National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Events (5)
- Ambulatory Care and Surgery (1)
- Antimicrobial Stewardship (1)
- Cardiovascular Conditions (2)
- Care Management (2)
- Catheter-Associated Urinary Tract Infection (CAUTI) (1)
- Children/Adolescents (3)
- Clinician-Patient Communication (1)
- Communication (2)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (1)
- Data (1)
- Education: Continuing Medical Education (2)
- Elderly (3)
- Emergency Medical Services (EMS) (1)
- Eye Disease and Health (1)
- Falls (1)
- Guidelines (2)
- Healthcare-Associated Infections (HAIs) (2)
- Healthcare Cost and Utilization Project (HCUP) (2)
- Healthcare Costs (3)
- Health Information Technology (HIT) (1)
- Heart Disease and Health (1)
- Hospitalization (4)
- Hospitals (1)
- (-) Inpatient Care (23)
- Intensive Care Unit (ICU) (1)
- Medical Expenditure Panel Survey (MEPS) (2)
- Mortality (1)
- Nursing Homes (1)
- Outcomes (2)
- Patient-Centered Outcomes Research (1)
- Patient and Family Engagement (1)
- Patient Experience (1)
- Patient Safety (10)
- Prevention (1)
- Provider (2)
- Provider: Health Personnel (1)
- Quality of Care (2)
- Screening (1)
- Shared Decision Making (1)
- Stroke (1)
- Teams (2)
- Training (1)
- Urinary Tract Infection (UTI) (1)
- Workflow (1)
- Workforce (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 23 of 23 Research Studies DisplayedStarmer 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
Selden TM, Karaca Z, Keenan P
AHRQ Author: Selden TM, Karaca Z, Keenan P, Kronick R
The growing difference between public and private payment rates for inpatient hospital care.
The difference between private and public (Medicare and Medicaid) payment rates for inpatient hospital stays widened between 1996 and 2012. Medical Expenditure Panel Survey data reveal that standardized private insurer payment rates in 2012 were approximately 75 percent greater than Medicare's-a sharp increase from the differential of approximately 10 percent in the period 1996-2001.
AHRQ-authored.
Citation: Selden TM, Karaca Z, Keenan P .
The growing difference between public and private payment rates for inpatient hospital care.
Health Aff 2015 Dec;34(12):2147-50. doi: 10.1377/hlthaff.2015.0706.
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Keywords: Medical Expenditure Panel Survey (MEPS), Healthcare Costs, Inpatient Care, Hospitalization
Michelson KA, Ho T, Pelletier A
A mobile, collaborative, real time task list for inpatient environments.
The researchers created a mobile, collaborative, real-time task list application on the iOS platform. They then described their experience designing and piloting the application with an inpatient pediatric ward team at an academic pediatric hospital. They found that physicians preferred the immediacy and familiarity of paper, and did not experience an efficiency benefit when using the electronic tasklist.
AHRQ-funded; HS000063.
Citation: Michelson KA, Ho T, Pelletier A .
A mobile, collaborative, real time task list for inpatient environments.
Appl Clin Inform 2015 Nov 18;6(4):677-83. doi: 10.4338/aci-2015-05-cr-0050.
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Keywords: Care Management, Communication, Health Information Technology (HIT), Inpatient Care, Health Information Technology (HIT)
Dykes PC, Stade D, Dalal A
Strategies for managing mobile devices for use by hospitalized inpatients.
The authors implemented the PROSPECT (Promoting Respect and Ongoing Safety through Patient-centeredness, Engagement, Communication and Technology) project at Brigham and Women's Hospital. The goal of PROSPECT is to transform the hospital environment by providing a suite of e-tools to facilitate teamwork. In this paper, the authors described decisions and challenges faced and related the strategies used and lessons learned.
AHRQ-funded; HS023535.
Citation: Dykes PC, Stade D, Dalal A .
Strategies for managing mobile devices for use by hospitalized inpatients.
AMIA Annu Symp Proc 2015 Nov 5;2015:522-31.
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Keywords: Communication, Inpatient Care, Patient and Family Engagement, Patient Safety, Teams
Chopra V, Flanders SA, Saint S
The Michigan Appropriateness Guide for Intravenous Catheters (MAGIC): Results from a multispecialty panel using the RAND/UCLA Appropriateness Method.
