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AHRQ Research Studies Date
Topics
- Ambulatory Care and Surgery (1)
- Cardiovascular Conditions (1)
- Care Coordination (4)
- Case Study (2)
- Children/Adolescents (4)
- Chronic Conditions (4)
- Clinician-Patient Communication (1)
- Communication (1)
- Comparative Effectiveness (1)
- Decision Making (2)
- Diabetes (1)
- Education: Curriculum (1)
- Elderly (4)
- Electronic Health Records (EHRs) (1)
- Emergency Department (4)
- Emergency Medical Services (EMS) (4)
- Healthcare Cost and Utilization Project (HCUP) (1)
- Health Information Technology (HIT) (1)
- Heart Disease and Health (1)
- Home Healthcare (2)
- Hospital Discharge (7)
- Hospitalization (1)
- Hospital Readmissions (2)
- Hospitals (1)
- Injuries and Wounds (1)
- Medicaid (1)
- Medicare (1)
- Medication (1)
- Neonatal Intensive Care Unit (NICU) (2)
- Newborns/Infants (1)
- Nursing Homes (2)
- Patient-Centered Healthcare (1)
- Patient-Centered Outcomes Research (2)
- Patient Experience (2)
- Patient Safety (4)
- Primary Care (1)
- Provider (1)
- Quality Improvement (2)
- Quality of Care (2)
- Surgery (1)
- Telehealth (1)
- (-) Transitions of Care (21)
- Young Adults (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 21 of 21 Research Studies DisplayedAcher AW, LeCaire TJ, Hundt AS
Using human factors and systems engineering to evaluate readmission after complex surgery.
The study objective was to use a human factors and systems engineering approach to understand contributors to surgical readmissions from a patient and provider perspective. Patients and clinician providers identified a number of factors during the transition of care that may have contributed to readmission, including poor patient and caregiver understanding; inadequate discharge preparation for home care; insufficient educational process and materials.
AHRQ-funded; HS022446.
Citation: Acher AW, LeCaire TJ, Hundt AS .
Using human factors and systems engineering to evaluate readmission after complex surgery.
J Am Coll Surg 2015 Oct;221(4):810-20. doi: 10.1016/j.jamcollsurg.2015.06.014..
Keywords: Surgery, Hospital Readmissions, Hospital Discharge, Transitions of Care, Electronic Health Records (EHRs)
Sawicki GS, Garvey KC, Toomey SL
Development and validation of the adolescent assessment of preparation for transition: a novel patient experience measure.
The authors developed an adolescent-reported measure of the quality of health care transition (HCT) preparation received from pediatric health care providers. They found that the Adolescent Assessment of Preparation for Transition (ADAPT) is a reliable, validated instrument measuring the quality of HCT preparation experiences reported by adolescents with chronic disease.
AHRQ-funded; HS020513.
Citation: Sawicki GS, Garvey KC, Toomey SL .
Development and validation of the adolescent assessment of preparation for transition: a novel patient experience measure.
J Adolesc Health 2015 Sep;57(3):282-7. doi: 10.1016/j.jadohealth.2015.06.004.
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Keywords: Children/Adolescents, Chronic Conditions, Patient Experience, Quality of Care, Transitions of Care
Gupta K, Mueller SK
Interhospital transfers: the need for standards.
Patient transfers from one hospital to another are common and occur for a multitude of reasons with varied outcomes. The authors discuss interhospital transfers and difficulties encountered by the providers who care for these patients. They recommend further research to identify more clearly which patients are most likely to benefit from transfer and why.
AHRQ-funded; HS023331.
Citation: Gupta K, Mueller SK .
Interhospital transfers: the need for standards.
J Hosp Med 2015 Jun;10(6):415-7. doi: 10.1002/jhm.2320.
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Keywords: Case Study, Decision Making, Elderly, Patient Safety, Transitions of Care
Marcum ZA, Hardy SE
Medication management skills in older skilled nursing facility residents transitioning home.
The objective of this pilot study was to describe potential medication management deficiencies of older SNF residents transitioning home. It found that medication management deficiencies were found to be common in a high-risk group of elderly adults making this important transition.
AHRQ-funded; HS020831.
Citation: Marcum ZA, Hardy SE .
Medication management skills in older skilled nursing facility residents transitioning home.
J Am Geriatr Soc 2015 Jun;63(6):1266-8. doi: 10.1111/jgs.13469..
Keywords: Patient Safety, Nursing Homes, Elderly, Medication, Transitions of Care
Wisk LE, Finkelstein JA, Sawicki GS
Predictors of timing of transfer from pediatric- to adult-focused primary care.
The researchers examined the timing of transfer to adult-focused primary care providers (PCPs), the time between last pediatric-focused and first adult-focused PCP visits, and the predictors of transfer timing. They found that most youths are transferring care later than recommended and with gaps of more than a year. They further noted that while youths with chronic conditions have shorter gaps, they may need even shorter transfer intervals to ensure continuous access to care.
