National Healthcare Quality and Disparities Report
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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
26 to 50 of 98 Research Studies DisplayedMasnick M, Morgan DJ, Sorkin JD
Can national healthcare-associated infections (HAIs) data differentiate hospitals in the United States?
This study was designed to determine whether patients using the Centers for Medicare and Medicaid Services (CMS) Hospital Compare website can use nationally reported healthcare-associated infection (HAI) data to differentiate hospitals. The authors concluded that HAI data generally are reported by enough hospitals to meet minimal criteria for useful comparisons in many geographic locations, though this varies by type of HAI.
AHRQ-funded; HS018111.
Citation: Masnick M, Morgan DJ, Sorkin JD .
Can national healthcare-associated infections (HAIs) data differentiate hospitals in the United States?
Infect Control Hosp Epidemiol 2017 Oct;38(10):1167-71. doi: 10.1017/ice.2017.179..
Keywords: Quality of Care, Healthcare-Associated Infections (HAIs), Hospitals, Provider Performance, Quality Measures
Schmajuk G, Yazdany J
Leveraging the electronic health record to improve quality and safety in rheumatology.
In the coming years, developing and leveraging tools within the electronic health record (EHR) will be the key to making the next big strides in improving the health of patients with rheumatoid arthritis and other rheumatic diseases, including building EHR infrastructure to capture patient outcomes and developing automated methods to retrieve information from free text of clinical notes.
AHRQ-funded; HS024412.
Citation: Schmajuk G, Yazdany J .
Leveraging the electronic health record to improve quality and safety in rheumatology.
Rheumatol Int 2017 Oct;37(10):1603-10. doi: 10.1007/s00296-017-3804-4.
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Keywords: Electronic Health Records (EHRs), Quality of Care, Patient Safety, Quality Improvement, Arthritis
Kamal AH, Taylor DH, Neely B
One size does not fit all: disease profiles of serious illness patients receiving specialty palliative care.
This study was one of the first to describe symptom burden and functional scores by diagnostic categories and care settings across a community-based interdisciplinary specialty palliative care program. Results demonstrated statistically significant and clinically relevant differences among settings of care, functional status, and symptom profiles between patients with various serious illnesses.
AHRQ-funded; HS023681.
Citation: Kamal AH, Taylor DH, Neely B .
One size does not fit all: disease profiles of serious illness patients receiving specialty palliative care.
J Pain Symptom Manage 2017 Oct;54(4):476-83. doi: 10.1016/j.jpainsymman.2017.07.035..
Keywords: Quality of Care, Palliative Care, Quality Improvement
Fisher KA, Mazor KM
Patient and family complaints in cancer care: what can we learn from the tip of the iceberg?
This paper comments on the Mack et al. article “Evaluation of Patient and Family Outpatient Complaints as a Strategy to Prioritize Efforts to Improve Cancer Care Delivery”, published in 2017 in The Joint Commission Journal on Quality and Patient Safety, in which Mack et al. categorized all complaints filed at a large outpatient cancer center during a two-year period, put forth a preliminary rating system for assessing complaint severity, and catalogued the actions taken in response to the complaints.
AHRQ-funded; HS024596; HS022757.
Citation: Fisher KA, Mazor KM .
Patient and family complaints in cancer care: what can we learn from the tip of the iceberg?
Jt Comm J Qual Patient Saf 2017 Oct;43(10):495-97. doi: 10.1016/j.jcjq.2017.07.003..
Keywords: Cancer, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Patient Experience, Patient Safety, Quality of Care, Quality Improvement
Ban KA, Gibbons MM, Ko CY
Surgical technical evidence review for colorectal surgery conducted for the AHRQ Safety Program for Improving Surgical Care and Recovery.
The objective of this article is to provide a comprehensive review of the evidence supporting the surgical components of the Improving Surgical Care and Recovery (ISCR) colorectal (CR) pathway. This review will evaluate the evidence supporting CR pathways and develop an evidence-based CR protocol to help hospitals participating in the ISCR program implement evidence-based practices.
AHRQ-funded; 233201500020I.
Citation: Ban KA, Gibbons MM, Ko CY .
Surgical technical evidence review for colorectal surgery conducted for the AHRQ Safety Program for Improving Surgical Care and Recovery.
J Am Coll Surg 2017 Oct;225(4):548-57.e3. doi: 10.1016/j.jamcollsurg.2017.06.017.
