National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Events (4)
- Back Health and Pain (1)
- Children/Adolescents (1)
- Data (1)
- Electronic Health Records (EHRs) (1)
- Evidence-Based Practice (2)
- Guidelines (1)
- Healthcare-Associated Infections (HAIs) (2)
- Healthcare Delivery (1)
- Health Information Technology (HIT) (1)
- Hospitals (3)
- Injuries and Wounds (2)
- Mortality (1)
- Orthopedics (1)
- Outcomes (1)
- Patient-Centered Healthcare (1)
- Patient-Centered Outcomes Research (1)
- Patient Experience (1)
- Patient Safety (5)
- Provider (1)
- Provider: Physician (1)
- (-) Quality Improvement (12)
- Quality of Care (8)
- Registries (1)
- Risk (2)
- Stroke (1)
- (-) Surgery (12)
- Teams (1)
- Transitions of Care (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 12 of 12 Research Studies DisplayedSkube SJ, Hu Z, Arsoniadis EG
Characterizing surgical site infection signals in clinical notes.
Building off of previous work for automated and semi-automated surgical site infections (SSIs) detection using expert-derived "strong features" from clinical notes, researchers hypothesized that additional SSI phrases may be contained in clinical notes. They systematically characterized phrases and expressions associated with SSIs. While 83 percent of expert-derived original terms overlapped with new terms and modifiers, an additional 362 modifiers associated with both positive and negative SSI signals were identified.
AHRQ-funded; HS024532.
Citation: Skube SJ, Hu Z, Arsoniadis EG .
Characterizing surgical site infection signals in clinical notes.
Stud Health Technol Inform 2017;245:955-59.
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Keywords: Healthcare-Associated Infections (HAIs), Surgery, Injuries and Wounds, Patient Safety, Adverse Events, Quality Improvement, Quality of Care
Haynes AB, Edmondson LB, Lipsitz SR
Mortality trends after a voluntary checklist-based surgical safety collaborative.
This study sought to determine whether completion of a voluntary, checklist-based surgical quality improvement program is associated with reduced 30-day postoperative mortality. It It found that, despite similar pre-existing rates and trends of postoperative mortality, hospitals in South Carolina completing a voluntary checklist-based surgical quality improvement program had a reduction in deaths after inpatient surgery over the first 3 years of the collaborative compared with other hospitals in the state.
AHRQ-funded; HS019631.
Citation: Haynes AB, Edmondson LB, Lipsitz SR .
Mortality trends after a voluntary checklist-based surgical safety collaborative.
Annals of Surgery 2017 Dec;266(6):923-29. doi: 10.1097/SLA.0000000000002249.
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Keywords: Mortality, Patient Safety, Surgery, Quality Improvement, Quality of Care
Ban KA, Gibbons MM, Ko CY
Surgical technical evidence review for colorectal surgery conducted for the AHRQ Safety Program for Improving Surgical Care and Recovery.
The objective of this article is to provide a comprehensive review of the evidence supporting the surgical components of the Improving Surgical Care and Recovery (ISCR) colorectal (CR) pathway. This review will evaluate the evidence supporting CR pathways and develop an evidence-based CR protocol to help hospitals participating in the ISCR program implement evidence-based practices.
AHRQ-funded; 233201500020I.
Citation: Ban KA, Gibbons MM, Ko CY .
Surgical technical evidence review for colorectal surgery conducted for the AHRQ Safety Program for Improving Surgical Care and Recovery.
J Am Coll Surg 2017 Oct;225(4):548-57.e3. doi: 10.1016/j.jamcollsurg.2017.06.017.
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Keywords: Evidence-Based Practice, Hospitals, Patient Safety, Quality Improvement, Surgery, Quality of Care, Guidelines
Spertus JA, Ghaferi AA
Transforming the National Surgical Quality Improvement Program to the delivery of precision medicine to improve the value of surgical care: Summary of the John R. Clarke keynote address for the Surgical Outcomes Club 2016 Annual Meeting.
The authors challenged the audience to begin thinking about implementing precision medicine in routine care. They argue that the profession of medicine is undergoing an unprecedented transformation from fee-for-service to value-based reimbursement. This offers an opportunity to rethink current practice patterns and redesign health care delivery to improve patients’ experiences and outcomes while lowering costs. The surgical community has a unique opportunity to embrace this challenge and develop tools to better tailor treatment to risk.
AHRQ-funded; HS023621.
Citation: Spertus JA, Ghaferi AA .
Transforming the National Surgical Quality Improvement Program to the delivery of precision medicine to improve the value of surgical care: Summary of the John R. Clarke keynote address for the Surgical Outcomes Club 2016 Annual Meeting.
JAMA Surg 2017 Sep;152(9):815-16. doi: 10.1001/jamasurg.2017.1610.
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Keywords: Healthcare Delivery, Quality of Care, Patient Safety, Quality Improvement, Surgery
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
Cramer JD, Patel UA, Maas MB
Is neck dissection associated with an increased risk of postoperative stroke?
The researchers investigated whether neck dissection is an independent risk factor for postoperative stroke. They found that the rate of postoperative stroke was greater with neck dissection than without it and concluded that stroke is a rare but highly morbid complication after head and neck surgery. Compared with other head and neck surgery, neck dissection in patients at risk for carotid artery stenosis is associated with an increased risk of postoperative stroke.
AHRQ-funded; HS023011.
Citation: Cramer JD, Patel UA, Maas MB .
Is neck dissection associated with an increased risk of postoperative stroke?
