National Healthcare Quality and Disparities Report
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Topics
- Adverse Drug Events (ADE) (17)
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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
76 to 100 of 156 Research Studies DisplayedGrunwell JR, Kamat PP, Miksa M
Trend and outcomes of video laryngoscope use across PICUs.
The use of video laryngoscopy for tracheal intubation is now common for adult ICUs, but has not been quantified in pediatric ICUs (PICUs). A retrospective review was conducted of PICUs across the US and four other countries. There was a wide variability of use of video laryngoscopy across PICUs. There has been a significant increase in the use of video laryngoscopy versus direct laryngoscopy from 2011 to 2015, which has resulted in a decrease in adverse outcomes.
AHRQ-funded; HS021583; HS022464.
Citation: Grunwell JR, Kamat PP, Miksa M .
Trend and outcomes of video laryngoscope use across PICUs.
Pediatr Crit Care Med 2017 Aug;18(8):741-49. doi: 10.1097/pcc.0000000000001175..
Keywords: Children/Adolescents, Intensive Care Unit (ICU), Patient Safety, Practice Patterns, Respiratory Conditions
Derose KP, Payan DD, Fulcar MA
Factors contributing to food insecurity among women living with HIV in the Dominican Republic: a qualitative study.
The researchers examined factors contributing to food insecurity among women living with HIV (WLHIV) in the Dominican Republic (DR). Respondents identified economic instability as the primary driver of food insecurity, precipitated by enacted stigma in the labor and social domains. Women described experiences of HIV-related labor discrimination in formal and informal sectors.
AHRQ-funded; HS000046.
Citation: Derose KP, Payan DD, Fulcar MA .
Factors contributing to food insecurity among women living with HIV in the Dominican Republic: a qualitative study.
PLoS One 2017 Jul 25;12(7):e0181568. doi: 10.1371/journal.pone.0181568.
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Keywords: Human Immunodeficiency Virus (HIV), Nutrition, Patient Safety, Social Stigma, Social Determinants of Health
Dyrbye LN, Shanafelt TD, Sinsky CA
AHRQ Author: Meyers D
https://nam.edu/burnout-among-health-care-professionals-a-call-to-explore-and-address-this-underrecognized-threat-to-safe-high-quality-care
Burnout among health care professionals: a call to explore and address this underrecognized threat to safe, high-quality care.
The high prevalence of burnout among health care professionals is cause for concern because it appears to be affecting quality, safety, and health care system performance. Efforts are needed to address this growing problem. Progress will require methodologically sound studies, adequate funding, and collaborative efforts. The authors hope that research sponsors, institutions, clinician organizations, researchers, clinicians, and patients join in supporting enhanced research efforts focused on these topics.
AHRQ-authored.
Citation: Dyrbye LN, Shanafelt TD, Sinsky CA .
Burnout among health care professionals: a call to explore and address this underrecognized threat to safe, high-quality care.
NAM Perspectives 2017 Jul 5.
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Keywords: Quality of Care, Provider: Health Personnel, Patient Safety, Workforce
Kang H, Gong Y
Developing a similarity searching module for patient safety event reporting system using semantic similarity measures.
In this study, three prevailing algorithms of semantic similarity were implemented to measure the similarities of the 366 patient safety events (PSE) annotated by the taxonomy of AHRQ. The result shows that the similarity scores reflect a higher consistency with the experts' review than those randomly assigned. Moreover, incorporating the algorithms into the reporting system enables a mechanism to learn and update, based upon PSE similarity.
AHRQ-funded; HS022895.
Citation: Kang H, Gong Y .
Developing a similarity searching module for patient safety event reporting system using semantic similarity measures.
BMC Med Inform Decis Mak 2017 Jul 5;17(Suppl 2):75. doi: 10.1186/s12911-017-0467-8.
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Keywords: Patient Safety, Adverse Events, Medical Errors, Health Information Technology (HIT)
Maitree R, Perez-Carrillo GJG, Shimony JS
Adaptive anatomical preservation optimal denoising for radiation therapy daily MRI.
An innovative method, adaptive anatomical preservation optimal denoising (AAPOD), was developed for optimal image denoising, i.e., to maximally reduce noise while preserving the tissue boundaries. The experimental results demonstrated that AAPOD was capable of reducing noise adaptively and optimally while avoiding tissue boundary losses.
AHRQ-funded; HS022888.
Citation: Maitree R, Perez-Carrillo GJG, Shimony JS .
Adaptive anatomical preservation optimal denoising for radiation therapy daily MRI.
