National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Access to Care (1)
- Ambulatory Care and Surgery (2)
- Antimicrobial Stewardship (1)
- Behavioral Health (1)
- Cancer (1)
- Care Management (1)
- Children/Adolescents (4)
- Chronic Conditions (1)
- Clinical Decision Support (CDS) (1)
- Clinician-Patient Communication (1)
- Communication (4)
- Community-Based Practice (1)
- Comparative Effectiveness (2)
- Critical Care (1)
- Decision Making (2)
- Diabetes (1)
- Diagnostic Safety and Quality (1)
- Education: Continuing Medical Education (4)
- Education: Patient and Caregiver (1)
- Elderly (1)
- Electronic Health Records (EHRs) (9)
- Emergency Department (4)
- Emergency Medical Services (EMS) (4)
- Evidence-Based Practice (1)
- Healthcare-Associated Infections (HAIs) (2)
- Healthcare Costs (1)
- Health Information Technology (HIT) (4)
- Health Services Research (HSR) (1)
- Home Healthcare (1)
- Hospitals (2)
- Imaging (1)
- Implementation (1)
- Influenza (1)
- Injuries and Wounds (1)
- Intensive Care Unit (ICU) (1)
- Medical Errors (1)
- Medicare (1)
- Neonatal Intensive Care Unit (NICU) (1)
- Newborns/Infants (1)
- Nursing (1)
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- Outcomes (1)
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- Patient-Centered Healthcare (2)
- Patient Safety (11)
- Payment (1)
- Practice Patterns (4)
- Prevention (4)
- Primary Care (4)
- Provider (1)
- (-) Provider: Health Personnel (42)
- Provider: Pharmacist (1)
- Provider Performance (2)
- Public Reporting (1)
- Quality Improvement (1)
- Quality of Care (3)
- Racial and Ethnic Minorities (1)
- Respiratory Conditions (1)
- Rural Health (1)
- Sickle Cell Disease (1)
- Stress (1)
- Surgery (4)
- Teams (1)
- Tobacco Use (1)
- Tools & Toolkits (1)
- Training (4)
- Trauma (1)
- Vaccination (1)
- Vulnerable Populations (1)
- Web-Based (2)
- Workflow (1)
- Workforce (5)
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 25 of 42 Research Studies DisplayedBenda N, Hettinger A, Bisantz A
Communication in the electronic age: an analysis of face-to-fact physician-nurse communication in the emergency department.
This study described the patterns and content of nurse to physician verbal conversations in three emergency departments (EDs) with electronic health records. It found that physician participants experienced significantly more communication events than nurse participants, while nurses initiated significantly more communication events than physicians. Most of the communication events occurred at the physician workstation followed by patient treatment areas.
AHRQ-funded; HS022542.
Citation: Benda N, Hettinger A, Bisantz A .
Communication in the electronic age: an analysis of face-to-fact physician-nurse communication in the emergency department.
Journal of Healthcare Informatics Research 2017 Dec;1(2):218-30.
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Keywords: Communication, Electronic Health Records (EHRs), Provider: Health Personnel, Emergency Department, Nursing
Rizvi RF, Marquard JL, Seywerd MA
Usability evaluation of an EHR's clinical notes interface from the perspective of attending and resident physicians: an exploratory study.
Usability of a commercial, inpatient Electronic Health Record (EHR) clinical notes documentation interface was analyzed from standpoints of two provider groups employing two standardized patient cases. The study results suggested that: (1) EHR usability and desirability is influenced by user characteristics, (2) repeated task performance improves user efficiency, and (3) user performance is correlated to their subjective system assessments.
AHRQ-funded; HS022085.
Citation: Rizvi RF, Marquard JL, Seywerd MA .
Usability evaluation of an EHR's clinical notes interface from the perspective of attending and resident physicians: an exploratory study.
Stud Health Technol Inform 2017;245:1128-32.
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Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Provider: Health Personnel
Mosaly PR, Mazur LM, Marks LB
Quantification of baseline pupillary response and task-evoked pupillary response during constant and incremental task load.
The objective of this study was to assess variability in baseline pupil size and task-evoked pupillary response (TEPR) during two basic working memory tasks: constant load of 3-letters memorization-recall (10 trials), and incremental load memorization-recall. It concluded that quantification of TEPR can be affected by shifts in baseline pupil size that are most likely affected by non-cognitive factors when other external factors are kept constant.
