National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Events (7)
- Behavioral Health (3)
- Cancer (2)
- Cancer: Breast Cancer (1)
- Care Coordination (3)
- Catheter-Associated Urinary Tract Infection (CAUTI) (1)
- Children/Adolescents (2)
- Chronic Conditions (1)
- Clinician-Patient Communication (16)
- (-) Communication (52)
- Community-Based Practice (1)
- Critical Care (1)
- Diagnostic Safety and Quality (2)
- Education: Continuing Medical Education (1)
- Education: Patient and Caregiver (5)
- Electronic Health Records (EHRs) (6)
- Emergency Medical Services (EMS) (1)
- Emergency Preparedness (1)
- Evidence-Based Practice (3)
- Genetics (1)
- Guidelines (2)
- Healthcare-Associated Infections (HAIs) (1)
- Healthcare Delivery (4)
- Health Information Exchange (HIE) (1)
- Health Information Technology (HIT) (12)
- Health Insurance (1)
- Health Literacy (1)
- Health Promotion (1)
- Health Services Research (HSR) (1)
- Hospital Discharge (1)
- Hospitals (1)
- Human Immunodeficiency Virus (HIV) (1)
- Implementation (1)
- Infectious Diseases (1)
- Intensive Care Unit (ICU) (2)
- Labor and Delivery (1)
- Low-Income (1)
- Medical Errors (6)
- Medical Liability (5)
- Medication (5)
- Medication: Safety (2)
- Nursing (2)
- Opioids (2)
- Outcomes (2)
- Patient-Centered Healthcare (4)
- Patient Adherence/Compliance (1)
- Patient and Family Engagement (8)
- Patient Experience (1)
- Patient Safety (10)
- Policy (3)
- Practice Patterns (2)
- Prevention (1)
- Primary Care (8)
- Provider (2)
- Provider: Health Personnel (1)
- Provider: Pharmacist (1)
- Provider: Physician (1)
- Public Health (1)
- Quality of Care (2)
- Quality of Life (1)
- Research Methodologies (1)
- Sexual Health (1)
- Shared Decision Making (5)
- Social Media (2)
- Social Stigma (1)
- Substance Abuse (1)
- Surgery (2)
- Teams (3)
- Telehealth (1)
- Transitions of Care (1)
- Transplantation (1)
- Vaccination (2)
- Web-Based (3)
- Women (1)
- Workflow (2)
- Workforce (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 25 of 52 Research Studies DisplayedMeisel ZF, Metlay JP, Sinnenberg L
A randomized trial testing the effect of narrative vignettes versus guideline summaries on provider response to a professional organization clinical policy for safe opioid prescribing.
The authors compared whether narrative vignettes embedded in the American College of Emergency Physicians (ACEP) daily e-newsletter improved dissemination of the clinical policy to ACEP members, and engagement of members with the clinical policy, compared with traditional summary text. They found that the vignettes outperformed traditional guideline text in promoting engagement with an evidence-based clinical guideline related to opioid prescriptions.
AHRQ-funded; HS021956.
Citation: Meisel ZF, Metlay JP, Sinnenberg L .
A randomized trial testing the effect of narrative vignettes versus guideline summaries on provider response to a professional organization clinical policy for safe opioid prescribing.
Ann Emerg Med 2016 Dec;68(6):719-28. doi: 10.1016/j.annemergmed.2016.03.007.
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Keywords: Communication, Evidence-Based Practice, Guidelines, Opioids, Medication, Medication: Safety, Policy, Provider
Mello MM, Greenberg Y, Senecal SK
Case outcomes in a communication-and-resolution program in New York hospitals.
The researchers sought to determine case outcomes in a communication-and-resolution program (CRP) implemented to respond to adverse events in general surgery. They concluded that the bulk of CRPs' work is in investigating and communicating about events not caused by substandard care. These CRPs were quite successful in handling such events, but less consistent in offering compensation in cases involving substandard care.
AHRQ-funded; R18 HS019505.
