National Healthcare Quality and Disparities Report
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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 57 Research Studies DisplayedSalinas KE, Bazan M, Rivera L
Experiences and communication preferences in pregnancy care among patients with a Spanish language preference: a qualitative study.
The purpose of this study was to explore Spanish-speaking patients' experiences and preferences regarding communication during pregnancy care with specific attention to language barriers. The researchers conducted focus groups with patients with a Spanish language preference who gave birth between July 2022 and February 2023 at an academic medical center. A total of seven focus groups with 27 total participants were held. The study identified three key themes regarding preferences in patient experiences and communication when seeking pregnancy care: 1. language discordance and concordance between patients and clinicians exist on a spectrum and are not binary; 2. language-discordant care presents communication challenges, even when interpreters are present; and 3. language discordance can be effectively addressed with positive interpersonal engagements between clinicians and patients.
AHRQ-funded; HS026370.
Citation: Salinas KE, Bazan M, Rivera L .
Experiences and communication preferences in pregnancy care among patients with a Spanish language preference: a qualitative study.
Obstet Gynecol 2023 Nov 1; 142(5):1227-36. doi: 10.1097/aog.0000000000005369..
Keywords: Maternal Care, Women, Communication, Cultural Competence, Racial and Ethnic Minorities
Sankar A, Everhart AO, Jena AB
Longitudinal patterns in testosterone prescribing after US FDA safety communication in 2014.
This study described changes in testosterone prescribing following a 2014 US Food and Drug Administration (FDA) safety communication and how changes varied by physician characteristics. The authors extracted data from a 20% random sample of Medicare fee-for-service administrative claims data from 2011 through 2019. This unique sample included 1,544,604 unique male beneficiaries who received evaluation and management (E&M) services from 58,819 unique physicians that prescribed testosterone between 2011 and 2013. Patients were classified by presence of coronary artery disease (CAD) and non-age-related hypogonadism. Physician characteristics included specialty and affiliations with teaching hospitals, for-profit hospitals, hospitals in integrated delivery networks, and hospitals in the top decile of case mix index. Among 65,089,560 physician-patient-quarter-year observations, mean (standard deviation) age ranged from 72.16 (5.84 SD) years for observations without CAD or non-age-related hypogonadism to 75.73 (6.92 SD) years with CAD and without non-age-related hypogonadism. Following the safety communication, immediate changes in off-label testosterone prescription levels fell by 0.22 percentage points (pp) for patients with CAD and by -0.16 pp for patients without CAD, with a similar change in on-label prescribing levels. The off-label testosterone prescription quarterly trend increased for patients with CAD and without CAD; on-label testosterone prescription trends declined for both groups. Primary care physicians had larger declines in off-label prescribing then non-primary care physicians, and physicians affiliated with teaching compared to nonteaching hospitals. On-label prescribing found no changes associated with physician and organizational characteristics.
AHRQ-funded; HS025164.
Citation: Sankar A, Everhart AO, Jena AB .
Longitudinal patterns in testosterone prescribing after US FDA safety communication in 2014.
Jt Comm J Qual Patient Saf 2023 Sep; 49(9):458-66. doi: 10.1016/j.jcjq.2023.05.003..
Keywords: Communication, Medication, Practice Patterns
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
DeSimone AK, Kapoor N, Lacson R
Impact of an automated closed-loop communication and tracking tool on the rate of recommendations for additional imaging in thoracic radiology reports.
The objectives of this retrospective, institutional review board-approved study set in academic quaternary care hospital were to assess the effects of feedback reports and the implementation of a closed-loop communication system based on rates of recommendations for additional imaging (RAIs) in thoracic radiology reports. A previously validated natural language processing tool was used to classify reports with an RAI. The results showed that feedback reports alone increased RAI rates; an IT intervention that promoted documentation of complete RAI in addition to feedback reports led to significant reductions in RAI rate, incomplete RAI, and improved overall completeness of radiology recommendations.
AHRQ-funded; HS029348.
Citation: DeSimone AK, Kapoor N, Lacson R .