J Med Imaging 2017 Jul;4(3):034004. doi: 10.1117/1.jmi.4.3.034004.
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Keywords: Imaging, Treatments, Cancer, Patient Safety
Savage EL, Fairbanks RJ, Ratwani RM
Are informed policies in place to promote safe and usable EHRs? A cross-industry comparison.
This study sought to compare government policies on usability and safety, and methods of examining compliance to those policies, across 3 federal agencies: the Office of the National Coordinator (ONC) and EHRs, the Federal Aviation Administration (FAA) and avionics, and the Food and Drug Administration (FDA) and medical devices. The goal was to identify whether differences in policies exist and, if they do exist, how policies and enforcement mechanisms from other industries might be applied to optimize EHR usability.
AHRQ-funded; HS023701.
Citation: Savage EL, Fairbanks RJ, Ratwani RM .
Are informed policies in place to promote safe and usable EHRs? A cross-industry comparison.
J Am Med Inform Assoc 2017 Jul 1;24(4):769-75. doi: 10.1093/jamia/ocw185.
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Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Patient Safety, Policy
Ing C, Sun LS, Friend AF
Differences in intraoperative hemodynamics between spinal and general anesthesia in infants undergoing pyloromyotomy.
The purpose of this study is to evaluate hemodynamic effects of spinal anesthesia compared to general anesthesia in a cohort of healthy infants. Its findings show that spinal anesthesia performed in healthy infants undergoing pyloromyotomy results in reduced intraoperative blood pressure changes from baseline, significantly higher blood pressure readings, and no increased bradycardia compared to general anesthesia.
AHRQ-funded; HS022941.
Citation: Ing C, Sun LS, Friend AF .
Differences in intraoperative hemodynamics between spinal and general anesthesia in infants undergoing pyloromyotomy.
Paediatr Anaesth 2017 Jul;27(7):733-41. doi: 10.1111/pan.13156.
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Keywords: Adverse Drug Events (ADE), Newborns/Infants, Medication, Patient Safety, Surgery
Roosan D, Weir C, Samore M
Identifying complexity in infectious diseases inpatient settings: an observation study.
This study sought to identify specific complexity-contributing factors in the infectious disease domain and the relationship with the complexity perceived by clinicians. Its factor analysis revealed three factors explaining 47 percent of total variance, namely task interaction and goals, urgency and acuity, and psychosocial behavior. A linear regression analysis showed no statistically significant association between complexity perceived by the physicians and objective complexity.
AHRQ-funded; HS023349.
Citation: Roosan D, Weir C, Samore M .
Identifying complexity in infectious diseases inpatient settings: an observation study.
J Biomed Inform 2017 Jul;71s:S13-s21. doi: 10.1016/j.jbi.2016.10.018.
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Keywords: Clinical Decision Support (CDS), Infectious Diseases, Inpatient Care, Patient Safety
Ing C, Wall MM, DiMaggio CJ
Latent class analysis of neurodevelopmental deficit after exposure to anesthesia in early childhood.
Although some studies have reported an association between early exposure to anesthesia and surgery and long-term neurodevelopmental deficit, the clinical phenotype of children exposed to anesthesia is still unknown. This study’s results suggest that in evaluating children exposed to surgery and anesthesia at an early age, the phenotype of interest may be children with deficits primarily in language and cognition, and not children with broad neurodevelopmental delay or primarily behavioral deficits.
AHRQ-funded; HS022941.
Citation: Ing C, Wall MM, DiMaggio CJ .
Latent class analysis of neurodevelopmental deficit after exposure to anesthesia in early childhood.
J Neurosurg Anesthesiol 2017 Jul;29(3):264-73. doi: 10.1097/ana.0000000000000303.
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Keywords: Adverse Drug Events (ADE), Children/Adolescents, Disabilities, Medication, Patient Safety
Furukawa MF, Spector WD, Rhona Limcangco M
AHRQ Author: Furukawa MF, Spector WD, Encinosa WE
Meaningful use of health information technology and declines in in-hospital adverse drug events.
Hospital adoption of electronic health records with Meaningful Use (MU) capabilities expected to improve medication safety has grown rapidly. This study has found that MU capabilities and interoperability were associated with lower occurrence of adverse drug events (ADEs), but the effects did not vary by experience with MU. About one-fifth of the decline in ADEs from 2010 to 2013 was attributable to MU capabilities.
AHRQ-authored.
Citation: Furukawa MF, Spector WD, Rhona Limcangco M .
Meaningful use of health information technology and declines in in-hospital adverse drug events.
