National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Events (3)
- Arthritis (2)
- Blood Clots (1)
- Cancer (1)
- Cardiovascular Conditions (2)
- Central Line-Associated Bloodstream Infections (CLABSI) (1)
- Children/Adolescents (1)
- Comprehensive Unit-based Safety Program (CUSP) (1)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (1)
- Critical Care (1)
- Data (1)
- Diabetes (1)
- Elderly (1)
- Electronic Health Records (EHRs) (4)
- Emergency Department (1)
- Evidence-Based Practice (2)
- Guidelines (1)
- Healthcare-Associated Infections (HAIs) (3)
- Healthcare Cost and Utilization Project (HCUP) (3)
- Healthcare Delivery (2)
- Health Information Technology (HIT) (4)
- Health Insurance (1)
- Heart Disease and Health (1)
- Hospitalization (1)
- Hospital Readmissions (1)
- Hospitals (6)
- Injuries and Wounds (1)
- Intensive Care Unit (ICU) (1)
- Maternal Care (1)
- Medical Errors (1)
- Medication (1)
- Mortality (1)
- Neurological Disorders (1)
- Nursing (1)
- Nursing Homes (1)
- Outcomes (4)
- Palliative Care (4)
- Patient-Centered Healthcare (1)
- Patient-Centered Outcomes Research (3)
- Patient Experience (1)
- Patient Safety (5)
- Pneumonia (2)
- Pregnancy (1)
- Primary Care (1)
- Provider Performance (3)
- Public Reporting (3)
- Quality Improvement (4)
- Quality Indicators (QIs) (5)
- (-) Quality Measures (30)
- Quality of Care (16)
- Quality of Life (1)
- Racial and Ethnic Minorities (1)
- Research Methodologies (3)
- Respiratory Conditions (1)
- Risk (1)
- Surgery (4)
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 30 Research Studies DisplayedSmith JJ, Johnston JM, Hiratsuka VY
Medical home implementation and trends in diabetes quality measures for AN/AI primary care patients.
The researchers investigated changes in trend for type 2 diabetes mellitus (DM-II) quality indicators after patient-centered medical home (PCMH) implementation at Southcentral Foundation, a tribal health organization in Alaska. They found that rates of new DM-II diagnoses were stable prior to but increased after implementation. DM-II rates of HbA1c screening increased, though not significantly before and remained stable after implementation.
AHRQ-funded; HS019154.
Citation: Smith JJ, Johnston JM, Hiratsuka VY .
Medical home implementation and trends in diabetes quality measures for AN/AI primary care patients.
Prim Care Diabetes 2015 Apr;9(2):120-6. doi: 10.1016/j.pcd.2014.06.005..
Keywords: Diabetes, Patient-Centered Healthcare, Primary Care, Quality Measures, Racial and Ethnic Minorities
LeBlanc TW, Ritchie CS, Friedman F
Adherence to measuring what matters items when caring for patients with hematologic malignancies versus solid tumors.
The authors sought to assess adherence to Measuring What Matters (MWM) measures by palliative care clinicians caring for patients with hematologic malignancies, compared to those with solid tumors. They found that MWM adherence regarding symptom assessment and meeting emotional needs was lower for patients with hematologic malignancies compared to those with solid tumors. They concluded that this finding suggests two key areas for quality improvement initiatives in palliative care for patients with hematologic malignancies.
AHRQ-funded; HS023681; HS022763.
Citation: LeBlanc TW, Ritchie CS, Friedman F .
Adherence to measuring what matters items when caring for patients with hematologic malignancies versus solid tumors.
J Pain Symptom Manage 2016 Dec;52(6):775-82. doi: 10.1016/j.jpainsymman.2016.09.004.
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Keywords: Cancer, Quality of Care, Palliative Care, Patient-Centered Outcomes Research, Quality Measures
Wysham NG, Hochman MJ, Wolf SP
Performance of consultative palliative care model in achieving quality metrics in the ICU.
The purpose of this paper was to assess adherence to proposed quality metrics of ICU-based palliative care by palliative care specialists. The authors found that palliative care consultations in an ICU setting are characterized by variable adherence to candidate ICU palliative care quality metrics. Although symptom management was the foremost reason for palliative care consultation, consultants infrequently documented symptom assessments. The consultants performed better in offering spiritual support and managing documented symptoms.
AHRQ-funded; HS023681.
Citation: Wysham NG, Hochman MJ, Wolf SP .
Performance of consultative palliative care model in achieving quality metrics in the ICU.
