National Healthcare Quality and Disparities Report
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Search All Research Studies
Topics
- Adverse Drug Events (ADE) (1)
- Adverse Events (2)
- Care Coordination (1)
- (-) Elderly (8)
- Health Information Technology (HIT) (1)
- Home Healthcare (3)
- (-) Hospital Discharge (8)
- Hospitalization (2)
- Hospital Readmissions (1)
- Hospitals (1)
- Long-Term Care (2)
- Medication (1)
- Medication: Safety (1)
- Nursing Homes (2)
- Patient and Family Engagement (1)
- Patient Safety (3)
- Risk (1)
- Shared Decision Making (1)
- Telehealth (1)
- (-) Transitions of Care (8)
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 8 of 8 Research Studies DisplayedXiao Y, Smith A, Abebe E
Understanding hazards for adverse drug events among older adults after hospital discharge: insights from frontline care professionals.
The purpose of this study was to utilize a systems approach to examine hazards to medication safety for older adults during care transitions. The researchers interviewed 38 hospital-based professionals (5 hospitalists, 24 nurses, 4 clinical pharmacists, 3 pharmacy technicians, and 2 social workers) from 4 hospitals about ADE risks after hospital discharge among older adults. For each concern the participants provided, the hazard for medication-related harms was coded and grouped by its sources utilizing a human factors and systems engineering model. The study found that the hazards fell into 6 groups: 1) medication tasks related at home, 2) patient and caregiver related, 3) hospital work system related, 4) home resource related, 5) hospital professional-patient collaborative work related, and 6) external environment related. The type of medications indicated most frequently when describing concerns included anticoagulants, insulins, and diuretics. The types of hazards coded the most were: complex dosing, patient and caregiver knowledge gaps in medication management, errors in discharge medications, unaffordable cost, inadequate understanding about changes in medications, and gaps in access to care or in sharing medication information.
AHRQ-funded; HS024436.
Citation: Xiao Y, Smith A, Abebe E .
Understanding hazards for adverse drug events among older adults after hospital discharge: insights from frontline care professionals.
J Patient Saf 2022 Dec 1;18(8):e1174-e80. doi: 10.1097/pts.0000000000001046..
Keywords: Elderly, Adverse Drug Events (ADE), Medication, Medication: Safety, Hospital Discharge, Hospitals, Transitions of Care
Harrison JD, Sudore RL, Auerbach AD
Automated telephone follow-up programs after hospital discharge: do older adults engage with these programs?
The purpose of this study was to examine whether and how older adults experience automated post-hospital discharge telephone follow-up programs and characterize the prevalence of patient-reported post-discharge issues. Eighteen thousand and seventy-six patients, all part of a post-hospital discharge program between May 1, 2018 and April 30, 2019, were included and categorized into age groups. The study found that more patients 65-84 years old were reached compared to patients 64 years old or less (84.3% compared to 78.9%). Patients aged 85 or older were more likely to have questions about their follow-up plans and require assistance scheduling appointments compared to those 64 years old or less (19.0% vs. 11.9%). The researchers concluded that post-hospital automated telephone calls are effective at reaching older adults.
AHRQ-funded; HS026383.
Citation: Harrison JD, Sudore RL, Auerbach AD .
Automated telephone follow-up programs after hospital discharge: do older adults engage with these programs?
J Am Geriatr Soc 2022 Oct;70(10):2980-87. doi: 10.1111/jgs.17939..
Keywords: Elderly, Patient and Family Engagement, Hospital Discharge, Transitions of Care, Telehealth, Health Information Technology (HIT)
Kapoor A, Field T, Handler S
Characteristics of long-term care residents that predict adverse events after hospitalization.
This study examined the characteristics of long-term care (LTC) residents that predict adverse events (AEs) after discharge from recent hospitalization. This cohort study looked at AEs that occurred at 32 nursing homes from six New England states. AE incidents involving a total of 555 LTC residents with 762 transitions from the hospital back to LTC were reviewed. The association between all AEs and preventable AEs developing in the 45 days following discharge back to LTC was measured. There were 283 discharges with one or more AEs and 212 with preventable AEs. Characteristics independently associated with higher risk of AEs included hospital length of stay (LOS) 9 or more days, 18 or more regularly scheduled medications, and 19 and above on the dependency in activities of daily living (ADL) scale.
AHRQ-funded; HS024422.
Citation: Kapoor A, Field T, Handler S .
Characteristics of long-term care residents that predict adverse events after hospitalization.
J Am Geriatr Soc 2020 Nov;68(11):2551-57. doi: 10.1111/jgs.16770..
