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
12151 to 12175 of 12254 Research Studies DisplayedZimring C, Denham ME, Jacob JT
http://journals.sagepub.com/doi/10.1177/193758671300701S09
The role of facility design in preventing healthcare-associated infection: interventions, conclusions, and research needs.
The objective of this report was to summarize the findings and provide recommendations based on the multidisciplinary literature review and industry scan, focusing on the links between the built environment and healthcare-associated infections. It concluded that there are currently few data that demonstrate a reduction in infection rates. There is a need for multidisciplinary collaboration and increased efforts to standardize the evaluation of environmental studies.
AHRQ-funded; 290201000024I.
Citation: Zimring C, Denham ME, Jacob JT .
The role of facility design in preventing healthcare-associated infection: interventions, conclusions, and research needs.
HERD 2013 Oct;7(1 suppl):127-39..
Keywords: Evidence-Based Practice, Quality of Care, Healthcare-Associated Infections (HAIs), Hospitals
Zimring C, Jacob JT, Denham ME
http://journals.sagepub.com/doi/pdf/10.1177/193758671300701S04
The role of facility design in preventing the transmission of healthcare-associated infections: Background and conceptual framework.
This paper describes the conceptual framework and methodology used to conduct a comprehensive literature review of current evidence evaluating the role of the built environment in the transmission of healthcare-associated infections. The methodology involves a chain of transmission interventions model that is a multidisciplinary conceptualization of the interaction between pathogens and the built environment. This model facilitated a systematic literature review of a very large amount of data.
AHRQ-funded; 290201000024I.
Citation: Zimring C, Jacob JT, Denham ME .
The role of facility design in preventing the transmission of healthcare-associated infections: Background and conceptual framework.
HERD 2013 Oct;7(1 suppl):18-30.
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Keywords: Evidence-Based Practice, Quality of Care, Healthcare-Associated Infections (HAIs), Research Methodologies
Jacob JT, Kasali A, Steinberg JP
http://journals.sagepub.com/doi/abs/10.1177/193758671300701S07
The role of the hospital environment in preventing healthcare-associated infections caused by pathogens transmitted through the air.
This review assesses and synthesizes available evidence in the infection control and healthcare design literature on strategies using the built environment to reduce the transmission of pathogens in the air that cause healthcare-associated infections (HAIs). It found that current evidence is limited by the complexity of the interactions between pathogens and potential hosts, and in the methods used to assess impact of these strategies.
AHRQ-funded; 290201000024I.
Citation: Jacob JT, Kasali A, Steinberg JP .
The role of the hospital environment in preventing healthcare-associated infections caused by pathogens transmitted through the air.
HERD 2013 Oct;7(1 suppl):74-98..
Keywords: Healthcare-Associated Infections (HAIs), Patient Safety, Quality of Care
Steinberg JP, Denham ME, Zimring C
https://www.researchgate.net/publication/276382905/download
The role of the hospital environment in the prevention of healthcare-associated infections by contact transmission.
The authors describe the role of the hospital environment in the spread of pathogens by direct and indirect contact. In addition, the prevention of transmission through interventions involving the built environment is discussed. They conclude that enhanced environmental cleaning including touchless technologies and self-cleaning surfaces can reduce environmental contamination and may prevent infections.
AHRQ-funded; 290201000024I.
Citation: Steinberg JP, Denham ME, Zimring C .
The role of the hospital environment in the prevention of healthcare-associated infections by contact transmission.
HERD 2013 Oct;7(1 suppl):46-73..
Keywords: Healthcare-Associated Infections (HAIs), Infectious Diseases, Hospitals, Prevention, Patient Safety
Denham ME, Kasali A, Steinberg JP
http://journals.sagepub.com/doi/abs/10.1177/193758671300701S08
The role of water in the transmission of healthcare-associated infections: opportunities for intervention through the environment.
The purpose of this review was to assess and synthesize available evidence in the infection control and healthcare design literature on strategies using the built environment to reduce the transmission of pathogens in water that cause healthcare-associated infections (HAIs). It determined that current evidence clearly identifying the environment’s role in the chain of infection is limited.
AHRQ-funded; 290201000024I.
Citation: Denham ME, Kasali A, Steinberg JP .