J Pain Symptom Manage 2016 Dec;52(6):873-77. doi: 10.1016/j.jpainsymman.2016.05.026.
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Keywords: Critical Care, Intensive Care Unit (ICU), Palliative Care, Quality of Care, Quality Measures
Yazdany J, Robbins M, Schmajuk G
Development of the American College of Rheumatology's rheumatoid arthritis electronic clinical quality measures.
The researchers sought to develop and test electronic clinical quality measures for rheumatoid arthritis. Disease activity assessment, functional status assessment, disease-modifying antirheumatic durg use, and tuberculosis screening measures have achieved national endorsement and are recommended for use in federal quality reporting programs.
AHRQ-funded; HS024412.
Citation: Yazdany J, Robbins M, Schmajuk G .
Development of the American College of Rheumatology's rheumatoid arthritis electronic clinical quality measures.
Arthritis Care Res 2016 Nov;68(11):1579-90. doi: 10.1002/acr.22984.
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Keywords: Electronic Health Records (EHRs), Medication, Quality Measures, Arthritis, Outcomes
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
Thompson MP, Kaplan CM, Cao Y
Reliability of 30-day readmission measures used in the hospital readmission reduction program.
The researchers assessed the reliability of risk-standardized readmission rates (RSRRs) for medical conditions and surgical procedures used in the Hospital Readmission Reduction Program (HRRP). They found that approximately 25 percent of payments for excess readmissions were tied to unreliable RSRRs. Unreliable measures blur the connection between hospital performance and incentives, and threaten the success of the HRRP.
AHRQ-funded; HS023783.
Citation: Thompson MP, Kaplan CM, Cao Y .
Reliability of 30-day readmission measures used in the hospital readmission reduction program.
Health Serv Res 2016 Oct 21;51(6):2095-114. doi: 10.1111/1475-6773.12587.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Hospital Readmissions, Hospitals, Elderly, Quality Measures
Suter LG, Barber CE, Herrin J
American College of Rheumatology white paper on performance outcome measures in rheumatology.
The objective of this study was to highlight the opportunities and challenges of developing and implementing performance outcome measures in rheumatology for accountability purposes. The authors' hypothetical outcome measure was a measure of rheumatoid arthritis disease activity intended for evaluating Accountable Care Organization performance. They provided a summary table of key take-home points for clinicians and policymakers. The authors concluded that the most effective and meaningful measures can only be created through the close collaboration of patients, providers, measure developers, and policymakers.
AHRQ-funded; HS024412.
Citation: Suter LG, Barber CE, Herrin J .
American College of Rheumatology white paper on performance outcome measures in rheumatology.
Arthritis Care Res 2016 Oct;68(10):1390-401. doi: 10.1002/acr.22936.
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Keywords: Quality of Care, Quality Measures, Outcomes, Arthritis
Ban KA, Cohen ME, Ko CY
Evaluation of the ProPublica surgeon scorecard "Adjusted Complication Rate" measure specifications.
The authors sought to (1) determine the proportion of cases excluded by ProPublica's specifications, (2) assess the proportion of inpatient complications excluded from ProPublica's measure, and (3) examine the validity of ProPublica's outcome measure by comparing performance on the measure to well-established postoperative outcome measures. They found that ProPublica's outcome measure specifications exclude 82% of cases, miss 84% of postoperative complications, and correlate poorly with well-established postoperative outcomes.
AHRQ-funded; HS021857.
Citation: Ban KA, Cohen ME, Ko CY .
Evaluation of the ProPublica surgeon scorecard "Adjusted Complication Rate" measure specifications.
Ann Surg 2016 Oct;264(4):566-74. doi: 10.1097/sla.0000000000001858.
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Keywords: Adverse Events, Outcomes, Public Reporting, Quality Measures, Surgery
Carlozzi NE, Schilling SG, Lai JS
HDQLIFE: the development of two new computer adaptive tests for use in Huntington disease, speech difficulties, and swallowing difficulties.
The authors developed a patient-reported outcome measure for use in the Huntington Disease Health-Related Quality of Life (HDQLIFE) Measurement System that focused on the impact that difficulties with speech and swallowing have on health-related quality of life in Huntington disease. These measures may have clinical utility in other populations where speech and swallowing difficulties are prevalent.
AHRQ-funded; HS023313.
Citation: Carlozzi NE, Schilling SG, Lai JS .
HDQLIFE: the development of two new computer adaptive tests for use in Huntington disease, speech difficulties, and swallowing difficulties.
Qual Life Res 2016 Oct;25(10):2417-27. doi: 10.1007/s11136-016-1273-y.
