National Healthcare Quality and Disparities Report
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Topics
- Adverse Events (2)
- Asthma (1)
- Children/Adolescents (2)
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- Quality Indicators (QIs) (1)
- Quality of Care (4)
- Respiratory Conditions (1)
- Sickle Cell Disease (1)
- Teams (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 10 of 10 Research Studies DisplayedO'Leary KJ, Johnson JK, Manojlovich M
Redesigning systems to improve teamwork and quality for hospitalized patients (RESET): study protocol evaluating the effect of mentored implementation to redesign clinical microsystems.
The goal of this study was to implement the Advanced and Integrated MicroSystems (AIMS) set of evidence-based complementary interventions across a range of clinical microsystems, to identify factors and strategies associated with successful implementation, and to evaluate impact on quality. The AIMS interventions are Unit-based Physician Teams; Unit Nurse-Physician Co-leadership; Enhanced Interprofessional Rounds; Unit-level Performance Reports; Patient Engagement Activities. Four hospital sites, each with a local leadership team, received guidance and resources to implement the AIMS interventions. A multi-method approach was used to collect and triangulate qualitative data during three visits to the sites. Outcomes included teamwork climate and adverse events.
AHRQ-funded; HS025649.
Citation: O'Leary KJ, Johnson JK, Manojlovich M .
Redesigning systems to improve teamwork and quality for hospitalized patients (RESET): study protocol evaluating the effect of mentored implementation to redesign clinical microsystems.
BMC Health Serv Res 2019 May 8;19(1):293. doi: 10.1186/s12913-019-4116-z..
Keywords: Evidence-Based Practice, Healthcare Delivery, Hospitalization, Inpatient Care, Quality of Care, Quality Improvement, Teams
Fisher KA, Smith KM, Gallagher TH
We want to know: patient comfort speaking up about breakdowns in care and patient experience.
The purpose of this study was to assess patient comfort speaking up about problems during hospitalisation and to identify patients at increased risk of having a problem and not feeling comfortable speaking up. The investigators suggest that creating conditions for patients to be comfortable speaking up may result in service recovery opportunities and improved patient experience. They assert that such efforts should consider the impact of health literacy and mental health on patient engagement in patient-safety activities.
AHRQ-funded; HS024596; HS022757.
Citation: Fisher KA, Smith KM, Gallagher TH .
We want to know: patient comfort speaking up about breakdowns in care and patient experience.
BMJ Qual Saf 2019 Mar;28(3):190-97. doi: 10.1136/bmjqs-2018-008159..
Keywords: Clinician-Patient Communication, Hospitalization, Patient Experience, Quality of Care, Quality Improvement
Al Danaf J, Chang BH, Shaear M
Surfacing and addressing hospitalized patients' needs: proactive nurse rounding as a tool.
This paper reported on rounding interventions employed at high performing hospitals, and provided three case studies on how proactive nurse rounding was successfully implemented to improve patient-centredness. The investigators concluded that proactive rounding interventions are a feasible approach to help surface and address hospitalized patients' needs in a timely manner.
AHRQ-funded; HS021921.
Citation: Al Danaf J, Chang BH, Shaear M .
Surfacing and addressing hospitalized patients' needs: proactive nurse rounding as a tool.
J Nurs Manag 2018 Jul;26(5):540-47. doi: 10.1111/jonm.12580..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Hospitalization, Hospitals, Inpatient Care, Nursing, Patient-Centered Healthcare, Patient Experience, Quality Improvement
Parikh K, Keller S, Ralston S
Inpatient quality improvement interventions for asthma: a meta-analysis.
This article reviewed interventional studies of inpatient-initiated asthma quality improvement (QI) to synthesize its impact on health care utilization. Thirty articles were included; 12 provided data on health care reutilization outcomes. The selected studies were categorized by intervention type and outcome. Risk ratios for readmissions were examined and a subanalyis of multimodal interventions conducted; the latter suggested lower readmission rates. A subanalysis of education and discharge planning interventions did not show an effect. The authors did not identify any inpatient strategies that impacted health care reutilization within 30 days of index hospitalization, but note that multimodal interventions demonstrated impact over the longer interval.
AHRQ-funded; HS024554.
Citation: Parikh K, Keller S, Ralston S .
Inpatient quality improvement interventions for asthma: a meta-analysis.
Pediatrics 2018 May;141(5). doi: 10.1542/peds.2017-3334.
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Keywords: Asthma, Children/Adolescents, Hospitalization, Inpatient Care, Quality Improvement
Swaminathan L, Flanders S, Rogers M
Improving PICC use and outcomes in hospitalised patients: an interrupted time series study using MAGIC criteria.
This study tested whether implementation of the Michigan Appropriateness Guide for Intravenous Catheters (MAGIC) can improve inappropriate peripherally inserted central catheter (PICC) use and patient outcomes. It concluded that, in a multihospital quality improvement project, implementation of MAGIC improved PICC appropriateness and reduced complications to a modest extent.
AHRQ-funded; HS022835.
