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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 14 of 14 Research Studies DisplayedDelaney LD, Howard R, Palazzolo K
Outcomes of a presurgical optimization program for elective hernia repairs among high-risk patients.
The authors evaluated the feasibility of evidence-based patient optimization before surgery by implementing a low-cost preoperative optimization clinic. They found that a hernia optimization clinic safely improved management of high-risk patients and increased operative yield for the institution. They concluded that their results represented an opportunity to create sustainable and scalable models that provide longitudinal care and optimize patients to improve outcomes of hernia repair.
AHRQ-funded; HS025778.
Citation: Delaney LD, Howard R, Palazzolo K .
Outcomes of a presurgical optimization program for elective hernia repairs among high-risk patients.
JAMA Netw Open 2021 Nov;4(11):e2130016. doi: 10.1001/jamanetworkopen.2021.30016..
Keywords: Surgery, Risk, Evidence-Based Practice, Quality Improvement, Quality of Care, Outcomes
Dworsky JQ, Shenoy R, Childers CP
Older veterans undergoing inpatient surgery: what is the compliance with best practice guidelines?
This study’s objective was to determine the documented compliance with best practice guidelines for optimal perioperative care for the older adult surgical patient that were created by the American College of Surgeons Quality Improvement Program and the American Geriatrics Society. The guidelines include 38 measures. A retrospective chart review was conducted on 86 older adults undergoing elective inpatient coronary artery bypass graft, prostatectomy, or colectomy over a 2-year period at a single Veterans Affairs hospital. Mean reported compliance across measures was 41% ± 4%. Of the 38 analyzed measures, 10 measures were achieved for 0 patients, and only 1 patient for 7 measures. Future work is needed to understand barriers for implementation.
AHRQ-funded; HS000046.
Citation: Dworsky JQ, Shenoy R, Childers CP .
Older veterans undergoing inpatient surgery: what is the compliance with best practice guidelines?
Surgery 2021 Feb;169(2):356-61. doi: 10.1016/j.surg.2020.08.033..
Keywords: Elderly, Surgery, Guidelines, Evidence-Based Practice, Quality Improvement, Quality of Care, Quality Measures
Reisz PA, Laviana AA, Zhao Z
Assessing the quality of surgical care for clinically localized prostate cancer: results from the CEASAR study.
Prior studies suggest that nationally endorsed quality measures for prostate cancer care are not linked closely with outcomes. Using a prospective, population based cohort the investigators measured clinically relevant variation in structure, process and outcome measures in men undergoing radical prostatectomy. The authors did not identify and meaningful variation in quality of care across racial groups, age groups and surgeon volume strata, in this cohort, suggesting that men were receiving comparable quality of care across these strata.
AHRQ-funded; HS019356.
Citation: Reisz PA, Laviana AA, Zhao Z .
Assessing the quality of surgical care for clinically localized prostate cancer: results from the CEASAR study.
J Urol 2020 Dec;204(6):1236-41. doi: 10.1097/ju.0000000000001198..
Keywords: Surgery, Cancer: Prostate Cancer, Cancer, Quality of Care, Quality of Life, Patient-Centered Outcomes Research, Comparative Effectiveness, Evidence-Based Practice
Hu QL, Grant MC, Hornor MA
Technical evidence review for emergency major abdominal operation conducted for the AHRQ Safety Program for Improving Surgical Care and Recovery.
This technical evidence review focuses on the use of enhanced recovery pathways (ERPs) for emergency major abdominal surgery conducted for the AHRQ Safety Program for Improving Surgical Care and Recovery (ISCR). This national ERP initiative is funded by AHRQ and implemented in 2017 through a collaboration with American College of Surgeons, and Johns Hopkins Medicine Armstrong Institute for Patient Safety and Quality. Five common emergency general surgery (EGS) procedures were focused on: perforated peptic ulcer repair, colectomy, lysis of adhesions, small bowel resection, and exploratory laparotomy. The authors identified seventeen candidate components for emergency major abdominal ERP. The components span the continuum of care from preoperative setting to hospital discharge. For every component they conducted a systematic literature review to find relevant studies. Each component was examined for rationale, evidence, and summary and recommendations. Many were supported by evidence and guidelines specific to their particular operation. Key gaps in literature were highlighted, specifically lack of evidence specific to these operations across many ERP processes.