Keywords: Elderly, Long-Term Care, Nursing Homes, Hospitalization, Adverse Events, Transitions of Care, Hospital Discharge, Risk
Kapoor A, Field T, Handler S
Adverse events in long-term care residents transitioning from hospital back to nursing home.
This study looked at adverse event rates of long-term care residents transitioning back to their nursing home after hospitalization. A prospective cohort study of LTC residents discharged from hospital back to LTC from March 1, 2016, to December 31, 2017 was conducted, and residents were followed up for 45 days. A random sample of 32 nursing homes located in 6 New England states was used, and 555 LTC residents were selected, contributing 762 transitions from hospital back to the same LTC facility. Most of the cohort were female (65.5%) and non-Hispanic white (93.7%). The study used trained nurse abstractors to review nursing home records to determine if an adverse event occurred. Out of 762 discharges there were 379 adverse events. The most common adverse events were pressure ulcers, skin tears, and falls followed by health care-acquired infections. 145 adverse events were considered less serious, with 28 life-threatening, and 8 were fatal. Most of the adverse events were considered preventable or ameliorable.
AHRQ-funded; HS024596.
Citation: Kapoor A, Field T, Handler S .
Adverse events in long-term care residents transitioning from hospital back to nursing home.
JAMA Intern Med 2019 Sep;179(9):1254-61. doi: 10.1001/jamainternmed.2019.2005..
Keywords: Adverse Events, Long-Term Care, Nursing Homes, Transitions of Care, Elderly, Patient Safety, Hospital Discharge, Hospitalization
Arbaje AI, Hughes A, Werner N
Information management goals and process failures during home visits for middle-aged and older adults receiving skilled home healthcare services after hospital discharge: a multisite, qualitative study.
The goal of this study was to identify information management (IM) process failures made during home health visits to middle-aged and older adults after hospital discharge. Communication risks included information overload, information underload, information scatter, information conflict, and erroneous information.
AHRQ-funded; HS022916.
Citation: Arbaje AI, Hughes A, Werner N .
Information management goals and process failures during home visits for middle-aged and older adults receiving skilled home healthcare services after hospital discharge: a multisite, qualitative study.
BMJ Qual Saf 2019 Feb;28(2):111-20. doi: 10.1136/bmjqs-2018-008163..
Keywords: Elderly, Home Healthcare, Hospital Discharge, Patient Safety, Transitions of Care
Baier RR, Wysocki A, Gravenstein S
A qualitative study of choosing home health care after hospitalization: the unintended consequences of 'patient choice' requirements.
The purpose of this qualitative study is to learn how quality reports are used when choosing home care. Focus groups with 13 home health consumers and interviews with 28 hospital case managers from five hospitals revealed that both groups were unaware of public reports about home care quality.
AHRQ-funded; HS021879
Citation: Baier RR, Wysocki A, Gravenstein S .
A qualitative study of choosing home health care after hospitalization: the unintended consequences of 'patient choice' requirements.
J Gen Intern Med. 2015 May;30(5):634-40. doi: 10.1007/s11606-014-3164-7..
Keywords: Shared Decision Making, Elderly, Home Healthcare, Hospital Discharge, Transitions of Care
Nasarwanji N, Werner NE, Carl K
Identifying challenges associated with the care transition workflow from hospital to skilled home health care: perspectives of home health care agency providers.
The authors studied the workflow for transitioning older adults from the hospital to skilled home health care (SHHC). They found three overarching challenges to optimal care transitions: information access, coordination, and communication/teamwork. They recommended that future investigations test whether redesigning the transition from hospital to SHHC improves workflow and care quality.
AHRQ-funded; HS022916.
Citation: Nasarwanji N, Werner NE, Carl K .
Identifying challenges associated with the care transition workflow from hospital to skilled home health care: perspectives of home health care agency providers.
Home Health Care Serv Q 2015;34(3-4):185-203. doi: 10.1080/01621424.2015.1092908.
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Keywords: Care Coordination, Elderly, Home Healthcare, Hospital Discharge, Transitions of Care
Clancy CM
AHRQ Author: Clancy CM
New hospital readmission policy links financial and quality incentives.
This article describes AHRQ-related projects to reduce hospital readmissions, including Porject RED (Re-Engineered Discharge), Project BOOST (Better Outcomes for Older adults through Safe Transitions), and Patient Safety Organizations (PSOs).
AHRQ-authored.
Citation: Clancy CM .
New hospital readmission policy links financial and quality incentives.
J Nurs Care Qual 2013 Jan-Mar;28(1):1-4. doi: 10.1097/NCQ.0b013e3182725d82.
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Keywords: Elderly, Hospital Discharge, Patient Safety, Hospital Readmissions, Transitions of Care