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Keywords: Evidence-Based Practice, Hospitals, Patient Safety, Quality Improvement, Surgery, Quality of Care, Guidelines
Ehlers AP, Khor S, Cizik AM
Use of patient-reported outcomes and satisfaction for quality assessments.
This study investigated the relationship between PROs and satisfaction among spine surgery patients. The authors hypothesized that there would be significant disparities between patient satisfaction and PROs at the 1-year postoperative time point. The study found that overall, patients undergoing elective lumbar spine surgery reported being satisfied with outcomes, but the reported responses in PROs were much more variable.
AHRQ-funded; HS020025.
Citation: Ehlers AP, Khor S, Cizik AM .
Use of patient-reported outcomes and satisfaction for quality assessments.
Am J Manag Care 2017 Oct;23(10):618-22..
Keywords: Patient-Centered Outcomes Research, Patient Experience, Quality of Care, Surgery, Outcomes, Orthopedics
Teppala S, Ottenbacher KJ, Eschbach K
Variation in functional status after hip fracture: facility and regional influence on mobility and self-care.
Little is known about variation in functional outcomes after postacute rehabilitation for patients with hip fracture. The researchers examined variation in mobility and self-care after hip fracture rehabilitation across inpatient rehabilitation facilities (IRFs), hospital referral regions (HRRs) and states. Variation in functional status following postacute hip fracture rehabilitation appears to occur primarily at the level of facilities rather than geographic location.
AHRQ-funded; HS022134.
Citation: Teppala S, Ottenbacher KJ, Eschbach K .
Variation in functional status after hip fracture: facility and regional influence on mobility and self-care.
J Gerontol A Biol Sci Med Sci 2017 Oct;72(10):1376-82. doi: 10.1093/gerona/glw249.
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Keywords: Injuries and Wounds, Quality of Care, Health Status, Rehabilitation, Patient Self-Management
Pranaat R, Mohan V, O'Reilly M
Use of simulation based on an electronic health records environment to evaluate the structure and accuracy of notes generated by medical scribes: Proof-of-concept study.
The objective of the researchers was to develop a virtual video-based simulation to demonstrate and quantify the variability and accuracy of scribes' transcribed notes in the EHR. Their high-fidelity, video-based EHR simulation was able to assess multiple performance indicators in medical scribes and demonstrate significant variability both in terms of structure and accuracy in clinical documentation.
AHRQ-funded; HS025141.
Citation: Pranaat R, Mohan V, O'Reilly M .
Use of simulation based on an electronic health records environment to evaluate the structure and accuracy of notes generated by medical scribes: Proof-of-concept study.
JMIR Med Inform 2017 Sep 20;5(3):e30. doi: 10.2196/medinform.7883.
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Keywords: Electronic Health Records (EHRs), Quality of Care, Patient Safety, Training
Yen PY, McAlearney AS, Sieck CJ
Health information technology (HIT) adaptation: refocusing on the journey to successful HIT implementation.
Measures commonly used to evaluate the success of HIT implementation, such as HIT adoption, technology acceptance, and clinical quality, fail to account for complex sociotechnical variability across contexts and the different trajectories within organizations because of different implementation plans and timelines. The authors propose a new focus, HIT adaptation, to illuminate factors that facilitate or hinder the connection between use of the EHR and improved quality of care.
AHRQ-funded; HS024767.
Citation: Yen PY, McAlearney AS, Sieck CJ .
Health information technology (HIT) adaptation: refocusing on the journey to successful HIT implementation.
JMIR Med Inform 2017 Sep 7;5(3):e28. doi: 10.2196/medinform.7476.
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Keywords: Electronic Health Records (EHRs), Quality of Care, Health Information Technology (HIT)
Cholan RA, Weiskopf NG, Rhoton D
From concepts and codes to healthcare quality measurement: understanding variations in value set vocabularies for a statin therapy clinical quality measure.
This study examined health care quality measures and found that the decisions Clinical Quality Measure developers make about which concepts and code groups to include or exclude in value set vocabularies can lead to inaccuracies in the measurement of quality of care.
AHRQ-funded; HS023908.
Citation: Cholan RA, Weiskopf NG, Rhoton D .
From concepts and codes to healthcare quality measurement: understanding variations in value set vocabularies for a statin therapy clinical quality measure.
eGEMS 2017 Sep 4;5(1):19. doi: 10.5334/egems.212..
Keywords: Quality of Care, Quality Measures, Quality Measures
Shaughnessy AF, Vaswani A, Andrews BK
Developing a clinician friendly tool to identify useful clinical practice guidelines: G-TRUST.
