National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Cardiovascular Conditions (1)
- Care Coordination (1)
- Caregiving (2)
- Children/Adolescents (3)
- Clinical Decision Support (CDS) (1)
- Communication (1)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (1)
- Disparities (1)
- Electronic Health Records (EHRs) (10)
- Falls (1)
- Healthcare-Associated Infections (HAIs) (2)
- Healthcare Costs (1)
- Healthcare Delivery (2)
- Health Information Exchange (HIE) (1)
- (-) Health Information Technology (HIT) (21)
- Health Systems (2)
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- Hospital Readmissions (2)
- (-) Hospitals (21)
- Implementation (1)
- Intensive Care Unit (ICU) (1)
- Low-Income (1)
- Patient-Centered Healthcare (2)
- Patient and Family Engagement (4)
- Patient Experience (2)
- Patient Safety (2)
- Primary Care (1)
- Public Health (1)
- Quality Improvement (3)
- Quality of Care (4)
- Racial and Ethnic Minorities (1)
- Respiratory Conditions (1)
- Risk (1)
- Sepsis (1)
- Stroke (1)
- Surgery (1)
- Telehealth (1)
- Urban Health (1)
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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 21 of 21 Research Studies DisplayedHaldar S, Mishra SR, Kim Y
Use and impact of an online community for hospital patients.
This study examined the impact of a technology resembling an online health community for hospitalized patients to exchange advice and provide each other support during their hospitalization. It was deployed at 1 pediatric and 1 adult hospital. Thirty participants were recruited and were interviewed bedside and were observed how they used the technology, along with follow-up phone interviews. It was found to be helpful to patients and that most (64%) of the shared advice was positive in nature. They also reported positive impacts to their quality, safety, and hospital experience due to the inpatient peer support community.
AHRQ-funded; HS022894.
Citation: Haldar S, Mishra SR, Kim Y .
Use and impact of an online community for hospital patients.
J Am Med Inform Assoc 2020 Apr;27(4):549-57. doi: 10.1093/jamia/ocz212..
Keywords: Health Information Technology (HIT), Hospitals, Patient and Family Engagement, Patient Experience
Smith AB, Mueller D, Garren B
Using qualitative research to reduce readmissions and optimize perioperative cystectomy care.
This study examined the need for qualitative research on meaningful patient-reported outcomes (PROs) to prevent complications and readmissions after cystectomy. The investigators looked at the potential use of mobile communication devices (mHealth) to capture patients’ experiences and to improve outcomes. Interviews were conducted with 15 readmitted patients and 10 of their partners over 45 semi-structured in-depth interviews. The most common perspectives were that patients and their caregivers were overloaded with cystectomy education; they need to know what are normal post-operative symptoms; and that using mHealth would help with patient and caregiver education.
AHRQ-funded; HS024134.
Citation: Smith AB, Mueller D, Garren B .
Using qualitative research to reduce readmissions and optimize perioperative cystectomy care.
Cancer 2019 Oct 15;125(20):3545-53. doi: 10.1002/cncr.32362..
Keywords: Hospital Readmissions, Surgery, Health Information Technology (HIT), Quality Improvement, Quality of Care, Hospitals, Patient-Centered Healthcare
Ji W, McKenna C, Ochoa A
Development and assessment of objective surveillance definitions for nonventilator hospital-acquired pneumonia.
The authors sought to propose and assess potentially objective, efficient, and reproducible surveillance definitions for non-ventilator hospital-acquired pneumonia (NV-HAP) using routine clinical data stored in electronic health record systems. They found that objective surveillance for NV-HAP using electronically computable definitions that incorporate common clinical criteria is feasible and generates incidence, mortality, and adjusted odds ratios for hospital mortality similar to estimates from manual surveillance. They concluded that these definitions have the potential to facilitate widespread, automated surveillance for NV-HAP and thus inform the development and evaluation of prevention programs.
AHRQ-funded; HS025008.
Citation: Ji W, McKenna C, Ochoa A .
