National Healthcare Quality and Disparities Report
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Search All Research Studies
Topics
- Cardiovascular Conditions (1)
- Care Coordination (3)
- Children's Health Insurance Program (CHIP) (1)
- Children/Adolescents (3)
- Chronic Conditions (1)
- Communication (2)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (1)
- Critical Care (1)
- Digestive Disease and Health (1)
- Emergency Department (1)
- Evidence-Based Practice (1)
- Healthcare Delivery (2)
- Hospital Discharge (7)
- Hospitalization (1)
- Hospital Readmissions (1)
- Hospitals (7)
- Long-Term Care (1)
- Mortality (1)
- Nursing Homes (3)
- Outcomes (2)
- Patient-Centered Healthcare (2)
- Patient-Centered Outcomes Research (1)
- Patient Experience (2)
- Patient Safety (4)
- Primary Care (1)
- Provider (1)
- Provider: Clinician (1)
- Quality Improvement (11)
- Quality Indicators (QIs) (1)
- Quality Measures (3)
- (-) Quality of Care (17)
- Rehabilitation (1)
- Stroke (1)
- Surgery (4)
- (-) Transitions of Care (17)
- Workflow (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 17 of 17 Research Studies DisplayedBourgoin A, Balaban R, Hochman M
AHRQ Author: Perfetto D, Hogan EM
Improving quality and safety for patients after hospital discharge: primary care as the lead integrator in postdischarge care transitions.
The purpose of this study was to explain primary care-based transition workflow processes for hospitalized patients. The researchers conducted interviews with primary care thought leaders, staff at 9 primary care sites, community agency staff, and recently discharged patients. The researchers found that primary care postdischarge workflows vary across the different settings, rarely include communications with the patient or the inpatient team during the hospitalization and vary widely across settings. The researchers recommended the use of principles for primary care practices to encourage active participation in the full spectrum of postdischarge care, from admission through the first postdischarge visit to primary care.
AHRQ-authored; AHRQ-funded; 233201500019I/HHSP23337002T.
Citation: Bourgoin A, Balaban R, Hochman M .
Improving quality and safety for patients after hospital discharge: primary care as the lead integrator in postdischarge care transitions.
J Ambul Care Manage 2022 Oct-Dec;45(4):310-20. doi: 10.1097/jac.0000000000000433..
Keywords: Quality of Care, Patient Safety, Hospital Discharge, Transitions of Care, Hospitals, Workflow
Chilakamarri P, Finn EB, Sather J
Failure mode and effect analysis: engineering safer neurocritical care transitions.
Investigators presented failure mode and effect analysis (FMEA) as a systems-engineering methodology to be applied to neurocritical care transitions to reduce failures in communication and improve patient safety. They described their local implementation of FMEA to improve the safety of inter-hospital transfer for patients with intracerebral and subarachnoid hemorrhage as evidence of success. They found that application of the FMEA approach yielded meaningful and sustained process change for patients with neurocritical care needs.
AHRQ-funded; HS023554.
Citation: Chilakamarri P, Finn EB, Sather J .
Failure mode and effect analysis: engineering safer neurocritical care transitions.
Neurocrit Care 2021 Aug;35(1):232-40. doi: 10.1007/s12028-020-01160-6..
Keywords: Patient Safety, Transitions of Care, Critical Care, Communication, Quality Improvement, Quality of Care
Fekieta R, Rosenberg A, Jenq GY
A new tool to assess clinician experience with patient care transitions.
The authors developed a brief survey to gauge clinician experience with patient care transfers that occur within a hospital. They found that, overall, the survey was feasible to implement and was built to optimize content, construct, and response process validity. Survey results drove practical improvement work, such as informing a verbal transfer protocol to improve nursing preparedness to receive patients on general medicine units. They concluded that, as a practical tool, the survey and its results can help hospital administrators to focus on categories of transfer activities that are most problematic for clinicians and to track trends for quality improvement.
AHRQ-funded; HS023554.
Citation: Fekieta R, Rosenberg A, Jenq GY .
A new tool to assess clinician experience with patient care transitions.
Qual Manag Health Care 2021 Apr-Jun;30(2):87-96. doi: 10.1097/qmh.0000000000000290..
Keywords: Transitions of Care, Quality Improvement, Quality of Care, Provider: Clinician, Provider
Sather J, Littauer R, Finn E
A multimodal intervention to improve the quality and safety of interhospital care transitions for nontraumatic intracerebral and subarachnoid hemorrhage.