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Keywords: Neurological Disorders, Quality of Life, Patient-Centered Outcomes Research, Health Information Technology (HIT), Quality Measures
Yazdany J, Myslinski R, Miller A
Methods for developing the American College of Rheumatology's electronic clinical quality measures.
The authors discuss the methodologic approach recommended by the American College of Rheumatology (ACR) to develop new electronic clinical quality measures (eCQMs) in priority areas. They recommend that the ACR’s eCQM development program evolve to address newly-identified gaps in care that are amenable to quality improvement and that input from rheumatologists continue to be a key ingredient for a measurement strategy that seeks not just to assess performance but to improve outcomes for patients.
AHRQ-funded; HS024412.
Citation: Yazdany J, Myslinski R, Miller A .
Methods for developing the American College of Rheumatology's electronic clinical quality measures.
Arthritis Care Res 2016 Oct;68(10):1402-9. doi: 10.1002/acr.22985.
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Keywords: Electronic Health Records (EHRs), Quality of Care, Health Information Technology (HIT), Quality Measures, Quality Measures
Diehl A, Yang T, Speck K
AHRQ Author: Battles J
Evaluating the accuracy of sampling strategies for estimation of compliance rate for ventilator-associated pneumonia process measures.
The researchers evaluated the accuracy of sampling strategies to estimate monthly compliance rates with ventilator-associated pneumonia prevention measures. They concluded that sampling process measures intermittently rather than continually can yield accurate estimates of process measure performance rates.
AHRQ-authored; AHRQ-funded; 290201000027I; 29032002T.
Citation: Diehl A, Yang T, Speck K .
Evaluating the accuracy of sampling strategies for estimation of compliance rate for ventilator-associated pneumonia process measures.
Infect Control Hosp Epidemiol 2016 Sep;37(9):1037-43. doi: 10.1017/ice.2016.136.
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Keywords: Comprehensive Unit-based Safety Program (CUSP), Healthcare-Associated Infections (HAIs), Pneumonia, Quality Improvement, Quality Measures
Farrow NE, Lau BD, JohnBull EA
Is the meaningful use venous thromboembolism VTE-6 measure meaningful? A retrospective analysis of one hospital's VTE-6 cases.
The researchers assessed the validity of the Meaningful Use VTE-6 measure by reviewing the quality of venous thromboembolism (VTE) prophylaxis provided to patients. Sixty percent of the patients identified as having sustained potentially preventable VTE were false positives. For the remaining forty percent, VTE was considered to be truly potentially preventable and those patients therefore provided targets for quality improvement measures.
AHRQ-funded; HS017952.
Citation: Farrow NE, Lau BD, JohnBull EA .
Is the meaningful use venous thromboembolism VTE-6 measure meaningful? A retrospective analysis of one hospital's VTE-6 cases.
Jt Comm J Qual Patient Saf 2016 Sep;42(9):410-6.
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Keywords: Blood Clots, Quality Improvement, Quality Measures, Quality Measures, Electronic Health Records (EHRs)
Connor JA, Larson C, Baird J
Use of a pediatric cardiovascular nursing consortium for development and evaluation of quality measures: The C4-MNP experience.
The authors aimed to identify and develop standardized measures representative of pediatric nursing care of the cardiovascular patient for benchmarking within freestanding children's hospitals. The Consortium of Congenital Cardiac Care-Measurement of Nursing Practice members developed quality measures within working groups and then individually critiqued all drafted measures. The process resulted in 10 measures eligible for testing. The Consortium will continue with implementation and testing of each measure, supporting the development of benchmarks and the evaluation of the association of the measures with patient outcomes.
AHRQ-funded; HS000063.
Citation: Connor JA, Larson C, Baird J .
Use of a pediatric cardiovascular nursing consortium for development and evaluation of quality measures: The C4-MNP experience.
J Pediatr Nurs 2016 Sep-Oct;31(5):471-7. doi: 10.1016/j.pedn.2016.04.010.
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Keywords: Children/Adolescents, Cardiovascular Conditions, Nursing, Quality Measures, Hospitals
Minami CA, Dahlke AR, Barnard C
Association between hospital characteristics and performance on the new hospital-acquired condition reduction program's surgical site infection measures.
This research letter evaluated the association between hospital characteristics and surgical site infection (SSI) measures. The authors found that hospitals with higher hospital quality summary scores were more frequently poor performers for SSI and had higher standardized infection ratios. Hospitals were more likely to be poor performers for colon SSI and hysterectomy SSI if they were a teaching hospital, safety-net hospital, or level I trauma center. Teaching hospitals were more likely to be poor performers for colorectal SSI, but the association was not as consistent for hysterectomy.
