National Healthcare Quality and Disparities Report
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Topics
- Blood Pressure (1)
- Cardiovascular Conditions (2)
- Children/Adolescents (3)
- Clinician-Patient Communication (1)
- Communication (1)
- Diagnostic Safety and Quality (1)
- (-) Education: Continuing Medical Education (21)
- Electronic Health Records (EHRs) (2)
- Emergency Department (1)
- Emergency Medical Services (EMS) (1)
- Evidence-Based Practice (2)
- Guidelines (2)
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- Health Information Technology (HIT) (2)
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- Health Services Research (HSR) (1)
- Heart Disease and Health (1)
- Hospitals (1)
- Human Immunodeficiency Virus (HIV) (1)
- Imaging (1)
- Implementation (1)
- Inpatient Care (2)
- Intensive Care Unit (ICU) (2)
- Maternal Care (1)
- Medical Liability (1)
- Obesity (1)
- Outcomes (1)
- Patient and Family Engagement (1)
- Patient Safety (3)
- Policy (1)
- Prevention (1)
- Primary Care (2)
- Provider (6)
- Provider: Clinician (1)
- Provider: Physician (1)
- Quality Improvement (1)
- Quality of Care (1)
- Screening (1)
- Simulation (2)
- Sleep Problems (1)
- Stroke (1)
- Surgery (2)
- Training (13)
- Web-Based (1)
- Women (1)
- Workflow (1)
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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 21 of 21 Research Studies DisplayedShields AD, Vidosh J, Thomson BA
Validation of a simulation-based resuscitation curriculum for maternal cardiac arrest.
The purpose of this study was to evaluate the knowledge, skills, and self-efficacy of health care participants completing a simulation-based blended learning training curriculum on managing maternal medical emergencies and maternal cardiac arrest. The study included a formative assessment of the Obstetric Life Support curriculum. The training consisted of self-guided pre-course work and an instructor-led simulation course using a customized low-fidelity simulator. Eighty-five participants consented to participation in the training (out of 88 invited); 77 participants completed the training over eight sessions. The study found that at baseline, less than 50% of participants were able to achieve a passing score on the cognitive assessment. After the course, mean cognitive assessment scores improved by 13 points, from 69.4% at baseline to 82.4% after the course. The researchers observed significant improvements in participant self-efficacy, and 92.6% of participants agreed or strongly agreed that the course met its educational objectives.
AHRQ-funded; HS026169.
Citation: Shields AD, Vidosh J, Thomson BA .
Validation of a simulation-based resuscitation curriculum for maternal cardiac arrest.
Obstet Gynecol 2023 Nov 1; 142(5):1189-98. doi: 10.1097/aog.0000000000005349..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Maternal Care, Simulation, Training, Education: Continuing Medical Education, Women
Pillado EB, Li RD, Eng JS
Defining sources and ramifications of mistreatment among female vascular surgery trainees.
This study examined mistreatment that occurred during training of vascular surgeon trainees and categorizes and identifies the sources. This cross-sectional study was an anonymous survey administered after the 2021 Vascular Surgery In-Training Examination. The survey represented all 125 vascular surgery training programs with 510 trainees (66.9% male) participating in the survey (83.6% response rate). Mistreatment was reported by 54.8% of trainees, with twice as many women reporting as men (82.3% vs 41.0%). Women reported higher rates of being shouted at (44.1% vs 21.1%); repeatedly reminded of errors (24.3% vs 16.1%); ignored/treated hostilely (28.9% vs 10.5%); subjected to crude/sexually demeaning remarks, stories, or jokes (19.2% vs 2.1%); evaluated by different standards (29.3% vs 2.1%); and mistaken for a non-physician (75.2% vs 3.5%). Patients and their families were given as the most common source of sexual harassment (66.7%), gender discrimination (90.4%), and racial discrimination (74.4%). Compared with men, women more frequently felt unprepared to respond to the behavior in the moment (10.4% vs 4.6%), did not know how to report mistreatment at their institution (7.6% vs 3.2%), and did not believe that their institution would take their mistreatment report seriously (9.0% vs 3.9%).
