National Healthcare Quality and Disparities Report
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Topics
- Adverse Events (8)
- Antibiotics (2)
- Antimicrobial Stewardship (2)
- Asthma (2)
- Behavioral Health (4)
- Blood Clots (2)
- Blood Thinners (2)
- Cancer (3)
- Cardiovascular Conditions (4)
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- Caregiving (2)
- Care Management (5)
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- Chronic Conditions (2)
- Clinical Decision Support (CDS) (1)
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- Communication (5)
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- COVID-19 (2)
- Critical Care (1)
- Depression (2)
- Diagnostic Safety and Quality (1)
- Disparities (1)
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- Education: Patient and Caregiver (1)
- Elderly (3)
- Electronic Health Records (EHRs) (5)
- Emergency Department (1)
- Evidence-Based Practice (3)
- Falls (1)
- Healthcare-Associated Infections (HAIs) (4)
- Healthcare Cost and Utilization Project (HCUP) (6)
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- Healthcare Delivery (2)
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- Health Information Technology (HIT) (11)
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- (-) Inpatient Care (59)
- Intensive Care Unit (ICU) (1)
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- Maternal Care (1)
- Medicaid (2)
- Medical Errors (3)
- Medicare (4)
- Medication (5)
- Methicillin-Resistant Staphylococcus aureus (MRSA) (1)
- Mortality (3)
- Newborns/Infants (2)
- Nursing (4)
- Orthopedics (1)
- Outcomes (3)
- Pain (1)
- Palliative Care (5)
- Patient-Centered Healthcare (1)
- Patient-Centered Outcomes Research (2)
- Patient and Family Engagement (3)
- Patient Experience (3)
- Patient Safety (11)
- Payment (1)
- Pneumonia (2)
- Policy (1)
- Practice Patterns (2)
- Pregnancy (1)
- Prevention (6)
- Provider (1)
- Provider: Nurse (2)
- Provider: Physician (1)
- Public Health (1)
- Quality Improvement (2)
- Quality Measures (2)
- Quality of Care (3)
- Quality of Life (1)
- Racial and Ethnic Minorities (1)
- Respiratory Conditions (3)
- Risk (1)
- Screening (1)
- Sepsis (2)
- Shared Decision Making (3)
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- Teams (1)
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- Transitions of Care (1)
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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 25 of 59 Research Studies DisplayedMoehring RW, Ashley ESD, Davis AE
Development of an electronic definition for de-escalation of antibiotics in hospitalized patients.
The authors defined antibiotic de-escalation as reduction in either the number of antibiotics or spectrum rank and performed a retrospective study among 5 hospitals. They found that their electronic de-escalation metric demonstrated variation among hospitals, units, and diagnoses. They suggested that their metric may be useful for assessing stewardship opportunities and impact.
AHRQ-funded; HS023866.
Citation: Moehring RW, Ashley ESD, Davis AE .
Development of an electronic definition for de-escalation of antibiotics in hospitalized patients.
Clin Infect Dis 2021 Dec 6;73(11):e4507-e14. doi: 10.1093/cid/ciaa932..
Keywords: Antimicrobial Stewardship, Antibiotics, Medication, Inpatient Care
Rasooly IR, Makeneni S, Khan AN
The alarm burden of excess continuous pulse oximetry monitoring among patients with bronchiolitis.
This study’s objective was to quantify alarm burden of excess continuous pulse oximetry monitoring among hospitalized infants with bronchiolitis who are not receiving supplemental oxygen. The authors evaluated admissions of 201 children (aged 0-24 months) with bronchiolitis. They categorized time ≥60 minutes following discontinuation of supplemental oxygen as "continuously monitored (guideline-discordant)," "intermittently measured (guideline-concordant)," or "unable to classify." Among 4402 classifiable hours, 77% of alarms occurred during periods of guideline-discordant monitoring. Patients experienced a median of 35 alarms during guideline-discordant, continuously monitored time, representing a rate of 6.7 alarms per hour. When the monitoring was guideline-concordant, median hourly alarm rate was 0.5 alarms per hour.
AHRQ-funded; HS026620.
Citation: Rasooly IR, Makeneni S, Khan AN .