Citation: Mello MM, Greenberg Y, Senecal SK .
Case outcomes in a communication-and-resolution program in New York hospitals.
Health Serv Res 2016 Dec;51 Suppl 3:2583-99. doi: 10.1111/1475-6773.12594.
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Keywords: Adverse Events, Communication, Medical Errors, Medical Liability, Surgery
Mello MM, Armstrong SJ, Greenberg Y
Challenges of implementing a communication-and-resolution program where multiple organizations must cooperate.
The researchers sought to implement a communication-and-resolution program (CRP) in a setting in which liability insurers and health care facilities must collaborate to resolve incidents involving a facility and separately insured clinicians. They found that sites experienced small victories in resolving particular cases and streamlining some working relationships, but they were unable to successfully implement a collaborative CRP.
AHRQ-funded; HS019531.
Citation: Mello MM, Armstrong SJ, Greenberg Y .
Challenges of implementing a communication-and-resolution program where multiple organizations must cooperate.
Health Serv Res 2016 Dec;51 Suppl 3:2550-68. doi: 10.1111/1475-6773.12580.
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Keywords: Communication, Medical Errors, Medical Liability, Patient Safety
Helmchen LA, Lambert BL, McDonald TB
Changes in physician practice patterns after implementation of a communication-and-resolution program.
The researchers tested if a 2006 communication-and-resolution program to address unexpected adverse outcomes was associated with changes in cost and use trajectories. They found that the intervention hospital recorded an increase in the number of patients with a principal diagnosis of chest pain. Among admitted patients, quarterly growth rates of clinical laboratory and radiology charges at the intervention hospital declined by 3.8 and 6.9 percentage points.
AHRQ-funded; HS019565.
Citation: Helmchen LA, Lambert BL, McDonald TB .
Changes in physician practice patterns after implementation of a communication-and-resolution program.
Health Serv Res 2016 Dec;51 Suppl 3:2516-36. doi: 10.1111/1475-6773.12610.
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Keywords: Adverse Events, Communication, Medical Errors, Medical Liability, Practice Patterns
Gallagher TH, Farrell ML, Karson H
Collaboration with regulators to support quality and accountability following medical errors: The Communication and Resolution Program Certification Pilot.
The Medical Quality Assurance Commission (MQAC, board of medicine) in Washington State has collaborated with the Foundation for Health Care Quality (FHCQ) on the CRP Certification pilot. A panel of physicians, risk managers, and patient advocates at FHCQ will review cases for use of the CRP key elements. After describing the process, the authors concluded that the CRP Certification program is a promising example of collaboration among institutions, insurers, and regulators to promote patient-centered accountability and learning following adverse events.
AHRQ-funded; HS019531.
Citation: Gallagher TH, Farrell ML, Karson H .
Collaboration with regulators to support quality and accountability following medical errors: The Communication and Resolution Program Certification Pilot.
Health Serv Res 2016 Dec;51 Suppl 3:2569-82. doi: 10.1111/1475-6773.12557.
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Keywords: Adverse Events, Communication, Medical Errors, Medical Liability, Patient Safety, Quality of Care
Naslund JA, Aschbrenner KA, Bartels SJ
How people with serious mental illness use smartphones, mobile apps, and social media.
The researchers surveyed individuals with serious mental illness to explore their use of mobile devices or whether they access social media. Among respondents (n = 70), 93 percent owned cellphones, 78 percent used text messaging, 50 percent owned smartphones, and 71 percent used social media such as Facebook. Most respondents reported daily use of text messaging, mobile apps, and social media.
AHRQ-funded; HS021695.
Citation: Naslund JA, Aschbrenner KA, Bartels SJ .
How people with serious mental illness use smartphones, mobile apps, and social media.
Psychiatr Rehabil J 2016 Dec;39(4):364-67. doi: 10.1037/prj0000207.
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Keywords: Communication, Community-Based Practice, Health Promotion, Behavioral Health, Social Media
Gordon HS, Street RL
How physicians, patients, and observers compare on the use of qualitative and quantitative measures of physician-patient communication.
