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AHRQ Research Studies Date
Topics
- Ambulatory Care and Surgery (1)
- Burnout (1)
- Clinician-Patient Communication (3)
- Communication (1)
- Community-Based Practice (1)
- (-) Consumer Assessment of Healthcare Providers and Systems (CAHPS) (18)
- Disparities (1)
- Education: Continuing Medical Education (1)
- Healthcare Cost and Utilization Project (HCUP) (1)
- Health Status (1)
- Hospitals (2)
- Inpatient Care (1)
- Medicare (1)
- Nursing (1)
- Nursing Homes (1)
- Patient-Centered Healthcare (3)
- Patient and Family Engagement (1)
- Patient Experience (13)
- Patient Safety (1)
- Practice Improvement (1)
- Primary Care (4)
- Provider: Health Personnel (1)
- Provider Performance (2)
- Quality Improvement (4)
- Quality Indicators (QIs) (1)
- Quality Measures (1)
- Quality of Care (5)
- Racial and Ethnic Minorities (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 18 of 18 Research Studies DisplayedBhaumik D, Schlesinger MJ
How exposure to patient narratives affects stereotyped choices of primary care clinicians.
Researchers examined whether patient narratives alter the impact of stereotyping on choice of primary care clinicians, specifically the assumption that female doctors will be more attentive to empathic relationships with patients. Individuals selected from a nationally representative Internet panel participated in a survey that provided performance data about 12 fictitious primary care physicians and included a randomized set of narrative feedback from patients. The results showed that exposure to patient narratives that do not disrupt gendered stereotypes increased the likelihood of choosing a female clinician; however, when a sufficient proportion of patient comments run counter to stereotypes, even a minority of narratives is sufficient to disrupt gendered-expectations and alter choices.
AHRQ-funded; HS016978.
Citation: Bhaumik D, Schlesinger MJ .
How exposure to patient narratives affects stereotyped choices of primary care clinicians.
PLoS One 2023 Dec 7; 18(12):e0295243. doi: 10.1371/journal.pone.0295243..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Primary Care
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
Martino SC, Reynolds KA, Grob R
Evaluation of a protocol for eliciting narrative accounts of pediatric inpatient experiences of care.
This study’s objective was to evaluate the measurement properties of a set of six items designed to elicit narrative accounts of pediatric inpatient experience. This cross-sectional survey with follow-up phone interviews used data from 163 participants recruited from a probability-based online panel of US adults. Eligible participants were family members of a child who had an overnight hospital stay in the past 12 months. Participants completed an online (n = 129) or phone (n = 34) survey about their child's hospitalization experience that contained closed-ended items from the Child HCAHPS Survey followed by the six narrative items. About two weeks after completing the survey, 47 participants additionally completed a one-hour, semi-structured phone interview, the results of which served as a "gold standard" for evaluating the fidelity of narrative responses. The average narrative was 248 words, with 79% of narratives mentioning a topic included on the Child HCAHPS survey; 89% mentioning a topic not covered by that survey; 75% including at least one detailed description of an actionable event. Overall, there was a 66% correspondence between narrative and interview responses, with higher correspondence in the phone than in the online condition (75% vs. 59%).
AHRQ-funded; HS025920; HS016978.
Citation: Martino SC, Reynolds KA, Grob R .
Evaluation of a protocol for eliciting narrative accounts of pediatric inpatient experiences of care.
Health Serv Res 2023 Apr;58(2):271-81. doi: 10.1111/1475-6773.14134.
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient Experience, Inpatient Care
Schuttner L, Guo R, Wong E
High-risk patient experiences associated with an intensive primary care management program in the Veterans Health Administration.
This study assessed high-risk patient experiences associated with an intensive primary care management program conducted at the Veterans Health Administration (VHA). The authors assessed patient experience using a patient survey based on the CAHPS Survey in 2019. Patient experience was assessed among 1) prior enrollees (n = 59) of an intensive management program (2014-2018); (2) nonenrollees (n = 356) at program sites; and (3) nonprogram site patients (n = 728). The VHA Office of Primary Care used a patient-centered medical home model (PACT) to deliver coordinated, continuous primary care through multidisciplinary teams. The PACT-Intensive Management (PIM) program was piloted at 5 sites from 2014 to 2018. Outcomes examined included patient ratings of patient-centered care; overall health care experience; and satisfaction with their usual outpatient care provider. Enrollees were more satisfied with their current provider versus nonenrollees within program sites. However, the authors weren’t sure if the benefits persisted after program conclusion.
