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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.
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1 to 6 of 6 Research Studies DisplayedAlagoz E, Saucke M, Arroyo N
Communication during interhospital transfers of emergency general surgery patients: a qualitative study of challenges and opportunities.
This study’s objective was to understand the nature of and challenges to communication between referring (RP) and accepting (AP) providers transferring emergency general surgery (EGS) patients from the transfer center nurse’s (TCN) perspective. Worse outcomes have been shown to be experienced by transferred EGS patients than directly admitted patients. The authors interviewed 17 transfer center nurses (TCNs) at an academic medical center regarding (in)efficient and (in)effective communication between RPs and APs. The in-person interviews were recorded, transcribed and managed in NVivo. Four researchers developed a codebook, which was then co-coded with the transcripts. A consensus was developed to discuss emergency themes and arrive at higher-level concepts. Issues relating to ineffective communication included RPs that provided incomplete information because of a lack of necessary infrastructure, personnel, or technical knowledge; competing clinical demands; or a fear of the transfer request being rejected. Inefficient communication resulted from RPs being unfamiliar with the information APs expected and the lack of a structured process to share information and communication also failed when providers disagreed about the necessity of the transfer.
AHRQ-funded; HS025224.
Citation: Alagoz E, Saucke M, Arroyo N .
Communication during interhospital transfers of emergency general surgery patients: a qualitative study of challenges and opportunities.
J Patient Saf 2022 Oct 1;18(7):711-16. doi: 10.1097/pts.0000000000000979..
Keywords: Care Coordination, Communication, Transitions of Care, Surgery
Berry JG, Glaspy T, Eagan B
Pediatric complex care and surgery comanagement: preparation for spinal fusion.
This study assessed the impact of preoperative comanagement with complex care pediatricians (CCP) on children with neuromuscular scoliosis undergoing spinal fusion surgery. A chart review of 79 children aged 5-21 years undergoing spinal fusion Jan. 2014-June 2016 was conducted at a children’s hospital. Cerebral palsy (64%) was the most common neuromuscular condition with the mean age of surgery of 14 years. Thirty-nine children had a preoperative CCP evaluation a median 63 days before the preanesthesia visit. More organ systems were affected by coexisting conditions in children with CCP evaluation than those without an evaluation. The rate of last-minute care coordination activities required for surgical clearance as well as last-minute development of new preoperative plans were lower for children with CCP evaluation than those without.
AHRQ-funded; HS024453.
Citation: Berry JG, Glaspy T, Eagan B .
Pediatric complex care and surgery comanagement: preparation for spinal fusion.
J Child Health Care 2020 Sep;24(3):402-10. doi: 10.1177/1367493519864741..
Keywords: Children/Adolescents, Surgery, Care Management, Care Coordination
Lin SC, Regenbogen SE, Hollingsworth JM
Coordination of care around surgery for colon cancer: insights from national patterns of physician encounters with Medicare beneficiaries.
This study researched the coordination of care before and after surgery for colon cancer patients using data from Medicare A and B records. There were quite a number of different combinations of care providers both preoperative and postoperative. Larger urban teaching hospitals had the most combinations in all phases.
AHRQ-funded; HS024525; HS024728.
Citation: Lin SC, Regenbogen SE, Hollingsworth JM .
Coordination of care around surgery for colon cancer: insights from national patterns of physician encounters with Medicare beneficiaries.
J Oncol Pract 2019 Feb;15(2):e110-e21. doi: 10.1200/jop.18.00228..
Keywords: Cancer, Cancer: Colorectal Cancer, Care Coordination, Medicare, Surgery
Everson J, Funk RJ, Kaufman SR
Repeated, close physician coronary artery bypass grafting teams associated with greater teamwork.
This study sought to determine whether observed patterns of physician interaction around shared patients are associated with higher levels of teamwork as perceived by physicians. It found that in hospitals where physicians repeatedly cared for patients with the same colleagues, physicians perceived better teamwork. When physicians who worked together also had other colleagues in common, the reported teamwork was stronger.
AHRQ-funded; HS024525; HS024728.
Citation: Everson J, Funk RJ, Kaufman SR .
Repeated, close physician coronary artery bypass grafting teams associated with greater teamwork.
Health Serv Res 2018 Apr;53(2):1025-41. doi: 10.1111/1475-6773.12703.
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Keywords: Cardiovascular Conditions, Care Coordination, Communication, Surgery, Teams
Weinger MB, Slagle JM, Kuntz AH
A multimodal intervention improves postanesthesia care unit handovers.
The researchers introduced a multimodal intervention in an adult and a pediatric postanesthesia care unit (PACU) to improve postoperative handovers between anesthesia providers (APs) and PACU registered nurses (RNs). They concluded that a multimodal intervention substantially improved interprofessional PACU handovers, including those by clinicians who had not undergone formal simulation training.
AHRQ-funded; HS016651.
Citation: Weinger MB, Slagle JM, Kuntz AH .
A multimodal intervention improves postanesthesia care unit handovers.
Anesth Analg 2015 Oct;121(4):957-71. doi: 10.1213/ane.0000000000000670..
Keywords: Patient Safety, Care Coordination, Surgery
McElroy LM, Macapagal KR, Collins KM
Clinician perceptions of operating room to intensive care unit handoffs and implications for patient safety: a qualitative study.
The goal of this study is to use qualitative research methods to describe clinician perceptions of OR-to-ICU handoffs, and to elucidate attributes of the handoff process associated with high quality, as well as those with poor quality that can lead to patient harm. The findings suggest that ambiguous roles and conflicting expectations of team members during the OR-to-ICU handoff can increase risk of patient harm.
AHRQ-funded; HS000078.
Citation: McElroy LM, Macapagal KR, Collins KM .
Clinician perceptions of operating room to intensive care unit handoffs and implications for patient safety: a qualitative study.
Am J Surg 2015 Oct;210(4):629-35. doi: 10.1016/j.amjsurg.2015.05.008..
Keywords: Patient Safety, Intensive Care Unit (ICU), Surgery, Adverse Events, Care Coordination