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
101 to 125 of 129 Research Studies DisplayedZingmond DS, Parikh P, Louie R
Improving hospital reporting of patient race and ethnicity--approaches to data auditing.
This study investigated new metrics to improve the reporting of patient race and ethnicity (R/E) by hospitals. It examined agreement between hospital reported R/E versus self-report among mothers delivering babies and a cancer cohort in California. It concluded that comparison between reported R/E and R/E estimates using zip code level data may be a reasonable first approach to evaluate and track hospital R/E reporting.
AHRQ-funded; HS019963.
Citation: Zingmond DS, Parikh P, Louie R .
Improving hospital reporting of patient race and ethnicity--approaches to data auditing.
Health Serv Res 2015 Aug;50 Suppl 1:1372-89. doi: 10.1111/1475-6773.12324..
Keywords: Racial and Ethnic Minorities, Hospitals, Hospital Discharge, Health Services Research (HSR), Registries, Quality Improvement, Quality of Care, Data
Dimou FM, Riall TS
Pancreatic resection results in a statewide surgical collaborative.
The authors believe that participation in a regional quality improvement collaborative may provide an alternative model to improving outcomes for patients undergoing pancreatic resection. Furthermore, they argue that a procedure-specific collaborative could help hospitals and physicians improve outcomes for complex procedures such as pancreatic resection.
AHRQ-funded; HS022134.
Citation: Dimou FM, Riall TS .
Pancreatic resection results in a statewide surgical collaborative.
Ann Surg Oncol 2015 Aug;22(8):2462-3. doi: 10.1245/s10434-015-4536-x..
Keywords: Surgery, Patient-Centered Outcomes Research, Quality Improvement, Quality of Care
Healy MA, Krell RW, Abdelsattar ZM
Pancreatic resection results in a statewide surgical collaborative.
This study sought to investigate changes over time in adverse outcomes after pancreatectomy across hospitals with different caseloads in a statewide surgical collaborative. It concluded that participation in regional quality collaboratives by lower-volume hospitals can attenuate the volume–outcome relationship for pancreatic surgery.
AHRQ-funded; HS20937; HS000053.
Citation: Healy MA, Krell RW, Abdelsattar ZM .
Pancreatic resection results in a statewide surgical collaborative.
Ann Surg Oncol 2015 Aug;22(8):2468-74. doi: 10.1245/s10434-015-4529-9..
Keywords: Surgery, Patient Safety, Adverse Events, Hospitals, Quality Improvement, Quality of Care
Salemi JL, Salinas-Miranda AA, Wilson RE
Transformative use of an improved all-payer hospital discharge data infrastructure for community-based participatory research: a sustainability pathway.
The researchers describe the use of a clinically enhanced maternal and child health (MCH) database to strengthen community-engaged research activities, and to support the sustainability of data infrastructure initiatives. The population-based, longitudinal database was used to supplement data collected from focus groups and community surveys with epidemiological and health care cost data on important MCH disparity issues in the target community.
AHRQ-funded; HS019997.
Citation: Salemi JL, Salinas-Miranda AA, Wilson RE .
Transformative use of an improved all-payer hospital discharge data infrastructure for community-based participatory research: a sustainability pathway.
Health Serv Res 2015 Aug;50 Suppl 1:1322-38. doi: 10.1111/1475-6773.12309..
Keywords: Maternal Care, Comparative Effectiveness, Hospital Discharge, Data, Quality Improvement
Bigback KM, Hoopes M, Dankovchik J
Using record linkage to improve race data quality for American Indians and Alaska Natives in two Pacific Northwest State Hospital Discharge Databases.
This study aimed to evaluate and adjust for American Indian and Alaska Native (AI/AN) racial misclassification in two hospital discharge datasets in the Pacific Northwest. It found that in Oregon, 55.4 percent of matching records were misclassified (66.5 percent miscoded white, and 22.1 percent were missing race information). Linkage increased ascertainment of AI/AN hospitalizations by 31.8 percent in Oregon and 33.9 percent in Washington.
AHRQ-funded; HS019972.
Citation: Bigback KM, Hoopes M, Dankovchik J .
Using record linkage to improve race data quality for American Indians and Alaska Natives in two Pacific Northwest State Hospital Discharge Databases.
Health Serv Res 2015 Aug;50 Suppl 1:1390-402. doi: 10.1111/1475-6773.12331..
Keywords: Racial and Ethnic Minorities, Quality Improvement, Registries, Hospital Discharge, Data
Morrato EH, Rabin B, Proctor J
Bringing it home: expanding the local reach of dissemination and implementation training via a university-based workshop.
