National Healthcare Quality and Disparities Report
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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 27 Research Studies DisplayedPhillips R, Kennedy J, Jaén C
Transforming physician certification to support physician self-motivation and capacity to improve quality and safety.
The American Board of Family Medicine (ABFM) is making strategic investments in the next major evolution of continuous certification. The ABFM is the first certifying board to launch a registry that is designed to support physician capacity for quality assessment, improvement, data-reporting requirements, and population management. The ABFM aims to help physicians maintain the privilege of self-governance by helping them continuously earn it.
AHRQ-funded; HS022583.
Citation: Phillips R, Kennedy J, Jaén C .
Transforming physician certification to support physician self-motivation and capacity to improve quality and safety.
Journal of Enterprise Transformation 2016 Dec 14;6(3-4):162-69. doi: 10.1080/19488289.2016.1216020.
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Keywords: Education: Continuing Medical Education, Quality of Care, Patient Safety, Provider
Wang D, Luque AE
Evaluation of a statewide HIV-HCV-STD online clinical education program by healthcare providers - a comparison of nursing and other disciplines.
The authors evaluated the New York State HIV-HCV-STD Clinical Education Initiative (CEI) online education program and compared the self-reported measures by clinicians from different disciplines. They found that physicians and nurse practitioners were the most satisfied, while pharmacists and case/care managers recorded lower than average responses. They recommended that online education programs consider the unique needs by clinicians from specific disciplines.
AHRQ-funded; HS022057.
Citation: Wang D, Luque AE .
Evaluation of a statewide HIV-HCV-STD online clinical education program by healthcare providers - a comparison of nursing and other disciplines.
Stud Health Technol Inform 2016;225:267-71.
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Keywords: Comparative Effectiveness, Education: Continuing Medical Education, Infectious Diseases, Provider, Web-Based
Rajaram R, Saddat L, Chung J
Impact of the 2011 ACGME resident duty hour reform on hospital patient experience and processes-of-care.
The investigators evaluated the association between resident duty hour reform and measures of processes-of-care and patient experience. They concluded that the 2011 Accreditation Council for Graduate Medical Education duty hour reform was not associated with improvements in process-of-care and patient experience measures.
AHRQ-funded; HS000078.
Citation: Rajaram R, Saddat L, Chung J .
Impact of the 2011 ACGME resident duty hour reform on hospital patient experience and processes-of-care.
BMJ Qual Saf 2016 Dec;25(12):962-70. doi: 10.1136/bmjqs-2015-004794.
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Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Education: Continuing Medical Education, Quality of Care, Patient Experience, Patient Safety
Thomas GW, Rojas-Murillo S, Hanley JM
Skill assessment in the interpretation of 3D fracture patterns from radiographs.
The researchers determined if 3D radiographic image interpretation can be reliably assessed, and whether this assessment varies by level of training. They concluded that the interpretation of radiographs to discern 3D information is a promising and a relatively unexplored area for surgical skill education and assessment.
AHRQ-funded; HS022077.
Citation: Thomas GW, Rojas-Murillo S, Hanley JM .
Skill assessment in the interpretation of 3D fracture patterns from radiographs.
Iowa Orthop J 2016;36:1-6.
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Keywords: Diagnostic Safety and Quality, Education: Continuing Medical Education, Injuries and Wounds, Imaging, Training
Ruis AR, Shaffer DW, Shirley DK
Teaching health care workers to adopt a systems perspective for improved control and prevention of health care-associated infections.
The authors argue that procedural approaches alone, even with high levels of adherence, are often insufficient to solve the growing problem of health care-associated infections (HAIs); it is equally important that interventions address the more complex cognitive aspects of HAI control and prevention. Health care workers (HCWs) face many patient care situations for which standard procedures have not been and cannot be developed.
AHRQ-funded; HS023791.
Citation: Ruis AR, Shaffer DW, Shirley DK .
Teaching health care workers to adopt a systems perspective for improved control and prevention of health care-associated infections.
Am J Infect Control 2016 Nov;44(11):1360-64. doi: 10.1016/j.ajic.2016.04.211.
