National Healthcare Quality and Disparities Report
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Search All Research Studies
AHRQ Research Studies Date
Topics
- Asthma (1)
- Catheter-Associated Urinary Tract Infection (CAUTI) (1)
- Children/Adolescents (2)
- (-) Clinical Decision Support (CDS) (7)
- Clinician-Patient Communication (1)
- Diagnostic Safety and Quality (2)
- Electronic Health Records (EHRs) (2)
- Emergency Department (1)
- Evidence-Based Practice (2)
- Healthcare-Associated Infections (HAIs) (1)
- Health Information Technology (HIT) (5)
- Implementation (1)
- Kidney Disease and Health (1)
- Outcomes (1)
- (-) Patient-Centered Outcomes Research (7)
- Racial and Ethnic Minorities (1)
- Respiratory Conditions (1)
- Sepsis (1)
- Shared Decision Making (1)
- Urinary Tract Infection (UTI) (1)
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 7 of 7 Research Studies DisplayedKrishnan JA, Margellos-Anast H, Kumar R
Coordinated Health Care Interventions for Childhood Asthma Gaps in Outcomes (CHICAGO) plan.
The purpose of this clinical trial was to compare an emergency-department- (ED) only intervention and home visits by community health workers for 6 months (ED-plus-home) and enhanced usual care (UC). The study enrolled children aged 5 to 11 years with uncontrolled asthma. The primary outcomes were change over 6 months in the Patient-Reported Outcomes Measurement Information System Asthma Impact Scale score in children and Satisfaction with Participation in Social Roles score in caregivers. The secondary outcomes included guideline-recommended ED discharge care and self-management. The study found that of the 373 children recruited, only 63% completed the 6-month follow-up visit. Differences in Asthma Impact Scores or caregivers' Satisfaction with Participation in Social Roles scores were not significant. However, in the intervention groups guideline-recommended ED discharge care improved significantly versus in the UC group, and self-management behaviors were significantly improved in the ED-plus-home group versus in the ED-only and UC groups.
AHRQ-funded; HS027804.
Citation: Krishnan JA, Margellos-Anast H, Kumar R .
Coordinated Health Care Interventions for Childhood Asthma Gaps in Outcomes (CHICAGO) plan.
J Allergy Clin Immunol Glob 2023 Aug; 2(3). doi: 10.1016/j.jacig.2023.100100..
Keywords: Children/Adolescents, Asthma, Respiratory Conditions, Outcomes, Patient-Centered Outcomes Research, Evidence-Based Practice, Emergency Department, Clinical Decision Support (CDS), Health Information Technology (HIT), Racial and Ethnic Minorities
Dhopeshwarkar RV, Freij M, Callaham M
AHRQ Author: Harrison MI, Swiger J, Lomotan EA, Dymek C
Lessons learned from a national initiative promoting publicly available standards-based clinical decision support.
The purpose of this study was to discuss lessons learned from a national program promoting publicly available, standards-based Clinical decision support (CDS) resources, describe the challenges encountered with their use, and make suggestions for areas of improvement. The source of the findings was an evaluation of the Agency for Healthcare Research and Quality (AHRQ) Patient-Centered Outcomes Research CDS Initiative, the purpose of which was to advance evidence into practice through standards-based and publicly available CDS. The researchers utilized a review of literature and program materials, conducted key informant interviews, and administered a web-based survey about a public repository of CDS archives and tools for writing standards-based CDS. The review identified key lessons for developing and implementing standards-based CDS through publicly available repositories such as CDS Connect. The researchers identified trust as a key factor in uptake, which can be strengthened by transparent information on underlying evidence, collaboration with experts, and feedback loops between users and developers to support continuous quality improvement. In addition, lower-resourced health systems will need more support to ensure effective implementation and utilization. Finally, the study found that health systems want more information about patient-centered, clinical, and cost-related outcomes to facilitate justifying the investment required to implement publicly available, standards-based CDS.
AHRQ-authored; AHRQ-funded; 233201500023I.
Citation: Dhopeshwarkar RV, Freij M, Callaham M .
Lessons learned from a national initiative promoting publicly available standards-based clinical decision support.
Appl Clin Inform 2023 May; 14(3):566-74. doi: 10.1055/s-0043-1769911..
Keywords: Clinical Decision Support (CDS), Health Information Technology (HIT), Patient-Centered Outcomes Research
Rizk S, Kaelin VC, Sim JGC
Implementing an electronic patient-reported outcome and decision support tool in early intervention.