The alarm burden of excess continuous pulse oximetry monitoring among patients with bronchiolitis.
J Hosp Med 2021 Dec;16(12):727-29. doi: 10.12788/jhm.3731..
Keywords: Newborns/Infants, Respiratory Conditions, Inpatient Care
Rosen MA, Romig M, Demko Z
Smart agent system for insulin infusion protocol management: a simulation-based human factors evaluation study.
The purpose of this study was to compare the insulin infusion management of critically ill patients by nurses using either a common standard (ie, human completion of insulin infusion protocol steps) or smart agent (SA) system that integrates the electronic health record and infusion pump and automates insulin dose selection. The investigators concluded that a systems engineering approach jointly optimised safety, efficiency and workload considerations.
AHRQ-funded; HS023553.
Citation: Rosen MA, Romig M, Demko Z .
Smart agent system for insulin infusion protocol management: a simulation-based human factors evaluation study.
BMJ Qual Saf 2021 Nov;30(11):893-900. doi: 10.1136/bmjqs-2020-011420..
Keywords: Inpatient Care, Critical Care
McAlearney AS, Hefner JL, MacEwan SR
Care Team perspectives about an inpatient portal: benefits and challenges of patients' portal use during hospitalization.
This study’s goal was to get care team member’s point of view on the benefits and challenges of inpatient portal implementation and use. Brief in-person interviews with 433 care team members across a six-hospital health system were held to explore opinions about patients’ use. The Inpatient Portal Evaluation Framework was used to characterize benefits and challenges of portal use that care team members reported affected patients, themselves, and the collaborative work of those care teams with their patients.
AHRQ-funded; HS024379; HS024091; HS024767.
Citation: McAlearney AS, Hefner JL, MacEwan SR .
Care Team perspectives about an inpatient portal: benefits and challenges of patients' portal use during hospitalization.
Med Care Res Rev 2021 Oct;78(5):537-47. doi: 10.1177/1077558720925296..
Keywords: Teams, Health Information Technology (HIT), Inpatient Care
Manojlovich M, Harrod M, Hofer T
Factors influencing physician responsiveness to nurse-initiated communication: a qualitative study.
How quickly physicians respond to communications from bedside nurses is important for the delivery of safe inpatient care. Delays in physician responsiveness can impede care or contribute to patient harm. Understanding contributory factors to physician responsiveness can provide insights to promote timely physician response, possibly improving communication to ensure safe patient care. The purpose of this study was to describe the factors contributing to physician responsiveness to text or numeric pages, telephone calls and face-to-face messages delivered by nurses on adult general care units.
Citation: Manojlovich M, Harrod M, Hofer T .
Factors influencing physician responsiveness to nurse-initiated communication: a qualitative study.
BMJ Qual Saf 2021 Sep;30(9):747-54. doi: 10.1136/bmjqs-2020-011441..
Keywords: Provider: Physician, Provider: Nurse, Communication, Inpatient Care
Siddique SM, Tipton K, Leas B
Interventions to reduce hospital length of stay in high-risk populations: a systematic review.
Many strategies to reduce hospital length of stay (LOS) have been implemented, but few studies have evaluated hospital-led interventions focused on high-risk populations. The Agency for Healthcare Research and Quality (AHRQ) Learning Health System panel commissioned this study to further evaluate system-level interventions for LOS reduction. The objective of this study was to identify and synthesize evidence regarding potential systems-level strategies to reduce LOS for patients at high risk for prolonged LOS.
AHRQ-funded; 75Q80120D00002.
Citation: Siddique SM, Tipton K, Leas B .
Interventions to reduce hospital length of stay in high-risk populations: a systematic review.
JAMA Netw Open 2021 Sep;4(9):e2125846. doi: 10.1001/jamanetworkopen.2021.25846..
Keywords: Learning Health Systems, Health Systems, Evidence-Based Practice, Hospital Discharge, Risk, Inpatient Care, Care Management
Connell SK, Burkhart Q, Tolpadi A
Quality of care for youth hospitalized for suicidal ideation and self-harm.
The authors examined performance on quality measures for pediatric inpatient suicidal ideation/self-harm care, and whether performance is associated with reutilization. Subjects were patients aged 5 to 17 years hospitalized for suicidal ideation/self-harm. Their findings revealed disparities and deficits in the quality of care received by youth with suicidal ideation/self-harm. They recommended providing caregivers lethal means restriction counseling prior to discharge in order to help prevent readmission.