The goal of this project was to develop a simple, easy-to-use checklist for clinicians to use to identify trustworthy, relevant, and useful practice guidelines, the Guideline Trustworthiness, Relevance, and Utility Scoring Tool (G-TRUST). They concluded that the 8-item G-TRUST developed by the project is potentially helpful as a tool for clinicians to identify useful guidelines.
AHRQ-funded; HS022940.
Citation: Shaughnessy AF, Vaswani A, Andrews BK .
Developing a clinician friendly tool to identify useful clinical practice guidelines: G-TRUST.
Ann Fam Med 2017 Sep;15(5):413-18. doi: 10.1370/afm.2119.
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Keywords: Evidence-Based Practice, Guidelines, Quality of Care, Patient-Centered Healthcare
Waljee JF, Dimick JB
Do patient-reported outcomes correlate with clinical outcomes following surgery?
This study examines whether patient-reported outcomes (PROs) correlate with clinical outcomes following surgery. PROs are distinct from clinical outcomes and represent a potential indicator of performance that can be targeted to improve quality of care. Future studies that examine the influence of measurement techniques, case mix, and disease characteristics on PROs will inform efforts to routinely and efficiently integrate these critical outcomes into existing strategies to capture treatment effectiveness and quality of care for surgical conditions.
AHRQ-funded; HS023313.
Citation: Waljee JF, Dimick JB .
Do patient-reported outcomes correlate with clinical outcomes following surgery?
Adv Surg 2017 Sep;51(1):141-50. doi: 10.1016/j.yasu.2017.03.011..
Keywords: Quality of Care, Outcomes, Patient-Centered Outcomes Research, Surgery, Patient Experience, Quality Measures
Spertus JA, Ghaferi AA
Transforming the National Surgical Quality Improvement Program to the delivery of precision medicine to improve the value of surgical care: Summary of the John R. Clarke keynote address for the Surgical Outcomes Club 2016 Annual Meeting.
The authors challenged the audience to begin thinking about implementing precision medicine in routine care. They argue that the profession of medicine is undergoing an unprecedented transformation from fee-for-service to value-based reimbursement. This offers an opportunity to rethink current practice patterns and redesign health care delivery to improve patients’ experiences and outcomes while lowering costs. The surgical community has a unique opportunity to embrace this challenge and develop tools to better tailor treatment to risk.
AHRQ-funded; HS023621.
Citation: Spertus JA, Ghaferi AA .
Transforming the National Surgical Quality Improvement Program to the delivery of precision medicine to improve the value of surgical care: Summary of the John R. Clarke keynote address for the Surgical Outcomes Club 2016 Annual Meeting.
JAMA Surg 2017 Sep;152(9):815-16. doi: 10.1001/jamasurg.2017.1610.
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Keywords: Healthcare Delivery, Quality of Care, Patient Safety, Quality Improvement, Surgery
Ahluwalia SC, Damberg CL, Silverman M
What defines a high-performing health care delivery system: a systematic review.
A systematic review was conducted to determine if there is a commonly used, agreed-on definition of what constitutes a "high-performing" health care delivery system. No consistent definition of a high-performing health care system or organization was identified. High performance was variably defined across different dimensions, including quality (93 percent of articles), cost (67 percent), access (35 percent), equity (26 percent), patient experience (21 percent), and patient safety (18 percent).
AHRQ-funded; HS024067.
Citation: Ahluwalia SC, Damberg CL, Silverman M .
What defines a high-performing health care delivery system: a systematic review.
Jt Comm J Qual Patient Saf 2017 Sep;43(9):450-59. doi: 10.1016/j.jcjq.2017.03.010.
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Keywords: Healthcare Delivery, Quality of Care, Policy, Quality Measures
Chen LM, Epstein AM, Orav EJ
Association of practice-level social and medical risk with performance in the Medicare physician value-based payment modifier program.
The objective of this cross-sectional observational study was to compare performance in the Physician Value-Based Payment Modifier (PVBM) Program by practice characteristics. The investigators found that during the first year of the Medicare Physician Value-Based Payment Modifier Program, physician practices that served more socially high-risk patients had lower quality and lower costs, and practices that served more medically high-risk patients had lower quality and higher costs.
AHRQ-funded; HS024698.
Citation: Chen LM, Epstein AM, Orav EJ .
Association of practice-level social and medical risk with performance in the Medicare physician value-based payment modifier program.
