National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (1)
- Adverse Events (6)
- Ambulatory Care and Surgery (1)
- Arthritis (1)
- Behavioral Health (1)
- Blood Clots (3)
- Cancer (2)
- Cancer: Lung Cancer (1)
- Cardiovascular Conditions (1)
- Care Coordination (1)
- Catheter-Associated Urinary Tract Infection (CAUTI) (2)
- Central Line-Associated Bloodstream Infections (CLABSI) (2)
- Children's Health Insurance Program (CHIP) (1)
- Children/Adolescents (5)
- Chronic Conditions (2)
- Clinician-Patient Communication (1)
- Communication (2)
- Community-Based Practice (3)
- Comparative Effectiveness (2)
- Comprehensive Unit-based Safety Program (CUSP) (1)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (4)
- Diabetes (4)
- Diagnostic Safety and Quality (2)
- Disparities (2)
- Education: Continuing Medical Education (3)
- Education: Curriculum (1)
- Elderly (1)
- Electronic Health Records (EHRs) (5)
- Emergency Department (2)
- Emergency Medical Services (EMS) (1)
- Evidence-Based Practice (9)
- Falls (1)
- Guidelines (4)
- Healthcare-Associated Infections (HAIs) (9)
- Healthcare Costs (3)
- Healthcare Delivery (7)
- Healthcare Utilization (1)
- Health Information Technology (HIT) (4)
- Health Literacy (1)
- Health Promotion (1)
- Health Services Research (HSR) (4)
- Health Status (1)
- Health Systems (2)
- Heart Disease and Health (4)
- Hospital Discharge (1)
- Hospital Readmissions (3)
- Hospitals (10)
- Implementation (3)
- Injuries and Wounds (1)
- Intensive Care Unit (ICU) (2)
- Labor and Delivery (1)
- Lifestyle Changes (1)
- Long-Term Care (2)
- Medical Errors (2)
- Medicare (2)
- Neonatal Intensive Care Unit (NICU) (1)
- Newborns/Infants (1)
- Nursing Homes (3)
- Nutrition (1)
- Obesity (1)
- Organizational Change (4)
- Outcomes (6)
- Pain (1)
- Palliative Care (1)
- Patient-Centered Healthcare (4)
- Patient-Centered Outcomes Research (8)
- Patient and Family Engagement (3)
- Patient Experience (4)
- Patient Safety (16)
- Payment (1)
- Pneumonia (2)
- Practice Improvement (2)
- Practice Patterns (1)
- Pregnancy (1)
- Pressure Ulcers (2)
- Prevention (9)
- Primary Care (8)
- Provider (3)
- Provider Performance (4)
- Public Health (1)
- Public Reporting (2)
- (-) Quality Improvement (75)
- Quality Indicators (QIs) (4)
- Quality Measures (10)
- Quality of Care (24)
- Racial and Ethnic Minorities (3)
- Registries (1)
- Rural Health (2)
- Shared Decision Making (1)
- Social Determinants of Health (1)
- Surgery (6)
- Teams (4)
- TeamSTEPPS (2)
- Telehealth (1)
- Tools & Toolkits (1)
- Training (3)
- Transitions of Care (1)
- Treatments (1)
- Urinary Tract Infection (UTI) (1)
- Workflow (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
26 to 50 of 75 Research Studies DisplayedZhu 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
Mazor KM, Smith KM, Fisher KA
Speak up! Addressing the paradox plaguing patient-centered care.
The authors discuss the patient-centered care paradox in which patients' perceptions of care rarely translate into improvements. Instead of placing the burden on patieents to voice their concerns, the authors recommended that health care systems and providers create an environment in which patients and family members feel safe raising concerns. The authors also addressed the issue that health care institutions cannot respond in real time even when patients do express a concern. They concluded by offering suggestions on how to improve this paradox.
AHRQ-funded; HS022757.
Citation: Mazor KM, Smith KM, Fisher KA .