The Colorado Research in Implementation Science Program (CRISP) developed and delivered an introductory D&I workshop adapted from national programs to extend training reach and foster a local learning community for D&I. This paper describes the context of the local training environment, findings from a pre-workshop needs assessment survey, training design and structure, and post-workshop evaluation. Lessons learned may inform others intending to develop local D&I training workshop.
AHRQ-funded; HS021138.
Citation: Morrato EH, Rabin B, Proctor J .
Bringing it home: expanding the local reach of dissemination and implementation training via a university-based workshop.
Implement Sci 2015 Jul 4;10:94. doi: 10.1186/s13012-015-0281-6..
Keywords: Communication, Education: Continuing Medical Education, Evidence-Based Practice, Guidelines, Quality of Care, Quality Improvement, Training, Implementation
Nembhard IM, Labao I, Savage S
Breaking the silence: determinants of voice for quality improvement in hospitals.
The researchers examined the drivers of “voice” for health professionals in hospitals. “Voice” is understood as the discretionary communication of ideas, suggestions, concerns, or opinions about work-related issues with the intent to improve organizational or unit functioning. They found that factors related to individuals (e.g., tenure), work (e.g., work configuration), organizational context (e.g., culture), data (e.g., benchmarking), and the external environment (e.g., attention) influenced health professionals’ voice.
AHRQ-funded; HS018987.
Citation: Nembhard IM, Labao I, Savage S .
Breaking the silence: determinants of voice for quality improvement in hospitals.
Health Care Manage Rev 2015 Jul-Sep;40(3):225-36. doi: 10.1097/hmr.0000000000000028..
Keywords: Hospitals, Quality Improvement, Quality of Care, Communication, Organizational Change, Health Services Research (HSR)
Abrahamson K, DeCrane S, Mueller C
Implementation of a nursing home quality improvement project to reduce resident pain: a qualitative case study.
This article describes the experiences of staff members working within nursing homes that successfully implemented a quality improvement project aimed at reducing resident pain. Findings from the interviews were organized using the Consolidated Framework for Implementation Research. Interdisciplinary communication, supportive leadership, training, and nursing assistant participation facilitated implementation. Increased documentation, resistance to change, and difficulty measuring outcomes were perceived challenges.
AHRQ-funded; HS018464.
Citation: Abrahamson K, DeCrane S, Mueller C .
Implementation of a nursing home quality improvement project to reduce resident pain: a qualitative case study.
J Nurs Care Qual 2015 Jul-Sep;30(3):261-8. doi: 10.1097/ncq.0000000000000099..
Keywords: Nursing Homes, Quality Improvement, Pain, Chronic Conditions
Solberg LI, Stuck LH, Crain AL
Organizational factors and change strategies associated with medical home transformation.
The researchers surveyed leaders of the first 132 primary care practices in Minnesota to achieve medical home certification. The Change Process Capability Questionnaire survey and the Physician Practice Connections survey showed that 80% to 100% of these certified clinics had 15 of the 18 organizational factors important for improving care processes and that 60% to 90% had successfully used 16 improvement strategies.
AHRQ-funded; HS019161.
Citation: Solberg LI, Stuck LH, Crain AL .
Organizational factors and change strategies associated with medical home transformation.
Am J Med Qual 2015 Jul-Aug;30(4):337-44. doi: 10.1177/1062860614532307.
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Keywords: Patient-Centered Healthcare, Primary Care, Practice Improvement, Organizational Change, Quality Improvement, Quality of Care, Healthcare Delivery
Shaikh U, Romano P, Paterniti DA
Organizing for quality improvement in health care: An example from childhood obesity prevention.
The researchers evaluated how the quality improvement (QI) intervention, Healthy Eating Active Living TeleHealth Community of Practice, at 7 rural California clinics addressed the challenges. of preventing and managing obesity and translation of evidence into practice. Key challenges were clinician and staff buy-in, changing ingrained clinical practices, and motivating patient and families. Facilitators included top-down organizational requirements for QI, linkages to local QI resources, and involvement of clinical champions.
AHRQ-funded; HS018567.
Citation: Shaikh U, Romano P, Paterniti DA .
Organizing for quality improvement in health care: An example from childhood obesity prevention.
Qual Manag Health Care 2015 Jul-Sep;24(3):121-8. doi: 10.1097/qmh.0000000000000066.