Development and assessment of objective surveillance definitions for nonventilator hospital-acquired pneumonia.
JAMA Netw Open 2019 Oct 2;2(10):e1913674. doi: 10.1001/jamanetworkopen.2019.13674..
Keywords: Healthcare-Associated Infections (HAIs), Hospitals, Respiratory Conditions, Public Health, Electronic Health Records (EHRs), Health Information Technology (HIT)
Vest JR, Unruh MA, Freedman S
Health systems' use of enterprise health information exchange vs single electronic health record vendor environments and unplanned readmissions.
Enterprise health information exchange (HIE) and a single electronic health record (EHR) vendor solution are 2 information exchange approaches to improve performance and increase the quality of care. This study sought to determine the association between adoption of enterprise HIE vs a single vendor environment and changes in unplanned readmissions. The investigators concluded that reductions in the probability of an unplanned readmission after a hospital adopts a single vendor environment suggested that HIE technologies can better support the aim of higher quality care.
AHRQ-funded; HS024717.
Citation: Vest JR, Unruh MA, Freedman S .
Health systems' use of enterprise health information exchange vs single electronic health record vendor environments and unplanned readmissions.
J Am Med Inform Assoc 2019 Oct;26(10):989-98. doi: 10.1093/jamia/ocz116..
Keywords: Health Systems, Health Information Exchange (HIE), Electronic Health Records (EHRs), Health Information Technology (HIT), Hospital Readmissions, Hospitals
Bush RA, Vemulakonda VM, Richardson AC
Providing access: differences in pediatric portal activation begin at patient check-in.
This study investigated patient portal use and activation patterns among pediatric urology patients at two geographically diverse tertiary pediatric hospitals. A retrospective cohort analysis was conducted of electronic portal audit records from 2011 to 2016. Out of 44,608 individuals offered a code for patient portal activation, only 19.3% activated portal access. Those patients were most likely to be female, Asian or white, non-Hispanic, and reporting English as the preferred language. This analysis showed that there are barriers to access by many patients and caregivers.
AHRQ-funded; HS024597; HS022404.
Citation: Bush RA, Vemulakonda VM, Richardson AC .
Providing access: differences in pediatric portal activation begin at patient check-in.
Appl Clin Inform 2019 Aug;10(4):670-78. doi: 10.1055/s-0039-1695792..
Keywords: Children/Adolescents, Hospitals, Electronic Health Records (EHRs), Health Information Technology (HIT)
Gadhia R, Schwamm LH, Viswanathan A
Evaluation of the experience of spoke hospitals in an academic telestroke network.
Implementation of telestroke has been associated with improved thrombolysis rates and clinical outcomes in remote or neurologically underserved spoke hospitals. Yet, the experience of spoke hospitals using telestroke has not been well described. In this study, the investigators sought to characterize spoke hospitals' perceptions of telestroke to understand perceived advantages, challenges, and barriers to use.
AHRQ-funded; HS024561.
Citation: Gadhia R, Schwamm LH, Viswanathan A .
Evaluation of the experience of spoke hospitals in an academic telestroke network.
Telemed J E Health 2019 Jul;25(7):584-90. doi: 10.1089/tmj.2018.0133..
Keywords: Telehealth, Health Information Technology (HIT), Hospitals, Stroke, Cardiovascular Conditions
Chai PR, Zhang H, Jambaulikar GD
An Internet of things buttons to measure and respond to restroom cleanliness in a hospital setting: descriptive study.
AHRQ-funded; HS024538; HS024713.
Citation: Chai PR, Zhang H, Jambaulikar GD .
An Internet of things buttons to measure and respond to restroom cleanliness in a hospital setting: descriptive study.
J Med Internet Res 2019 Jun 19;21(6):e13588. doi: 10.2196/13588..
Keywords: Hospitals, Health Information Technology (HIT), Patient Safety, Healthcare-Associated Infections (HAIs)
Dalal AK, Fuller T, Garabedian P
Systems engineering and human factors support of a system of novel EHR-integrated tools to prevent harm in the hospital.