AHRQ-funded; HS025291.
Citation: Connell SK, Burkhart Q, Tolpadi A .
Quality of care for youth hospitalized for suicidal ideation and self-harm.
Acad Pediatr 2021 Sep-Oct;21(7):1179-86. doi: 10.1016/j.acap.2021.05.019..
Keywords: Children/Adolescents, Behavioral Health, Inpatient Care, Quality Measures, Quality of Care
Piatkowski M, Taylor E, Wong B
Designing a patient room as a fall protection strategy: the perspectives of healthcare design experts.
This multi-year study aimed to better understand how patient room design can increase stability during ambulation, serving as a fall protection strategy for frail and/or elderly patients. Specifically, the aim of this portion of the study was to ascertain the architect's perspective on designing a room to mitigate the risk of falls, as well as to evaluate the face validity of a predictive algorithm to assess risk in room design using the input of a design advisory council (AC).
AHRQ-funded; HS025606.
Citation: Piatkowski M, Taylor E, Wong B .
Designing a patient room as a fall protection strategy: the perspectives of healthcare design experts.
Int J Environ Res Public Health 2021 Aug 19;18(16). doi: 10.3390/ijerph18168769..
Keywords: Falls, Patient Safety, Prevention, Adverse Events, Inpatient Care
Krein SL, Harrod M, Weston LE
Comparing peripherally inserted central catheter-related practices across hospitals with different insertion models: a multisite qualitative study.
Researchers compared peripherally inserted central catheters (PICCs)-related processes across hospitals with different insertion delivery models. They concluded that vascular access nurses play critical roles in all aspects of PICC-related care. Further, there is variation in PICC decision-making, care and maintenance, and patient education across hospitals.
AHRQ-funded; HS025891.
Citation: Krein SL, Harrod M, Weston LE .
Comparing peripherally inserted central catheter-related practices across hospitals with different insertion models: a multisite qualitative study.
BMJ Qual Saf 2021 Aug;30(8):628-38. doi: 10.1136/bmjqs-2020-011987..
Keywords: Inpatient Care, Shared Decision Making, Patient Safety, Hospitals
Bogetz JF, Revette A, DeCourcey DD
Clinical care strategies that support parents of children with complex chronic conditions.
This paper examines the best clinical care strategies that support parents of children with complex chronic conditions facing inpatient and end-of-life care in the ICU. Qualitative analysis of 21 open-response items from the cross-sectional “Survey of Caring for Children with Complex Chronic Conditions” was done. Open-ended responses from 110 of 114 survey respondents who were parents of children who received care at a large academic institution and died between 2006 and 2015 were analyzed. Most of the children had congenital/chromosomal complex chronic conditions and had died an average of 3.9 years prior to their parents’ study participation. The respondents emphasized the relational aspects of clinical care including inclusivity of their expertise on their child’s needs, recognition of their unique experiences as parents, and maintenance of connection with clinicians through bereavement.
AHRQ-funded; HS022986.
Citation: Bogetz JF, Revette A, DeCourcey DD .
Clinical care strategies that support parents of children with complex chronic conditions.
Pediatr Crit Care Med 2021 Jul;22(7):595-602. doi: 10.1097/pcc.0000000000002726..
Keywords: Children/Adolescents, Chronic Conditions, Palliative Care, Inpatient Care
Lasater KB, Sloane DM, McHugh MD
Evaluation of hospital nurse-to-patient staffing ratios and sepsis bundles on patient outcomes.
Despite nurses' responsibilities in recognition and treatment of sepsis, little evidence documents whether patient-to-nurse staffing ratios are associated with clinical outcomes for patients with sepsis. Using linked data sources from 2017 including MEDPAR patient claims, Hospital Compare, American Hospital Association, and a large survey of nurses, the investigators estimated the effect of hospital patient-to-nurse staffing ratios and adherence to the Early Management Bundle for patients with Severe Sepsis/Septic Shock SEP-1 sepsis bundles on patients' odds of in-hospital and 60-day mortality, readmission, and length of stay.
