National Healthcare Quality and Disparities Report
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Topics
- Cancer (1)
- Children/Adolescents (1)
- Diagnostic Safety and Quality (2)
- Electronic Health Records (EHRs) (1)
- Emergency Department (2)
- Emergency Medical Services (EMS) (1)
- Evidence-Based Practice (1)
- Healthcare Delivery (1)
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- (-) Hospitals (11)
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- (-) Quality Improvement (11)
- Quality Indicators (QIs) (3)
- Quality Measures (1)
- Quality of Care (8)
- Risk (1)
- Sepsis (1)
- Social Determinants of Health (1)
- Stroke (1)
- Surgery (4)
- Surveys on Patient Safety Culture (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 11 of 11 Research Studies DisplayedSilver CM, Yang AD, Shan Y
Changes in surgical outcomes in a Statewide Quality Improvement Collaborative with introduction of simultaneous, comprehensive interventions.
Researchers investigated whether a comprehensive quality improvement program implemented simultaneously across hospitals at the formation of a quality improvement collaborative (QIC) would improve patient outcomes. They analyzed risk-adjusted rates of postoperative morbidity and mortality for patients who had undergone surgery at hospitals in the Illinois Surgical Quality Improvement Collaborative (ISQIC); analyses compared ISQIC hospitals with hospitals in the NSQIP Participant Use File (PUF). Although complication rates decreased at both ISQIC and PUF hospitals, findings showed that participation in ISQIC was associated with a significantly greater improvement in death or serious morbidity. The researchers concluded that these results emphasize the potential of QICs to improve patient outcomes.
AHRQ-funded; HS024516.
Citation: Silver CM, Yang AD, Shan Y .
Changes in surgical outcomes in a Statewide Quality Improvement Collaborative with introduction of simultaneous, comprehensive interventions.
J Am Coll Surg 2023 Jul 1; 237(1):128-38. doi: 10.1097/xcs.0000000000000679..
Keywords: Surgery, Outcomes, Quality Improvement, Quality of Care, Hospitals
Colton K, Richards CT, Pruitt PB
Early stroke recognition and time-based emergency care performance metrics for intracerebral hemorrhage.
This study compared time for early stroke recognition for intracerebral hemorrhage for hospitals with and without stroke teams. An observational cohort study was conducted at an urban comprehensive stroke center from 2009 to 2017 with 204 cases included. Stroke team activation resulted in faster emergency care compared to no activation. This process resulted in shorter onset-to-arrival times, higher NIH Stroke Scale scores, and higher Glasgow Coma Scale scores.
AHRQ-funded; HS023437.
Citation: Colton K, Richards CT, Pruitt PB .
Early stroke recognition and time-based emergency care performance metrics for intracerebral hemorrhage.
J Stroke Cerebrovasc Dis 2020 Feb;29(2):104552. doi: 10.1016/j.jstrokecerebrovasdis.2019.104552..
Keywords: Stroke, Emergency Department, Provider Performance, Diagnostic Safety and Quality, Quality Improvement, Quality Indicators (QIs), Patient-Centered Outcomes Research, Outcomes, Quality of Care, Evidence-Based Practice, Hospitals
Sheetz KH, Dimick JB, Nathan H
Centralization of high-risk cancer surgery within existing hospital systems.
Centralization is often proposed as a strategy to improve the quality of certain high-risk health care services. In this study, the investigators evaluated the extent to which existing hospital systems centralize high-risk cancer surgery and whether centralization is associated with short-term clinical outcomes. The investigators concluded that greater centralization of complex cancer surgery within existing hospital systems was associated with better outcomes.
AHRQ-funded; HS023597.
Citation: Sheetz KH, Dimick JB, Nathan H .
Centralization of high-risk cancer surgery within existing hospital systems.
J Clin Oncol 2019 Dec 1;37(34):3234-42. doi: 10.1200/jco.18.02035..
