National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
Data
- Data Infographics
- Data Visualizations
- Data Tools
- Data Innovations
- All-Payer Claims Database
- Healthcare Cost and Utilization Project (HCUP)
- Medical Expenditure Panel Survey (MEPS)
- AHRQ Quality Indicator Tools for Data Analytics
- State Snapshots
- United States Health Information Knowledgebase (USHIK)
- Data Sources Available from AHRQ
Search All Research Studies
AHRQ Research Studies Date
Topics
- Adverse Events (1)
- Alcohol Use (1)
- Asthma (2)
- Behavioral Health (1)
- Cancer (2)
- Cancer: Breast Cancer (1)
- Cancer: Prostate Cancer (1)
- Care Coordination (2)
- Caregiving (4)
- Children/Adolescents (6)
- Chronic Conditions (2)
- (-) Clinician-Patient Communication (43)
- Communication (24)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (2)
- COVID-19 (1)
- Critical Care (1)
- Cultural Competence (2)
- Diagnostic Safety and Quality (1)
- Digestive Disease and Health (1)
- Disparities (1)
- Education: Continuing Medical Education (1)
- Education: Patient and Caregiver (2)
- Elderly (2)
- Electronic Health Records (EHRs) (4)
- Emergency Department (3)
- Evidence-Based Practice (1)
- Healthcare Costs (1)
- Healthcare Delivery (1)
- Health Information Technology (HIT) (8)
- Health Literacy (2)
- Hospital Discharge (2)
- Hospitalization (2)
- Hospitals (2)
- Infectious Diseases (1)
- Inpatient Care (2)
- Maternal Care (1)
- Medical Errors (1)
- Newborns/Infants (1)
- Nursing Homes (1)
- Nutrition (1)
- Obesity (2)
- Obesity: Weight Management (2)
- Palliative Care (1)
- Patient-Centered Healthcare (5)
- Patient and Family Engagement (15)
- Patient Experience (9)
- Patient Safety (2)
- Patient Self-Management (2)
- Policy (2)
- Primary Care (1)
- Provider: Clinician (1)
- Provider: Health Personnel (1)
- Provider: Nurse (1)
- Provider: Physician (1)
- Provider Performance (1)
- Racial and Ethnic Minorities (2)
- Shared Decision Making (15)
- Social Media (1)
- Substance Abuse (1)
- Surgery (2)
- Telehealth (2)
- Training (1)
- Transitions of Care (1)
- Vaccination (1)
- Web-Based (3)
- Women (1)
- Young Adults (1)
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 43 Research Studies DisplayedBuchanan CL, Morris MA, Matlock D
Parental experience and understanding of parent-provider discussions of treatment for infants with ureteropelvic junction obstruction.
The objective of this study was to understand what families perceive as necessary information to guide decisionmaking in the treatment of children with ureteropelvic junction obstruction (UPJO). The authors conducted semi-structured interviews with parents of children with UPJO. Their findings were organized into three major themes: barriers to meaningful participation in decisionmaking, logistical aspects, and psychosocial aspects. They concluded that these results highlighted the importance of caregivers needing clear and accurate information to engage in meaningful discussions related to surgical decisionmaking regarding UPJO treatment. They recommended patient education and enhanced psychosocial support for more meaningful parental engagement in the surgical decisionmaking process.
AHRQ-funded; HS024597.
Citation: Buchanan CL, Morris MA, Matlock D .
Parental experience and understanding of parent-provider discussions of treatment for infants with ureteropelvic junction obstruction.
PEC Innov 2023 Dec; 2:100142. doi: 10.1016/j.pecinn.2023.100142..
Keywords: Newborns/Infants, Patient Experience, Shared Decision Making, Patient and Family Engagement, Clinician-Patient Communication
DiMeo A, Karlage A, Schoenherr K
Cultural brokering in pregnancy care: a critical review.
This study is a literature review of cultural brokering during pregnancy. The authors identified 33 articles in their literature search. They found that cultural brokering is not clearly defined in the current literature. Only a few articles provided information about language concordance between cultural brokers and patients or clinicians, with no articles describing the impact of cultural brokering on health outcomes. Cultural broker facilitating was described as providing information about language concordance between cultural brokers and patients or clinicians. Barriers included misunderstanding the responsibilities, difficulty maintaining personal boundaries, and limited availability and accessibility of cultural brokers. They propose cultural brokering as interactions that cover four key aims: (1) language support; (2) bridging cultural differences; (3) social support and advocacy; and (4) navigation of the healthcare system.
