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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
1 to 15 of 15 Research Studies DisplayedBurns Z, Khasnabish S, Hurley AC
Classification of injurious fall severity in hospitalized adults.
The purpose of this project was to refine the National Database of Nursing Quality Indicators Major injury classification to derive a valid and reliable categorization of the types and severities of Major inpatient fall-related injuries. Three subcategories were created: A - injuries that caused temporary functional impairment, major facial injury without internal injury, or disruption of a surgical wound; B - injuries that caused long-term functional impairment or had the potential risk of increased mortality; and C - injuries that had a well-established risk of mortality. These subcategories enhanced the National Database of Nursing Quality Indicators categorization. Using this project’s administration manual, trained personnel can classify injurious fall severity with excellent reliability.
AHRQ-funded; HS025128.
Citation: Burns Z, Khasnabish S, Hurley AC .
Classification of injurious fall severity in hospitalized adults.
J Gerontol A Biol Sci Med Sci 2020 Sep 25;75(10):e138-e44. doi: 10.1093/gerona/glaa004..
Keywords: Elderly, Falls, Injuries and Wounds, Nursing, Quality Measures, Quality Indicators (QIs), Quality of Care, Inpatient Care
Mueller KL, Naganathan S, Griffey RT
Counseling on Access to Lethal Means-Emergency Department (CALM-ED): a quality improvement program for firearm injury prevention.
The authors evaluated the feasibility of the Counseling on Access to Lethal Means intervention in the Emergency Department (CALM-ED) by non-physician personnel. Their quality improvement study was conducted in an urban, academic ED with over 90,000 annual patient visits, and considered adult patients who were discharged after presenting to the ED with a suicidal crisis. They found that an ED-based CALM quality-improvement intervention was feasible for implementation by non-physician personnel and was well received by patients and families. They concluded that the intervention has the potential to help saves lives at times of suicide crisis.
AHRQ-funded; HS025052.
Citation: Mueller KL, Naganathan S, Griffey RT .
Counseling on Access to Lethal Means-Emergency Department (CALM-ED): a quality improvement program for firearm injury prevention.
West J Emerg Med 2020 Aug 20;21(5):1123-30. doi: 10.5811/westjem.2020.5.46952.
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Keywords: Emergency Department, Injuries and Wounds, Prevention, Quality Improvement, Quality of Care, Domestic Violence, Behavioral Health
Tignanelli CJ, Silverman GM, Lindemann EA
Natural language processing of prehospital emergency medical services trauma records allows for automated characterization of treatment appropriateness.
Incomplete prehospital trauma care is a significant contributor to preventable deaths. Current databases lack timelines easily constructible of clinical events. Temporal associations and procedural indications are critical to characterize treatment appropriateness. Natural language processing (NLP) methods present a novel approach to bridge this gap. In this study, the investigators sought to evaluate the efficacy of a novel and automated NLP pipeline to determine treatment appropriateness from a sample of prehospital EMS motor vehicle crash records.
AHRQ-funded; HS026379.
Citation: Tignanelli CJ, Silverman GM, Lindemann EA .
Natural language processing of prehospital emergency medical services trauma records allows for automated characterization of treatment appropriateness.
J Trauma Acute Care Surg 2020 May;88(5):607-14. doi: 10.1097/ta.0000000000002598.
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Keywords: Trauma, Injuries and Wounds, Electronic Health Records (EHRs), Health Information Technology (HIT), Quality Improvement, Quality of Care
Sanghavi P, Pan S, Caudry D
Assessment of nursing home reporting of major injury falls for quality measurement on Nursing Home Compare.
The purpose of this study was to assess the accuracy of nursing home self-report of major injury falls on the Minimum Data Set (MDS). They linked inpatient claims for major injury falls with MDS assessments. The investigators concluded that the nursing home-reported data used for the Nursing Home Compare (NHC) falls measure may be highly inaccurate.
AHRQ-funded; HS026957.
Citation: Sanghavi P, Pan S, Caudry D .
Assessment of nursing home reporting of major injury falls for quality measurement on Nursing Home Compare.
Health Serv Res 2020 Apr;55(2):201-10. doi: 10.1111/1475-6773.13247..
Keywords: Falls, Nursing Homes, Quality Measures, Quality Indicators (QIs), Quality of Care, Elderly, Public Reporting, Injuries and Wounds
McArdle J, Sorensen A, Fowler CI
Strategies to improve management of shoulder dystocia under the AHRQ Safety Program for Perinatal Care.