JAMA 2017 Aug 1;318(5):453-61. doi: 10.1001/jama.2017.9643..
Keywords: Healthcare Costs, Medicaid, Medicare, Payment, Quality of Care
Hatfield LA, Zaslavsky AM
Implications of variation in the relationships between beneficiary characteristics and Medicare Advantage CAHPS measures.
The researchers studied how differences in quality score adjustments across Medicare Advantage contracts change comparisons for individuals and contracts. They found that, for average consumers, standard adjustment is sufficient to represent variation in contract quality standardized to a common population. For people with characteristics far from average, personalized reporting using their characteristics and contract-specific coefficients can substantially change the expected quality measures across contracts.
AHRQ-funded; HS016978.
Citation: Hatfield LA, Zaslavsky AM .
Implications of variation in the relationships between beneficiary characteristics and Medicare Advantage CAHPS measures.
Health Serv Res 2017 Aug;52(4):1310-29. doi: 10.1111/1475-6773.12544.
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Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Medicare, Health Status, Patient Experience, Quality of Care, Quality Improvement, Quality Measures
Acher AW, Campbell-Flohr SA, Brenny-Fitzpatrick M
Improving patient-centered transitional care after complex abdominal surgery.
Poor-quality transitions of care from hospital to home contribute to high rates of readmission after complex abdominal surgery. The Coordinated Transitional Care (C-TraC) program improved readmission rates in medical patients, but evidence-based surgical transitional care protocols are still lacking. This pilot study evaluated the feasibility and preliminary effectiveness of an adapted surgical C-TraC protocol. The investigators concluded that a phone-based transitional care protocol for surgical patients is feasible, with <1% refusals and 95% engagement.
patients is feasible, with <1% refusals and 95% engagement.
AHRQ-funded; HS022446.
AHRQ-funded; HS022446.
Citation: Acher AW, Campbell-Flohr SA, Brenny-Fitzpatrick M .
Improving patient-centered transitional care after complex abdominal surgery.
J Am Coll Surg 2017 Aug;225(2):259-65. doi: 10.1016/j.jamcollsurg.2017.04.008..
Keywords: Patient-Centered Healthcare, Quality of Care, Quality Improvement, Surgery, Transitions of Care
Adams JL, Paddock SM
Misclassification risk of tier-based physician quality performance systems.
The authors estimated misclassification rates for two-category high-quality physician identification systems. They found that current methods for profiling physicians on quality may produce misleading results, and that misclassification is a policy-relevant measure of the potential impact of tiering on providers, payers, and patients. They concluded that quantifying misclassification rates should inform the construction of high-performance networks and quality improvement initiatives.
AHRQ-funded; HS021860.
Citation: Adams JL, Paddock SM .
Misclassification risk of tier-based physician quality performance systems.
Health Serv Res 2017 Aug;52(4):1277-96. doi: 10.1111/1475-6773.12561.
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Keywords: Provider Performance, Quality of Care, Payment
Guo JW, Bennett H, Crouch BI
Reference website use patterns of poison control center specialists.
The purpose of this pilot study was to describe web reference use patterns of poison control center specialists using time tracking software. Investigators analyzed two weeks of web site use data from Utah poison control center (PCC) computers to describe patterns of reference web site use. The study demonstrated the utility of time tracking software for better understanding reference utilization in the PCC setting.
AHRQ-funded; HS021472.
Citation: Guo JW, Bennett H, Crouch BI .
Reference website use patterns of poison control center specialists.
2017 IEEE International Conference on Healthcare Informatics (ICHI) 2017 Aug:453. doi: 10.1109/ICHI.2017.40..
Keywords: Patient Safety, Imaging, Quality of Care
Fisher K, Smith K, Gallagher T
We want to know: eliciting hospitalized patients' perspectives on breakdowns in care.
Researchers interviewed a broad sample of patients during hospitalization and postdischarge to elicit patient perspectives on breakdowns in care. When asked directly, almost 4 out of 10 hospitalized patients reported a breakdown in their care. Patient- perceived breakdowns in care are frequently associated with perceived harm, illustrating the importance of detecting and addressing these events.
AHRQ-funded; HS024596; HS022757.
Citation: Fisher K, Smith K, Gallagher T .
We want to know: eliciting hospitalized patients' perspectives on breakdowns in care.
J Hosp Med 2017 Aug;12(8):603-09. doi: 10.12788/jhm.2783.