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Keywords: Clostridium difficile Infections, Education: Continuing Medical Education, Healthcare-Associated Infections (HAIs), Prevention, Provider
Barsuk JH, Cohen ER, Williams MV
The effect of simulation-based mastery learning on thoracentesis referral patterns.
This study aimed to (1) assess the effect of simulation-based mastery learning (SBML) on internal medicine residents' simulated thoracentesis skills and (2) compare thoracentesis referral patterns, self-confidence, and reasons for referral between traditionally trained residents (non-SBML-trained), SBML-trained residents, and hospitalist physicians. This study identified confidence and time as reasons physicians refer thoracenteses rather than perform them at the bedside.
AHRQ-funded; HS021202.
Citation: Barsuk JH, Cohen ER, Williams MV .
The effect of simulation-based mastery learning on thoracentesis referral patterns.
J Hosp Med 2016 Nov;11(11):792-95. doi: 10.1002/jhm.2623..
Keywords: Education: Continuing Medical Education, Provider Performance, Training
Klerman EB, Beckett SA, Landrigan CP
Applying mathematical models to predict resident physician performance and alertness on traditional and novel work schedules.
Using a mathematical model of the effects of circadian rhythms and length of time awake on objective performance and subjective alertness, the researchers compared predictions for traditional intern schedules to those that limit work to </= 16 consecutive hours. Their model predicted fewer hours with poor performance and alertness, especially during night-time work hours, for all three novel schedules than for either of the two traditional schedules.
AHRQ-funded; HS017357.
Citation: Klerman EB, Beckett SA, Landrigan CP .
Applying mathematical models to predict resident physician performance and alertness on traditional and novel work schedules.
BMC Med Educ 2016 Sep 13;16(1):239. doi: 10.1186/s12909-016-0751-9.
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Keywords: Education: Continuing Medical Education, Patient Safety, Provider Performance, Workforce
Pradarelli JC, Jaffe GA, Lemak CH
A leadership development program for surgeons: first-year participant evaluation.
The researchers evaluated a Leadership Development Program for practicing surgeons by exploring how the program's strengths and weaknesses affected the surgeons' development as physician-leaders. They found that surgeon-participants reported positive impacts of the program on their day-to-day work activities and general career perspective as well as on their long-term career development plans. The participants also recommended areas where the program could be improved. The authors concluded that a curriculum designed specifically for surgeons may enable future programs to equip surgeons better for important leadership roles in a complex health care environment.
AHRQ-funded; HS023597.
Citation: Pradarelli JC, Jaffe GA, Lemak CH .
A leadership development program for surgeons: first-year participant evaluation.
Surgery 2016 Aug;160(2):255-63. doi: 10.1016/j.surg.2016.03.011.
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Keywords: Education: Continuing Medical Education, Provider: Health Personnel, Surgery
Ishizuka M, Rangarajan V, Sawyer TL
The development of tracheal intubation proficiency outside the operating suite during pediatric critical care medicine fellowship training: a retrospective cohort study using cumulative sum analysis.
The researchers hypothesized that both overall and first-attempt tracheal intubation success rates by pediatric critical care medicine fellows would improve over the course of training. They found that all fellows who completed 3 years of training during the study period achieved an acceptable 90% overall tracheal intubation success rate. They concluded that further investigations on a larger scale across different training programs are necessary to clarify intensity and duration of the training to achieve tracheal intubation procedural competency.
AHRQ-funded; HS021583; HS022464.
Citation: Ishizuka M, Rangarajan V, Sawyer TL .
The development of tracheal intubation proficiency outside the operating suite during pediatric critical care medicine fellowship training: a retrospective cohort study using cumulative sum analysis.
Pediatr Crit Care Med 2016 Jul;17(7):e309-16. doi: 10.1097/pcc.0000000000000774.
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Keywords: Children/Adolescents, Critical Care, Education: Continuing Medical Education, Children/Adolescents, Respiratory Conditions
Augustine J, Warholak TL, Hines LE
Ability and use of comparative effectiveness research by P&T committee members and support staff: a 1-year follow-up.
