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AHRQ Research Studies Date
Topics
- Ambulatory Care and Surgery (1)
- Care Coordination (2)
- Children/Adolescents (2)
- Clinician-Patient Communication (3)
- Communication (1)
- Community-Based Practice (1)
- (-) Consumer Assessment of Healthcare Providers and Systems (CAHPS) (13)
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- Implementation (1)
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- Patient Experience (10)
- Practice Improvement (1)
- Primary Care (5)
- Primary Care: Models of Care (1)
- Provider: Health Personnel (1)
- Provider Performance (3)
- Quality Improvement (3)
- Quality Measures (2)
- Quality of Care (5)
- Teams (1)
- Transitions of Care (1)
- Transplantation (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 13 of 13 Research Studies DisplayedBhaumik D, Schlesinger MJ
How exposure to patient narratives affects stereotyped choices of primary care clinicians.
Researchers examined whether patient narratives alter the impact of stereotyping on choice of primary care clinicians, specifically the assumption that female doctors will be more attentive to empathic relationships with patients. Individuals selected from a nationally representative Internet panel participated in a survey that provided performance data about 12 fictitious primary care physicians and included a randomized set of narrative feedback from patients. The results showed that exposure to patient narratives that do not disrupt gendered stereotypes increased the likelihood of choosing a female clinician; however, when a sufficient proportion of patient comments run counter to stereotypes, even a minority of narratives is sufficient to disrupt gendered-expectations and alter choices.
AHRQ-funded; HS016978.
Citation: Bhaumik D, Schlesinger MJ .
How exposure to patient narratives affects stereotyped choices of primary care clinicians.
PLoS One 2023 Dec 7; 18(12):e0295243. doi: 10.1371/journal.pone.0295243..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Primary Care
Hays RD, Walling AM, Sudore RL
Support for use of Consumer Assessment of Healthcare Providers and Systems communication items among seriously ill patients.
High-quality doctor-patient communication is essential for patients with serious illnesses. The purpose of this study was to assess the reliability and validity of Consumer Assessment of Healthcare Providers and Systems (CAHPS(®)) communication items among patients with serious illnesses. The study found that Eigenvalues and internal consistency reliability supported a 5-item communication scale. Item characteristic curves revealed a monotonic relationship of response options with the communication score. Item thresholds indicated that most patients reported positive patient experiences, and item slopes confirmed that all items were strongly related to the communication score. Reliability of the communication scale was higher for assessing patients with negative experiences of care than for the positive end of the spectrum. Communication was positively correlated with confidence in other's knowledge of ACP medical wishes, ACP engagement, and confidence in filling out ACP-related medical forms.
AHRQ-funded; HS029321.
Citation: Hays RD, Walling AM, Sudore RL .
Support for use of Consumer Assessment of Healthcare Providers and Systems communication items among seriously ill patients.
J Palliat Med 2023 Sep; 26(9):1234-39. doi: 10.1089/jpm.2022.0572..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Clinician-Patient Communication, Communication, Provider: Health Personnel
Martino SC, Reynolds KA, Grob R
Evaluation of a protocol for eliciting narrative accounts of pediatric inpatient experiences of care.
This study’s objective was to evaluate the measurement properties of a set of six items designed to elicit narrative accounts of pediatric inpatient experience. This cross-sectional survey with follow-up phone interviews used data from 163 participants recruited from a probability-based online panel of US adults. Eligible participants were family members of a child who had an overnight hospital stay in the past 12 months. Participants completed an online (n = 129) or phone (n = 34) survey about their child's hospitalization experience that contained closed-ended items from the Child HCAHPS Survey followed by the six narrative items. About two weeks after completing the survey, 47 participants additionally completed a one-hour, semi-structured phone interview, the results of which served as a "gold standard" for evaluating the fidelity of narrative responses. The average narrative was 248 words, with 79% of narratives mentioning a topic included on the Child HCAHPS survey; 89% mentioning a topic not covered by that survey; 75% including at least one detailed description of an actionable event. Overall, there was a 66% correspondence between narrative and interview responses, with higher correspondence in the phone than in the online condition (75% vs. 59%).