Speak up! Addressing the paradox plaguing patient-centered care.
Ann Intern Med 2016 May 3;164(9):618-9. doi: 10.7326/m15-2416.
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Keywords: Healthcare Delivery, Patient and Family Engagement, Patient-Centered Healthcare, Quality Improvement
Padula WV, Gibbons RD, Valuck RJ
Are evidence-based practices associated with effective prevention of hospital-acquired pressure ulcers in US academic medical centers?
The objective of this study was to evaluate the longitudinal impact of CMS policy and quality improvement adoption on hospital-acquired pressure ulcers (HAPU) rates. It concluded that HAPU rates were significantly lower after changes in CMS reimbursement. Reductions are associated with hospital-wide implementation of evidence-based practices for HAPU prevention.
AHRQ-funded; HS023710.
Citation: Padula WV, Gibbons RD, Valuck RJ .
Are evidence-based practices associated with effective prevention of hospital-acquired pressure ulcers in US academic medical centers?
Med Care 2016 May;54(5):512-8. doi: 10.1097/mlr.0000000000000516..
Keywords: Evidence-Based Practice, Healthcare-Associated Infections (HAIs), Pressure Ulcers, Quality Improvement
Berian JR, Paruch JL, Cohen ME
Does performance vary within the same hospital when separately examining different patient subgroups?
The researchers sought to determine whether performance differs within a given hospital for 6 contrasting patient subgroups and to identify the percentage of hospitals with greater than chance differences in performance. They found that overall quality differed for elderly vs nonelderly, renal insufficiency vs normal renal function patients, cancer vs noncancer, and emergency vs nonemergency. They concluded that quality programs can consider separate reports for these subgroups to identify opportunities for quality improvement.
AHRQ-funded; HS021857.
Citation: Berian JR, Paruch JL, Cohen ME .
Does performance vary within the same hospital when separately examining different patient subgroups?
J Am Coll Surg 2016 May;222(5):790-97.e1. doi: 10.1016/j.jamcollsurg.2016.01.057.
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Keywords: Emergency Medical Services (EMS), Hospitals, Outcomes, Quality Improvement, Social Determinants of Health
Gray CP, Harrison MI, Hung D
AHRQ Author: Harrison MI
Medical assistants as flow managers in primary care: challenges and recommendations.
Drawing on an empirical study of a large, multispecialty delivery system engaged in reconfiguration of primary care, the authors found that using medical assistants (Mas) as flow managers required overcoming several challenges. These included entrenched social and occupational hierarchies between physicians and MAs, a lack of adequate training and mentorship, and difficulty attracting and retaining talented MAs.
AHRQ-authored; AHRQ-funded; 2902010000221.
Citation: Gray CP, Harrison MI, Hung D .
Medical assistants as flow managers in primary care: challenges and recommendations.
J Healthc Manag 2016 May-Jun;61(3):181-91.
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Keywords: Primary Care, Organizational Change, Practice Improvement, Quality Improvement, Quality of Care, Workflow, Provider
Balbale SN, Etingen B, Malhiot A
Perceptions of chronic illness care among veterans with multiple chronic conditions.
The purpose of this study was to use the Patient Assessment of Chronic Illness Care (PACIC) instrument to examine perceptions of chronic care among veterans with multiple chronic conditions (MCC). The authors concluded that quality improvements are needed to strengthen care continuity and coordination.
AHRQ-funded; HS000084.
Citation: Balbale SN, Etingen B, Malhiot A .
Perceptions of chronic illness care among veterans with multiple chronic conditions.
Mil Med 2016 May;181(5):439-44. doi: 10.7205/milmed-d-15-00207..
Keywords: Chronic Conditions, Patient Experience, Quality Improvement
Rinke ML, Mock CK, Persing NM
The Armstrong Institute Resident/Fellow Scholars: a multispecialty curriculum to train future leaders in patient safety and quality improvement.
The purpose of the study was to determine if a year-long, multispecialty resident and fellow quality improvement (QI) curriculum was feasible and led to improvements in QI beliefs and self-reported behaviors.
