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AHRQ Research Studies Date
Topics
- Ambulatory Care and Surgery (1)
- Burnout (1)
- Children/Adolescents (2)
- Clinician-Patient Communication (2)
- Communication (2)
- (-) Consumer Assessment of Healthcare Providers and Systems (CAHPS) (18)
- Cultural Competence (2)
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- Patient Experience (14)
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- Provider: Clinician (1)
- Provider: Health Personnel (1)
- Provider: Nurse (2)
- Provider: Physician (1)
- Provider Performance (5)
- Quality Improvement (8)
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- Quality of Care (14)
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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
1 to 18 of 18 Research Studies DisplayedQuigley DD, Qureshi N, Palimaru A
Content and actionability of recommendations to providers after shadow coaching.
This paper examined the content of the recommendations given to shadow-coached providers aimed at improving provider-patient interactions, to characterize these recommendations, and to examine their actionability. Using CAHPS data, the study’s findings showed that patient experience surveys were effective at identifying where improvement is needed but are not always informative enough to instruct providers on how to modify and improve their interactions with patients. Analyzing the feedback given to coached providers as part of an effective shadow-coaching program provides details about implementation on shadow-coaching feedback.
AHRQ-funded; HS025920.
Citation: Quigley DD, Qureshi N, Palimaru A .
Content and actionability of recommendations to providers after shadow coaching.
Qual Manag Health Care 2022 Oct-Dec;31(4):199-209. doi: 10.1097/qmh.0000000000000354..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient Experience, Quality Improvement, Quality of Care, Practice Improvement, Clinician-Patient Communication, Communication
Quigley D, Qureshi N, Rybowski L
AHRQ Author: Ginsberg C
Summary of the 2020 AHRQ research meeting on 'Advancing Methods of Implementing and Evaluating Patient experience improvement using consumer assessment of Healthcare Providers and Systems (CAHPS®) Surveys'.
The purpose of this AHRQ authored paper was to discuss the Agency for Healthcare Research and Quality research meeting on using Consumer Assessment of Healthcare Providers and Systems (CAHPS®) data for quality improvement (QI). The author reports on 3 topics addressed, including: lessons learned about organizational factors/environment for improving patient experience; 2) organizational use of data to improve patient experience; and 3) information provided by evaluations utilizing CAHPS data and their use in implementing successful programs to improve patient experience. The author further identified key themes, including: Early and frequent engagement of providers and stakeholders, QI process standardization, complementing CAHPS data with other data, and compiling dashboards of CAHPS scores to identify and track improvement. The author concluded that much can be learned and achieved from organization-level studies.
AHRQ-authored; AHRQ-funded; HS025920; HS016978.
Citation: Quigley D, Qureshi N, Rybowski L .
Summary of the 2020 AHRQ research meeting on 'Advancing Methods of Implementing and Evaluating Patient experience improvement using consumer assessment of Healthcare Providers and Systems (CAHPS®) Surveys'.
Expert Rev Pharmacoecon Outcomes Res 2022 Sep;22(6):883-90. doi: 10.1080/14737167.2022.2064848..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Quality Improvement, Quality of Care, Patient Experience
Fowler FJ, Brenner PS, Cosenza C
How responding in Spanish affects CAHPS results.
The purpose of this study was to examine the associations of language and ethnicity with responses to CAHPS surveys and assess the effect of responding to CAHPS surveys in Spanish. The researchers surveyed patients who had received care at a Connecticut community health center within 6 or 12 months of being sent a CAHPS survey that asks about care experiences. Three hypotheses were tested: 1. Spanish speakers are more likely to choose extreme response options. 2. The meaning of the Spanish translation is different than the English version of the questions, with Spanish speakers providing different answers because of meaning differences. 3. Spanish speakers have different expectations regarding their health care than those who answer in English. Researchers evaluated any differences by ethnicity and language. The study found that those answering in Spanish gave significantly more positive reports than the other two groups on three of the five measures, and higher than the non-Hispanic respondents on a fourth. The study concluded that subjects answering in Spanish gave more positive reports of their medical experiences than Hispanics and non-Hispanics answering in English.