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Keywords: Quality Improvement, Children/Adolescents, Obesity, Prevention, Primary Care
Crane S, Sloane PD, Elder N
Reporting and using near-miss events to improve patient safety in diverse primary care practices: a collaborative approach to learning from our mistakes.
This study assessed the feasibility of a near-miss reporting system in primary care practices and to describe initial reports and practice responses to them. It found that all 7 practices successfully implemented the system, reporting 632 near-miss events in 9 months and initiating 32 quality improvement projects based on the reports.
AHRQ-funded; HS019558.
Citation: Crane S, Sloane PD, Elder N .
Reporting and using near-miss events to improve patient safety in diverse primary care practices: a collaborative approach to learning from our mistakes.
J Am Board Fam Med 2015 Jul-Aug;28(4):452-60. doi: 10.3122/jabfm.2015.04.140050..
Keywords: Adverse Events, Medical Errors, Patient Safety, Primary Care, Public Reporting, Quality Improvement, Quality of Care
Gittner LS, Husaini BA, Hull PC
Use of Six Sigma for eliminating missed opportunities for prevention services.
Delivery of primary care preventative services can be significantly increased utilizing Six Sigma methods. This study compare missed preventative service opportunities in the study clinic with the community clinic in the same practice. The study clinic had 100% preventative services, compared with only 16.3 percent in the community clinic.
AHRQ-funded; HS011131.
Citation: Gittner LS, Husaini BA, Hull PC .
Use of Six Sigma for eliminating missed opportunities for prevention services.
J Nurs Care Qual 2015 Jul-Sep;30(3):254-60. doi: 10.1097/ncq.0000000000000113..
Keywords: Community-Based Practice, Prevention, Primary Care, Quality Improvement
Padula WV, Makic MB, Mishra MK
Comparative effectiveness of quality improvement interventions for pressure ulcer prevention in academic medical centers in the United States.
This study was conducted to determine the comparative effectiveness of quality improvement interventions associated with reduced hospital-acquired pressure ulcer rates. The effect size analysis identified five effective interventions that each reduced pressure ulcer rates: leadership initiatives, visual tools, pressure ulcer staging, skin care, and patient nutrition.
AHRQ-funded; HS023710.
Citation: Padula WV, Makic MB, Mishra MK .
Comparative effectiveness of quality improvement interventions for pressure ulcer prevention in academic medical centers in the United States.
Jt Comm J Qual Patient Saf 2015 Jun;41(6):246-5..
Keywords: Comparative Effectiveness, Healthcare-Associated Infections (HAIs), Patient Safety, Pressure Ulcers, Prevention, Quality Improvement
Padula WV, Makic MB, Wald HL
Hospital-acquired pressure ulcers at academic medical centers in the United States, 2008-2012: tracking changes since the CMS nonpayment policy.
This study was conducted to define changes in hospital-acquired pressure ulcers (HAPU) incidence and variance since 2008. It found that HAPU incidence rates decreased significantly among 210 University HealthSystems Consortium academic medical centers after the enactment of the CMS nonpayment policy. This suggests that governmental policy was a significant driver of change in clinical practice for wound care and created incentives for preventive efforts on the part of hospitals.
AHRQ-funded; HS023710.
Citation: Padula WV, Makic MB, Wald HL .
Hospital-acquired pressure ulcers at academic medical centers in the United States, 2008-2012: tracking changes since the CMS nonpayment policy.
Jt Comm J Qual Patient Saf 2015 Jun;41(6):257-63..
Keywords: Healthcare-Associated Infections (HAIs), Patient Safety, Policy, Pressure Ulcers, Prevention, Quality Improvement
Abrahamson K, Miech E, Davila HW
Pay-for-performance policy and data-driven decision making within nursing homes: a qualitative study.
The researchers explored ways in which data were collected, thought about and used by nursing home employees as a result of participation in a pay-for-performance (P4P) program. Their findings indicated that participants in the Minnesota Performance-based Incentive Payment Program’s quality improvement (QI) projects perceived a change in the rate and manner in which they gathered, used, and considered data in their QI decisions.
AHRQ-funded; HS018464
Citation: Abrahamson K, Miech E, Davila HW .
Pay-for-performance policy and data-driven decision making within nursing homes: a qualitative study.
BMJ Qual Saf. 2015 May;24(5):311-7. doi: 10.1136/bmjqs-2014-003362..
Keywords: Nursing Homes, Long-Term Care, Payment, Provider Performance, Shared Decision Making, Policy, Quality Improvement, Quality of Care
Roxbury CR, Yang J, Salazar J
Safety and postoperative adverse events in pediatric otologic surgery: analysis of American College of Surgeons NSQIP-P 30-day outcomes.
