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AHRQ Research Studies Date
Topics
- Access to Care (2)
- Adverse Drug Events (ADE) (1)
- Adverse Events (1)
- (-) Ambulatory Care and Surgery (37)
- Antibiotics (1)
- Behavioral Health (2)
- Blood Pressure (1)
- Blood Thinners (1)
- Cardiovascular Conditions (1)
- Care Management (2)
- Central Line-Associated Bloodstream Infections (CLABSI) (1)
- Children/Adolescents (7)
- Chronic Conditions (3)
- Clinical Decision Support (CDS) (1)
- Clinician-Patient Communication (2)
- Communication (2)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (1)
- COVID-19 (1)
- Depression (1)
- Diagnostic Safety and Quality (2)
- Digestive Disease and Health (1)
- Education: Patient and Caregiver (1)
- Electronic Health Records (EHRs) (6)
- Emergency Medical Services (EMS) (1)
- Genetics (1)
- Healthcare-Associated Infections (HAIs) (1)
- Healthcare Cost and Utilization Project (HCUP) (1)
- Healthcare Costs (3)
- Healthcare Delivery (5)
- Healthcare Utilization (1)
- Health Information Technology (HIT) (6)
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- Health Services Research (HSR) (1)
- Health Systems (1)
- Hospitalization (1)
- Hospitals (3)
- Implementation (1)
- Kidney Disease and Health (1)
- Medicaid (2)
- Medical Errors (2)
- Medical Expenditure Panel Survey (MEPS) (1)
- Medicare (1)
- Medication (7)
- Medication: Safety (3)
- Opioids (2)
- Pain (2)
- Patient-Centered Healthcare (1)
- Patient-Centered Outcomes Research (1)
- Patient Experience (1)
- Patient Safety (7)
- Payment (4)
- Practice Patterns (1)
- Prevention (1)
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- Provider (1)
- Provider: Clinician (1)
- Provider: Health Personnel (2)
- Provider: Nurse (1)
- Provider: Physician (1)
- Provider Performance (1)
- Quality Improvement (2)
- Quality Indicators (QIs) (1)
- Quality of Care (5)
- Racial and Ethnic Minorities (1)
- Registries (1)
- Respiratory Conditions (1)
- Risk (1)
- Rural/Inner-City Residents (1)
- Sepsis (1)
- Shared Decision Making (1)
- Surgery (1)
- Tools & Toolkits (1)
- Urban Health (1)
- Vulnerable Populations (1)
- Workflow (4)
- Young Adults (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 25 of 37 Research Studies DisplayedBenneyan JC, White T, Nehls N
Systems analysis of a dedicated ambulatory respiratory unit for seeing and ensuring follow-up of patients with COVID-19 symptoms.
This paper is a systems analysis of a dedicated ambulatory respiratory unit for patients with COVID-19 symptoms. Workflow redesigns were necessitated by COVID and included new ambulatory workflows to handle surge volumes, protect patients and staff, and ensure timely reliable care. The workflow innovations observed can possibly be used to benefit routine care. Observations found that more than 85% of follow-ups were completed within 24 hours, and no staff or patient infections were associated with unit operations. Identified issues included role confusion, staffing and gatekeeping bottlenecks, and patient reluctance to visit in person or discuss concerns on the phone.
AHRQ-funded; HS027282.
Citation: Benneyan JC, White T, Nehls N .
Systems analysis of a dedicated ambulatory respiratory unit for seeing and ensuring follow-up of patients with COVID-19 symptoms.
J Ambul Care Manage 2021 Oct-Dec;44(4):293-303. doi: 10.1097/jac.0000000000000390..
Keywords: COVID-19, Ambulatory Care and Surgery, Respiratory Conditions, Workflow, Healthcare Delivery
Lafferty M, Manojlovich M, Griggs JJ
Clinicians report barriers and facilitators to high-quality ambulatory oncology care.