AHRQ-funded; HS024516.
Citation: Pillado EB, Li RD, Eng JS .
Defining sources and ramifications of mistreatment among female vascular surgery trainees.
J Vasc Surg 2023 Sep; 78(3):797-804. doi: 10.1016/j.jvs.2023.03.504..
Keywords: Provider: Physician, Education: Continuing Medical Education
Tarnutzer AA, Gold D, Wang Z
Impact of clinician training background and stroke location on bedside diagnostic test accuracy in the acute vestibular syndrome - a meta-analysis.
Researchers conducted a systematic review to assess the accuracy of bedside diagnosis of acute dizziness/vertigo to differentiate peripheral vestibular from central neurologic causes. Their review indicated that the Head Impulse, Nystagmus, Test of Skew (HINTS) examination by trained clinicians can differentiate peripheral from central causes and show higher diagnostic accuracy for stroke in the first 24-48 hours than MRI diffusion-weighted imaging. They concluded that these techniques should be disseminated to clinicians evaluating dizziness/vertigo.
AHRQ-funded; HS029350.
Citation: Tarnutzer AA, Gold D, Wang Z .
Impact of clinician training background and stroke location on bedside diagnostic test accuracy in the acute vestibular syndrome - a meta-analysis.
Ann Neurol 2023 Aug; 94(2):295-308. doi: 10.1002/ana.26661..
Keywords: Diagnostic Safety and Quality, Training, Education: Continuing Medical Education, Provider: Clinician, Stroke, Cardiovascular Conditions
Katzman JG, Balbus J, Herring D
AHRQ Author: Bole A
Clinician education on climate change and health: virtual learning community models.
The Climate Change and Human Health Extension for Community Healthcare Outcomes program (Climate ECHO) is a weekly virtual mentoring program for health-care and public health professionals addressing foundational climate and health educational needs for clinicians. The program includes three objectives: 1) to increase knowledge and self-efficacy of climate change; 2) to improve communication among clinicians, community health workers, and patients regarding the health-related effects of climate change; and 3) to advance knowledge on environmental justice and health equity to reduce health disparities. In February 2021 Climate ECHO introduced a pilot program, with contributions from the United Systems Global Change Research Program’s Interagency Crosscutting Group on Climate Change and Human Health. Project ECHO has participants from over 190 countries and builds virtual communities of practice, where peer participants meet consistently to learn from each other and subject matter experts. The U.S. Department of Health and Human Services’ Office of Climate Change and Health Equity, the Centers for Disease Control and Prevention’s Office of Climate and Health, the National Oceanic and Atmospheric Administration’s Climate Program Office, the National Park Service’s One Health Program, and other non-governmental organizations partnered to support the development of multiple programs focused on climate change and health. The first 8-week pilot program included 625 participants from 45 U.S. states and 25 countries. Most participants were health professionals. Participants reported high levels of satisfaction with the program, indicating increased climate-related knowledge and improved communication skills. After the sessions, participants report a greater likelihood of communicating about climate effects with colleagues and patients.
AHRQ-authored.
Citation: Katzman JG, Balbus J, Herring D .
Clinician education on climate change and health: virtual learning community models.
Lancet Planet Health 2023 Jun; 7(6):e444-e46. doi: 10.1016/s2542-5196(23)00087-6..
Keywords: Education: Continuing Medical Education, Training
Sullivan CE, Weber LS, Lamas PV
Expanding APHON's Pediatric Chemotherapy/Biotherapy Provider and Instructor program to Spanish-speaking countries: pilot series development and evaluation.
This article described the process of adapting and implementing Provider and Instructor program courses for standardized, comprehensive pediatric chemotherapy/biotherapy education in Latin American and Caribbean countries, culturally adapted and translated to Spanish by the Association of Pediatric Hematology/Oncology Nurses (APHON). The Spanish APHON Provider program was piloted four times and the Instructor program twice with nurses from Mexico, Central America, the Caribbean, South America, and Spain. Statistical analysis identified factors associated with pass rates. The Spanish APHON program was deemed appropriate for nurses' education and practice levels in Latin American and Caribbean countries.
AHRQ-funded; HS013852.
