National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (1)
- Adverse Events (3)
- Antibiotics (1)
- Antimicrobial Stewardship (2)
- Cardiovascular Conditions (1)
- Central Line-Associated Bloodstream Infections (CLABSI) (1)
- Children/Adolescents (6)
- Chronic Conditions (2)
- Communication (1)
- Comparative Effectiveness (1)
- (-) Critical Care (24)
- Diagnostic Safety and Quality (1)
- Disparities (1)
- Elderly (2)
- Electronic Health Records (EHRs) (1)
- Emergency Medical Services (EMS) (2)
- Evidence-Based Practice (1)
- Guidelines (1)
- Healthcare-Associated Infections (HAIs) (3)
- Healthcare Costs (1)
- Health Information Technology (HIT) (1)
- Home Healthcare (1)
- Hospital Discharge (1)
- Imaging (1)
- Intensive Care Unit (ICU) (10)
- Medical Errors (1)
- Medication (1)
- Methicillin-Resistant Staphylococcus aureus (MRSA) (1)
- Newborns/Infants (2)
- Nursing (2)
- Organizational Change (2)
- Patient-Centered Outcomes Research (1)
- Patient Safety (9)
- Prevention (2)
- Provider: Pharmacist (1)
- Provider: Physician (1)
- Quality of Care (1)
- Racial and Ethnic Minorities (1)
- Shared Decision Making (1)
- Stroke (2)
- Surgery (1)
- Telehealth (1)
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 24 of 24 Research Studies DisplayedChase AM, Forehand CC, Keats KR
Evaluation of critical care pharmacist evening services at an academic medical center.
This study’s purpose was to investigate the number of interventions, type of interventions, and associated cost savings with the addition of 1 board certified critical care clinical pharmacist to evening shift. Over a 12-week period, a prospective collection and characterization of 1 evening shift critical care pharmacist’s clinical interventions was conducted. Interventions were collected and categorized daily from 1 pm to 11 pm Monday through Friday. The authors collected a total of 510 interventions with an average of 9.8 interventions accepted per day. The highest proportion of interventions occurred in the medical intensive care unit, and the most common interventions included transitions of care, medication dose adjustment, and antibiotic de-escalation. They calculated an estimated cost avoidance of $66,537.80 for an average of $1279.57 saved per day. Additionally, 4.1% of interventions were considered high yield interventions upon independent review by 2 pharmacists.
AHRQ-funded; HS029009; HS028485.
Citation: Chase AM, Forehand CC, Keats KR .
Evaluation of critical care pharmacist evening services at an academic medical center.
Hosp Pharm 2024 Apr; 59(2):228-33. doi: 10.1177/00185787231207996..
Keywords: Provider: Pharmacist, Medication, Critical Care
Ducharme-Crevier L, Furlong-Dillard J, Jung P
Safety of primary nasotracheal intubation in the pediatric intensive care unit (PICU).
This study examined the safety of using primary nasal tracheal intubation (TI) in the pediatric intensive care unit (PICU), which is a minority of all TI procedures. The authors evaluated the association between TI route and safety outcomes in a prospectively collected quality improvement database (National Emergency Airway Registry for Children: NEAR4KIDS) from 2013 to 2020. The primary outcome was severe desaturation and/or severe adverse TI-associated events (TIAEs), using NEAR4KIDS definitions. A total of 22,741 TIs were reported from 60 PICUs, with the majority (96.2%) oral and 3.8% nasal. Infants were represented in higher proportion in the nasal TI than the oral TI (75.9%, vs 46.2%), as well as children with cardiac conditions (46.9% vs. 14.4%). Severe desaturation or severe TIAE occurred in 23.7% of nasal and 22.5% of oral TI. With propensity score (PS) matching, the prevalence of severe desaturation and or severe adverse TIAEs was 23.6% of nasal vs. 19.8% of oral TI (absolute difference 3.8%). First attempt success rate was 72.1% of nasal TI versus 69.2% of oral TI. With PS matching, the overall success rate was not different between two groups (nasal 72.2% vs. oral 71.5%).
AHRQ-funded; HS024511.
Citation: Ducharme-Crevier L, Furlong-Dillard J, Jung P .
Safety of primary nasotracheal intubation in the pediatric intensive care unit (PICU).