The study’s objective was to provide a follow-up assessment of the use of comparative effectiveness research (CER) in the pharmacy and therapeutics (P&T) committee decision-making process, using information collected from participants 1 year after attending a live continuing education program. It concluded that health professionals attending a continuing education CER program reported higher use of CER materials compared with nonattendees.
AHRQ-funded; HS019220.
Citation: Augustine J, Warholak TL, Hines LE .
Ability and use of comparative effectiveness research by P&T committee members and support staff: a 1-year follow-up.
J Manag Care Spec Pharm 2016 Jun;22(6):618-25. doi: 10.18553/jmcp.2016.22.6.618.
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Keywords: Comparative Effectiveness, Education: Continuing Medical Education, Provider: Health Personnel, Provider: Pharmacist
Kamal AH, Anderson WG, Boss RD
The Cambia Sojourns Scholars Leadership Program: project summaries from the inaugural scholar cohort.
The Cambia Health Foundation designed the Sojourns Scholar Leadership Program to facilitate leadership development among budding palliative care leaders. This paper presents the background, aims, and results to date of each of the projects from the scholars of the inaugural cohort.
AHRQ-funded; HS023681.
Citation: Kamal AH, Anderson WG, Boss RD .
The Cambia Sojourns Scholars Leadership Program: project summaries from the inaugural scholar cohort.
J Palliat Med 2016 Jun;19(6):591-600. doi: 10.1089/jpm.2016.0086.
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Keywords: Healthcare Delivery, Education: Continuing Medical Education, Palliative Care, Training
Snyder ME, Frail CK, Gernant SA
Fellowships in community pharmacy research: experiences of five schools and colleges of pharmacy.
The researchers described common facilitators, challenges, and lessons learned in 5 schools and colleges of pharmacy in establishing community pharmacy research fellowships. They found that common characteristics across the programs include length of training, prerequisites, graduate coursework, mentoring structure, and immersion into a pharmacist patient care practice. A common challenge has been recruitment, with many programs experiencing at least one year without filling the fellowship position.
AHRQ-funded; HS022119.
Citation: Snyder ME, Frail CK, Gernant SA .
Fellowships in community pharmacy research: experiences of five schools and colleges of pharmacy.
J Am Pharm Assoc 2016 May-Jun;56(3):316-22. doi: 10.1016/j.japh.2015.11.015.
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Keywords: Community-Based Practice, Education: Continuing Medical Education, Provider: Pharmacist
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
Kayle M, Brennan-Cook J, Carter BM
Evaluation of a sickle cell disease educational website for emergency providers.
Electronic surveys were used to conduct a formal evaluation of the accuracy and relevance of the website's content, as well as the effectiveness of the education modules in improving knowledge among health care providers. Both sickle cell disease experts and ED providers agreed that the module content was clear and easy to understand, accurate, comprehensive, relevant, and met module objectives.
AHRQ-funded; HS019646.
Citation: Kayle M, Brennan-Cook J, Carter BM .
Evaluation of a sickle cell disease educational website for emergency providers.
Adv Emerg Nurs J 2016 Apr-Jun;38(2):123-32. doi: 10.1097/tme.0000000000000099.
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Keywords: Education: Continuing Medical Education, Emergency Department, Health Information Technology (HIT), Provider, Sickle Cell Disease
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
Sulzer SH, Feinstein NW, Wendland CL
Assessing empathy development in medical education: a systematic review.
The authors examined how researchers define the central construct of empathy and what they choose to measure. They found that the majority of studies were characterised by internal inconsistencies and vagueness in both the conceptualization and operationalization of empathy, constraining the validity and usefulness of the research. They suggested that future research follow the lead of basic scientific research that conceptualizes empathy as relational rather than as a personal quality that may be modified wholesale through appropriate training.
AHRQ-funded; HS000032.
Citation: Sulzer SH, Feinstein NW, Wendland CL .
Assessing empathy development in medical education: a systematic review.