Impact of an automated closed-loop communication and tracking tool on the rate of recommendations for additional imaging in thoracic radiology reports.
J Am Coll Radiol 2023 Aug; 20(8):781-88. doi: 10.1016/j.jacr.2023.05.004..
Keywords: Imaging, Health Information Technology (HIT), Communication
Niederdeppe J, Avery RJ, Liu J
Is exposure to pharmaceutical direct-to-consumer advertising for heart disease and diabetes associated with physical activity and dietary behavior?
This study examined associations between estimated exposure to direct consumer-to-advertising (DTCA) for drugs focused on heart disease/cholesterol and diabetes and self-reported exercise and consumption of a variety of unhealthy foods (candy, sugary drinks, alcohol, and fast food). The authors estimated exposure to DTCA by combining data from Kantar Media Intelligence (Kantar) on televised pharmaceutical DTCA airings in the U.S. from January 2003 to August 2016 (n = 7,696,851 airings) with thirteen years of data from the Simmons National Consumer Survey (Simmons), a mailed survey on television viewing patterns. They estimated associations between exposure to advertising (both overall and for advertisements with specific content) and self-reported physical activity and dietary behavior using Simmons data from January 2004 to December 2016 (n = 288,483 respondents from n = 157,621 unique households in the U.S.). They found that higher estimated exposure to DTCA for heart disease and diabetes drugs were not consistently associated with meaningful differences in the frequency of engaging in regular physical activity. However, greater estimated exposure to DTCA for both diseases were linked to small but consistently higher volume of consumption of candy, sugar-sweetened beverages, alcohol, and fast food.
AHRQ-funded; HS025983.
Citation: Niederdeppe J, Avery RJ, Liu J .
Is exposure to pharmaceutical direct-to-consumer advertising for heart disease and diabetes associated with physical activity and dietary behavior?
Soc Sci Med 2023 Aug; 330:116062. doi: 10.1016/j.socscimed.2023.116062..
Keywords: Communication, Diabetes, Heart Disease and Health, Medication
Stierman EK, O'Brien BT, Stagg J
AHRQ Author: Fabiyi CA, Chew E, Harding B, Mistry KB
Statewide perinatal quality improvement, teamwork, and communication activities in Oklahoma and Texas.
The objective of this study was to describe perinatal quality improvement activities, specifically the implementation of Alliance for Innovation on Maternal Health (AIM) patient safety bundles and use of teamwork and communication tools in obstetric units. Researchers conducted a survey of AIM-enrolled hospitals in Oklahoma and Texas and gathered data on obstetric unit organization and QI processes. Their findings showed that adoption of QI processes varied and also highlighted the need to reinforce support for rural obstetric units, which often face greater barriers to implementing patient safety and QI processes than urban units. The researchers concluded that this has implications for implementing future perinatal QI initiatives.
AHRQ-authored; AHRQ-funded; 233201500020I.
Citation: Stierman EK, O'Brien BT, Stagg J .
Statewide perinatal quality improvement, teamwork, and communication activities in Oklahoma and Texas.
Qual Manag Health Care 2023 Jul-Sep; 32(3):177-88. doi: 10.1097/qmh.0000000000000407..
Keywords: Quality Improvement, Teams, Communication, Maternal Care, Quality of Care
Saucke MC, Alagoz E, Arroyo N
The invisible work of transfer centre nurses: a qualitative study of strategies to overcome communication challenges.
The objective of this study was to explore the role of transfer center nurses and their strategies to facilitate communication between providers during calls related to interhospital transfers. Researchers conducted semi-structured interviews with 17 transfer center nurses at one tertiary medical center and asked them to describe their work. The results indicated that transfer center nurses employed multiple strategies to overcome communication challenges; providers' lack of knowledge of the nurses' role can impede respectful and efficient transfer conversations. The researchers concluded that interventions to support and optimize the transfer center nurses' critical work are needed.
AHRQ-funded; HS025224.
Citation: Saucke MC, Alagoz E, Arroyo N .
The invisible work of transfer centre nurses: a qualitative study of strategies to overcome communication challenges.