The purpose of this study using TeamSTEPPS was to assess the implementation of safety strategies to improve management of births complicated by shoulder dystocia in labor and delivery units. Results suggested that successful management of shoulder dystocia requires a rapid, standardized, and coordinated response. The Safety Program for Perinatal Care strategies to increase safety of shoulder dystocia management are scalable, replicable, and adaptable to unit needs and circumstances.
AHRQ-funded; 2902010000241.
Citation: McArdle J, Sorensen A, Fowler CI .
Strategies to improve management of shoulder dystocia under the AHRQ Safety Program for Perinatal Care.
J Obstet Gynecol Neonatal Nurs 2018 Mar;47(2):191-201. doi: 10.1016/j.jogn.2017.11.014.
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Keywords: Labor and Delivery, Newborns/Infants, Pregnancy, Adverse Events, TeamSTEPPS, Injuries and Wounds, Care Management, Education: Continuing Medical Education, Training, Tools & Toolkits, Patient Safety, Nursing, Communication, Quality of Care
Leland NE, Lepore M, Wong C
Delivering high quality hip fracture rehabilitation: the perspective of occupational and physical therapy practitioners.
This study aimed to identify rehabilitation practitioners' perspectives on the practices that constitute high quality hip fracture rehabilitation. The investigators suggest that guidelines are critical tools to facilitate clinical decision-making and achieve desired patient outcomes. The authors suggest that future research is needed to verify the findings from other stakeholders (e.g., patients), ensure the alignment of our findings with current evidence, and develop measures for evaluating their delivery and relationship to desired outcomes.
AHRQ-funded; HS022907.
Citation: Leland NE, Lepore M, Wong C .
Delivering high quality hip fracture rehabilitation: the perspective of occupational and physical therapy practitioners.
Disabil Rehabil 2018 Mar;40(6):646-54. doi: 10.1080/09638288.2016.1273973..
Keywords: Healthcare Delivery, Injuries and Wounds, Quality of Care, Quality Improvement, Rehabilitation
Skube SJ, Hu Z, Arsoniadis EG
Characterizing surgical site infection signals in clinical notes.
Building off of previous work for automated and semi-automated surgical site infections (SSIs) detection using expert-derived "strong features" from clinical notes, researchers hypothesized that additional SSI phrases may be contained in clinical notes. They systematically characterized phrases and expressions associated with SSIs. While 83 percent of expert-derived original terms overlapped with new terms and modifiers, an additional 362 modifiers associated with both positive and negative SSI signals were identified.
AHRQ-funded; HS024532.
Citation: Skube SJ, Hu Z, Arsoniadis EG .
Characterizing surgical site infection signals in clinical notes.
Stud Health Technol Inform 2017;245:955-59.
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Keywords: Healthcare-Associated Infections (HAIs), Surgery, Injuries and Wounds, Patient Safety, Adverse Events, Quality Improvement, Quality of Care
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
Baernholdt M, Hinton ID, Guofen Y
A national comparison of rural/urban pressure ulcer and fall rates.
Despite recent decline in hospital acquired conditions (HACs), rates for pressure ulcers (PURs) and falls (FRs) remain at levels that require improvement. Contextual factors and care processes may impact HACs. Using the National Database of Nursing Quality Indicators (NDNQI®) this study examined differences in care processes and community, hospital, and nursing unit characteristics that influence PURs and FRs in 4238 rural and urban nursing units.
AHRQ-funded; HS023147.
Citation: Baernholdt M, Hinton ID, Guofen Y .
A national comparison of rural/urban pressure ulcer and fall rates.
Online J Issues Nurs 2017 May;22(2):1-12. doi: 10.3912/OJIN.Vol22No02PPT60..
Keywords: Injuries and Wounds, Nursing, Patient Safety, Pressure Ulcers, Quality of Care, Quality Improvement, Quality Indicators (QIs), Quality Measures, Rural Health, Urban Health
Hu Z, Melton GB, Arsoniadis EG
Strategies for handling missing clinical data for automated surgical site infection detection from the electronic health record.
Proper handling of missing data is important for many secondary uses of electronic health record (EHR) data. Data imputation methods can be used to handle missing data, but their use for postoperative complication detection is unclear. Overall, models with missing data imputation almost always outperformed reference models without imputation that included only cases with complete data for detection of SSI overall achieving very good average area under the curve values.
AHRQ-funded; HS024532.
Citation: Hu Z, Melton GB, Arsoniadis EG .
Strategies for handling missing clinical data for automated surgical site infection detection from the electronic health record.
J Biomed Inform 2017 Apr;68:112-20. doi: 10.1016/j.jbi.2017.03.009.