Regionalization of care has increased interhospital transfers (IHTs) of nontraumatic intracerebral hemorrhage (ICH) and subarachnoid hemorrhage (SAH) to specialized centers yet exposes patients to the latent risks inherent to IHT. In this study, the researchers examined how a multimodal quality improvement intervention affected quality and safety measures for patients with ICH or SAH exposed to IHT.
AHRQ-funded; HS023554.
Citation: Sather J, Littauer R, Finn E .
A multimodal intervention to improve the quality and safety of interhospital care transitions for nontraumatic intracerebral and subarachnoid hemorrhage.
Jt Comm J Qual Patient Saf 2021 Feb;47(2):99-106. doi: 10.1016/j.jcjq.2020.10.003..
Keywords: Transitions of Care, Hospitals, Patient Safety, Quality Improvement, Quality of Care, Care Coordination
Gonzalez MR, Junge-Maughan L, Lipsitz LA
ECHO-CT: an interdisciplinary videoconference model for identifying potential postdischarge transition-of-care events.
In this paper, data collected through the Extension for Community Health Outcomes- Care Transitions (ECHO-CT) model were used to identify and classify transition-of-care events (TCEs). Findings showed that the TCEs identified highlight areas in which providers can work to reduce issues arising during the course of discharge to post-acute care facilities. Recommendations included standardized processes to identify, record, and report TCEs in order to provide high-quality, safe care for patients as they move across care settings.
AHRQ-funded; HS025702.
Citation: Gonzalez MR, Junge-Maughan L, Lipsitz LA .
ECHO-CT: an interdisciplinary videoconference model for identifying potential postdischarge transition-of-care events.
J Hosp Med 2021 Feb;16(2):93-96. doi: 10.12788/jhm.3523..
Keywords: Transitions of Care, Hospital Discharge, Quality Improvement, Quality of Care
Ingraham A, Reinke CE
Optimizing safety for surgical patients undergoing interhospital transfer.
This article discusses the need for standardization and improvement of the interhospital transfer process. The authors advocate studying and adapting quality improvement efforts directed at other transitions of care so that care will improve for surgical patients transferred between acute care institutions.
AHRQ-funded; HS025224.
Citation: Ingraham A, Reinke CE .
Optimizing safety for surgical patients undergoing interhospital transfer.
Surg Clin North Am 2021 Feb;101(1):57-69. doi: 10.1016/j.suc.2020.09.002..
Keywords: Patient Safety, Surgery, Transitions of Care, Hospitals, Quality Improvement, Quality of Care
Campbell Britton M, Petersen-Pickett J, Hodshon B
Mapping the care transition from hospital to skilled nursing facility.
Researchers used process mapping to illustrate the sequence of events involved with hospital discharge and admission to a skilled nursing facility (SNF). These transitions are often associated with breakdowns in communication that may place patients at risk for adverse events. A quality improvement (QI) team worked with frontline staff at an academic medical center and two local SNFs in the northeastern United States. The final process map included care management, medicine, nursing, admissions and physical therapy service staff. The process map showed numerous activities that need to be coordinated between care teams, and highlighted specific opportunities for improving communication between different teams.
AHRQ-funded; HS023554.
Citation: Campbell Britton M, Petersen-Pickett J, Hodshon B .
Mapping the care transition from hospital to skilled nursing facility.
J Eval Clin Pract 2020 Jun;26(3):786-90. doi: 10.1111/jep.13238..
Keywords: Transitions of Care, Care Coordination, Quality Improvement, Communication, Hospital Discharge, Hospitals, Nursing Homes, Quality of Care
Desai AD, Zhou C, Simon TD
Validation of a parent-reported hospital-to-home transition experience measure.
This study examined the validity of the Pediatric Transition Experience Measure (P-TEM), which is an 8-item, parent-reported measure that globally assesses hospital-to-home transition quality from discharge through follow-up compared to other validation measures. The other measures it was compared to included the 1) Child Hospital Consumer Assessment of Healthcare Providers and Systems Discharge Composite, 2) Center of Excellence on Quality of Care Measures for Children with Complex Needs parent-reported measures, 3) change in health-related quality of life from admission to postdischarge, and 4) 30-day emergency department revisits or readmissions. The P-TEM measure compared favorably with the Child Hospital Consumer Assessment of Healthcare Providers and Systems Discharge Composite measure and the other measures as well.
AHRQ-funded; HS024299.
Citation: Desai AD, Zhou C, Simon TD .
Validation of a parent-reported hospital-to-home transition experience measure.