The study’s aim was to identify and prioritize early intervention (EI) stakeholders' perspectives of supports and barriers to implementing the Young Children's Participation and Environment Measure (YC-PEM), an electronic patient-reported outcome (e-PRO) tool, for scaling its implementation across multiple local and state EI programs. A mixed-methods study was conducted with EI families (n = 6), service coordinators (n = 9), and program leadership (n = 7). Semi-structured interviews and focus groups were conducted and used to share quantitative trial results. All three stakeholder groups identified thematic supports and barriers across multiple constructs within each of four Consolidated Framework for Implementation Research (CFIR) domains: (1) Six themes for "intervention characteristics," (2) Six themes for "process," (3) Three themes for "inner setting," and (4) Four themes for "outer setting." Priorities from stakeholders included prioritized reaching families with diverse linguistic preferences and user navigation needs, further tailoring its interface with automated data capture and exchange processes ("process"); and fostering a positive implementation climate ("inner setting"). Improving EI access (“outer setting”) using YC-PEM e-PRO results was also articulated by service coordinators and program leadership.
AHRQ-funded; HS027583.
Citation: Rizk S, Kaelin VC, Sim JGC .
Implementing an electronic patient-reported outcome and decision support tool in early intervention.
Appl Clin Inform 2023 Jan; 14(1):91-107. doi: 10.1055/s-0042-1760631..
Keywords: Clinical Decision Support (CDS), Health Information Technology (HIT), Children/Adolescents, Evidence-Based Practice, Patient-Centered Outcomes Research, Implementation
Goldstein SL
Automated/integrated real-time clinical decision support in acute kidney injury.
The author argues that early, real-time identification and notification to healthcare providers of patients at risk for, or with, acute or chronic kidney disease can drive simple interventions to reduce harm. Similarly, he believes that screening patients at risk for acute kidney injury with these platforms to alert research personnel will lead to improve study subject recruitment.
AHRQ-funded; HS023763; HS021114.
Citation: Goldstein SL .
Automated/integrated real-time clinical decision support in acute kidney injury.
Curr Opin Crit Care 2015 Dec;21(6):485-9. doi: 10.1097/mcc.0000000000000250.
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Keywords: Clinical Decision Support (CDS), Kidney Disease and Health, Electronic Health Records (EHRs), Patient-Centered Outcomes Research, Diagnostic Safety and Quality
El-Jawahri A, Mitchell SL, Paasche-Orlow MK
A randomized controlled trial of a CPR and intubation video decision support tool for hospitalized patients.
The researchers examined the impact of a video decision tool for CPR and intubation on patients’ choices, knowledge, medical orders, and discussions with providers. They found that seriously ill patients who viewed a video about CPR and intubation were more likely not to want these treatments, be better informed about their options, have orders to forgo CPR/ intubation, and discuss preferences with providers.
AHRQ-funded; HS018780.
Citation: El-Jawahri A, Mitchell SL, Paasche-Orlow MK .
A randomized controlled trial of a CPR and intubation video decision support tool for hospitalized patients.
J Gen Intern Med 2015 Aug;30(8):1071-80. doi: 10.1007/s11606-015-3200-2..
Keywords: Patient-Centered Outcomes Research, Clinical Decision Support (CDS), Shared Decision Making, Clinician-Patient Communication
Makam AN, Nguyen OK, Auerbach AD
Diagnostic accuracy and effectiveness of automated electronic sepsis alert systems: a systematic review.
This review aimed to determine whether automated real-time electronic sepsis alerts can: (1) accurately identify sepsis and (2) improve process measures and outcomes. It found that automated sepsis alerts derived from electronic health data may improve care processes but tend to have poor positive predictive value and do not improve mortality or length of stay.
AHRQ-funded; HS022418.
Citation: Makam AN, Nguyen OK, Auerbach AD .
Diagnostic accuracy and effectiveness of automated electronic sepsis alert systems: a systematic review.
J Hosp Med 2015 Jun;10(6):396-402. doi: 10.1002/jhm.2347..
Keywords: Clinical Decision Support (CDS), Health Information Technology (HIT), Sepsis, Diagnostic Safety and Quality, Patient-Centered Outcomes Research
Baillie CA, Epps M, Hanish A
Usability and impact of a computerized clinical decision support intervention designed to reduce urinary catheter utilization and catheter-associated urinary tract infections.
The researchers evaluated the usability and effectiveness of a computerized clinical decision support (CDS) intervention aimed at reducing the duration of urinary tract catheterizations. They found that usability improved to 15% with the revised reminder. The catheter utilization ratio declined over the 3 time periods, as did CAUTIs per 1,000 patient-days. They concluded that the usability of the reminder was highly dependent on its user interface, with a homegrown version of the reminder resulting in higher impact than a stock reminder.
AHRQ-funded; HS016946.
Citation: Baillie CA, Epps M, Hanish A .
Usability and impact of a computerized clinical decision support intervention designed to reduce urinary catheter utilization and catheter-associated urinary tract infections.
Infect Control Hosp Epidemiol 2014 Sep;35(9):1147-55. doi: 10.1086/677630.
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Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Clinical Decision Support (CDS), Electronic Health Records (EHRs), Health Information Technology (HIT), Healthcare-Associated Infections (HAIs), Patient-Centered Outcomes Research, Urinary Tract Infection (UTI)