AHRQ-funded; HS025920; HS016978.
Citation: Martino SC, Reynolds KA, Grob R .
Evaluation of a protocol for eliciting narrative accounts of pediatric inpatient experiences of care.
Health Serv Res 2023 Apr;58(2):271-81. doi: 10.1111/1475-6773.14134.
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient Experience, Inpatient Care
Schuttner L, Guo R, Wong E
High-risk patient experiences associated with an intensive primary care management program in the Veterans Health Administration.
This study assessed high-risk patient experiences associated with an intensive primary care management program conducted at the Veterans Health Administration (VHA). The authors assessed patient experience using a patient survey based on the CAHPS Survey in 2019. Patient experience was assessed among 1) prior enrollees (n = 59) of an intensive management program (2014-2018); (2) nonenrollees (n = 356) at program sites; and (3) nonprogram site patients (n = 728). The VHA Office of Primary Care used a patient-centered medical home model (PACT) to deliver coordinated, continuous primary care through multidisciplinary teams. The PACT-Intensive Management (PIM) program was piloted at 5 sites from 2014 to 2018. Outcomes examined included patient ratings of patient-centered care; overall health care experience; and satisfaction with their usual outpatient care provider. Enrollees were more satisfied with their current provider versus nonenrollees within program sites. However, the authors weren’t sure if the benefits persisted after program conclusion.
AHRQ-funded; HS026369.
Citation: Schuttner L, Guo R, Wong E .
High-risk patient experiences associated with an intensive primary care management program in the Veterans Health Administration.
J Ambul Care Manage 2023 Jan-Mar;46(1):45-53. doi: 10.1097/jac.0000000000000428..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient Experience, Primary Care
Quigley DD, Elliott MN, Slaughter ME
Follow-up shadow coaching improves primary care provider-patient interactions and maintains improvements when conducted regularly: a spline model analysis.
The purpose of this study was to explore whether a second shadow coaching session (re-coaching) improves the patient experience and maintains it over time. The researchers observed a statistically significant increase of 3.7 points among re-coached providers after re-coaching on overall provider rating (OPR) and 3.5 points on provider communication (PC) (differences of 1, 3, and 5 points or more are considered small, medium, and large, respectively). Improvements from the re-coaching endured for 12 months for OPR and 8 months for PC.
AHRQ-funded; HS025920.
Citation: Quigley DD, Elliott MN, Slaughter ME .
Follow-up shadow coaching improves primary care provider-patient interactions and maintains improvements when conducted regularly: a spline model analysis.
J Gen Intern Med 2023 Jan; 38(1):221-27. doi: 10.1007/s11606-022-07881-y..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Primary Care, Clinician-Patient Communication, Patient Experience, Provider Performance
Nembhard IM, Matta S, Shaller D
Learning from patients: the impact of using patients' narratives on patient experience scores.
The purpose of this study was to assess whether primary care clinics that often share patients' narratives with their staff have higher patient experience survey scores. The researchers conducted a 1-year study of 5,545 adult patients and 276 staff affiliated with nine clinics in one health system. The study found the frequency of sharing useful narratives with staff was related with patient experience scores for all measures, a result which was conditional upon staff confidence in their own knowledge. For operational measures such as care coordination, higher levels of sharing was associated with subsequently higher performance for more confident staff and lower performance or no difference for less confident staff, depending on the measure. For relational measures such as patient-provider communication, increased sharing was associated with higher scores for less confident staff and lower scores for more confident staff.
AHRQ-funded; HS016978.
Citation: Nembhard IM, Matta S, Shaller D .
Learning from patients: the impact of using patients' narratives on patient experience scores.