Intensive Care Med Paediatr Neonatal 2024; 2(1):7. doi: 10.1007/s44253-024-00035-4..
Keywords: Children/Adolescents, Intensive Care Unit (ICU), Patient Safety, Critical Care
Gladen KM, Tellez D, Napolitano N
Adverse tracheal intubation events in critically ill underweight and obese children: retrospective study of the National Emergency Airway for Children Registry (2013-2020).
This retrospective cohort study’s aim was to determine the association between being underweight or obese with adverse airway outcomes, including adverse tracheal intubation (TI)-associated events (TIAEs) and/or severe peri-intubation hypoxemia (pulse oximetry oxygen saturation < 80%) in critically ill children. The National Emergency Airway for Children registry dataset of 2013-2020 was used to identify 24,342 critically ill children who underwent TI between 2013 and 2020. Underweight was most common in infants (34%); and obesity was most common in children older than 8 years old (15.1%). The underweight patients more often had oxygenation and ventilation failure (34.0%, 36.2%, respectively) as the indication for TI and a history of difficult airway (16.7%). Apneic oxygenation was used more often in overweight and obese patients (19.1%, 19.6%) than in underweight or normal weight patients (14.1%, 17.1%). TIAEs and/or hypoxemia occurred more often in underweight (27.1%) and obese (24.3%) patients. TI in underweight children was associated with greater odds of adverse airway outcome compared with normal weight children after adjusting for potential confounders (underweight: adjusted odds ratio [aOR], 1.09). Both underweight and obesity were associated with hypoxemia after adjusting for covariates and site clustering (underweight: aOR, 1.11; and obesity: aOR, 1.22).
AHRQ-funded; HS024511.
Citation: Gladen KM, Tellez D, Napolitano N .
Adverse tracheal intubation events in critically ill underweight and obese children: retrospective study of the National Emergency Airway for Children Registry (2013-2020).
Pediatr Crit Care Med 2024 Feb; 25(2):147-58. doi: 10.1097/pcc.0000000000003387..
Keywords: Children/Adolescents, Critical Care
Van Damme DM, McRae EM, Irving SY
Tracheal intubation by advanced practice registered nurses in pediatric critical care: retrospective study from the National Emergency Airway for Children Registry (2015-2019).
A study was conducted from 2015-2019 to compare the success rates of tracheal intubation (TI) administered by advanced practice registered nurses (APRNs), vs. more experienced clinicians. It also compared the rates of TI-associated events (TIAE). The study subjects were critically ill children in need of tracheal intubation. The findings indicated a lower TI success rate for APRNs when compared to more experienced clinicians. The study did not find significant differences in adverse events.
AHRQ-funded; HS024511.
Citation: Van Damme DM, McRae EM, Irving SY .
Tracheal intubation by advanced practice registered nurses in pediatric critical care: retrospective study from the National Emergency Airway for Children Registry (2015-2019).
Pediatr Crit Care Med 2024 Feb; 25(2):139-46. doi: 10.1097/pcc.0000000000003386..
Keywords: Children/Adolescents, Critical Care, Nursing
Loi MV, Lee JH, Huh JW
Ketamine use in the intubation of critically ill children with neurological indications: a multicenter retrospective analysis.
This study examined use of ketamine in children undergoing tubal intubation (TI) for a primary neurological indication. The authors conducted a retrospective observational cohort study of critically ill children undergoing TI for neurological indications in 53 international pediatric intensive care units and emergency departments. They screened all intubations from 2014 to 2020 entered into the multicenter National Emergency Airway Registry for Children (NEAR4KIDS) registry database. Of 21,562 TIs, 2,073 were performed for a primary neurological indication, including 190 for traumatic brain injury/trauma. Patients received ketamine in 495 TIs (23.9%), which increased from 10% in 2014 to 41% in 2020. Criteria for ketamine use includes a coindication of respiratory failure, difficult airway history, and use of vagolytic agents, apneic oxygenation, and video laryngoscopy. Composite adverse outcomes were reported in 289 (13.9%) TIs and were more common in the ketamine group (17.0% vs. 13.0%). After adjusting for location, patient age and co-diagnoses, the presence of respiratory failure and shock, difficult airway history, provider demographics, intubating device, and the use of apneic oxygenation, vagolytic agents, and neuromuscular blockade, ketamine use was not significantly associated with increased composite adverse outcomes. This paucity of association remained even when only neurotrauma intubations were considered (10.6% vs. 7.7%).
