National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Caregiving (1)
- Clinician-Patient Communication (2)
- Communication (2)
- Diagnostic Safety and Quality (1)
- Electronic Health Records (EHRs) (1)
- (-) Emergency Department (4)
- Health Information Technology (HIT) (2)
- Imaging (1)
- Kidney Disease and Health (1)
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- Patient and Family Engagement (1)
- (-) Shared Decision Making (4)
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 4 of 4 Research Studies DisplayedAronson PL, Schaeffer P, Niccolai LM
Parents' perspectives on communication and shared decision making for febrile infants ≤60 days old.
This study examined parents’ perceptions of receiving and understanding information in the emergency department (ED) and their perspectives on shared decision making (SDM) in the management of febrile infants 60 days of age or less. The authors conducted semistructured interviews with 23 parents of febrile infants ≤60 days old evaluated in the pediatric ED at an urban, academic medical center. Themes for parents’ perspectives on SDM included: 1) giving parents the opportunity to express their opinions and concerns builds confidence in the decision making process, 2) parents’ preferences for participation in decision making vary considerably, and 3) different perceptions about risk influence parents’ preferences about having their infant undergo a lumbar puncture (LP). Parents valued risk and benefits of having their infant undergo an LP differently, which influences their preferences.
AHRQ-funded; HS026006.
Citation: Aronson PL, Schaeffer P, Niccolai LM .
Parents' perspectives on communication and shared decision making for febrile infants ≤60 days old.
Pediatr Emerg Care 2021 Dec;37(12):e1213-e19. doi: 10.1097/pec.0000000000001977..
Keywords: Newborns/Infants, Clinician-Patient Communication, Communication, Shared Decision Making, Emergency Department
Chartash D, Sharifi M, Emerson B
Documentation of shared decisionmaking in the emergency department.
Patient-centered communication and shared decision making is a vital element of clinical practice, but little is known about its impact or value in the emergency department (ED) setting. The researchers of this study developed a natural language processing tool using regular expressions to identify shared decision making, patient-centered communications, and to describe visit-, site-, and temporal-level patterns within a large health system. The study took place in two parts: part 1 was the development and validation of the natural language processing tool, and part 2 was a retrospective analysis of shared decision making and patient discussion using the processing tool to assess ED physician and advanced practitioner documentation from 2013 to 2020. Compared to chart review of 600 ED notes, the accuracy rates of the natural language processing tool were 96.7% and 88.9% respectively. Between 2013 to 2020 the researchers observed greater likelihood of shared decision-making documentation among physicians vs advanced practice providers, higher likelihood among female vs male patients, and lower likelihood of shared decision-making in Black patients compared with White patients. The researchers also found that patient discussion and shared decision-making were associated with higher levels of commercial insurance status and level of triage. The study concluded that a natural language processing tool was developed, validated, and utilized to identify incidences of shared decision making from ED documentation, with the researchers finding multiple possible factors which contribute to variation in shared decision making.
AHRQ-funded; HS025701.
Citation: Chartash D, Sharifi M, Emerson B .
Documentation of shared decisionmaking in the emergency department.
Ann Emerg Med 2021 Nov;78(5):637-49. doi: 10.1016/j.annemergmed.2021.04.038..
Keywords: Shared Decision Making, Emergency Department, Patient-Centered Healthcare, Electronic Health Records (EHRs), Health Information Technology (HIT)
Schoenfeld EM, Poronsky KE, Westafer LM
Feasibility and efficacy of a decision aid for emergency department patients with suspected ureterolithiasis: protocol for an adaptive randomized controlled trial.
Both ultrasound and CT scan can be used for diagnosis of ureterolithiasis (or renal colic, the pain from an obstructing kidney stone), but the majority of patients receive a CT scan. Diagnostic pathways utilizing ultrasound have been shown to decrease radiation exposure to patients but are potentially less accurate. The investigators developed a decision aid to facilitate SDM in this scenario. The objective of this study was to determine the effects of this decision aid, as compared to usual care, on patient knowledge, radiation exposure, engagement, safety, and healthcare utilization.
AHRQ-funded; HS025701.
Citation: Schoenfeld EM, Poronsky KE, Westafer LM .
Feasibility and efficacy of a decision aid for emergency department patients with suspected ureterolithiasis: protocol for an adaptive randomized controlled trial.
Trials 2021 Mar 10;22(1):201. doi: 10.1186/s13063-021-05140-9..
Keywords: Emergency Department, Shared Decision Making, Kidney Disease and Health, Imaging, Diagnostic Safety and Quality
Aronson PL, Politi MC, Schaeffer P
Development of an app to facilitate communication and shared decision-making with parents of febrile infants ≤ 60 days old.
This study’s aim was to develop and test a tool to engage parents of febrile infants 60 days or less of age evaluated in the emergency department (ED). The tool was designed to improve communication between parents and healthcare providers and to support shared decision-making (SDM) about whether to perform a lumbar puncture (LP) for infants 29 to 60 days of age. The authors conducted a multi-phase development and testing process including individual, semi-structured interviews with parents and clinicians; design of a “storyboard” of the tool with design impression testing; development of a software application prototype called e-Care; and usability testing of e-Care using qualitative assessment and the System Usability Scale (SUS). The authors interviewed 27 parents and 23 clinicians. After the interviews, they developed separate versions of e-Care for infants aged 28 days or less and 29 to 60 days of age in both English and Spanish. e-Care is divided into 4 sections: 1) homepage; 2) why testing is done; 3) what tests are done; and 4) what happens after testing. The mean SUS score given by parents and clinicians was 90.3 representing “excellent” usability.
AHRQ-funded; HS026006.
Citation: Aronson PL, Politi MC, Schaeffer P .
Development of an app to facilitate communication and shared decision-making with parents of febrile infants ≤ 60 days old.
Acad Emerg Med 2021 Jan;28(1):46-59. doi: 10.1111/acem.14082..
Keywords: Clinician-Patient Communication, Communication, Newborns/Infants, Caregiving, Shared Decision Making, Patient and Family Engagement, Emergency Department, Health Information Technology (HIT)