AHRQ-funded; HS021857.
Citation: Minami CA, Dahlke AR, Barnard C .
Association between hospital characteristics and performance on the new hospital-acquired condition reduction program's surgical site infection measures.
JAMA Surg 2016 Aug;151(8):777-9. doi: 10.1001/jamasurg.2016.0408.
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Keywords: Healthcare-Associated Infections (HAIs), Surgery, Injuries and Wounds, Adverse Events, Quality Measures, Hospitals, Quality of Care
Alexander GL, Madsen RW, Miller E
A national report of nursing home information technology adoption and quality measures.
The purpose of this article is to describe a national model being used as a guiding framework to assess trends in nursing home IT adoption, called IT sophistication, and quality measures. Through this model, the authors answer the following research question: Do relationships exist between nursing home IT sophistication and quality measures?
AHRQ-funded; HS022497.
Citation: Alexander GL, Madsen RW, Miller E .
A national report of nursing home information technology adoption and quality measures.
J Nurs Care Qual 2016 Jul-Sep;31(3):201-6. doi: 10.1097/ncq.0000000000000187.
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Keywords: Nursing Homes, Health Information Technology (HIT), Quality Measures
Maurer M, Firminger K, Dardees P
Understanding consumer perceptions and awareness of hospital-based maternity care quality measures.
This study explored factors that may influence use of comparative public reports for hospital maternity care. It found that, when describing high-quality maternity care, participants focused on interactions with providers, including respect for preferences and communication. The importance of quality measures was influenced by the extent to which they focused on babies' health, were perceived as the hospital's responsibility, and were perceived as representing "standard care."
AHRQ-funded; HS021873.
Citation: Maurer M, Firminger K, Dardees P .
Understanding consumer perceptions and awareness of hospital-based maternity care quality measures.
Health Serv Res 2016 Jun;51 Suppl 2:1188-211. doi: 10.1111/1475-6773.12472.
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Keywords: Maternal Care, Pregnancy, Patient Experience, Quality Measures, Quality of Care, Public Reporting
Encinosa W, Hsiao CJ, Firminger K
AHRQ Author: Encinosa W, Hsiao CJ
What performance measures do consumers find useful when selecting marketplace health plans?
This study explored consumers’ ability to use measures from eValue8, the leading tool that large employers use to compare and select health plans. It found that consumers have different views of health plan measures compared with employers. For example, consumers care most about measures indicating how well plans support long-term patient–physician relationships—many plan measures were seen to be intrusive in this relationship.
AHRQ-authored.
Citation: Encinosa W, Hsiao CJ, Firminger K .
What performance measures do consumers find useful when selecting marketplace health plans?
Am J Accountable Care 2016 Jun;4(2):10-16.
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Keywords: Health Insurance, Provider Performance, Quality Measures
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
Wahl ER, Yazdany J
Challenges and opportunities in using patient-reported outcomes in quality measurement in rheumatology.
This article reviews the use of patient-reported outcomes (PROs) in assessing health care quality, and highlights challenges and opportunities specific to their use in rheumatology quality measurement. It describes the current use of PROs as quality measures in rheumatology, and frames an agenda for future work supporting development of meaningful quality measures based on PROs.
AHRQ-funded; HS024412.
Citation: Wahl ER, Yazdany J .
Challenges and opportunities in using patient-reported outcomes in quality measurement in rheumatology.
Rheum Dis Clin North Am 2016 May;42(2):363-75. doi: 10.1016/j.rdc.2016.01.008.
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Keywords: Quality of Care, Outcomes, Quality Indicators (QIs), Quality Measures
Burda BU, Holmer HK, Norris SL
Limitations of A Measurement Tool to Assess Systematic Reviews (AMSTAR) and suggestions for improvement.
A Measurement Tool to Assess Systematic Reviews (AMSTAR) is a commonly used tool to assess the quality of systematic reviews; however, modifications are needed to improve its usability, reliability, and validity. In this commentary, the authors summarize their experience and the experiences of others who have used AMSTAR and provide suggestions for its improvement.
AHRQ-funded; HS018500.
Citation: Burda BU, Holmer HK, Norris SL .
Limitations of A Measurement Tool to Assess Systematic Reviews (AMSTAR) and suggestions for improvement.
Syst Rev 2016 Apr 12;5:58. doi: 10.1186/s13643-016-0237-1.