AHRQ-funded; HS026232.
Citation: Lasater KB, Sloane DM, McHugh MD .
Evaluation of hospital nurse-to-patient staffing ratios and sepsis bundles on patient outcomes.
Am J Infect Control 2021 Jul;49(7):868-73. doi: 10.1016/j.ajic.2020.12.002..
Keywords: Sepsis, Nursing, Provider: Nurse, Inpatient Care, Hospitals
Rasooly IR, Kern-Goldberger AS, Xiao Rasooly IR, Kern-Goldberger AS, Xiao R
Physiologic monitor alarm burden and nurses' subjective workload in a children's hospital.
Physiologic monitor alarms occur at high rates in children's hospitals; ≤1% are actionable. The burden of alarms has implications for patient safety and is challenging to measure directly. Nurse workload, measured by using a version of the National Aeronautics and Space Administration Task Load Index (NASA-TLX) validated among nurses, is a useful indicator of work burden that has been associated with patient outcomes. The objective of this study was to measure the relationship between alarm count and nurse workload by using the NASA-TLX.
AHRQ-funded; R18 HS026620.
Citation: Rasooly IR, Kern-Goldberger AS, Xiao Rasooly IR, Kern-Goldberger AS, Xiao R .
Physiologic monitor alarm burden and nurses' subjective workload in a children's hospital.
Hosp Pediatr 2021 Jul;11(7):703-10. doi: 10.1542/hpeds.2020-003509..
Keywords: Children/Adolescents, Nursing, Inpatient Care, Patient Safety
Lee K, Gani F, Canner JK
Racial disparities in utilization of palliative care among patients admitted with advanced solid organ malignancies.
The primary objective of this study was to describe racial differences in the use of inpatient palliative care consultations (IPCC) for patients with advanced cancer who are admitted to a hospital in the United States. Hospital admissions of patients with advanced cancers were identified through the National Inpatient Dataset. Findings showed that death during hospitalization was a significant modifier of the relationship between race and receipt of palliative care consultation. There were significant racial disparities in the utilization of IPCC for patients with advanced cancer.
AHRQ-funded; HS024736.
Citation: Lee K, Gani F, Canner JK .
Racial disparities in utilization of palliative care among patients admitted with advanced solid organ malignancies.
Am J Hosp Palliat Care 2021 Jun;38(6):539-46. doi: 10.1177/1049909120922779..
Keywords: Healthcare Cost and Utilization Project (HCUP), Palliative Care, Cancer, Disparities, Racial and Ethnic Minorities, Healthcare Utilization, Inpatient Care, Chronic Conditions
Masonbrink AR, Harris M, Hall M
Safety events in children's hospitals during the COVID-19 pandemic.
The coronavirus disease 2019 (COVID-19) pandemic has impacted hospitals, potentially affecting quality and safety. The objective of this study was to compare pediatric hospitalization safety events during the pandemic versus previous years. The investigators concluded that postoperative sepsis rates increased among children hospitalized during COVID-19. They suggest that efforts are needed to improve safety of postoperative care for hospitalized children.
AHRQ-funded; HS024554; HS024592.
Citation: Masonbrink AR, Harris M, Hall M .
Safety events in children's hospitals during the COVID-19 pandemic.
Hosp Pediatr 2021 Jun;11(6):e95-e100. doi: 10.1542/hpeds.2020-004937..
Keywords: Children/Adolescents, COVID-19, Patient Safety, Sepsis, Adverse Events, Hospitalization, Hospitals, Inpatient Care, Infectious Diseases, Public Health
Vaughn VM, Yost M, Abshire C
Trends in venous thromboembolism anticoagulation in patients hospitalized with COVID-19.