AHRQ-funded; HS016978.
Citation: Fowler FJ, Brenner PS, Cosenza C .
How responding in Spanish affects CAHPS results.
BMC Health Serv Res 2022 Jul 8;22(1):884. doi: 10.1186/s12913-022-08262-1..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Cultural Competence, Patient Experience, Quality of Care, Racial and Ethnic Minorities
Merkow RP, Chung JW, Slota JM
Correlation of the US News and World Report-calculated nurse staffing index with actual hospital-reported nurse staffing.
This study’s objective was to understand how the Nurse Staffing Index (NSI) used in the US News and World Report “Best Hospitals” rankings correlates to actual nurse staffing levels. Nurse staffing data was obtained from publicly available data in the states of Illinois, California, and New Jersey. No other states had publicly accessible data. Hospital characteristics were obtained from the 2016 American Hospital Association (AHA) survey. The NSI was calculated using AHA data and is defined as the number of FTE RNs per adjusted patient day. Hospital characteristics were assessed using Hospital Compare data. Higher actual hospital-reported nurse staffing in Illinois and New Jersey was paradoxically associated with lower nurse staffing when measured by the NSI. California hospital-reported staffing intensity was weakly correctly with the NSI and RN nursing hours per patient day was not correlated with any of the 9 structural measures of hospital quality, while NSI was positively correlated with 3 of the 9 measures, particularly hospital volume status. None of the 11 outcome measures the authors assessed were associated with RN nursing hours per patient day or the NSI in either Illinois or California. All 12 patient experience measures were significantly and positively correlated with RN nursing hours in Illinois. However, none of the patient experience measures were significantly associated with the NSI in Illinois. The authors concluded that the NSI may not measure actual nurse staffing as intended.
AHRQ-funded; HS024516; HS026385.
Citation: Merkow RP, Chung JW, Slota JM .
Correlation of the US News and World Report-calculated nurse staffing index with actual hospital-reported nurse staffing.
J Nurs Care Qual 2022 Jul-Sep;37(3):195-98. doi: 10.1097/ncq.0000000000000619..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Provider: Nurse, Workforce
Schwartz ML, Rahman M, Thomas KS
Consumer selection and home health agency quality and patient experience stars.
The objective of this study was to compare the impact of the introduction of two distinct sets of star ratings, quality of care, and patient experience, on home health agency (HHA) selection. The investigators concluded that the introduction of quality of care and patient experience stars were associated with changes in HHA selection; however, the strength of these relationships was weaker than observed in other health care settings where a single star rating was reported.
AHRQ-funded; HS026440.
Citation: Schwartz ML, Rahman M, Thomas KS .
Consumer selection and home health agency quality and patient experience stars.
Health Serv Res 2022 Feb;57(1):113-24. doi: 10.1111/1475-6773.13867..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Home Healthcare, Patient Experience, Quality Measures, Quality of Care, Provider Performance, Quality Indicators (QIs)
Quigley DD, Predmore Z
What parents have to say: content and actionability of narrative comments from Child HCAHPS survey.
The purpose of this study was to examine the content and actionability of written comments from parents and guardians on the Child Hospital Consumer Assessment of Healthcare Providers and Systems (Child HCAHPS) survey. The investigators concluded that Child HCAHPS comments provided rich detail and a large portion were deemed actionable. Comments also provided insights into topics both on the survey itself and on many other inpatient pediatric issues raised by parents and guardians.
AHRQ-funded; HS025920.
Citation: Quigley DD, Predmore Z .
What parents have to say: content and actionability of narrative comments from Child HCAHPS survey.
Hosp Pediatr 2022 Feb;12(2):205-19. doi: 10.1542/hpeds.2021-006032..