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Keywords: Research Methodologies, Data, Evidence-Based Practice, Guidelines, Quality Measures
Singh H, Sittig DF
Measuring and improving patient safety through health information technology: the Health IT Safety Framework.
The authors propose a new framework, the Health IT Safety (HITS) measurement framework, to provide a conceptual foundation for health IT-related patient safety measurement, monitoring, and improvement. The HITS framework follows both Continuous Quality Improvement (CQI) and sociotechnical approaches and calls for new measures and measurement activities to address safety concerns. A long term framework goal is to enable rigorous measurement that helps achieve the safety benefits of health IT in real-world clinical settings.
AHRQ-funded; HS022087.
Citation: Singh H, Sittig DF .
Measuring and improving patient safety through health information technology: the Health IT Safety Framework.
BMJ Qual Saf 2016 Apr;25(4):226-32. doi: 10.1136/bmjqs-2015-004486.
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Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Medical Errors, Health Information Technology (HIT), Patient Safety, Quality Measures
McConnell KJ, Lindrooth RC, Wholey DR
Modern management practices and hospital admissions.
The researchers investigated whether the modern management practices and publicly reported performance measures are associated with choice of hospital for patients with acute myocardial infarction (AMI). They found that, overall, a one standard deviation change in management practice scores is associated with an 8% increase in AMI admissions.
AHRQ-funded; HS018466.
Citation: McConnell KJ, Lindrooth RC, Wholey DR .
Modern management practices and hospital admissions.
Health Econ 2016 Apr;25(4):470-85. doi: 10.1002/hec.3171.
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Keywords: Hospitals, Heart Disease and Health, Cardiovascular Conditions, Quality Indicators (QIs), Quality Measures, Quality of Care, Public Reporting, Provider Performance
Kamal AH, Bull J, Ritchie CS
Adherence to measuring what matters measures using point-of-care data collection across diverse clinical settings.
The purpose of this paper was to evaluate the implementation of Measuring What Matters (MWM) measures by exploring documentation of quality measure adherence across six diverse clinical settings inherent to palliative care practice. The authors found that the lowest adherence involved comprehensive assessments during the first visit in hospitalized patients in the intensive care unit and that the highest adherence across all settings involved documentation of management of moderate to severe pain. They recommended additional studies for better understanding of benchmarks and acceptable ranges for adherence tailored to various clinical settings.
AHRQ-funded; HS023681; HS022763.
Citation: Kamal AH, Bull J, Ritchie CS .
Adherence to measuring what matters measures using point-of-care data collection across diverse clinical settings.
J Pain Symptom Manage 2016 Mar;51(3):497-503. doi: 10.1016/j.jpainsymman.2015.12.313.
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Keywords: Quality Measures, Palliative Care, Patient-Centered Outcomes Research, Quality of Care, Patient Safety
Rock C, Thom KA, Harris AD
A multicenter longitudinal study of hospital-onset bacteremia: time for a new quality outcome measure?
This study evaluates hospital-onset bacteremia (HOB) as a healthcare-associated infection-related outcome measure by assessing the association between HOB and central-line-associated bloodstream infection (CLABSI) rates and comparing the power of each to discriminate quality among intensive care units (ICUs). The researchers found that change in HOB rate is strongly associated with change in CLABSI rate and has greater power to discriminate between ICU performances.
AHRQ-funded; HS022291.
Citation: Rock C, Thom KA, Harris AD .
A multicenter longitudinal study of hospital-onset bacteremia: time for a new quality outcome measure?
Infect Control Hosp Epidemiol 2016 Feb;37(2):143-8. doi: 10.1017/ice.2015.261.
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Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Patient Safety, Quality Measures, Quality Measures
Dy SM, Herr K, Bernacki RE
Methodological research priorities in palliative care and hospice quality measurement.
The authors describe three key priorities: 1) defining the population of interest for palliative care quality indicators, 2) developing methods to measure quality from different data sources, and 3) conducting research to advance the development of patient/family-reported indicators. They apply these concepts to the key quality domain of advance care planning and address relevance to implementation of indicators in improving care in order to facilitate improved quality measurement across all populations with serious illness and care for patients and families.
AHRQ-funded; HS023681.
Citation: Dy SM, Herr K, Bernacki RE .
Methodological research priorities in palliative care and hospice quality measurement.
J Pain Symptom Manage 2016 Feb;51(2):155-62. doi: 10.1016/j.jpainsymman.2015.10.019.
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Keywords: Research Methodologies, Palliative Care, Quality Measures, Quality Indicators (QIs), Quality of Care