This study’s aim was to examine clinician-reported factors within ambulatory oncology practices that affect care delivery processes and outcomes for patients and clinicians. Survey data were collected in 2017 from 298 clinicians across 29 ambulatory practices in Michigan. Clinicians provided written comments on 5 work-system components of the Systems Engineering Initiative for Patient Safety model that affected care delivery and outcome. Unfavorable aspects included staffing shortages and high patient volume, limited physical space, electronic health record usability issues, and order entry. Favorable aspects focused on the skills of colleagues, and collaboration and teamwork of the clinical staff.
AHRQ-funded; HS024914.
Citation: Lafferty M, Manojlovich M, Griggs JJ .
Clinicians report barriers and facilitators to high-quality ambulatory oncology care.
Cancer Nurs 2021 Sep-Oct;44(5):E303-E10. doi: 10.1097/ncc.0000000000000832..
Keywords: Ambulatory Care and Surgery, Healthcare Delivery, Quality of Care
Joseph A, Neyens D, Mihandoust S
Impact of surgical table orientation on flow disruptions and movement patterns during pediatric outpatient surgeries.
This quantitative observational study observed the impacts of surgical table orientation on flow disruptions (FDs), the number of contacts between team members, and the distance traveled. Findings showed that the orientation of the surgical table significantly influenced staff workflow and movement in the operating room, with an angled surgical table orientation being the least disruptive to surgical work. The anesthesia provider, scrub nurse, and circulating nurse experienced more FDs compared to the surgeon.
AHRQ-funded; HS024380.
Citation: Joseph A, Neyens D, Mihandoust S .
Impact of surgical table orientation on flow disruptions and movement patterns during pediatric outpatient surgeries.
Int J Environ Res Public Health 2021 Jul 31;18(15). doi: 10.3390/ijerph18158114..
Keywords: Children/Adolescents, Ambulatory Care and Surgery, Surgery, Workflow
Shi Y, Amill-Rosario A, Rudin RS
Barriers to using clinical decision support in ambulatory care: do clinics in health systems fare better?
In this study, the investigators quantified the use of clinical decision support (CDS) and the specific barriers reported by ambulatory clinics and examined whether CDS utilization and barriers differed based on clinics' affiliation with health systems, providing a benchmark for future empirical research and policies related to this topic.
AHRQ-funded; HS024067.
Citation: Shi Y, Amill-Rosario A, Rudin RS .
Barriers to using clinical decision support in ambulatory care: do clinics in health systems fare better?
J Am Med Inform Assoc 2021 Jul 30;28(8):1667-75. doi: 10.1093/jamia/ocab064..
Keywords: Clinical Decision Support (CDS), Shared Decision Making, Ambulatory Care and Surgery, Health Information Technology (HIT), Health Systems
Watterson TL, Stone JA, Brown R
CancelRx: a health IT tool to reduce medication discrepancies in the outpatient setting.
Medication list discrepancies between outpatient clinics and pharmacies can lead to medication errors. Within the last decade, a new health information technology (IT), CancelRx, emerged to send a medication cancellation message from the clinic's electronic health record (EHR) to the outpatient pharmacy's software. The objective of this study was to measure the impact of CancelRx on reducing medication discrepancies between the EHR and pharmacy dispensing software.
AHRQ-funded; HS025793.
Citation: Watterson TL, Stone JA, Brown R .
CancelRx: a health IT tool to reduce medication discrepancies in the outpatient setting.
J Am Med Inform Assoc 2021 Jul 14;28(7):1526-33. doi: 10.1093/jamia/ocab038..
Keywords: Medication: Safety, Medication, Medical Errors, Adverse Drug Events (ADE), Adverse Events, Patient Safety, Electronic Health Records (EHRs), Health Information Technology (HIT), Ambulatory Care and Surgery
Chou LN, Kuo YF, Raji MA
Potentially inappropriate medication prescribing by nurse practitioners and physicians.
This study compared prescribing rates for potentially inappropriate medications (PIMs) by physicians and nurse practitioners (NPs). The authors used 100% Texas Medicare data to define physician and NP visits in 2016. Rates of visits with a PIM prescription from the same provider was measured by initial and refill visits. There were 24.1 per 1000 visits for PIM prescriptions, 9.0 per 1000 visits for an initial PM and 15.1 per 1000 visits for a refill PIM. Visits to an NP was less likely to result in an initial and refill PIM visit than a visit to a physician. There was a strong association of lower odds of a black enrollee receiving a PIM by an NP than white enrollees. There was also less likelihood of receiving a PIM refill from an NP in older patients and in those with more comorbidities.