AHRQ-funded; HS026369.
Citation: Schuttner L, Guo R, Wong E .
High-risk patient experiences associated with an intensive primary care management program in the Veterans Health Administration.
J Ambul Care Manage 2023 Jan-Mar;46(1):45-53. doi: 10.1097/jac.0000000000000428..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient Experience, Primary Care
Quigley DD, Elliott MN, Slaughter ME
Follow-up shadow coaching improves primary care provider-patient interactions and maintains improvements when conducted regularly: a spline model analysis.
The purpose of this study was to explore whether a second shadow coaching session (re-coaching) improves the patient experience and maintains it over time. The researchers observed a statistically significant increase of 3.7 points among re-coached providers after re-coaching on overall provider rating (OPR) and 3.5 points on provider communication (PC) (differences of 1, 3, and 5 points or more are considered small, medium, and large, respectively). Improvements from the re-coaching endured for 12 months for OPR and 8 months for PC.
AHRQ-funded; HS025920.
Citation: Quigley DD, Elliott MN, Slaughter ME .
Follow-up shadow coaching improves primary care provider-patient interactions and maintains improvements when conducted regularly: a spline model analysis.
J Gen Intern Med 2023 Jan; 38(1):221-27. doi: 10.1007/s11606-022-07881-y..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Primary Care, Clinician-Patient Communication, Patient Experience, Provider Performance
Nembhard IM, Matta S, Shaller D
Learning from patients: the impact of using patients' narratives on patient experience scores.
The purpose of this study was to assess whether primary care clinics that often share patients' narratives with their staff have higher patient experience survey scores. The researchers conducted a 1-year study of 5,545 adult patients and 276 staff affiliated with nine clinics in one health system. The study found the frequency of sharing useful narratives with staff was related with patient experience scores for all measures, a result which was conditional upon staff confidence in their own knowledge. For operational measures such as care coordination, higher levels of sharing was associated with subsequently higher performance for more confident staff and lower performance or no difference for less confident staff, depending on the measure. For relational measures such as patient-provider communication, increased sharing was associated with higher scores for less confident staff and lower scores for more confident staff.
AHRQ-funded; HS016978.
Citation: Nembhard IM, Matta S, Shaller D .
Learning from patients: the impact of using patients' narratives on patient experience scores.
Health Care Manage Rev 2023 Jan-Mar; 49(1):2-13. doi: 10.1097/hmr.0000000000000386..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient Experience, Provider Performance
Quigley DD, Quereshi N, Hays RD
Reasons primary care practices chose patient experience surveys during patient-centered medical home transformation.
This study’s objective was to identify reasons primary care practices chose to implement a patient experience survey during their patient-centered medical home transformation. The authors conducted interviews with a stratified-random sample of 105 of these practices. Fifty-one practices used a Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey and 53 administered another patient survey. The three most common reasons to use a survey were given as: (1) to compare performance against other practices, which requires systematically collected data across large numbers of practices (ie, the Consumer Assessment of Healthcare Providers and Systems survey), (2) participation in an external patient-centered medical home program, and (3) survey administration cost. A second patient survey was used to identify quality improvement needs.
AHRQ-funded; HS016980; HS025920.
Citation: Quigley DD, Quereshi N, Hays RD .
Reasons primary care practices chose patient experience surveys during patient-centered medical home transformation.
J Ambul Care Manage 2023 Jan-Mar;46(1):34-44. doi: 10.1097/jac.0000000000000442.
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient-Centered Healthcare, Primary Care, Quality Improvement, Practice Improvement
Martsolf GR, Gibson TB, Benevent R
AHRQ Author: Jiang HJ, Stocks C
An examination of hospital nurse staffing and patient experience with care: Differences between cross-sectional and longitudinal estimates.
The researchers studied the association between hospital nurse staffing and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores. After controlling for unobserved hospital characteristics, they found that the positive influences of increased nurse staffing levels and skill mix were relatively small in size and limited to a few measures of patients' inpatient experience.
AHRQ-authored.
Citation: Martsolf GR, Gibson TB, Benevent R .
