National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Events (2)
- Ambulatory Care and Surgery (1)
- Behavioral Health (1)
- Burnout (1)
- Cancer (2)
- Cancer: Lung Cancer (1)
- Cardiovascular Conditions (2)
- Care Coordination (2)
- Care Management (2)
- Case Study (1)
- Chronic Conditions (1)
- Clinician-Patient Communication (1)
- Communication (4)
- Critical Care (1)
- Depression (1)
- Elderly (1)
- Evidence-Based Practice (1)
- Guidelines (1)
- Healthcare-Associated Infections (HAIs) (1)
- Healthcare Delivery (4)
- Health Information Technology (HIT) (3)
- Hospital Readmissions (1)
- Hospitals (4)
- Implementation (1)
- Inpatient Care (1)
- Intensive Care Unit (ICU) (2)
- Labor and Delivery (1)
- Maternal Care (1)
- Medicare (1)
- Mortality (1)
- Neonatal Intensive Care Unit (NICU) (1)
- Newborns/Infants (2)
- Nursing (1)
- Organizational Change (2)
- Outcomes (4)
- Patient-Centered Healthcare (4)
- Patient-Centered Outcomes Research (1)
- Patient Safety (5)
- Practice Improvement (1)
- Practice Patterns (1)
- Pregnancy (1)
- Prevention (1)
- Primary Care (6)
- Provider: Physician (1)
- Quality Improvement (4)
- Quality of Care (4)
- Rural Health (1)
- Surgery (2)
- (-) Teams (22)
- TeamSTEPPS (1)
- Tools & Toolkits (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 22 of 22 Research Studies DisplayedO'Leary KJ, Johnson JK, Williams MV
Effect of complementary interventions to redesign care on teamwork and quality for hospitalized medical patients: a pragmatic controlled trial.
The objective of this pragmatic controlled trial was to evaluate the effect of interventions to redesign hospital care delivery on teamwork and patient outcomes. Survey participants were healthcare professionals and hospitalized medical patients in medical units at four U.S. hospitals. The results showed that the median teamwork climate score was higher after the intervention among nurses, but that interventions to redesign care for hospitalized patients were not associated with improved patient outcomes.
AHRQ-funded; HS02564.
Citation: O'Leary KJ, Johnson JK, Williams MV .
Effect of complementary interventions to redesign care on teamwork and quality for hospitalized medical patients: a pragmatic controlled trial.
Ann Intern Med 2023 Nov; 176(11):1456-64. doi: 10.7326/m23-0953..
Keywords: Teams, Inpatient Care, Hospitals, Quality of Care, Outcomes
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
Stierman EK, O'Brien BT, Stagg J
AHRQ Author: Fabiyi CA, Chew E, Harding B, Mistry KB
Statewide perinatal quality improvement, teamwork, and communication activities in Oklahoma and Texas.
The objective of this study was to describe perinatal quality improvement activities, specifically the implementation of Alliance for Innovation on Maternal Health (AIM) patient safety bundles and use of teamwork and communication tools in obstetric units. Researchers conducted a survey of AIM-enrolled hospitals in Oklahoma and Texas and gathered data on obstetric unit organization and QI processes. Their findings showed that adoption of QI processes varied and also highlighted the need to reinforce support for rural obstetric units, which often face greater barriers to implementing patient safety and QI processes than urban units. The researchers concluded that this has implications for implementing future perinatal QI initiatives.
AHRQ-authored; AHRQ-funded; 233201500020I.
Citation: Stierman EK, O'Brien BT, Stagg J .
Statewide perinatal quality improvement, teamwork, and communication activities in Oklahoma and Texas.
Qual Manag Health Care 2023 Jul-Sep; 32(3):177-88. doi: 10.1097/qmh.0000000000000407..
Keywords: Quality Improvement, Teams, Communication, Maternal Care, Quality of Care
Casalino LP, Jung HY, Bodenheimer T
The association of teamlets and teams with physician burnout and patient outcomes.