AHRQ-funded; HS023458; HS024062.
Citation: Mosaly PR, Mazur LM, Marks LB .
Quantification of baseline pupillary response and task-evoked pupillary response during constant and incremental task load.
Ergonomics 2017 Oct;60(10):1369-75. doi: 10.1080/00140139.2017.1288930.
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Keywords: Health Information Technology (HIT), Provider: Health Personnel, Patient Safety
Kruse GR, Hays H, Orav EJ
Meaningful use of the Indian Health Service electronic health record.
This study sought to understand the use of electronic health record (EHR) functionalities by physicians practicing in an underserved setting. Physicians routinely used a median 7 of 10 EHR functionalities targeted by the Meaningful Use program, but only 5 percent used all 10. Most (63 percent) felt the EHR improved quality of care. Many (76 percent) reported increased documentation time and poorer quality patient-physician interactions (45 percent).
AHRQ-funded; 290200900023I.
Citation: Kruse GR, Hays H, Orav EJ .
Meaningful use of the Indian Health Service electronic health record.
Health Serv Res 2017 Aug;52(4):1349-63. doi: 10.1111/1475-6773.12531.
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Keywords: Electronic Health Records (EHRs), Provider: Health Personnel, Practice Patterns, Vulnerable Populations
Davis MM, Howk S, Spurlock M
A qualitative study of clinic and community member perspectives on intervention toolkits: "unless the toolkit is used it won't help solve the problem.".
Researchers conducted this study to explore what clinic and community-based users want in intervention toolkits and to identify the factors that support application in practice. They found that participants wanted toolkits targeted at the right audience and demonstrated to be effective. Well organized toolkits, often with a quick start guide, with tools that were easy to tailor and apply were desired.
AHRQ-funded; HS022981.
Citation: Davis MM, Howk S, Spurlock M .
A qualitative study of clinic and community member perspectives on intervention toolkits: "unless the toolkit is used it won't help solve the problem.".
BMC Health Serv Res 2017 Jul 18;17(1):497. doi: 10.1186/s12913-017-2413-y.
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Keywords: Provider: Health Personnel, Ambulatory Care and Surgery, Primary Care, Tools & Toolkits, Implementation
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
Bush RA, Connelly CD, Perez A
Physician perception of the role of the patient portal in pediatric health.
Little information regarding physician opinion of the patient portal is available, with almost no information gathered in the pediatric environment. Using a mixed-methods approach, physicians in a large pediatric medical facility and integrated delivery network were surveyed by online quantitative questionnaire and structured interviews. Physicians reported the portal's role in more communication efficiency for patients, parents, and providers.
AHRQ-funded; HS022404.
Citation: Bush RA, Connelly CD, Perez A .
Physician perception of the role of the patient portal in pediatric health.
J Ambul Care Manage 2017 Jul/Sep;40(3):238-45. doi: 10.1097/jac.0000000000000175.
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Keywords: Children/Adolescents, Electronic Health Records (EHRs), Provider: Health Personnel, Clinician-Patient Communication, Web-Based
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
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
Scerbo MW, Britt RC, Montano M
Effects of a retention interval and refresher session on intracorporeal suturing and knot tying skill and mental workload.
The effects of refraining from practice for different intervals on laparoscopic suturing and mental workload were assessed with a secondary task developed by the authors. When participants who reached proficiency in suturing and knot tying were reassessed after either 1 or 5 months without practice, their performance times increased by 35 percent and secondary task scores decreased by 30 percent. These deficits, however, were nearly reversed after a single refresher session.
AHRQ-funded; HS020386.
Citation: Scerbo MW, Britt RC, Montano M .
Effects of a retention interval and refresher session on intracorporeal suturing and knot tying skill and mental workload.
Surgery 2017 May;161(5):1209-14. doi: 10.1016/j.surg.2016.11.011.
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Keywords: Surgery, Education: Continuing Medical Education, Training, Provider: Health Personnel
Kruser JM, Taylor LJ, Campbell TC
"Best case/worst case": training surgeons to use a novel communication tool for high-risk acute surgical problems.
"Best Case/Worst Case" (BC/WC) is a communication tool designed to promote goal-concordant care during discussions about high-risk surgery. The objective of this study was to evaluate a structured training program designed to teach surgeons how to use BC/WC. It concluded that : surgeons can learn to use BC/WC with older patients considering acute high-risk surgical interventions..