AHRQ-funded; HS021282; HS017952.
Citation: Rinke ML, Mock CK, Persing NM .
The Armstrong Institute Resident/Fellow Scholars: a multispecialty curriculum to train future leaders in patient safety and quality improvement.
Am J Med Qual 2016 May;31(3):224-32. doi: 10.1177/1062860614568523..
Keywords: Education: Continuing Medical Education, Education: Curriculum, Patient Safety, Quality Improvement
Wyer P, Stojanovic Z, Shaffer JA
Combining training in knowledge translation with quality improvement reduced 30-day heart failure readmissions in a community hospital: a case study.
The authors linked multidisciplinary training in evidence-based practice to an initiative to decrease 30-day readmissions among patients admitted to a community teaching hospital for heart failure (HF). They discovered that training of a multidisciplinary hospital team in use of a knowledge translation model, combined with ongoing facilitation, led to implementation of a budget neutral program that decreased HF readmissions.
AHRQ-funded; HS018607.
Citation: Wyer P, Stojanovic Z, Shaffer JA .
Combining training in knowledge translation with quality improvement reduced 30-day heart failure readmissions in a community hospital: a case study.
J Eval Clin Pract 2016 Apr;22(2):171-9. doi: 10.1111/jep.12450.
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Keywords: Evidence-Based Practice, Heart Disease and Health, Quality Improvement, Hospital Readmissions, Training
Harrison MI, Paez K, Carman KL
AHRQ Author: Harrison MI
Effects of organizational context on Lean implementation in five hospital systems.
In order to help reduce gaps in knowledge of effects of intraorganizational context, the authors researched Lean implementation initiatives in five organizations and examined 12 of their Lean rapid improvement projects. They identified intraorganizational characteristics including CEO commitment to Lean and active support for it, prior organizational capacity for quality improvement-based performance improvement, and alignment of the Lean initiative with the organizational mission.
AHRQ-authored.
Citation: Harrison MI, Paez K, Carman KL .
Effects of organizational context on Lean implementation in five hospital systems.
Health Care Manage Rev 2016 Apr-Jun;41(2):127-44. doi: 10.1097/hmr.0000000000000049..
Keywords: Organizational Change, Hospitals, Quality Improvement, Quality of Care, Healthcare Delivery, Implementation
Lavallee DC, Chenok KE, Love RM
Incorporating patient-reported outcomes into health care to engage patients and enhance care.
The authors examine the opportunities for using patient-reported outcomes to enhance care delivery and outcomes as health care information needs and technology platforms change. They highlight emerging practices in which patient-reported outcomes provide value to patients and clinicians and improve care delivery. Finally, they examine present and future challenges to maximizing the use of patient-reported outcomes in the clinic.
AHRQ-funded; HS022789.
Citation: Lavallee DC, Chenok KE, Love RM .
Incorporating patient-reported outcomes into health care to engage patients and enhance care.
Health Aff 2016 Apr;35(4):575-82. doi: 10.1377/hlthaff.2015.1362.
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Keywords: Healthcare Delivery, Shared Decision Making, Patient-Centered Outcomes Research, Patient and Family Engagement, Quality Improvement
Rising KL, Carr BG, Hess EP
Patient-centered outcomes research in emergency care: opportunities, challenges, and future directions.
The authors explored factors unique to patient-centered emergency care research and highlighted specific areas of potential alignment within each of the five national PCORI priorities.
AHRQ-funded; HS023901.
Citation: Rising KL, Carr BG, Hess EP .
Patient-centered outcomes research in emergency care: opportunities, challenges, and future directions.
Acad Emerg Med 2016 Apr;23(4):497-502. doi: 10.1111/acem.12944.
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Keywords: Emergency Department, Patient-Centered Outcomes Research, Patient-Centered Healthcare, Quality Improvement, Quality of Care, Evidence-Based Practice
Leary JC, Schainker EG, Leyenaar JK
The unwritten rules of mentorship: facilitators of and barriers to effective mentorship in pediatric hospital medicine.