This study examined systems engineering and human factors support of a system of novel electronic health record (EHR)-integrated tools for patient safety in the hospital. The authors established a Patient Safety Learning Laboratory of 2 core and 3 individual project teams to introduce a suite of digital health tools integrated with their EHR to identify, assess, and mitigate threats to patient safety. They identified 7 themes regarding use of 12 systems engineering and human factors over the 4-year project.
AHRQ-funded; HS023535.
Citation: Dalal AK, Fuller T, Garabedian P .
Systems engineering and human factors support of a system of novel EHR-integrated tools to prevent harm in the hospital.
J Am Med Inform Assoc 2019 Jun;26(6):553-60. doi: 10.1093/jamia/ocz002..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Patient Safety, Hospitals, Quality Improvement, Quality of Care
Asan O, Scanlan MC, Crotty B
Parental perceptions of displayed patient data in a PICU: an example of unintentional empowerment.
The objective of this study was to explore the perceptions of parents of pediatric patients in a PICU regarding real-time open electronic health record data displayed in patient rooms. The investigators suggest that a new health information technology system providing continuous access to open electronic health record data may be an effective way to empower and engage parents in the PICU, but also note potential drawbacks.
AHRQ-funded; HS023626.
Citation: Asan O, Scanlan MC, Crotty B .
Parental perceptions of displayed patient data in a PICU: an example of unintentional empowerment.
Pediatr Crit Care Med 2019 May;20(5):435-41. doi: 10.1097/pcc.0000000000001895..
Keywords: Caregiving, Children/Adolescents, Communication, Electronic Health Records (EHRs), Health Information Technology (HIT), Hospitals, Intensive Care Unit (ICU), Patient and Family Engagement
Larsen E, Hoffman D, Rivera C
Continuing patient care during electronic health record downtime.
This study examined the impact of electronic health record (EHR) downtime in hospitals on patient care. Two mid-Atlantic hospitals where the EHR system was either fully or partially unavailable were used to document the problems using historic performance data and semistructured interviews. A total of 17 hospital employees were interviewed. Laboratory test results were delayed an average of 62% during downtime events. Paper documentation created during the downtime period was often incomplete or incorrect. The authors provided recommendations to improve downtime contingency plans based on their findings.
AHRQ-funded; HS024350.
Citation: Larsen E, Hoffman D, Rivera C .
Continuing patient care during electronic health record downtime.
Appl Clin Inform 2019 May;10(3):495-504. doi: 10.1055/s-0039-1692678..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Healthcare Delivery, Hospitals, Quality of Care
Toomey SL, Elliott MN, Zaslavsky AM
Improving response rates and representation of hard-to-reach groups in family experience surveys.
This study examined the use of an audio-enabled tablet to survey parents of children discharged from 4 units of a children’s hospital. Normal mail survey response rates are very low, especially for black, Latino, and low-income respondents. This survey was done day of discharge at the hospital and there was a response rate of 71.1% via tablet versus 16.3% for mail only. The Child Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey was used. Tablet response rates were highest with fathers, those more likely to have a high school education or less, less likely to be white, and more likely to be publicly insured. The results are promising for future surveys using tablet administration.
AHRQ-funded; HS020513; HS025299.
Citation: Toomey SL, Elliott MN, Zaslavsky AM .
Improving response rates and representation of hard-to-reach groups in family experience surveys.
Acad Pediatr 2019 May - Jun;19(4):446-53. doi: 10.1016/j.acap.2018.07.007..
Keywords: Caregiving, Children/Adolescents, Consumer Assessment of Healthcare Providers and Systems (CAHPS), Health Information Technology (HIT), Hospitals, Low-Income, Patient Experience, Quality of Care, Quality Improvement, Racial and Ethnic Minorities
Delahanty RJ, Alvarez J, Flynn LM
Development and evaluation of a machine learning model for the early identification of patients at risk for sepsis.