Med Educ 2016 Mar;50(3):300-10. doi: 10.1111/medu.12806.
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Keywords: Education: Academic, Education: Continuing Medical Education, Patient-Centered Healthcare, Clinician-Patient Communication
Fordis M, King JE, Bonaduce de Nigris F
Dissemination of evidence from systematic reviews through academic CME providers: a feasibility study.
This study explored the feasibility of working with continuing medical education (CME) directors and faculty to promote systematic review utilization. They found that potential barriers included faculty unfamiliarity with systematic reviews, challenges in maintaining review currency, and review scope. Systematic review evidence and summary products proved acceptable to CME directors, course faculty, and learners by multiple measures, demonstrating the feasibility of approaches to use AHRQ-SRs in CME courses and programming.
AHRQ-funded; 290200810015.
Citation: Fordis M, King JE, Bonaduce de Nigris F .
Dissemination of evidence from systematic reviews through academic CME providers: a feasibility study.
J Contin Educ Health Prof 2016 Spring;36(2):104-12. doi: 10.1097/ceh.0000000000000074.
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Keywords: Communication, Education: Continuing Medical Education, Evidence-Based Practice, Implementation
Calaman S, Hepps JH, Bismilla Z
The creation of standard-setting videos to support faculty observations of learner performance and entrustment decisions.
The authors report their experience developing videos that represent five levels of performance for an entrustable professional activities (EPA) for patient handoffs. They describe a process that begins with mapping the EPA to the critical competencies needed to make an entrustment decision. Each competency is then defined by five milestones (behavioral descriptors of performance at five advancing levels).
AHRQ-funded; HS019456.
Citation: Calaman S, Hepps JH, Bismilla Z .
The creation of standard-setting videos to support faculty observations of learner performance and entrustment decisions.
Acad Med 2016 Feb;91(2):204-9. doi: 10.1097/acm.0000000000000853..
Keywords: Education: Continuing Medical Education, Provider Performance, Patient Safety, Quality of Care
Gurm HS, Sanz-Guerrero J, Johnson DD
Using simulation for teaching femoral arterial access: a multicentric collaboration.
The purpose of this paper was to assess the impact of simulation training on complications associated with femoral arterial access obtained by first year cardiology fellows. The authors found that incorporation of simulation in the training of first year fellows was associated with an improvement in proficiency and a clinically meaningful reduction in vascular complications.
AHRQ-funded; HS020447.
Citation: Gurm HS, Sanz-Guerrero J, Johnson DD .
Using simulation for teaching femoral arterial access: a multicentric collaboration.
Catheter Cardiovasc Interv 2016 Feb 15;87(3):376-80. doi: 10.1002/ccd.26256.
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Keywords: Adverse Events, Education: Continuing Medical Education, Patient Safety, Surgery, Training
Broder-Fingert S, Ferrone CF, Giauque A
Residents' knowledge and comfort with caring for children with autism spectrum disorder.
The authors evaluated a cohort of pediatric residents’ knowledge of and comfort with caring for children with autism spectrum disorder (ASD). Their data suggest that more education is needed to increase resident competence in caring for individuals with ASD. Residents reported very low rates of direct communication with patients with ASD and no residents had used pictures to communicate with these patients. The authors found it concerning that few residents had found resources to help these patients with their communication needs. At the same time, comfort with using pictures to communicate was scored higher than other domains.
AHRQ-funded; HS000063.
Citation: Broder-Fingert S, Ferrone CF, Giauque A .
Residents' knowledge and comfort with caring for children with autism spectrum disorder.
Clin Pediatr 2014 Dec;53(14):1390-2. doi: 10.1177/0009922814526982.
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Keywords: Autism, Children/Adolescents, Education: Continuing Medical Education, Children/Adolescents, Clinician-Patient Communication
Smith CS, Hill W, Francovich C
Diagnostic reasoning across the medical education continuum.