Health Care Manage Rev 2023 Jan-Mar; 49(1):2-13. doi: 10.1097/hmr.0000000000000386..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient Experience, Provider Performance
Quigley DD, Quereshi N, Hays RD
Reasons primary care practices chose patient experience surveys during patient-centered medical home transformation.
This study’s objective was to identify reasons primary care practices chose to implement a patient experience survey during their patient-centered medical home transformation. The authors conducted interviews with a stratified-random sample of 105 of these practices. Fifty-one practices used a Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey and 53 administered another patient survey. The three most common reasons to use a survey were given as: (1) to compare performance against other practices, which requires systematically collected data across large numbers of practices (ie, the Consumer Assessment of Healthcare Providers and Systems survey), (2) participation in an external patient-centered medical home program, and (3) survey administration cost. A second patient survey was used to identify quality improvement needs.
AHRQ-funded; HS016980; HS025920.
Citation: Quigley DD, Quereshi N, Hays RD .
Reasons primary care practices chose patient experience surveys during patient-centered medical home transformation.
J Ambul Care Manage 2023 Jan-Mar;46(1):34-44. doi: 10.1097/jac.0000000000000442.
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient-Centered Healthcare, Primary Care, Quality Improvement, Practice Improvement
Quigley DD, Qureshi N, Masarweh LA
Practice leaders report targeting several types of changes in care experienced by patients during patient-centered medical home transformation.
This study looked at how primary care practices implemented changes during the transition to becoming a patient-centered medical home (PCMH). The authors examined 105 primary care practice leader experiences during PCMH transformation using semi-structured interviews. Practices most commonly targeted changes in care coordination (30%), access to care (25%), and provider communication (24%). Reported areas for PCMH transformation were measured by Clinician & Group CAHPS, PCMH CAHPS, or supplemental CAHPS survey items, including team-based care (35%), providing more on-site services (28%), care management (22%), patient-centered culture (18%), and chronic condition health education (13%). Many PCMH changes are captured by CAHPS survey items, but some are not.
AHRQ-funded; HS025920.
Citation: Quigley DD, Qureshi N, Masarweh LA .
Practice leaders report targeting several types of changes in care experienced by patients during patient-centered medical home transformation.
J Patient Exp 2020 Dec;7(6):1509-18. doi: 10.1177/2374373520934231..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Primary Care: Models of Care, Primary Care, Patient-Centered Healthcare, Patient Experience, Care Coordination, Quality Improvement, Quality of Care, Implementation
Short MN, Ho V
Weighing the effects of vertical integration versus market concentration on hospital quality.
Provider organizations are increasing in complexity, as hospitals acquire physician practices and physician organizations grow in size. At the same time, hospitals are merging with each other to improve bargaining power with insurers. In this study, the investigators analyzed 29 quality measures reported to the Center for Medicare and Medicaid Services' Hospital Compare database for 2008 to 2015 to test whether vertical integration between hospitals and physicians or increases in hospital market concentration influenced patient outcomes.
AHRQ-funded; HS024727.
Citation: Short MN, Ho V .
Weighing the effects of vertical integration versus market concentration on hospital quality.
Med Care Res Rev 2020 Dec;77(6):538-48. doi: 10.1177/1077558719828938.
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Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Quality of Care, Patient Experience, Hospitals, Medicare, Provider Performance, Health Systems
Feng JY, Toomey SL, Elliott MN
Factors associated with family experience in pediatric inpatient care.
Researchers assessed which aspects of pediatric inpatient experience have the strongest relationships with parents' willingness to recommend a hospital. Their cross-sectional study examined surveys completed by parents of children hospitalized at hospitals using the Child Hospital Consumer Assessment of Healthcare Providers and Systems Survey. They found that child comfort and nurse-parent communication showed the strongest relationships with willingness to recommend, followed by preparing to leave the hospital, doctor-parent communication, and keeping parents informed. They recommended improvement efforts focusing on creating an age-appropriate environment, improving the effectiveness of provider interactions, and engaging parents to share their values and concerns.