The role of water in the transmission of healthcare-associated infections: opportunities for intervention through the environment.
HERD 2013 Oct;7(1 suppl):99-126..
Keywords: Healthcare-Associated Infections (HAIs), Patient Safety, Quality of Care
Hall KK, Kamerow DB
http://journals.sagepub.com/doi/abs/10.1177/193758671300701S03
Understanding the role of facility design in the acquisition and prevention of healthcare-associated infections.
The authors characterize the HAI-Design project and discuss briefly each paper in this issue. These papers highlight how the built environment can impact patient safety through the use of a specific and high-impact example: healthcare-associated infections. The overall goal is to identify design strategies that appear to be effective in interrupting pathogen transmission and reducing HAIs.
AHRQ-funded; 290201000024I.
Citation: Hall KK, Kamerow DB .
Understanding the role of facility design in the acquisition and prevention of healthcare-associated infections.
HERD 2013 Oct;7(1 suppl):13-17..
Keywords: Healthcare-Associated Infections (HAIs), Patient Safety, Quality of Care
Nurgalieva ZZ, Franzini L, Morgan RO
Utilization of lymph node dissection, race/ethnicity, and breast cancer outcomes.
This study reports on the impact of nodal surgery utilization on survival among white, African American, Hispanic, and Asian women in a large population of women with breast cancer. It found that the disparities in survival among African American and Hispanic women with breast cancer are not explained by nodal surgery utilization among women with micrometastasis and macrometastasis in sentinel lymph nodes.
AHRQ-funded; HS018956.
Citation: Nurgalieva ZZ, Franzini L, Morgan RO .
Utilization of lymph node dissection, race/ethnicity, and breast cancer outcomes.
Am J Manag Care 2013 Oct;19(10):805-10..
Keywords: Cancer: Breast Cancer, Comparative Effectiveness, Disparities, Patient-Centered Outcomes Research, Racial and Ethnic Minorities
O'Donnell BE, Schneider KM, Brooks JM
Standardizing Medicare payment information to support examining geographic variation in costs.
This paper describes a method for standardizing claim payments, and demonstrates the difference in actual versus standardized payments by geographic region. It found that without standardization of payments, certain areas of the country are mischaracterized as either high or low healthcare resource-consuming areas.
AHRQ-funded; HS019574; HS019440.
Citation: O'Donnell BE, Schneider KM, Brooks JM .
Standardizing Medicare payment information to support examining geographic variation in costs.
Medicare Medicaid Res Rev 2013 Sep 10;3(3). doi: 10.5600/mmrr.003.03.a06..
Keywords: Medicare, Healthcare Costs, Hospitalization, Hospitals
Glanz JM, Wagner NM, Narwaney KJ
A mixed methods study of parental vaccine decision making and parent-provider trust.
Given the growing public health problem of parental vaccine hesitancy, researchers investigated parental vaccine decisionmaking through the use of focus groups and a mailed survey. They found that parents had overall trust in their pediatricians but not in the information they provided about vaccines. Parents refusing or delaying vaccines were twice as likely to begin thinking about vaccines before their child was born.
AHRQ-funded; HS019760
Citation: Glanz JM, Wagner NM, Narwaney KJ .
A mixed methods study of parental vaccine decision making and parent-provider trust.
Acad Pediatr. 2013 Sep-Oct;13(5):481-8. doi: 10.1016/j.acap.2013.05.030..
Keywords: Children/Adolescents, Vaccination, Education: Patient and Caregiver, Healthcare Utilization, Shared Decision Making
Myers SR, Salhi RA, Lerner EB
A pilot study describing access to emergency care in two states using a model emergency care categorization system.
To improve regionalization of care and patient decisions when seeking emergency care, the researchers surveyed emergency departments (EDs) in 2 States. They found that 25 percent provided advanced care, 10.5 percent comprehensive care, and 1.6 percent pediatric critical care. Overall, 75.1 percent of the population could reach advanced or comprehensive ED within 60 minutes by ground transportation.
AHRQ-funded; HS017960; HS018604
Citation: Myers SR, Salhi RA, Lerner EB .
A pilot study describing access to emergency care in two states using a model emergency care categorization system.