AHRQ-funded; HS020642; HS020642.
Citation: Chou LN, Kuo YF, Raji MA .
Potentially inappropriate medication prescribing by nurse practitioners and physicians.
J Am Geriatr Soc 2021 Jul;69(7):1916-24. doi: 10.1111/jgs.17120..
Keywords: Medication: Safety, Medication, Provider: Physician, Provider: Nurse, Hospitalization, Practice Patterns, Ambulatory Care and Surgery
Staley BS, Milko LV, Waltz M
Evaluating the clinical utility of early exome sequencing in diverse pediatric outpatient populations in the North Carolina Clinical Genomic Evaluation of Next-generation Exome Sequencing (NCGENES) 2 study: a randomized controlled trial.
Exome sequencing (ES) has probable utility for shortening the diagnostic odyssey of children with suspected genetic disorders. This report described the design and methods of a study evaluating the potential of ES as a routine clinical tool for pediatric patients who have suspected genetic conditions and who are in the early stages of the diagnostic odyssey.
AHRQ-funded; HS000032.
Citation: Staley BS, Milko LV, Waltz M .
Evaluating the clinical utility of early exome sequencing in diverse pediatric outpatient populations in the North Carolina Clinical Genomic Evaluation of Next-generation Exome Sequencing (NCGENES) 2 study: a randomized controlled trial.
Trials 2021 Jun 14;22(1):395. doi: 10.1186/s13063-021-05341-2..
Keywords: Children/Adolescents, Genetics, Ambulatory Care and Surgery
Shekelle PG, Pane JD, Agniel D
Assessment of variation in electronic health record capabilities and reported clinical quality performance in ambulatory care clinics, 2014-2017.
This study’s objective was to assess the association between electronic health records (EHRs) with different degrees of capabilities and publicly reported ambulatory quality measures in at least 3 clinical domains of care. This cross-sectional and longitudinal study was conducted using survey responses from 1141 ambulatory clinics in Minnesota, Washington, and Wisconsin affiliated with a health system and reported performance measures in 2014 to 2017. A composite measure of EHR capability that considered 50 EHR capabilities was created using 7 functional domains: no functional EHR, EHR underuser, EHR, neither underuser nor superuser, and EHR superuser; as well as a standardized composite of ambulatory clinical measures that included a median of 13 individual measures (3 to 25). The proportion of clinics that were EHR superusers increased from 51% in 2014 to 61% in 2017. In all survey years EHR superusers had better clinical quality performance than other clinics. This difference in scores translated into an approximately 9% difference in a clinic’s rank order in clinical quality.
AHRQ-funded; HS024067.
Citation: Shekelle PG, Pane JD, Agniel D .
Assessment of variation in electronic health record capabilities and reported clinical quality performance in ambulatory care clinics, 2014-2017.
JAMA Netw Open 2021 Apr;4(4):e217476. doi: 10.1001/jamanetworkopen.2021.7476..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Ambulatory Care and Surgery, Provider Performance, Quality of Care
Ahmedov M, Pourat N, Liu H
Consumer Assessment of Healthcare Providers and Systems (CAHPS®) survey of experiences with ambulatory healthcare for Asians and non-Hispanic Whites in the United States.
This paper discusses the results of the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Clinical and Group (CG-CAHPS) Adult Visit Survey 1.0 which includes data on care experiences to compare specific aspects of care of Asians and Whites. Most surveys were administered by mail with a sample comprised of 64% female, 89% White, 2% Asian, 39% 65 years or older, and 32% were high school graduates or less. Asians reported worse access, lower scores on office staff courtesy and helpfulness and rating their doctors, and were less likely to recommend their doctors to family/friends than did Whites.
AHRQ-funded; HS016980; HS016978.
Citation: Ahmedov M, Pourat N, Liu H .
