National Healthcare Quality and Disparities Report
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Topics
- Adverse Drug Events (ADE) (9)
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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
76 to 100 of 132 Research Studies DisplayedFiscella K, Fogarty C, Salas E
What can primary care learn from sports teams?
The authors used sports teams to illustrate key principles from team science and to extract practical lessons for primary care teams.
AHRQ-funded; HS022440.
Citation: Fiscella K, Fogarty C, Salas E .
What can primary care learn from sports teams?
J Ambul Care Manage 2016 Jul-Sep;39(3):279-85. doi: 10.1097/jac.0000000000000120.
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Keywords: Patient Safety, Primary Care, Quality Improvement, Teams
Al-Mutairi A, Meyer AN, Thomas EJ
Accuracy of the safer Dx instrument to identify diagnostic errors in primary care.
The researchers aimed to test the accuracy of an instrument to help detect presence or absence of diagnostic error through record reviews. They found that their Safer Dx Instrument helped quantify the likelihood of diagnostic error in primary care visits, achieving a high degree of accuracy for measuring their presence or absence.
AHRQ-funded; HS022087.
Citation: Al-Mutairi A, Meyer AN, Thomas EJ .
Accuracy of the safer Dx instrument to identify diagnostic errors in primary care.
J Gen Intern Med 2016 Jun;31(6):602-8. doi: 10.1007/s11606-016-3601-x.
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Keywords: Primary Care, Diagnostic Safety and Quality, Medical Errors, Patient Safety, Quality Improvement
Simmons SF, Schnelle JF, Sathe NA
Defining safety in the nursing home setting: Implications for future research.
AHRQ’s Common Format for nursing homes (NHs) accommodates voluntary reporting for 4 adverse events: falls with injury, pressure ulcers, medication errors, and infections. In 2015, AHRQ funded a technical brief to describe the state of the science related to safety in the NH setting to inform a research agenda. Thirty-six recent systematic reviews evaluated NH safety-related interventions to address these 4 adverse events and reported mostly mixed evidence about effective approaches to ameliorate them.
AHRQ-funded; 290201500003I.
Citation: Simmons SF, Schnelle JF, Sathe NA .
Defining safety in the nursing home setting: Implications for future research.
J Am Med Dir Assoc 2016 Jun;17(6):473-81. doi: 10.1016/j.jamda.2016.03.005..
Keywords: Nursing Homes, Long-Term Care, Adverse Events, Patient Safety, Evidence-Based Practice
Pronovost PJ, Cleeman JI, Wright D
AHRQ Author: Cleeman JI
Fifteen years after to Err is Human: a success story to learn from.
This paper provides a historical profile of the central line-associated bloodstream infection (CLABSI) success story, comparing infection rates before and 15 years after the IOM report. It discusses the five elements essential to the national success in reducing CLABSI rates: a reliable and valid measurement system, evidence-based care practices, investment in implementation sciences, local ownership and peer learning communities, and coordination and alignment of CLABSI reduction efforts.
AHRQ-authored.
Citation: Pronovost PJ, Cleeman JI, Wright D .
Fifteen years after to Err is Human: a success story to learn from.
BMJ Qual Saf 2016 Jun;25(6):396-9. doi: 10.1136/bmjqs-2015-004720.
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Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Patient Safety, Medical Errors, Evidence-Based Practice, Quality of Care
Landrigan CP, Stockwell D, Toomey SL
Performance of the Global Assessment of Pediatric Patient Safety (GAPPS) Tool.
This study's objective was to develop and test the Global Assessment of Pediatric Patient Safety (GAPPS) trigger tool, which measures hospital-wide rates of adverse events (AEs) and preventable AEs. In total, 3,814 medical records were reviewed. It found that both primary and secondary reviewers agreed 92 percent of the time on presence or absence of a suspected AE.
AHRQ-funded; HS020513.
Citation: Landrigan CP, Stockwell D, Toomey SL .
Performance of the Global Assessment of Pediatric Patient Safety (GAPPS) Tool.
Pediatrics 2016 Jun;137(6):pii: e20154076. doi: 10.1542/peds.2015-4076.
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Keywords: Patient Safety, Children/Adolescents, Tools & Toolkits, Adverse Events, Children/Adolescents
Liu S, Mazur T, Li H
SU-F-T-275: A correlation study on 3D fluence-based QA and 2D dose measurement-based QA.
