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AHRQ Research Studies Date
Topics
- Adverse Events (1)
- Ambulatory Care and Surgery (1)
- Cancer (1)
- Cancer: Colorectal Cancer (1)
- (-) Care Coordination (17)
- Care Management (1)
- Case Study (1)
- Chronic Conditions (1)
- Communication (4)
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- Elderly (1)
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- Hospital Discharge (3)
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- Intensive Care Unit (ICU) (1)
- Medical Errors (1)
- Medicare (1)
- Patient-Centered Healthcare (3)
- Patient-Centered Outcomes Research (1)
- Patient Safety (3)
- Policy (1)
- Primary Care (5)
- Provider: Health Personnel (1)
- Public Health (1)
- Surgery (3)
- Transitions of Care (5)
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 17 of 17 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
Norton JM, Ip A, Ruggiano N
AHRQ Author: Camara DS, Hsiao CJ, Bierman AS
Assessing progress toward the vision of a comprehensive, shared electronic care plan: scoping review.
People with multiple chronic conditions often receive care from a broad array of clinicians across multiple health care settings, making it difficult to share care plans between those facilities and providers. One method for possibly improving care for those individuals is through the development and use of comprehensive, shared, electronic care (e-care) plans. The purpose of the study was to review existing e-care plans and related initiatives that could be utilized to develop a comprehensive, shared e-care plan, and facilitate the National Institutes of Health and Agency for Healthcare Research and Quality joint initiative’s creation of e-care planning tools for people with multiple chronic conditions. The researchers conducted a review of literature from 2015-2020, as well as interviews of expert informants to identify information missing from the literature search. The study identified 7 different interventions for e-care plans and 3 different projects for health care data standards, all of which included elements which could be utilized to further the goals of developing a comprehensive, shared e-care plan. The study concluded that while none of the existing interventions met all the optimal e-care plan criteria for people with multiple chronic conditions, each plan included the infrastructure necessary to progress toward that goal. The researchers reported that gaps must first be addressed, but that a comprehensive, shared e-care plan can improve care coordination across multiple care settings and clinicians.
AHRQ-authored.
Citation: Norton JM, Ip A, Ruggiano N .
Assessing progress toward the vision of a comprehensive, shared electronic care plan: scoping review.
J Med Internet Res 2022 Jun 10;24(6):e36569. doi: 10.2196/36569..
Keywords: Chronic Conditions, Care Coordination, Electronic Health Records (EHRs), Health Information Technology (HIT), Healthcare Delivery, Health Information Exchange (HIE)
Valley TS, Schutz A, Peltan ID
Organization of outpatient care after COVID-19 hospitalization.
The purpose of this study was to describe post-discharge care delivery for patients with postacute sequelae of COVID-19 (PASC) across a large network of US academic and community hospitals. Beginning in July, 2021, the researchers surveyed 47 hospitals which were participating in the National Heart, Lung, and Blood Institute Clinical Trials Network for the Prevention and Early Treatment of Acute Lung Injury (PETAL Network.) Surveys were completed by physicians, hospital administrators, social workers, research staff or other clinicians over an 8-week period, and data from the 2019 American Hospital Association annual survey database were used to describe the hospitals. The study found that 79% (37) of the responding hospitals provided COVID-specific discharge information to patients hospitalized with COVID-19. Only 26% of hospitals provided discharge information that included potential symptoms or impairments of postacute sequelae of COVID-19. Seventy percent (33) had a PASC clinic (a postdischarge outpatient clinic designed specifically for patients with COVID). Hospitals without PASC clinics were more likely to be located in a ZIP code with a higher Medicare population and a median annual income lower than $40,000, and were also more likely to be smaller, for-profit hospitals. The researchers identified several core areas for possible improvements in PASC care, including: examining the impact of PASC clinics on patient outcomes; assessing the extent to which the pathophysiology and management of PASC differ from sequelae of other infections and syndromes; and exploring whether an inability to systematically identify patients for PASC care may result in an inability for some patients to receive needed care. The researchers concluded that PASC clinics may offer opportunities to coordinate care and serve as an opportunity for making iterative gains in knowledge about PASC clinics and related models and processes and their effectiveness in improving longer-term patient-centered outcomes for survivors of COVID-19.
AHRQ-funded; HS028038.
Citation: Valley TS, Schutz A, Peltan ID .
Organization of outpatient care after COVID-19 hospitalization.
Chest 2022 Jun;161(6):1485-89. doi: 10.1016/j.chest.2022.01.034..
Keywords: COVID-19, Ambulatory Care and Surgery, Hospitalization, Care Coordination, Healthcare Delivery
Usher MC, Tignanelli CJ, Hilliard B
Responding to COVID-19 through interhospital resource coordination: a mixed-methods evaluation
Researchers sought to describe a novel hospital system approach to managing the COVID-19 pandemic, including multihospital coordination capability and transfer of COVID-19 patients to a single, dedicated hospital. They found that, with standardized communication, interhospital transfers were a safe and effective method of cohorting COVID-19 patients, were well-received by health care providers, and had the potential to improve care quality.
AHRQ-funded; HS026379; HS026732.