J Am Med Inform Assoc 2017 Jul 1;24(4):729-36. doi: 10.1093/jamia/ocw183.
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Keywords: Health Information Technology (HIT), Electronic Health Records (EHRs), Adverse Drug Events (ADE), Patient Safety, Hospitals
Galambos C, Rantz M, Back J
Older adults' perceptions of and preferences for a fall risk assessment system: exploring stages of acceptance model.
The study aim was to explore the perceptions and preferences of older adults and their family members about a fall risk assessment system. Using a qualitative approach, this study found that there was acceptance of the technology as participants adapted to it. Two themes were present across the five points in time-safety and usefulness. Five stages of acceptance emerged from the data from preinstallation to 2 years postinstallation.
AHRQ-funded; HS018477.
Citation: Galambos C, Rantz M, Back J .
Older adults' perceptions of and preferences for a fall risk assessment system: exploring stages of acceptance model.
Comput Inform Nurs 2017 Jul;35(7):331-37. doi: 10.1097/cin.0000000000000330.
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Keywords: Elderly, Falls, Risk, Patient Safety
Koronkowski MJ, Semla TP, Schmader KE
Recent literature update on medication risk in older adults, 2015-2016.
Medications can pose considerable risk in older adults. This article intended to provide a narrative review of key publications in medication safety for clinicians and researchers committed to improving medication safety in older adults. It annotates four articles addressing this concern from 2016.
AHRQ-funded; HS023779.
Citation: Koronkowski MJ, Semla TP, Schmader KE .
Recent literature update on medication risk in older adults, 2015-2016.
J Am Geriatr Soc 2017 Jul;65(7):1401-05. doi: 10.1111/jgs.14887.
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Keywords: Elderly, Medication, Medication: Safety, Adverse Drug Events (ADE), Adverse Events, Patient Safety
Ottosen MJ, Engebretson JC, Etchegaray JM
Steps in developing a patient-centered measure of hospital design factors.
This research methodology column focuses on describing a four-step medical ethnography approach that can be used in developing patient-centered measures of interest to those studying built environments. The authors use this approach to illustrate how one might develop a measure that can be used to understand parent perceptions of the safety culture in neonatal intensive care units.
AHRQ-funded; HS022944.
Citation: Ottosen MJ, Engebretson JC, Etchegaray JM .
Steps in developing a patient-centered measure of hospital design factors.
HERD 2017 Jul;10(4):10-16. doi: 10.1177/1937586716685290.
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Keywords: Patient Safety, Neonatal Intensive Care Unit (NICU), Quality Measures, Research Methodologies
Rawat N, Yang T, Ali KJ
Two-state collaborative study of a multifaceted intervention to decrease ventilator-associated events.
Given strong national interest in improving ventilated patient care, the National Institute of Health and AHRQ funded a two-state collaborative to reduce ventilator-associated events. The researchers described the collaborative's impact on ventilator-associated event rates in 56 ICUs. They found that compliance with all evidence-based interventions improved over the course of the collaborative. This study is the largest to date affirming that best practices can prevent ventilator-associated events.
AHRQ-funded; 29032002T.
Citation: Rawat N, Yang T, Ali KJ .
Two-state collaborative study of a multifaceted intervention to decrease ventilator-associated events.
Crit Care Med 2017 Jul;45(7):1208-15. doi: 10.1097/ccm.0000000000002463.
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Keywords: Healthcare-Associated Infections (HAIs), Intensive Care Unit (ICU), Adverse Events, Patient Safety, Prevention
McAlearney AS, Hefner JL, Sieck CJ
Searching for Management Approaches To Reduce HAI Transmission (SMART): a study protocol.
Using a mixed-methods approach to evaluate the contribution of management factors to successful HAI-reduction efforts, this study aims to develop valid and reliable measures of structural management practices associated with the recommended central line-associated bloodstream infections Management Strategies for use as a survey (HAI Management Practice Guideline Survey) to support HAI-reduction efforts in both medical/surgical units and ICUs.
AHRQ-funded; HS024958.
Citation: McAlearney AS, Hefner JL, Sieck CJ .
Searching for Management Approaches To Reduce HAI Transmission (SMART): a study protocol.
Implement Sci 2017 Jun 28;12(1):82. doi: 10.1186/s13012-017-0610-z.
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Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Healthcare-Associated Infections (HAIs), Patient Safety, Research Methodologies
Arnold S
AHRQ Author: Arnold S
The imperative to address diagnostic safety.
