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
76 to 89 of 89 Research Studies DisplayedPoghosyan L, Liu J, Shang J
Practice environments and job satisfaction and turnover intentions of nurse practitioners: implications for primary care workforce capacity.
Researchers examined nurse practitioner (NP) practice environments in primary care organizations and the extent to which they were associated with NP retention measures. NPs rated the relationship between NPs and physicians favorably, contrary to the relationship between NPs and administrators. With every unit increase in each standardized subscale score, the odds of job satisfaction increased about 20 percent whereas the odds of intention of turnover decreased about 20 percent.
AHRQ-funded; HS020999.
Citation: Poghosyan L, Liu J, Shang J .
Practice environments and job satisfaction and turnover intentions of nurse practitioners: implications for primary care workforce capacity.
Health Care Manage Rev 2017 Apr/Jun;42(2):162-71. doi: 10.1097/hmr.0000000000000094.
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Keywords: Primary Care, Provider: Nurse, Provider: Clinician, Provider, Workforce
Scott KW, Orav EJ, Cutler DM
Changes in hospital-physician affiliations in U.S. hospitals and their effect on quality of care.
This study examined changes in U.S. acute care hospitals that reported employment relationships with their physicians and to determine whether quality of care improved after the hospitals switched to this integration model. It concluded that during the past decade, hospitals have increasingly become employers of physicians. The study's findings suggest that physician employment alone probably is not a sufficient tool for improving hospital care.
AHRQ-funded; HS000055.
Citation: Scott KW, Orav EJ, Cutler DM .
Changes in hospital-physician affiliations in U.S. hospitals and their effect on quality of care.
Ann Intern Med 2017 Jan 3;166(1):1-8. doi: 10.7326/m16-0125.
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Keywords: Hospitals, Quality of Care, Critical Care, Workforce
de Cordova PB
Staffing and nurse-perceived quality of care.
This article comments on a study by Cho and colleagues, the purpose of which was to explore the associations between nurse staffing and overtime with nurse-perceived patient safety and care left undone. Cho and colleagues found that as patients per nurse and nurse work hours increase, so does the perception of reduced patient safety. The author argues that the study reinforces the view that educating nurses, administrators and policymakers about the importance of nurse staffing on quality care should continue.
AHRQ-funded; HS024339.
Citation: de Cordova PB .
Staffing and nurse-perceived quality of care.
Evid Based Nurs 2017 Jan;20(1):19. doi: 10.1136/eb-2016-102478.
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Keywords: Quality of Care, Provider, Nursing, Workforce
Laccetti AL, Chen B, Cai J
Increase in cancer center staff effort related to electronic patient portal use.
The authors examined patterns of use of electronic portals by clinic staff at a National Cancer Institute-designated comprehensive cancer center. They found that from 2011 to 2014, staff portal activity increased approximately 10-fold, and sixteen percent of all actions occurred outside clinic hours. They concluded that cancer center employee use of an electronic patient portal has increased markedly over time, particularly among nursing staff.
AHRQ-funded; HS022418.
Citation: Laccetti AL, Chen B, Cai J .
Increase in cancer center staff effort related to electronic patient portal use.
J Oncol Pract 2016 Dec;12(12):e981-e90. doi: 10.1200/jop.2016.011817.
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Keywords: Cancer, Health Information Technology (HIT), Provider: Health Personnel, Web-Based, Workforce
Klerman EB, Beckett SA, Landrigan CP
Applying mathematical models to predict resident physician performance and alertness on traditional and novel work schedules.
Using a mathematical model of the effects of circadian rhythms and length of time awake on objective performance and subjective alertness, the researchers compared predictions for traditional intern schedules to those that limit work to </= 16 consecutive hours. Their model predicted fewer hours with poor performance and alertness, especially during night-time work hours, for all three novel schedules than for either of the two traditional schedules.
AHRQ-funded; HS017357.
Citation: Klerman EB, Beckett SA, Landrigan CP .
Applying mathematical models to predict resident physician performance and alertness on traditional and novel work schedules.
BMC Med Educ 2016 Sep 13;16(1):239. doi: 10.1186/s12909-016-0751-9.
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Keywords: Education: Continuing Medical Education, Patient Safety, Provider Performance, Workforce
Silber JH, Rosenbaum PR, McHugh MD
Comparison of the value of nursing work environments in hospitals across different levels of patient risk.
This study tested whether hospitals with better nursing work environments displayed better value than those with worse nursing. It found that hospitals with better nursing environments and above-average staffing levels were associated with better value (lower mortality with similar costs) compared with hospitals without nursing environment recognition and with below-average staffing, especially for higher-risk patients.
AHRQ-funded; HS018338.
Citation: Silber JH, Rosenbaum PR, McHugh MD .
Comparison of the value of nursing work environments in hospitals across different levels of patient risk.
JAMA Surg 2016 Jun;151(6):527-36. doi: 10.1001/jamasurg.2015.4908.
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Keywords: Healthcare Costs, Quality of Care, Nursing, Workforce
Morris AM, Ricci KA, Griffin AR
AHRQ Author: Heslin KC
Personal and professional challenges confronted by hospital staff following hurricane sandy: a qualitative assessment of management perspectives.
This qualitative study assessed the personal and professional challenges that affected staff decisions to report to work following a natural disaster and examined the role of management in addressing staff needs and concerns. Results indicated that staff encountered several barriers in the initial post-Sandy period including transportation problems, personal property damage, and communication issues.
AHRQ-authored.
Citation: Morris AM, Ricci KA, Griffin AR .