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Keywords: Data, Electronic Health Records (EHRs), Healthcare-Associated Infections (HAIs), Registries, Surgery, Injuries and Wounds, Health Information Technology (HIT), Quality Improvement, Quality of Care, Adverse Events
Calderwood MS, Kleinman K, Huang SS
Surgical site infections: volume-outcome relationship and year-to-year stability of performance rankings.
The researchers evaluated the volume-outcome relationship as well as the year-to-year stability of performance rankings following coronary artery bypass graft (CABG) surgery and hip arthroplasty. They concluded that aggregate surgical site infection risk is highest in hospitals with low annual procedure volumes. Even for higher volume hospitals, year-to-year random variation makes past experience an unreliable estimator of current performance.
AHRQ-funded; HS021424.
Citation: Calderwood MS, Kleinman K, Huang SS .
Surgical site infections: volume-outcome relationship and year-to-year stability of performance rankings.
Med Care 2017 Jan;55(1):79-85. doi: 10.1097/mlr.0000000000000620.
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Keywords: Surgery, Healthcare-Associated Infections (HAIs), Adverse Events, Injuries and Wounds, Hospitals, Provider Performance, Quality Indicators (QIs), Quality of Care, Patient Safety, Elderly
Conlon C, Asch S, Hanson M
Assessing the value of high-quality care for work-associated carpal tunnel syndrome in a large integrated health care system: study design.
The researchers described the design of a study that is assessing quality of care for work-associated carpal tunnel syndrome and associations with clinical outcomes and costs. They found that time off work was generally short and related to surgery. They recommended systematic efforts to evaluate and improve quality of medical care for this condition.
AHRQ-funded; HS018982.
Citation: Conlon C, Asch S, Hanson M .
Assessing the value of high-quality care for work-associated carpal tunnel syndrome in a large integrated health care system: study design.
Perm J 2016 Fall;20(4):87-95. doi: 10.7812/tpp/15-220.
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Keywords: Healthcare Delivery, Quality of Care, Injuries and Wounds, Neurological Disorders, Patient-Centered Outcomes Research
Minami CA, Dahlke AR, Barnard C
Association between hospital characteristics and performance on the new hospital-acquired condition reduction program's surgical site infection measures.
This research letter evaluated the association between hospital characteristics and surgical site infection (SSI) measures. The authors found that hospitals with higher hospital quality summary scores were more frequently poor performers for SSI and had higher standardized infection ratios. Hospitals were more likely to be poor performers for colon SSI and hysterectomy SSI if they were a teaching hospital, safety-net hospital, or level I trauma center. Teaching hospitals were more likely to be poor performers for colorectal SSI, but the association was not as consistent for hysterectomy.
AHRQ-funded; HS021857.
Citation: Minami CA, Dahlke AR, Barnard C .
Association between hospital characteristics and performance on the new hospital-acquired condition reduction program's surgical site infection measures.
JAMA Surg 2016 Aug;151(8):777-9. doi: 10.1001/jamasurg.2016.0408.
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Keywords: Healthcare-Associated Infections (HAIs), Surgery, Injuries and Wounds, Adverse Events, Quality Measures, Hospitals, Quality of Care
Durkin MJ, Dicks KV, Baker AW
Postoperative infection in spine surgery: does the month matter?
The authors evaluated for seasonal variation of surgical site infection (SSI) following spine surgery in a network of nonteaching community hospitals. They found that the rate of SSI following fusion or spinal laminectomy/laminoplasty was higher during the summer in this network of community hospitals, most likely due to S. aureus rather than the July effect.
AHRQ-funded; HS023866.
Citation: Durkin MJ, Dicks KV, Baker AW .
Postoperative infection in spine surgery: does the month matter?
J Neurosurg Spine 2015 Jul;23(1):128-34. doi: 10.3171/2014.10.spine14559.
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Keywords: Surgery, Healthcare-Associated Infections (HAIs), Injuries and Wounds, Adverse Events, Patient Safety, Hospitals, Outcomes, Quality of Care
Curtin CM, Hernandez-Boussard T
Readmissions after treatment of distal radius fractures.
The authors assessed the rates and associated diagnoses of readmissions for patients having received an intervention for treatment of distal radius fracture. Using AHRQ data sets, they found that many distal radius fracture patients return to the health care system for pain-related issues, and they recommended implementation of better pain management.
AHRQ-funded; HS018558.
Citation: Curtin CM, Hernandez-Boussard T .
Readmissions after treatment of distal radius fractures.
J Hand Surg Am 2014 Oct;39(10):1926-32. doi: 10.1016/j.jhsa.2014.07.041.
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Keywords: Injuries and Wounds, Quality of Care, Healthcare Cost and Utilization Project (HCUP), Pain, Hospital Readmissions