The aim of this paper was to demonstrate the feasibility and creditability of computing and verifying 3D fluencies to assure IMRT and VMAT treatment deliveries, by correlating the passing rates of the 3D fluence-based QA (P(alpha)) to the passing rates of 2D dose measurement based QA (P(Dm)). It concluded that the demonstrated correlations improve the creditability of using 3D fluence-based QA for assuring treatment deliveries for IMRT/VMAT plans.
AHRQ-funded; HS022888.
Citation: Liu S, Mazur T, Li H .
SU-F-T-275: A correlation study on 3D fluence-based QA and 2D dose measurement-based QA.
Med Phys 2016 Jun;43(6 Part 17):3525-26. doi: 10.1118/1.4956415.
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Keywords: Cancer, Healthcare Delivery, Treatments, Patient Safety, Health Information Technology (HIT)
Liu S, Wu Y, Chang X
TU-FG-201-03: Automatic pre-delivery verification using statistical analysis of consistencies in treatment plan parameters by the treatment site and modality.
A novel computer software system, namely APDV (Automatic Pre-Delivery Verification), was developed for verifying patient treatment plan parameters right prior to treatment deliveries in order to automatically detect and prevent catastrophic errors. This study implemented APDV as a stand-alone program to ensure required real time performance. It concluded that APDV could be useful in detecting and preventing catastrophic errors immediately before treatment deliveries.
AHRQ-funded; HS022888.
Citation: Liu S, Wu Y, Chang X .
TU-FG-201-03: Automatic pre-delivery verification using statistical analysis of consistencies in treatment plan parameters by the treatment site and modality.
Med Phys 2016 Jun;43(6 Part 35):3753. doi: 10.1118/1.4957526.
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Keywords: Cancer, Healthcare Delivery, Treatments, Patient Safety, Health Information Technology (HIT)
Wang SV, Franklin JM, Glynn RJ
Prediction of rates of thromboembolic and major bleeding outcomes with dabigatran or warfarin among patients with atrial fibrillation: new initiator cohort study.
The authors compared stratified event rates from randomized controlled trials with predicted event rates from models developed in observational data and assessed their ability to accurately capture observed rates of thromboembolism and major bleeding for patients treated with dabigatran or warfarin as part of routine care. They found that estimated rates of thromboembolism under dabigatran or warfarin treatment in randomized controlled trials were close to observed rates in routine care patients, but that rates of major bleeding were underestimated. They concluded that models developed in routine care patients can provide accurate, tailored estimates of risk and benefit under alternative treatment to enhance patient centered care.
AHRQ-funded; HS022193.
Citation: Wang SV, Franklin JM, Glynn RJ .
Prediction of rates of thromboembolic and major bleeding outcomes with dabigatran or warfarin among patients with atrial fibrillation: new initiator cohort study.
BMJ 2016 May 24;353:i2607. doi: 10.1136/bmj.i2607.
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Keywords: Blood Thinners, Adverse Drug Events (ADE), Blood Clots, Patient Safety, Medication
Jindai K, Sterkel AK, Reed KD
Limb embolism in a 52-year-old woman.
In response to a photo quiz, the authors make the following diagnosis: arterial thrombus caused by Histoplasma capsulatum deriving from native valve endocarditis caused by the same organism. Various aspects of the case are discussed.
AHRQ-funded; HS022465; HS023779.
Citation: Jindai K, Sterkel AK, Reed KD .
Limb embolism in a 52-year-old woman.
Clin Infect Dis 2016 May 15;62(10):1320-1. doi: 10.1093/cid/ciw081.
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Keywords: Blood Clots, Care Management, Case Study, Diagnostic Safety and Quality, Patient Safety
Hernandez-Boussard TM, McDonald KM, Morrison DE
Risks of adverse events in colorectal patients: population-based study.
The authors sought to assess adverse events in colorectal surgical patients. They found important differential rates of adverse events by diagnostic category, with the highest odds ratio occurring in patients undergoing surgery for ischemic colitis.
AHRQ-funded; HS018558.
Citation: Hernandez-Boussard TM, McDonald KM, Morrison DE .
Risks of adverse events in colorectal patients: population-based study.