AHRQ-funded; HS000078.
Citation: Kruser JM, Taylor LJ, Campbell TC .
"Best case/worst case": training surgeons to use a novel communication tool for high-risk acute surgical problems.
J Pain Symptom Manage 2017 Apr;53(4):711-19.e5. doi: 10.1016/j.jpainsymman.2016.11.014.
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Keywords: Communication, Decision Making, Provider: Health Personnel, Surgery, Training
Rocque GB, Dionne-Odom JN, Sylvia Huang CH
Implementation and impact of patient lay navigator-led advance care planning conversations.
Advance care planning (ACP) improves alignment between patient preferences for life-sustaining treatment and care received at end of life (EOL). This study evaluated implementation of lay navigator-led ACP and concluded that a navigator-led ACP program was feasible and may be associated with lower rates of resource utilization near EOL.
AHRQ-funded; HS023009.
Citation: Rocque GB, Dionne-Odom JN, Sylvia Huang CH .
Implementation and impact of patient lay navigator-led advance care planning conversations.
J Pain Symptom Manage 2017 Apr;53(4):682-92. doi: 10.1016/j.jpainsymman.2016.11.012.
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Keywords: Communication, Elderly, Palliative Care, Patient-Centered Healthcare, Provider: Health Personnel
Hanauer DA, Branford GL, Greenberg G
Two-year longitudinal assessment of physicians' perceptions after replacement of a longstanding homegrown electronic health record: does a J-curve of satisfaction really exist?
This report describes a 2-year prospective, longitudinal survey of attending physicians in 3 clinical areas (family medicine, general pediatrics, internal medicine) who experienced a transition from a homegrown electronic health record (EHR) to a vendor EHR. The primary goal was to determine if perceptions followed a J-curve pattern in which they initially dropped but eventually surpassed baseline measures. A J-curve was not found for any measures, including workflow, safety, communication, and satisfaction.
AHRQ-funded; HS023613.
Citation: Hanauer DA, Branford GL, Greenberg G .
Two-year longitudinal assessment of physicians' perceptions after replacement of a longstanding homegrown electronic health record: does a J-curve of satisfaction really exist?
J Am Med Inform Assoc 2017 Apr 1;24(e1):e157-e65. doi: 10.1093/jamia/ocw077.
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Keywords: Electronic Health Records (EHRs), Provider: Health Personnel, Ambulatory Care and Surgery, Patient Safety, Workflow
Blecker S, Meisel T, Dickson VV
"We're almost guests in their clinical care": inpatient provider attitudes toward chronic disease management.
The purpose of this study was to explore inpatient provider attitudes about chronic disease management and, in particular, barriers and facilitators of chronic disease management in the hospital. It found that a strong relationship with the outpatient provider and involvement of specialists were facilitators of inpatient chronic disease management. Providers perceived benefits to in-hospital chronic disease management for both processes of care and clinical outcomes.
AHRQ-funded; HS023683.
Citation: Blecker S, Meisel T, Dickson VV .
"We're almost guests in their clinical care": inpatient provider attitudes toward chronic disease management.
J Hosp Med 2017 Mar;12(3):162-67. doi: 10.12788/jhm.2699.
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Keywords: Care Management, Chronic Conditions, Hospitals, Provider: Health Personnel
Johnson TJ, Winger DG, Hickey RW
Comparison of physician implicit racial bias toward adults versus children.
This study compared implicit racial bias toward adults versus children among resident physicians working in a pediatric emergency department. It found that resident physicians have implicit racial bias against black children, similar to levels of bias against black adults. Bias in the study did not vary by resident demographic characteristics, including specialty, suggesting that pediatric residents are as susceptible as other physicians to implicit bias.
AHRQ-funded; HS017587.
Citation: Johnson TJ, Winger DG, Hickey RW .
Comparison of physician implicit racial bias toward adults versus children.
Acad Pediatr 2017 Mar;17(2):120-26. doi: 10.1016/j.acap.2016.08.010.
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Keywords: Children/Adolescents, Emergency Department, Provider: Health Personnel, Children/Adolescents, Racial and Ethnic Minorities
Smith SA, Yount N, Sorra J
Exploring relationships between hospital patient safety culture and Consumer Reports safety scores.