Consumer Assessment of Healthcare Providers and Systems (CAHPS®) survey of experiences with ambulatory healthcare for Asians and non-Hispanic Whites in the United States.
J Patient Rep Outcomes 2021 Mar 24;5(1):29. doi: 10.1186/s41687-021-00303-3..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Racial and Ethnic Minorities, Patient Experience, Quality of Care, Ambulatory Care and Surgery
Post B, Norton EC, Hollenbeck B
Hospital-physician integration and Medicare's site-based outpatient payments.
AHRQ-funded; HS027044.
Citation: Post B, Norton EC, Hollenbeck B .
Hospital-physician integration and Medicare's site-based outpatient payments.
Health Serv Res 2021 Feb;56(1):7-15. doi: 10.1111/1475-6773.13613..
Keywords: Hospitals, Payment, Medicare, Ambulatory Care and Surgery, Healthcare Delivery
Hood-Medland EA, White AEC, Kravitz RL
Agenda setting and visit openings in primary care visits involving patients taking opioids for chronic pain.
This study looked at primary care visit opening styles to assess use of agenda and non-agenda setting visit openings and their effects on participant experience with patients taking opioids for chronic pain. The study analyzed 83 video-recorded US primary care visits at a single academic medical center in California. A total of 49 family medicine and internal resident physicians and 83 patients were filmed. The authors developed a coding scheme that assessed the presence of agenda setting, distinct visit opening styles, and the number of total topics, major topics, surprise patient topics, and returns to prior topics discusses. They identified 2 visit opening styles with agenda setting (agenda eliciting, agenda reframing) and 3 non-agenda opening styles (open-ended question, patient launch, physician launch). Only 11% of visits included agenda setting and was associated with fewer surprise patient topics than visits without agenda setting.
AHRQ-funded; HS022236.
Citation: Hood-Medland EA, White AEC, Kravitz RL .
Agenda setting and visit openings in primary care visits involving patients taking opioids for chronic pain.
BMC Fam Pract 2021 Jan 4;22(1):4. doi: 10.1186/s12875-020-01317-4..
Keywords: Primary Care, Opioids, Medication, Pain, Chronic Conditions, Clinician-Patient Communication, Communication, Ambulatory Care and Surgery
Stephens KA, Ike B, Baldwin LM
Challenges and approaches to population management of long-term opioid therapy patients.
Primary care is challenged with safely prescribing opioids for patients with chronic noncancer pain (CNCP), specifically to address risks for overdose, opioid use disorder, and death. In this study, the investigators identified sociotechnical challenges, approaches, and recommendations in primary care to effectively track and monitor patients on long-term opioid therapy, a key component for supporting adoption of opioid prescribing guidelines.
AHRQ-funded; HS023750.
Citation: Stephens KA, Ike B, Baldwin LM .
Challenges and approaches to population management of long-term opioid therapy patients.
J Am Board Fam Med 2021 Jan-Feb;34(1):89-98. doi: 10.3122/jabfm.2021.01.190100..
Keywords: Opioids, Pain, Chronic Conditions, Care Management, Medication, Primary Care, Ambulatory Care and Surgery
Rinke ML, Heo M, Saiman L
Pediatric ambulatory central line-associated bloodstream infections.
Pediatrics 2021 Jan;147(1). doi: 10.1542/peds.2020-0524.
This study looked at ambulatory pediatric central line-associated bloodstream infection (CLABSI) incidence density, risk factors, and outcomes. This retrospective cohort with nested case-control study used data from 5 sites from 2010 through 2015. Chart review was used to confirm central line (CL) use and adjudicated CLABSIs. Out of 4600 potential at-risk children, 247 (15%) experienced 466 ambulatory CLABSIs. Incidence density was highest among patients with tunneled externalized catheters versus peripherally inserted central catheters and totally implanted devices. Clinic visits and low albumin levels were potentially associated with CLABSI. Prophylactic antimicrobial agents for underlying conditions within the preceding 30 days and operating room CL placement were inversely associated with CLABSI. A total of 396 patients were hospitalized because of ambulatory CLABSI with an 8-day median length of stay.