AHRQ-funded; 233201500020I.
Citation: Hu QL, Grant MC, Hornor MA .
Technical evidence review for emergency major abdominal operation conducted for the AHRQ Safety Program for Improving Surgical Care and Recovery.
J Am Coll Surg 2020 Dec;231(6):743-64.e5. doi: 10.1016/j.jamcollsurg.2020.08.772..
Keywords: Evidence-Based Practice, Surgery, Patient Safety, Quality Improvement, Quality of Care, Patient-Centered Outcomes Research
Hu QL, Fischer CP, Wescott AB
Evidence review for the American College of Surgeons Quality Verification part I: building quality and safety resources and infrastructure.
The goal of this review was to synthesize the evidence supporting the first 4 of 12 American College of Surgeons (ACS) Quality Verification Program core principles of building quality and safety resources and infrastructure. Findings showed that, despite heterogeneous study design and lack of randomized controlled trials, the available literature supports the importance of committed top-level hospital leadership, mid-level leadership, and committee dedicated to surgical quality and culture of safety and high reliability. In conclusion, adequate resources and infrastructure integral to the ACS Quality Verification Program are critical to achieving safe and high-quality surgical outcomes.
AHRQ-funded; 233201500020I.
Citation: Hu QL, Fischer CP, Wescott AB .
Evidence review for the American College of Surgeons Quality Verification part I: building quality and safety resources and infrastructure.
J Am Coll Surg 2020 Nov;231(5):557-69.e1. doi: 10.1016/j.jamcollsurg.2020.08.758..
Keywords: Quality Improvement, Quality of Care, Patient Safety, Surgery, Evidence-Based Practice
Liu JY, Hu QL, Lamaina M
Surgical technical evidence review for acute cholecystectomy conducted for the Agency for Healthcare Research and Quality Safety Program for Improving Surgical Care and Recovery.
In this study, the authors identified 13 overall components to consider for a nonelective laparoscopic cholecystectomy for acute cholecystitis enhanced recovery pathways. They indicated that hospitals participating in AHRQ’s Safety Program for Improving Surgical Care and Recovery will be supported in carrying out practices that enhance care for patients and in gathering data to support continuous quality improvement around the enhanced recovery pathways.
AHRQ-funded; 233201500020I.
Citation: Liu JY, Hu QL, Lamaina M .
Surgical technical evidence review for acute cholecystectomy conducted for the Agency for Healthcare Research and Quality Safety Program for Improving Surgical Care and Recovery.
J Am Coll Surg 2020 Mar;230(3):354.e1. doi: 10.1016/j.jamcollsurg.2019.11.014..
Keywords: Surgery, Quality Improvement, Quality of Care, Patient Safety, Evidence-Based Practice
Grant MC, Gibbons MM, Ko CY
Evidence review conducted for the AHRQ Safety Program for Improving Surgical Care and Recovery: focus on anesthesiology for gynecologic surgery.
This paper is an evidence review of enhanced recovery after surgery (ERAS) protocols for gynecologic surgery that will be used as part of AHRQ’s Safety Program for Improving Surgical Care and Recovery. This initiative was developed in partnership with the American College of Surgeons and the Johns Hopkins Medicine Armstrong Institute for Patient Safety and Quality. The authors conducted a literature review of the various anesthesia components which may influence outcomes and facilitate recovery after gynecological surgery. They included interventions for preoperative, intraoperative, and postoperative phases of care and then summarized the best available evidence for ERAS for gynecological surgery. The best evidence was summarized for recommendations to be used in the initiative.
Citation: Grant MC, Gibbons MM, Ko CY .
Evidence review conducted for the AHRQ Safety Program for Improving Surgical Care and Recovery: focus on anesthesiology for gynecologic surgery.
AHRQ-funded; 233201500020I..