AHRQ-funded; HS026370.
Citation: DiMeo A, Karlage A, Schoenherr K .
Cultural brokering in pregnancy care: a critical review.
Int J Gynaecol Obstet 2023 Nov; 163(2):357-66. doi: 10.1002/ijgo.15063..
Keywords: Maternal Care, Women, Clinician-Patient Communication, Cultural Competence
Steitz BD, Padi-Adjirackor NA, Griffith KN
Impact of notification policy on patient-before-clinician review of immediately released test results.
The 21st Century Cures Act requires that test results be made available immediately upon request. Not all organizations send notifications when those results become available. The purpose of this study was to measure the effect of notification policies on rates of patient-before-clinician result review and patient-initiated messaging. The researchers implemented 2 policies, immediate notifications for all results, and notifications only to patients who opted in to the system. In the group with immediate notification of test results, the ratio of patient-before-clinician review rose 4-fold and the ratio of patients who sent messages increased 3%. After transition to opt-in notifications, patient-before-clinician review decreased 2.4% and patient-initiated messaging decreased 0.4%.
AHRQ-funded; HS026395.
Citation: Steitz BD, Padi-Adjirackor NA, Griffith KN .
Impact of notification policy on patient-before-clinician review of immediately released test results.
J Am Med Inform Assoc 2023 Sep 25; 30(10):1707-10. doi: 10.1093/jamia/ocad126..
Keywords: Policy, Clinician-Patient Communication
Hays RD, Walling AM, Sudore RL
Support for use of Consumer Assessment of Healthcare Providers and Systems communication items among seriously ill patients.
High-quality doctor-patient communication is essential for patients with serious illnesses. The purpose of this study was to assess the reliability and validity of Consumer Assessment of Healthcare Providers and Systems (CAHPS(®)) communication items among patients with serious illnesses. The study found that Eigenvalues and internal consistency reliability supported a 5-item communication scale. Item characteristic curves revealed a monotonic relationship of response options with the communication score. Item thresholds indicated that most patients reported positive patient experiences, and item slopes confirmed that all items were strongly related to the communication score. Reliability of the communication scale was higher for assessing patients with negative experiences of care than for the positive end of the spectrum. Communication was positively correlated with confidence in other's knowledge of ACP medical wishes, ACP engagement, and confidence in filling out ACP-related medical forms.
AHRQ-funded; HS029321.
Citation: Hays RD, Walling AM, Sudore RL .
Support for use of Consumer Assessment of Healthcare Providers and Systems communication items among seriously ill patients.
J Palliat Med 2023 Sep; 26(9):1234-39. doi: 10.1089/jpm.2022.0572..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Clinician-Patient Communication, Communication, Provider: Health Personnel
Rankine J, Kidd KM, Sequeira GM
Adolescent perspectives on the use of telemedicine for confidential health care: an exploratory mixed-methods study.
Gender-diverse youth (GDY) may benefit from telemedicine access but may have unique confidentiality issues; this article examined adolescents' perceived acceptability, preferences, and self-efficacy related to the use of telemedicine for confidential care. Participants included GDY and cisgender females aged 12 to 17 who were surveyed following a telemedicine visit with an adolescent medicine subspecialist. Results indicated that adolescents were interested in using telemedicine for confidential care but recognized threats to confidentiality. The authors concluded that clinicians and health systems should consider youth's preferences and unique confidentiality needs to ensure equitable access, uptake, and outcomes.
AHRQ-funded; HS026393.
Citation: Rankine J, Kidd KM, Sequeira GM .
Adolescent perspectives on the use of telemedicine for confidential health care: an exploratory mixed-methods study.
J Adolesc Health 2023 Aug; 73(2):360-66. doi: 10.1016/j.jadohealth.2023.04.005..
Keywords: Clinician-Patient Communication, Communication
Cho Y, Yang R, Gong Y
Use of electronic communication with clinicians among cancer survivors: Health Information National Trend Survey in 2019 and 2020.
