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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 13 of 13 Research Studies DisplayedLarson EL, Cohen B, Liu J
Assessing intensity of nursing care needs using electronically available data.
The aim of this project was to develop and test a Nursing Intensity of Care Index using electronically available data from 152,072 patient discharges from three hospitals. In preliminary testing, data for the Nursing Intensity of Care Index, which accurately reflect nursing care intensity, can be obtained electronically in real time. The next steps will be a discrete-event simulation model and large-scale field trials.
AHRQ-funded; HS024915.
Citation: Larson EL, Cohen B, Liu J .
Assessing intensity of nursing care needs using electronically available data.
Comput Inform Nurs 2017 Dec;35(12):617-23. doi: 10.1097/cin.0000000000000375.
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Keywords: Electronic Health Records (EHRs), Nursing, Workforce
Dyrbye LN, Shanafelt TD, Sinsky CA
AHRQ Author: Meyers D
https://nam.edu/burnout-among-health-care-professionals-a-call-to-explore-and-address-this-underrecognized-threat-to-safe-high-quality-care
Burnout among health care professionals: a call to explore and address this underrecognized threat to safe, high-quality care.
The high prevalence of burnout among health care professionals is cause for concern because it appears to be affecting quality, safety, and health care system performance. Efforts are needed to address this growing problem. Progress will require methodologically sound studies, adequate funding, and collaborative efforts. The authors hope that research sponsors, institutions, clinician organizations, researchers, clinicians, and patients join in supporting enhanced research efforts focused on these topics.
AHRQ-authored.
Citation: Dyrbye LN, Shanafelt TD, Sinsky CA .
Burnout among health care professionals: a call to explore and address this underrecognized threat to safe, high-quality care.
NAM Perspectives 2017 Jul 5.
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Keywords: Quality of Care, Provider: Health Personnel, Patient Safety, Workforce
Loresto FL, Jr., Jupiter D, Kuo YF
Examining differences in characteristics between patients receiving primary care from nurse practitioners or physicians using Medicare Current Beneficiary Survey data and Medicare claims data.
There is a perception that nurse practitioners (NPs), as compared with primary care medical doctors (PCMDs), tend to provide care to healthier patients. In this study, patients utilizing NP-only or PCMD-only models for primary care were characterized and compared in terms of functional, cognitive, and psychological factors. The results were contrary to the initial perception. In terms of health status, NP-only patients were similar to PCMD-only patients.
AHRQ-funded; HS020642.
Citation: Loresto FL, Jr., Jupiter D, Kuo YF .
Examining differences in characteristics between patients receiving primary care from nurse practitioners or physicians using Medicare Current Beneficiary Survey data and Medicare claims data.
J Am Assoc Nurse Pract 2017 Jun;29(6):340-47. doi: 10.1002/2327-6924.12465.
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Keywords: Provider: Health Personnel, Medicare, Primary Care, Workforce
Washington DM, Paasche-Orlow MK, Liebschutz JM
Promoting progress or propagating problems: strategic plans and the advancement of academic faculty diversity in U.S. medical schools.
The aim of this study was to investigate whether academic institutions that have engaged in strategic planning for faculty diversity, as exhibited by plan presence on their websites, had a higher rate of underrepresented minorities in medicine (URM) faculty growth than institutions who do not have evidence of such planning.
AHRQ-funded; HS022242.
Citation: Washington DM, Paasche-Orlow MK, Liebschutz JM .
Promoting progress or propagating problems: strategic plans and the advancement of academic faculty diversity in U.S. medical schools.
J Natl Med Assoc 2017 Summer;109(2):72-78. doi: 10.1016/j.jnma.2016.10.001..
Keywords: Education: Curriculum, Racial and Ethnic Minorities, Workforce
Kavalieratos D, Siconolfi DE, Steinhauser KE
"It is like heart failure. It is chronic ... and it will kill you": a qualitative analysis of burnout among hospice and palliative care clinicians.
This study explored burnout among palliative care clinicians, specifically their experiences with burnout, their perceived sources of burnout, and potential individual, interpersonal, organizational, and policy-level solutions to address burnout. Common sources of burnout included increasing workload, tensions between nonspecialists and palliative care specialists, and regulatory issues. Participants proposed antiburnout solutions, including promoting the provision of generalist palliative care, frequent rotations on-and-off service, and organizational support for self-care.
AHRQ-funded; HS023681; HS022989.
Citation: Kavalieratos D, Siconolfi DE, Steinhauser KE .
"It is like heart failure. It is chronic ... and it will kill you": a qualitative analysis of burnout among hospice and palliative care clinicians.
J Pain Symptom Manage 2017 May;53(5):901-10.e1. doi: 10.1016/j.jpainsymman.2016.12.337.
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Keywords: Provider: Health Personnel, Palliative Care, Workforce
Poghosyan 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
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: 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