AHRQ-funded; HS000063; HS020513.
Citation: Wisk LE, Finkelstein JA, Sawicki GS .
Predictors of timing of transfer from pediatric- to adult-focused primary care.
JAMA Pediatr 2015 Jun;169(6):e150951. doi: 10.1001/jamapediatrics.2015.0951.
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Keywords: Children/Adolescents, Chronic Conditions, Primary Care, Transitions of Care, Young Adults
Baier RR, Wysocki A, Gravenstein S
A qualitative study of choosing home health care after hospitalization: the unintended consequences of 'patient choice' requirements.
The purpose of this qualitative study is to learn how quality reports are used when choosing home care. Focus groups with 13 home health consumers and interviews with 28 hospital case managers from five hospitals revealed that both groups were unaware of public reports about home care quality.
AHRQ-funded; HS021879
Citation: Baier RR, Wysocki A, Gravenstein S .
A qualitative study of choosing home health care after hospitalization: the unintended consequences of 'patient choice' requirements.
J Gen Intern Med. 2015 May;30(5):634-40. doi: 10.1007/s11606-014-3164-7..
Keywords: Decision Making, Elderly, Home Healthcare, Hospital Discharge, Transitions of Care
Desai AD, Popalisky J, Simon TD
The effectiveness of family-centered transition processes from hospital settings to home: a review of the literature.
The objective of this study was to conduct a targeted literature review of studies examining the effectiveness of family-centered transition processes from hospital-and emergency department (ED)-to-home for improving patient health outcomes and health care utilization. It determined that patient-tailored discharge education is associated with improved patient health outcomes in pediatric ED patients.
AHRQ-funded; HS020506.
Citation: Desai AD, Popalisky J, Simon TD .
The effectiveness of family-centered transition processes from hospital settings to home: a review of the literature.
Hosp Pediatr 2015 Apr;5(4):219-31. doi: 10.1542/hpeds.2014-0097..
Keywords: Patient-Centered Outcomes Research, Hospital Discharge, Emergency Department, Emergency Medical Services (EMS), Transitions of Care
Kindermann DR, Mutter RL, Houchens RL
Emergency department transfers and transfer relationships in United States hospitals.
The study objective was to describe transfers out of hospital-based emergency departments (EDs) in a total of 97,021 ED transfer encounters. Among the 50 highest transfer rate disease categories, in U.S. EDs, patients are often transported great distances, more commonly to large teaching hospitals with greater resources.
AHRQ-funded; 290201300002C
Citation: Kindermann DR, Mutter RL, Houchens RL .
Emergency department transfers and transfer relationships in United States hospitals.
Acad Emerg Med. 2015 Feb;22(2):157-65. doi: 10.1111/acem.12586..
Keywords: Healthcare Cost and Utilization Project (HCUP), Emergency Department, Transitions of Care, Hospitals
Hilligoss B, Vogus TJ
Navigating care transitions: a process model of how doctors overcome organizational barriers and create awareness.
Using interviews and observations of doctors, the researchers examined transitions from an emergency department to inpatient units through a 2-year study of an academic medical center. They describe and document 3 challenges to between-unit transitions of care and identify the adaptive workarounds that doctors employ to resolve these challenges, thus addressing a significant gap in the literature on high-reliability healthcare organizations.
AHRQ-funded; HS018758
Citation: Hilligoss B, Vogus TJ .
Navigating care transitions: a process model of how doctors overcome organizational barriers and create awareness.
Med Care Res Rev. 2015 Feb;72(1):25-48. doi: 10.1177/1077558714563170..
Keywords: Transitions of Care, Emergency Department, Hospitalization, Care Coordination
Kindermann DR, Mutter RL, Houchens RL
AHRQ Author: Mutter RL
The transfer instability index: a novel metric of emergency department transfer relationships.
The researchers developed the “transfer instability index” to describe sending hospitals’ relationships with receiving hospitals. They found that emergency departments with a greater share of publicly insured patients had a greater transfer instability index, which may indicate less stable, protocolized, and regionalized transfer relationships.
AHRQ-funded; 290201300002C.
Citation: Kindermann DR, Mutter RL, Houchens RL .
The transfer instability index: a novel metric of emergency department transfer relationships.
Acad Emerg Med 2015 Feb;22(2):166-71. doi: 10.1111/acem.12589..
Keywords: Emergency Medical Services (EMS), Emergency Department, Transitions of Care, Medicaid, Medicare
Dy SM, Ashok M, Wines RC
A framework to guide implementation research for care transitions interventions.
The authors described a framework for evaluating implementation of hospital to ambulatory care transitions interventions and application to a case study. They adapted the general Consolidated Framework for Implementation Research, adding elements relevant to other complex interventions, such as conceptualization around organizations and around patient- and caregiver-centeredness.