Keywords: Children/Adolescents, Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient Experience
Yount N, Zebrak KA, Famolaro T
Linking patient safety culture to quality ratings in the nursing home setting.
This study examined the relationship between scores on the AHRQ Surveys on Patient Safety Culture™ (SOPS®) Nursing Home Survey (NH SOPS) and Centers for Medicare and Medicaid Services Nursing Home Five-Star Quality Ratings. The authors used data on 186 nursing homes to conduct multiple regression analyses predicting the Five-Star Quality Ratings from the NH SOPS survey measures. Five NH SOPS measures were related to the Overall, Health Inspections, and Quality Five-Star Ratings; four NH SOPS measures were related to at least two of the four Five-Star Quality Ratings and three SOPS measures were related to one Five-Star Rating. No NH SOPS measures were significantly associated with the Staffing Five-Star Rating.
AHRQ-funded; 233201500026I.
Citation: Yount N, Zebrak KA, Famolaro T .
Linking patient safety culture to quality ratings in the nursing home setting.
J Appl Gerontol 2022 Jan;41(1):73-81. doi: 10.1177/0733464820969283..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient Safety, Nursing Homes, Long-Term Care, Quality Indicators (QIs), Quality Measures, Quality Improvement, Quality of Care
Quigley DD, Elliott MN, Slaughter ME
Shadow coaching improves patient experience with care, but gains erode later.
Health care organizations strive to improve patient care experiences. Some use one-on-one provider counseling (shadow coaching) to identify and target modifiable provider behaviors. In this study, the investigators examined whether shadow coaching improved patient experience across 44 primary care practices in a large urban Federally Qualified Health Center. The investigators concluded that shadow coaching improved providers' overall performance and communication immediately after being coached.
AHRQ-funded; HS025920.
Citation: Quigley DD, Elliott MN, Slaughter ME .
Shadow coaching improves patient experience with care, but gains erode later.
Med Care 2021 Nov;59(11):950-60. doi: 10.1097/mlr.0000000000001629..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient Experience, Provider Performance, Quality Improvement, Quality of Care, Primary Care
Roberts ET, Song Z, Ding L
Changes in patient experiences and assessment of gaming among large clinician practices in precursors of the merit-based incentive payment system.
Medicare's Merit-Based Incentive Payment System (MIPS), a public reporting and pay-for-performance program, adjusts clinician payments based on publicly reported measures that are chosen primarily by clinicians or their practices. Within precursor programs of the MIPS, this study examined 1) practices' selection of Consumer Assessment of Healthcare Providers and Systems (CAHPS) patient experience measures for quality scoring under pay-for-performance and 2) the association between mandated public reporting on CAHPS measures and performance on those measures.
AHRQ-funded; HS026727.
Citation: Roberts ET, Song Z, Ding L .
Changes in patient experiences and assessment of gaming among large clinician practices in precursors of the merit-based incentive payment system.
JAMA Health Forum 2021 Oct;2(10). doi: 10.1001/jamahealthforum.2021.3105..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient Experience, Medicare, Provider Performance, Payment, Quality Improvement, Quality of Care
Fowler FJ, Brenner PS, Hargraves JL
Comparing web and mail protocols for administering Hospital Consumer Assessment of Healthcare Providers and Systems surveys.
This study’s objective was to compare results of using web-based and mail HCAHPS data collection protocols. The cohort included patients who were hospitalized in a New England Hospital. Patients who provided email addresses were randomized to 1 of 3 data collection protocols: web-only, web with postal mail follow-up, and postal mail only. Those who did not provide email addresses were surveyed by postal mail only. The study lasted 8 weeks. Measures looked at included response rates, characteristics of respondents, 6 composite measures of their patient experiences, and two ratings of the hospital. Web-only response rates were significantly lower than for mail or combined protocols, and those who had not provided email addresses also had lower response rates. Older adults over age 65 were more likely to respond to all protocols, especially for mail-only respondents. Respondents without email addresses were older, less educated, and reported worse health than those who had email addresses.