In this study, the investigators aimed to use machine learning to develop a new sepsis screening tool, the Risk of Sepsis (RoS) score, and compare it with a slate of benchmark sepsis-screening tools, including the Systemic Inflammatory Response Syndrome, Sequential Organ Failure Assessment (SOFA), qSOFA, Modified Early Warning Score, and National Early Warning Score. The investigators concluded that in this retrospective study, RoS was more timely and discriminant than benchmark screening tools, including those recommend by the Sepsis-3 Task Force.
AHRQ-funded; HS024750.
Citation: Delahanty RJ, Alvarez J, Flynn LM .
Development and evaluation of a machine learning model for the early identification of patients at risk for sepsis.
Ann Emerg Med 2019 Apr;73(4):334-44. doi: 10.1016/j.annemergmed.2018.11.036..
Keywords: Health Information Technology (HIT), Hospitals, Risk, Sepsis
Sadasivaiah S, Lyles CR, Kyoi S
Disparities in patient-reported interest in web-based patient portals: survey at an urban academic safety-net hospital.
Offering hospitalized patients' enrollment into a health system's patient portal may improve patient experience and engagement throughout the care continuum, especially across care transitions, but this process is less studied than portal engagement in the ambulatory setting. The objective of this study was to evaluate sociodemographic characteristics associated with interest in a health care system's portal among hospitalized patients and reasons for no interest.
AHRQ-funded; HS022408; HS022561; HS023558.
Citation: Sadasivaiah S, Lyles CR, Kyoi S .
Disparities in patient-reported interest in web-based patient portals: survey at an urban academic safety-net hospital.
J Med Internet Res 2019 Mar 26;21(3):e11421. doi: 10.2196/11421..
Keywords: Disparities, Patient-Centered Healthcare, Electronic Health Records (EHRs), Health Information Technology (HIT), Healthcare Delivery, Hospitals, Patient and Family Engagement, Urban Health
McAlearney AS, Fareed N, Gaughan A
Empowering patients during hospitalization: perspectives on inpatient portal use.
This study looked at the effects of instituting an inpatient portal at hospitals and its impact on feelings of patient empowerment. Patients (n=120) who used an inpatient portal were interviewed at day 15 of hospitalization or 6 months after discharge. They also interviewed care team members (n=331) at 4 weeks, 6 months, and 1 year after implementation about their perspectives on patient use of the portal. Three features were most commonly used: 1) ordering meals, 2) looking up health information, and 3) viewing the care team. Most patients did not feel comfortable using the secure message feature. The inpatient portal promoted independence, reduced anxiety, informed families, and increased empowerment. The findings suggest that hospitals should encourage implementation of inpatient portals in their institution.
AHRQ-funded; HS024091; HS024767; HS024379.
Citation: McAlearney AS, Fareed N, Gaughan A .
Empowering patients during hospitalization: perspectives on inpatient portal use.
Appl Clin Inform 2019 Jan;10(1):103-12. doi: 10.1055/s-0039-1677722..
Keywords: Health Information Technology (HIT), Patient and Family Engagement, Hospitalization, Hospitals
Fareed N, Walker D, Sieck CJ
Inpatient portal clusters: identifying user groups based on portal features.
The investigators conducted a cluster analysis of inpatient portal (IPP) users from an academic medical center to improve understanding of who uses these portals and how. They identified five groups of IPP users who demonstrated distinct preferences, recommended training on IPP use to enhance patient engagement, and discussed implications of their findings for future research.
AHRQ-funded; HS024379; HS024091; HS024349.
Citation: Fareed N, Walker D, Sieck CJ .
Inpatient portal clusters: identifying user groups based on portal features.
J Am Med Inform Assoc 2019 Jan;26(1):28-36. doi: 10.1093/jamia/ocy147..
Keywords: Health Information Technology (HIT), Hospitals
Nuckols TK, Asch SM, Patel V
Implementing Computerized Provider Order Entry In Acute Care Hospitals in the United States could generate substantial savings to society.