AHRQ-funded; 290200710056I.
Citation: Dy SM, Ashok M, Wines RC .
A framework to guide implementation research for care transitions interventions.
J Healthc Qual 2015 Jan-Feb;37(1):41-54. doi: 10.1097/01.JHQ.0000460121.06309.f9.
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Keywords: Care Coordination, Case Study, Hospital Discharge, Patient-Centered Outcomes Research, Transitions of Care
Nasarwanji N, Werner NE, Carl K
Identifying challenges associated with the care transition workflow from hospital to skilled home health care: perspectives of home health care agency providers.
The authors studied the workflow for transitioning older adults from the hospital to skilled home health care (SHHC). They found three overarching challenges to optimal care transitions: information access, coordination, and communication/teamwork. They recommended that future investigations test whether redesigning the transition from hospital to SHHC improves workflow and care quality.
AHRQ-funded; HS022916.
Citation: Nasarwanji N, Werner NE, Carl K .
Identifying challenges associated with the care transition workflow from hospital to skilled home health care: perspectives of home health care agency providers.
Home Health Care Serv Q 2015;34(3-4):185-203. doi: 10.1080/01621424.2015.1092908.
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Keywords: Care Coordination, Elderly, Home Healthcare, Hospital Discharge, Transitions of Care
Tupper JB, Gray CE, Pearson KB
Safety of rural nursing home-to-emergency department transfers: Improving communication and patient information sharing across settings.
This paper reports on the evaluation of a demonstration in 10 rural communities to improve the safety of nursing facility (NF) transfers to hospital emergency departments by forming interprofessional teams of hospital, emergency medical service, and NF staff to develop and implement tools and protocols for standardizing critical interfacility communication pathways and information sharing. Study findings showed significant improvement in key areas, including infection status and baseline mental functioning. Accurate and consistent information sharing of advance directives and medication lists remains a challenge.
AHRQ-funded; HS019064.
Citation: Tupper JB, Gray CE, Pearson KB .
Safety of rural nursing home-to-emergency department transfers: Improving communication and patient information sharing across settings.
J Healthc Qual 2015 Jan-Feb;37(1):55-65. doi: 10.1097/01.jhq.0000460120.68190.15.
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Keywords: Communication, Emergency Medical Services (EMS), Nursing Homes, Patient Safety, Transitions of Care
Auger KA, Simon TD, Cooperberg D
Summary of STARNet: Seamless Transitions and (Re)admissions Network.
The Seamless Transitions and (Re)admissions Network (STARNet) met in December 2012 to synthesize ongoing hospital-to-home transition work, discuss goals, and develop a plan to centralize transition information in the future. The authors of this report reviewed the current knowledge regarding hospital-to-home transitions, outlined the challenges of measuring and reducing readmissions, and highlighted research gaps, listing potential measures for transition quality.
AHRQ-funded; HS020506.
Citation: Auger KA, Simon TD, Cooperberg D .
Summary of STARNet: Seamless Transitions and (Re)admissions Network.
Pediatrics 2015 Jan;135(1):164-75. doi: 10.1542/peds.2014-1887.
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Keywords: Children/Adolescents, Hospital Discharge, Transitions of Care, Quality Improvement, Quality of Care
Moyer VA, Papile LA, Eichenwald E
An intervention to improve transitions from NICU to ambulatory care: quasi-experimental study.
The authors tested whether a multifaceted intervention that included a health coach to assist families and an enhanced personal health record to improve the quality of information available to parents and community professionals would decrease adverse events and improve family assessment of the transition of infants born prematurely or with complex medical problems to home. They found that a multicomponent discharge intervention designed to address specific problems identified using Healthcare Failure Modes and Effects Analysis did not reduce certain adverse outcomes in the post-discharge period.
AHRQ-funded; HS017889.
Citation: Moyer VA, Papile LA, Eichenwald E .
An intervention to improve transitions from NICU to ambulatory care: quasi-experimental study.
BMJ Qual Saf 2014 Dec;23(12):e3. doi: 10.1136/bmjqs-2012-001726.
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Keywords: Neonatal Intensive Care Unit (NICU), Ambulatory Care and Surgery, Patient Safety, Quality Improvement, Transitions of Care
Davis AM, Brown RF, Taylor JL
Transition care for children with special health care needs.
This article examined 25 studies evaluating transition care programs for children with special health care needs moving from pediatric to adult care. The majority of studies concerned patients with diabetes or transplant patients.The authors also interviewed key informants representing clinicians who provide transition care. They found that there is no accepted way to measure transition success.
AHRQ-funded; 290201200009I
Citation: Davis AM, Brown RF, Taylor JL .
Transition care for children with special health care needs.
