National Healthcare Quality and Disparities Report
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Topics
- Access to Care (4)
- Adverse Drug Events (ADE) (1)
- Adverse Events (2)
- Ambulatory Care and Surgery (1)
- Cardiovascular Conditions (1)
- Care Management (1)
- Children/Adolescents (2)
- Communication (1)
- Critical Care (2)
- Disparities (3)
- Elderly (1)
- Emergency Department (5)
- Healthcare Cost and Utilization Project (HCUP) (4)
- Healthcare Costs (3)
- (-) Healthcare Delivery (26)
- Healthcare Utilization (1)
- Health Information Technology (HIT) (1)
- Health Insurance (1)
- Health Services Research (HSR) (1)
- Heart Disease and Health (1)
- Hospitalization (3)
- Hospital Readmissions (1)
- Hospitals (6)
- Intensive Care Unit (ICU) (2)
- Medicaid (1)
- Medicare (2)
- Mortality (1)
- Neurological Disorders (1)
- Opioids (1)
- Orthopedics (2)
- Outcomes (2)
- Patient-Centered Outcomes Research (1)
- Patient Safety (4)
- Payment (1)
- Provider (1)
- Provider: Clinician (1)
- Quality Improvement (2)
- Quality Measures (1)
- Quality of Care (3)
- Racial and Ethnic Minorities (2)
- Research Methodologies (1)
- Shared Decision Making (1)
- (-) Surgery (26)
- Teams (2)
- Telehealth (1)
- Transitions of Care (5)
- Transplantation (1)
- Trauma (1)
- Workflow (2)
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 26 Research Studies DisplayedLai LY, Kaufman SR, Modi PK
Impact of advanced practice provider integration into multispecialty group practices on outcomes following major surgery.
Researchers examined the impact of advanced practice provider (APP) integration into multispecialty group practices on outcomes after major surgery. Using Medicare data, they found that integration of APPs into multispecialty group practices was associated with improved postoperative outcomes after major surgery. They recommended that future research identify the mechanisms by which APPs improve outcomes to inform optimal utilization.
AHRQ-funded; HS025707.
Citation: Lai LY, Kaufman SR, Modi PK .
Impact of advanced practice provider integration into multispecialty group practices on outcomes following major surgery.
Surg Innov 2022 Feb;29(1):111-17. doi: 10.1177/15533506211013150..
Keywords: Surgery, Healthcare Delivery
Kemp MT, Williams AM, Brown CS
Practical guidance for early identification of barriers in surgical telehealth clinics.
The authors provide advice on early identification of and response to barriers in telehealth settings in order to help patients receive optimal care. Their focus is on standardizing expectations, assessing technological knowledge and resource access, evaluating understanding and comfort with telehealth, and assessing social support.
AHRQ-funded; HS000053.
Citation: Kemp MT, Williams AM, Brown CS .
Practical guidance for early identification of barriers in surgical telehealth clinics.
Ann Surg 2021 Jun;273(6):e268-e70. doi: 10.1097/sla.0000000000004633..
Keywords: Surgery, Telehealth, Health Information Technology (HIT), Healthcare Delivery, Access to Care
Hollingsworth JM, Yu X, Yan PL
Provider care team segregation and operative mortality following coronary artery bypass grafting.
The purpose of this study was to examine whether provider care team segregation within hospitals contributes to the higher mortality rate of Black patients following coronary artery bypass grafting compared to their White counterparts. Using national Medicare data, findings showed that Black patients who undergo coronary artery bypass grafting at a hospital with a higher level of provider care team segregation die more frequently after surgery than Black patients treated at a hospital with a lower level.
AHRQ-funded; HS026908.
Citation: Hollingsworth JM, Yu X, Yan PL .
Provider care team segregation and operative mortality following coronary artery bypass grafting.
Circ Cardiovasc Qual Outcomes 2021 May;14(5):e007778. doi: 10.1161/circoutcomes.120.007778..
Keywords: Surgery, Heart Disease and Health, Cardiovascular Conditions, Mortality, Teams, Healthcare Delivery, Racial and Ethnic Minorities
Jurewicz KA, Neyens DM, Catchpole K
Observational study of anaesthesia workflow to evaluate physical workspace design and layout.