This study aimed to characterize successful pediatric hospitalists' past and current mentorship experiences and identify facilitators of and barriers to effective mentorship in pediatric hospital medicine (PHM). They found that several themes emerged regarding facilitators of and barriers to effective mentorship in PHM. These "unwritten rules of mentorship" may serve as a guide to establish and maintain beneficial mentorship relationships and overcome challenges.
AHRQ-funded; HS024133.
Citation: Leary JC, Schainker EG, Leyenaar JK .
The unwritten rules of mentorship: facilitators of and barriers to effective mentorship in pediatric hospital medicine.
Hosp Pediatr 2016 Apr;6(4):219-25. doi: 10.1542/hpeds.2015-0108..
Keywords: Education: Continuing Medical Education, Hospitals, Children/Adolescents, Quality Improvement, Training
Mitchell SE, Martin J, Holmes S
AHRQ Author: Brach C
How hospitals reengineer their discharge processes to reduce readmissions.
The Re-Engineered Discharge (RED) program is a hospital-based initiative shown to decrease hospital reutilization. Researchers implemented the RED in 10 hospitals to study the implementation process. They found wide variability in the fidelity of the RED intervention. Engaged leadership and multidisciplinary implementation teams were keys to success of the program. Eight out of 10 hospitals reported improvement in 30-day readmission rates after RED implementation.
AHRQ-authored; AHRQ-funded; 290200600012I.
Citation: Mitchell SE, Martin J, Holmes S .
How hospitals reengineer their discharge processes to reduce readmissions.
J Healthc Qual 2016 Mar-Apr;38(2):116-26. doi: 10.1097/jhq.0000000000000005..
Keywords: Hospital Discharge, Hospital Readmissions, Quality Improvement
Rajaram R, Paruch JL, Mohanty S
Patterns and predictors of chemotherapy use for resected non-small cell lung cancer.
The researchers sought to evaluate chemotherapy use in resected stage IB to IIIA non-small cell lung cancer (NSCLC) over time and to identify predictors of perioperative chemotherapy administration. They found that the use of chemotherapy has significantly increased in patients with resected stage IB to IIIA NSCLC.
AHRQ-funded; HS000078.
Citation: Rajaram R, Paruch JL, Mohanty S .
Patterns and predictors of chemotherapy use for resected non-small cell lung cancer.
Ann Thorac Surg 2016 Feb;101(2):533-40. doi: 10.1016/j.athoracsur.2015.08.077..
Keywords: Treatments, Cancer: Lung Cancer, Surgery, Outcomes, Quality Improvement
Hays RD, Mallett JS, Gaillot S
Performance of the Medicare Consumer Assessment of Health Care Providers and Systems (CAHPS) physical functioning items.
This study evaluated physical functioning items in Medicare beneficiaries. It concluded that the physical functioning items target relatively easy activities, providing information for a minority of people in the sample with the lowest levels of physical functioning. Items representing higher levels of physical functioning are needed for the majority of the Medicare beneficiaries.
AHRQ-funded; HS016980.
Citation: Hays RD, Mallett JS, Gaillot S .
Performance of the Medicare Consumer Assessment of Health Care Providers and Systems (CAHPS) physical functioning items.
Med Care 2016 Feb;54(2):205-9. doi: 10.1097/mlr.0000000000000475..
Keywords: Medicare, Consumer Assessment of Healthcare Providers and Systems (CAHPS), Health Status, Quality Improvement
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
Sathe NA, Nocon RS, Hughes B
The costs of participating in a diabetes quality improvement collaborative: Variation among five clinics.
The costs over the first four years-from June 2009 through May 2013-of an ongoing diabetes Quality improvement collaborative were characterized by activities and over time. Cost/diabetic patient/year ranged across clinic sites from $6 (largest clinic) to $68 (smallest clinic).