Citation: Usher MC, Tignanelli CJ, Hilliard B .
Responding to COVID-19 through interhospital resource coordination: a mixed-methods evaluation
J Patient Saf 2022 Jun 1;18(4):287-94. doi: 10.1097/pts.0000000000000916..
Keywords: COVID-19, Hospitals, Healthcare Delivery, Public Health, Care Coordination, Transitions of Care
Everson J, Adler-Milstein JR, Hollingsworth JM
Dispersion in the hospital network of shared patients is associated with less efficient care.
The purpose of this study was to examine the level of distribution of patient-sharing networks across U.S. hospitals and its relationship with 3 measures of care delivered by hospitals that were likely to relate to coordination. The researchers utilized data from 2016 Medicare Fee-for-Service claims to measure the volume of patients that hospitals treated in common, and then calculated a measure of dispersion for each hospital. The relationship between network dispersion, Medicare spending per beneficiary, readmission rates, and emergency department (ED) throughput rates were then estimated. The study reported that hospitals with more dispersed networks had greater spending rates but not higher admission rates or slower ED processes. Among hospitals with less resources, more dispersion was associated with higher readmission rates and slower ED processes. The researchers concluded that dispersed interhospital networks create difficulties in coordinating patients who are treated at multiple hospitals, and that the structure of patient-sharing networks may be an overlooked factor that influences the delivery of care in health care organizations.
AHRQ-funded; HS026395, HS024525, HS024728, HS024454.
Citation: Everson J, Adler-Milstein JR, Hollingsworth JM .
Dispersion in the hospital network of shared patients is associated with less efficient care.
Health Care Manage Rev 2022 Apr-Jun;47(2):88-99. doi: 10.1097/hmr.0000000000000295..
Keywords: Medicare, Hospitals, Care Coordination, Healthcare Delivery
Ahern J, Singer S, Bhanja A
Considering dentists within the healthcare team: a cross-sectional, multi-state analysis of primary care provider and staff perspectives.
The authors used novel survey data to examine the extent to which primary care providers, other providers, and staff consider dentists part of the healthcare team, and assessed associated practice and individual characteristics. Their findings indicated that dentists are frequently not considered part of the healthcare team in primary care settings. Further, varied responses within practices suggested that provider and staff perceptions may pose challenges to integrating dentists into primary care. Respondents in practices with more integrated diabetes care management processes were more likely to consider dentists as part of the healthcare team, reflecting dental care recommendations made by the American Diabetes Association.
AHRQ-funded; HS024067.
Citation: Ahern J, Singer S, Bhanja A .
Considering dentists within the healthcare team: a cross-sectional, multi-state analysis of primary care provider and staff perspectives.
J Gen Intern Med 2022 Jan;37(1):246-48. doi: 10.1007/s11606-020-06564-w..
Keywords: Primary Care, Provider: Health Personnel, Patient-Centered Healthcare, Care Coordination
El-Shami K, Oeffinger KC, Erb NL
American Cancer Society colorectal cancer survivorship care guidelines.
Communication and coordination of care between the treating oncologist and the primary care clinician is critical to effectively and efficiently manage the long-term care of colorectal cancer (CRC) survivors. The guidelines in this article are intended to assist primary care clinicians in delivering risk-based health care for CRC survivors who have completed active therapy.
AHRQ-funded; HS020937.
Citation: El-Shami K, Oeffinger KC, Erb NL .
American Cancer Society colorectal cancer survivorship care guidelines.
CA Cancer J Clin 2015 Nov-Dec;65(6):428-55. doi: 10.3322/caac.21286.
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Keywords: Cancer, Cancer: Colorectal Cancer, Care Coordination, Guidelines, Primary Care
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
Rosenbluth G, Bale JF, Starmer AJ
Variation in printed handoff documents: results and recommendations from a multicenter needs assessment.
The objective of this study was to determine whether variability exists in the content of printed handoff documents and to identify key data elements that should be uniformly included in these documents. It identified substantial variation in both the structure and content of printed handoff documents. Only 4 of 23 possible data elements (17 percent) were uniformly present in all sites’ handoff documents.
AHRQ-funded; HS019456.
Citation: Rosenbluth G, Bale JF, Starmer AJ .
Variation in printed handoff documents: results and recommendations from a multicenter needs assessment.
J Hosp Med 2015 Aug;10(8):517-24. doi: 10.1002/jhm.2380..
Keywords: Patient Safety, Medical Errors, Communication, Comparative Effectiveness, Care Coordination
Van Cleave J, Boudreau AA, McAllister J
Care coordination over time in medical homes for children with special health care needs.
This study explored how care coordination changes conceptually and practically in primary care practices when implementing the medical home and to identify reasons for different types of changes. They found that in high-performing medical homes, care coordination activities changed from being mostly reactive to patients’ episodic needs to being more systematically proactive and comprehensive.
AHRQ-funded; HS019157.
Citation: Van Cleave J, Boudreau AA, McAllister J .
Care coordination over time in medical homes for children with special health care needs.
Pediatrics 2015 Jun;135(6):1018-26. doi: 10.1542/peds.2014-1067..