The researchers aimed to study linguistic and non-linguistic elements of diagnostic reasoning across the continuum of medical education. They identified three major findings: (1) The "apprentice effect" in novices (high stress and low narrative competence); (2) logistic concept growth in intermediates; and (3) a cognitive state transition (between analytical and intuitive approaches) in experts.
AHRQ-funded; HS018063.
Citation: Smith CS, Hill W, Francovich C .
Diagnostic reasoning across the medical education continuum.
Healthcare 2014 Jul 15;2(3):253-71. doi: 10.3390/healthcare2030253.
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Keywords: Education: Continuing Medical Education, Education: Continuing Medical Education, Patient Safety, Training
Cook JM, Newman E
A consensus statement on trauma mental health: the New Haven Competency Conference process and major findings.
The purpose of this article was to state the need for a comprehensive model of trauma-focused, empirically informed competencies for psychiatrists, and describe the work resulting from the New Haven Competencies consensus conference. The 60 participating experts outlined 5 broad foundational and functional competencies in the areas of trauma-focused and trauma-informed scientific knowledge, psychosocial assessment, psychosocial interventions, professionalism, and relational and systems. Eight cross-cutting competencies were voted into the resulting consensus statement.
AHRQ-funded; HS021602.
Citation: Cook JM, Newman E .
A consensus statement on trauma mental health: the New Haven Competency Conference process and major findings.
Psychol Trauma 2014 Jul;6(4):300-07. doi: 10.1037/a0036747..
Keywords: Trauma, Behavioral Health, Evidence-Based Practice, Education: Continuing Medical Education, Training
Shelton J, Kummerow K, Phillips S
Patient safety in the era of the 80-hour workweek.
The purpose of this paper was to evaluate the effect of duty-hour regulations (DHR) on patient safety. The researchers found no differences in the patient safety indicator (PSI) rates over time for hemorrhage or hematoma, physiologic or metabolic derangement, accidental puncture or laceration, or wound dehiscence. Teaching hospitals had higher rates than non-teaching hospitals both preintervention and postintervention for all the PSIs except wound dehiscence.
AHRQ-funded; HS013833.
Citation: Shelton J, Kummerow K, Phillips S .
Patient safety in the era of the 80-hour workweek.
J Surg Educ 2014 Jul-Aug;71(4):551-9. doi: 10.1016/j.jsurg.2013.12.011.
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Keywords: Adverse Events, Education: Continuing Medical Education, Patient Safety, Quality Indicators (QIs), Provider
Arora VM, Berhie S, Horwitz LI
Using standardized videos to validate a measure of handoff quality: the handoff mini-clinical examination exercise.
The researchers report the results of the development of a shorter Handoff Mini-Clinical Examination Exercise (CEX), along with the formal establishment of its construct validity, namely its ability to distinguish between levels of performance in 3 domains of handoff quality. They were able to demonstrate evidence that the Handoff Mini-CEX can draw reliable and valid conclusions regarding handoff performance by physicians in U.S. hospitals.
AHRQ-funded; HS018278
Citation: Arora VM, Berhie S, Horwitz LI .
Using standardized videos to validate a measure of handoff quality: the handoff mini-clinical examination exercise.
J Hospital Med. 2014 Jul;9(7):441-6. doi: 10.1002/jhm.2185.
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Keywords: Provider Performance, Quality Measures, Quality Improvement, Quality of Care, Education: Continuing Medical Education, Patient Safety
Stahl JE, Balasubramanian HJ, Gao X
Balancing clinical experience in outpatient residency training.
In order to balance the range of clinical experiences to which medical residents are exposed during their training, the authors set out to develop a framework for systematically optimizing patient reassignment at the beginning of the academic year. Their approach was based on a computer algorithm that they designed to sort patient panels by weighting factors of interest such as age, gender, and complexity.
AHRQ-funded; HS018795.
Citation: Stahl JE, Balasubramanian HJ, Gao X .
Balancing clinical experience in outpatient residency training.
Med Decis Making. 2014 May;34(4):464-72. doi: 10.1177/0272989X14524304..
Keywords: Education: Continuing Medical Education, Health Information Technology (HIT), Patient Safety