This study’s objective was to characterize frequency, variation across hospitals, and change over time in VTE prophylaxis and treatment-dose anticoagulation in patients hospitalized for COVID-19, as well as the association of anticoagulation strategies with in-hospital and 60-day mortality. This cohort study used adults hospitalized with COVID-19 from 30 pseudorandom hospitals in Michigan from March 7, 2020, to June 17, 2020. Main outcomes measured were the effect of nonadherence and anticoagulation strategies on in-hospital and 60-day mortality. Of a total 1351 patients with COVID-19 with a median age of 64 years, 47.7% women and 48.9% Black, only 18 (1.3%) had a confirmed VTE, and 219 (16.2%) received treatment-dose anticoagulation. Use of treatment-dose anticoagulation without imaging ranged from 0% to 29% across hospitals and increased over time. Of 1127 patients who ever received anticoagulation, 392 missed 2 or more days of prophylaxis. Missed prophylaxis varied from 11% to 61% across hospitals and decreased markedly over time. VTE nonadherence was associated with higher 60-day (adjusted hazard ratio [aHR], 1.31) but not in-hospital mortality (aHR, 0.97). Receiving any dose of anticoagulation (vs no anticoagulation) was associated with lower in-hospital mortality (only prophylactic dose: aHR, 0.36; any treatment dose: aHR, 0.38). However, only the prophylactic dose of anticoagulation remained associated with lower mortality at 60 days (prophylactic dose: aHR, 0.71; treatment dose: aHR, 0.92).
AHRQ-funded; HS026530.
Citation: Vaughn VM, Yost M, Abshire C .
Trends in venous thromboembolism anticoagulation in patients hospitalized with COVID-19.
JAMA Netw Open 2021 Jun 1; 4(6):e2111788. doi: 10.1001/jamanetworkopen.2021.11788..
Keywords: COVID-19, Blood Clots, Blood Thinners, Medication, Inpatient Care, Cardiovascular Conditions
McGrath SP, Perreard IM, MacKenzie T
Patterns in continuous pulse oximetry data prior to pulseless electrical activity arrest in the general care setting.
This study’s objective was to understand if features derived from continuous pulse oximetry data can provide advanced warning of pulseless electrical activity arrest in general care inpatients. A retrospective analysis of SpO2 and pulse rate data derived from continuous pulse oximetry was performed for patients with electrical pulseless activity (n = 38) and control patients (n = 42). The pulseless electrical activity arrest group tended to have lower mean SpO2 and higher mean pulse rates over time intervals ranging from 1 minute to 1 hour. Several hours to the rescue event changes in variability were observed. Up to 20 minutes before rescue events, pulse rate features were significantly different from feature values for the preceding 30-minute interval. Similar results were found at 10 minutes before the event. These differences might be useful for predicting and preventing rescue events.
AHRQ-funded; HS024403.
Citation: McGrath SP, Perreard IM, MacKenzie T .
Patterns in continuous pulse oximetry data prior to pulseless electrical activity arrest in the general care setting.
J Clin Monit Comput 2021 May;35(3):537-45. doi: 10.1007/s10877-020-00509-8..
Keywords: Patient Safety, Inpatient Care, Hospitals, Prevention, Cardiovascular Conditions
Iroz CB, Dahl CM, Cassimatis IR
Prophylactic anticoagulation for preterm premature rupture of membranes: a decision analysis.
The objective of this study was to determine the optimal modality for venous thromboembolism prophylaxis during hospitalization for preterm premature rupture of membranes using a decision analysis model. The investigators concluded that their results did not support the routine use of prophylactic anticoagulation in women admitted to the hospital for preterm premature rupture of membranes.
AHRQ-funded; HS000084.
Citation: Iroz CB, Dahl CM, Cassimatis IR .
Prophylactic anticoagulation for preterm premature rupture of membranes: a decision analysis.
Am J Obstet Gynecol MFM 2021 May;3(3):100311. doi: 10.1016/j.ajogmf.2021.100311..
Keywords: Blood Clots, Blood Thinners, Prevention, Shared Decision Making, Pregnancy, Maternal Care, Inpatient Care, Women, Medication
Deshpande A, Richter SS, Haessler S
De-escalation of empiric antibiotics following negative cultures in hospitalized patients with pneumonia: rates and outcomes.