An examination of hospital nurse staffing and patient experience with care: Differences between cross-sectional and longitudinal estimates.
Health Serv Res 2016 Dec;51(6):2221-41. doi: 10.1111/1475-6773.12462.
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Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Nursing, Patient Experience, Patient Experience, Healthcare Cost and Utilization Project (HCUP)
Melnick ER, Powsner SM
Empathy in the time of burnout.
The authors argue that before adding empathy measurements to the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey, it would be wise to consider that measurement fatigue contributes to burnout. Adding empathy measurements might reduce empathy: a perverse Hawthorne effect. A health care system hoping for more substantial physician-patient relationships must invest more in the well-being of its caregivers.
AHRQ-funded; HS021271.
Citation: Melnick ER, Powsner SM .
Empathy in the time of burnout.
Mayo Clin Proc 2016 Dec;91(12):1678-79. doi: 10.1016/j.mayocp.2016.09.003.
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Keywords: Burnout, Consumer Assessment of Healthcare Providers and Systems (CAHPS), Hospitals, Patient Experience
Rajaram R, Saddat L, Chung J
Impact of the 2011 ACGME resident duty hour reform on hospital patient experience and processes-of-care.
The investigators evaluated the association between resident duty hour reform and measures of processes-of-care and patient experience. They concluded that the 2011 Accreditation Council for Graduate Medical Education duty hour reform was not associated with improvements in process-of-care and patient experience measures.
AHRQ-funded; HS000078.
Citation: Rajaram R, Saddat L, Chung J .
Impact of the 2011 ACGME resident duty hour reform on hospital patient experience and processes-of-care.
BMJ Qual Saf 2016 Dec;25(12):962-70. doi: 10.1136/bmjqs-2015-004794.
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Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Education: Continuing Medical Education, Quality of Care, Patient Experience, Patient Safety
Bilimoria KY, Barnard C
The new CMS Hospital Quality Star Ratings: the stars are not aligned.
This viewpoint paper discussed the Overall Hospital Quality Star Ratings, released by the Centers for Medicare and Medicaid Services, including issues concerning stakeholders. The authors recommended continuing vigorous work to improve the availability of meaningful measures. They concluded that current hospital rating systems do not provide comprehensive, relevant, accessible information, and current composites may mislead patients, payers, and hospitals; however, opportunities to provide meaningful hospital quality report cards are within reach.
AHRQ-funded; HS021857; HS024516.
Citation: Bilimoria KY, Barnard C .
The new CMS Hospital Quality Star Ratings: the stars are not aligned.
JAMA 2016 Nov 1;316(17):1761-62. doi: 10.1001/jama.2016.13679.
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Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Quality of Care, Hospitals, Quality Improvement, Quality Measures
Dorr DA, Anastas T, Ramsey K
Effect of a pragmatic, cluster-randomized controlled trial on patient experience with care: The Transforming Outcomes for Patients Through Medical Home Evaluation and reDesign (TOPMED) Study.
This study's objective is to understand whether focusing on high value elements (HVEs) would improve patient experience with care. The authors found that practices targeting HVEs showed significantly more improvement in patient experience of care. However, contemporaneous trends may have affected results, leading to declines in patient experience.
AHRQ-funded; HS017832.
Citation: Dorr DA, Anastas T, Ramsey K .
Effect of a pragmatic, cluster-randomized controlled trial on patient experience with care: The Transforming Outcomes for Patients Through Medical Home Evaluation and reDesign (TOPMED) Study.
Med Care 2016 Aug;54(8):745-51. doi: 10.1097/mlr.0000000000000552.
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Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient-Centered Healthcare, Patient Experience
Cleary PD
Evolving concepts of patient-centered care and the assessment of patient care experiences: optimism and opposition.
Improving the infrastructure supporting certain aspects of care may have broad effects because system changes can influence multiple outcomes. Thus, rather than detract from general quality improvement efforts, making changes that facilitate patient-centered care may lead to broader improvements. There is good reason to be optimistic that our health care system will increasingly be "patient centered."
AHRQ-funded; HS016978.
Citation: Cleary PD .
Evolving concepts of patient-centered care and the assessment of patient care experiences: optimism and opposition.
J Health Polit Policy Law 2016 Aug;41(4):675-96. doi: 10.1215/03616878-3620881.