The objective of this study was to observe the relationship between task switching and physical layout, and then use the data collected to design and assess different anesthesia workspace layouts. Six videos of anesthesia providers from a single medical center in the United States were analyzed. Findings showed that current operating theater layouts do not fit work demands. The authors reported a simple method that facilitates a quick layout design assessment and showed that the anesthesia workspace can be improved to better suit workflow and patient care. They suggested that this arrangement could reduce anesthesia workload while improving task flow efficiency and potentially the safety of care.
AHRQ-funded; HS024380.
Citation: Jurewicz KA, Neyens DM, Catchpole K .
Observational study of anaesthesia workflow to evaluate physical workspace design and layout.
Br J Anaesth 2021 Mar;126(3):633-41. doi: 10.1016/j.bja.2020.08.063..
Keywords: Workflow, Healthcare Delivery, Surgery
Fernandes-Taylor S, Yang DY, Schumacher J
Factors associated with Interhospital transfers of emergency general surgery patients from emergency departments.
This study looked at the factors contributing to transfer of emergency general surgery (EGS) patients to another hospital. Data from the AHRQ Nationwide Emergency Department Sample (NEDS) from 2010-2014 was analyzed. The transfer rate during that time was 1.9%. Patients with Medicare or other insurance had higher odds of transfer compared to patients with private health insurance. Odds of transfer increased with a greater number of comorbid conditions as well as resuscitation, intestinal obstruction, and conditions of the upper gastrointestinal tract. Transfers were more likely to originate from rural hospitals or Level I or II trauma centers.
AHRQ-funded; HS025224.
Citation: Fernandes-Taylor S, Yang DY, Schumacher J .
Factors associated with Interhospital transfers of emergency general surgery patients from emergency departments.
Am J Emerg Med 2021 Feb;40:83-88. doi: 10.1016/j.ajem.2020.12.012..
Keywords: Healthcare Cost and Utilization Project (HCUP), Surgery, Emergency Department, Transitions of Care, Hospitals, Healthcare Delivery
Feldman AG, Marsh R, Kempe A
Barriers to pretransplant immunization: a qualitative interview study of pediatric solid organ transplant stakeholders.
Investigators described the experiences and beliefs of pediatric transplant stakeholders regarding factors that contribute to low pre-transplant immunization rates. Five central themes emerged: gaps in knowledge about timing and safety of pre-transplant immunizations; lack of communication, coordination, and follow-up between team members; lack of centralized immunization records; subspecialty clinics functioning as the medical home for transplant candidates, but not able to provide all needed immunizations; and differences between organ type in prioritization and completion of pre-transplant immunization. The authors recommended new tools to overcome these barriers and to increase immunization rates in transplant candidates.
AHRQ-funded; HS026510.
Citation: Feldman AG, Marsh R, Kempe A .
Barriers to pretransplant immunization: a qualitative interview study of pediatric solid organ transplant stakeholders.
J Pediatr 2020 Dec;227:60-68. doi: 10.1016/j.jpeds.2020.07.038..
Keywords: Children/Adolescents, Transplantation, Surgery, Healthcare Delivery, Healthcare Utilization
Tameron AM, Ricci KB, Oslock WM
The association between self-declared acute care surgery services and critical care resources: results from a national survey.
In this study, the investigators examined differences in critical care structures and processes between hospitals with Acute Care Surgery (ACS) versus general surgeon on call (GSOC) models for emergency general surgery (EGS) care. The investigators concluded that while harnessing of critical care structures and processes varied across hospitals that had implemented ACS, overall ACS models of care appeared to have more robust critical care practices.
AHRQ-funded; HS022694.
Citation: Tameron AM, Ricci KB, Oslock WM .
The association between self-declared acute care surgery services and critical care resources: results from a national survey.
J Crit Care 2020 Dec;60:84-90. doi: 10.1016/j.jcrc.2020.04.002..
Keywords: Surgery, Critical Care, Emergency Department, Healthcare Delivery, Hospitals
Santry HP, Strassels SA, Ingraham AM
Identifying the fundamental structures and processes of care contributing to emergency general surgery quality using a mixed-methods Donabedian approach.
Acute Care Surgery (ACS) was developed as a structured, team-based approach to providing round-the-clock emergency general surgery (EGS) care for adult patients needing treatment for diseases such as cholecystitis, gastrointestinal perforation, and necrotizing fasciitis. In this study, the investigators sought to use a Donabedian approach to elucidate potential EGS structures and processes that might be associated with improved outcomes as an initial step in designing the optimal model of acute care surgery care for EGS patients.
AHRQ-funded; HS022694.
