National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Events (2)
- Anxiety (1)
- Behavioral Health (1)
- Children/Adolescents (1)
- Chronic Conditions (1)
- Clinical Decision Support (CDS) (1)
- Communication (1)
- Education: Patient and Caregiver (1)
- Elderly (8)
- Electronic Health Records (EHRs) (1)
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- Evidence-Based Practice (2)
- (-) Falls (17)
- Health Information Technology (HIT) (4)
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- Patient and Family Engagement (2)
- Patient Safety (7)
- Prevention (7)
- Public Reporting (1)
- Quality Improvement (1)
- Quality Indicators (QIs) (2)
- Quality Measures (2)
- Quality of Care (3)
- Risk (2)
- Tools & Toolkits (2)
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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 17 of 17 Research Studies DisplayedPatterson BW, Jacobsohn GC, Maru AP
Comparing strategies for identifying falls in older adult emergency department visits using EHR data.
This study compared seven different strategies for identifying falls in older adult emergency department (ED) visits using electronic health record (EHR) data. This retrospective cohort study used randomly selected data from 500 ED visits by patients 65 and older at an academic medical center from December 2016 to April 2017. The seven strategies tested were: Chief complaint (CC), ICD codes, Restrictive ICD codes, Broad ICD codes, Combined approaches, Natural language processing (NLP), and Manual abstraction (gold standard). When compared with manual chart review, NLP was found to be the most accurate fall identification strategy, followed by a combination of a restrictive ICD code-based definition with CC.
AHRQ-funded; HS024558.
Citation: Patterson BW, Jacobsohn GC, Maru AP .
Comparing strategies for identifying falls in older adult emergency department visits using EHR data.
J Am Geriatr Soc 2020 Dec;68(12):2965-67. doi: 10.1111/jgs.16831..
Keywords: Elderly, Falls, Emergency Department, Electronic Health Records (EHRs), Health Information Technology (HIT)
Dykes PC, Burns Z, Adelman J
Evaluation of a patient-centered fall-prevention tool kit to reduce falls and injuries: a nonrandomized controlled trial.
The purpose of this study was to assess whether a fall-prevention tool kit that engages patients and families in the fall-prevention process throughout hospitalization is associated with reduced falls and injurious falls. Findings showed that, in this nonrandomized controlled trial, implementation of a fall-prevention tool kit was associated with a significant reduction in falls and related injuries. A patient-care team partnership appeared to be beneficial for prevention of falls and fall-related injuries.
AHRQ-funded; HS023535.
Citation: Dykes PC, Burns Z, Adelman J .
Evaluation of a patient-centered fall-prevention tool kit to reduce falls and injuries: a nonrandomized controlled trial.
JAMA Netw Open 2020 Nov 2;3(11):e2025889. doi: 10.1001/jamanetworkopen.2020.25889..
Keywords: Falls, Injuries and Wounds, Prevention, Tools & Toolkits, Patient and Family Engagement, Patient-Centered Healthcare, Clinical Decision Support (CDS), Hospitalization, Hospitals
Burns 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
Hoffman GJ, Tinetti ME, Ha J
Prehospital and posthospital fall injuries in older US adults.
Investigators estimated the risk of older adult fall injury within and across discrete periods during a 12-month care episode anchored by an acute hospitalization using national data from 2006 to 2014. Participants in this cohort study included Medicare fee-for-service beneficiaries aged 65 and older from the Health and Retirement Study. The investigators found that an episode-based assessment of fall injury illustrated substantial variability in period-specific risks over an extended period including an anchor hospitalization. Risk transitions between periods included sizable increases just before hospitalization that do not fully subside after hospital discharge. Financial incentives to coordinate hospital and posthospital care for patients at risk for fall injury are needed.
AHRQ-funded; HS025838.
Citation: Hoffman GJ, Tinetti ME, Ha J .
Prehospital and posthospital fall injuries in older US adults.
JAMA Netw Open 2020 Aug 3;3(8):e2013243. doi: 10.1001/jamanetworkopen.2020.13243..
Keywords: Elderly, Falls, Injuries and Wounds, Risk, Hospitalization, Medicare
Lurie JD, Zagaria AB, Ellis L
Surface perturbation training to prevent falls in older adults: a highly pragmatic, randomized controlled trial.
This study’s objective was to determine if adding a component of surface-perturbation training to usual gait/balance training was more effective than gait/balance training alone for reducing falls and fall-related injuries in high-risk older adults referred to physical therapy. This multi-center trial took place at 8 outpatient physical therapy clinics. The cohort included 506 patients aged 65 and older at high fall risk. The group was randomized between treatment with and without surface-perturbation treadmill training. The results were that the training did not significantly reduce risk of any fall but did significantly reduce chance of a fall-related injury after the first 3 months.