Keywords: Patient Safety, Surgery, Quality Improvement, Quality of Care, Evidence-Based Practice, Patient-Centered Outcomes Research, Women
Soffin EM, Gibbons MM, Wick EC
Evidence review conducted for the Agency for Healthcare Research and Quality Safety Program for I
This evidence review was conducted as part of AHRQ’s Safety Program for Improving Surgical Care and Recovery. An evidence review of interventions was conducted to create an enhanced recovery after surgery (ERAS) protocol for anesthesiology for hip fracture repair surgery. The researchers identified anesthesiology components of care and evaluated them across the perioperative continuum. They created ERAS protocols for the preoperative, intraoperative, and postoperative phases.
AHRQ-funded; 233201500020I.
Citation: Soffin EM, Gibbons MM, Wick EC .
Evidence review conducted for the Agency for Healthcare Research and Quality Safety Program for I
Anesth Analg 2019 Jun;128(6):1107-17. doi: 10.1213/ane.0000000000003925..
Keywords: Evidence-Based Practice, Patient-Centered Outcomes Research, Surgery, Orthopedics, Quality Improvement, Quality of Care, Outcomes, Care Management
Calderwood MS, Yokoe DS, Murphy MV
Effectiveness of a multistate quality improvement campaign in reducing risk of surgical site infections following hip and knee arthroplasty.
The authors assessed the effect of a multistate quality improvement campaign to promote the adoption of evidence-based surgical site infection (SSI) prevention practices. Rates of SSI among Medicare beneficiaries undergoing hip and knee arthroplasty during pre-intervention and post-intervention in five states included in a multistate trial of the Project JOINTS campaign and five matched comparison states were analyzed. The authors found a larger reduction of SSI rates following hip and knee arthroplasty in intervention states than in the matched control states.
AHRQ-funded; HS021424.
Citation: Calderwood MS, Yokoe DS, Murphy MV .
Effectiveness of a multistate quality improvement campaign in reducing risk of surgical site infections following hip and knee arthroplasty.
BMJ Qual Saf 2019 May;28(5):374-81. doi: 10.1136/bmjqs-2018-007982..
Keywords: Healthcare-Associated Infections (HAIs), Surgery, Orthopedics, Quality Improvement, Quality of Care, Evidence-Based Practice, Prevention, Patient Safety
Ban KA, Gibbons MM, Ko CY
Evidence review conducted for the Agency for Healthcare Research and Quality Safety Program for Improving
This evidence review was conducted for AHRQ in partnership with the American College of Surgeons and the Johns Hopkins Armstrong Institute for Patient Safety and Quality who have developed the Safety Program for Improving Surgical Care and Recovery (ISCR). This national effort will disseminate best practices in perioperative care to more than 750 hospitals across multiple procedures in the next 5 years. This evidence-based review is focused on improving patient safety of anesthesiology for colorectal (CR) surgery. Components reviewed included carbohydrate loading, reduced fasting, multimodal preanesthesia medicine, antibiotic prophylaxis, normothermia, blood transfusion, intraoperative fluid management/goal-directed fluid therapy, a standardized intraoperative anesthesia pathway, and standard postoperative multimodal analgesic regiments. The results of this review will be used to develop an evidence-based CR protocol for implementation.
AHRQ-funded; 233201500020I.
Citation: Ban KA, Gibbons MM, Ko CY .
Evidence review conducted for the Agency for Healthcare Research and Quality Safety Program for Improving
Anesth Analg 2019 May;128(5):879-89. doi: 10.1213/ane.0000000000003366..
Keywords: Evidence-Based Practice, Surgery, Quality Improvement, Quality of Care, Patient Safety, Patient-Centered Outcomes Research, Antibiotics, Medication, Medication: Safety
Soffin EM, Gibbons MM, Ko CY
Evidence review conducted for the Agency for Healthcare Research and Quality Safety program for improving surgical care and recovery: focus on anesthesiology for total hip arthroplasty.
