National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Events (1)
- Ambulatory Care and Surgery (2)
- Burnout (1)
- Children/Adolescents (1)
- Clinical Decision Support (CDS) (1)
- Communication (1)
- Diagnostic Safety and Quality (1)
- Education: Continuing Medical Education (1)
- Electronic Health Records (EHRs) (5)
- Emergency Department (1)
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- Genetics (1)
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- Organizational Change (1)
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- Patient Safety (3)
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- Provider (1)
- Provider: Health Personnel (1)
- Quality Improvement (3)
- Quality of Care (3)
- Shared Decision Making (1)
- Stress (1)
- Tools & Toolkits (1)
- Training (1)
- (-) Workflow (10)
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 10 of 10 Research Studies DisplayedLowry C, Orr K, Embry B
Primary care scribes: writing a new story for safety net clinics.
The researchers conducted an evaluation of trained volunteer scribes for primary care clinics serving a diverse, low-income population in a US safety net system, which implemented a new EHR between 2011 and 2014. In a safety net primary care system, trained volunteer scribes were associated with improved clinician efficiency and experience and no difference in patient satisfaction.
AHRQ-funded; HS022561; HS023558.
Citation: Lowry C, Orr K, Embry B .
Primary care scribes: writing a new story for safety net clinics.
BMJ Open Qual 2017 Oct 25;6(2):e000124. doi: 10.1136/bmjoq-2017-000124.
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Keywords: Electronic Health Records (EHRs), Patient Experience, Primary Care, Health Information Technology (HIT), Workflow
Benda NC, Fairbanks RJ, Fairbanks RJ
Are you paying attention? Related guidance on how concepts of attention may inform effective time sharing of tasks in emergency medicine.
The authors respond to an earlier article providing a thoughtful introduction to the importance of teaching effective task switching in emergency medicine. Their letter introduces the concept of attention, provides examples of tasks that can be most safely and effectively time shared, and notes that these principles must be considered in designing tools for the time sharing and rapid switching of tasks necessary in the ED environment.
AHRQ-funded; HS022542.
Citation: Benda NC, Fairbanks RJ, Fairbanks RJ .
Are you paying attention? Related guidance on how concepts of attention may inform effective time sharing of tasks in emergency medicine.
Ann Emerg Med 2017 May;69(5):669-70. doi: 10.1016/j.annemergmed.2017.01.027.
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Keywords: Workflow, Emergency Medical Services (EMS), Emergency Department, Patient Safety
Calvitti A, Hochheiser H, Ashfaq S
Physician activity during outpatient visits and subjective workload.
The researchers describe methods for capturing and analyzing EHR use and clinical workflow of physicians during outpatient encounters and relating activity to physicians' self-reported workload. They found that visit activity was highly variable across individual physicians, and the observed activity metrics ranged widely as correlates to subjective workload.
AHRQ-funded; HS021290.
Citation: Calvitti A, Hochheiser H, Ashfaq S .
Physician activity during outpatient visits and subjective workload.
J Biomed Inform 2017 May;69:135-49. doi: 10.1016/j.jbi.2017.03.011.
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Keywords: Healthcare Delivery, Electronic Health Records (EHRs), Health Information Technology (HIT), Workflow, Ambulatory Care and Surgery
Hanauer DA, Branford GL, Greenberg G
Two-year longitudinal assessment of physicians' perceptions after replacement of a longstanding homegrown electronic health record: does a J-curve of satisfaction really exist?
This report describes a 2-year prospective, longitudinal survey of attending physicians in 3 clinical areas (family medicine, general pediatrics, internal medicine) who experienced a transition from a homegrown electronic health record (EHR) to a vendor EHR. The primary goal was to determine if perceptions followed a J-curve pattern in which they initially dropped but eventually surpassed baseline measures. A J-curve was not found for any measures, including workflow, safety, communication, and satisfaction.
AHRQ-funded; HS023613.
Citation: Hanauer DA, Branford GL, Greenberg G .
Two-year longitudinal assessment of physicians' perceptions after replacement of a longstanding homegrown electronic health record: does a J-curve of satisfaction really exist?
J Am Med Inform Assoc 2017 Apr 1;24(e1):e157-e65. doi: 10.1093/jamia/ocw077.
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Keywords: Electronic Health Records (EHRs), Provider: Health Personnel, Ambulatory Care and Surgery, Patient Safety, Workflow
Narayanan J, Dobrin S, Choi J
Structured clinical documentation in the electronic medical record to improve quality and to support practice-based research in epilepsy.
The researchers describe a stepwise process for building structured clinical documentation support tools in the electronic medical record (EMR) that define best practices in epilepsy, and describe how they incorporated these toolkits into their clinical workflow. These tools write notes and capture hundreds of fields of data including several score tests. They also summarize brain imaging, blood laboratory, and electroencephalography results, and document neuromodulation treatments.