J Surg Res 2016 May 15;202(2):328-34. doi: 10.1016/j.jss.2016.01.013.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Adverse Events, Surgery, Patient Safety, Risk, Quality Indicators (QIs), Quality of Care, Quality Measures
Yang D, Wooten HO, Green O
A software tool to automatically assure and report daily treatment deliveries by a Cobalt-60 radiation therapy device.
The researchers developed a method for verification of treatment delivery after each treatment fraction in order to detect and correct errors, and they developed a comprehensive daily report. The end result has been integrated into a commercial version of the treatment delivery system, and it has been in clinical use for over one year.
AHRQ-funded; HS022888.
Citation: Yang D, Wooten HO, Green O .
A software tool to automatically assure and report daily treatment deliveries by a Cobalt-60 radiation therapy device.
J Appl Clin Med Phys 2016 May 8;17(3):6001.
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Keywords: Treatments, Cancer, Quality of Care, Patient Safety
Robinson JD, Tate A, Heritage J
Agenda-setting revisited: when and how do primary-care physicians solicit patients' additional concerns?
The authors assessed the distribution, content, and effectiveness of physicians' post-chief-complaint, agenda-setting questions. They found that physicians' questions designed to solicit concerns additional to chief concerns occurred in only 32% of visits. Further, those that were formatted so as to allow for 'concerns' were significantly more likely to generate some type of agenda item.
AHRQ-funded; HS010922; HS013343.
Citation: Robinson JD, Tate A, Heritage J .
Agenda-setting revisited: when and how do primary-care physicians solicit patients' additional concerns?
Patient Educ Couns 2016 May;99(5):718-23. doi: 10.1016/j.pec.2015.12.009.
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Keywords: Communication, Primary Care, Patient-Centered Healthcare, Patient Safety, Clinician-Patient Communication
Grant PJ, Greene MT, Chopra V
Assessing the Caprini score for risk assessment of venous thromboembolism in hospitalized medical patients.
The authors examined how well the Caprini risk assessment model predicts venous thromboembolism in hospitalized medical patients. They concluded that the Caprini risk assessment model was unable to identify a subset of medical patients who benefit from pharmacologic prophylaxis.
AHRQ-funded; HS022835.
Citation: Grant PJ, Greene MT, Chopra V .
Assessing the Caprini score for risk assessment of venous thromboembolism in hospitalized medical patients.
Am J Med 2016 May;129(5):528-35. doi: 10.1016/j.amjmed.2015.10.027.
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Keywords: Adverse Events, Blood Clots, Hospitalization, Risk, Patient Safety
Musuuza JS, Barker A, Ngam C
Assessment of fidelity in interventions to improve hand hygiene of healthcare workers: a systematic review.
The researchers examined fidelity reporting in interventions to improve hand hygiene compliance and assessed 5 measures of intervention fidelity. They found that participant responsiveness and adherence to the intervention were the most frequently unreported fidelity measures, while quality of the delivery was the most frequently reported measure. To facilitate replication and effective implementation, the authors recommended that reporting fidelity should be standard practice when describing results of complex behavioral interventions such as hand hygiene.
AHRQ-funded; HS024039.
Citation: Musuuza JS, Barker A, Ngam C .
Assessment of fidelity in interventions to improve hand hygiene of healthcare workers: a systematic review.
Infect Control Hosp Epidemiol 2016 May;37(5):567-75. doi: 10.1017/ice.2015.341.
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Keywords: Healthcare-Associated Infections (HAIs), Provider: Health Personnel, Patient Safety, Prevention
McElroy LM, Khorzad R, Nannicelli AP
Failure mode and effects analysis: a comparison of two common risk prioritisation methods.
The investigators compared a simplified scoring method with the traditional scoring method to determine the degree of congruence in identifying high-risk failures. They found that the simplified method did not result in the same degree of discrimination in the ranking of failures offered by the traditional method.
AHRQ-funded; HS000078.
Citation: McElroy LM, Khorzad R, Nannicelli AP .
Failure mode and effects analysis: a comparison of two common risk prioritisation methods.
BMJ Qual Saf 2016 May;25(5):329-36. doi: 10.1136/bmjqs-2015-004130.
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Keywords: Adverse Events, Intensive Care Unit (ICU), Outcomes, Patient Safety, Risk
Topaz M, Seger DL, Slight SP
Rising drug allergy alert overrides in electronic health records: an observational retrospective study of a decade of experience.