Acad Emerg Med. 2013 Sep;20(9):894-903. doi: 10.1111/acem.12208..
Keywords: Emergency Medical Services (EMS), Access to Care, Critical Care, Shared Decision Making
Williams SE, Rothman RL, Offit PA
A randomized trial to increase acceptance of childhood vaccines by vaccine-hesitant parents: a pilot study.
This pilot study evaluated an educational intervention (a video and written information) to improve parental attitudes and vaccine-uptake in vaccine-hesitant parents. It found a modest increase in parental attitudes toward vaccines but no difference in receipt of vaccines between the intervention and control groups at 12 weeks.
AHRQ-funded; HS019675
Citation: Williams SE, Rothman RL, Offit PA .
A randomized trial to increase acceptance of childhood vaccines by vaccine-hesitant parents: a pilot study.
Acad Pediatr. 2013 Sep-Oct;13(5):475-80. doi: 10.1016/j.acap.2013.03.011..
Keywords: Children/Adolescents, Vaccination, Education: Patient and Caregiver, Healthcare Utilization
Robin Yabroff K, Short PF, Machlin S
AHRQ Author: Machlin S
Access to preventive health care for cancer survivors.
The researchers evaluated the association between cancer survivorship and access to primary and preventive health care. They concluded that, although access and preventive care use in cancer survivors is generally equivalent or greater compared to that of other individuals, disparities for uninsured and publicly insured cancer survivors aged 18-64 years suggest that improvements in survivor care are needed.
AHRQ-authored.
Citation: Robin Yabroff K, Short PF, Machlin S .
Access to preventive health care for cancer survivors.
Am J Prev Med 2013 Sep;45(3):304-12. doi: 10.1016/j.amepre.2013.04.021.
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Keywords: Access to Care, Cancer, Medical Expenditure Panel Survey (MEPS), Prevention, Primary Care
Galarraga O, Genberg BL, Martin RA
Conditional economic incentives to improve HIV treatment adherence: literature review and theoretical considerations.
This review summarizes various theories from micro- and behavioral-economics to social and clinical psychology that may help to understand how conditional economic incentives (CEI) work, and how they may be integrated with theories of health behavior that focus more on internal motivation. It concluded that appropriate CEI can help patients adhere to HIV treatment in the short-term, while incentives are in place.
AHRQ-funded; HS019657
Citation: Galarraga O, Genberg BL, Martin RA .
Conditional economic incentives to improve HIV treatment adherence: literature review and theoretical considerations.
AIDS Behav. 2013 Sep;17(7):2283-92. doi: 10.1007/s10461-013-0415-2..
Keywords: Human Immunodeficiency Virus (HIV), Patient Self-Management, Chronic Conditions, Medication, Patient Adherence/Compliance
Hong AL, Sawyer MD, Shore A
Decreasing central-line-associated bloodstream infections in Connecticut intensive care units.
This study demonstrated that the Comprehensive Unit-based Safety Program, a multifaceted approach to prevent central line-associated bloodstream infections (CLABSIs) could be implemented in Connecticut (following successful implementation in Michigan). The program was associated with a reduction in CLABSI rates in Connecticut, even though the State’s baseline CLABSI rate was already low.
AHRQ-funded; 290200600022
Citation: Hong AL, Sawyer MD, Shore A .
Decreasing central-line-associated bloodstream infections in Connecticut intensive care units.
J Healthc Qual. 2013 Sep-Oct;35(5):78-87. doi: 10.1111/j.1945-1474.2012.00210.x..
Keywords: Comprehensive Unit-based Safety Program (CUSP), Healthcare-Associated Infections (HAIs), Central Line-Associated Bloodstream Infections (CLABSI), Patient Safety, Quality of Care
Suskind AM, Clemens JQ, Dunn RL
Effectiveness of mesh compared with nonmesh sling surgery in Medicare beneficiaries.
This study assessed the effectiveness of mesh compared to nonmesh slings in the surgical treatment of female incontinence. It found that overall rates of complications were similar for patients undergoing either mesh or nonmesh sling procedures. However, patients undergoing the nonmesh procedure were more likely to require a subsequent intervention for bladder outlet obstruction.
AHRQ-funded; HS018726.