This study’s objective was to describe cancer survivors' use of electronic communication (e-communication) with clinicians and identify factors associated with their use, including the COVID-19 pandemic. The authors conducted a secondary analysis of cancer survivors (N = 1,482) from the combined Health Information National Trends Survey HINTS 5 Cycle 3 and Cycle 4. Survivors' use of e-communication was defined by at least one of four e-communication use behaviors in the previous 12 months. Cancer survivors had a 64% prevalence of e-communication use, with older adults (≥65 years old) were less likely to use e-communication. Survivors who were white, living in a metro area, diagnosed with breast cancer, seeking cancer-related information previously, or having a regular health care provider were more likely to use e-communication. The start of the COVID-19 pandemic was marginally associated with the increased e-communication use when other variables were controlled.
AHRQ-funded; HS027846.
Citation: Cho Y, Yang R, Gong Y .
Use of electronic communication with clinicians among cancer survivors: Health Information National Trend Survey in 2019 and 2020.
Telemed J E Health 2023 Jun; 29(6):866-74. doi: 10.1089/tmj.2022.0203..
Keywords: Clinician-Patient Communication, Communication, Cancer, Telehealth, Health Information Technology (HIT)
Alexandre W, Muhammad H, Agbalajobi O
Alcohol treatment discussions and clinical outcomes among patients with alcohol-related cirrhosis.
The purpose of this study was to investigate the relationships between medical dialogues concerning alcohol use disorder (AUD) treatment, AUD treatment engagement, and mortality rates. The retrospective cohort study encompassed all patients diagnosed with cirrhosis and AUD receiving hepatology care within a single healthcare system in 2015. Baseline data on demographics, medical history, liver disease, and AUD treatment were examined. Information on AUD treatment discussions, initiation, alcohol cessation, and the subsequent 5-year mortality rates was gathered. Out of 436 patients with alcohol-related cirrhosis, 15% received AUD treatment at baseline, with 11% undergoing behavioral therapy, 2% receiving pharmacotherapy, and 1% obtaining both. Within the first year after the initial hepatology visit, 37 patients had AUD treatment, 51 remained in treatment, and 14 discontinued. Hepatology-documented AUD treatment recommendations were provided to 30% of patients, while 26% received primary care-documented recommendations. The majority of hepatology (86%) and primary care (88%) recommendations focused on behavioral therapy. Among patients with persistent alcohol use at baseline, AUD treatment after one year was significantly and independently associated with hepatology or primary care treatment discussions, and negatively associated with Medicaid insurance. When treatment discussions occurred in both settings, high treatment rates followed. Over five years, 35% of patients died. Ongoing alcohol use, age, hepatic decompensation, and hepatocellular carcinoma significantly contributed to mortality in the final survival model. In patients with alcohol-related cirrhosis, AUD treatment discussions were documented in fewer than half of hepatology and primary care encounters; however, such discussions were significantly correlated with AUD treatment receipt.
AHRQ-funded; HS019461.
Citation: Alexandre W, Muhammad H, Agbalajobi O .
Alcohol treatment discussions and clinical outcomes among patients with alcohol-related cirrhosis.
BMC Gastroenterol 2023 Feb 2; 23(1):29. doi: 10.1186/s12876-023-02656-z..
Keywords: Alcohol Use, Substance Abuse, Behavioral Health, Clinician-Patient Communication, Communication
Hsueh L, Huang J, Millman AK
Cross-sectional association of patient language and patient-provider language concordance with video telemedicine use among patients with limited English proficiency.
The surge in telemedicine use during the COVID-19 pandemic underscores the need to address gaps in patient care, particularly for individuals with limited English proficiency. The purpose of this study was to investigate the relationship between patient language, patient-provider language alignment, and the type of telemedicine visit (video or phone consultation). The researchers conducted a cross-sectional analysis using automated data from primary care telemedicine appointments scheduled between March 16, 2020, and October 31, 2020 within a comprehensive healthcare delivery system in Northern California. A total of 22,427 completed primary care telemedicine visits booked by 13,764 patients with limited English proficiency through the patient portal. The study examined the cross-sectional link between electronic health record-documented patient language (with Spanish as the reference) and patient-provider language concordance, considering patient demographics, technology access, and technology familiarity. RESULTS: The study found that among all scheduled appointments, 34.5% (n=7747) were video consultations. The three most common patient languages were Spanish (42.4%), Cantonese (16.9%), and Mandarin (10.3%). After adjusting for demographic and technology factors, video visit usage was higher for patients speaking Cantonese, Mandarin, or Vietnamese, compared to Spanish-speaking patients, but lower for those who spoke Punjabi. Language concordance was linked to decreased video visit utilization and influenced the relationship between speaking Spanish, Cantonese, and Korean with video visit usage. Furthermore, for all language groups, patients with prior video visit experience were more likely to use video visits again.
