR Hum Factors 2016 Dec 09;3(2):e29. doi: 10.2196/humanfactors.6642.
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Keywords: Tools & Toolkits, Clinician-Patient Communication, Teams, Health Information Technology (HIT), Care Coordination
Nguyen V, Okafor N, Zhang J
Using TURF to understand the functions of interruptions.
TURF stands for Task, User, Representation, and Function (TURF) analyses. This paper explores interruptions as an emergent feature of communication in teams. The authors focus on emergency medicine as this complex environment requires team based concurrent management of multiple patients coping with limited resources in a life-critical and interruption-laden environment. They classify interruptions into those activities that support required work and those interruptions that create unnecessary breaks in workflow.
AHRQ-funded; HS021236; HS017586.
Citation: Nguyen V, Okafor N, Zhang J .
Using TURF to understand the functions of interruptions.
AMIA Annu Symp Proc 2014 Nov;2014:917-23..
Keywords: Communication, Emergency Department, Health Information Technology (HIT), Teams