Personal and professional challenges confronted by hospital staff following hurricane sandy: a qualitative assessment of management perspectives.
BMC Emerg Med 2016 May 5;16(1):18. doi: 10.1186/s12873-016-0082-5.
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Keywords: Communication, Emergency Preparedness, Workforce
Arora VM, Prochaska MT, Farnan JM
Patient perceptions of whom is most involved in their care with successive duty hour limits.
The researchers aimed to assess if patients’ perceptions of who is most involved in their care changed with residency duty hours. They found that after successive residency duty hours limits, hospitalized patients were more likely to report the attending physician and less likely to report the resident or intern as most involved in their hospital care.
AHRQ-funded; HS010597; HS016967.
Citation: Arora VM, Prochaska MT, Farnan JM .
Patient perceptions of whom is most involved in their care with successive duty hour limits.
J Gen Intern Med 2015 Sep;30(9):1275-8. doi: 10.1007/s11606-015-3239-0..
Keywords: Education: Continuing Medical Education, Inpatient Care, Provider, Clinician-Patient Communication, Workforce
Song Z, Chopra V, McMahon LF
Addressing the primary care workforce crisis.
In this commentary, the authors propose that CMS explicitly reward teaching hospitals if a certain share of their graduates (they propose 30%) remain in primary care 3 years after residency, either through additional payments or release of a withhold. This step could help address the shortage of primary care physicians that now calls for more policy attention and urgency.
AHRQ-funded; HS022835.
Citation: Song Z, Chopra V, McMahon LF .
Addressing the primary care workforce crisis.
Am J Manag Care 2015 Aug;21(8):e452-4..
Keywords: Education: Continuing Medical Education, Policy, Primary Care, Provider, Workforce
Kerlin MP, Harhay MO, Kahn JM
Nighttime intensivist staffing, mortality, and limits on life support: a retrospective cohort study.
This study assesses whether the relationships between nighttime staffing models and clinical outcomes are mediated by differences in end-of-life decision-making. It found little evidence that nighttime physician staffing models affect patient outcomes. ICUs without physicians at night may exhibit reduced hospital mortality that is possibly attributable to differences in end-of-life care practices.
AHRQ-funded; HS018406.
Citation: Kerlin MP, Harhay MO, Kahn JM .
Nighttime intensivist staffing, mortality, and limits on life support: a retrospective cohort study.
Chest 2015 Apr;147(4):951-8. doi: 10.1378/chest.14-0501..
Keywords: Shared Decision Making, Mortality, Outcomes, Workforce
Pylypchuk Y, Sarpong E
AHRQ Author: Pylypchuk Y, Sarpong E
Nurse practitioners and their effects on visits to primary care physicians.
The researchers examined the effects of visits to nurse practitioners (NPs) on the demand for primary care physician services. Using a system of simultaneous equations where states’ education requirements for NPs are an identifying exclusion restriction, they found that patients who visit an NP are significantly less likely to visit PCPs, and to receive prescribed medication, medical check-up, and diagnosis from PCPs.
AHRQ-authored
Citation: Pylypchuk Y, Sarpong E .
Nurse practitioners and their effects on visits to primary care physicians.
B E J Econom Anal Policy 2015 Apr;15(2):837–64..
Keywords: Healthcare Delivery, Education: Continuing Medical Education, Primary Care, Provider, Workforce
Dill JS, Morgan JC, Weiner B
Frontline health care workers and perceived career mobility: do high-performance work practices make a difference?
This study examined how high-performance work practices (HPWPs) that focus on career development are related to an individuals' perceived mobility with their current employer, and also examined the relationships between perceived mobility, job satisfaction, and turnover intent. The findings suggest that tuition remission and educational release time positively predict perceived mobility, while measures of perceived organizational support in one's current position and perceived supervisor support for career development are also significant predictors of perceived mobility. Additionally, perceived mobility is a significant predictor of job satisfaction and intent to stay with current employer.
AHRQ-funded; HS000032.
Citation: Dill JS, Morgan JC, Weiner B .
Frontline health care workers and perceived career mobility: do high-performance work practices make a difference?
Health Care Manage Rev 2014 Oct-Dec;39(4):318-28. doi: 10.1097/HMR.0b013e31829fcbfd.
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Keywords: Provider: Health Personnel, Provider Performance, Workforce
Gabler NB, Ratcliffe SJ, Wagner J
Mortality among patients admitted to strained intensive care units.
A study of 264,401 patients admitted to 155 U.S. intensive care units (ICUs) found several factors associated with small increases in mortality: ICU census on the day of a patient’s admission, the presence of higher acuity patients, and the proportion of new admissions. These sources of ICU strain were associated with mortality increases particularly in ICUs employing closed staffing models.
AHRQ-funded; HS018406
Citation: Gabler NB, Ratcliffe SJ, Wagner J .
Mortality among patients admitted to strained intensive care units.
Am J Respir Crit Care. 2013 Oct 1;188(7):800-6. doi: 10.1164/rccm.201304-0622OC..
Keywords: Mortality, Intensive Care Unit (ICU), Critical Care, Patient Safety, Workforce
Brewer BB, Verran JA
Measuring nursing unit environments with four composite measure.
This article describes a research study that developed four unit-level composite measures reflecting the work environment of nurses. These four measures (originally measured with 14 instruments) enhance the interpretation of environmental factors that have the greatest impact on patient outcomes.
AHRQ-funded; HS011973
Citation: Brewer BB, Verran JA .
Measuring nursing unit environments with four composite measure.
Nurs Econ. 2013 Sep-Oct;31(5):241-9..
Keywords: Patient Safety, Nursing, Workforce