The purpose of this study was to compare several different measures of physician-patient communication. Communication was measured with rating scales completed by patients and physicians and by two groups of external observers who used rating scales or coded the frequency of communication behaviors. The findings highlight the potential for using observers' ratings as an alternate measure of communication to more labor intensive frequency measures.
AHRQ-funded; HS010876.
Citation: Gordon HS, Street RL .
How physicians, patients, and observers compare on the use of qualitative and quantitative measures of physician-patient communication.
Eval Health Prof 2016 Dec;39(4):496-511. doi: 10.1177/0163278715625737.
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Keywords: Communication, Shared Decision Making, Patient and Family Engagement, Clinician-Patient Communication
Sulzer SH, Muenchow E, Potvin A
Improving patient-centered communication of the borderline personality disorder diagnosis.
This study aimed to understand how clinicians communicate the diagnosis of borderline personality disorder (BPD) with patients, and compare these practices with patient communication preferences. It found that the majority of clinicians sampled did not actively share the BPD diagnosis with their patients, while the majority of patients wanted to be told that they had the disorder, as well as have their providers discuss the stigma they would face.
AHRQ-funded; HS000032.
Citation: Sulzer SH, Muenchow E, Potvin A .
Improving patient-centered communication of the borderline personality disorder diagnosis.
J Ment Health 2016;25(1):5-9. doi: 10.3109/09638237.2015.1022253.
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Keywords: Communication, Diagnostic Safety and Quality, Behavioral Health, Clinician-Patient Communication, Social Stigma
Traino HM, Siminoff LA
Keep it going: maintaining health conversations using relational and instrumental approaches.
The researchers examined how elements of relational and instrumental communication occurring within the first five minutes of the request impacted the length of the discussion. Sixteen U.S. tissue banking organizations and their staff making telephone requests for donation to families of tissue-donation eligible patients agreed to participate in the research. The researchers concluded that aspects of both relational and instrumental communication were associated with discussion length.
AHRQ-funded; HS013152.
Citation: Traino HM, Siminoff LA .
Keep it going: maintaining health conversations using relational and instrumental approaches.
Health Commun 2016;31(3):308-19. doi: 10.1080/10410236.2014.950020.
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Keywords: Communication, Patient and Family Engagement, Clinician-Patient Communication
Sentell T, Chang A, Ahn HJ
Maternal language and adverse birth outcomes in a statewide analysis.
The study goal was to consider the relationship of maternal language to birth outcomes using Hawaii’s hospitalization data. It found that non-English speakers had approximately two times higher risk of having an obstetric trauma during a vaginal birth when other factors, including race/ethnicity, were controlled. Non-English speakers also had higher rates of potentially high-risk deliveries.
AHRQ-funded; HS019990; HS021903.
Citation: Sentell T, Chang A, Ahn HJ .
Maternal language and adverse birth outcomes in a statewide analysis.
Women Health 2016;56(3):257-80. doi: 10.1080/03630242.2015.1088114.
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Keywords: Adverse Events, Communication, Labor and Delivery, Outcomes
Lambert BL, Centomani NM, Smith KM
The "Seven Pillars" response to patient safety incidents: effects on medical liability processes and outcomes.
This study's objective was to determine whether a communication and resolution approach to patient harm is associated with changes in medical liability processes and outcomes. It found that the intervention nearly doubled the number of incident reports, halved the number of claims, and reduced legal fees and costs as well as total costs per claim, settlement amounts, and self-insurance costs. The study found that a communication and optimal resolution (CANDOR) approach to adverse events was associated with long-lasting, clinically and financially significant changes in a large set of core medical liability process and outcome measures.
AHRQ-funded; HS019565.
Citation: Lambert BL, Centomani NM, Smith KM .
The "Seven Pillars" response to patient safety incidents: effects on medical liability processes and outcomes.
Health Serv Res 2016 Dec;51 Suppl 3:2491-515. doi: 10.1111/1475-6773.12548.