Diagnostic errors are likely to impact most of us in our lifetime. The author discusses two studies pointing to the vastness of the challenge and the urgency to act now. He also discusses other aspects of this issue and highlights two current AHRQ dedicated research opportunities on diagnostic safety: one to look at the incidence and causes of diagnostic errors in ambulatory care, and the second to look at improvement strategies and interventions.
AHRQ-authored.
Citation: Arnold S .
The imperative to address diagnostic safety.
Diagnosis 2017 Jun 27;4(2):55-56. doi: 10.1515/dx-2017-0017.
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Keywords: Diagnostic Safety and Quality, Medical Errors, Ambulatory Care and Surgery, Patient Safety, Quality Improvement
McDonald KM, Su G, Lisker S
Implementation science for ambulatory care safety: a novel method to develop context-sensitive interventions to reduce quality gaps in monitoring high-risk patients.
The researchers aimed to demonstrate a novel method to identify common vulnerabilities across clinics and generate attributes for context-flexible population-level monitoring solutions for widespread implementation to improve quality. Using a National Academies framework and context-sensitivity theory, they identified common systems vulnerabilities and developed preliminary concepts for improving the robustness for monitoring patients with high-risk conditions ("design seeds" for potential solutions).
AHRQ-funded; HS023558.
Citation: McDonald KM, Su G, Lisker S .
Implementation science for ambulatory care safety: a novel method to develop context-sensitive interventions to reduce quality gaps in monitoring high-risk patients.
Implement Sci 2017 Jun 24;12(1):79. doi: 10.1186/s13012-017-0609-5.
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Keywords: Ambulatory Care and Surgery, Patient Safety, Quality Improvement
Rickard CM, Marsh NM, Webster J
Peripherally InSerted CEntral catheter dressing and securement in patients with cancer: the PISCES trial. protocol for a 2x2 factorial, superiority randomised controlled trial.
The researchers designed this trial to assess the clinical and cost-effectiveness of dressing and securements to prevent peripherally inserted central catheters (PICCs) failure. For the dressing hypothesis, they hypothesize (chlorhexidine gluconate (CHG) discs will reduce catheter-associated bloodstream infection (CABSI) compared with no CHG disc. For the securement hypothesis, they hypothesize that integrated securement dressing will reduce composite PICC failure (infection (CABSI/local infection), occlusion, dislodgement or thrombosis), compared with securement device.
AHRQ-funded; HS022835.
Citation: Rickard CM, Marsh NM, Webster J .
Peripherally InSerted CEntral catheter dressing and securement in patients with cancer: the PISCES trial. protocol for a 2x2 factorial, superiority randomised controlled trial.
BMJ Open 2017 Jun 15;7(6):e015291. doi: 10.1136/bmjopen-2016-015291.
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Keywords: Cancer, Catheter-Associated Urinary Tract Infection (CAUTI), Healthcare-Associated Infections (HAIs), Patient Safety
Le P, Martinez KA, Pappas MA
A decision model to estimate a risk threshold for venous thromboembolism prophylaxis in hospitalized medical patients.
To determine a threshold for prophylaxis based on risk of venous thromboembolism, the researchers constructed a decision model with a decision-tree following patients for 3 months after hospitalization, and a lifetime Markov model with 3-month cycles. They found that the prophylaxis threshold was relatively insensitive to low-molecular-weight heparin cost and bleeding risk, but very sensitive to patient age and life expectancy.
AHRQ-funded; HS022883.
Citation: Le P, Martinez KA, Pappas MA .
A decision model to estimate a risk threshold for venous thromboembolism prophylaxis in hospitalized medical patients.
J Thromb Haemost 2017 Jun;15(6):1132-41. doi: 10.1111/jth.13687.
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Keywords: Adverse Events, Clinical Decision Support (CDS), Inpatient Care, Patient Safety, Risk
Hanlon JT, Zhao X, Naples JG
Central nervous system medication burden and serious falls in older nursing home residents.
The researchers examined the association between CNS medication burden and serious falls in those with a recent fall history. They found that CNS medication burden, approximately 3 + standardized daily doses, was associated with an increased risk of serious falls in nursing home residents with recent fall.
AHRQ-funded; HS023779.
Citation: Hanlon JT, Zhao X, Naples JG .
Central nervous system medication burden and serious falls in older nursing home residents.
J Am Geriatr Soc 2017 Jun;65(6):1183-89. doi: 10.1111/jgs.14759.