AHRQ-funded; HS022464, HS024511.
Citation: Loi MV, Lee JH, Huh JW .
Ketamine use in the intubation of critically ill children with neurological indications: a multicenter retrospective analysis.
Neurocrit Care 2024 Feb; 40(1):205-14. doi: 10.1007/s12028-023-01734-0.
Keywords: Children/Adolescents, Critical Care, Adverse Drug Events (ADE), Adverse Events, Patient Safety
Sick-Samuels AC, Koontz DW, Xie A
A survey of PICU clinician practices and perceptions regarding respiratory cultures in the evaluation of ventilator-associated infections in the BrighT STAR Collaborative.
A survey of medical professionals from 16 different academic pediatric hospitals was conducted from May 2021-January 2022. The goal of the survey was to examine respiratory culture practices, drivers, and barriers in mechanically ventilated patients. The study concluded that respiratory culture practices were inconsistent.
AHRQ-funded; HS028634.
Citation: Sick-Samuels AC, Koontz DW, Xie A .
A survey of PICU clinician practices and perceptions regarding respiratory cultures in the evaluation of ventilator-associated infections in the BrighT STAR Collaborative.
Pediatr Crit Care Med 2024 Jan; 25(1):e20-e30. doi: 10.1097/pcc.0000000000003379..
Keywords: Children/Adolescents, Intensive Care Unit (ICU), Critical Care, Healthcare-Associated Infections (HAIs)
Qureshi N, Kroger J, Zangwill KM
Changes in perceptions of antibiotic stewardship among neonatal intensive care unit providers over the course of a learning collaborative: a prospective, multisite, mixed-methods evaluation.
The purpose of this study was to assess clinician perceptions towards the value and implementation of antibiotic stewardship (AS) in neonatal intensive care units (NICU). The researchers conducted a mixed-methods study of AS perceptions utilizing surveys and interviews in 30 California NICUs before and after a multicenter collaborative (Optimizing Antibiotic Use in California NICUs [OASCN]). The study found that pre-OASCN, 24% of respondents believed there was "a lot of" or "some" inappropriate prescribing, often driven by fear of a bad outcome or hesitation to change existing practices. Clinicians reported statistically significant increases in AS importance, perceived AS activity, and more openness to change after OASCN.
AHRQ-funded; HS026168.
Citation: Qureshi N, Kroger J, Zangwill KM .
Changes in perceptions of antibiotic stewardship among neonatal intensive care unit providers over the course of a learning collaborative: a prospective, multisite, mixed-methods evaluation.
J Perinatol 2024 Jan; 44(1):62-70. doi: 10.1038/s41372-023-01823-0..
Keywords: Antibiotics, Antimicrobial Stewardship, Newborns/Infants, Intensive Care Unit (ICU), Critical Care
Moore CL, Broder J, Gunn ML
Comparative effectiveness research: alternatives to "traditional" computed tomography use in the acute care setting.
The goal was to seek consensus in identifying and prioritizing research questions and themes that involve the comparative effectiveness of "traditional" computed tomography use versus alternative diagnostic strategies in the acute care setting. A modified Delphi technique was used that included input from emergency physicians, emergency radiologists, medical physicists, and an industry expert to achieve this.
AHRQ-funded; HS021271; HS023498.
Citation: Moore CL, Broder J, Gunn ML .
Comparative effectiveness research: alternatives to "traditional" computed tomography use in the acute care setting.
Acad Emerg Med 2015 Dec;22(12):1465-73. doi: 10.1111/acem.12831.
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Keywords: Comparative Effectiveness, Imaging, Critical Care, Emergency Medical Services (EMS)
Rehder KJ, Giuliano JS, Jr., Napolitano N
Increased occurrence of tracheal intubation-associated events during nights and weekends in the PICU.
Little is known about how the incidence of tracheal intubation-associated events is affected by the time of day, day of the week, or presence of in-hospital attending-level intensivists. After analyzing 5,096 tracheal intubation courses from the prospective multicenter National Emergency Airway Registry for Children, the researchers found that a higher occurrence of tracheal intubation-associated events was observed during nights and weekends, due primarily to emergent intubations.
AHRQ-funded; HS022464; HS021583.
Citation: Rehder KJ, Giuliano JS, Jr., Napolitano N .