AHRQ-funded; HS000084.
Citation: Sathe NA, Nocon RS, Hughes B .
The costs of participating in a diabetes quality improvement collaborative: Variation among five clinics.
Jt Comm J Qual Patient Saf. 2016 Jan;42(1):18-25..
Keywords: Diabetes, Quality Improvement, Healthcare Costs, Health Services Research (HSR)
Fisher ES, Shortell SM, Savitz LA
Implementation science: A potential catalyst for delivery system reform.
Understanding which of the multitude of technological, policy, and organizational changes under way are most effective at improving care is a critical challenge. This article describes 3 ideas that could be helpful: application of a well-grounded conceptual framework; distinguishing 3 distinct types of innovations that health systems are using to improve care; and a focus on building the information systems needed to accelerate timely learning.
AHRQ-funded; HS024075.
Citation: Fisher ES, Shortell SM, Savitz LA .
Implementation science: A potential catalyst for delivery system reform.
JAMA 2016 Jan 26;315(4):339-40. doi: 10.1001/jama.2015.17949..
Keywords: Healthcare Delivery, Implementation, Quality Improvement, Quality of Care, Health Systems
Li S, Rehder KJ, Giuliano JS, Jr.
Development of a quality improvement bundle to reduce tracheal intubation-associated events in pediatric ICUs.
This paper described a methodology to develop a bundle to improve quality and safety of tracheal intubations in the pediatric intensive care unit. The Airway Bundle Checklist consists of four parts: a risk factor assessment, a plan generation, a preprocedure time-out, and a postprocedure huddle to identify improvement opportunities.
AHRQ-funded; HS021583.
Citation: Li S, Rehder KJ, Giuliano JS, Jr. .
Development of a quality improvement bundle to reduce tracheal intubation-associated events in pediatric ICUs.
Am J Med Qual 2016 Jan-Feb;31(1):47-55. doi: 10.1177/1062860614547259.
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Keywords: Adverse Events, Intensive Care Unit (ICU), Quality Improvement, Patient Safety, Children/Adolescents
Sathe NA, Nocon RS, Hughes B
The costs of participating in a diabetes quality improvement collaborative: Variation among five clinics.
The costs over the first four years-from June 2009 through May 2013-of an ongoing diabetes Quality improvement collaborative were characterized by activities and over time. Cost/diabetic patient/year ranged across clinic sites from $6 (largest clinic) to $68 (smallest clinic).
AHRQ-funded; HS000084.
Citation: Sathe NA, Nocon RS, Hughes B .
The costs of participating in a diabetes quality improvement collaborative: Variation among five clinics.
Jt Comm J Qual Patient Saf 2016 Jan;42(1):18-25..
Keywords: Diabetes, Quality Improvement, Healthcare Costs, Health Services Research (HSR)
Patel SR, Gorritz M, Olfson M
Training community-based primary care physicians in the screening and management of mental health disorders among Latino primary care patients.
The researchers evaluated a quality improvement intervention to improve the screening and management (e.g., referral to psychiatric care) of common mental disorders in small independent Latino primary care practices. They concluded that improving the quality of mental health care in low-resourced primary care settings may require academic detailing and consultation/liaison psychiatric intervention supplemented with staff outreach to achieve meaningful improvement in the processes of care.
AHRQ-funded; HS021112.
Citation: Patel SR, Gorritz M, Olfson M .
Training community-based primary care physicians in the screening and management of mental health disorders among Latino primary care patients.
Gen Hosp Psychiatry 2016 Jan-Feb;38:71-8. doi: 10.1016/j.genhosppsych.2015.09.006.
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Keywords: Community-Based Practice, Primary Care, Behavioral Health, Racial and Ethnic Minorities, Quality Improvement
Murphy DJ, Lyu PF, Gregg SR
Using incentives to improve resource utilization: a quasi-experimental evaluation of an ICU quality improvement program.