This study looked at ambulatory pediatric central line-associated bloodstream infection (CLABSI) incidence density, risk factors, and outcomes. This retrospective cohort with nested case-control study used data from 5 sites from 2010 through 2015. Chart review was used to confirm central line (CL) use and adjudicated CLABSIs. Out of 4600 potential at-risk children, 247 (15%) experienced 466 ambulatory CLABSIs. Incidence density was highest among patients with tunneled externalized catheters versus peripherally inserted central catheters and totally implanted devices. Clinic visits and low albumin levels were potentially associated with CLABSI. Prophylactic antimicrobial agents for underlying conditions within the preceding 30 days and operating room CL placement were inversely associated with CLABSI. A total of 396 patients were hospitalized because of ambulatory CLABSI with an 8-day median length of stay.
AHRQ-funded; HS024432.
Citation: Rinke ML, Heo M, Saiman L .
Pediatric ambulatory central line-associated bloodstream infections.
Pediatrics 2021 Jan;147(1). doi: 10.1542/peds.2020-0524..
Keywords: Children/Adolescents, Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Ambulatory Care and Surgery, Risk, Sepsis
Shenkman E, Thompson L, Bussing R
AHRQ Author: Mistry KB
Provider specialty and receipt of metabolic monitoring for children taking antipsychotics.
Metabolic monitoring is important for children taking antipsychotic medication, given the risk for increased BMI, impaired glucose metabolism, and hyperlipidemia. The purpose of this study was to examine the influence of provider specialty on the receipt of metabolic monitoring. Specifically, differences in the receipt of recommended care when a child receives outpatient care from a primary care provider (PCP), a mental health provider with prescribing privileges, or both was examined.
AHRQ-authored; AHRQ-funded; HS025298.
Citation: Shenkman E, Thompson L, Bussing R .
Provider specialty and receipt of metabolic monitoring for children taking antipsychotics.
Pediatrics 2021 Jan;147(1):e20200658. doi: 10.1542/peds.2020-0658..
Keywords: Children/Adolescents, Medication: Safety, Medication, Ambulatory Care and Surgery
Sharma AE, Yang J, Del Rosario JB
What safety events are reported for ambulatory care? Analysis of incident reports from a Patient Safety Organization.
Health care staff document patient safety events using incident reporting systems, which are compiled within Patient Safety Organization databases. In this study, researchers sought to describe the patterns and characteristics of incident reporting behaviors for ambulatory care from in-situ reporting systems from the United States. The investigators concluded that outpatient reporting systems were limited for primary care and home/community settings, but ambulatory care systems reported more harmful events related to diagnosis and patient and caregiver challenges.
AHRQ-funded; HS21322.
Citation: Sharma AE, Yang J, Del Rosario JB .
What safety events are reported for ambulatory care? Analysis of incident reports from a Patient Safety Organization.
Jt Comm J Qual Patient Saf 2021 Jan;47(1):5-14. doi: 10.1016/j.jcjq.2020.08.010..
Keywords: Patient Safety, Ambulatory Care and Surgery
Gooding HC, Brown CA, Wisk LE
Investing in our future: the importance of ambulatory visits to achieving blood pressure control in young adults.
In this commentary, the authors discuss an article written by King, et al. and published in 2017 in the Journal of Clinical Hypertension, entitled “The importance of frequent return visits and hypertension control among US young adults: a multidisciplinary group practice observational study.”
AHRQ-funded; K12 HS022986.
Citation: Gooding HC, Brown CA, Wisk LE .
Investing in our future: the importance of ambulatory visits to achieving blood pressure control in young adults.
J Clin Hypertens 2017 Dec;19(12):1298-300. doi: 10.1111/jch.13100..
Keywords: Ambulatory Care and Surgery, Care Management, Blood Pressure, Young Adults
Sarkar U, McDonald K, Motala A
Pragmatic insights on patient safety priorities and intervention strategies in ambulatory settings.
In this article, the investigators (1) reviewed the methods and results for the key informant input process for a Technical Brief on ambulatory safety commissioned by the Agency for Healthcare Research and Quality (AHRQ), (2) summarized the key informant perspectives on ambulatory safety, (3) expanded on key informant input with specific recommendations for an ambulatory safety agenda, (4) reported on existing initiatives and progress related to key informant perspectives and our recommendations, and (5) proposed specific research and policy activities that would advance ambulatory safety.