This study assessed antibiotic de-escalation practices across hospitals and their associations with outcomes in hospitalized patients diagnosed with pneumonia with negative cultures. The authors included 14,170 adults admitted with pneumonia in 2010-2015 to 164 US hospitals if they had negative blood and/or respiratory cultures and received both anti-MRSA and antipseudomonal agents other than quinolones. If empiric drugs were stopped on day 4 while continuing another antibiotic it was defined at de-escalation. Patients were propensity adjusted for de-escalation and compared on in-hospital 14-day mortality, late deterioration with ICU transfer, length-of-stay (LOS) and costs. Thirteen percent (1924 patients) had both initial empiric drugs stopped by hospital day 4. De-escalation rates at hospitals ranged from 2-35% and the established rate quartiles were not significantly associated with outcomes. Even at hospitals in the top quartile of de-escalation, the de-escalation rates were lower than 50%.
AHRQ-funded; HS025026; HS024277.
Citation: Deshpande A, Richter SS, Haessler S .
De-escalation of empiric antibiotics following negative cultures in hospitalized patients with pneumonia: rates and outcomes.
Clin Infect Dis 2021 Apr 26;72(8):1314-22. doi: 10.1093/cid/ciaa212..
Keywords: Antimicrobial Stewardship, Antibiotics, Medication, Pneumonia, Respiratory Conditions, Methicillin-Resistant Staphylococcus aureus (MRSA), Healthcare-Associated Infections (HAIs), Inpatient Care
Acharya C, Sehrawat TS, McGuire DB
Perspectives of inpatients with cirrhosis and caregivers on using health information technology: cross-sectional multicenter study.
Perspectives of inpatients with cirrhosis and caregivers on using health information technology: cross-sectional multicenter study.
J Med Internet Res 2021 Apr 9;23(4):e24639. doi: 10.2196/24639.
This cross-sectional multicenter study examined reasons why health IT interventions were refused among patient-caregiver dyads of inpatients with cirrhosis. A total of 349 patient-caregiver dyads at three Virginia hospitals were approached of which 87 (25%) agreed to participate. Patients with cirrhosis admitted with gastrointestinal bleeding without opioid use or hepatic encephalopathy were more likely to participate than those with opioid or alcohol-related etiologies. Privacy was not a major factor in refusal, but caregiver and study burden were.
J Med Internet Res 2021 Apr 9;23(4):e24639. doi: 10.2196/24639.
This cross-sectional multicenter study examined reasons why health IT interventions were refused among patient-caregiver dyads of inpatients with cirrhosis. A total of 349 patient-caregiver dyads at three Virginia hospitals were approached of which 87 (25%) agreed to participate. Patients with cirrhosis admitted with gastrointestinal bleeding without opioid use or hepatic encephalopathy were more likely to participate than those with opioid or alcohol-related etiologies. Privacy was not a major factor in refusal, but caregiver and study burden were.
AHRQ-funded; HS025412.
Citation: Acharya C, Sehrawat TS, McGuire DB .
Perspectives of inpatients with cirrhosis and caregivers on using health information technology: cross-sectional multicenter study.
J Med Internet Res 2021 Apr 9;23(4):e24639. doi: 10.2196/24639..
Keywords: Health Information Technology (HIT), Caregiving, Inpatient Care
MacEwan SR, Gaughan A, Hefner JL
Identifying the role of inpatient portals to support health literacy: perspectives from patients and care team members.
Health literacy is a fundamental contributor to an individual's ability to self-manage their health and appropriately use health care services. Tools that positively impact health literacy therefore have potential to improve health outcomes. Inpatient portals are a tool that provides patients an opportunity to cultivate health literacy skills during hospitalization. This study investigated how inpatient portal use could impact attributes of health literacy.
AHRQ-funded; HS024091; HS024767; HS024379.
Citation: MacEwan SR, Gaughan A, Hefner JL .
Identifying the role of inpatient portals to support health literacy: perspectives from patients and care team members.
Patient Educ Couns 2021 Apr;104(4):836-43. doi: 10.1016/j.pec.2020.09.028..
Keywords: Health Literacy, Health Information Technology (HIT), Hospitalization, Inpatient Care
Kelly MM, Smith CA, Hoonakker PLT
Stakeholder perspectives in anticipation of sharing physicians' notes with parents of hospitalized children.
Researchers sought to elicit stakeholder perspectives on the anticipated benefits and challenges of sharing hospital physicians' admission and daily progress notes with parents at the bedside during their child's hospitalization and to identify strategies to aid implementation of inpatient note sharing. Focus groups with 34 stakeholders at a children's hospital were conducted. The researchers identified four anticipated benefits of sharing inpatient notes, five expected challenges, and three suggested implementation strategies.