Pediatrics. 2014 Nov;134(5):900-8. doi: 10.1542/peds.2014-1909..
Keywords: Children/Adolescents, Transitions of Care, Chronic Conditions
Garfield CF, Lee Y, Kim HN
Paternal and maternal concerns for their very low-birth-weight infants transitioning from the NICU to home.
The authors examined the concerns and coping mechanisms of fathers and mothers of very low-birth-weight neonatal intensive care unit (NICU) infants as they transition to home from the NICU. They found that overriding concerns included pervasive uncertainty, lingering medical concerns, and partner-related adjustment concerns that differed by gender. They concluded that many parental concerns can be addressed with improved discharge information exchanges and anticipatory guidance.
AHRQ-funded; HS020316.
Citation: Garfield CF, Lee Y, Kim HN .
Paternal and maternal concerns for their very low-birth-weight infants transitioning from the NICU to home.
J Perinat Neonatal Nurs 2014 Oct-Dec;28(4):305-12. doi: 10.1097/jpn.0000000000000021.
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Keywords: Care Coordination, Hospital Discharge, Neonatal Intensive Care Unit (NICU), Newborns/Infants, Transitions of Care
Foster NA, Elfenbein DM, Kelley W, Jr.
Comparison of helicopter versus ground transport for the interfacility transport of isolated spinal injury.
The investigators aimed to determine whether ground transport (GT) for interfacility transfer of patients with spinal injury resulted in less favorable clinical outcomes compared with helicopter aeromedical transport systems (HEMS). They found that GT for interfacility transfer of patients with spinal injury appears to be safe and suitable for patients who lack other compelling reasons for HEMS.
AHRQ-funded; HS000032.
Citation: Foster NA, Elfenbein DM, Kelley W, Jr. .
Comparison of helicopter versus ground transport for the interfacility transport of isolated spinal injury.
Spine J 2014 Jul;14(7):1147-54. doi: 10.1016/j.spinee.2013.07.478.
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Keywords: Emergency Medical Services (EMS), Transitions of Care, Injuries and Wounds
O'Toole JK, West DC, Starmer AJ
Placing faculty development front and center in a multisite educational initiative: lessons from the I-PASS Handoff study.
The authors describe their experience developing a multi-institutional faculty development program to support the I-PASS (IIPE-PRIS Accelerating Safe Signouts) Study and offer a set of generalizable strategies to guide the creation of other large-scale, multi-institutional faculty development programs. They conclude that the lessons learned inform a set of key strategies that can be applied to a broad range of similar large-scale faculty development projects in the future.
AHRQ-funded; HS019456.
Citation: O'Toole JK, West DC, Starmer AJ .
Placing faculty development front and center in a multisite educational initiative: lessons from the I-PASS Handoff study.
Acad Pediatr 2014 May-Jun;14(3):221-4. doi: 10.1016/j.acap.2014.02.013.
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Keywords: Education: Curriculum, Provider, Patient-Centered Healthcare, Transitions of Care
Black JT, Romano PS, Sadeghi B
A remote monitoring and telephone nurse coaching intervention to reduce readmissions among patients with heart failure: study protocol for the Better
The objective of this randomized controlled comparative effectiveness study was to evaluate the effectiveness of a care transition intervention that included pre-discharge education about heart failure and post-discharge telephone nurse coaching combined with home telemonitoring of weight, blood pressure, heart rate, and symptoms in reducing all-cause 180-day hospital readmissions for older adults hospitalized with heart failure.
AHRQ-funded; HS019311.
Citation: Black JT, Romano PS, Sadeghi B .
A remote monitoring and telephone nurse coaching intervention to reduce readmissions among patients with heart failure: study protocol for the Better
Trials 2014 Apr 13;15:124. doi: 10.1186/1745-6215-15-124..
Keywords: Cardiovascular Conditions, Comparative Effectiveness, Health Information Technology (HIT), Heart Disease and Health, Hospital Readmissions, Telehealth, Transitions of Care
Ritholz MD, Wolpert H, Beste M
Patient-provider relationships across the transition from pediatric to adult diabetes care: a qualitative study.
The purpose of this study was to explore perceptions that emerging adults with type 1 diabetes (T1D) have of their patient-provider relationships across the transition from pediatric to adult care. Several themes emerged from the analysis including the importance of improving provider approaches to transition. Patients recommended that pediatric providers actively promote emerging adults’ autonomy while maintaining parental support.
AHRQ-funded; HS000063.
Citation: Ritholz MD, Wolpert H, Beste M .
Patient-provider relationships across the transition from pediatric to adult diabetes care: a qualitative study.
Diabetes Educ 2014 Jan-Feb;40(1):40-7. doi: 10.1177/0145721713513177..
Keywords: Chronic Conditions, Diabetes, Patient Experience, Clinician-Patient Communication, Transitions of Care