AHRQ-funded; 290201500010I.
Citation: Sarkar U, McDonald K, Motala A .
Pragmatic insights on patient safety priorities and intervention strategies in ambulatory settings.
Jt Comm J Qual Patient Saf 2017 Dec;43(12):661-70. doi: 10.1016/j.jcjq.2017.06.009..
Keywords: Ambulatory Care and Surgery, Patient Safety, Quality of Care
Biener AI, Selden TM
AHRQ Author: Biener AI, Selden TM
Public and private payments for physician office visits.
Using data for 2014-15 from the Medical Expenditure Panel Survey to estimate standardized payments for nonelderly adults' physician office visits by type of insurance, researchers found that adults with public insurance, especially Medicaid, had substantially lower provider payments, out-of-pocket spending, and third-party payments than their peers with employer-sponsored or Marketplace insurance.
AHRQ-authored.
Citation: Biener AI, Selden TM .
Public and private payments for physician office visits.
Health Aff 2017 Dec;36(12):2160-64. doi: 10.1377/hlthaff.2017.0749.
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Keywords: Healthcare Costs, Payment, Health Insurance, Ambulatory Care and Surgery, Medical Expenditure Panel Survey (MEPS)
Kohler-Forsberg O, Madsen T, Behrendt-Moller I
Trajectories of suicidal ideation over 6 months among 482 outpatients with bipolar disorder.
The researchers aimed to investigate 6-months trajectories of suicidal ideation among adults with bipolar disorder. Using data from the Bipolar CHOICE study, they identified four distinct trajectories and found that more than one in ten adult outpatients with bipolar disorder had moderately increased suicidal ideation throughout 6 months of pharmacotherapy. They recommended that the identified predictors may help clinicians to identify those with additional need for treatment against suicidal thoughts, and future studies need to investigate whether targeted treatment may improve the course of persistent suicidal ideation.
AHRQ-funded; HS019371.
Citation: Kohler-Forsberg O, Madsen T, Behrendt-Moller I .
Trajectories of suicidal ideation over 6 months among 482 outpatients with bipolar disorder.
J Affect Disord 2017 Dec 1;223:146-52. doi: 10.1016/j.jad.2017.07.038.
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Keywords: Behavioral Health, Medication, Ambulatory Care and Surgery, Patient-Centered Healthcare
Cotter D, Barrus D, Ma M
Effects of ESRD bundling on efficiency of U.S. dialysis centers.
The study aim was to evaluate whether the 2011 ESRD Prospective Payment System (PPS) improved the efficiency of U.S. dialysis centers and to identify which providers demonstrated changes in their efficiency after the PPS implementation. It found that about 36 percent of facilities were functioning efficiently in 2010, dropping to only 21-22 percent efficiently operating facilities in 2011-12.
AHRQ-funded; HS024190.
Citation: Cotter D, Barrus D, Ma M .
Effects of ESRD bundling on efficiency of U.S. dialysis centers.
Nephrol News Issues 2017 Oct 18.
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Keywords: Kidney Disease and Health, Payment, Ambulatory Care and Surgery
Clarity C, Sarkar U, Lee J
Clinician perspectives on the management of abnormal subcritical tests in an urban academic safety-net health care system.
Missed or delayed follow-up of abnormal subcritical tests (tests that do not require immediate medical attention) can lead to poor patient outcomes. Safety-net health systems with limited resources and socially complex patients are vulnerable to safety gaps resulting from delayed management. In this study, clinician perspectives to identify system challenges, vulnerable situations, and potential solutions, were sought in focus groups.
AHRQ-funded; HS023558.
Citation: Clarity C, Sarkar U, Lee J .
Clinician perspectives on the management of abnormal subcritical tests in an urban academic safety-net health care system.
Jt Comm J Qual Patient Saf 2017 Oct;43(10):517-23. doi: 10.1016/j.jcjq.2017.05.007..