AHRQ-funded; HS016978.
Citation: Fowler FJ, Brenner PS, Hargraves JL .
Comparing web and mail protocols for administering Hospital Consumer Assessment of Healthcare Providers and Systems surveys.
Med Care 2021 Oct;59(10):907-12. doi: 10.1097/mlr.0000000000001627..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Hospitals, Health Information Technology (HIT), Quality Measures, Provider Performance, Quality of Care
Prasad T, Buta E, Cleary PD
Is patient-physician gender concordance related to the quality of patient care experiences?
There is great interest in identifying factors that are related to positive patient experiences such as physician communication style. Documented gender-specific physician communication and patient behavior differences raise the question of whether gender concordant relationships (i.e., both the provider and patient share the same gender) might affect patient experiences. The objective of this study was to assess whether patient experiences were more positive in gender concordant primary care relationships.
AHRQ-funded; HS016978.
Citation: Prasad T, Buta E, Cleary PD .
Is patient-physician gender concordance related to the quality of patient care experiences?
J Gen Intern Med 2021 Oct;36(10):3058-63. doi: 10.1007/s11606-020-06411-y..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient Experience
Quigley DD, Slaughter ME, Gidengil C
Usefulness of child HCAHPS survey data for improving inpatient pediatric care experiences.
Quality improvement (QI) requires data, indicators, and national benchmarks. Knowledge about the usefulness of Child Hospital Consumer Assessment of Healthcare Providers and Systems (Child HCAHPS) data are lacking. In this study the investigators examined quality leader and frontline staff perceptions about patient experience measurement and use of Child HCAHPS data for QI. The investigators surveyed children's hospital leaders and staff about their use of Child HCAHPS for QI, including measures from other studies. They compared scale and item means for leaders and staff and compared means to other studies.
AHRQ-funded; HS025920.
Citation: Quigley DD, Slaughter ME, Gidengil C .
Usefulness of child HCAHPS survey data for improving inpatient pediatric care experiences.
Hosp Pediatr 2021 Oct;11(10):e199-e214. doi: 10.1542/hpeds.2020-004283..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Children/Adolescents, Hospitals, Patient Experience, Quality Improvement, Quality Measures, Quality of Care
Quigley DD, Qureshi N, AlMasarweh L
Using CAHPS patient experience data for patient-centered medical home transformation.
The purpose of this study was to examine how primary care practices used the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey and its patient-centered medical home (PCMH) items during their PCMH transition. The investigators concluded that CAHPS surveys were considered actionable for PCMH transformation and used in standardizing and coordinating care. The CAHPS PCMH items were considered integral to the continuous QI needed for moving beyond formal PCMH recognition and maximizing transformation.
AHRQ-funded; HS016980; HS025920.
Citation: Quigley DD, Qureshi N, AlMasarweh L .
Using CAHPS patient experience data for patient-centered medical home transformation.
Am J Manag Care 2021 Sep;27(9):e322-e29. doi: 10.37765/ajmc.2021.88745..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient Experience, Patient-Centered Healthcare, Primary Care, Practice Improvement, Healthcare Delivery, Quality Improvement, Quality of Care
Meyers DJ, Rahman M, Mor V
Association of Medicare Advantage Star Ratings with racial, ethnic, and socioeconomic disparities in quality of care.