This study described safety and postoperative sequelae of pediatric otologic surgery and identify predictive factors for postoperative events. It found that pediatric otologic procedures are common and have low rates of global 30-day postoperative events. Tympanomastoidectomy and cochlear implantation have the highest risk of 30-day readmission.
AHRQ-funded; HS022932.
Citation: Roxbury CR, Yang J, Salazar J .
Safety and postoperative adverse events in pediatric otologic surgery: analysis of American College of Surgeons NSQIP-P 30-day outcomes.
Otolaryngol Head Neck Surg 2015 May;152(5):790-5. doi: 10.1177/0194599815575711..
Keywords: Adverse Events, Children/Adolescents, Surgery, Patient Safety, Children/Adolescents, Quality Improvement
Rinke ML, Chen AR, Milstone AM
Bringing central line-associated bloodstream infection prevention home: catheter maintenance practices and beliefs of pediatric oncology patients and families.
The researchers investigated (1) the extent to which best-practice central line maintenance practices were employed in the homes of pediatric oncology patients and by whom, (2) caregiver beliefs about central line care and central line-associated blood stream infection (CLABSI) risk, (3) barriers to optimal central line care by families, and (4) educational experiences and preferences regarding central line care. They concluded that interventions aimed at reducing ambulatory CLABSIs should target appropriate educational experiences for adult caregivers and patients and identify ways to improve compliance with best-practice care.
AHRQ-funded; HS021282.
Citation: Rinke ML, Chen AR, Milstone AM .
Bringing central line-associated bloodstream infection prevention home: catheter maintenance practices and beliefs of pediatric oncology patients and families.
Jt Comm J Qual Patient Saf 2015 Apr;41(4):177-85.
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Keywords: Children/Adolescents, Central Line-Associated Bloodstream Infections (CLABSI), Patient Safety, Ambulatory Care and Surgery, Quality Improvement
De Martino RR, Hoel AW, Beck AW
Participation in the Vascular Quality Initiative is associated with improved perioperative medication use, which is associated with longer patient survival.
The researchers analyzed the effect of Vascular Quality Initiative (VQI) participation on perioperative (preoperative and postoperative) medical management (MM) use over time and the effect of discharge MM on patient survival. They demonstrated that MM is associated with improved survival after a number of vascular procedures, and that VQI participation improves the use of MM, demonstrating that involvement in an organized quality effort can affect patient outcomes.
AHRQ-funded; HS021581.
Citation: De Martino RR, Hoel AW, Beck AW .
Participation in the Vascular Quality Initiative is associated with improved perioperative medication use, which is associated with longer patient survival.
J Vasc Surg 2015 Apr;61(4):1010-9. doi: 10.1016/j.jvs.2014.11.073.
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Keywords: Medication, Quality Improvement, Patient-Centered Outcomes Research, Practice Patterns
Whicher D, Kass N, Saghai Y
The views of quality improvement professionals and comparative effectiveness researchers on ethics, IRBs, and oversight.
The authors conducted a series of semi-structured focus groups with quality improvement (QI) and comparative effectiveness research (CER) professionals to understand their experiences and views of the ethical and regulatory challenges that exist. They found that most participants have experienced challenges related to the ethical oversight of QI and CER activities, and many believe that current regulatory criteria for distinguishing clinical practice from clinical research requiring ethical oversight are confusing.
AHRQ-funded; HS000029.
Citation: Whicher D, Kass N, Saghai Y .
The views of quality improvement professionals and comparative effectiveness researchers on ethics, IRBs, and oversight.
J Empir Res Hum Res Ethics 2015 Apr;10(2):132-44. doi: 10.1177/1556264615571558.
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Keywords: Comparative Effectiveness, Healthcare Delivery, Quality Improvement, Research Methodologies
Brady PW, Zix J, Brilli R
Developing and evaluating the success of a family activated medical emergency team: a quality improvement report.
The researchers aimed to develop a reliable process for family-activated medical emergency teams (METs) and to evaluate its effect on MET call rate and subsequent transfer to the intensive care unit (ICU). They found that children with family-activated METs were transferred to the ICU less commonly than those with clinician MET calls. Families, like clinicians, most commonly called MET for concerns of clinical deterioration; however, families also identified lack of response from clinicians and a dismissive interaction between team and family.
AHRQ-funded; HS021114.
Citation: Brady PW, Zix J, Brilli R .