Increased occurrence of tracheal intubation-associated events during nights and weekends in the PICU.
Crit Care Med 2015 Dec;43(12):2668-74. doi: 10.1097/ccm.0000000000001313.
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Keywords: Newborns/Infants, Intensive Care Unit (ICU), Adverse Events, Patient Safety, Critical Care
Kerlin MP, Cooke CR
Understanding costs when seeking value in critical care.
The authors discuss a study by Gershengorn and colleagues about daily ICU costs in five ICUs within a single medical center. They argue that although the authors should be commended on advancing the understanding of ICU costs, we should also recognize that efforts to reduce ICU length of stay will necessarily be insufficient to make a real dent in our health care economy.
AHRQ-funded; HS020672.
Citation: Kerlin MP, Cooke CR .
Understanding costs when seeking value in critical care.
Ann Am Thorac Soc 2015 Dec;12(12):1743-4. doi: 10.1513/AnnalsATS.201510-660ED.
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Keywords: Critical Care, Healthcare Costs, Intensive Care Unit (ICU)
Shaw JJ, Santry HP
Who gets early tracheostomy? Evidence of unequal treatment at 185 academic medical centers.
The researchers identified clinical and demographic disparities the reasons for variation in time from intubation to tracheostomy. They found that although early tracheostomy was associated with increased survival, there were still significant disparities in time to tracheostomy according to sex, race, and type of insurance.
AHRQ-funded; HS022694.
Citation: Shaw JJ, Santry HP .
Who gets early tracheostomy? Evidence of unequal treatment at 185 academic medical centers.
Chest 2015 Nov;148(5):1242-50. doi: 10.1378/chest.15-0576..
Keywords: Disparities, Quality of Care, Critical Care
Peterson LR, Wright MO, Beaumont JL
Nonimpact of decolonization as an adjunctive measure to contact precautions for the control of methicillin-resistant Staphylococcus aureus transmission in acute care.
This was an observational study comparing methicillin-resistant Staphylococcus aureus (MRSA) transmission with no decolonization of medical patients to required decolonization of all MRSA carriers during two consecutive periods: baseline with no decolonization of medical patients and universal MRSA carrier decolonization. The study concluded that decolonization of MRSA patients does not add benefit when contact precautions are used for patients colonized with MRSA in acute (hospital) care.
AHRQ-funded; HS019968.
Citation: Peterson LR, Wright MO, Beaumont JL .
Nonimpact of decolonization as an adjunctive measure to contact precautions for the control of methicillin-resistant Staphylococcus aureus transmission in acute care.
Antimicrob Agents Chemother 2015 Oct 12;60(1):99-104. doi: 10.1128/aac.02046-15.
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Keywords: Methicillin-Resistant Staphylococcus aureus (MRSA), Critical Care, Antimicrobial Stewardship, Elderly, Patient Safety
Croft LD, Harris AD, Pineles L
The effect of universal glove and gown use on adverse events in intensive care unit patients.
The researchers assessed if wearing gloves and gowns during all patient contact in the intensive care unit (ICU) changes adverse event rates. They found that in ICUs where healthcare workers donned gloves and gowns for all patient contact, patients were no more likely to experience adverse events than in control ICUs. Concerns of adverse events resulting from universal glove and gown use were not supported.
AHRQ-funded; 29020060001.
Citation: Croft LD, Harris AD, Pineles L .
The effect of universal glove and gown use on adverse events in intensive care unit patients.
Clin Infect Dis 2015 Aug 15;61(4):545-53. doi: 10.1093/cid/civ315..
Keywords: Patient Safety, Intensive Care Unit (ICU), Adverse Events, Healthcare-Associated Infections (HAIs), Critical Care
McConnochie KM, Ronis SD, Wood NE
Effectiveness and safety of acute care telemedicine for children with regular and special healthcare needs.
The authors assessed the hypothesis that effectiveness and safety of the Health-e-Access telemedicine model for care of children with special healthcare needs (CSHCN) with acute illness equaled those for care of children in regular childcare and schools (CRS). They concluded that observations support safety and effectiveness of Health-e-Access telemedicine for both CSHCN and CRS.
AHRQ-funded; HS016871; HS015165; HS018912.
Citation: McConnochie KM, Ronis SD, Wood NE .