This cross-sectional study looked at racial/ethnic minority and socioeconomic disparities in ratings for Medicare Advantage (MA) plans, which disproportionately enroll these populations. A total of 1,578,564 enrollees were included in this analysis that used 22 measures of quality and satisfaction at the individual enrollee level, aggregated into simulated star ratings from 2-5 stratified by socioeconomic status (SES) and race/ethnicity. Low SES enrollees had simulated stratified star ratings 0.5 stars lower than individuals with high SES in the same contract. Black enrollees had simulated star ratings that were 0.3 stars lower and Hispanic enrollees had 0.1 lower simulated star ratings than White enrollees in the same contract. There was a larger difference in ratings with 4.5 to 5-star contracts with Black and Hispanic enrollees with Whites, and no statistical difference in 2.0 to 2.5 star-rated contracts. There was only low correlation between simulated ratings for enrollees of low SES and high SES.
AHRQ-funded; HS02705101.
Citation: Meyers DJ, Rahman M, Mor V .
Association of Medicare Advantage Star Ratings with racial, ethnic, and socioeconomic disparities in quality of care.
JAMA Health Forum 2021 Jun;2(6):e210793..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Medicare, Patient Experience, Disparities, Quality Measures, Provider Performance, Quality of Care, Racial and Ethnic Minorities
Chatterjee P, Qi M, Werner RM
Association of Medicaid expansion with quality in safety-net hospitals.
The authors compared changes in quality from 2012 to 2018 between safety net hospitals (SNHs) in states that expanded Medicaid vs those in states that did not. They found that, despite reductions in uncompensated care and improvements in operating margins, there appeared to be little evidence of quality improvement among SNHs in states that expanded Medicaid compared with those in states that did not.
AHRQ-funded; HS024266.
Citation: Chatterjee P, Qi M, Werner RM .
Association of Medicaid expansion with quality in safety-net hospitals.
JAMA Intern Med 2021 May;181(5):590-97. doi: 10.1001/jamainternmed.2020.9142..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Hospitals, Medicaid, Quality Improvement, Quality of Care
Willard-Grace R, Knox M, Huang B
Primary care clinician burnout and engagement association with clinical quality and patient experience.
Burnout and engagement are commonly conceptualized as opposite ends of a spectrum, and there is concern that high clinician burnout and lack of engagement may adversely impact patient care. In this study, the investigators matched self-reported data on burnout and engagement for 182 primary care clinicians with data on clinical quality (cancer screenings, hypertension and diabetes control) and patient experience (Clinician and Group Survey-Consumer Assessment of Healthcare Providers and Systems [CG-CAHPS] communication scores, overall rating, and likelihood to recommend the clinic).
AHRQ-funded; HS026067.
Citation: Willard-Grace R, Knox M, Huang B .
Primary care clinician burnout and engagement association with clinical quality and patient experience.
J Am Board Fam Med 2021 May-Jun;34(3):542-52. doi: 10.3122/jabfm.2021.03.200515..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Burnout, Patient Experience, Patient and Family Engagement, Provider: Clinician, Provider: Physician, Quality of Care, Provider: Nurse, Provider: Health Personnel
Kirby JB, Berdahl TA, Stone RA
AHRQ Author: Kirby JB, Berdahl TA
Perceptions of patient-provider communication across the six largest Asian subgroups in the USA.
Investigators sought to estimate racial/ethnic differences in perceptions of provider communication among the six largest Asian subgroups. Using MEPS data, they found that negative views of provider communication are not pervasive among all Asians but, rather, primarily reflect the perceptions of Chinese and, possibly, Vietnamese patients. They recommended that researchers, policymakers, health plan executives, and others who produce or use data on patients' experiences with health care avoid categorizing all Asians into a single group.
AHRQ-authored.
Citation: Kirby JB, Berdahl TA, Stone RA .
Perceptions of patient-provider communication across the six largest Asian subgroups in the USA.
J Gen Intern Med 2021 Apr;36(4):888-93. doi: 10.1007/s11606-020-06391-z..
Keywords: Medical Expenditure Panel Survey (MEPS), Consumer Assessment of Healthcare Providers and Systems (CAHPS), Clinician-Patient Communication, Communication, Patient Experience, Racial and Ethnic Minorities, Cultural Competence
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