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Keywords: Adverse Events, Medical Liability, Medical Errors, Communication, Patient Safety
Harrod M, Montoya A, Mody L
Challenges for nurses caring for individuals with peripherally inserted central catheters in skilled nursing facilities.
The researchers sought to understand the perceived preparedness of frontline nurses (registered nurses (RNs), licensed practical nurses (LPNs)), unit nurse managers, and skilled nursing facility (SNF) administrators in providing care for residents with peripherally inserted central catheters (PICCs) in SNFs. They noted differences between resident self-reported PICC concerns (quality of life) and those described by frontline nurses.
AHRQ-funded; HS019979; HS022835.
Citation: Harrod M, Montoya A, Mody L .
Challenges for nurses caring for individuals with peripherally inserted central catheters in skilled nursing facilities.
J Am Geriatr Soc 2016 Oct;64(10):2059-64. doi: 10.1111/jgs.14341.
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Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Communication, Nursing, Quality of Life, Transitions of Care
Krouss M, Croft L, Morgan DJ
Physician understanding and ability to communicate harms and benefits of common medical treatments.
The researchers evaluated physician understanding of harms and benefits of common tests and therapies. They found that most clinicians overestimate harms and benefits for most treatments. Likewise, most of the clinicians in our study reported rarely or never using statistical terms to explain treatment options to patients. However, they were interested in resources to improve understanding of treatment effect size.
AHRQ-funded; HS018111.
Citation: Krouss M, Croft L, Morgan DJ .
Physician understanding and ability to communicate harms and benefits of common medical treatments.
JAMA Intern Med 2016 Oct;176(10):1565-67. doi: 10.1001/jamainternmed.2016.5027.
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Keywords: Adverse Events, Communication, Education: Patient and Caregiver, Patient Safety, Clinician-Patient Communication
Curtis LM, Mullen RJ, Russell A
An efficacy trial of an electronic health record-based strategy to inform patients on safe medication use: the role of written and spoken communication.
The researchers tested the feasibility and efficacy of an electronic health record (EHR) strategy that automated the delivery of print medication information at the time of prescribing. They found that written information and physician counseling were independently associated with patient understanding of risk information and that receiving both was most beneficial. They concluded that although an EHR can be a reliable means to deliver tangible, print medication education to patients, it cannot replace physician-patient communication, and that offering both written and spoken information resulted in a synergistic effect for informing patients.
AHRQ-funded; HS017220.
Citation: Curtis LM, Mullen RJ, Russell A .
An efficacy trial of an electronic health record-based strategy to inform patients on safe medication use: the role of written and spoken communication.
Patient Educ Couns 2016 Sep;99(9):1489-95. doi: 10.1016/j.pec.2016.07.004.
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Keywords: Electronic Health Records (EHRs), Communication, Education: Patient and Caregiver, Medication: Safety, Medication
Shay LA, Street RL, Jr., Baldwin AS
Characterizing safety-net providers' HPV vaccine recommendations to undecided parents: a pilot study.
The researchers developed a tool to describe strength and content of provider HPV vaccination recommendations. The tool showed how providers undercut their recommendations through qualifications or support them with a rationale. The authors recommended that providers would benefit from communication skills training on how to make explicit recommendations with an evidence-based rationale.
AHRQ-funded; HS022418.
Citation: Shay LA, Street RL, Jr., Baldwin AS .
Characterizing safety-net providers' HPV vaccine recommendations to undecided parents: a pilot study.
Patient Educ Couns 2016 Sep;99(9):1452-60. doi: 10.1016/j.pec.2016.06.027.
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Keywords: Practice Patterns, Vaccination, Infectious Diseases, Sexual Health, Clinician-Patient Communication, Guidelines, Evidence-Based Practice, Communication
Mueller SK, Schnipper JL, Giannelli K
Impact of regionalized care on concordance of plan and preventable adverse events on general medicine services.