Effectiveness and safety of acute care telemedicine for children with regular and special healthcare needs.
Telemed J E Health 2015 Aug;21(8):611-21. doi: 10.1089/tmj.2014.0175.
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Keywords: Critical Care, Children/Adolescents, Patient Safety, Patient-Centered Outcomes Research, Telehealth
Collins CE, Pringle PL, Santry HP
Innovation or rebranding, acute care surgery diffusion will continue.
The researchers conducted a qualitative study comprising face-to-face interviews with senior surgeons responsible for acute care surgery (ACS) at 18 teaching hospitals chosen to ensure diversity of opinions and practice environment. Their analysis suggests that the implementation of ACS, whether a true health care delivery innovation or an innovative rebranding, fits into the Rogers’ diffusion of innovation theory.
AHRQ-funded; HS022694.
Citation: Collins CE, Pringle PL, Santry HP .
Innovation or rebranding, acute care surgery diffusion will continue.
J Surg Res 2015 Aug;197(2):354-62. doi: 10.1016/j.jss.2015.03.046..
Keywords: Surgery, Critical Care, Organizational Change, Provider: Physician
Kiyoshi-Teo H, Blegen M
Influence of institutional guidelines on oral hygiene practices in intensive care units.
The purpose of this study was to explore how characteristics of institutional guidelines for oral hygiene influence nurses’ oral hygiene practices and perceptions of that practice. It concluded that the content and dissemination method of institutional guidelines on oral hygiene do influence the oral hygiene practices of critical care nurses.
AHRQ-funded; HS018879.
Citation: Kiyoshi-Teo H, Blegen M .
Influence of institutional guidelines on oral hygiene practices in intensive care units.
Am J Crit Care 2015 Jul;24(4):309-18. doi: 10.4037/ajcc2015920..
Keywords: Intensive Care Unit (ICU), Nursing, Critical Care, Prevention, Guidelines
Lyerly MJ, Albright KC, Boehme AK
Patient selection for drip and ship thrombolysis in acute ischemic stroke.
The authors sought to determine whether the population of their offsite stroke patients receiving thrombolysis differed from patients treated directly at their stroke center. Their results showed that a smaller proportion of blacks and older adults arrived at their center from other facilities, possibly reflecting differences in how patients are selected for thrombolysis and transferred to a higher level of care.
AHRQ-funded; HS013852.
Citation: Lyerly MJ, Albright KC, Boehme AK .
Patient selection for drip and ship thrombolysis in acute ischemic stroke.
South Med J 2015 Jul;108(7):393-8. doi: 10.14423/smj.0000000000000306.
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Keywords: Critical Care, Elderly, Stroke, Racial and Ethnic Minorities
Murray DJ, Freeman BD, Boulet JR
Decision making in trauma settings: simulation to improve diagnostic skills.
The objective of this study was to determine whether simulation could be used to provide teams the experiences in managing scenarios that require the use of heuristic as well as analytic diagnostic skills to effectively recognize and treat potentially life-threatening injuries. The results of this preliminary study indicates that teams led by more senior residents received higher scores when managing heuristic scenarios but were less effective when managing the scenarios that require a more analytic approach.
AHRQ-funded; HS018734; HS022265.
Citation: Murray DJ, Freeman BD, Boulet JR .
Decision making in trauma settings: simulation to improve diagnostic skills.
Simul Healthc 2015 Jun;10(3):139-45. doi: 10.1097/sih.0000000000000073..
Keywords: Shared Decision Making, Diagnostic Safety and Quality, Critical Care, Patient Safety, Medical Errors
Prvu Bettger J, McCoy L, Smith EE
Contemporary trends and predictors of postacute service use and routine discharge home after stroke.
The authors examined trends in discharge to inpatient rehabilitation facilities, skilled nursing facilities, home with home health, and home without services for patients with ischemic or hemorrhagic stroke at hospitals participating in Get With The Guidelines-Stroke. They found that four in 10 stroke patients are discharged home without postacute care services. They recommended further research to explain the shift in service use by type and its effect on outcomes.
AHRQ-funded; HS019479.
Citation: Prvu Bettger J, McCoy L, Smith EE .
Contemporary trends and predictors of postacute service use and routine discharge home after stroke.
J Am Heart Assoc 2015 Feb 23;4(2). doi: 10.1161/jaha.114.001038.