Citation: Suskind AM, Clemens JQ, Dunn RL .
Effectiveness of mesh compared with nonmesh sling surgery in Medicare beneficiaries.
Obstet Gynecol. 2013 Sep;122(3):546-52. doi: 10.1097/AOG.0b013e31829e8543..
Keywords: Comparative Effectiveness, Elderly, Patient-Centered Outcomes Research, Surgery, Women, Outcomes, Medicare, Evidence-Based Practice
Quigley DD, Martino SC, Brown JA
Evaluating the content of the communication items in the CAHPS clinician and group survey and supplemental items with what high-performing physicians say they do.
The authors examined the content of the CAHPS® Clinician and Group Survey and found that the survey items captured many of the most commonly mentioned doctor-patient communication behaviors and practices identified by high-performing physicians. However, three key aspects of communication--nonverbal communication, greeting patients, and tracking personal information about patients--were not captured by the current survey.
AHRQ-funded; HS016980.
Citation: Quigley DD, Martino SC, Brown JA .
Evaluating the content of the communication items in the CAHPS clinician and group survey and supplemental items with what high-performing physicians say they do.
Patient. 2013;6(3):169-77. doi: 10.1007/s40271-013-0016-1..
Keywords: Communication, Consumer Assessment of Healthcare Providers and Systems (CAHPS), Quality of Care, Clinician-Patient Communication, Provider Performance
Shoemaker SJ, Staub-DeLong L, Wasserman M
Factors affecting adoption and implementation of AHRQ health literacy tools in pharmacies.
The purpose of this study is to understand the facilitators and barriers to the adoption and implementation of AHRQ’s health literacy tools, particularly a tool to assess a pharmacy’s health literacy practices. The study found facilitators including awareness of health literacy, a culture of innovation, and a change champion. It also identified barriers such as lack of leadership support and limited staff time.
AHRQ-funded; 290200600011I
Citation: Shoemaker SJ, Staub-DeLong L, Wasserman M .
Factors affecting adoption and implementation of AHRQ health literacy tools in pharmacies.
Res Social Adm Pharm. 2013 Sep-Oct;9(5):553-63. doi: 10.1016/j.sapharm.2013.05.003..
Keywords: Health Literacy, Education: Patient and Caregiver, Practice Patterns, Tools & Toolkits, Medication
Beaubrun AC, Kanda E, Bond TC
Form CMS-2728 data versus erythropoietin claims data: implications for quality of care studies.
The purpose of this study was to compare predialysis erythropoietin-simulating agents (ESA) care reported on Form CMS-2728 with Medicare claims for ESA treatment submitted for patients 67 years and older at initiation of dialysis with Medicare as the primary payer. It found that the agreement between Form CMS-2728 and claims data is poor and discordant results are observed when comparing the use of these data sources to predict health outcomes.
AHRQ-funded; HS000032.
Citation: Beaubrun AC, Kanda E, Bond TC .
Form CMS-2728 data versus erythropoietin claims data: implications for quality of care studies.
Ren Fail 2013;35(3):320-6. doi: 10.3109/0886022x.2012.747967..
Keywords: Medicare, Data, Elderly, Quality of Care, Kidney Disease and Health
Paez K, Roper RA, Andrews RM
AHRQ Author: Roper RA, Andrews RM
Health information technology and hospital patient safety: a conceptual model to guide research.
The authors developed a conceptual model to guide research in sorting out the complex relationships between health information technology (HIT) and the quality and safety of care. They found the model difficult to operationalize because available HIT adoption data did not characterize features and extent of usage, and patient safety measures did not elucidate the process failures leading to safety-related outcomes. Their findings illustrated the critical need for collecting data that are germane to HIT and the possible mechanisms by which HIT may affect inpatient safety.
AHRQ-authored; AHRQ-funded.
Citation: Paez K, Roper RA, Andrews RM .
Health information technology and hospital patient safety: a conceptual model to guide research.
Jt Comm J Qual Patient Saf 2013 Sep;39(9):415-25.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Health Information Technology (HIT), Hospitals, Quality of Care, Patient Safety
Quick B, Harrison TR, King AJ
It's up to you: a multi-message, phased driver facility campaign to increase organ donation registration rates in Illinois.
