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
201 to 222 of 222 Research Studies DisplayedMody L, Meddings J, Edson BS
Enhancing resident safety by preventing healthcare-associated infection: a national initiative to reduce catheter-associated urinary tract infections in nursing homes.
The authors describe a new initiative based on lessons learned from a recent multimodal Targeted Infection Prevention program in a group of nursing homes as well as a national initiative to prevent catheter-associated urinary tract infections in over 950 acute care hospitals. This initiative will now be implemented in nearly 500 nursing homes through a project funded by AHRQ. It will emphasize professional development in catheter utilization, catheter care and maintenance, and antimicrobial stewardship.
AHRQ-funded; 2902010000251; HS019979; HS019767.
Citation: Mody L, Meddings J, Edson BS .
Enhancing resident safety by preventing healthcare-associated infection: a national initiative to reduce catheter-associated urinary tract infections in nursing homes.
Clin Infect Dis 2015 Jul 1;61(1):86-94. doi: 10.1093/cid/civ236..
Keywords: Nursing Homes, Healthcare-Associated Infections (HAIs), Urinary Tract Infection (UTI), Patient Safety, Inpatient Care
Reistetter TA, Kuo YF, Karmarkar AM
Geographic and facility variation in inpatient stroke rehabilitation: multilevel analysis of functional status.
This study examined geographic and facility variation in cognitive and motor functional outcomes after postacute inpatient rehabilitation in patients with stroke. Its findings suggest that variation in motor and cognitive function at discharge after postacute rehabilitation in patients with stroke is accounted for more by facility than geographic location.
AHRQ-funded; HS022134.
Citation: Reistetter TA, Kuo YF, Karmarkar AM .
Geographic and facility variation in inpatient stroke rehabilitation: multilevel analysis of functional status.
Arch Phys Med Rehabil 2015 Jul;96(7):1248-54. doi: 10.1016/j.apmr.2015.02.020..
Keywords: Stroke, Cardiovascular Conditions, Inpatient Care, Outcomes
Stockwell DC, Bisarya H, Classen DC
A trigger tool to detect harm in pediatric inpatient settings.
The researchers developed and pilot tested a trigger tool that would identify the most common causes of harm in pediatric inpatient environments. After reviewing review 100 randomly selected inpatient records from each of 6 academic children’s hospitals, they found that the most common patient harms were intravenous catheter infiltrations/burns, respiratory distress, constipation, pain, and surgical complications.
AHRQ-funded; HS020513.
Citation: Stockwell DC, Bisarya H, Classen DC .
A trigger tool to detect harm in pediatric inpatient settings.
Pediatrics 2015 Jun;135(6):1036-42. doi: 10.1542/peds.2014-2152..
Keywords: Children/Adolescents, Patient Safety, Inpatient Care, Children/Adolescents, Adverse Events
Sjoding MW, Prescott HC, Wunsch H
Hospitals with the highest intensive care utilization provide lower quality pneumonia care to the elderly.
The researchers investigate the relationship between a hospital’s ICU admission rate for elderly patients with pneumonia and the quality of care it provided to patients with pneumonia. They found that quality of care was lower among hospitals with the highest rates of ICU admission for elderly patients with pneumonia; such hospitals were less likely to deliver pneumonia processes of care and had worse outcomes for patients with pneumonia.
AHRQ-funded; HS020672.
Citation: Sjoding MW, Prescott HC, Wunsch H .
Hospitals with the highest intensive care utilization provide lower quality pneumonia care to the elderly.
Crit Care Med 2015 Jun;43(6):1178-86. doi: 10.1097/ccm.0000000000000925..
Keywords: Intensive Care Unit (ICU), Elderly, Inpatient Care, Quality of Care, Outcomes
Meddings J, Saint S, Fowler KE
The Ann Arbor criteria for appropriate urinary catheter use in hospitalized medical patients: results obtained by using the RAND/UCLA Appropriateness Method.
A 15-member multidisciplinary panel used the RAND/UCLA Appropriateness Method to assess the appropriateness of using Foley catheters, intermittent straight catheters, and external condom catheters for hospitalized adults on medical services in 299 scenarios, including urinary retention, incontinence, and wounds. The panel concluded that these new appropriateness criteria can inform large-scale collaborative and bedside efforts to reduce inappropriate urinary catheter use.
AHRQ-funded; 290201000025I; HS019767
Citation: Meddings J, Saint S, Fowler KE .
The Ann Arbor criteria for appropriate urinary catheter use in hospitalized medical patients: results obtained by using the RAND/UCLA Appropriateness Method.
Ann Intern Med. 2015 May 5;162(9 Suppl):S1-34. doi: 10.7326/m14-1304..
Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Shared Decision Making, Guidelines, Healthcare-Associated Infections (HAIs), Inpatient Care, Patient Safety
Pakyz AL, Moczygemba LR, Wang H
An evaluation of the association between an antimicrobial stewardship score and antimicrobial usage.
The objective of the study was to determine whether an antimicrobial stewardship ‘intensity’ score predicts hospital antimicrobial usage. It concluded that the strategy component of a score developed to measure the intensity of antimicrobial stewardship was associated with the amount of antimicrobials used.
AHRQ-funded; HS018578.
Citation: Pakyz AL, Moczygemba LR, Wang H .
An evaluation of the association between an antimicrobial stewardship score and antimicrobial usage.
J Antimicrob Chemother 2015 May;70(5):1588-91. doi: 10.1093/jac/dku555..
Keywords: Antimicrobial Stewardship, Inpatient Care, Patient Safety
Press VG, Matthiesen MI, Ranadive A
Insights into inpatients with poor vision: a high value proposition.
The researchers studied the initial feasibility and efficacy of screening and correcting inpatients’ vision. Over 800 hospitalized patients’ vision was screened. Those participants who failed a vision screen (Snellen chart) test performed by research assistants were given non-prescription readers that corrected most participants’ vision.
AHRQ-funded; HS016967.
Citation: Press VG, Matthiesen MI, Ranadive A .
Insights into inpatients with poor vision: a high value proposition.
J Hosp Med 2015 May;10(5):311-3. doi: 10.1002/jhm.2342..
Keywords: Eye Disease and Health, Screening, Inpatient Care, Hospitalization
Hernandez-Boussard T, McDonald KM, Rhoads KF
Patient safety in plastic surgery: identifying areas for quality improvement efforts.
The study’s aim was to assess risk-adjusted rates of inpatient adverse events (AEs) for general reconstructive soft tissue procedures using established measures. It found that plastic surgery patients had a significantly lower risk-adjusted rate compared to other surgical inpatients for all events evaluated except for failure to rescue and postoperative hemorrhage or hematoma.
AHRQ-funded; HS018558.
Citation: Hernandez-Boussard T, McDonald KM, Rhoads KF .
Patient safety in plastic surgery: identifying areas for quality improvement efforts.
Ann Plast Surg 2015 May;74(5):597-602. doi: 10.1097/SAP.0b013e318297791e..
Keywords: Healthcare Cost and Utilization Project (HCUP), Adverse Events, Inpatient Care, Hospitalization, Patient Safety
Goldberger ZD, Nallamothu BK, Nichol G
Policies allowing family presence during resuscitation and patterns of care during in-hospital cardiac arrest.
A growing number of hospitals have begun to implement policies allowing for family presence during resuscitation (FPDR). However, the overall safety of these policies and their effect on resuscitation care is unknown. This study suggests that hospitals with an FPDR policy generally have no statistically significant differences in outcomes and processes of care as hospitals without this policy.
AHRQ-funded; HS020672.
Citation: Goldberger ZD, Nallamothu BK, Nichol G .
Policies allowing family presence during resuscitation and patterns of care during in-hospital cardiac arrest.
Circ Cardiovasc Qual Outcomes 2015 May;8(3):226-34. doi: 10.1161/circoutcomes.114.001272..
Keywords: Cardiovascular Conditions, Patient Safety, Patient-Centered Outcomes Research, Inpatient Care
Maynard G, Kulasa K, Ramos P
Impact of a hypoglycemia reduction bundle and a systems approach to inpatient glycemic management.
In order to improve inpatient glycemic management in a 550-bed academic medical center, the researchers implemented a hypoglycemia reduction bundle, proactive surveillance of glycemic outliers, and an interdisciplinary data-driven approach to glycemic management. By using this approach with multiple mutually reinforcing interventions, they were able to cut severe inpatient hypoglycemia by more than half, while simultaneously improving glycemic control.
AHRQ-funded; HS020594
Citation: Maynard G, Kulasa K, Ramos P .
Impact of a hypoglycemia reduction bundle and a systems approach to inpatient glycemic management.
Endocr Pract. 2015 Apr;21(4):355-67. doi: 10.4158/ep14367.or..
Keywords: Care Management, Inpatient Care, Prevention
Galarraga JE, Mutter R, Pines JM
AHRQ Author: Mutter R
Costs associated with ambulatory care sensitive conditions across hospital-based settings.
The objective of this study was to identify the cost differences in payments and charges for ambulatory care-sensitive conditions (ACSC) visits in three different hospital-based settings: outpatient visits, ED visits, and inpatient admissions. After adjusting for patient demographics and comorbid conditions, charges for an inpatient ACSC visit were four times higher ($11,414 vs. $2,563) when compared to an ED visit.
AHRQ-authored.
Citation: Galarraga JE, Mutter R, Pines JM .