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Keywords: Critical Care, Hospital Discharge, Home Healthcare, Stroke
Edwards JD, Vasilevskis EE, Yoo EJ
Adults with childhood-onset chronic conditions admitted to US pediatric and adult intensive care units.
The purpose of the study is to compare demographics, intensive care unit (ICU) admission characteristics, and ICU outcomes among adults with childhood-onset chronic conditions (COCCs) admitted to US pediatric and adult ICUs. It found that adults with COCCs admitted to pediatric units were significantly more likely to be younger, have lower functional status, and be nontrauma patients than those in adult units.
AHRQ-funded; HS017716.
Citation: Edwards JD, Vasilevskis EE, Yoo EJ .
Adults with childhood-onset chronic conditions admitted to US pediatric and adult intensive care units.
J Crit Care 2015 Feb;30(1):201-6. doi: 10.1016/j.jcrc.2014.10.016..
Keywords: Intensive Care Unit (ICU), Chronic Conditions, Critical Care
Sjoding MW, Cooke CR
Chronic critical illness: a growing legacy of successful advances in critical care*.
As the population ages, and advances in critical care continue to improve survival among the most severely ill patients, many assert that the incidence of chronic critical illness (CCI) will continue to rise. The authors discuss an article (Kahn, et al) in the same issue that highlights the growing incidence of CCI and the problems it poses.
AHRQ-funded; HS020672.
Citation: Sjoding MW, Cooke CR .
Chronic critical illness: a growing legacy of successful advances in critical care*.
Crit Care Med 2015 Feb;43(2):476-7. doi: 10.1097/ccm.0000000000000780..
Keywords: Critical Care, Chronic Conditions, Intensive Care Unit (ICU)
Harrison AM, Thongprayoon C, Kashyap R
Developing the surveillance algorithm for detection of failure to recognize and treat severe sepsis.
The objective of this study was to advance, test, and refine a detection and alert system (“sniffer”) for delays in recognition and treatment of severe sepsis that could be used in the critical care setting. They found that a sepsis sniffer (essentially an automated surveillance algorithm) was able to correctly identify delay in recognition and treatment of severe sepsis.
AHRQ-funded; HS022799.
Citation: Harrison AM, Thongprayoon C, Kashyap R .
Developing the surveillance algorithm for detection of failure to recognize and treat severe sepsis.
Mayo Clin Proc 2015 Feb;90(2):166-75. doi: 10.1016/j.mayocp.2014.11.014..
Keywords: Patient Safety, Electronic Health Records (EHRs), Critical Care, Health Information Technology (HIT)
Sanghavi P, Jena AB, Newhouse JP
Outcomes after out-of-hospital cardiac arrest treated by basic vs advanced life support.
Patients with out-of-hospital cardiac arrest who received basic life support had a higher survival rate and had better neurological functioning at hospital discharge and at 90 days after discharge than those patients who received advanced life support.
AHRQ-funded; HS022798
Citation: Sanghavi P, Jena AB, Newhouse JP .
Outcomes after out-of-hospital cardiac arrest treated by basic vs advanced life support.
JAMA Intern Med. 2015 Feb;175(2):196-204. doi: 10.1001/jamainternmed.2014.5420..
Keywords: Emergency Medical Services (EMS), Cardiovascular Conditions, Critical Care
Rangachari P, Madaio M, Rethemeyer RK
The evolution of knowledge exchanges enabling successful practice change in two intensive care units.
There are gaps in understanding the mechanisms by which top-down communications enable practice change. The authors sought to address these gaps in order to help identify evidence-based management strategies for successful practice change at the unit level. They found that both intensive care units studied experienced substantially improved outcomes and indicated a statistically significant increase in proactive communications. Early in the study, champions emerged within each unit to initiate process improvements. The authors concluded that the study helped to identify evidence-based management strategies for successful practice change at the unit level.
AHRQ-funded; HS019785.
Citation: Rangachari P, Madaio M, Rethemeyer RK .
The evolution of knowledge exchanges enabling successful practice change in two intensive care units.
Health Care Manage Rev 2015 Jan-Mar;40(1):65-78. doi: 10.1097/hmr.0000000000000001.
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Keywords: Intensive Care Unit (ICU), Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Critical Care, Communication, Evidence-Based Practice, Organizational Change, Prevention, Patient Safety