This project applied successful strategies previously employed in driver facility campaigns to examine whether these strategies would be effective in growing a registry where the majority of individuals have already had the opportunity to register as an organ donor. In facilities with historically high and low registration percentages, these strategies resulted in higher organ donor registration rates, compared with control facilities.
AHRQ-funded; HS019218
Citation: Quick B, Harrison TR, King AJ .
It's up to you: a multi-message, phased driver facility campaign to increase organ donation registration rates in Illinois.
Clin Transplant. 2013 Sep-Oct;27(5):E546-53. doi: 10.1111/ctr.12208..
Keywords: Comparative Effectiveness, Registries, Transplantation, Education: Patient and Caregiver, Evidence-Based Practice
Radecki RP
Letter by Radecki regarding article, "safety of thrombolysis in stroke mimics: results from a multicenter cohort study".
In this letter commenting on an article on the treatment of stroke mimics, the author asserts that the difficult question of the acceptable rate of misdiagnosis remains. He suggests that patients undergoing thrombolytic therapy for acute ischemic stroke have confirmatory testing such as an MRI with diffusion-weighted sequences and that the incidence of neuroimaging negative events be reported.
AHRQ-funded; HS017586
Citation: Radecki RP .
Letter by Radecki regarding article, "safety of thrombolysis in stroke mimics: results from a multicenter cohort study".
Stroke. 2013 Sep;44(9):e105. doi: 10.1161/STROKEAHA.113.002040..
Keywords: Stroke, Shared Decision Making, Patient Safety, Blood Clots
Fitzgibbons Jr RJ, Ramanan B, Arya S
Long-term results of a randomized controlled trial of a nonoperative strategy (watchful waiting) for men with minimally symptomatic inguinal hernias.
This study of 254 men with minimally symptomatic inguinal hernia who were assigned to watchful waiting (WW) found that WW is a reasonable and safe strategy. However, the study which followed these patients for up to 11.5 years found that symptoms usually progressed and an operation was eventually needed, with 79 percent of men older than 65 and 62 percent of younger men receiving surgical repair.
AHRQ-funded; HS09860
Citation: Fitzgibbons Jr RJ, Ramanan B, Arya S .
Long-term results of a randomized controlled trial of a nonoperative strategy (watchful waiting) for men with minimally symptomatic inguinal hernias.
Ann Surg. 2013 Sep;258(3):508-15. doi: 10.1097/SLA.0b013e3182a19725..
Keywords: Surgery, Men's Health, Quality of Care, Patient Safety, Shared Decision Making
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
Baur C, Brach C
AHRQ Author: Brach C
Pharmacy research on health literacy can contribute to national goals and health care system improvements.
Three key points about health literacy underscore the articles in this special issue: 1. Effective health communication utilizes both the spoken and written word; 2. A number of health literacy tools can help pharmacists implement health literacy practices; 3. Readability assessments can be a step on a path toward more productive provider–patient communication.
AHRQ-authored.
Citation: Baur C, Brach C .
Pharmacy research on health literacy can contribute to national goals and health care system improvements.
Res Social Adm Pharm 2013 Sep-Oct;9(5):498-502. doi: 10.1016/j.sapharm.2013.06.012.
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Keywords: Healthcare Delivery, Communication, Health Literacy, Provider: Pharmacist
Matthews CA, Whitehead WE, Townsend MK
Risk factors for urinary, fecal, or dual incontinence in the Nurses' Health Study.
This study estimating the prevalence of urinary incontinence, fecal incontinence, and dual incontinence in a group of 64,396 women aged 62-87 years found that 38 percent had urinary incontinence alone, 4 percent had fecal incontinence alone, and 7 percent had dual incontinence. Dual incontinence was primarily associated with advanced age, decompensating medical conditions, depression, and multiparity.
AHRQ-funded; HS018695.
Citation: Matthews CA, Whitehead WE, Townsend MK .
Risk factors for urinary, fecal, or dual incontinence in the Nurses' Health Study.
Obstet Gynecol. 2013 Sep;122(3):539-45. doi: 10.1097/AOG.0b013e31829efbff..
Keywords: Chronic Conditions, Elderly, Women