This study regionalized 3 inpatient general medical teams to nursing units and examined the association with communication and preventable adverse events (AEs). It found that regionalization of care teams improved recognition of care team members, discussion of daily care plan, and agreement on estimated discharge date, but did not significantly improve nurse and physician concordance of the care plan or reduce the odds of preventable AEs.
AHRQ-funded; HS023331.
Citation: Mueller SK, Schnipper JL, Giannelli K .
Impact of regionalized care on concordance of plan and preventable adverse events on general medicine services.
J Hosp Med 2016 Sep;11(9):620-7. doi: 10.1002/jhm.2566.
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Keywords: Adverse Events, Communication, Hospitals, Patient Safety, Teams
Goss FR, Zhou L, Weiner SG
Incidence of speech recognition errors in the emergency department.
The study’s aim was to determine the incidence and types of speech recognition (SR) errors introduced by computerized SR technology in the emergency department (ED). It found that SR errors occur commonly with annunciation errors being the most frequent. Error rates were comparable if not lower than previous studies. Fifteen percent of errors were deemed critical, potentially leading to miscommunication that could affect patient care.
AHRQ-funded; HS024264.
Citation: Goss FR, Zhou L, Weiner SG .
Incidence of speech recognition errors in the emergency department.
Int J Med Inform 2016 Sep;93:70-3. doi: 10.1016/j.ijmedinf.2016.05.005.
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Keywords: Communication, Emergency Medical Services (EMS), Health Information Technology (HIT), Patient Safety
Gulbrandsen P, Clayman ML, Beach MC
Shared decision-making as an existential journey: aiming for restored autonomous capacity.
The researchers described the different ways in which illness represents an existential problem, and its implications for shared decision-making. They found that the fundamental uncertainty, state of vulnerability, and lack of power of the ill patient, imbue shared decision-making with a deeper existential significance and call for greater attention to the emotional and relational dimensions of care. They propose that the aim of shared decision-making should be restoration of the patient's autonomous capacity.
AHRQ-funded; HS022932.
Citation: Gulbrandsen P, Clayman ML, Beach MC .
Shared decision-making as an existential journey: aiming for restored autonomous capacity.
Patient Educ Couns 2016 Sep;99(9):1505-10. doi: 10.1016/j.pec.2016.07.014.
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Keywords: Communication, Shared Decision Making, Patient-Centered Healthcare, Patient and Family Engagement, Clinician-Patient Communication
McGinty EE, Samples H, Bandara SN
The emerging public discourse on state legalization of marijuana for recreational use in the US: analysis of news media coverage, 2010-2014.
The authors assessed the volume and content of US news media coverage on recreational marijuana policy. In the news outlets studies, they found that 53% of news stories mentioned pro-legalization arguments and 47% mentioned anti-legalization arguments. They concluded that it is critical for the public health community to develop communication strategies to convey accurately the rapidly evolving research evidence regarding recreational marijuana policy.
AHRQ-funded; HS000029.
Citation: McGinty EE, Samples H, Bandara SN .
The emerging public discourse on state legalization of marijuana for recreational use in the US: analysis of news media coverage, 2010-2014.
Prev Med 2016 Sep;90:114-20. doi: 10.1016/j.ypmed.2016.06.040.
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Keywords: Communication, Policy, Policy, Public Health
Menefee HK, Thompson MJ, Guterbock TM
Mechanisms of communicating health information through Facebook: implications for consumer health information technology design.
The authors aimed to characterize patients' use of communication mechanisms within Facebook for health information communication to provide insight into how consumer HIT solutions may be better designed to meet patients' communication needs and preferences. They found that participants consider multiple factors, including what information they intended to share, what they were trying to accomplish, attributes of technology, and attributes and communication practices of their social networks.
AHRQ-funded; HS022930.
Citation: Menefee HK, Thompson MJ, Guterbock TM .
Mechanisms of communicating health information through Facebook: implications for consumer health information technology design.
J Med Internet Res 2016 Aug 11;18(8):e218. doi: 10.2196/jmir.5949.