Citation: Sullivan CE, Weber LS, Lamas PV .
Expanding APHON's Pediatric Chemotherapy/Biotherapy Provider and Instructor program to Spanish-speaking countries: pilot series development and evaluation.
J Pediatr Hematol Oncol Nurs 2023 Mar-Apr; 40(2):119-32. doi: 10.1177/27527530221121729..
Keywords: Children/Adolescents, Education: Continuing Medical Education, Training
Prey JE, Polubriaginof F, Kuperman GJ
A global analysis of approaches to sharing clinical data with patients.
The authors investigated the current state of approaches for providing patients with access to their own clinical information. They found that efforts to improve patient access to data are active on a global-scale; however, there are many open questions about best practices and much can be learned by adopting an international perspective to guide future implementation efforts.
AHRQ-funded; HS021816.
Citation: Prey JE, Polubriaginof F, Kuperman GJ .
A global analysis of approaches to sharing clinical data with patients.
Stud Health Technol Inform 2015;216:907.
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Keywords: Education: Continuing Medical Education, Electronic Health Records (EHRs), Health Information Technology (HIT), Patient and Family Engagement
Starmer 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
Lewiss RE, Chan W, Sheng AY
Research priorities in the utilization and interpretation of diagnostic imaging: Education, assessment, and competency.
A group of radiologists, physicists, and emergency physicians convened at the 2015 Academic Emergency Medicine consensus conference to discuss and prioritize a research agenda related to education, assessment, and competency in ordering and interpreting diagnostic imaging. In this article, the authors review the supporting reliability and validity evidence and make specific recommendations for future research on the education, competency, and assessment of learning diagnostic imaging.
AHRQ-funded; HS023498.
Citation: Lewiss RE, Chan W, Sheng AY .
Research priorities in the utilization and interpretation of diagnostic imaging: Education, assessment, and competency.
Acad Emerg Med 2015 Dec;22(12):1447-54. doi: 10.1111/acem.12833.
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Keywords: Imaging, Education: Continuing Medical Education, Emergency Department, Emergency Medical Services (EMS), Healthcare Utilization, Health Services Research (HSR)
Mohan V, Scholl G, Gold JA
Intelligent simulation model to facilitate EHR training.
The authors proposed Six Principles that are EHR-agnostic and provide the framework for the development of an intelligent simulation model that can optimize EHR training by replicating real-world clinical conditions and appropriate cognitive loads.
AHRQ-funded; HS021637.
Citation: Mohan V, Scholl G, Gold JA .
Intelligent simulation model to facilitate EHR training.
AMIA Annu Symp Proc 2015 Nov 5;2015:925-32.
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Keywords: Education: Continuing Medical Education, Health Information Technology (HIT), Patient Safety, Training, Electronic Health Records (EHRs)
Wolfe H, Maltese MR, Niles DE
Blood pressure directed booster trainings improve intensive care unit provider retention of excellent cardiopulmonary resuscitation skills.
The authors incorporated arterial blood pressure (ABP) tracings into Booster Trainings, hypothesizing that ABP-directed CPR Booster Trainings would improve intensive care unit (ICU) provider 3-month retention of excellent CPR skills without need for interval retraining. They found that the ABP-directed CPR booster trainings improved ICU provider 3-month retention of excellent CPR skills without the need for interval retraining.
AHRQ-funded; HS022469; HS022464.
Citation: Wolfe H, Maltese MR, Niles DE .
Blood pressure directed booster trainings improve intensive care unit provider retention of excellent cardiopulmonary resuscitation skills.
Pediatr Emerg Care 2015 Nov;31(11):743-7. doi: 10.1097/pec.0000000000000394.
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Keywords: Blood Pressure, Education: Continuing Medical Education, Intensive Care Unit (ICU), Patient Safety, Training
Carayon P, Weinger MB, Brown R
How do residents spend their time in the intensive care unit?
The researchers described the work of residents and the distribution of their time in 6 intensive care units (ICUs) of 2 medical centers (MCs). The found that residents spent most time performing direct patient care and care coordination activities. The distribution of activities, which varied across MCs and across ICUs, highlights the need to consider the local context on residents' work in ICUs.