Keywords: Care Coordination, Care Management, Patient-Centered Healthcare, Primary Care
Jones CD, Vu MB, O'Donnell CM
A failure to communicate: a qualitative exploration of care coordination between hospitalists and primary care providers around patient hospitalizations.
The purpose of this study was to understand the challenges in coordination of care, as well as potential solutions, from the perspective of hospitalists and PCPs in North Carolina. Hospitalists and PCPs were found to encounter similar care coordination challenges, including (1) lack of time, (2) difficulty reaching other clinicians, and (3) lack of personal relationships with other clinicians.
AHRQ-funded; HS020940.
Citation: Jones CD, Vu MB, O'Donnell CM .
A failure to communicate: a qualitative exploration of care coordination between hospitalists and primary care providers around patient hospitalizations.
J Gen Intern Med 2015 Apr;30(4):417-24. doi: 10.1007/s11606-014-3056-x..
Keywords: Care Coordination, Communication, Hospital Discharge, Hospitalization, Primary Care
Brennan PF, Valdez R, Alexander G
Patient-centered care, collaboration, communication, and coordination: a report from AMIA's 2013 Policy Meeting.
AMIA’s 2013 Health Policy Invitational was focused on examining existing challenges surrounding full engagement of the patient and crafting a research agenda and policy framework encouraging the use of informatics solutions to achieve this goal. This paper summarizes the meeting as well as the research agenda and policy recommendations prioritized among the invited experts and stakeholders.
AHRQ-funded; HS021825.
Citation: Brennan PF, Valdez R, Alexander G .
Patient-centered care, collaboration, communication, and coordination: a report from AMIA's 2013 Policy Meeting.
J Am Med Inform Assoc 2015 Apr;22(e1):e2-6. doi: 10.1136/amiajnl-2014-003176..
Keywords: Care Coordination, Communication, Electronic Health Records (EHRs), Health Information Technology (HIT), Patient-Centered Healthcare, Policy
Hilligoss B, Vogus TJ
Navigating care transitions: a process model of how doctors overcome organizational barriers and create awareness.
Using interviews and observations of doctors, the researchers examined transitions from an emergency department to inpatient units through a 2-year study of an academic medical center. They describe and document 3 challenges to between-unit transitions of care and identify the adaptive workarounds that doctors employ to resolve these challenges, thus addressing a significant gap in the literature on high-reliability healthcare organizations.
AHRQ-funded; HS018758
Citation: Hilligoss B, Vogus TJ .
Navigating care transitions: a process model of how doctors overcome organizational barriers and create awareness.
Med Care Res Rev. 2015 Feb;72(1):25-48. doi: 10.1177/1077558714563170..
Keywords: Transitions of Care, Emergency Department, Hospitalization, Care Coordination
Hsiao CJ, King J, Hing E
AHRQ Author: Hsiao CJ
The role of health information technology in care coordination in the United States.
This study used 2012 national data to explore the extent to which office-based physicians in the United States receive patient health information (electronically or non-electronically) needed to coordinate care with providers outside their practice, as well as with hospitals. It found that a higher percentage of physicians using health information technology (HIT) received patient information necessary for care coordination than those who did not use HIT.
AHRQ-authored.
Citation: Hsiao CJ, King J, Hing E .
The role of health information technology in care coordination in the United States.
Med Care. 2015 Feb;53(2):184-90. doi: 10.1097/mlr.0000000000000276..
Keywords: Health Information Technology (HIT), Care Coordination, Primary Care, Hospitals
Dy SM, Ashok M, Wines RC
A framework to guide implementation research for care transitions interventions.
The authors described a framework for evaluating implementation of hospital to ambulatory care transitions interventions and application to a case study. They adapted the general Consolidated Framework for Implementation Research, adding elements relevant to other complex interventions, such as conceptualization around organizations and around patient- and caregiver-centeredness.
AHRQ-funded; 290200710056I.
Citation: Dy SM, Ashok M, Wines RC .
A framework to guide implementation research for care transitions interventions.
J Healthc Qual 2015 Jan-Feb;37(1):41-54. doi: 10.1097/01.JHQ.0000460121.06309.f9.
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Keywords: Care Coordination, Case Study, Hospital Discharge, Patient-Centered Outcomes Research, Transitions of Care
Nasarwanji N, Werner NE, Carl K
Identifying challenges associated with the care transition workflow from hospital to skilled home health care: perspectives of home health care agency providers.
The authors studied the workflow for transitioning older adults from the hospital to skilled home health care (SHHC). They found three overarching challenges to optimal care transitions: information access, coordination, and communication/teamwork. They recommended that future investigations test whether redesigning the transition from hospital to SHHC improves workflow and care quality.
AHRQ-funded; HS022916.
Citation: Nasarwanji N, Werner NE, Carl K .
Identifying challenges associated with the care transition workflow from hospital to skilled home health care: perspectives of home health care agency providers.
Home Health Care Serv Q 2015;34(3-4):185-203. doi: 10.1080/01621424.2015.1092908.
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Keywords: Care Coordination, Elderly, Home Healthcare, Hospital Discharge, Transitions of Care