Costs associated with ambulatory care sensitive conditions across hospital-based settings.
Acad Emerg Med. 2015 Feb;22(2):172-81. doi: 10.1111/acem.12579..
Keywords: Medical Expenditure Panel Survey (MEPS), Healthcare Costs, Emergency Medical Services (EMS), Ambulatory Care and Surgery, Inpatient Care
Berry JG, Hall M, Neff J
Children with medical complexity and Medicaid: spending and cost savings.
The authors described the expenditures for children with medical complexity insured by Medicaid across the care continuum, reported the increasingly large amount of spending on hospital care for these children, and presented a business case that estimates how cost savings might be achieved from potential reductions in hospital and emergency department use and shows how the savings could underwrite investments in outpatient and community care. They concluded by discussing the importance of these findings in the context of Medicaid's quality of care and health care reform.
AHRQ-funded; HS023092.
Citation: Berry JG, Hall M, Neff J .
Children with medical complexity and Medicaid: spending and cost savings.
Health Aff 2014 Dec;33(12):2199-206. doi: 10.1377/hlthaff.2014.0828.
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Keywords: Children/Adolescents, Medicaid, Healthcare Costs, Inpatient Care, Quality of Care
Banerjee T, Enayati M, Keller JM
Monitoring patients in hospital beds using unobtrusive depth sensors.
The researchers presented an approach for patient activity recognition in hospital rooms using depth data collected using a Kinect sensor. They described a technique to reduce false alerts such as pillows falling off the bed or equipment movement. They tested their algorithm on 96 hours obtained in two hospital rooms from the University of Missouri Hospital.
AHRQ-funded; HS018477.
Citation: Banerjee T, Enayati M, Keller JM .
Monitoring patients in hospital beds using unobtrusive depth sensors.
Conf Proc IEEE Eng Med Biol Soc 2014;2014:5904-7. doi: 10.1109/embc.2014.6944972.
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Keywords: Care Management, Inpatient Care, Health Information Technology (HIT), Patient Safety
Prey JE, Restaino S, Vawdrey DK
Providing hospital patients with access to their medical records.
The researchers conducted two experiments to better understand clinician and patient perceptions about giving patients access to their medical records during hospital encounters. They found that increased patient information sharing in the inpatient setting is beneficial and desirable to patients, and generally acceptable to clinicians.
AHRQ-funded; HS021816.
Citation: Prey JE, Restaino S, Vawdrey DK .
Providing hospital patients with access to their medical records.
AMIA Annu Symp Proc 2014 Nov 14;2014:1884-93.
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Keywords: Electronic Health Records (EHRs), Inpatient Care, Patient and Family Engagement, Provider, Clinician-Patient Communication
Zhang R, Pakhomov SV, Lee JT
Using language models to identify relevant new information in inpatient clinical notes.
The authors investigated the use of language models for identification of new information in inpatient notes and evaluated their methods using expert-derived reference standards. They found that the average proportion of redundant information was similar between inpatient and outpatient progress notes, and that advanced practice providers tended to have higher rates of redundancy in their notes compared to physicians.
AHRQ-funded; HS022085.
Citation: Zhang R, Pakhomov SV, Lee JT .
Using language models to identify relevant new information in inpatient clinical notes.
AMIA Annu Symp Proc 2014 Nov 14;2014:1268-76.
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Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Inpatient Care
Martsolf GR, Auerbach D, Benevent R
AHRQ Author: Stocks C, Jiang HJ
Examining the value of inpatient nurse staffing: an assessment of quality and patient care costs.
The authors assessed the effect of nurse staffing on quality of care and inpatient care costs. They found that increases in nurse staffing levels were associated with reductions in nursing-sensitive adverse events and length of stay, while changing skill mix by increasing the number of registered nurses, as a proportion of licensed nursing staff, led to reductions in costs.
AHRQ-authored; AHRQ-funded; 290200600009C.
Citation: Martsolf GR, Auerbach D, Benevent R .
Examining the value of inpatient nurse staffing: an assessment of quality and patient care costs.
Med Care 2014 Nov;52(11):982-8. doi: 10.1097/mlr.0000000000000248.
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Keywords: Healthcare Costs, Quality of Care, Healthcare Cost and Utilization Project (HCUP), Inpatient Care, Nursing
Cooke CR, Iwashyna TJ
Sepsis mandates: improving inpatient care while advancing quality improvement.
In light of improvements in the care of the acutely ill hospitalized patients and changes in the epidemiology of hospital care, the authors recommend new quality mandates focused on sepsis. These mandates should: (1) address the reality that sepsis is frequently underdiagnosed, (2) focus on catalyzing and aggregating local efforts for quality improvements, and (3) plan for a phased implementation, improving measures in select sites prior to national roll-out.