This cross-sectional observational study’s goal was to determine the prevalence and performance of primary care teamlets and teams. Survey participants included 688 general internists and family physicians. Physicians were assigned to one of four teamlet/team categories (e.g., teamlet/no team) and, in secondary analyses, to one of eight teamlet/team categories that classified teamlets into high, medium, and low collaboration as perceived by the physician (e.g., teamlet perceived-high collaboration/no team) based on their responses. The majority of physicians (77.4%) practiced in teamlets; 36.7% in teams. The four categories were divided as follows: 49.1% practiced in the teamlet/no team category; 28.3% in the teamlet/team category; 8.4% in no teamlet/team; 14.1% in no teamlet/no team. Results showed that 15.7%, 47.4%, and 14.4% of physicians practiced in perceived high-, medium-, and low-collaboration teamlets. Physicians who did not practice in a teamlet or team had significantly lower rate of burnout compared to the three teamlet/team categories. There were no significant differences in outcomes or Medicare spending by teamlet/team or teamlet perceived-collaboration/team categories compared to no teamlet/no team, for Medicare beneficiaries in general, or for dual-eligible beneficiaries.
AHRQ-funded; HS025716.
Citation: Casalino LP, Jung HY, Bodenheimer T .
The association of teamlets and teams with physician burnout and patient outcomes.
J Gen Intern Med 2023 May; 38(6):1384-92. doi: 10.1007/s11606-022-07894-7..
Keywords: Teams, Burnout, Primary Care, Provider: Physician
Gregory ME, MacEwan SR, Sova LN
A qualitative examination of interprofessional teamwork for infection prevention: development of a model and solutions.
The objective of this study was to investigate the role of interprofessional teamwork in the prevention of health care-associated infections (HAIs), focusing on central line-associated bloodstream infection (CLABSI) and catheter-associated urinary tract infection (CAUTI) prevention. The authors interviewed participating physicians, nurses, and other staff from 18 hospitals about interprofessional collaboration, and proposed an Input-Mediator-Output-Input (IMOI) model as well as strategies to support teamwork for the prevention of HAIs.
AHRQ-funded; HS024958.
Citation: Gregory ME, MacEwan SR, Sova LN .
A qualitative examination of interprofessional teamwork for infection prevention: development of a model and solutions.
Med Care Res Rev 2023 Feb;80(1):30-42. doi: 10.1177/10775587221103973..
Keywords: Teams, Prevention, Healthcare-Associated Infections (HAIs)
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)
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
Burstein PD, Zalenski DM, Edwards JL
Changing labor and delivery practice: focus on achieving practice and documentation standardization with the goal of improving neonatal outcomes.
The researchers established a multifactorial shoulder dystocia response and management protocol to promote sustainable practice change. In the first year, there was a threefold increase in shoulder dystocia reporting, which continued in years 2 and 3. In the first year, 96 percent of clinicians completed all training elements. Overall teams reached a 99 percent adoption rate of the shoulder dystocia protocol.
AHRQ-funded; HS019608.
Citation: Burstein PD, Zalenski DM, Edwards JL .
Changing labor and delivery practice: focus on achieving practice and documentation standardization with the goal of improving neonatal outcomes.
Health Serv Res 2016 Dec;51 Suppl 3:2472-86. doi: 10.1111/1475-6773.12589.
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Keywords: Labor and Delivery, Newborns/Infants, Adverse Events, Quality Improvement, Quality of Care, Patient Safety, Patient-Centered Outcomes Research, Outcomes, Guidelines, Evidence-Based Practice, Pregnancy, Teams
Profit J, Lee HC, Sharek PJ
Comparing NICU teamwork and safety climate across two commonly used survey instruments.
The objectives of this study were to assess variation in safety and teamwork climate and in the neonatal intensive care unit (NICU) setting, and compare measurement of safety culture scales using two different instruments (Safety Attitudes Questionnaire (SAQ) and Hospital Survey on Patient Safety Culture (HSOPSC)). It concluded that large variation and opportunities for improvement in patient safety culture exist across NICUs. Important systematic differences exist between SAQ and HSOPSC.
AHRQ-funded; HS014246.
Citation: Profit J, Lee HC, Sharek PJ .
Comparing NICU teamwork and safety climate across two commonly used survey instruments.
BMJ Qual Saf 2016 Dec;25(12):954-61. doi: 10.1136/bmjqs-2014-003924.