Keywords: Surgery, Cancer, Risk, Hospitals, Health Systems, Quality Improvement, Quality Indicators (QIs), Quality of Care, Outcomes
Keshvani N, Berger K, Gupta A
Improving respiratory rate accuracy in the hospital: a quality improvement initiative.
Researchers initiated a quality improvement (QI) initiative in hospitals to improve respiratory rate measurement accuracy. Time-keeping devices were added to vital sign carts and patient care assistants were retrained on a newly modified workflow that included concomitant respiratory rate (RR) measurement during automated blood pressure measurement. The median RR measurement rate increased postintervention. This intervention was associated with a 7.8% reduced incidence of tachypnea-specific systemic inflammatory response syndrome. This QI initiative was interdisciplinary, low-cost, and low-tech.
AHRQ-funded; HS022418.
Citation: Keshvani N, Berger K, Gupta A .
Improving respiratory rate accuracy in the hospital: a quality improvement initiative.
J Hosp Med 2019 Nov 1;14(10):673-77. doi: 10.12788/jhm.3232..
Keywords: Patient-Centered Outcomes Research, Quality Improvement, Inpatient Care, Diagnostic Safety and Quality, Hospitals, Quality of Care, Outcomes
Odell DD, Quinn CM, Matulewicz RS
Association between hospital safety culture and surgical outcomes in a statewide surgical quality improvement collaborative.
The "safety culture" within hospital systems is increasingly recognized as important to delivery of high-quality care. In this study, the investigators examined the safety culture in a statewide hospital quality improvement collaborative and its associations with surgical outcomes. The authors found, among other results that operating room safety culture scores were highest (97.7% positive) compared with the other domains, and ratings of hospital management were lowest (75.9% positive).
AHRQ-funded; HS024516.
Citation: Odell DD, Quinn CM, Matulewicz RS .
Association between hospital safety culture and surgical outcomes in a statewide surgical quality improvement collaborative.
J Am Coll Surg 2019 Aug;229(2):175-83. doi: 10.1016/j.jamcollsurg.2019.02.046..
Keywords: Hospitals, Patient Safety, Quality of Care, Quality Improvement, Outcomes, Surgery, Surveys on Patient Safety Culture
Desai AD, Starmer AJ
Process metrics and outcomes to inform quality improvement in pediatric hospital medicine.
This article provides an overview of the selection, development, and use of process and outcome measures for pediatric hospital medicine quality improvement initiatives. It reviews commonly used categories of process and outcome measures, provides a list of common sources and repositories of previously validated measures, and provides a blueprint for the development of novel measures.
AHRQ-funded; HS024299.
Citation: Desai AD, Starmer AJ .
Process metrics and outcomes to inform quality improvement in pediatric hospital medicine.
Pediatr Clin North Am 2019 Aug;66(4):725-37. doi: 10.1016/j.pcl.2019.03.002..
Keywords: Children/Adolescents, Hospitals, Quality of Care, Quality Improvement, Quality Measures, Outcomes, Patient-Centered Outcomes Research
Austrian JS, Jamin CT, Doty GR
Impact of an emergency department electronic sepsis surveillance system on patient mortality and length of stay.
The goal of this study was to determine if an electronic health record (EHR) based sepsis alert system could improve quality of care and clinical outcomes for patients with sepsis. A patient-level, interrupted time series study of emergency department patients with severe sepsis or septic shock was conducted, with an intervention introduced at the approximate mid-point--a system of interruptive sepsis alerts triggered by abnormal vital signs or laboratory results. Mean length of stay for patients with sepsis decreased significantly following the introduction of the alert, but the alert system had no effect on mortality or other clinical or process measures. The researchers conclude that a more sophisticated algorithm for sepsis identification is needed to improve outcomes.
AHRQ-funded; HS023683.
Citation: Austrian JS, Jamin CT, Doty GR .
Impact of an emergency department electronic sepsis surveillance system on patient mortality and length of stay.