The authors organized and conducted a multidisciplinary meeting of national and international experts to develop appropriateness criteria for use, care, and management of peripherally inserted central catheters (PICCs) and related ventricular assist devices (VADs) in hospitalized patients. Among the objectives were developing a list of appropriate indications for use of PICCs in relation to other VADs, and defining the appropriateness of practices associated with the insertion and care of PICCs.
AHRQ-funded; HS022835.
Citation: Chopra V, Flanders SA, Saint S .
The Michigan Appropriateness Guide for Intravenous Catheters (MAGIC): Results from a multispecialty panel using the RAND/UCLA Appropriateness Method.
Ann Intern Med 2015 Sep 15;163(6 Suppl):S1-40. doi: 10.7326/m15-0744..
Keywords: Adverse Events, Guidelines, Inpatient Care, Patient Safety
Smith MW, Friedman B, Karaca Z
AHRQ Author: Friedman B, Karaca Z, Wong HS
Predicting inpatient hospital payments in the United States: a retrospective analysis.
The researchers evaluated whether payment-to-charge ratios (PCRs) can be predicted for hospitals in States that do not provide detailed financial data. They found that inpatient payments can be estimated with modest accuracy for community hospital stays funded by Medicare, Medicaid, and private insurance.
AHRQ-authored.
Citation: Smith MW, Friedman B, Karaca Z .
Predicting inpatient hospital payments in the United States: a retrospective analysis.
BMC Health Serv Res 2015 Sep 10;15(1):372. doi: 10.1186/s12913-015-1040-8..
Keywords: Healthcare Cost and Utilization Project (HCUP), Inpatient Care, Healthcare Costs, Hospitalization
O'Leary KJ, Creden AJ, Slade ME
Implementation of unit-based interventions to improve teamwork and patient safety on a medical service.
The authors compared a pre- versus post-intervention on Structured Interdisciplinary Rounds (SIDRs). They found that paired analyses for 82 professionals completing surveys revealed improved teamwork, which was driven mainly by nurses, and that the adverse events rate was similar across study periods; however, SIDR did not reduce adverse events.
AHRQ-funded; HS019630.
Citation: O'Leary KJ, Creden AJ, Slade ME .
Implementation of unit-based interventions to improve teamwork and patient safety on a medical service.
Am J Med Qual 2015 Sep-Oct;30(5):409-16. doi: 10.1177/1062860614538093.
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Keywords: Adverse Events, Provider: Health Personnel, Inpatient Care, Patient Safety, Teams
Arora VM, Prochaska MT, Farnan JM
Patient perceptions of whom is most involved in their care with successive duty hour limits.
The researchers aimed to assess if patients’ perceptions of who is most involved in their care changed with residency duty hours. They found that after successive residency duty hours limits, hospitalized patients were more likely to report the attending physician and less likely to report the resident or intern as most involved in their hospital care.
AHRQ-funded; HS010597; HS016967.
Citation: Arora VM, Prochaska MT, Farnan JM .
Patient perceptions of whom is most involved in their care with successive duty hour limits.
J Gen Intern Med 2015 Sep;30(9):1275-8. doi: 10.1007/s11606-015-3239-0..
Keywords: Education: Continuing Medical Education, Inpatient Care, Provider, Clinician-Patient Communication, Workforce
Arbaje Al, Yu Q, Newhall KA
Prevalence, geographic variation, and trends in hospital services relevant to the care of older adults: development of the senior care services scale and examination of measurement properties.
The researchers presented the development of the Senior Care Services Scale (SCSS) through: (1) identification of hospital services relevant to the care of older adults; (2) development of a taxonomy classifying these services; and (3) description of prevalence, geographic variation, and trends in service provision in US hospitals. They found that over time, hospitals offered more inpatient specialty services and fewer post-acute community services.
AHRQ-funded; HS022916.
Citation: Arbaje Al, Yu Q, Newhall KA .
Prevalence, geographic variation, and trends in hospital services relevant to the care of older adults: development of the senior care services scale and examination of measurement properties.
Med Care 2015 Sep;53(9):768-75. doi: 10.1097/mlr.0000000000000408..