AHRQ-funded; HS025189
Citation: Hsueh L, Huang J, Millman AK .
Cross-sectional association of patient language and patient-provider language concordance with video telemedicine use among patients with limited English proficiency.
J Gen Intern Med 2023 Feb;38(3):633-40. doi: 10.1007/s11606-022-07887-6.
Keywords: Telehealth, Health Information Technology (HIT), Cultural Competence, Clinician-Patient Communication, Communication, Healthcare Delivery, COVID-19
Kim KM, Giannitrapani KF, Garcia A
Patient characteristics associated with occurrence of preoperative goals-of-care conversations.
This study’s goal was to evaluate the association between patient risk of hospitalization or death and goals-of-care conversations documented with a completed Life-Sustaining Treatment (LST) Decisions Initiative note among veterans undergoing surgery. This retrospective cross-sectional study included 190,040 veterans who underwent operations between January 2017 and February 2020. The main outcome looked at was preoperative LST note completion (30 days before or on the day of surgery) or no LST note completion within the 30-day preoperative period prior to or on the day of the index operation. Of 190,040 veterans (90.8% men), 3.8% completed an LST note before surgery, and 96.2% did not complete an LST note. In the groups with and without LST note completion before surgery, most were aged between 65 and 84 years, male, and Whites. Compared with patients who completed an LST, patients who did not tended to be female, married, Black, and in better health; to have a lower risk of hospitalization or death; or to undergo neurosurgical or urologic surgical procedures. Over the 3-year study interval, unadjusted rates of LST note completion before surgery increased from 0.1% to 9.6%. High-risk surgery was not associated with increased LST note completion before surgery. Veterans who underwent cardiothoracic surgery had the highest likelihood of LST note completion before surgery.
AHRQ-funded; F32 HS028747.
Citation: Kim KM, Giannitrapani KF, Garcia A .
Patient characteristics associated with occurrence of preoperative goals-of-care conversations.
JAMA Netw Open 2023 Feb;6(2):e2255407. doi: 10.1001/jamanetworkopen.2022.55407.
Keywords: Surgery, Clinician-Patient Communication, Communication
Zisman-Ilani Y, Thompson KD, Siegel LS
Crohn's disease shared decision making intervention leads to more patients choosing combination therapy: a cluster randomised controlled trial.
The purpose of this multi-site cluster randomised controlled trial was to test the impact of standard Crohn's disease care and compare with the impact of shared decision making (SDM) on the provider’s choice of therapy, quality of decisions, and provider trust. A total of 158 adult patients with Crohn's disease within 15 years of their diagnosis, with no prior Crohn's disease complications, and who were candidates to receive immunomodulators or biologics, from 14 diverse gastroenterology practices in the US, participated in the study. 99 of those participants received the intervention and 59 received standard care. The study found that participants in the intervention group chose combination therapy more frequently, had a significantly lower decisional conflict, and had greater trust in their provider.
AHRQ-funded; HS021747.
Citation: Zisman-Ilani Y, Thompson KD, Siegel LS .
Crohn's disease shared decision making intervention leads to more patients choosing combination therapy: a cluster randomised controlled trial.
Aliment Pharmacol Ther 2023 Jan;57(2):205-14. doi: 10.1111/apt.17286..
Keywords: Digestive Disease and Health, Chronic Conditions, Shared Decision Making, Patient-Centered Healthcare, Clinician-Patient Communication
Quigley DD, Elliott MN, Slaughter ME
Follow-up shadow coaching improves primary care provider-patient interactions and maintains improvements when conducted regularly: a spline model analysis.
The purpose of this study was to explore whether a second shadow coaching session (re-coaching) improves the patient experience and maintains it over time. The researchers observed a statistically significant increase of 3.7 points among re-coached providers after re-coaching on overall provider rating (OPR) and 3.5 points on provider communication (PC) (differences of 1, 3, and 5 points or more are considered small, medium, and large, respectively). Improvements from the re-coaching endured for 12 months for OPR and 8 months for PC.
AHRQ-funded; HS025920.
Citation: Quigley DD, Elliott MN, Slaughter ME .
Follow-up shadow coaching improves primary care provider-patient interactions and maintains improvements when conducted regularly: a spline model analysis.