J Am Med Inform Assoc 2018 May;25(5):523-29. doi: 10.1093/jamia/ocx072..
Keywords: Electronic Health Records (EHRs), Emergency Department, Health Information Technology (HIT), Hospitals, Mortality, Outcomes, Quality Improvement, Quality of Care, Sepsis
McMahon LF, Jr., Howell JD
The hospital: still the doctors' workplace(s) - a cautionary note for approaches to safety and value improvement.
The authors discuss a study by Shahian et al. exploring an important concept: What is the relationship between global hospital safety indicators and specific hospital-level clinical outcomes? They insist that studies assessing hospital quality, safety, and outcomes also address the multiproduct nature of hospital outcomes, operations, safety, and quality.
AHRQ-funded; HS018334.
Citation: McMahon LF, Jr., Howell JD .
The hospital: still the doctors' workplace(s) - a cautionary note for approaches to safety and value improvement.
Health Serv Res 2018 Apr;53(2):601-07. doi: 10.1111/1475-6773.12780.
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Keywords: Hospitals, Outcomes, Quality Indicators (QIs), Quality Improvement
Berian JR, Paruch JL, Cohen ME
Does performance vary within the same hospital when separately examining different patient subgroups?
The researchers sought to determine whether performance differs within a given hospital for 6 contrasting patient subgroups and to identify the percentage of hospitals with greater than chance differences in performance. They found that overall quality differed for elderly vs nonelderly, renal insufficiency vs normal renal function patients, cancer vs noncancer, and emergency vs nonemergency. They concluded that quality programs can consider separate reports for these subgroups to identify opportunities for quality improvement.
AHRQ-funded; HS021857.
Citation: Berian JR, Paruch JL, Cohen ME .
Does performance vary within the same hospital when separately examining different patient subgroups?
J Am Coll Surg 2016 May;222(5):790-97.e1. doi: 10.1016/j.jamcollsurg.2016.01.057.
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Keywords: Emergency Medical Services (EMS), Hospitals, Outcomes, Quality Improvement, Social Determinants of Health
Blecker S, Goldfeld K, Park H
Impact of an intervention to improve weekend hospital care at an academic medical center: an observational study.
The purpose of this study was to evaluate the impact of a weekend hospital intervention on processes of care and clinical outcomes. The multifaceted intervention included expanded weekend diagnostic services, improved weekend discharge processes, and increased physician and care management services on weekends. The intervention was associated with a reduction in length of stay and an increase in weekend discharges.
AHRQ-funded; HS023683.
Citation: Blecker S, Goldfeld K, Park H .
Impact of an intervention to improve weekend hospital care at an academic medical center: an observational study.
J Gen Intern Med 2015 Nov;30(11):1657-64. doi: 10.1007/s11606-015-3330-6.
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Keywords: Quality Improvement, Quality of Care, Hospitals, Hospital Discharge, Hospital Readmissions, Healthcare Delivery, Outcomes, Patient-Centered Outcomes Research
Dahlke AR, Chung JW, Holl JL
Evaluation of initial participation in public reporting of American College of Surgeons NSQIP surgical outcomes on Medicare's Hospital Compare website.
The objective of this paper was to compare CMS-National Surgical Quality Improvement Program (CMS-NSQIP) participating hospitals with American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) hospitals that elected not to participate in Hospital Compare. The researchers found few measurable differences between CMS-NSQIP participating and nonparticipating hospitals.
AHRQ-funded; HS021857.
Citation: Dahlke AR, Chung JW, Holl JL .
Evaluation of initial participation in public reporting of American College of Surgeons NSQIP surgical outcomes on Medicare's Hospital Compare website.
J Am Coll Surg 2014 Mar;218(3):374-80, 80.e1-5. doi: 10.1016/j.jamcollsurg.2013.11.022.
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Keywords: Hospitals, Outcomes, Public Reporting, Quality Improvement, Surgery