Otolaryngol Head Neck Surg 2017 Aug;157(2):226-32. doi: 10.1177/0194599817698414.
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Keywords: Orthopedics, Quality Improvement, Risk, Stroke, Surgery
Roxbury CR, Li L, Rhee D
Safety and perioperative adverse events in pediatric endoscopic sinus surgery: an ACS-NSQIP-P analysis.
This study describes safety outcomes of pediatric endoscopic sinus surgery (ESS) to identify risk factors for 30-day postoperative adverse events using the National Surgical Quality Improvement Program-Pediatric (NSQIP-P) database. It concluded that urgent/emergent procedures carry the greatest risk of postoperative adverse events, and black children are significantly more likely to undergo higher acuity surgery than white children.
AHRQ-funded; HS022932.
Citation: Roxbury CR, Li L, Rhee D .
Safety and perioperative adverse events in pediatric endoscopic sinus surgery: an ACS-NSQIP-P analysis.
Int Forum Allergy Rhinol 2017 Aug;7(8):827-36. doi: 10.1002/alr.21954.
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Keywords: Adverse Events, Children/Adolescents, Quality Improvement, Risk, Surgery
Patel NK, Moses RA, Martin BI
Validation of using claims data to measure safety of lumbar fusion surgery.
The researchers report the accuracy of a claims-based approach for reporting repeat surgery compared with medical records abstraction as the "gold standard." They found that claims-based ascertainment of safety at a single institution was very accurate. However, accuracy depended on careful attention to the timing of outcomes, as well as the definitions and coding of repeat surgery, including how orthopedic device removal codes are classified.
AHRQ-funded; HS021695.
Citation: Patel NK, Moses RA, Martin BI .
Validation of using claims data to measure safety of lumbar fusion surgery.
Spine 2017 May 1;42(9):682-91. doi: 10.1097/brs.0000000000001879.
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Keywords: Adverse Events, Back Health and Pain, Quality Improvement, Outcomes, Surgery
Berian JR, Thomas JM, Minami CA
Evaluation of a novel mentor program to improve surgical care for US hospitals.
This study evaluated a novel mentor program for 27 US surgeons, charged with improving quality at their respective hospitals, having been paired 1:1 with 27 surgeon mentors through a state-wide quality improvement (QI) initiative. It found that mentorship played a vital role in advancing surgeon knowledge and engagement with QI in the Illinois Surgical Quality Improvement Collaborative.
AHRQ-funded; HS024516.
Citation: Berian JR, Thomas JM, Minami CA .
Evaluation of a novel mentor program to improve surgical care for US hospitals.
Int J Qual Health Care 2017 Apr 1;29(2):234-42. doi: 10.1093/intqhc/mzx005.
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Keywords: Hospitals, Quality Improvement, Patient Safety, Surgery, Quality of Care, Provider: Physician, Provider
Brooks JV, Gorbenko K, Bosk C
Interactional resources for quality improvement: Learning from participants through a qualitative study.
The aim of this analysis was to identify the types of interactional support hospital teams sought in a surgical quality improvement project. Respondents reported needing the following types of interactional support: (1) a critical outside perspective on their implementation progress; (2) opportunities to learn from peers, especially around clinical innovations; and (3) external validation to help establish visibility for and commitment to the project.
AHRQ-funded; 290201000027I.
Citation: Brooks JV, Gorbenko K, Bosk C .
Interactional resources for quality improvement: Learning from participants through a qualitative study.
Qual Manag Health Care 2017 Apr/Jun;26(2):55-62. doi: 10.1097/qmh.0000000000000128.
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Keywords: Quality Improvement, Quality of Care, Surgery, Hospitals, Teams
Hu Z, Melton GB, Arsoniadis EG
Strategies for handling missing clinical data for automated surgical site infection detection from the electronic health record.
Proper handling of missing data is important for many secondary uses of electronic health record (EHR) data. Data imputation methods can be used to handle missing data, but their use for postoperative complication detection is unclear. Overall, models with missing data imputation almost always outperformed reference models without imputation that included only cases with complete data for detection of SSI overall achieving very good average area under the curve values.
AHRQ-funded; HS024532.
Citation: Hu Z, Melton GB, Arsoniadis EG .
Strategies for handling missing clinical data for automated surgical site infection detection from the electronic health record.
J Biomed Inform 2017 Apr;68:112-20. doi: 10.1016/j.jbi.2017.03.009.
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Keywords: Data, Electronic Health Records (EHRs), Healthcare-Associated Infections (HAIs), Registries, Surgery, Injuries and Wounds, Health Information Technology (HIT), Quality Improvement, Quality of Care, Adverse Events
Franklin PD
Research priorities for optimal use of patient-reported outcomes in quality and outcome improvement for total knee arthroplasty.
This paper uses the traditional quality management's framework of inputs (patients), processes (clinical care), and outcomes to outline priority research questions to learn how clinicians, hospital managers, and patients can interpret patient-reported outcomes to improve total knee arthroplasty care and outcomes. It concludes that research should identify best practices to minimize variation in a patient's health status before surgery.
AHRQ-funded; HS018910.
Citation: Franklin PD .
Research priorities for optimal use of patient-reported outcomes in quality and outcome improvement for total knee arthroplasty.
J Am Acad Orthop Surg 2017 Feb;25 Suppl 1:S51-s54. doi: 10.5435/jaaos-d-16-00632.
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Keywords: Patient-Centered Outcomes Research, Surgery, Quality Improvement, Patient Experience, Evidence-Based Practice