This study examines whether patient safety culture perceptions of U.S. hospital staff in a large national survey are related to publicly reported patient safety ratings of hospitals. It found a positive relationship between hospital staff perceptions of patient safety culture and the Consumer Reports Hospital Safety Score, which is a composite of patient experience and outcomes data from federal databases.
AHRQ-funded; 290201300003C.
Citation: Smith SA, Yount N, Sorra J .
Exploring relationships between hospital patient safety culture and Consumer Reports safety scores.
BMC Health Serv Res 2017 Feb 16;17(1):143. doi: 10.1186/s12913-017-2078-6.
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Keywords: Hospitals, Patient Safety, Provider, Provider: Health Personnel
Ford JH, 2nd, Oliver KA, Giles M
Maintenance of certification: how performance in practice changes improve tobacco cessation in addiction psychiatrists' practice.
This study reports on findings from a Maintenance of Certification (MOC) Performance in Practice (PIP) module designed and evaluated by addiction psychiatrists who are members of the American Academy of Addiction Psychiatry. It found that simple change projects designed to improve clinical practice led to substantial changes in self-reported chart documentation for the selected measure.
AHRQ-funded; HS021962.
Citation: Ford JH, 2nd, Oliver KA, Giles M .
Maintenance of certification: how performance in practice changes improve tobacco cessation in addiction psychiatrists' practice.
Am J Addict 2017 Jan;26(1):34-41. doi: 10.1111/ajad.12480.
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Keywords: Behavioral Health, Education: Continuing Medical Education, Provider: Health Personnel, Quality Improvement, Tobacco Use
Doberne JW, Redd T, Lattin D
Perspectives and uses of the electronic health record among US pediatricians: a national survey.
This survey found that the electronic health record (EHR) was the most commonly used source of initial patient information. Seventy-two percent of 808 pediatricians participating reported requiring between 2 and 10 minutes to complete an initial review of the EHR. Several moderately severe information barriers were reported regarding the display of information in the EHR.
AHRQ-funded; HS022981.
Citation: Doberne JW, Redd T, Lattin D .
Perspectives and uses of the electronic health record among US pediatricians: a national survey.
J Ambul Care Manage 2017 Jan/Mar;40(1):59-68. doi: 10.1097/jac.0000000000000167.
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Keywords: Electronic Health Records (EHRs), Provider: Health Personnel, Children/Adolescents, Practice Patterns
Press A, Khan S, McCullagh L
Avoiding alert fatigue in pulmonary embolism decision support: a new method to examine 'trigger rates.'
The authors developed a new and innovative usability process named 'sensitivity and specificity trigger analysis' (SSTA) as part of a larger project around a pulmonary embolism decision support tool. They explored a unique methodology, SSTA, used to limit inaccurate triggering of a clinical decision support tool prior to integration into the electronic health record. They concluded that their methodology can be applied to other studies aiming to decrease triggering rates and increase adoption rates of previously validated clinical decision support system tools.
AHRQ-funded; HS022061.
Citation: Press A, Khan S, McCullagh L .
Avoiding alert fatigue in pulmonary embolism decision support: a new method to examine 'trigger rates.'
Evid Based Med 2016 Dec;21(6):203-07. doi: 10.1136/ebmed-2016-110440.
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Keywords: Clinical Decision Support (CDS), Respiratory Conditions, Electronic Health Records (EHRs), Provider: Health Personnel, Patient Safety
Laccetti AL, Chen B, Cai J
Increase in cancer center staff effort related to electronic patient portal use.
The authors examined patterns of use of electronic portals by clinic staff at a National Cancer Institute-designated comprehensive cancer center. They found that from 2011 to 2014, staff portal activity increased approximately 10-fold, and sixteen percent of all actions occurred outside clinic hours. They concluded that cancer center employee use of an electronic patient portal has increased markedly over time, particularly among nursing staff.
AHRQ-funded; HS022418.
Citation: Laccetti AL, Chen B, Cai J .
Increase in cancer center staff effort related to electronic patient portal use.
J Oncol Pract 2016 Dec;12(12):e981-e90. doi: 10.1200/jop.2016.011817.
