National Healthcare Quality and Disparities Report
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Topics
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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
101 to 125 of 139 Research Studies DisplayedBurstein 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
Campbell-Voytal K, Daly JM, Nagykaldi ZJ
Team science approach to developing consensus on research good practices for practice-based research networks: A case study.
Using peer learning strategies, seven experienced practice-based research networks (PBRNs) working in collaborative teams articulated procedures for PBRN Research Good Practices (PRGPs). The PRGPs is a PBRN-specific resource to facilitate PBRN management and staff training, to promote adherence to study protocols, and to increase validity and generalizability of study findings. This paper describes the team science processes which culminated in the PRGPs.
AHRQ-funded; HS016713; HS019601.
Citation: Campbell-Voytal K, Daly JM, Nagykaldi ZJ .
Team science approach to developing consensus on research good practices for practice-based research networks: A case study.
Clin Transl Sci 2015 Dec;8(6):632-7. doi: 10.1111/cts.12363.
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Keywords: Primary Care: Models of Care, Practice-Based Research Network (PBRN), Primary Care, Teams, Implementation
Etchegaray JM, Thomas EJ
Engaging employees: the importance of high-performance work systems for patient safety.
The researchers developed and tested survey items that measure high-performance work systems (HPWSs), reported psychometric characteristics of the survey, and examined associations between HPWSs and teamwork culture, safety culture, and overall patient safety grade. They concluded that the HPWSs survey was reliable, distinct from safety culture and teamwork culture based on a confirmatory factor analysis.
AHRQ-funded; HS017145.
Citation: Etchegaray JM, Thomas EJ .
Engaging employees: the importance of high-performance work systems for patient safety.
J Patient Saf 2015 Dec;11(4):221-7. doi: 10.1097/pts.0000000000000076.
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Keywords: Patient Safety, Quality of Care, Teams
Nembhard IM, Morrow CT, Bradley EH
Implementing role-changing versus time-changing innovations in health care: differences in helpfulness of staff improvement teams, management, and network for learning.
This paper examined the hypothesis that the degree to which access to groups that can alter organizational learning depends on innovation type. Team representativeness and network membership were positively associated with implementing role-changing practices; while senior management engagement was positively associated with implementing time-changing practices. The authors concluded that these findings advance implementation science by explaining mixed results across past studies, that the nature of change for workers alters potential facilitators' effects on implementation.
AHRQ-funded; HS018987.
Citation: Nembhard IM, Morrow CT, Bradley EH .
Implementing role-changing versus time-changing innovations in health care: differences in helpfulness of staff improvement teams, management, and network for learning.
Med Care Res Rev 2015 Dec;72(6):707-35. doi: 10.1177/1077558715592315.
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Keywords: Healthcare Delivery, Quality Improvement, Organizational Change, Teams, Quality of Care, Learning Health Systems, Implementation
Fernandez R, Grand JA
Leveraging social science-healthcare collaborations to improve teamwork and patient safety.
This article highlights guiding team science principles from the organizational psychology literature that can be applied to the study of teams in healthcare. The authors' goal is to provide some common language and understanding around teams and teamwork. Additionally, they hope to impart an appreciation for the potential synergy present within clinician-social scientist collaborations.
AHRQ-funded; HS020295; HS022458.
Citation: Fernandez R, Grand JA .
Leveraging social science-healthcare collaborations to improve teamwork and patient safety.
Curr Probl Pediatr Adolesc Health Care 2015 Dec;45(12):370-7. doi: 10.1016/j.cppeds.2015.10.005.
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Keywords: Patient Safety, Teams, Quality Improvement, Quality of Care, Medical Errors, Adverse Events
Graetz I, Huang J, Brand R
The impact of electronic health records and teamwork on diabetes care quality.
The researchers examined whether team cohesion among primary care team members changed the association between EHR use and changes in clinical outcomes for patients with diabetes. They found that patients cared for by higher cohesion primary care teams experienced modest but statistically significantly greater EHR-related health outcome improvements, compared with patients cared for by providers practicing in lower cohesion teams.
AHRQ-funded; HS015280; HS021082.
Citation: Graetz I, Huang J, Brand R .
The impact of electronic health records and teamwork on diabetes care quality.