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Keywords: Hospitals, Intensive Care Unit (ICU), Neonatal Intensive Care Unit (NICU), Newborns/Infants, Patient Safety, Teams
Lee SJ, Clark MA, Cox JV
Achieving coordinated care for patients with complex cases of cancer: a multiteam system approach.
The authors outlined challenges of care coordination in the context of a multiteam system (MTS), through the care experience of a patient in the Dallas County integrated safety-net system. A cancer diagnosis triggered an additional need for augmented coordination between his different provider teams. The authors recommend that further research and practice investigate the relationships of MTS coordination for shared care management, transfer to and from specialty care, treatment compliance, barriers to care, and health outcomes of chronic comorbid conditions, as well as cancer control and surveillance.
AHRQ-funded; HS022418.
Citation: Lee SJ, Clark MA, Cox JV .
Achieving coordinated care for patients with complex cases of cancer: a multiteam system approach.
J Oncol Pract 2016 Nov;12(11):1029-38. doi: 10.1200/jop.2016.013664.
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Keywords: Cancer, Care Coordination, Chronic Conditions, Patient-Centered Healthcare, Teams
Hollingsworth JM, Funk RJ, Garrison SA
Association between physician teamwork and health system outcomes after coronary artery bypass grafting.
The researchers tested whether teamwork (assessed with the bipartite clustering coefficient) among multiple providers dispersed across many care locations is a determinant of surgical outcomes by examining national Medicare data from patients undergoing CABG. They found that health systems with higher teamwork levels had significantly lower 60-day rates of emergency department visit, readmission, and mortality.
AHRQ-funded; HS020927.
Citation: Hollingsworth JM, Funk RJ, Garrison SA .
Association between physician teamwork and health system outcomes after coronary artery bypass grafting.
Circ Cardiovasc Qual Outcomes 2016 Nov;9(6):641-48. doi: 10.1161/circoutcomes.116.002714.
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Keywords: Teams, Outcomes, Medicare, Surgery, Hospital Readmissions, Cardiovascular Conditions
Gerber DE, Reimer T, Williams EL
Resolving rivalries and realigning goals: challenges of clinical and research multiteam systems.
This article describes the care processes for a 64-year-old man with newly diagnosed advanced non-small-cell lung cancer who was enrolled in a first-line clinical trial of a new immunotherapy regimen. Research team and clinical team members have limited knowledge of the roles and work of individuals outside their team. Recommendations to increase trust and collaboration are provided.
AHRQ-funded; HS022418.
Citation: Gerber DE, Reimer T, Williams EL .
Resolving rivalries and realigning goals: challenges of clinical and research multiteam systems.
J Oncol Pract 2016 Nov;12(11):1020-28. doi: 10.1200/jop.2016.013060.
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Keywords: Cancer, Cancer: Lung Cancer, Case Study, Healthcare Delivery, Patient-Centered Healthcare, Teams
Rodriguez HP, Chen X, Martinez AE
Availability of primary care team members can improve teamwork and readiness for change.
Researchers conducted a survey of adult primary care providers and staff in California safety net practices to assess primary care team structure (team size, team member availability, and access to interdisciplinary expertise), teamwork, and readiness for change. Greater team member availability was associated with greater readiness for change, but the relationship was stronger for staff than for primary care providers.
AHRQ-funded; HS020120.
Citation: Rodriguez HP, Chen X, Martinez AE .
Availability of primary care team members can improve teamwork and readiness for change.
Health Care Manage Rev 2016 Oct-Dec;41(4):286-95. doi: 10.1097/hmr.0000000000000082.
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Keywords: Primary Care, Teams, Patient-Centered Healthcare, Organizational Change, Practice Improvement
Carney RM, Freedland KE, Steinmeyer BC
Collaborative care for depression symptoms in an outpatient cardiology setting: a randomized clinical trial.
The purpose of this study was to determine whether collaborative care (CC) for patients who screen positive for depression during an outpatient cardiology visit results in greater improvement in depression symptoms and better medical outcomes than seen in patients who screen positive for depression but receive only usual care (UC). Tthis trial did not show that CC produces better depression outcomes than UC.
AHRQ-funded; HS018335.
Citation: Carney RM, Freedland KE, Steinmeyer BC .
Collaborative care for depression symptoms in an outpatient cardiology setting: a randomized clinical trial.