J Gen Intern Med 2023 Jan; 38(1):221-27. doi: 10.1007/s11606-022-07881-y..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Primary Care, Clinician-Patient Communication, Patient Experience, Provider Performance
Rao BR, Jung EH, Dickert NW
Getting cost discussions right: nudging patients to avoid cognitive pitfalls.
The purpose of this article was to discuss the challenges of high out-of-pocket medication costs and their negative impact on healthcare, patient behavior, and access to quality care. The authors report that integrating cost information into medical decisions can be a useful tool for improving patient outcomes, but there are several cognitive biases that can skew patients' decisions in different directions. The article emphasizes the need for using nudge strategies as a focused counterweight to address out-of-pocket costs and other complex medical decisions. The authors explain that nudges involving manipulations in framing and choice architecture can be harnessed to impact decisions in a predictable way without restricting options or changing economic incentives. The article suggests several nudge strategies that clinicians can employ to help patients make better decisions and avoid cognitive pitfalls in shared decision-making discussions related to out-of-pocket costs.
AHRQ-funded; HS028558.
Citation: Rao BR, Jung EH, Dickert NW .
Getting cost discussions right: nudging patients to avoid cognitive pitfalls.
Circ Cardiovasc Qual Outcomes 2023 Jan; 16(1):e009447. doi: 10.1161/circoutcomes.122.009447..
Keywords: Healthcare Costs, Shared Decision Making, Clinician-Patient Communication, Communication
Kelly MM, Hoonakker PLT, Nacht CL
Parent perspectives on sharing pediatric hospitalization clinical notes.
This qualitative study sought to identify parent perceptions of the benefits and challenges of real-time note access during their child's hospitalization and strategies to optimize note-sharing at the bedside. The study conducted 60-minute interviews with 28 parents who were given access to their child's admission and daily progress notes on a bedside tablet (iPad) and interviewed upon discharge. The parents described 6 benefits of having note access, which: provided a recap and improved their knowledge about their child's care plan, enhanced communication, facilitated empowerment, increased autonomy, and incited positive emotions. Potential challenges described included: causing confusion, hindering communication with the health care team, highlighting problems with note content, and inciting negative emotions. The parents recommended 4 strategies to support sharing: provide preemptive communication about expectations, optimize the note release process, consider parent-friendly note template modifications, and offer informational resources for parents.
AHRQ-funded; HS027214.
Citation: Kelly MM, Hoonakker PLT, Nacht CL .
Parent perspectives on sharing pediatric hospitalization clinical notes.
Pediatrics 2023 Jan; 151(1). doi: 10.1542/peds.2022-057756..
Keywords: Children/Adolescents, Hospitals, Clinician-Patient Communication, Communication, Hospitalization
Quintana Y, Fahy D, Crotty B
InfoSAGE: Supporting elders and families through online family networks.
With an increasingly elderly population, families are finding it increasingly challenging to coordinate care for their older family members. This paper reports on the findings of InfoSAGE, an online private social network that has tools for communication and care coordination for elders and their families.
AHRQ-funded; HS021495; HS024869.
Citation: Quintana Y, Fahy D, Crotty B .
InfoSAGE: Supporting elders and families through online family networks.
AMIA Annu Symp Proc 2018 Dec 5;2018:932-41..
Keywords: Elderly, Caregiving, Health Information Technology (HIT), Communication, Clinician-Patient Communication, Care Coordination
Khan A, Spector ND, Baird JD
Patient safety after implementation of a coproduced family centered communication programme: multicenter before and after intervention study.
The objective of this prospective, multicenter before and after intervention was to determine whether medical errors, family experience, and communication processes improved after implementation of the intervention to standardize the structure of healthcare provider-family communication on family centered rounds. The investigators concluded that although overall errors were unchanged, harmful medical errors decreased and family experience and communication processes improved.
AHRQ-funded; HS00063.
Citation: Khan A, Spector ND, Baird JD .
Patient safety after implementation of a coproduced family centered communication programme: multicenter before and after intervention study.
BMJ 2018 Dec 5;363:k4764. doi: 10.1136/bmj.k4764..
Keywords: Adverse Events, Clinician-Patient Communication, Communication, Medical Errors, Patient and Family Engagement, Patient Safety
Abu HO, Anatchkova MD, Erskine NA
Are we "missing the big picture" in transitions of care? Perspectives of healthcare providers managing patients with unplanned hospitalization.
The objective of this qualitative study was to explore the factors that negatively/positively influence care transitions following an unplanned hospitalization from the perspective of healthcare providers. The study identified factors within and outside the discharging healthcare facility that influence care transitions and ultimately affect patient-centered outcomes and provider satisfaction with delivered care.