Pediatrics 2020 Feb;145(2):pii: e20192150. doi: 10.1542/peds.2019-2150..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Children/Adolescents, Patient Experience, Transitions of Care, Hospital Discharge, Quality Improvement, Quality of Care, Quality Measures
Lauerman MH, Herrera AV, Albrecht JS
Interhospital transfers with wide variability in emergency general surgery.
This study examined modern hospital practices for interhospital transfers of emergency general surgery patients. A retrospective review of the Maryland Health Services Cost Review Commission database was conducted from 2013 to 2015. The majority of patients (94.1%) were not transferred with only 3.2% transferred to a hospital and 2.7% transferred from a hospital. For individual hospitals, there was a range of 0-30.5% of encounters transferred to a hospital, 0.02-14.62% transferred from a hospital and 69.25-99.95% not transferred.
AHRQ-funded; HS024560.
Citation: Lauerman MH, Herrera AV, Albrecht JS .
Interhospital transfers with wide variability in emergency general surgery.
Am Surg 2019 Jun;85(6):595-600..
Keywords: Emergency Department, Healthcare Delivery, Hospitalization, Hospitals, Outcomes, Quality of Care, Surgery, Transitions of Care
Shah S, Xian Y, Sheng S
Use, temporal trends, and outcomes of endovascular therapy after interhospital transfer in the United States.
This study examined the use, trends and outcomes of endovascular therapy (EVT) after interhospital transfer in the United Sates. This cohort study analyzed trends from over 1.8 million patients with ischemic stroke admitted to 2143 Get With The Guidelines-Stroke participating hospitals between 2012 and 2017. There were differences in mortality for interhospital transfer patients, although those differences disappeared after adjusting for delay in EVT initiation.
AHRQ-funded; HS024561.
Citation: Shah S, Xian Y, Sheng S .
Use, temporal trends, and outcomes of endovascular therapy after interhospital transfer in the United States.
Circulation 2019 Mar 26;139(13):1568-77. doi: 10.1161/circulationaha.118.036509..
Keywords: Stroke, Cardiovascular Conditions, Transitions of Care, Outcomes, Healthcare Delivery, Hospitals, Mortality, Quality of Care
Gupta S, Zengul FD, Davlyatov GK
Reduction in hospitals' readmission rates: role of hospital-based skilled nursing facilities.
The purpose of this study was to examine the association between hospital-based skilled nursing facilities (HBSNFs) and hospitals' readmission rates. Data sources included the American Hospital Association Annual Survey, Area Health Resources Files, CMS Medicare cost reports and Hospital Compare. Results showed that the presence of HBSNFs was associated with lower readmission rates for acute myocardial infarction and pneumonia. Further, higher skilled nursing facilities to hospitals ratio were associated with lower readmission rates.
AHRQ-funded; HS023345.
Citation: Gupta S, Zengul FD, Davlyatov GK .
Reduction in hospitals' readmission rates: role of hospital-based skilled nursing facilities.
Inquiry 2019 Jan-Dec;56:46958018817994. doi: 10.1177/0046958018817994..
Keywords: Hospital Readmissions, Transitions of Care, Care Coordination, Hospitals, Quality Indicators (QIs), Quality Measures, Quality of Care
Balentine CJ, Kenzik K, Chu DI
Planning post-discharge destination for gastrointestinal surgery patients: room for improvement?
Investigators compared short-term recovery for patients discharged to inpatient rehabilitation versus skilled nursing facilities after gastrointestinal surgery. They found that there was no difference in 30-day readmission rates, but post-discharge mortality was higher for patients discharged to skilled nursing facilities compared to inpatient rehabilitation.
AHRQ-funded; HS023009.
Citation: Balentine CJ, Kenzik K, Chu DI .
Planning post-discharge destination for gastrointestinal surgery patients: room for improvement?
Am J Surg 2018 Nov;216(5):912-18. doi: 10.1016/j.amjsurg.2018.05.004..
Keywords: Hospital Discharge, Surgery, Digestive Disease and Health, Rehabilitation, Nursing Homes, Quality Improvement, Quality of Care, Transitions of Care
Desai AD, Simon TD, Leyenaar JK
Utilizing family-centered process and outcome measures to assess hospital-to-home transition quality.
This commentary describes the success of using 8 new caregiver-reported measures to assess the quality of hospital- and emergency department (ED)-to-home transitions in pediatric patients. This measures were originally created by the national Pediatric Quality Measures Program mandated by the Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA). An original article describing these measures was published 2016 and there have been several follow-up studies. These measures are undergoing further testing.