AHRQ-funded; HS015274.
Citation: Carayon P, Weinger MB, Brown R .
How do residents spend their time in the intensive care unit?
Am J Med Sci 2015 Nov;350(5):403-8. doi: 10.1097/maj.0000000000000520.
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Keywords: Education: Continuing Medical Education, Intensive Care Unit (ICU), Provider, Training
Lindman BR, Tong CW, Carlson DE
National Institutes of Health career development awards for cardiovascular physician-scientists: recent trends and strategies for success.
The authors report on recent success rates for obtaining NIH K awards, provide strategies for preparing a successful application and navigating the early career period for aspiring cardiovascular investigators, and offer cardiovascular division leadership perspectives regarding K awards in the current era. Their objective is to offer practical advice that will equip trainees considering an investigator path for success.
AHRQ-funded; HS023000.
Citation: Lindman BR, Tong CW, Carlson DE .
National Institutes of Health career development awards for cardiovascular physician-scientists: recent trends and strategies for success.
J Am Coll Cardiol 2015 Oct 20;66(16):1816-27. doi: 10.1016/j.jacc.2015.08.858..
Keywords: Education: Continuing Medical Education, Provider, Training
Gance-Cleveland B, Aldrich H, Dandreaux D
A virtual childhood obesity collaborative: satisfaction with online continuing education.
This descriptive study evaluated school-based health center (SBHC) providers’ satisfaction with Web based continuing education as part of a virtual childhood obesity intervention. Participation in the first two learning sessions was higher than the last two. Provider satisfaction of training modules by question type and content area was quite high. Many providers also reported plans to make changes in their practice after completing the training.
AHRQ-funded; HS018646.
Citation: Gance-Cleveland B, Aldrich H, Dandreaux D .
A virtual childhood obesity collaborative: satisfaction with online continuing education.
J Pediatr Health Care 2015 Sep-Oct;29(5):413-23. doi: 10.1016/j.pedhc.2015.01.006..
Keywords: Education: Continuing Medical Education, Obesity, Children/Adolescents, Prevention, Web-Based
Rajaram R, Chung JW, Cohen ME
Association of the 2011 ACGME resident duty hour reform with postoperative patient outcomes in surgical specialties.
The 2011 ACGME resident duty hour reform implemented additional restrictions to existing duty hour policies. The study’s objective was to determine the association between this reform and patient outcomes among several surgical specialties. It found that implementation of the 2011 ACGME resident duty hour reform was not associated with a significant change in patient outcomes for several surgical specialties in the 2 years after reform.
AHRQ-funded; HS000078.
Citation: Rajaram R, Chung JW, Cohen ME .
Association of the 2011 ACGME resident duty hour reform with postoperative patient outcomes in surgical specialties.
J Am Coll Surg 2015 Sep;221(3):748-57. doi: 10.1016/j.jamcollsurg.2015.06.010..
Keywords: Education: Continuing Medical Education, Outcomes, Surgery, Training
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
Wang D, Le XH, Luque AE
Identifying effective approaches for dissemination of clinical evidence--correlation analyses on promotional activities and usage of a guideline-driven interactive case simulation tool in a statewide HIV-HCV-STD clinical education program.
The investigators analyzed correlations between promotional activities and usage of a guideline-driven interactive case simulation tool (ICST) for insomnia screening and treatment in a statewide HIV-HCV-STD clinical education program. They found that promotional activities were strongly correlated with the number of audience as well as the intensity of use of the target resource, with strong correlations identified between the sending of email newsletters and the intensity of resource use by promotion recipients, by new users, and through the most convenient access channel associated with the promotion.
AHRQ-funded; HS022057.
Citation: Wang D, Le XH, Luque AE .
Identifying effective approaches for dissemination of clinical evidence--correlation analyses on promotional activities and usage of a guideline-driven interactive case simulation tool in a statewide HIV-HCV-STD clinical education program.
Stud Health Technol Inform 2015;216:515-9.