Citation: Santry HP, Strassels SA, Ingraham AM .
Identifying the fundamental structures and processes of care contributing to emergency general surgery quality using a mixed-methods Donabedian approach.
BMC Med Res Methodol 2020 Oct 2;20(1):247. doi: 10.1186/s12874-020-01096-7..
Keywords: Surgery, Critical Care, Healthcare Delivery, Health Services Research (HSR), Research Methodologies
Vakayil V, Ingraham NE, Robbins AJ
Epidemiological trends of surgical admissions to the intensive care unit in the United States.
Epidemiologic assessment of surgical admissions into intensive care units (ICUs) provides a framework to evaluate health care system efficiency and project future health care needs. The investigators performed a 9-year (2008-2016), retrospective, cohort analysis of all adult admissions to 88 surgical ICUs. They concluded that temporal analysis demonstrated a significant change in the type of surgical patients admitted to the ICU over the last decade, with decreasing mortality and LOS in selected cohorts, but an increasing rate of FS deterioration.
AHRQ-funded; HS026379.
Citation: Vakayil V, Ingraham NE, Robbins AJ .
Epidemiological trends of surgical admissions to the intensive care unit in the United States.
J Trauma Acute Care Surg 2020 Aug;89(2):279-88. doi: 10.1097/ta.0000000000002768..
Keywords: Intensive Care Unit (ICU), Surgery, Healthcare Delivery
Oslock WM, Ricci KB, Ingraham AM
Role of interprofessional teams in emergency general surgery patient outcomes.
This paper discusses the results of a 2015 survey of acute care hospitals, which asked whether residents and advanced practice providers participate in emergency general surgery care. The data was then linked to patient data from 17 State Inpatient Databases using American Hospital Association identifiers to determine if that was associated with better management of patients, mortality, or complications. Eighty-three hospitals and 49,271 unique emergency general surgery admissions were included in the dataset. Hospitals with residents had reduced odds of systemic complications compared with hospitals without them or other clinical support. Hospitals with only residents had the lowest odds of operative complication.
AHRQ-funded; HS022694.
Citation: Oslock WM, Ricci KB, Ingraham AM .
Role of interprofessional teams in emergency general surgery patient outcomes.
Surgery 2020 Aug;168(2):347-53. doi: 10.1016/j.surg.2020.04.046..
Keywords: Healthcare Cost and Utilization Project (HCUP), Teams, Surgery, Adverse Events, Hospitals, Healthcare Delivery
Kaye DR, Luckenbaugh AN, Oerline M
Understanding the costs associated with surgical care delivery in the Medicare population.
This study’s objective was to quantify the costs of inpatient and outpatient surgery in the Medicare population. Claims data from a 20% national sample of Medicare beneficiaries was used. Results showed that, while spending on inpatient surgery contributed the most to total surgical payments, it declined over the study period, driven by decreases in index hospitalization and readmissions payments. In contrast, spending on outpatient surgery increased across all sites of care (hospital outpatient department, physician office, and ambulatory surgery center). Ophthalmology and hand surgery witnessed the greatest growth in surgical spending over the study period. Surgical care accounts for half of all Medicare spending.
AHRQ-funded; HS024525; HS024728.
Citation: Kaye DR, Luckenbaugh AN, Oerline M .
Understanding the costs associated with surgical care delivery in the Medicare population.
Ann Surg 2020 Jan;271(1):23-28. doi: 10.1097/sla.0000000000003165..
Keywords: Surgery, Healthcare Delivery, Healthcare Costs, Medicare, Elderly, Hospitalization
Ingraham A, Wang X, Havlena J
Factors associated with the interhospital transfer of emergency general surgery patients.
Researchers used data from the Nationwide Inpatient Sample to determine patient- and hospital-level factors associated with interhospital emergency general surgery (EGS) transfers. They identified that hospital-level characteristics more strongly predicted the need for transfer than patient-related factors. They recommended considering these factors in order to facilitate transfer decision-making.
AHRQ-funded; HS025224.
Citation: Ingraham A, Wang X, Havlena J .
Factors associated with the interhospital transfer of emergency general surgery patients.
J Surg Res 2019 Aug;240:191-200. doi: 10.1016/j.jss.2018.11.053..
Keywords: Healthcare Cost and Utilization Project (HCUP), Emergency Department, Surgery, Shared Decision Making, Hospitals, Healthcare Delivery, Transitions of Care
Dy CJ, Tipping AD, Nickel KB
Variation in the delivery of inpatient orthopaedic care to Medicaid beneficiaries within a single metropolitan region.