AHRQ-funded; HS020513; HS025299.
Citation: Feng JY, Toomey SL, Elliott MN .
Factors associated with family experience in pediatric inpatient care.
Pediatrics 2020 Mar;145(3): e20191264. doi: 10.1542/peds.2019-1264..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Children/Adolescents, Quality Measures, Quality of Care, Inpatient Care, Patient Experience, Hospitals, Hospitalization, Patient and Family Engagement, Clinician-Patient Communication
Nembhard IM, Buta E, Lee YSH
A quasi-experiment assessing the six-months effects of a nurse care coordination program on patient care experiences and clinician teamwork in community health centers.
The authors assessed effects of adding care coordination formally to nurses’ roles on care experiences of high-risk patients and clinician teamwork during the first 6 months of use. They conducted a quasi-experimental study in which changes in staff and patient experiences at six community health center practice locations that introduced the added-role approach for high-risk patients were compared to changes in six locations without the program in the same health system. They found that there were some positive effects of adding care coordination to nurses' role within 6 months of implementation, suggesting value in this improvement strategy. They concluded that addressing compatibility between coordination and other job demands is important when implementing this approach to coordination.
AHRQ-funded; HS016978.
Citation: Nembhard IM, Buta E, Lee YSH .
A quasi-experiment assessing the six-months effects of a nurse care coordination program on patient care experiences and clinician teamwork in community health centers.
BMC Health Serv Res 2020 Feb 24;20(1):137. doi: 10.1186/s12913-020-4986-0..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Care Coordination, Nursing, Patient Experience, Community-Based Practice, Patient-Centered Healthcare, Ambulatory Care and Surgery, Teams
Shen NT, Wu A, Farrell K
Patient perspectives of high-quality care on the liver transplant waiting list: a qualitative study.
The prevalence of advanced liver disease and listing for liver transplantation is increasing. Prior assessments of quality of care neither incorporate nor emphasize the patient perspective on quality of care, which may impact clinical outcomes. In this study the investigators aimed to identify patients' perceptions on what constitutes high quality of care, comparing the findings to existing frameworks and assessments to determine if a patient-derived tool assessing quality of care could facilitate efforts to improve health care.
AHRQ-funded; HS000066.
Citation: Shen NT, Wu A, Farrell K .
Patient perspectives of high-quality care on the liver transplant waiting list: a qualitative study.
Liver Transpl 2020 Feb;26(2):238-46. doi: 10.1002/lt.25645..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Transplantation, Quality of Care, Healthcare Delivery, Patient Experience
Desai AD, Zhou C, Simon TD
Validation of a parent-reported hospital-to-home transition experience measure.
This study examined the validity of the Pediatric Transition Experience Measure (P-TEM), which is an 8-item, parent-reported measure that globally assesses hospital-to-home transition quality from discharge through follow-up compared to other validation measures. The other measures it was compared to included the 1) Child Hospital Consumer Assessment of Healthcare Providers and Systems Discharge Composite, 2) Center of Excellence on Quality of Care Measures for Children with Complex Needs parent-reported measures, 3) change in health-related quality of life from admission to postdischarge, and 4) 30-day emergency department revisits or readmissions. The P-TEM measure compared favorably with the Child Hospital Consumer Assessment of Healthcare Providers and Systems Discharge Composite measure and the other measures as well.
AHRQ-funded; HS024299.
Citation: Desai AD, Zhou C, Simon TD .
Validation of a parent-reported hospital-to-home transition experience measure.
Pediatrics 2020 Feb;145(2):pii: e20192150. doi: 10.1542/peds.2019-2150..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Children/Adolescents, Patient Experience, Transitions of Care, Hospital Discharge, Quality Improvement, Quality of Care, Quality Measures