Citation: Swaminathan L, Flanders S, Rogers M .
Improving PICC use and outcomes in hospitalised patients: an interrupted time series study using MAGIC criteria.
BMJ Qual Saf 2018 Apr;27(4):271-78. doi: 10.1136/bmjqs-2017-007342.
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Keywords: Adverse Events, Guidelines, Hospitalization, Patient-Centered Outcomes Research, Quality Improvement
Bhise V, Sittig DF, Vaghani V
An electronic trigger based on care escalation to identify preventable adverse events in hospitalised patients.
Researchers refined the methods of the Institute of Healthcare Improvement's Global Trigger Tool application and leveraged electronic health record data to improve detection of preventable adverse events, including diagnostic errors. In the studied sample, preventable adverse events were identified, including adverse drug events, patient falls, procedure-related complications, and hospital-associated infections. The authors concluded that such e-triggers can help overcome limitations of currently available methods to detect preventable harm in hospitalized patients.
AHRQ-funded; HS022087; HS023602.
Citation: Bhise V, Sittig DF, Vaghani V .
An electronic trigger based on care escalation to identify preventable adverse events in hospitalised patients.
BMJ Qual Saf 2018 Mar;27(3):241-46. doi: 10.1136/bmjqs-2017-006975..
Keywords: Adverse Events, Electronic Health Records (EHRs), Health Information Technology (HIT), Hospitalization, Hospitals, Patient Safety, Prevention, Quality of Care, Quality Improvement, Quality Indicators (QIs)
Cline DM, Silva S, Freiermuth CE
Emergency department (ED), ED observation, day hospital, and hospital admissions for adults with sickle cell disease.
In the context of a two-institution quality improvement project to implement best practices for management of patients with sickle cell disease (SCD) vaso-occlusive crisis (VOC), researchers prospectively compared acute care encounters for utilization of 1) emergency department (ED); 2) ED observation unit; 3) day hospital, and 4) hospital admission, of two different patient cohorts with SCD. They found that healthcare utilization varied dramatically between individual patients.
AHRQ-funded; HS019646.
Citation: Cline DM, Silva S, Freiermuth CE .
Emergency department (ED), ED observation, day hospital, and hospital admissions for adults with sickle cell disease.
West J Emerg Med 2018 Mar;19(2):311-18. doi: 10.5811/westjem.2017.9.35422.
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Keywords: Emergency Department, Healthcare Utilization, Hospitalization, Quality Improvement, Sickle Cell Disease
Ellimoottil C, Syrjamaki JD, Volt JD
Validation of a claims-based algorithm to characterize episodes of care.
The Michigan Value Collaborative (MVC) developed a claims-based algorithm to provide hospitals with data on events that occur to patients beyond the hospitalization. In this article, the investigators discuss the validation of MVC's claims-based algorithm. They indicate that their findings suggest that the MVC claims-based algorithm identifies and classifies claims with high fidelity and outperforms medical records in the identification of postdischarge events.
AHRQ-funded; HS024193.
Citation: Ellimoottil C, Syrjamaki JD, Volt JD .
Validation of a claims-based algorithm to characterize episodes of care.
Am J Manag Care 2017 Nov;23(11):e382-e86..
Keywords: Hospital Discharge, Hospital Readmissions, Hospitalization, Hospitals, Quality of Care, Quality Improvement
Badawy J, Nguyen OK, Clark C
Is everyone really breathing 20 times a minute? Assessing epidemiology and variation in recorded respiratory rate in hospitalised adults.
The researchers sought to assess the potential accuracy of respiratory rate (RR) by analyzing the distribution and variation as a proxy, since RR should be normally distributed if recorded accurately. The observed patterns suggest that RR is inaccurately recorded, even among those with cardiopulmonary compromise, and represents a 'spot' estimate with values of 18 and 20 breaths per minute representing 'normal.’
AHRQ-funded; HS022418.
Citation: Badawy J, Nguyen OK, Clark C .
Is everyone really breathing 20 times a minute? Assessing epidemiology and variation in recorded respiratory rate in hospitalised adults.
BMJ Qual Saf 2017 Oct;26(10):832-36. doi: 10.1136/bmjqs-2017-006671.
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Keywords: Hospitalization, Inpatient Care, Patient Safety, Quality Improvement, Respiratory Conditions
Farbman KS, Michelson KA, Neuman MI
Reducing hospitalization rates for children with anaphylaxis.
A quality improvement (QI) intervention was conducted to improve care and reduce hospitalization rates for children with anaphylaxis. This intervention was able to safely reduce unnecessary hospitalizations for children with anaphylaxis and sustain the change over 3 years by using a QI initiative that included evidence-based guideline development and implementation, reinforced by provider reminders and structured feedback.
AHRQ-funded; HS000063.
Citation: Farbman KS, Michelson KA, Neuman MI .
Reducing hospitalization rates for children with anaphylaxis.
Pediatrics 2017 Jun;139(6). doi: 10.1542/peds.2016-4114.
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Keywords: Children/Adolescents, Hospitalization, Quality Improvement, Prevention