AHRQ-funded; HS020672
Citation: Cooke CR, Iwashyna TJ .
Sepsis mandates: improving inpatient care while advancing quality improvement.
JAMA. 2014 Oct 8;312(14):1397-8. doi: 10.1001/jama.2014.11350..
Keywords: Quality of Care, Hospitalization, Inpatient Care, Critical Care, Sepsis
Rosenman MB, Szucs KA, Finnell SM
Nascent regional system for alerting infection preventionists about patients with multidrug-resistant gram-negative bacteria: implementation and initial results.
The authors sought to build and to begin evaluating a regional automated system to notify infection preventionists (IPs) when a patient with a history of gram-negative rod multidrug-resistant organism (GNRMDRO) is admitted to an emergency department (ED) or inpatient setting. They found it feasible to create a regional microbiology-based alert system and observed substantial crossover between institutions. They concluded that this system, if it contributes to timely isolation, may help reduce the spread of GNRMDROs.
AHRQ-funded; HS020014.
Citation: Rosenman MB, Szucs KA, Finnell SM .
Nascent regional system for alerting infection preventionists about patients with multidrug-resistant gram-negative bacteria: implementation and initial results.
Infect Control Hosp Epidemiol 2014 Oct;35 Suppl 3:S40-7. doi: 10.1086/677833.
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Keywords: Emergency Department, Infectious Diseases, Inpatient Care, Patient Safety, Prevention
Edelson DP, Yuen TC, Mancini ME
Hospital cardiac arrest resuscitation practice in the United States: a nationally representative survey.
The authors describe variance in in-hospital cardiac arrest (IHCA) resuscitation care among hospitals. Their survey of 100 hospitals found wide variability among hospitals and practices for resuscitation care in the U.S. with opportunities for improvement, for example, in training.
AHRQ-funded; HS020416
Citation: Edelson DP, Yuen TC, Mancini ME .
Hospital cardiac arrest resuscitation practice in the United States: a nationally representative survey.
J Hosp Med. 2014 Jun;9(6):353-7. doi: 10.1002/jhm.2174..
Keywords: Cardiovascular Conditions, Hospitalization, Quality of Care, Inpatient Care
Setoguchi S, Zhu Y, Jalbert JJ
Validity of deterministic record linkage using multiple indirect personal identifiers: linking a large registry to claims data.
The researchers compared the validity of several deterministic record linkage methods with multiple indirect identifiers by using data from the Centers for Medicare and Medicaid Services (CMS) implantable cardioverter-defibrillator (ICD) registry and administrative Medicare inpatient claims data. Linkage rules using 2 or 3 indirect, patient-level identifiers and hospital ID produced linkages with sensitivity of 95% and specificity of 98% compared with a gold standard linkage rule.
AHRQ-funded; 29020050016I; HS017731.
Citation: Setoguchi S, Zhu Y, Jalbert JJ .
Validity of deterministic record linkage using multiple indirect personal identifiers: linking a large registry to claims data.
Circ Cardiovasc Qual Outcomes 2014 May;7(3):475-80. doi: 10.1161/circoutcomes.113.000294..
Keywords: Medical Devices, Medicare, Registries, Data, Inpatient Care
Blecker S, Goldfeld K, Park N
Electronic health record use, intensity of hospital care, and patient outcomes.
The purpose of this study was to determine whether a metric for measuring intensity of hospital care based on use of the electronic health record was associated with patient-level outcomes. The investigators found that intensity of inpatient care, measured by electronic health record interactions, significantly diminished from Friday to Saturday, and this decrease was associated with length of stay.
AHRQ-funded; HS023683.
Citation: Blecker S, Goldfeld K, Park N .
Electronic health record use, intensity of hospital care, and patient outcomes.
Am J Med 2014 Mar;127(3):216-21. doi: 10.1016/j.amjmed.2013.11.010..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Inpatient Care
Waters TM, Chandler AM, Mion LC
Use of International Classification of Diseases, Ninth Revision, Clinical Modification, codes to identify inpatient fall-related injuries.
The researchers compared falls and fall-related injuries that a fall evaluator or hospital incident report identified with injuries identified according to discharge ICD-9-CM codes for the same set of inpatient episodes of care. They found that the CMS-targeted ICD-9-CM codes used to identify fall-related injuries in claims data do not always detect the most-serious falls.
AHRQ-funded; HS020627.
Citation: Waters TM, Chandler AM, Mion LC .
Use of International Classification of Diseases, Ninth Revision, Clinical Modification, codes to identify inpatient fall-related injuries.
J Am Geriatr Soc 2013 Dec;61(12):2186-91. doi: 10.1111/jgs.12539..
Keywords: Falls, Elderly, Patient Safety, Inpatient Care, Adverse Events