J Adv Nurs 2023 Jul; 79(7):2539-52. doi: 10.1111/jan.15603..
Keywords: Communication, Provider: Nurse, Nursing
Weinstein R, Brohinsky J, Meltzer A
AHRQ Author: Weinstein R
Establishing and maintaining trust: how the U.S. Preventive Services Task Force uses strategic communications to build confidence in and disseminate its evidence-based recommendations.
This article examined ways in which strategic communications support for the United States Preventive Services Task Force helped to fulfill its mission to improve the health of people nationwide through evidence-based preventive services recommendations. Communications challenges specific to the USPSTF are described, and two case examples of strategic communications approaches provided.
AHRQ-authored.
Citation: Weinstein R, Brohinsky J, Meltzer A .
Establishing and maintaining trust: how the U.S. Preventive Services Task Force uses strategic communications to build confidence in and disseminate its evidence-based recommendations.
J Health Commun 2023 Jun 3; 28(6):344-48. doi: 10.1080/10810730.2023.2208532..
Keywords: U.S. Preventive Services Task Force (USPSTF), Communication, Evidence-Based Practice, Guidelines, Prevention
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)
Alpert A, Lakdawalla D, Sood N
Prescription drug advertising and drug utilization: the role of Medicare Part D.
The purpose of this paper was to explore how direct-to-consumer advertising (DTCA) for prescription drugs affects use by leveraging a large and plausibly exogenous shock to DTCA influenced by the introduction of Medicare Part D. Part D led to greater increases in advertising in geographic areas with greater concentrations of Medicare beneficiaries. The researchers explored the effect of this increase in advertising on non-elderly individuals to separate the effects of advertising from the direct effects of Part D. The study found that exposure to advertising resulted in large increases in treatment initiation and improved adherence to medication. Advertising also had substantial positive spillover effects on non-advertised generic drugs.
AHRQ-funded; HS025983.
Citation: Alpert A, Lakdawalla D, Sood N .
Prescription drug advertising and drug utilization: the role of Medicare Part D.
J Public Econ 2023 May; 221. doi: 10.1016/j.jpubeco.2023.104860..
Keywords: Communication, Medication, Medicare
Lee BY, Greene D, Scannell SA
The need for systems approaches for precision communications in public health.
This paper discusses the major challenges in communicating health-related information due to the involvement of multiple complex systems from the creation of the information to the sources and channels of dispersion to the information users themselves. The virality of COVID-19 misinformation and disinformation brought this issue to light very prominently. The authors discuss a range of systems approaches and methods, such as systems mapping and systems modeling, that can help better elucidate complex systems. They believe using these methods to better characterize the various systems involved in communicating public health-related information can lead to the development of more tailored, precise, and proactive communications. Their hope is that proceeding in an iterative manner to help design, implement, and adjust such communications strategies can increase impact and leave less opportunity for misinformation and disinformation to spread.
AHRQ-funded; HS028165.
Citation: Lee BY, Greene D, Scannell SA .
The need for systems approaches for precision communications in public health.
J Health Commun 2023 Apr 7; 28(sup1):13-24. doi: 10.1080/10810730.2023.2220668..
Keywords: Communication, Public Health
DiStefano MJ, Markell JM, Doherty CC
Association between drug characteristics and manufacturer spending on direct-to-consumer advertising.
The purpose of this exploratory cross-sectional study was to pinpoint the attributes of drugs that correlate with a larger portion of promotional expenditure on consumer-targeted advertising. The researchers conducted an examination of drug traits and promotional expenses for the top 150 best-selling branded prescription medications in the US in 2020, using data from IQVIA National Sales Perspectives. IQVIA Channel Dynamics provided promotional spending information. Various drug features were assessed, including 2020 total sales and promotional spending, clinical benefit ratings, number of indications, off-label usage, molecule type, condition treated, administration method, generic availability, FDA approval year, World Health Organization anatomical therapeutic chemical classification, Medicare average annual spending per beneficiary, drug sales percentage, market size, and market competitiveness. Data was obtained from health technology assessment agencies and drug databases. The study found that in 2020, the median proportion of promotional spending allocated to direct-to-consumer advertising was 13.5% with a median promotional spending of $20.9 million and median total sales of $1.51 billion. Sixteen of the top 150 drugs had incomplete data, resulting in a primary study sample of 134 drugs. After adjusting for multiple drug characteristics, the mean proportion of total promotional spending allocated to direct-to-consumer advertising for the remaining 134 drugs was an absolute 14.3% higher for drugs with low added clinical benefit compared to those with high added clinical benefit and an absolute 1.5% higher for each 10% increase in total sales.