Keywords: Urban Health, Rural/Inner-City Residents, Diagnostic Safety and Quality, Patient Safety, Vulnerable Populations, Ambulatory Care and Surgery, Communication, Provider: Clinician
Ratanawongsa N, Matta GY, Lyles CR
Multitasking and silent electronic health record use in ambulatory visits.
The researchers studied time allocation and transitions into and out of silent electronic health record (EHR) use in clinics after EHR implementation. Silent EHR use (n = 193 instances) occurred while clinicians viewed (39.4 percent) or entered (24.4 percent) information, prescribed (13.5 percent), reconciled medications (8.3 percent), arranged appointments (5.2 percent), ordered tests or referrals (5.2 percent),and sought or typed patient education (3.1 percent).
AHRQ-funded; HS022408; HS023558; HS022561.
Citation: Ratanawongsa N, Matta GY, Lyles CR .
Multitasking and silent electronic health record use in ambulatory visits.
JAMA Intern Med 2017 Sep;177(9):1382-85. doi: 10.1001/jamainternmed.2017.2668.
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Keywords: Electronic Health Records (EHRs), Ambulatory Care and Surgery, Health Information Technology (HIT)
Ray KN, Martsolf GR, Mehrotra A
Trends in visits to specialist physicians involving nurse practitioners and physician assistants, 2001 to 2013.
The purpose of this study is to examine trends in specialist physician visits where nurse practitioners (NPs) and physician assistants (PAs) provide care, based on the hypothesis that NPs and PAs provide care to patients of specialist physicians in increasing numbers, primarily for routine follow-up visits. Using the National Ambulatory Medical Care Survey (NAMCS) information on samples office visits, researchers identified visits to specialist physicians, divided these into surgical and medical specialists and examined unadjusted trends from 2001 - 2013 in the percentage of visits with NP or PA involvement. Visit characteristics associated with higher likelihood of NP or PA involvement were examined.
AHRQ-funded; HS022989.
Citation: Ray KN, Martsolf GR, Mehrotra A .
Trends in visits to specialist physicians involving nurse practitioners and physician assistants, 2001 to 2013.
JAMA Intern Med 2017 Aug;177(8):1213-16. doi: 10.1001/jamainternmed.2017.1630..
Keywords: Access to Care, Ambulatory Care and Surgery, Healthcare Delivery, Primary Care, Provider
Davis MM, Howk S, Spurlock M
A qualitative study of clinic and community member perspectives on intervention toolkits: "unless the toolkit is used it won't help solve the problem.".
Researchers conducted this study to explore what clinic and community-based users want in intervention toolkits and to identify the factors that support application in practice. They found that participants wanted toolkits targeted at the right audience and demonstrated to be effective. Well organized toolkits, often with a quick start guide, with tools that were easy to tailor and apply were desired.
AHRQ-funded; HS022981.
Citation: Davis MM, Howk S, Spurlock M .
A qualitative study of clinic and community member perspectives on intervention toolkits: "unless the toolkit is used it won't help solve the problem.".
BMC Health Serv Res 2017 Jul 18;17(1):497. doi: 10.1186/s12913-017-2413-y.
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Keywords: Provider: Health Personnel, Ambulatory Care and Surgery, Primary Care, Tools & Toolkits, Implementation
Lee SY, Cherian R, Ly I
Designing and implementing an electronic patient registry to improve warfarin monitoring in the ambulatory setting.
The researchers designed and implemented an electronic registry in conjunction with a complementary work flow that established an active tracking system leading to improved treatment monitoring for patients on anticoagulation therapy. For the cohort of the 357 patients in the registry, the no-show rate decreased from 31 percent (preimplementation) to 21 percent (postimplementation).
AHRQ-funded; HS023558; HS021322.
Citation: Lee SY, Cherian R, Ly I .
Designing and implementing an electronic patient registry to improve warfarin monitoring in the ambulatory setting.
Jt Comm J Qual Patient Saf 2017 Jul;43(7):353-60. doi: 10.1016/j.jcjq.2017.03.006.
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Keywords: Health Information Technology (HIT), Registries, Blood Thinners, Medication, Ambulatory Care and Surgery