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Keywords: Communication, Quality of Care, Inpatient Care, Patient Experience, Patient-Centered Outcomes Research
Forman-Hoffman VL, Middleton JC, McKeeman JL
Quality improvement, implementation, and dissemination strategies to improve mental health care for children and adolescents: a systematic review.
The researchers describe the process by which they created an online interactive community resources map for use in the Connect for Health randomized controlled trial. The trial was conducted in the 6 pediatric practices that cared for the highest percentage of children with overweight or obesity. Parents and community partners identified several community resources that could help support behavior change.
AHRQ-funded; 290201200008I.
Citation: Forman-Hoffman VL, Middleton JC, McKeeman JL .
Quality improvement, implementation, and dissemination strategies to improve mental health care for children and adolescents: a systematic review.
Implement Sci 2017 Jul 24;12(1):93. doi: 10.1186/s13012-017-0626-4.
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Keywords: Children/Adolescents, Communication, Behavioral Health, Quality of Care, Quality Improvement
Dyrbye LN, Shanafelt TD, Sinsky CA
AHRQ Author: Meyers D
https://nam.edu/burnout-among-health-care-professionals-a-call-to-explore-and-address-this-underrecognized-threat-to-safe-high-quality-care
Burnout among health care professionals: a call to explore and address this underrecognized threat to safe, high-quality care.
The high prevalence of burnout among health care professionals is cause for concern because it appears to be affecting quality, safety, and health care system performance. Efforts are needed to address this growing problem. Progress will require methodologically sound studies, adequate funding, and collaborative efforts. The authors hope that research sponsors, institutions, clinician organizations, researchers, clinicians, and patients join in supporting enhanced research efforts focused on these topics.
AHRQ-authored.
Citation: Dyrbye LN, Shanafelt TD, Sinsky CA .
Burnout among health care professionals: a call to explore and address this underrecognized threat to safe, high-quality care.
NAM Perspectives 2017 Jul 5.
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Keywords: Quality of Care, Provider: Health Personnel, Patient Safety, Workforce
Rinne ST, Castaneda J, Lindenauer PK
Chronic obstructive pulmonary disease readmissions and other measures of hospital quality.
This study examined the association between COPD readmissions and other quality measures. There were modest correlations between COPD readmission rates and readmission rates for other medical conditions, including heart failure , acute myocardial infarction, pneumonia, and stroke . In contrast, it also found low correlations between COPD readmission rates and readmission rates for surgical conditions, as well as mortality rates for all measured conditions.
AHRQ-funded; HS016978.
Citation: Rinne ST, Castaneda J, Lindenauer PK .
Chronic obstructive pulmonary disease readmissions and other measures of hospital quality.
Am J Respir Crit Care Med 2017 Jul 1;196(1):47-55. doi: 10.1164/rccm.201609-1944OC.
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Keywords: Respiratory Conditions, Consumer Assessment of Healthcare Providers and Systems (CAHPS), Quality of Care, Hospital Readmissions, Hospitals
Shahu A, Schwartz J, Perez M
Discerning quality: an analysis of informed consent documents for common cardiovascular procedures.
In this study, the investigators aimed to assess variation in quality of informed consent documents associated with three commonly performed cardiovascular procedures: left heart catheterisation, transesophageal echocardiography and implantation of a cardioverter defibrillator. The authors focused on basic elements of consent documents with the goal of illuminating opportunities to establish minimum standards for informed consent.
AHRQ-funded; HS023000.
Citation: Shahu A, Schwartz J, Perez M .
Discerning quality: an analysis of informed consent documents for common cardiovascular procedures.
BMJ Qual Saf 2017 Jul;26(7):569-71. doi: 10.1136/bmjqs-2016-005663..
Keywords: Cardiovascular Conditions, Surgery, Treatments, Quality of Care
Flieger SP
Impact of a patient-centered medical home pilot on utilization, quality, and costs and variation in medical homeness.
This study evaluated the impact of a patient-centered medical home (PCMH) pilot on utilization, costs, and quality and assessed variation in PCMH components. There were no statistically significant findings for utilization, cost, or quality in the expected direction. Medical Home Index (MHI) scores suggest variation in type and level of implemented features.
AHRQ-funded; HS021385.
Citation: Flieger SP .
Impact of a patient-centered medical home pilot on utilization, quality, and costs and variation in medical homeness.
J Ambul Care Manage 2017 Jul/Sep;40(3):228-37. doi: 10.1097/jac.0000000000000162.
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Keywords: Patient-Centered Healthcare, Quality of Care, Primary Care, Healthcare Costs, Healthcare Utilization