AHRQ-funded; HS000029.
Citation: DiStefano MJ, Markell JM, Doherty CC .
Association between drug characteristics and manufacturer spending on direct-to-consumer advertising.
JAMA 2023 Feb 7; 329(5):386-92. doi: 10.1001/jama.2022.23968..
Keywords: Medication, Communication
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
Becker MW, Kashy DA, Harben A
A novel strategy to optimize critical information on over the counter labels for older adults.
In this article, the authors described two experiments in which they evaluated the impact of over-the-counter (OTC) medication label designs that employ highlighting and warning labels placed on package fronts on the attention and use of critical information by older consumers. In both experiments. participants aged 65 or over were required to access and use critical label information to respond correctly to questions. Highlighting or placing critical information on the front of packaging significantly improved response accuracy. The authors concluded that these results are relevant for regulations which dictate label design to further ease and safety of use of medications for older adults.
AHRQ-funded; HS025386.
Citation: Becker MW, Kashy DA, Harben A .
A novel strategy to optimize critical information on over the counter labels for older adults.
Health Sci Rep 2023 Jan 25; 6(1):e1062. doi: 10.1002/hsr2.1062..
Keywords: Elderly, Medication: Safety, Medication, Patient Safety, Communication
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
Starmer AJ, Spector ND, O'Toole JK
Implementation of the I-PASS handoff program in diverse clinical environments: a multicenter prospective effectiveness implementation study.
The purpose of this study was to assess I-PASS patient handoff intervention implementation across diverse settings to evaluate whether there it impacted pediatric patient safety and communication. External teams provided coaching over 18 months to hospital residents from diverse specialties across 32 hospitals (12 community, 20 academic) with 2735 resident physicians and 760 faculty champions from multiple specialties (16 internal medicine, 13 pediatric, 3 other) participating. The researchers collected 1942 error surveillance reports. Following I-PASS implementation, major and minor handoff-related reported adverse events decreased 47%. Intervention implementation was related with increased inclusion of all five key handoff data elements in verbal and written handoffs, as well as increased frequency of handoffs with high quality verbal and written patient summaries, verbal and written contingency plans, and verbal receiver syntheses.
AHRQ-funded; HS023291.
Citation: Starmer AJ, Spector ND, O'Toole JK .
Implementation of the I-PASS handoff program in diverse clinical environments: a multicenter prospective effectiveness implementation study.
J Hosp Med 2023 Jan; 18(1):5-14. doi: 10.1002/jhm.12979..
Keywords: Transitions of Care, Implementation, 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
Frasier LL, Pavuluri Quamme SR, Wiegmann D
Evaluation of intraoperative hand-off frequency, duration, and context: a mixed methods analysis.
The authors sought a better understanding of the coordination and impact of intraoperative hand-offs. They found that intraoperative hand-offs were frequent and not well coordinated with intraoperative events including counts and other hand-offs. Anchoring and announced hand-offs occurred in a small proportion of cases. They recommended that future work focus on optimizing timing, content, and participation in intraoperative hand-offs.
AHRQ-funded; HS022403.
Citation: Frasier LL, Pavuluri Quamme SR, Wiegmann D .
Evaluation of intraoperative hand-off frequency, duration, and context: a mixed methods analysis.
J Surg Res 2020 Dec;256:124-30. doi: 10.1016/j.jss.2020.06.007..