AHRQ-funded; HS024057.
Citation: Narayanan J, Dobrin S, Choi J .
Structured clinical documentation in the electronic medical record to improve quality and to support practice-based research in epilepsy.
Epilepsia 2017 Jan;58(1):68-76. doi: 10.1111/epi.13607.
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Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Neurological Disorders, Quality of Care, Quality Improvement, Tools & Toolkits, Workflow
Starmer AJ, Destino L, Yoon CS
Intern and resident workflow patterns on pediatric inpatient units: a multicenter time-motion study.
The researchers sought to quantify the proportion of time spent by residents in direct care, indirect care activities, and education across 9 pediatric institutions. They found that across all sites and levels of training, trainees spent more time in interprofessional communication (34.7 percent), and at the computer (20.5 percent), and less time in contact with patients and families (12.0 percent) and in educational activities (4.7 percent).
AHRQ-funded; HS019456.
Citation: Starmer AJ, Destino L, Yoon CS .
Intern and resident workflow patterns on pediatric inpatient units: a multicenter time-motion study.
JAMA Pediatr 2015 Dec;169(12):1175-7. doi: 10.1001/jamapediatrics.2015.2471..
Keywords: Children/Adolescents, Education: Continuing Medical Education, Inpatient Care, Provider, Training, Workflow
Cutting EM, Overby CL, Banchero M
Using workflow modeling to identify areas to improve genetic test processes in the University of Maryland Translational Pharmacogenomics Project.
The researchers used information gained from focus groups in order to illustrate the current process of delivering genetic test results to clinicians. They proposed a business process model and notation (BPMN) representation of this process for a Translational Pharmacogenomics Project being implemented at the University of Maryland Medical Center. They found that the current process could be improved to reduce input errors, better inform and notify clinicians about the implications of certain genetic tests, and make results more easily understood. They demonstrated theiruse of BPMN to improve this important clinical process for CYP2C19 genetic testing.
AHRQ-funded; HS023390.
Citation: Cutting EM, Overby CL, Banchero M .
Using workflow modeling to identify areas to improve genetic test processes in the University of Maryland Translational Pharmacogenomics Project.
AMIA Annu Symp Proc 2015 Nov 5;2015:466-74.
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Keywords: Genetics, Diagnostic Safety and Quality, Medication, Workflow, Quality Improvement, Quality of Care, Organizational Change
Gephart S, Carrington JM, Finley B
A systematic review of nurses' experiences with unintended consequences when using the electronic health record.
The purpose of this article is to present the state of the science on nurses' experiences with unintended consequences of electronic health records (EHRs). Findings demonstrate that nurses experience changes to workflow, must continually adapt to meet patient's needs in the context of imperfect EHR systems, and have difficulty accessing the information they need to make patient care decisions. Implications for nurse administrators include the need for continual engagement with nurses along the continuum of EHR design, as well as the need to encourage nurses to speak up and acknowledge workflow changes that threaten patient safety or do not support work efficiency.
AHRQ-funded; HS021074.
Citation: Gephart S, Carrington JM, Finley B .
A systematic review of nurses' experiences with unintended consequences when using the electronic health record.
Nurs Adm Q 2015 Oct-Dec;39(4):345-56. doi: 10.1097/naq.0000000000000119.
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Keywords: Adverse Events, Clinical Decision Support (CDS), Electronic Health Records (EHRs), Nursing, Workflow
Linzer M, Poplau S, Grossman E
A cluster randomized trial of interventions to improve work conditions and clinician burnout in primary care: results from the Healthy Work Place (HWP) Study.
This study aimed to assess if improvements in work conditions reduce clinician stress and burnout. It found that burnout was more likely to improve with workflow interventions and with targeted QI projects than in controls. Also, interventions in communication or workflow led to greater improvements in clinician satisfaction.
AHRQ-funded; HS018160.
Citation: Linzer M, Poplau S, Grossman E .
A cluster randomized trial of interventions to improve work conditions and clinician burnout in primary care: results from the Healthy Work Place (HWP) Study.
J Gen Intern Med 2015 Aug;30(8):1105-11. doi: 10.1007/s11606-015-3235-4..
Keywords: Burnout, Stress, Primary Care, Workflow, Quality Improvement, Quality of Care, Communication
Butler KA, Mercer E, Bahrami A
Model checking for verification of interactive health IT systems.
The authors proposed to formalize the relationship between HIT and the conceptual work that increasingly typifies modern care. They demonstrated the method on a patient contact system to show that model checking is effective for interactive systems and that much of it can be automated.
AHRQ-funded; HS021233.
Citation: Butler KA, Mercer E, Bahrami A .
Model checking for verification of interactive health IT systems.
AMIA Annu Symp Proc 2015;2015:349-58.
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Keywords: Shared Decision Making, Health Information Technology (HIT), Health Information Technology (HIT), Patient Safety, Workflow