This study examined rates of Medicaid-funded surgical procedures for orthopedic patients. The authors hypothesized that orthopedists and hospitals are often unwilling to perform surgery on underinsured patients. The payer mix was examined for select inpatient orthopedic surgical procedures within a single region, including elective cases (total knee or hip arthroplasty; spinal decompression or fusion) and trauma cases (hip hemiarthroplasty; femoral or tibial or fibular fracture repair) among 22 hospitals from 2011 to 2016 for patients aged 18 to 64 years. For all cases (n = 19,204) the mean percentage of Medicaid-funded surgical procedures was 7.6%. Elective surgery cases were 5.5% and trauma cases 14.7% which supports their beliefs about delivery rates of orthopedic care on the basis of socioeconomic markers.
AHRQ-funded; HS019455.
Citation: Dy CJ, Tipping AD, Nickel KB .
Variation in the delivery of inpatient orthopaedic care to Medicaid beneficiaries within a single metropolitan region.
J Bone Joint Surg Am 2019 Aug 21;101(16):1451-59. doi: 10.2106/jbjs.18.01198.
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Keywords: Orthopedics, Healthcare Delivery, Medicaid, Surgery, Access to Care, Disparities, Health Insurance
Hoonakker PLT, Wooldridge AR, Hose BZ
Information flow during pediatric trauma care transitions: things falling through the cracks.
In order to investigate information flow during pediatric trauma care transitions, researchers interviewed 18 clinicians about communication and coordination between the emergency department, operating room, and pediatric intensive care unit, then surveyed the clinicians about patient safety during these transitions. They found that, despite the fact that the many services and units involved in pediatric trauma cooperate well together during trauma cases, important patient care information is often lost when transitioning patients between units. To manage the transition of this fragile and complex population better, they recommend finding ways to manage the information flow during these transitions better by, for instance, providing technological support to ensure shared mental models.
AHRQ-funded; HS023837.
Citation: Hoonakker PLT, Wooldridge AR, Hose BZ .
Information flow during pediatric trauma care transitions: things falling through the cracks.
Intern Emerg Med 2019 Aug;14(5):797-805. doi: 10.1007/s11739-019-02110-7..
Keywords: Children/Adolescents, Communication, Emergency Department, Healthcare Delivery, Intensive Care Unit (ICU), Patient Safety, Provider, Provider: Clinician, Surgery, Transitions of Care, Trauma
Joseph A, Khoshkenar A, Taaffe KM
Minor flow disruptions, traffic-related factors and their effect on major flow disruptions in the operating room.
This study researched the impact of minor flow disruptions (FDs) on operating room (OR) flow and how it contributes to an increase in serious adverse events. The rate of minor FDs increases the rate of major FDs. More major and minor FDs occur in the anesthesia area than in all other OR areas. They concluded that room design and layout issues contribute to those FDs and that is an important consideration in OR design.
AHRQ-funded; HS024380.
Citation: Joseph A, Khoshkenar A, Taaffe KM .
Minor flow disruptions, traffic-related factors and their effect on major flow disruptions in the operating room.
BMJ Qual Saf 2019 Apr;28(4):276-83. doi: 10.1136/bmjqs-2018-007957.
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Keywords: Adverse Events, Healthcare Delivery, Patient Safety, Surgery, Workflow
Lauerman MH, Herrera AV, Albrecht JS
Interhospital transfers with wide variability in emergency general surgery.
This study examined modern hospital practices for interhospital transfers of emergency general surgery patients. A retrospective review of the Maryland Health Services Cost Review Commission database was conducted from 2013 to 2015. The majority of patients (94.1%) were not transferred with only 3.2% transferred to a hospital and 2.7% transferred from a hospital. For individual hospitals, there was a range of 0-30.5% of encounters transferred to a hospital, 0.02-14.62% transferred from a hospital and 69.25-99.95% not transferred.
AHRQ-funded; HS024560.
Citation: Lauerman MH, Herrera AV, Albrecht JS .
Interhospital transfers with wide variability in emergency general surgery.
Am Surg 2019 Jun;85(6):595-600..
Keywords: Emergency Department, Healthcare Delivery, Hospitalization, Hospitals, Outcomes, Quality of Care, Surgery, Transitions of Care
Borza T, Oerline MK, Skolarus TA
Association between hospital participation in Medicare Shared Savings Program Accountable Care Organizations and readmission following major surgery.