The authors aimed to explore the common drug allergy alerts over the last 10 years and the reasons why providers tend to override these alerts. They found that alarmingly, alerts for immune mediated and life threatening reactions with definite allergen and prescribed medication matches were overridden 72.8 percent and 74.1 percent of the time, respectively.
AHRQ-funded; HS022728.
Citation: Topaz M, Seger DL, Slight SP .
Rising drug allergy alert overrides in electronic health records: an observational retrospective study of a decade of experience.
J Am Med Inform Assoc 2016 May;23(3):601-8. doi: 10.1093/jamia/ocv143.
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Keywords: Electronic Health Records (EHRs), Adverse Drug Events (ADE), Medication, Medication: Safety, Patient Safety
Tischendorf J, de Avila RA, Safdar N
Risk of infection following colonization with carbapenem-resistant Enterobactericeae: a systematic review.
The authors examined the risk of developing infection among those colonized with carbapenem-resistant enterobacteriaceae (CRE). They found an overall 16.5% risk of infection with CRE, with the most common site of infection being the lung. They concluded that, given the high mortality rate observed with CRE infection and the difficulty in treating these infections, research to investigate and develop strategies to eliminate the colonization state are needed.
AHRQ-funded; HS023791; HS024039.
Citation: Tischendorf J, de Avila RA, Safdar N .
Risk of infection following colonization with carbapenem-resistant Enterobactericeae: a systematic review.
Am J Infect Control 2016 May;44(5):539-43. doi: 10.1016/j.ajic.2015.12.005.
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Keywords: Antibiotics, Healthcare-Associated Infections (HAIs), Patient Safety, Risk, Risk
Rinke ML, Mock CK, Persing NM
The Armstrong Institute Resident/Fellow Scholars: a multispecialty curriculum to train future leaders in patient safety and quality improvement.
The purpose of the study was to determine if a year-long, multispecialty resident and fellow quality improvement (QI) curriculum was feasible and led to improvements in QI beliefs and self-reported behaviors.
AHRQ-funded; HS021282; HS017952.
Citation: Rinke ML, Mock CK, Persing NM .
The Armstrong Institute Resident/Fellow Scholars: a multispecialty curriculum to train future leaders in patient safety and quality improvement.
Am J Med Qual 2016 May;31(3):224-32. doi: 10.1177/1062860614568523..
Keywords: Education: Continuing Medical Education, Education: Curriculum, Patient Safety, Quality Improvement
Holcomb CN, Graham LA, Richman JS
The incremental risk of coronary stents on postoperative adverse events: a matched cohort study.
The objective of this study was to determine the incremental risk of coronary stents on adverse events in surgical patients and whether it varies over time from stent placement. It concluded that surgery after coronary stent placement is associated with an approximate 2 percent absolute risk for postoperative heart attack but no difference in mortality compared with nonstented matched controls.
AHRQ-funded; HS013852.
Citation: Holcomb CN, Graham LA, Richman JS .
The incremental risk of coronary stents on postoperative adverse events: a matched cohort study.
Ann Surg 2016 May;263(5):924-30. doi: 10.1097/sla.0000000000001246..
Keywords: Adverse Events, Risk, Surgery, Patient Safety, Heart Disease and Health, Cardiovascular Conditions
Heid C, Knobloch MJ, Schulz LT
Use of the health belief model to study patient perceptions of antimicrobial stewardship in the acute care setting.
The authors identified themes associated with patient perceptions of antibiotic use and the role of patients in inpatient antimicrobial stewardship. They found that general medicine inpatients receiving at least one anti-infective medication recognized antibiotic resistance as a serious public health threat but expressed low perceived susceptibility to being personally affected by antibiotic resistance. Few participants reported being offered the opportunity to engage in shared decision making while hospitalized. The researchers concluded that the likelihood of patient engagement in stewardship practices is currently limited by low perceived susceptibility and lack of cues to act.
AHRQ-funded; HS023791.
Citation: Heid C, Knobloch MJ, Schulz LT .
Use of the health belief model to study patient perceptions of antimicrobial stewardship in the acute care setting.
Infect Control Hosp Epidemiol 2016 May;37(5):576-82. doi: 10.1017/ice.2015.342.
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Keywords: Critical Care, Antimicrobial Stewardship, Antibiotics, Patient and Family Engagement, Patient Safety
Lee JH, Turner DA, Kamat P
The number of tracheal intubation attempts matters! A prospective multi-institutional pediatric observational study.