AHRQ-funded; HS024133; HS024299; HS020506.
Citation: Desai AD, Simon TD, Leyenaar JK .
Utilizing family-centered process and outcome measures to assess hospital-to-home transition quality.
Acad Pediatr 2018 Nov - Dec;18(8):843-46. doi: 10.1016/j.acap.2018.07.013..
Keywords: Hospital Discharge, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Transitions of Care, Quality of Care, Quality Measures, Quality Improvement, Children's Health Insurance Program (CHIP), Evidence-Based Practice
Acher AW, Campbell-Flohr SA, Brenny-Fitzpatrick M
Improving patient-centered transitional care after complex abdominal surgery.
Poor-quality transitions of care from hospital to home contribute to high rates of readmission after complex abdominal surgery. The Coordinated Transitional Care (C-TraC) program improved readmission rates in medical patients, but evidence-based surgical transitional care protocols are still lacking. This pilot study evaluated the feasibility and preliminary effectiveness of an adapted surgical C-TraC protocol. The investigators concluded that a phone-based transitional care protocol for surgical patients is feasible, with <1% refusals and 95% engagement.
patients is feasible, with <1% refusals and 95% engagement.
AHRQ-funded; HS022446.
AHRQ-funded; HS022446.
Citation: Acher AW, Campbell-Flohr SA, Brenny-Fitzpatrick M .
Improving patient-centered transitional care after complex abdominal surgery.
J Am Coll Surg 2017 Aug;225(2):259-65. doi: 10.1016/j.jamcollsurg.2017.04.008..
Keywords: Patient-Centered Healthcare, Quality of Care, Quality Improvement, Surgery, Transitions of Care
Lindquist LA, Miller RK, Saltsman WS
SGIM-AMDA-AGS consensus best practice recommendations for transitioning patients' healthcare from skilled nursing facilities to the community.
The authors assembled a cross-cutting team of experts representing primary care physicians (PCPs), home care physicians, physicians who see patients in skilled nursing facilities (SNF physicians), skilled nursing facility medical directors, human factors engineers, transitional care researchers, geriatricians, internists, family practitioners, and three major organizations: AMDA, SGIM, and AGS. This team identified issues and developed best practices perceived as feasible for SNF physician and PCP practices to accomplish.
AHRQ-funded; HS022916.
Citation: Lindquist LA, Miller RK, Saltsman WS .
SGIM-AMDA-AGS consensus best practice recommendations for transitioning patients' healthcare from skilled nursing facilities to the community.
J Gen Intern Med 2017 Feb;32(2):199-203. doi: 10.1007/s11606-016-3850-8.
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Keywords: Quality of Care, Long-Term Care, Nursing Homes, Primary Care, Transitions of Care
Sawicki GS, Garvey KC, Toomey SL
Development and validation of the adolescent assessment of preparation for transition: a novel patient experience measure.
The authors developed an adolescent-reported measure of the quality of health care transition (HCT) preparation received from pediatric health care providers. They found that the Adolescent Assessment of Preparation for Transition (ADAPT) is a reliable, validated instrument measuring the quality of HCT preparation experiences reported by adolescents with chronic disease.
AHRQ-funded; HS020513.
Citation: Sawicki GS, Garvey KC, Toomey SL .
Development and validation of the adolescent assessment of preparation for transition: a novel patient experience measure.
J Adolesc Health 2015 Sep;57(3):282-7. doi: 10.1016/j.jadohealth.2015.06.004.
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Keywords: Children/Adolescents, Chronic Conditions, Patient Experience, Quality of Care, Transitions of Care
Auger KA, Simon TD, Cooperberg D
Summary of STARNet: Seamless Transitions and (Re)admissions Network.
The Seamless Transitions and (Re)admissions Network (STARNet) met in December 2012 to synthesize ongoing hospital-to-home transition work, discuss goals, and develop a plan to centralize transition information in the future. The authors of this report reviewed the current knowledge regarding hospital-to-home transitions, outlined the challenges of measuring and reducing readmissions, and highlighted research gaps, listing potential measures for transition quality.
AHRQ-funded; HS020506.
Citation: Auger KA, Simon TD, Cooperberg D .
Summary of STARNet: Seamless Transitions and (Re)admissions Network.
Pediatrics 2015 Jan;135(1):164-75. doi: 10.1542/peds.2014-1887.
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Keywords: Children/Adolescents, Hospital Discharge, Transitions of Care, Quality Improvement, Quality of Care