Developing and evaluating the success of a family activated medical emergency team: a quality improvement report.
BMJ Qual Saf 2015 Mar;24(3):203-11. doi: 10.1136/bmjqs-2014-003001.
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Keywords: Communication, Emergency Medical Services (EMS), Hospitals, Children/Adolescents, Quality Improvement
Hendrix KS, Downs SM, Carroll AE
Pediatricians' responses to printed clinical reminders: does highlighting prompts improve responsiveness?
The authors tested whether selectively highlighting clinical decision support prompts in yellow would improve physicians' responsiveness. They found that highlighting reminder prompts did not increase physicians' responsiveness. They suggested possible explanations and offer alternative strategies to increasing physician responsiveness to prompts.
AHRQ-funded; HS020640; HS018453; HS017939.
Citation: Hendrix KS, Downs SM, Carroll AE .
Pediatricians' responses to printed clinical reminders: does highlighting prompts improve responsiveness?
Acad Pediatr 2015 Mar-Apr;15(2):158-64. doi: 10.1016/j.acap.2014.10.009.
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Keywords: Clinical Decision Support (CDS), Children/Adolescents, Primary Care, Practice Patterns, Quality Improvement
Michtalik HJ, Carolan HT, Haut ER
Use of provider-level dashboards and pay-for-performance in venous thromboembolism prophylaxis.
The researchers sequentially examined an individualized physician dashboard and pay-for-performance program to improve venous thromboembolism (VTE) prophylaxis rates among hospitalists. They found that direct feedback using dashboards was associated with significantly improved compliance, with further improvement after incorporating an individual physician pay-for-performance program.
AHRQ-funded; HS017952; HS022331.
Citation: Michtalik HJ, Carolan HT, Haut ER .
Use of provider-level dashboards and pay-for-performance in venous thromboembolism prophylaxis.
J Hosp Med 2015 Mar;10(3):172-8. doi: 10.1002/jhm.2303..
Keywords: Provider Performance, Payment, Blood Clots, Prevention, Quality Improvement, Quality of Care, Hospitals, Patient Safety
Minami CA, Dahlke A, Bilimoria KY
Public reporting in surgery: an emerging opportunity to improve care and inform patients.
The authors reviewed the benefits and concerns surrounding public reporting and then suggested some possible solutions to these problems in a stride toward better implementation and utilization of public reporting to improve surgical outcomes. They concluded that, although there are problems with the current approach, continual refinement of public reporting systems has the potential to provide individualized, relevant data that would not only lend a sense of agency to the American public but also motivate hospitals to engage in meaningful quality improvement.
AHRQ-funded; HS021857.
Citation: Minami CA, Dahlke A, Bilimoria KY .
Public reporting in surgery: an emerging opportunity to improve care and inform patients.
Ann Surg 2015 Feb;261(2):241-2. doi: 10.1097/sla.0000000000001033.
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Keywords: Quality of Care, Outcomes, Public Reporting, Quality Improvement, Surgery
Ryan AM, Burgess JF, Pesko MF
The early effects of Medicare's mandatory hospital pay-for-performance program.
This study evaluated the impact of hospital value-based purchasing (HVBP) on clinical quality and patient experience during its initial implementation period. It found that hospitals that were exposed to HVBP did not show greater improvement for either the clinical process or patient experience measures during the program’s initial implementation period.
AHRQ-funded; HS018546
Citation: Ryan AM, Burgess JF, Pesko MF .
The early effects of Medicare's mandatory hospital pay-for-performance program.
Health Serv Res. 2015 Feb;50(1):81-97. doi: 10.1111/1475-6773.12206..
Keywords: Medicare, Provider Performance, Payment, Hospitals, Quality Improvement, Quality of Care, Patient Experience
Kamal AH, Hanson LC, Casarett DJ
The quality imperative for palliative care.
This article discusses moving beyond demonstrating what palliative care is to focusing on the quality of how it is accomplished. This effort includes developing standardized methods to collect data without adding additional burden, comparing and sharing experiences to promote discipline-wide quality assessment and improvement initiatives, and demonstrating intentions for quality improvement on the clinical frontline.
AHRQ-funded; HS022763.
Citation: Kamal AH, Hanson LC, Casarett DJ .
The quality imperative for palliative care.
J Pain Symptom Manage 2015 Feb;49(2):243-53. doi: 10.1016/j.jpainsymman.2014.06.008.
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Keywords: Palliative Care, Quality Improvement, Quality of Care, Healthcare Delivery