Accountable Care Organizations (ACOs) and readmission rates following major surgery. A retrospective cohort study was conducted using a 20% national Medicare sample to identify beneficiaries undergoing 1 of 7 common surgical procedures: abdominal aortic aneurysm repair, colectomy, cystectomy, prostatectomy, lung resection, total knee arthroplasty, and total hip arthroplasty between 2010 and 2014. Thirty-day risk-adjusted readmission rates was the primary outcome studied. Out of 2974 hospitals in the study, 389 were ACO affiliated. While rates fell for both cohorts, ACO hospitals had a higher decrease in hospitalizations over the same time period.
AHRQ-funded; HS024728; HS024525.
Citation: Borza T, Oerline MK, Skolarus TA .
Association between hospital participation in Medicare Shared Savings Program Accountable Care Organizations and readmission following major surgery.
Ann Surg 2019 May;269(5):873-78. doi: 10.1097/sla.0000000000002737..
Keywords: Hospitals, Surgery, Hospital Readmissions, Medicare, Healthcare Costs, Healthcare Delivery
Symer MM, Abelson JS, Yeo L
Barriers to regionalized surgical care: public perspective survey and geospatial analysis.
A cross-sectional telephone survey was performed as part of the Cornell National Social Survey. Participants had an average age of 50 and were 48.9% female. Almost half were unwilling to travel 5 hours or more to get regionalized care. Participants who were aged 70 or more had a decreased willingness to travel a perceived 30 minutes or more to a center. The higher the income, the more willingness to travel increased distances. Major perceived barriers were transportation, life disruption, social support, income levels, poor health and remoteness.
AHRQ-funded; HS000066.
Citation: Symer MM, Abelson JS, Yeo L .
Barriers to regionalized surgical care: public perspective survey and geospatial analysis.
Ann Surg 2019 Jan;269(1):73-78. doi: 10.1097/sla.0000000000002556..
Keywords: Surgery, Access to Care, Healthcare Delivery
Wahl TS, Goss LE, Morris MS
Enhanced Recovery After Surgery (ERAS) eliminates racial disparities in postoperative length of stay after colorectal surgery.
The purpose of this study was to investigate the effects of enhanced recovery after surgery (ERAS) on racial disparities in postoperative length of stay (pLOS) after colorectal surgery. The authors hypothesized that ERAS would reduce disparities in pLOS between black and white patients. They concluded that ERAS eliminated racial differences in pLOS between black and white patients undergoing colorectal surgery. Reduced pLOS occurred without increases in mortality, readmissions, and most postoperative complications.
AHRQ-funded; HS013852.
Citation: Wahl TS, Goss LE, Morris MS .
Enhanced Recovery After Surgery (ERAS) eliminates racial disparities in postoperative length of stay after colorectal surgery.
Ann Surg 2018 Dec;268(6):1026-35. doi: 10.1097/sla.0000000000002307..
Keywords: Surgery, Racial and Ethnic Minorities, Disparities, Care Management, Healthcare Delivery, Hospitalization, Patient-Centered Outcomes Research, Outcomes
Mueller SK, Zheng J, Orav J
Interhospital transfer and receipt of specialty procedures.
This study examines the practice of transferring patients between acute care hospitals, and whether the patient actually receives the specialty services at the new hospital which is the reason for the transfer. A retrospective analysis used 2013 100% Master Beneficiary Summary and Inpatient claims files from the CMS. The cohort were aged 65 and above, continuously enrolled in Medicare A and B, with an acute care hospitalization claim, and transferred to another acute hospital with a primary diagnosis of acute myocardial infarction, gastrointestinal bleed, renal failure, or hip fracture/dislocation. Of the 19,613 included beneficiaries, between 32.4% and 89.1% did not receive any associated specialty procedure at the receiving hospital.
AHRQ-funded; HS023331.
Citation: Mueller SK, Zheng J, Orav J .
Interhospital transfer and receipt of specialty procedures.
J Hosp Med 2018 Jun;13(6):383-87. doi: 10.12788/jhm.2875..
Keywords: Transitions of Care, Patient Safety, Surgery, Healthcare Delivery
Spertus JA, Ghaferi AA
Transforming the National Surgical Quality Improvement Program to the delivery of precision medicine to improve the value of surgical care: Summary of the John R. Clarke keynote address for the Surgical Outcomes Club 2016 Annual Meeting.