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Keywords: Communication, Education: Patient and Caregiver, Health Information Technology (HIT), Social Media, Web-Based
Jones LK, Jennings BM, Goelz RM
An ethogram to quantify operating room behavior.
The researchers adopted a method from the field of ethology for observing and quantifying the interpersonal interactions of operating room (OR) team members. They found that the ethogram's high interobserver reliability indicates its utility for yielding largely objective, descriptive, quantitative data on OR behavior.
AHRQ-funded; HS023403.
Citation: Jones LK, Jennings BM, Goelz RM .
An ethogram to quantify operating room behavior.
Ann Behav Med 2016 Aug;50(4):487-96. doi: 10.1007/s12160-016-9773-0.
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Keywords: Communication, Provider: Physician, Provider, Surgery, Patient Safety
Costa DK, Dammeyer J, White M
Interprofessional team interactions about complex care in the ICU: pilot development of an observational rating tool.
The purpose of this study was to examine the reliability of an observational rating tool to assess team interactions about the awakening and breathing coordination, delirium, and early mobility (ABCDE) bundle in one ICU. It provided pilot evidence of reliability of an observational rating tool to assess interprofessional team interactions about ABCDE.
AHRQ-funded; HS024552.
Citation: Costa DK, Dammeyer J, White M .
Interprofessional team interactions about complex care in the ICU: pilot development of an observational rating tool.
BMC Res Notes 2016 Aug 18;9:408. doi: 10.1186/s13104-016-2213-1.
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Keywords: Healthcare Delivery, Communication, Critical Care, Intensive Care Unit (ICU), Teams
Feraco AM, Starmer AJ, Sectish TC
Reliability of verbal handoff assessment and handoff quality before and after implementation of a resident handoff bundle.
This study developed validity evidence for the use of the Verbal Handoff Assessment Tool (VHAT),examined the reliability of VHAT scores, and determined whether implementation of a resident handoff bundle was associated with improved verbal patient handoffs among pediatric resident physicians. It found that verbal handoffs improved following implementation of a resident handoff bundle, though gains were variable across the two clinical units.
AHRQ-funded; HS019456.
Citation: Feraco AM, Starmer AJ, Sectish TC .
Reliability of verbal handoff assessment and handoff quality before and after implementation of a resident handoff bundle.
Acad Pediatr 2016 Aug;16(6):524-31. doi: 10.1016/j.acap.2016.04.002.
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Keywords: Care Coordination, Communication, Children/Adolescents
Shoemaker SJ, Parchman ML, Fuda KK
AHRQ Author: Ricciardi
A review of instruments to measure interprofessional team-based primary care.
The study’s aims were to develop a conceptual framework of high-functioning primary care teams to identify and review instruments that measure the constructs identified in the framework. The majority of instruments were surveys, and the remainder were observational checklists. They addressed multiple constructs, most commonly communication, heedful interrelating , respectful interactions, and shared explicit goals.
AHRQ-authored.
Citation: Shoemaker SJ, Parchman ML, Fuda KK .
A review of instruments to measure interprofessional team-based primary care.
J Interprof Care 2016 Jul;30(4):423-32. doi: 10.3109/13561820.2016.1154023..
Keywords: Communication, Healthcare Delivery, Primary Care, Teams
Smith KJ, Handler SM, Kapoor WN
Automated communication tools and computer-based medication reconciliation to decrease hospital discharge medication errors.
This study examines a health care system’s implementation of a broader set of automated primary care physician communication tools, including computerized medication reconciliation, and its impact on discharge medication errors. It found that implementation of automated health system–based tools, including computerized discharge medication reconciliation, decreased hospital discharge medication errors in medically complex patients.
AHRQ-funded; HS018151.
Citation: Smith KJ, Handler SM, Kapoor WN .
Automated communication tools and computer-based medication reconciliation to decrease hospital discharge medication errors.
Am J Med Qual 2016 Jul;31(4):315-22. doi: 10.1177/1062860615574327..
Keywords: Health Information Technology (HIT), Communication, Medication, Medical Errors, Hospital Discharge