Citation: Kelly MM, Smith CA, Hoonakker PLT .
Stakeholder perspectives in anticipation of sharing physicians' notes with parents of hospitalized children.
Acad Pediatr 2021 Mar;21(2):259-64. doi: 10.1016/j.acap.2020.11.018..
Keywords: Children/Adolescents, Inpatient Care, Electronic Health Records (EHRs), Health Information Technology (HIT), Communication, Clinician-Patient Communication
Kohn R, Harhay MO, Bayes B
Influence of bedspacing on outcomes of hospitalised medicine service patients: a retrospective cohort study.
The objective of this cohort study was to assess the association of bedspacing with patient-centered outcomes among United States patients admitted to general medicine services. The study compared internal medicine, family medicine and geriatric service patients who were bedspaced versus cohorted for the entirety of their hospital stay within three large, urban hospitals. Findings showed that bedspacing was associated with adverse patient-centered outcomes. Recommendations for future work included a need to confirm these findings, to understand mechanisms contributing to adverse outcomes, and to identify factors that mitigate these adverse effects in order to provide high-value, patient-centered care to hospitalized patients.
AHRQ-funded; HS026372.
Citation: Kohn R, Harhay MO, Bayes B .
Influence of bedspacing on outcomes of hospitalised medicine service patients: a retrospective cohort study.
BMJ Qual Saf 2021 Feb;30(2):116-22. doi: 10.1136/bmjqs-2019-010675..
Keywords: Patient-Centered Outcomes Research, Outcomes, Inpatient Care, Hospitals, Healthcare Delivery, Care Management, Adverse Events
Haldar S, Khelifi M, Mishra SR
Designing inpatient portals to support patient agency and dynamic hospital experiences.
Inpatient portals could help patients engage in their hospital care, yet several design, usability, and adoption issues prevent this technology from fulfilling its potential. Despite patients having needs that extend beyond the scope of existing inpatient portals, we know less about how to design such portals that support them. To learn about effective designs, the investigators created three mid-fidelity prototypes representing novel approaches for inpatient portal design.
AHRQ-funded; HS022894.
Citation: Haldar S, Khelifi M, Mishra SR .
Designing inpatient portals to support patient agency and dynamic hospital experiences.
AMIA Annu Symp Proc 2021 Jan 25;2021:524-33..
Keywords: Patient Experience, Inpatient Care, Health Information Technology (HIT), Hospitals
Haldar S, Mishra SR, Khelifi M
Exploring the design of an inpatient peer support tool: views of adult patients.
To better understand the opportunities for an inpatient peer support tool, the investigators surveyed 100 adult patients and caregivers, and conducted follow-up, semi-structured interviews with 15 adult patients. In this paper, the investigators describe five key peer support needs that their adult patient participants expressed: (1) adjusting to the hospital environment, (2) understanding and normalizing medical care, (3) communicating with providers, (4) reporting and preventing medical errors, and (5) empowering peers.
AHRQ-funded; HS022894.
Citation: Haldar S, Mishra SR, Khelifi M .
Exploring the design of an inpatient peer support tool: views of adult patients.
AMIA Annu Symp Proc 2018 Dec 5;2018:1282-91..
Keywords: Inpatient Care, Patient and Family Engagement
Selden TM, Karaca Z, Decker S
AHRQ Author: Selden TM, Karaca Z, Decker S
Has inpatient hospital treatment before and after age 65 changed as the difference between private and Medicare payment rates has widened?
This study examined whether inpatient hospital treatment before and after age 65 changed as the difference between private and Medicare payment rates widened. Using a large discharge dataset covering the period 2001-2011, the investigators tracked changes at age 65 in multiple dimensions of hospital care.
AHRQ-authored.
Citation: Selden TM, Karaca Z, Decker S .
Has inpatient hospital treatment before and after age 65 changed as the difference between private and Medicare payment rates has widened?
Int J Health Econ Manag 2018 Dec;18(4):409-23. doi: 10.1007/s10754-018-9240-5..
Keywords: Payment, Healthcare Cost and Utilization Project (HCUP), Hospitalization, Inpatient Care, Medicare