Am J Manag Care 2015 Dec;21(12):878-84.
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Keywords: Diabetes, Electronic Health Records (EHRs), Quality of Care, Primary Care, Teams
Dykes PC, Stade D, Dalal A
Strategies for managing mobile devices for use by hospitalized inpatients.
The authors implemented the PROSPECT (Promoting Respect and Ongoing Safety through Patient-centeredness, Engagement, Communication and Technology) project at Brigham and Women's Hospital. The goal of PROSPECT is to transform the hospital environment by providing a suite of e-tools to facilitate teamwork. In this paper, the authors described decisions and challenges faced and related the strategies used and lessons learned.
AHRQ-funded; HS023535.
Citation: Dykes PC, Stade D, Dalal A .
Strategies for managing mobile devices for use by hospitalized inpatients.
AMIA Annu Symp Proc 2015 Nov 5;2015:522-31.
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Keywords: Communication, Inpatient Care, Patient and Family Engagement, Patient Safety, Teams
Rosenman ED, Ilgen JS, Shandro JR
A systematic review of tools used to assess team leadership in health care action teams.
This review summarized the characteristics of tools used to assess leadership in health care action (HCA) teams. It described 61 team leadership assessment tools. Forty-nine tools provided behaviors, skills, or characteristics to define leadership. Forty-four tools assessed leadership as one component of a larger assessment, 13 tools identified leadership as the primary focus of the assessment, and 4 assessed leadership style.
AHRQ-funded; HS020295.
Citation: Rosenman ED, Ilgen JS, Shandro JR .
A systematic review of tools used to assess team leadership in health care action teams.
Acad Med 2015 Oct;90(10):1408-22. doi: 10.1097/acm.0000000000000848.
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Keywords: Teams, Tools & Toolkits
O'Leary KJ, Creden AJ, Slade ME
Implementation of unit-based interventions to improve teamwork and patient safety on a medical service.
The authors compared a pre- versus post-intervention on Structured Interdisciplinary Rounds (SIDRs). They found that paired analyses for 82 professionals completing surveys revealed improved teamwork, which was driven mainly by nurses, and that the adverse events rate was similar across study periods; however, SIDR did not reduce adverse events.
AHRQ-funded; HS019630.
Citation: O'Leary KJ, Creden AJ, Slade ME .
Implementation of unit-based interventions to improve teamwork and patient safety on a medical service.
Am J Med Qual 2015 Sep-Oct;30(5):409-16. doi: 10.1177/1062860614538093.
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Keywords: Adverse Events, Provider: Health Personnel, Inpatient Care, Patient Safety, Teams
Xie A, Carayon P, Cox ED
Application of participatory ergonomics to the redesign of the family-centred rounds process.
This study applied a participatory ergonomics (PE) approach to redesigning the family-centred rounds (FCR) process to improve family engagement. Human factors and ergonomics (HFE) principles were integrated in both the content and process of FCR redesign. The authors described activities of the PE process and presented data on PE process evaluation. They concluded that to demonstrate the value of PE-based FCR redesign, future research should document its impact on FCR process measures and patient outcome measures.
AHRQ-funded; HS018680.
Citation: Xie A, Carayon P, Cox ED .
Application of participatory ergonomics to the redesign of the family-centred rounds process.
Ergonomics 2015;58(10):1726-44. doi: 10.1080/00140139.2015.1029534.
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Keywords: Healthcare Delivery, Hospitals, Patient and Family Engagement, Patient-Centered Healthcare, Teams
Ward MM, Zhu X, Lampman M
TeamSTEPPS implementation in community hospitals: adherence to recommended training approaches.
The purpose of this paper is to examine approaches taken by community hospital personnel and compare those to the best practices recommended by Weaver et al. The authors find that training implementation in community hospitals differs significantly from the established, research-based principles for effective team training described in the research literature, which is largely based in academic medical centers.
AHRQ-funded; HS018396.
Citation: Ward MM, Zhu X, Lampman M .
TeamSTEPPS implementation in community hospitals: adherence to recommended training approaches.
Int J Health Care Qual Assur 2015;28(3):234-44. doi: 10.1108/ijhcqa-10-2013-0124..
Keywords: TeamSTEPPS, Hospitals, Training, Teams