This study was conducted to evaluate from the societal perspective the cost-utility of implementing computerized physician order entry (CPOE) in acute care hospitals in the United States. It found that relative to paper ordering and using typical estimates of implementation costs, CPOE had, on average, a 99 percent probability of yielding savings to society and improving health.
AHRQ-funded; HS017954.
Citation: Nuckols TK, Asch SM, Patel V .
Implementing Computerized Provider Order Entry In Acute Care Hospitals in the United States could generate substantial savings to society.
Jt Comm J Qual Patient Saf 2015 Aug;41(8):341-50..
Keywords: Health Information Technology (HIT), Hospitals, Clinical Decision Support (CDS), Healthcare Costs
Yuan CT, Bradley EH, Nembhard IM
A mixed methods study of how clinician 'super users' influence others during the implementation of electronic health records.
The researchers present the results of a comparative case study in which they sought to identify the mechanisms of super users’ influence on implementation success and examine the impact of a core contextual factor: how super users are selected. They found that super users on both medical units in a large hospital were more proactive, provided more comprehensive explanations for their actions, used positive framing, and shared information.
AHRQ-funded; HS018987; HS022201; HS017589.
Citation: Yuan CT, Bradley EH, Nembhard IM .
A mixed methods study of how clinician 'super users' influence others during the implementation of electronic health records.
BMC Med Inform Decis Mak 2015 Apr 10;15:26. doi: 10.1186/s12911-015-0154-6..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Hospitals
Hsiao CJ, King J, Hing E
AHRQ Author: Hsiao CJ
The role of health information technology in care coordination in the United States.
This study used 2012 national data to explore the extent to which office-based physicians in the United States receive patient health information (electronically or non-electronically) needed to coordinate care with providers outside their practice, as well as with hospitals. It found that a higher percentage of physicians using health information technology (HIT) received patient information necessary for care coordination than those who did not use HIT.
AHRQ-authored.
Citation: Hsiao CJ, King J, Hing E .
The role of health information technology in care coordination in the United States.
Med Care. 2015 Feb;53(2):184-90. doi: 10.1097/mlr.0000000000000276..
Keywords: Health Information Technology (HIT), Care Coordination, Primary Care, Hospitals
Rangachari P
Using social knowledge networking technology to enable meaningful use of electronic health record technology in hospitals and health systems.
In this paper, Rangachari (1) reviewed the theoretical literatures on technology use & implementation, and identified a framework for understanding & overcoming unintended adverse consequences of implementing Electronic Health Records; (2) outlined a broad project proposal to test the applicability of the framework in enabling "meaningful use" of Electronic Health Records in a healthcare context; and (3) identified strategies for successful implementation of Electronic Health Records in hospitals & health systems, based on the literature review and application.
AHRQ-funded; HS024335.
Citation: Rangachari P .
Using social knowledge networking technology to enable meaningful use of electronic health record technology in hospitals and health systems.
J Hosp Adm 2014 Dec;3(6):66-78. doi: 10.5430/jha.v3n6p66.
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Keywords: Health Systems, Electronic Health Records (EHRs), Health Information Technology (HIT), Hospitals, Implementation
Adler-Milstein J, DesRoches CM, Furukawa MF
AHRQ Author: Furukawa MF
More than half of US hospitals have at least a basic EHR, but stage 2 criteria remain challenging for most.
The investigators used American Hospital Association data to assess progress and challenges in EHR adoption. They found that most hospitals are able to meet many of the stage 2 meaningful-use criteria, but only 5.8 percent of hospitals are able to meet them all.
AHRQ-authored.
Citation: Adler-Milstein J, DesRoches CM, Furukawa MF .
More than half of US hospitals have at least a basic EHR, but stage 2 criteria remain challenging for most.
Health Aff 2014 Sep;33(9):1664-71. doi: 10.1377/hlthaff.2014.0453.
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Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Hospitals
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