Keywords: Elderly, Inpatient Care
Lim E, Cheng Y, Reuschel C
Risk-adjusted in-hospital mortality models for congestive heart failure and acute myocardial infarction: Value of clinical laboratory data and race/ethnicity.
This study examined the impact of key laboratory and race/ethnicity data on the prediction of in-hospital mortality for congestive heart failure (CHF) and acute myocardial infarction (AMI). It found that adding a simple three-level summary measure based on the number of abnormal laboratory data observed to hospital administrative claims data significantly improved the model prediction for inpatient mortality.
AHRQ-funded; HS019990.
Citation: Lim E, Cheng Y, Reuschel C .
Risk-adjusted in-hospital mortality models for congestive heart failure and acute myocardial infarction: Value of clinical laboratory data and race/ethnicity.
Health Serv Res 2015 Aug;50 Suppl 1:1351-71. doi: 10.1111/1475-6773.12325..
Keywords: Heart Disease and Health, Mortality, Data, Inpatient Care
Toomey SL, Zaslavsky AM, Elliott MN
The development of a pediatric inpatient experience of care measure: Child HCAHPS.
This article describes the development of Child Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), which included a national field test with 69 hospitals in 34 States, psychometric analysis, and end-user testing of the final survey. The final Child HCAHPS instrument has 62 items, including 39 patient experience items, 10 screeners, 12 demographic/descriptive items and 1 open-ended item.
AHRQ-funded; HS020513.
Citation: Toomey SL, Zaslavsky AM, Elliott MN .
The development of a pediatric inpatient experience of care measure: Child HCAHPS.
Pediatrics 2015 Aug;136(2):360-9. doi: 10.1542/peds.2015-0966..
Keywords: Children/Adolescents, Consumer Assessment of Healthcare Providers and Systems (CAHPS), Hospitals, Inpatient Care, Patient Experience, Quality of Care
Mody L, Meddings J, Edson BS
Enhancing resident safety by preventing healthcare-associated infection: a national initiative to reduce catheter-associated urinary tract infections in nursing homes.
The authors describe a new initiative based on lessons learned from a recent multimodal Targeted Infection Prevention program in a group of nursing homes as well as a national initiative to prevent catheter-associated urinary tract infections in over 950 acute care hospitals. This initiative will now be implemented in nearly 500 nursing homes through a project funded by AHRQ. It will emphasize professional development in catheter utilization, catheter care and maintenance, and antimicrobial stewardship.
AHRQ-funded; 2902010000251; HS019979; HS019767.
Citation: Mody L, Meddings J, Edson BS .
Enhancing resident safety by preventing healthcare-associated infection: a national initiative to reduce catheter-associated urinary tract infections in nursing homes.
Clin Infect Dis 2015 Jul 1;61(1):86-94. doi: 10.1093/cid/civ236..
Keywords: Nursing Homes, Healthcare-Associated Infections (HAIs), Urinary Tract Infection (UTI), Patient Safety, Inpatient Care
Reistetter TA, Kuo YF, Karmarkar AM
Geographic and facility variation in inpatient stroke rehabilitation: multilevel analysis of functional status.
This study examined geographic and facility variation in cognitive and motor functional outcomes after postacute inpatient rehabilitation in patients with stroke. Its findings suggest that variation in motor and cognitive function at discharge after postacute rehabilitation in patients with stroke is accounted for more by facility than geographic location.
AHRQ-funded; HS022134.
Citation: Reistetter TA, Kuo YF, Karmarkar AM .
Geographic and facility variation in inpatient stroke rehabilitation: multilevel analysis of functional status.
Arch Phys Med Rehabil 2015 Jul;96(7):1248-54. doi: 10.1016/j.apmr.2015.02.020..
Keywords: Stroke, Cardiovascular Conditions, Inpatient Care, Outcomes
Stockwell DC, Bisarya H, Classen DC
A trigger tool to detect harm in pediatric inpatient settings.
The researchers developed and pilot tested a trigger tool that would identify the most common causes of harm in pediatric inpatient environments. After reviewing review 100 randomly selected inpatient records from each of 6 academic children’s hospitals, they found that the most common patient harms were intravenous catheter infiltrations/burns, respiratory distress, constipation, pain, and surgical complications.