AHRQ-funded; HS018459.
Citation: Lurie JD, Zagaria AB, Ellis L .
Surface perturbation training to prevent falls in older adults: a highly pragmatic, randomized controlled trial.
Phys Ther 2020 Jul 19;100(7):1153-62. doi: 10.1093/ptj/pzaa023..
Keywords: Elderly, Falls, Prevention, Training
Bushnell GA, Gerhard T, Crystal S
Benzodiazepine treatment and fracture risk in young persons with anxiety disorders.
This study examined whether benzodiazepine treatment increases fall and fracture risk in young persons as it has been shown to do in older adults. They examined whether children (6-17 years) and young adults (18-24) recently diagnosed with anxiety disorder had an increased fracture risk. A cohort of commercially insured children and young adults who had initiated use of benzodiazepine or SSRIs were followed for 3 months, or until fracture, treatment discontinuation or switching or disenrollment occurred. The cohort consisted of 120,715 children and 179,768 young adults. There was an increased fracture rate found in children, but not young adults.
AHRQ-funded; HS026001.
Citation: Bushnell GA, Gerhard T, Crystal S .
Benzodiazepine treatment and fracture risk in young persons with anxiety disorders.
Pediatrics 2020 Jul;146(1):e20193478. doi: 10.1542/peds.2019-3478..
Keywords: Children/Adolescents, Young Adults, Medication, Falls, Injuries and Wounds, Risk, Anxiety, Behavioral Health
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
Christiansen TL, Lipsitz S, Scanlan M
Patient activation related to fall prevention: a multisite study.
The purpose of this study was to examine the impact of the Fall TIPS (Tailoring Interventions for Patient Safety) program on patient activation related to fall prevention. Researchers used the short form Patient Activation Measure (PAM-13) adapted for fall prevention. Their findings showed that patient activation improved from preintervention to postintervention at all three studied sites. Patients with access to the Fall TIPS program are more activated and engaged in their fall prevention plan. Recommendations include engaging patients in the fall prevention plan to increase their knowledge, skill, and confidence.
AHRQ-funded; HS023535.
Citation: Christiansen TL, Lipsitz S, Scanlan M .
Patient activation related to fall prevention: a multisite study.
Jt Comm J Qual Patient Saf 2020 Mar;46(3):129-35. doi: 10.1016/j.jcjq.2019.11.010..
Keywords: Falls, Prevention, Patient Safety, Patient and Family Engagement, Education: Patient and Caregiver
Khasnabish S, Burns Z, Couch M
Best practices for data visualization: creating and evaluating a report for an evidence-based fall prevention program.
This case report applied principles from the data visualization literature and feedback from nurses to develop an effective report to display adherence with an evidence-based fall prevention program. The literature emphasized that the ideal display maximizes the information communicated, minimizes the cognitive efforts involved with interpretation, and selects the correct type of display. Lessons learned from this study can inform report development for clinicians in implementation science.
AHRQ-funded; HS025128.
Citation: Khasnabish S, Burns Z, Couch M .
Best practices for data visualization: creating and evaluating a report for an evidence-based fall prevention program.
J Am Med Inform Assoc 2020 Feb;27(2):308-14. doi: 10.1093/jamia/ocz190..
Keywords: Falls, Prevention, Evidence-Based Practice
Arling PA, Abrahamson K, Miech EJ
Communication and effectiveness in a US nursing home quality-improvement collaborative.
The investigators explored the relationship between changes in resident health outcomes, practitioner communication patterns, and practitioner perceptions of group effectiveness within a quality-improvement collaborative of nursing home clinicians. They found that reductions in fall rates were highest in facilities where respondents experienced the highest levels of communication with collaborative members outside of scheduled meetings. Clinician and practitioner observations were discussed.
AHRQ-funded; HS018464.
Citation: Arling PA, Abrahamson K, Miech EJ .
Communication and effectiveness in a US nursing home quality-improvement collaborative.
Nurs Health Sci 2014 Sep;16(3):291-7. doi: 10.1111/nhs.12098.
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Keywords: Communication, Falls, Nursing Homes, Quality of Care, Prevention, Quality Improvement
Wang F, Skubic M, Rantz M
Quantitative gait measurement with pulse-Doppler radar for passive in-home gait assessment.
The researchers proposed and validated a low-cost Doppler radar system for passive and continuous in-home gait assessment. Using signal processing techniques, they estimated human torso velocity and leg swing for step recognition. They found that the radar system has achieved a high accuracy on the step time estimation, while the walking speed estimation is systematically affected by the walking path direction.