The authors challenged the audience to begin thinking about implementing precision medicine in routine care. They argue that the profession of medicine is undergoing an unprecedented transformation from fee-for-service to value-based reimbursement. This offers an opportunity to rethink current practice patterns and redesign health care delivery to improve patients’ experiences and outcomes while lowering costs. The surgical community has a unique opportunity to embrace this challenge and develop tools to better tailor treatment to risk.
AHRQ-funded; HS023621.
Citation: Spertus JA, Ghaferi AA .
Transforming the National Surgical Quality Improvement Program to the delivery of precision medicine to improve the value of surgical care: Summary of the John R. Clarke keynote address for the Surgical Outcomes Club 2016 Annual Meeting.
JAMA Surg 2017 Sep;152(9):815-16. doi: 10.1001/jamasurg.2017.1610.
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Keywords: Healthcare Delivery, Quality of Care, Patient Safety, Quality Improvement, Surgery
Waljee JF, Cron DC, Steiger RM
Effect of preoperative opioid exposure on healthcare utilization and expenditures following elective abdominal surgery.
The researchers examined the extent to which preoperative opioid use is correlated with healthcare utilization and costs following elective surgical procedures. They found that compared with non-users, patients using opioids preoperatively were more likely to have a longer hospital stay and were more likely to be discharged to a rehabilitation facility , adjusting for covariates.
AHRQ-funded; HS023313.
Citation: Waljee JF, Cron DC, Steiger RM .
Effect of preoperative opioid exposure on healthcare utilization and expenditures following elective abdominal surgery.
Ann Surg 2017 Apr;265(4):715-21. doi: 10.1097/sla.0000000000002117.
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Keywords: Opioids, Surgery, Healthcare Delivery, Healthcare Costs, Adverse Drug Events (ADE)
Dy CJ, Baty J, Saeed MJ
A population-based analysis of time to surgery and travel distances for brachial plexus surgery.
Since the published brachial plexus injuries (BPI) experience is largely from individual centers, the authors used a population-based approach to evaluate the delivery of care for patients with BPI. They found that nearly one third of patients underwent BPI surgery more than 1 year after the injury, with patients initially treated at smaller hospitals at risk for undergoing delayed BPI surgery. These findings can inform efforts to expedite timely referral of patients with BPI to experienced centers.
AHRQ-funded; HS019455.
Citation: Dy CJ, Baty J, Saeed MJ .
A population-based analysis of time to surgery and travel distances for brachial plexus surgery.
J Hand Surg Am 2016 Sep;41(9):903-09.e3. doi: 10.1016/j.jhsa.2016.07.054.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Healthcare Delivery, Surgery, Neurological Disorders
Minami CA, Sheils CR, Bilimoria KY
Process improvement in surgery.
The authors reviewed aspects of process improvement-quality improvement that are relevant to the currently practicing surgeon. They discussed commonly used quality improvement data platforms, process improvement methodologies, examples of successful local quality improvement initiatives, the role of regional surgical improvement collaboratives, common barriers to quality improvement efforts, and potential solutions to overcome them.
AHRQ-funded; HS000078.
Citation: Minami CA, Sheils CR, Bilimoria KY .
Process improvement in surgery.
Curr Probl Surg 2016 Feb;53(2):62-96. doi: 10.1067/j.cpsurg.2015.11.001.
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Keywords: Healthcare Delivery, Quality of Care, Quality Improvement, Quality Measures, Surgery
Dy CY, Marx RG, Ghomrawi HM
The potential influence of regionalization strategies on delivery of care for elective total joint arthroplasty.
Regionalization of total joint arthroplasty (TJA) to high volume hospitals (HVHs) may affect access to care and complication risk. Using administrative data, the authors found that the complication risk was higher if patients went to a local low volume hospital. Black and Medicaid patients were more likely to utilize the local low volume hospital than a local HVH. Utilizing a local HVH is associated with lower complication risks, but patients from vulnerable groups were less likely to utilize these patterns.
AHRQ-funded; HS016075.
Citation: Dy CY, Marx RG, Ghomrawi HM .
The potential influence of regionalization strategies on delivery of care for elective total joint arthroplasty.
J Arthroplasty 2015 Jan;30(1):1-6. doi: 10.1016/j.arth.2014.08.017.
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Keywords: Access to Care, Disparities, Healthcare Delivery, Orthopedics, Surgery