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Keywords: Cancer, Health Information Technology (HIT), Provider: Health Personnel, Web-Based, Workforce
Thomas KS, Allen SM
Interagency partnership to deliver veteran-directed home and community-based services: interviews with Aging and Disability Network agency personnel regarding their experience with partner Department of Veterans Affairs medical centers.
The objective of this article is to describe the Aging and Disability Network agency (ADNA) personnel's perceptions of the implementation of the VD-HCBS program with partner Department of Veterans Affairs medical centers (VAMCs). Results suggest that the majority of ADNA personnel interviewed perceive the collaboration experience to be positive. Interviewees reported several key mechanisms for facilitating a successful partnership.
AHRQ-funded; HS000011.
Citation: Thomas KS, Allen SM .
Interagency partnership to deliver veteran-directed home and community-based services: interviews with Aging and Disability Network agency personnel regarding their experience with partner Department of Veterans Affairs medical centers.
J Rehabil Res Dev 2016;53(5):611-18. doi: 10.1682/jrrd.2015.02.0019.
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Keywords: Community-Based Practice, Provider: Health Personnel, Home Healthcare, Training
Mueller LR, Donnelly JP, Jacobson KE
National characteristics of emergency medical services in frontier and remote areas.
This study sought to describe the national characteristics and outcomes of EMS care provided in frontier and remote (FAR) areas in the continental United States (US). It found that FAR responses were more likely to be of American Indian or Alaska Native race. Age, ethnicity, location type, and clinical impressions were similar between FAR and non-FAR responses. On-scene death was more likely in FAR than non-FAR responses.
AHRQ-funded; HS013852.
Citation: Mueller LR, Donnelly JP, Jacobson KE .
National characteristics of emergency medical services in frontier and remote areas.
Prehosp Emerg Care 2016;20(2):191-9. doi: 10.3109/10903127.2015.1086846.
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Keywords: Emergency Medical Services (EMS), Rural Health, Provider: Health Personnel, Health Services Research (HSR), Outcomes
Nathan H, Dimick JB
Opportunities for surgical leadership in managing population health costs.
The concept of population health management—long a mainstay in primary care and chronic disease management—is taking root in surgery. The 2010 Affordable Care Act (ACA) ushered in the implementation of several innovative payment models that shift accountability for population costs to health systems and providers. The authors discuss the implications of th trends for the surgical profession.
AHRQ-funded; HS024763.
Citation: Nathan H, Dimick JB .
Opportunities for surgical leadership in managing population health costs.
Ann Surg 2016 Dec;264(6):909-10. doi: 10.1097/sla.0000000000001759.
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Keywords: Healthcare Costs, Payment, Provider: Health Personnel, Surgery
Sakata KK, Stephenson LS, Mulanax A
Professional and interprofessional differences in electronic health records use and recognition of safety issues in critically ill patients.
The authors conducted this study to determine how each professional group - physicians, nurses, and pharmacists - reviews electronic health records (EHR) data in preparation for rounds and their ability to identify patient safety issues. They found significant and non-overlapping differences in individual profession recognition of patient safety issues in the EHR which may be attributed to differences in EHR use.
AHRQ-funded; HS023793; HS021637.
Citation: Sakata KK, Stephenson LS, Mulanax A .
Professional and interprofessional differences in electronic health records use and recognition of safety issues in critically ill patients.
J Interprof Care 2016 Sep;30(5):636-42. doi: 10.1080/13561820.2016.1193479.
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Keywords: Critical Care, Electronic Health Records (EHRs), Provider: Health Personnel, Intensive Care Unit (ICU), Patient Safety
Ray KN, Kahn JM, Miller E
Use of adult-trained medical subspecialists by children seeking medical subspecialty care.
The objectives of this study are to quantify the use of adult-trained medical subspecialists by children and to determine the association between geographic access to pediatric subspecialty care and the use of adult-trained subspecialists. Among medical subspecialty fields with pediatric and adult-trained subspecialists, the authors found that adult-trained subspecialists provided 10% of care to children overall and 18% of care to children living more than 90 minutes from pediatric referral centers.
AHRQ-funded; HS022989.
Citation: Ray KN, Kahn JM, Miller E .
Use of adult-trained medical subspecialists by children seeking medical subspecialty care.
J Pediatr 2016 Sep;176:173-81.e1. doi: 10.1016/j.jpeds.2016.05.073.
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Keywords: Access to Care, Children/Adolescents, Provider: Health Personnel, Children/Adolescents