AHRQ-funded; HS018477.
Citation: Wang F, Skubic M, Rantz M .
Quantitative gait measurement with pulse-Doppler radar for passive in-home gait assessment.
IEEE Trans Biomed Eng 2014 Sep;61(9):2434-43. doi: 10.1109/tbme.2014.2319333..
Keywords: Health Information Technology (HIT), Patient Safety, Falls, Elderly
Smucker DR, Regan S, Elder NC
Patient safety incidents in home hospice care: the experiences of hospice interdisciplinary team members.
The study objective was to explore the types and characteristics of patient safety incidents in home hospice care from the experiences of hospice interdisciplinary team members. Based on interviews of 19 experienced hospice leaders, the most commonly described categories of patient harm were injuries from falls and inadequate symptom control.
AHRQ-funded; HS018245
Citation: Smucker DR, Regan S, Elder NC .
Patient safety incidents in home hospice care: the experiences of hospice interdisciplinary team members.
J Palliat Med. 2014 May;17(5):540-4. doi: 10.1089/jpm.2013.0111..
Keywords: Patient Safety, Home Healthcare, Falls, Chronic Conditions
Enayati M, Banerjee T, Popescu M
A novel web-based depth video rewind approach toward fall preventive interventions in hospitals.
The purpose of this study was to implement a web-based application to provide the ability to rewind and review depth videos captured in hospital rooms to investigate the event chains that led to patient’s fall at a specific time. It proposes a novel web application to ease the process of search and review of the videos by means of new visualization techniques to highlight video frames that contain potential risk of fall based on our previous research.
AHRQ-funded; HS018477.
Citation: Enayati M, Banerjee T, Popescu M .
A novel web-based depth video rewind approach toward fall preventive interventions in hospitals.
Conf Proc IEEE Eng Med Biol Soc 2014;2014:4511-4. doi: 10.1109/embc.2014.6944626..
Keywords: Health Information Technology (HIT), Web-Based, Falls, Hospitals
Stone EE, Skubic M, Back J
Automated health alerts from Kinect-based in-home gait measurements.
This paper details initial investigation of a method for automatically generating alerts to clinicians in response to changes in in-home gait parameters. The three case studies discussed illustrate the potential of automated alerts based on in-home gait data for notifying caregivers of changes in an individual's gait that may be indicative of changes in health status.
AHRQ-funded; HS018477.
Citation: Stone EE, Skubic M, Back J .
Automated health alerts from Kinect-based in-home gait measurements.
Conf Proc IEEE Eng Med Biol Soc 2014;2014:2961-4. doi: 10.1109/embc.2014.6944244..
Keywords: Patient Safety, Health Information Technology (HIT), Elderly, Falls
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
Clancy CM
AHRQ Author: Clancy CM
Evidence-based toolkit helps organizations reduce patient falls.
This article describes an evidence-based hospital fall-prevention toolkit developed by AHRQ that helps clinicians negotiate the change process at their organization. It was created by a team with expertise both in fall prevention and in organizational change, including staff from the RAND Corporation, ECRI Institute, and Boston University.
AHRQ-authored.
Citation: Clancy CM .
Evidence-based toolkit helps organizations reduce patient falls.
J Nurs Care Qual 2013 Jul-Sep;28(3):195-7. doi: 10.1097/NCQ.0b013e318294a9d1.
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Keywords: Evidence-Based Practice, Falls, Tools & Toolkits, Patient Safety, Prevention
Hempel S, Newberry S, Wang Z
AHRQ Author: Spector WD
Hospital fall prevention: a systematic review of implementation, components, adherence, and effectiveness.
The authors sought to document systematically the implementation, components, comparators, adherence, and effectiveness of published fall prevention approaches in U.S. acute care hospitals. They found that most interventions included multiple components, and the pooled postintervention incidence rate ratio (IRR) was 0.77. They found no systematic association between implementation intensity, intervention complexity, comparator information, or adherence levels and IRR. They concluded that promising approaches exist, but better reporting of outcomes, implementation, adherence, intervention components, and comparison group information is necessary to establish evidence on how hospitals can successfully prevent falls.
AHRQ-authored; AHRQ-funded; 290201000017I.
Citation: Hempel S, Newberry S, Wang Z .
Hospital fall prevention: a systematic review of implementation, components, adherence, and effectiveness.
J Am Geriatr Soc 2013 Apr;61(4):483-94. doi: 10.1111/jgs.12169.
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Keywords: Adverse Events, Falls, Hospitals, Patient Safety, Prevention