AHRQ-funded; HS020513.
Citation: Stockwell DC, Bisarya H, Classen DC .
A trigger tool to detect harm in pediatric inpatient settings.
Pediatrics 2015 Jun;135(6):1036-42. doi: 10.1542/peds.2014-2152..
Keywords: Children/Adolescents, Patient Safety, Inpatient Care, Children/Adolescents, Adverse Events
Sjoding MW, Prescott HC, Wunsch H
Hospitals with the highest intensive care utilization provide lower quality pneumonia care to the elderly.
The researchers investigate the relationship between a hospital’s ICU admission rate for elderly patients with pneumonia and the quality of care it provided to patients with pneumonia. They found that quality of care was lower among hospitals with the highest rates of ICU admission for elderly patients with pneumonia; such hospitals were less likely to deliver pneumonia processes of care and had worse outcomes for patients with pneumonia.
AHRQ-funded; HS020672.
Citation: Sjoding MW, Prescott HC, Wunsch H .
Hospitals with the highest intensive care utilization provide lower quality pneumonia care to the elderly.
Crit Care Med 2015 Jun;43(6):1178-86. doi: 10.1097/ccm.0000000000000925..
Keywords: Intensive Care Unit (ICU), Elderly, Inpatient Care, Quality of Care, Outcomes
Meddings J, Saint S, Fowler KE
The Ann Arbor criteria for appropriate urinary catheter use in hospitalized medical patients: results obtained by using the RAND/UCLA Appropriateness Method.
A 15-member multidisciplinary panel used the RAND/UCLA Appropriateness Method to assess the appropriateness of using Foley catheters, intermittent straight catheters, and external condom catheters for hospitalized adults on medical services in 299 scenarios, including urinary retention, incontinence, and wounds. The panel concluded that these new appropriateness criteria can inform large-scale collaborative and bedside efforts to reduce inappropriate urinary catheter use.
AHRQ-funded; 290201000025I; HS019767
Citation: Meddings J, Saint S, Fowler KE .
The Ann Arbor criteria for appropriate urinary catheter use in hospitalized medical patients: results obtained by using the RAND/UCLA Appropriateness Method.
Ann Intern Med. 2015 May 5;162(9 Suppl):S1-34. doi: 10.7326/m14-1304..
Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Shared Decision Making, Guidelines, Healthcare-Associated Infections (HAIs), Inpatient Care, Patient Safety
Pakyz AL, Moczygemba LR, Wang H
An evaluation of the association between an antimicrobial stewardship score and antimicrobial usage.
The objective of the study was to determine whether an antimicrobial stewardship ‘intensity’ score predicts hospital antimicrobial usage. It concluded that the strategy component of a score developed to measure the intensity of antimicrobial stewardship was associated with the amount of antimicrobials used.
AHRQ-funded; HS018578.
Citation: Pakyz AL, Moczygemba LR, Wang H .
An evaluation of the association between an antimicrobial stewardship score and antimicrobial usage.
J Antimicrob Chemother 2015 May;70(5):1588-91. doi: 10.1093/jac/dku555..
Keywords: Antimicrobial Stewardship, Inpatient Care, Patient Safety
Press VG, Matthiesen MI, Ranadive A
Insights into inpatients with poor vision: a high value proposition.
The researchers studied the initial feasibility and efficacy of screening and correcting inpatients’ vision. Over 800 hospitalized patients’ vision was screened. Those participants who failed a vision screen (Snellen chart) test performed by research assistants were given non-prescription readers that corrected most participants’ vision.
AHRQ-funded; HS016967.
Citation: Press VG, Matthiesen MI, Ranadive A .
Insights into inpatients with poor vision: a high value proposition.
J Hosp Med 2015 May;10(5):311-3. doi: 10.1002/jhm.2342..
Keywords: Eye Disease and Health, Screening, Inpatient Care, Hospitalization
Hernandez-Boussard T, McDonald KM, Rhoads KF
Patient safety in plastic surgery: identifying areas for quality improvement efforts.