The objective of this study is to determine the association between number of tracheal intubation (TI) attempts and severe desaturation (SpO2 < 70 percent) and adverse TI associated events (TIAEs). It found that the number of TI attempts was associated with desaturations and increased occurrence of TIAEs in critically ill children with acute respiratory failure.
AHRQ-funded; HS021583; HS022464.
Citation: Lee JH, Turner DA, Kamat P .
The number of tracheal intubation attempts matters! A prospective multi-institutional pediatric observational study.
BMC Pediatr 2016 Apr 29;16:58. doi: 10.1186/s12887-016-0593-y.
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Keywords: Adverse Events, Children/Adolescents, Respiratory Conditions, Patient Safety, Children/Adolescents
Khan A, Furtak SL, Melvin P
Parent-reported errors and adverse events in hospitalized children.
The researchers sought to determine the frequency with which parents experience patient safety incidents and the proportion of reported incidents that meet standard definitions of medical errors and preventable adverse events (AEs). They found that parents frequently reported errors and preventable AEs, many of which were not otherwise documented in the medical record.
AHRQ-funded; HS022986.
Citation: Khan A, Furtak SL, Melvin P .
Parent-reported errors and adverse events in hospitalized children.
JAMA Pediatr 2016 Apr 4;170(4):e154608. doi: 10.1001/jamapediatrics.2015.4608..
Keywords: Children/Adolescents, Hospitalization, Patient Safety, Adverse Events, Medical Errors
McElroy LM, Woods DM, Yanes AF
Applying the WHO conceptual framework for the International Classification for Patient Safety to a surgical population.
The researchers aimed to test the applicability of the International Classification for Patient Safety to a surgical population by developing a codebook for future use by researchers. They found that the most common severity classification was 'reportable circumstance' and that the most common incident type was 'resources/organizational management.' They noted that several aspects of surgical care were encompassed by more than one classification, including operating room scheduling, delays in care, trainee-related incidents, interruptions, and handoffs. They concluded that a framework for patient safety can be applied to facilitate the organization and analysis of surgical safety data.
AHRQ-funded; HS000078.
Citation: McElroy LM, Woods DM, Yanes AF .
Applying the WHO conceptual framework for the International Classification for Patient Safety to a surgical population.
Int J Qual Health Care 2016 Apr;28(2):166-74. doi: 10.1093/intqhc/mzw001.
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Keywords: Surgery, Patient Safety, Transplantation, Adverse Events, Medical Errors
Bauer NS, Carroll AE, Saha C
Experience with decision support system and comfort with topic predict clinicians' responses to alerts and reminders.
The researchers examined factors associated with clinician response to computer decision support system (CDSS) prompts as part of a larger, ongoing quality improvement effort to optimize CDSS use. They found that clinicians were more likely to respond to topics rated as "easy" to discuss. The position of the prompt on the page, clinician gender, and the patient's age, race/ethnicity, and preferred language were also predictive of prompt response rate.
AHRQ-funded; HS017939; HS020640; HS022681.
Citation: Bauer NS, Carroll AE, Saha C .
Experience with decision support system and comfort with topic predict clinicians' responses to alerts and reminders.
J Am Med Inform Assoc 2016 Apr;23(e1):e125-30. doi: 10.1093/jamia/ocv148.
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Keywords: Clinical Decision Support (CDS), Patient Safety, Children/Adolescents, Health Information Technology (HIT), Children/Adolescents
Plasek JM, Goss FR, Lai KH
Food entries in a large allergy data repository.
This study examined, encoded, and grouped foods that caused any adverse sensitivity in a large allergy repository using natural language processing and standard terminologies. It identified 158,552 food allergen records (2,140 unique terms) in the Partners repository, corresponding to 672 food allergen concepts. High-frequency groups included shellfish (19.3 percent), fruits or vegetables (18.4 percent), dairy (9.0 percent), and peanuts (8.5 percent).
AHRQ-funded; HS022728.
Citation: Plasek JM, Goss FR, Lai KH .
Food entries in a large allergy data repository.
J Am Med Inform Assoc 2016 Apr;23(e1):e79-87. doi: 10.1093/jamia/ocv128.
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Keywords: Data, Health Information Technology (HIT), Electronic Health Records (EHRs), Patient Safety