Successes using enhanced recovery after surgery (ERAS) protocols for total hip arthroplasty (THA) are increasingly being reported. The Agency for Healthcare Research and Quality, in partnership with the American College of Surgeons and the Johns Hopkins Medicine Armstrong Institute for Patient Safety and Quality, has developed the Safety Program for Improving Surgical Care and Recovery. In this study, the investigators conducted an evidence review to select anesthetic interventions that positively influence outcomes and facilitate recovery after total hip arthroplasty (THA).
AHRQ-funded; 233201500020I.
Citation: Soffin EM, Gibbons MM, Ko CY .
Evidence review conducted for the Agency for Healthcare Research and Quality Safety program for improving surgical care and recovery: focus on anesthesiology for total hip arthroplasty.
Anesth Analg 2019 Mar;128(3):454-65. doi: 10.1213/ane.0000000000003663..
Keywords: Evidence-Based Practice, Patient-Centered Outcomes Research, Surgery, Patient Safety, Quality Improvement, Quality of Care
Hornor MA, Liu JY, Hu QL
Surgical technical evidence review for acute appendectomy conducted for the Agency for Healthcare Research and Quality Safety Program for Improving Surgical Care and Recovery.
This evidence review uses enhanced recovery pathways (ERPs) protocols developed for the AHRQ-funded Safety Program for Improving Surgical Care and Recovery (ISCR Program) to develop ERPs for acute appendectomy surgery. The authors classified appendicitis into uncomplicated (nonperforated) and complicated (perforated or gangrenous) to help with risk stratification. They identified 13 components for appendectomy for review. The processes are organized by perioperative phase, and each phase includes the rationale, evidence review, summary of guidelines, and a recommendation summary of the evidence for or against inclusion in the ERP. Preoperative management components included: education and counseling; preoperative antibiotics; initial nonsurgical management for perforated appendicitis with abscess or phlegmon, venous thromboembolism prophylaxis, delay for operation for 12-24 hours for uncomplicated appendicitis. Intraoperative management components include: laparoscopic surgical technique, peritoneal drain placement, urinary catheter placement, and prophylactic nasogastric tube insertion. Postoperative management components include same-day surgery discharge for uncomplicated appendicitis, antibiotics, early oral alimentation, and early mobilization. Of the ERPs reviewed: there was no evidence to support the routine use of abdominal drainage in patients undergoing appendectomies, urinary catheter insertion for laparoscopic surgery, use of prophylactic nasogastric tube placement, postoperative antibiotic use for uncomplicated appendicitis, and early oral alimentation for uncomplicated appendicitis.
AHRQ-funded.
Citation: Hornor MA, Liu JY, Hu QL .
Surgical technical evidence review for acute appendectomy conducted for the Agency for Healthcare Research and Quality Safety Program for Improving Surgical Care and Recovery.
J Am Coll Surg 2018 Dec;227(6):605-17.e2. doi: 10.1016/j.jamcollsurg.2018.09.024..
Keywords: Surgery, Quality Improvement, Quality of Care, Patient Safety, Evidence-Based Practice, Patient-Centered Outcomes Research, Outcomes
Childers CP, Siletz AE, Singer ES
Surgical technical evidence review for elective total joint replacement conducted for the AHRQ Safety Program for Improving Surgical Care and Recovery.
AHRQ, the American College of Surgeons, and the Johns Hopkins Medicine Armstrong Institute for Patent Safety and Quality have developed the Safety Program for Improving Surgical Care and Recovery - a national effort to catalyze implementation of practices to improve perioperative care and enhance recovery of surgical patients. This review synthesizes evidence that can be used to develop a protocol for elective total knee arthroplasty and total hip arthroplasty.
AHRQ-funded; 233201500020I.
Citation: Childers CP, Siletz AE, Singer ES .
Surgical technical evidence review for elective total joint replacement conducted for the AHRQ Safety Program for Improving Surgical Care and Recovery.
Geriatr Orthop Surg Rehabil 2018 Feb 12;9:2151458518754451. doi: 10.1177/2151458518754451.
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Keywords: Evidence-Based Practice, Orthopedics, Patient Safety, Surgery, Quality Improvement, Quality of Care, Patient-Centered Outcomes Research
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