The study’s aim was to assess risk-adjusted rates of inpatient adverse events (AEs) for general reconstructive soft tissue procedures using established measures. It found that plastic surgery patients had a significantly lower risk-adjusted rate compared to other surgical inpatients for all events evaluated except for failure to rescue and postoperative hemorrhage or hematoma.
AHRQ-funded; HS018558.
Citation: Hernandez-Boussard T, McDonald KM, Rhoads KF .
Patient safety in plastic surgery: identifying areas for quality improvement efforts.
Ann Plast Surg 2015 May;74(5):597-602. doi: 10.1097/SAP.0b013e318297791e..
Keywords: Healthcare Cost and Utilization Project (HCUP), Adverse Events, Inpatient Care, Hospitalization, Patient Safety
Goldberger ZD, Nallamothu BK, Nichol G
Policies allowing family presence during resuscitation and patterns of care during in-hospital cardiac arrest.
A growing number of hospitals have begun to implement policies allowing for family presence during resuscitation (FPDR). However, the overall safety of these policies and their effect on resuscitation care is unknown. This study suggests that hospitals with an FPDR policy generally have no statistically significant differences in outcomes and processes of care as hospitals without this policy.
AHRQ-funded; HS020672.
Citation: Goldberger ZD, Nallamothu BK, Nichol G .
Policies allowing family presence during resuscitation and patterns of care during in-hospital cardiac arrest.
Circ Cardiovasc Qual Outcomes 2015 May;8(3):226-34. doi: 10.1161/circoutcomes.114.001272..
Keywords: Cardiovascular Conditions, Patient Safety, Patient-Centered Outcomes Research, Inpatient Care
Maynard G, Kulasa K, Ramos P
Impact of a hypoglycemia reduction bundle and a systems approach to inpatient glycemic management.
In order to improve inpatient glycemic management in a 550-bed academic medical center, the researchers implemented a hypoglycemia reduction bundle, proactive surveillance of glycemic outliers, and an interdisciplinary data-driven approach to glycemic management. By using this approach with multiple mutually reinforcing interventions, they were able to cut severe inpatient hypoglycemia by more than half, while simultaneously improving glycemic control.
AHRQ-funded; HS020594
Citation: Maynard G, Kulasa K, Ramos P .
Impact of a hypoglycemia reduction bundle and a systems approach to inpatient glycemic management.
Endocr Pract. 2015 Apr;21(4):355-67. doi: 10.4158/ep14367.or..
Keywords: Care Management, Inpatient Care, Prevention
Galarraga JE, Mutter R, Pines JM
AHRQ Author: Mutter R
Costs associated with ambulatory care sensitive conditions across hospital-based settings.
The objective of this study was to identify the cost differences in payments and charges for ambulatory care-sensitive conditions (ACSC) visits in three different hospital-based settings: outpatient visits, ED visits, and inpatient admissions. After adjusting for patient demographics and comorbid conditions, charges for an inpatient ACSC visit were four times higher ($11,414 vs. $2,563) when compared to an ED visit.
AHRQ-authored.
Citation: Galarraga JE, Mutter R, Pines JM .
Costs associated with ambulatory care sensitive conditions across hospital-based settings.
Acad Emerg Med. 2015 Feb;22(2):172-81. doi: 10.1111/acem.12579..
Keywords: Medical Expenditure Panel Survey (MEPS), Healthcare Costs, Emergency Medical Services (EMS), Ambulatory Care and Surgery, Inpatient Care
Waters TM, Chandler AM, Mion LC
Use of International Classification of Diseases, Ninth Revision, Clinical Modification, codes to identify inpatient fall-related injuries.
The researchers compared falls and fall-related injuries that a fall evaluator or hospital incident report identified with injuries identified according to discharge ICD-9-CM codes for the same set of inpatient episodes of care. They found that the CMS-targeted ICD-9-CM codes used to identify fall-related injuries in claims data do not always detect the most-serious falls.
AHRQ-funded; HS020627.
Citation: Waters TM, Chandler AM, Mion LC .
Use of International Classification of Diseases, Ninth Revision, Clinical Modification, codes to identify inpatient fall-related injuries.
J Am Geriatr Soc 2013 Dec;61(12):2186-91. doi: 10.1111/jgs.12539..
Keywords: Falls, Elderly, Patient Safety, Inpatient Care, Adverse Events