Keywords: Surgery, Transitions of Care, Communication, Teams
Thate JA, Couture B, Schnock KO
Information needs and the use of documentation to support collaborative decision-making: implications for the reduction of central line-associated blood stream infections.
It is clear that interdisciplinary communication and collaboration have the potential to mitigate healthcare-associated harm, yet there is limited research on how communication through documentation in the patient record can support collaborative decision making. Understanding what information is needed to support collaborative decision making is necessary to design electronic health information systems that facilitate effective communication and, ultimately, safe care. To explore this issue, the investigators focused on information needs related to central venous catheter management and the prevention of central line-associated blood stream infections.
AHRQ-funded; HS0235335.
Citation: Thate JA, Couture B, Schnock KO .
Information needs and the use of documentation to support collaborative decision-making: implications for the reduction of central line-associated blood stream infections.
Comput Inform Nurs 2020 Nov 2;39(4):208-14. doi: 10.1097/cin.0000000000000683..
Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Shared Decision Making, Communication, Electronic Health Records (EHRs), Health Information Technology (HIT), Nursing
Stransky ML, Oshita JY, Morris MA
Prevalence of behavioral health problems among adults with and without communication disabilities.
Adults with communication disabilities (CDs) experience poor health and health care outcomes. Few studies have examined behavioral health outcomes among this population. In this retrospective cohort study, the investigators compared the behavioral health of adults with CDs to their peers without such disabilities. The investigators examined the 2012 National Health Interview Survey Voice, Speech, and Language Supplement.
AHRQ-funded; HS022242.
Citation: Stransky ML, Oshita JY, Morris MA .
Prevalence of behavioral health problems among adults with and without communication disabilities.
J Am Board Fam Med 2020 Nov-Dec;33(6):932-41. doi: 10.3122/jabfm.2020.06.200216..
Keywords: Behavioral Health, Disabilities, Communication
Kranz AM, Ryan J, Mahmud A, AM, Ryan J, Mahmud A
Association of primary and specialty care integration on physician communication and cancer screening in safety-net clinics.
Lack of cancer screenings are more common in community health centers (CHCs) which provide primary care to disadvantaged populations due to difficulty accessing specialty care for their patients. This study’s objective was to describe CHCs use to integrate care with specialists and examine whether strongly integrated CHCs have higher rates of screening colorectal and cervical cancers. A 2017 survey of CHCs in 12 states and the District of Columbia was used to estimate the association between a composite measure of CHC/specialist integration and cancer screening rates and 4 measures of CHC/specialist communication using multivariate regression models. More integrated CHCs had higher screening rates of colorectal and cervical cancer and had significantly higher rates of knowing that specialist visits happened, knowing visit outcomes, receiving information after visits, and timely receipt of information.
AHRQ-funded; HS024067.
Citation: Kranz AM, Ryan J, Mahmud A, AM, Ryan J, Mahmud A .
Association of primary and specialty care integration on physician communication and cancer screening in safety-net clinics.
Prev Chronic Dis 2020 Oct 29;17:E134. doi: 10.5888/pcd17.200025..
Keywords: Cancer, Screening, Communication, Prevention, Patient-Centered Healthcare, Healthcare Delivery
Rogith D, Satterly T, Singh H
Application of human factors methods to understand missed follow-up of abnormal test results.
This study demonstrated application of human factors methods for understanding causes for lack of timely follow-up of abnormal test results ("missed results") in outpatient settings. The investigators identified 30 cases of missed test results by querying electronic health record data, developed a critical decision method based interview guide to understand decision-making processes, and interviewed physicians who ordered these tests. They analyzed transcribed responses, developed a CI-based flow model, and conducted a fault tree analysis to identify hierarchical relationships between factors that delayed action.
AHRQ-funded; HS022087; HS022901.
Citation: Rogith D, Satterly T, Singh H .
Application of human factors methods to understand missed follow-up of abnormal test results.
Appl Clin Inform 2020 Oct;11(5):692-98. doi: 10.1055/s-0040-1716537..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Shared Decision Making, Diagnostic Safety and Quality, Communication, Clinician-Patient Communication