AHRQ-funded; HS022694.
Citation: Abu HO, Anatchkova MD, Erskine NA .
Are we "missing the big picture" in transitions of care? Perspectives of healthcare providers managing patients with unplanned hospitalization.
Appl Nurs Res 2018 Dec;44:60-66. doi: 10.1016/j.apnr.2018.09.006..
Keywords: Hospital Discharge, Hospitalization, Transitions of Care, Clinician-Patient Communication
Fisher KA, Tan ASL, Matlock DD
Keeping the patient in the center: common challenges in the practice of shared decision making.
This study examines the practice of shared-decision making (SDM) to achieve patient-centered decisions. It was determined that not all circumstances make it possible for that to happen and there have to be some basic elements present. Those elements include the patients’ health literacy, their emotional state, their relationship with the clinician and the nature of the decision.
AHRQ-funded; HS024596.
Citation: Fisher KA, Tan ASL, Matlock DD .
Keeping the patient in the center: common challenges in the practice of shared decision making.
Patient Educ Couns 2018 Dec;101(12):2195-201. doi: 10.1016/j.pec.2018.08.007..
Keywords: Clinician-Patient Communication, Shared Decision Making, Health Literacy, Patient-Centered Healthcare, Patient and Family Engagement
Quintana Y, Crotty B, Fahy D
Information sharing across generations and environments (InfoSAGE): study design and methodology protocol.
This open prospective cohort study aimed to assess a novel, Internet based, family-centric communication and collaboration platform created to address the information needs of elders and their informal caregivers in a community setting. It used a mixed methods approach, utilizing qualitative survey data along with website usage analytic data.
AHRQ-funded; HS021495.
Citation: Quintana Y, Crotty B, Fahy D .
Information sharing across generations and environments (InfoSAGE): study design and methodology protocol.
BMC Med Inform Decis Mak 2018 Nov 20;18(1):105. doi: 10.1186/s12911-018-0697-4.
.
BMC Med Inform Decis Mak 2018 Nov 20;18(1):105. doi: 10.1186/s12911-018-0697-4.
.
Keywords: Caregiving, Communication, Shared Decision Making, Elderly, Health Information Technology (HIT), Patient-Centered Healthcare, Clinician-Patient Communication, Web-Based
Cornelius T, Moise N, Birk JL
The presence of companions during emergency department evaluation and its impact on perceptions of clinician-patient communication.
Investigators studies whether having a companion present during an emergency department visit improves clinician-patient communication. An observation cohort of patients with suspected acute coronary syndrome were recruited at an academic medical center from 2013-2016. There was no observational difference except when the patient had a high school education or less.
AHRQ-funded; HS025198.
Citation: Cornelius T, Moise N, Birk JL .
The presence of companions during emergency department evaluation and its impact on perceptions of clinician-patient communication.
Emerg Med J 2018 Nov;35(11):701-03. doi: 10.1136/emermed-2018-207735..
Keywords: Clinician-Patient Communication, Shared Decision Making, Emergency Department, Patient and Family Engagement
Schoenfeld EM, Kanzaria HK, Quigley DD
Patient preferences regarding shared decision making in the emergency department: findings from a multisite survey.
In this study, the investigators sought to determine patients' desired level of involvement in medical decisions and their perceptions of potential barriers and facilitators to shared decision making in the emergency department (ED). They found that the majority of ED patients wanted to be involved in medical decisions, especially in the case of a "serious" medical problem, and felt that they had the ability to do so. Nevertheless, many patients were unlikely to actively seek involvement and defaulted to allowing the physician to make decisions during the ED visit.
AHRQ-funded; HS025701.
Citation: Schoenfeld EM, Kanzaria HK, Quigley DD .
Patient preferences regarding shared decision making in the emergency department: findings from a multisite survey.
Acad Emerg Med 2018 Oct;25(10):1118-28. doi: 10.1111/acem.13499..
Keywords: Clinician-Patient Communication, Shared Decision Making, Emergency Department, Patient and Family Engagement, Patient Experience
Sieck CJ, Walker DM, Hefner JL
Understanding secure messaging in the inpatient environment: a new avenue for communication and patient engagement.