In this paper, the investigators described the effect of a multifaceted quality improvement program designed to decrease the avoidable arterial blood gases, chest radiographs, and red blood cell transfusions on utilization of these resources and patient outcomes. The researchers found that implementation of their multifaceted quality improvement program, including financial incentives, was associated with significant improvements in resource utilization. They suggest that their findings provide evidence supporting the safety, effectiveness, and sustainability of incentive-based quality improvement interventions.
AHRQ-funded; HS000055.
Citation: Murphy DJ, Lyu PF, Gregg SR .
Using incentives to improve resource utilization: a quasi-experimental evaluation of an ICU quality improvement program.
Crit Care Med 2016 Jan;44(1):162-70. doi: 10.1097/ccm.0000000000001395..
Keywords: Healthcare Utilization, Quality Improvement
Van der Wees PJ, Friedberg MW, Guzman EA
Comparing the implementation of team approaches for improving diabetes care in community health centers.
The researchers sought to clarify implementation processes and experiences of integrating office-based medical assistant (MA) panel management and community health worker (CHW) community-based management into routine care for diabetic patients. They found that CHW and MA responsibilities converged over time to focus on health coaching of diabetic patients, with the MA health coaches experiencing difficulty in allocating dedicated time due to other responsibilities. Time constraints also limited the personal introduction of patients to health coaches by clinicians. Participants highlighted the importance of a supportive team climate and proactive leadership as important enablers for MAs and CHWs to implement their health coaching responsibilities. This study suggests that a flexible approach to implementing health coaching is more important than fidelity to rigid models that do not allow for variable allocation of responsibilities across team members.
AHRQ-funded; HS020120.
Citation: Van der Wees PJ, Friedberg MW, Guzman EA .
Comparing the implementation of team approaches for improving diabetes care in community health centers.
BMC Health Serv Res 2014 Dec 3;14:608. doi: 10.1186/s12913-014-0608-z.
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Keywords: Community-Based Practice, Diabetes, Patient-Centered Healthcare, Quality Improvement, Teams
Moyer VA, Papile LA, Eichenwald E
An intervention to improve transitions from NICU to ambulatory care: quasi-experimental study.
The authors tested whether a multifaceted intervention that included a health coach to assist families and an enhanced personal health record to improve the quality of information available to parents and community professionals would decrease adverse events and improve family assessment of the transition of infants born prematurely or with complex medical problems to home. They found that a multicomponent discharge intervention designed to address specific problems identified using Healthcare Failure Modes and Effects Analysis did not reduce certain adverse outcomes in the post-discharge period.
AHRQ-funded; HS017889.
Citation: Moyer VA, Papile LA, Eichenwald E .
An intervention to improve transitions from NICU to ambulatory care: quasi-experimental study.
BMJ Qual Saf 2014 Dec;23(12):e3. doi: 10.1136/bmjqs-2012-001726.
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Keywords: Neonatal Intensive Care Unit (NICU), Ambulatory Care and Surgery, Patient Safety, Quality Improvement, Transitions of Care
Meeks DW, Meyer AN, Rose B
Exploring new avenues to assess the sharp end of patient safety: an analysis of nationally aggregated peer review data.
The researchers described outcomes of peer review within the Department of Veterans Affairs (VA) healthcare system and identified opportunities to leverage peer review data for measurement and improvement of safety. Results showed that the most common process contributing to substandard care was 'timing and appropriateness of treatment'; approximately 16% had diagnosis-related performance concerns. The authors concluded that peer review may be a useful tool for healthcare organizations to assess their sharp end clinical performance, particularly safety events related to diagnostic and treatment errors.
AHRQ-funded; HS022087.
Citation: Meeks DW, Meyer AN, Rose B .
Exploring new avenues to assess the sharp end of patient safety: an analysis of nationally aggregated peer review data.
BMJ Qual Saf 2014 Dec;23(12):1023-30. doi: 10.1136/bmjqs-2014-003239.
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Keywords: Adverse Events, Medical Errors, Patient Safety, Quality Improvement