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Keywords: Human Immunodeficiency Virus (HIV), Education: Continuing Medical Education, Simulation, Guidelines, Evidence-Based Practice, Health Promotion, Screening, Sleep Problems, Training
Song Z, Chopra V, McMahon LF
Addressing the primary care workforce crisis.
In this commentary, the authors propose that CMS explicitly reward teaching hospitals if a certain share of their graduates (they propose 30%) remain in primary care 3 years after residency, either through additional payments or release of a withhold. This step could help address the shortage of primary care physicians that now calls for more policy attention and urgency.
AHRQ-funded; HS022835.
Citation: Song Z, Chopra V, McMahon LF .
Addressing the primary care workforce crisis.
Am J Manag Care 2015 Aug;21(8):e452-4..
Keywords: Education: Continuing Medical Education, Policy, Primary Care, Provider, Workforce
Morrato EH, Rabin B, Proctor J
Bringing it home: expanding the local reach of dissemination and implementation training via a university-based workshop.
The Colorado Research in Implementation Science Program (CRISP) developed and delivered an introductory D&I workshop adapted from national programs to extend training reach and foster a local learning community for D&I. This paper describes the context of the local training environment, findings from a pre-workshop needs assessment survey, training design and structure, and post-workshop evaluation. Lessons learned may inform others intending to develop local D&I training workshop.
AHRQ-funded; HS021138.
Citation: Morrato EH, Rabin B, Proctor J .
Bringing it home: expanding the local reach of dissemination and implementation training via a university-based workshop.
Implement Sci 2015 Jul 4;10:94. doi: 10.1186/s13012-015-0281-6..
Keywords: Communication, Education: Continuing Medical Education, Evidence-Based Practice, Guidelines, Quality of Care, Quality Improvement, Training, Implementation
Ballard TN, Grenda TR, Cohn AM
Innovative scheduling solutions for graduate medical education.
Operations research can be applied to solving numerous logistical problems, including residency scheduling dilemmas. The authors pointed out that training programs will need to employ more advanced approaches to solving scheduling dilemmas, and operations research offers innovative approaches to enable graduate medical education programs to efficiently address this constantly changing field.
AHRQ-funded; HS000053.
Citation: Ballard TN, Grenda TR, Cohn AM .
Innovative scheduling solutions for graduate medical education.
J Grad Med Educ 2015 Jun;7(2):169-70. doi: 10.4300/jgme-d-14-00581.1.
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Keywords: Education: Continuing Medical Education, Training
Pradarelli JC, Campbell DA, Dimick JB
Hospital credentialing and privileging of surgeons: a potential safety blind spot.
Taylor v Intuitive, the first of at least 26 lawsuits against Intuitive, went to trial alleging injuries or death tied to the da Vinci Surgical System, a new robotic surgical system. This discussion of the events surrounding the case of Taylor v Intuitive highlights the importance of hospitals’ credentialing and privileging mechanisms for maintaining the quality and safety of surgical care, especially regarding new technologies for which practicing surgeons may not have formal training.
AHRQ-funded; HS017765.
Citation: Pradarelli JC, Campbell DA, Dimick JB .
Hospital credentialing and privileging of surgeons: a potential safety blind spot.
JAMA 2015 Apr 7;313(13):1313-4. doi: 10.1001/jama.2015.1943..
Keywords: Patient Safety, Surgery, Education: Continuing Medical Education, Medical Liability, Hospitals
Pylypchuk Y, Sarpong E
AHRQ Author: Pylypchuk Y, Sarpong E
Nurse practitioners and their effects on visits to primary care physicians.
The researchers examined the effects of visits to nurse practitioners (NPs) on the demand for primary care physician services. Using a system of simultaneous equations where states’ education requirements for NPs are an identifying exclusion restriction, they found that patients who visit an NP are significantly less likely to visit PCPs, and to receive prescribed medication, medical check-up, and diagnosis from PCPs.
AHRQ-authored
Citation: Pylypchuk Y, Sarpong E .
Nurse practitioners and their effects on visits to primary care physicians.
B E J Econom Anal Policy 2015 Apr;15(2):837–64..
Keywords: Healthcare Delivery, Education: Continuing Medical Education, Primary Care, Provider, Workforce