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Keywords: Elderly, Falls, Medication, Nursing Homes, Patient Safety
Smith SN, Reichert HA, Ameling JM
Dissecting Leapfrog: how well do Leapfrog safe practices scores correlate with Hospital Compare ratings and penalties, and how much do they matter?
Voluntary Leapfrog Safe Practices Score (SPS) measures were among the first public reports of hospital performance. Recently, Medicare's Hospital Compare website has reported compulsory measures. Leapfrog's Hospital Safety Score (HSS) grades incorporate SPS and Medicare measures. The researchers evaluated associations between Leapfrog SPS and Medicare measures. They found that voluntary Leapfrog SPS measures skew toward positive self-report and bear little association with compulsory Medicare outcomes and penalties.
AHRQ-funded; HS019767; HS024385; HS018334.
Citation: Smith SN, Reichert HA, Ameling JM .
Dissecting Leapfrog: how well do Leapfrog safe practices scores correlate with Hospital Compare ratings and penalties, and how much do they matter?
Med Care 2017 Jun;55(6):606-14. doi: 10.1097/mlr.0000000000000716.
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Keywords: Patient Safety, Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Hospitals, Provider Performance
Barker AK, Ngam C, Musuuza JS
Reducing Clostridium difficile in the inpatient setting: a systematic review of the adherence to and effectiveness of C. difficile prevention bundles.
Researchers conducted a systematic review to examine the components of Clostridium difficile infection (CDI) prevention bundles, their implementation processes, and their impact on CDI rates. They concluded that given the lack of randomized controlled trials in the literature, assessing a causal relationship between bundled interventions and CDI rates is currently impossible.
AHRQ-funded; HS023791.
Citation: Barker AK, Ngam C, Musuuza JS .
Reducing Clostridium difficile in the inpatient setting: a systematic review of the adherence to and effectiveness of C. difficile prevention bundles.
Infect Control Hosp Epidemiol 2017 Jun;38(6):639-50. doi: 10.1017/ice.2017.7.
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Keywords: Antimicrobial Stewardship, Guidelines, Healthcare-Associated Infections (HAIs), Patient Safety, Prevention
Cannon CM, Musuuza JS, Barker AK
Risk of Clostridium difficile infection in hematology-oncology patients colonized with toxigenic C. difficile.
This study determined that the prevalence of colonization with toxigenic Clostridium difficile among patients with hematological malignancies and/or bone marrow transplant at admission to a 566-bed academic medical care center was 9.3 percent. Thirteen percent of colonized patients developed symptomatic disease during hospitalization. This population may benefit from targeted C. difficile infection control interventions.
AHRQ-funded; HS024039; HS023791.
Citation: Cannon CM, Musuuza JS, Barker AK .
Risk of Clostridium difficile infection in hematology-oncology patients colonized with toxigenic C. difficile.
Infect Control Hosp Epidemiol 2017 Jun;38(6):718-20. doi: 10.1017/ice.2017.48.
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Keywords: Cancer, Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Patient Safety, Risk
Eriksson CO, Stoner RC, Eden KB
The association between hospital capacity strain and inpatient outcomes in highly developed countries: a systematic review.
This systematic literature review sought to understand whether hospital capacity strain is associated with worse health outcomes for hospitalized patients and to evaluate benefits and harms of health system interventions to improve care quality during times of hospital capacity strain. It concluded that in highly developed countries, hospital capacity strain is associated with increased mortality and worsened health outcomes.
AHRQ-funded; HS022981.
Citation: Eriksson CO, Stoner RC, Eden KB .
The association between hospital capacity strain and inpatient outcomes in highly developed countries: a systematic review.
J Gen Intern Med 2017 Jun;32(6):686-96. doi: 10.1007/s11606-016-3936-3.
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Keywords: Hospitalization, Hospitals, Inpatient Care, Patient-Centered Outcomes Research, Patient Safety
Singh H, Schiff GD, Graber ML
The global burden of diagnostic errors in primary care.
In this narrative review, the authors discuss the global significance, burden and contributory factors related to diagnostic errors in primary care. They then synthesize available literature to discuss the types of presenting symptoms and conditions most commonly affected. Finally, they summarize interventions based on available data and suggest next steps to reduce the global burden of diagnostic errors.
AHRQ-funded; HS022087; HS023602.
Citation: Singh H, Schiff GD, Graber ML .
The global burden of diagnostic errors in primary care.
BMJ Qual Saf 2017 Jun;26(6):484-94. doi: 10.1136/bmjqs-2016-005401.
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Keywords: Diagnostic Safety and Quality, Health Information Technology (HIT), Medical Errors, Patient Safety, Primary Care