Patient portals, and the secure messaging feature in particular, have been studied in the outpatient setting, but research in the inpatient setting is relatively less mature. In this study, the investigators analyzed and categorized messages sent within an inpatient portal to understand the topics discussed in secure messaging in the inpatient environment. They concluded that their analysis of secure message content suggested certain message types and topics such as Alerts/Requests and Questions about symptoms and treatment plans were particularly important to patients.
AHRQ-funded; HS024091; HS024349; HS024379.
Citation: Sieck CJ, Walker DM, Hefner JL .
Understanding secure messaging in the inpatient environment: a new avenue for communication and patient engagement.
Appl Clin Inform 2018 Oct;9(4):860-68. doi: 10.1055/s-0038-1675814..
Keywords: Clinician-Patient Communication, Communication, Electronic Health Records (EHRs), Health Information Technology (HIT), Inpatient Care, Patient and Family Engagement
Barr PJ, Bonasia K, Verma K
Audio-/videorecording clinic visits for patient's personal use in the United States: cross-sectional survey.
The objectives of this study were to (1) determine the prevalence of audiorecording clinic visits for patients' personal use in the United States, (2) assess the attitudes of clinicians and public toward recording, and (3) identify whether policies exist to guide recording practices in 49 of the largest health systems in the United States. The authors indicate policy guidance from health systems and further examination of the impact of recordings-positive or negative-on care delivery, clinician-related outcomes, and patients' behavioral and health-related outcomes is urgently required.
AHRQ-funded; HS024075.
Citation: Barr PJ, Bonasia K, Verma K .
Audio-/videorecording clinic visits for patient's personal use in the United States: cross-sectional survey.
J Med Internet Res 2018 Sep 12;20(9):e11308. doi: 10.2196/11308..
Keywords: Clinician-Patient Communication
Callon W, Beach MC, Links AR
An expanded framework to define and measure shared decision-making in dialogue: a 'top-down' and 'bottom-up' approach.
In this study, the investigators aimed to develop a comprehensive, descriptive framework to measure shared decision making (SDM) in clinical encounters. They listened to audio-recorded dialogue to identify all communication processes related to decision making and coded 55 pediatric otolaryngology visits using the framework and report interrater reliability. They identified 14 clinician behaviors and 5 patient behaviors that had not been previously described, and developed a new descriptive (what does happen), rather than normative (what should happen), SDM framework.
AHRQ-funded; HS022932.
Citation: Callon W, Beach MC, Links AR .
An expanded framework to define and measure shared decision-making in dialogue: a 'top-down' and 'bottom-up' approach.
Patient Educ Couns 2018 Aug;101(8):1368-77. doi: 10.1016/j.pec.2018.03.014..
Keywords: Clinician-Patient Communication, Communication, Shared Decision Making
Schoenfeld EM, Goff SL, Downs G
A qualitative analysis of patients' perceptions of shared decision making in the emergency department: "let me know i have a choice.".
In this study, the investigators sought to explore the use of shared decision making (SDM) from the perspectives of emergency department (ED) patients, focusing on what affects patients' desired level of involvement and what barriers and facilitators patients found most relevant to their experience. The investigators concluded that this exploration suggested that most patients wanted some degree of involvement in medical decision making but more proactive engagement of patients by clinicians was often needed.
AHRQ-funded; HS024311.
Citation: Schoenfeld EM, Goff SL, Downs G .
A qualitative analysis of patients' perceptions of shared decision making in the emergency department: "let me know i have a choice.".
Acad Emerg Med 2018 Jul;25(7):716-27. doi: 10.1111/acem.13416.
.
.
Keywords: Clinician-Patient Communication, Shared Decision Making, Emergency Department, Patient and Family Engagement, Patient Experience
Hefner JL, Sieck CJ, McAlearney AS
Training to optimize collaborative use of an inpatient portal.
Inpatient portals are an emerging technology that can facilitate collaborative interactions between patients and care teams, but little is known about how organizations attempt to implement and facilitate inpatient portal use for their providers. The investigators found that interviews with 220 care team members and 4 IT staff identified 3 new areas of training needed to optimize inpatient portal implementation and use that extend beyond training to use other technologies.
AHRQ-funded; HS024379; HS024091; HS024767.
Citation: Hefner JL, Sieck CJ, McAlearney AS .
Training to optimize collaborative use of an inpatient portal.
Appl Clin Inform 2018 Jul;9(3):558-64. doi: 10.1055/s-0038-1666993..
Keywords: Health Information Technology (HIT), Clinician-Patient Communication, Communication, Inpatient Care