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Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient-Centered Healthcare, Patient Experience, Quality of Care, Quality Improvement
Mukamel DB, Amin A, Weimer DL
When patients customize nursing home ratings, choices and rankings differ from the government's version.
Report cards currently published by the Centers for Medicare and Medicaid Services (CMS) offer composite quality measures, such as the one featured on the Nursing Home Compare website. Nursing Home Compare Plus is an alternative that allows patients and their families to create their own composite scores based on their own preferences and medical needs. When comparing Nursing Home Compare Plus to Medicare's five-star ratings, we found only minimal agreement on ranking of nursing homes.
AHRQ-funded; HS021844.
Citation: Mukamel DB, Amin A, Weimer DL .
When patients customize nursing home ratings, choices and rankings differ from the government's version.
Health Aff 2016 Apr;35(4):714-9. doi: 10.1377/hlthaff.2015.1340.
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Keywords: Nursing Homes, Quality of Care, Quality Indicators (QIs), Patient Experience, Consumer Assessment of Healthcare Providers and Systems (CAHPS)
Hays RD, Mallett JS, Gaillot S
Performance of the Medicare Consumer Assessment of Health Care Providers and Systems (CAHPS) physical functioning items.
This study evaluated physical functioning items in Medicare beneficiaries. It concluded that the physical functioning items target relatively easy activities, providing information for a minority of people in the sample with the lowest levels of physical functioning. Items representing higher levels of physical functioning are needed for the majority of the Medicare beneficiaries.
AHRQ-funded; HS016980.
Citation: Hays RD, Mallett JS, Gaillot S .
Performance of the Medicare Consumer Assessment of Health Care Providers and Systems (CAHPS) physical functioning items.
Med Care 2016 Feb;54(2):205-9. doi: 10.1097/mlr.0000000000000475..
Keywords: Medicare, Consumer Assessment of Healthcare Providers and Systems (CAHPS), Health Status, Quality Improvement
Kanouse DE, Schlesinger M, Shaller D
How patient comments affect consumers' use of physician performance measures.
In order to evaluate the relationship between patient characteristics and the frequency and duration of incident steroid use, the researchers applied a 2-part hurdle model to Medicare data. Their study identified differences in predictors of frequency and duration of medication use and suggests the utility of two-part models to examine drug utilization patterns.
AHRQ-funded; HS016978; HS016980.
Citation: Kanouse DE, Schlesinger M, Shaller D .
How patient comments affect consumers' use of physician performance measures.
Med Care 2016 Jan;54(1):24-31. doi: 10.1097/mlr.0000000000000443..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Quality of Care, Patient and Family Engagement, Patient Experience, Clinician-Patient Communication
Mayer LA, Elliott MN, Haas A
Less use of extreme response options by asians to standardized care scenarios may explain some racial/ethnic differences in CAHPS scores.
The researchers explored whether lower extreme response tendency ( ERT) is observed for Asians than whites in response to standardized vignettes depicting patient experiences of care and whether ERT might in part explain Asians reporting worse care than whites. They concluded that lower ERT in Asians may partially explain observations of lower observed mean CAHPS scores for Asians in real-world settings.
AHRQ-funded; HS016980.
Citation: Mayer LA, Elliott MN, Haas A .
Less use of extreme response options by asians to standardized care scenarios may explain some racial/ethnic differences in CAHPS scores.
Med Care 2016 Jan;54(1):38-44. doi: 10.1097/mlr.0000000000000453..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Disparities, Racial and Ethnic Minorities, Patient Experience, Patient Experience
Stucky BD, Hays RD, Edelen MO
Possibilities for shortening the CAHPS Clinician and Group Survey.
This paper explores the impact on reliability and validity of the Consumer Assessment of Healthcare Providers and Systems (CAHPS) domain scores of reducing the numbers of items used to assess the 3 core Clinician and Group adult survey CAHPS domains (Provider Communication, Access to Care, and Courteous and Helpful Office Staff).
AHRQ-funded; HS016980.
Citation: Stucky BD, Hays RD, Edelen MO .
Possibilities for shortening the CAHPS Clinician and Group Survey.
Med Care 2016 Jan;54(1):32-7. doi: 10.1097/mlr.0000000000000452..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient Experience, Ambulatory Care and Surgery, Community-Based Practice