Int J Cardiol 2016 Sep 15;219:164-71. doi: 10.1016/j.ijcard.2016.06.045.
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Keywords: Care Management, Cardiovascular Conditions, Depression, Healthcare Delivery, Behavioral Health, Outcomes, Ambulatory Care and Surgery, Teams
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
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
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
Poghosyan L, Liu J
Nurse practitioner autonomy and relationships with leadership affect teamwork in primary care practices: a cross-sectional survey.
The authors investigated whether nurse practitioner (NP) autonomy within primary care practices and the relationships they have with leadership affect teamwork between NPs and physicians. They concluded that NP autonomy and favorable relationships with leadership improve teamwork, and they recommended that policy and organizational change focus on promoting NP autonomy and improving the relationship between NPs and leadership to improve teamwork and consequently improve patient care and outcomes.
AHRQ-funded; HS020999.
Citation: Poghosyan L, Liu J .
Nurse practitioner autonomy and relationships with leadership affect teamwork in primary care practices: a cross-sectional survey.
J Gen Intern Med 2016 Jul;31(7):771-7. doi: 10.1007/s11606-016-3652-z.
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Keywords: Nursing, Organizational Change, Primary Care, Teams
Fiscella K, Fogarty C, Salas E
What can primary care learn from sports teams?
The authors used sports teams to illustrate key principles from team science and to extract practical lessons for primary care teams.
AHRQ-funded; HS022440.
Citation: Fiscella K, Fogarty C, Salas E .
What can primary care learn from sports teams?
J Ambul Care Manage 2016 Jul-Sep;39(3):279-85. doi: 10.1097/jac.0000000000000120.
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Keywords: Patient Safety, Primary Care, Quality Improvement, Teams
Zhu X, Baloh J, Ward MM
Deliberation makes a difference: preparation strategies for TeamSTEPPS implementation in small and rural hospitals.
The researchers studied the implementation of TeamSTEPPS in 14 critical access hospitals, proposing five strategic preparation steps for TeamSTEPPS. They discussed potential steps that hospitals may take to better prepare for TeamSTEPPS implementation.
AHRQ-funded; HS024112; HS018396.
Citation: Zhu X, Baloh J, Ward MM .
Deliberation makes a difference: preparation strategies for TeamSTEPPS implementation in small and rural hospitals.
Med Care Res Rev 2016 Jun;73(3):283-307. doi: 10.1177/1077558715607349.
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Keywords: TeamSTEPPS, Teams, Rural Health, Hospitals, Implementation, Quality Improvement, Quality of Care
Howard HA, Malouin R, Callow-Rucker M
Care managers and knowledge shift in primary care patient-centered medical home transformation.
Based on a health insurance company-sponsored primary care transformation project, this study explores the perceptions of care management from the perspective of providers and practice staff to examine shifts in knowledge and their broader implications for primary care. It demonstrates how the diffusion of clinical power and knowledge production redefine primary care relationships to patients, as traditional hierarchies shift to team-based care.
AHRQ-funded; HS020046; HS01795.
Citation: Howard HA, Malouin R, Callow-Rucker M .
Care managers and knowledge shift in primary care patient-centered medical home transformation.
Hum Organ 2016 Spring;75(1):10-20..
Keywords: Care Management, Patient-Centered Healthcare, Primary Care, Practice Patterns, Teams
Ghaferi AA, Dimick JB
Importance of teamwork, communication and culture on failure-to-rescue in the elderly.
The researchers reviewed the literature evaluating surgery, mortality, failure-to-rescue and the elderly. This was followed by a review of ongoing studies and unpublished work aiming to understand better the mechanisms underlying variations in surgical mortality in elderly patients. They concluded that although elderly surgical patients experienced failure-to-rescue events at much higher rates than their younger counterparts, patient-level effects did not sufficiently explain these differences.
AHRQ-funded; HS023621; HS024403; HS023597.
Citation: Ghaferi AA, Dimick JB .
Importance of teamwork, communication and culture on failure-to-rescue in the elderly.
Br J Surg 2016 Jan;103(2):e47-51. doi: 10.1002/bjs.10031.
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Keywords: Elderly, Mortality, Surgery, Teams, Patient Safety