National Healthcare Quality and Disparities Report
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Topics
- Adverse Events (4)
- Asthma (1)
- Caregiving (1)
- Care Management (1)
- Children/Adolescents (2)
- Clinical Decision Support (CDS) (1)
- Clinician-Patient Communication (1)
- Communication (2)
- Decision Making (2)
- Dementia (1)
- Diagnostic Safety and Quality (1)
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- Electronic Health Records (EHRs) (3)
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- Health Information Technology (HIT) (5)
- Imaging (1)
- Injuries and Wounds (1)
- Labor and Delivery (1)
- Medical Errors (2)
- Medical Expenditure Panel Survey (MEPS) (1)
- Medication (2)
- Neurological Disorders (2)
- Newborns/Infants (1)
- Nursing (1)
- Nutrition (1)
- Patient-Centered Healthcare (2)
- Patient-Centered Outcomes Research (1)
- Patient Safety (9)
- Patient Self-Management (1)
- Practice-Based Research Network (PBRN) (1)
- Pregnancy (1)
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- Quality Improvement (6)
- Quality Indicators (QIs) (1)
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- Quality of Life (1)
- Risk (1)
- Stroke (1)
- Surgery (2)
- Teams (1)
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- (-) Tools & Toolkits (20)
- Training (2)
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 20 of 20 Research Studies DisplayedHempel S, Miake-Lye I, Brega AG
AHRQ Author: Spector WD
Quality improvement toolkits: recommendations for development.
The authors convened a panel of health care stakeholders informed by a literature review that analyzed 44 publications and 27 toolkits. The panel formed 12 recommendations for content and 1 recommendation for toolkit development methods. The authors then established a set of key recommendations and suggestions addressing the content, development, and evaluation methods of quality improvement toolkits, together with a ready-to-use checklist.
AHRQ-authored.
Citation: Hempel S, Miake-Lye I, Brega AG .
Quality improvement toolkits: recommendations for development.
Am J Med Qual 2019 Nov/Dec;34(6):538-44. doi: 10.1177/1062860618822102..
Keywords: Quality Improvement, Quality of Care, Tools & Toolkits
Mixon AS, Smith GR, Mallouk M
Design of MARQUIS2: study protocol for a mentored implementation study of an evidence-based toolkit to improve patient safety through medication reconciliation.
The first Multi-center Medication Reconciliation Quality Improvement Study (MARQUIS1) demonstrated that implementation of a medication reconciliation best practices toolkit decreased total unintentional medication discrepancies in five hospitals. In this study, the investigators sought to implement the MARQUIS toolkit in more diverse hospitals, incorporating lessons learned from MARQUIS1.
AHRQ-funded; HS023757; HS025486.
Citation: Mixon AS, Smith GR, Mallouk M .
Design of MARQUIS2: study protocol for a mentored implementation study of an evidence-based toolkit to improve patient safety through medication reconciliation.
BMC Health Serv Res 2019 Sep 11;19(1):659. doi: 10.1186/s12913-019-4491-5.
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Keywords: Evidence-Based Practice, Medication, Patient Safety, Quality of Care, Quality Improvement, Quality Indicators (QIs), Quality Measures, Tools & Toolkits
Dossett L, Miller J, Jagsi R
A modified communication and optimal resolution program for intersystem medical error discovery: protocol for an implementation study.
AHRQ’s Communication and Optimal Resolution (CANDOR) Toolkit facilitates transparent communication, error prevention, and achieving optimal resolution with patients and families; how medical errors should be addressed when they are discovered between systems-intersystem medical error discovery (IMED)-remains unclear. This study aims to develop and test implementation of a modified CANDOR process for application to IMED scenarios. Step 1 of aim 1 is currently underway. This work is expected to provide important insights into the potential utility of an implementation toolkit to improve transparent communication and optimal resolution of IMED scenarios.
AHRQ-funded; HS026030.
Citation: Dossett L, Miller J, Jagsi R .
A modified communication and optimal resolution program for intersystem medical error discovery: protocol for an implementation study.
JMIR Res Protoc 2019 Jul 2;8(7):e13396. doi: 10.2196/13396..
Keywords: Adverse Events, Communication, Clinician-Patient Communication, Medical Errors, Patient Safety, Tools & Toolkits
Simon KC, Munson R, Ong A
Design and implementation of structured clinical documentation support tools for treating stroke patients.
This article describes the development of a customized structured clinical documentation toolkit that standardizes patient data collection to conform to Best Practices for treating patients with stroke. The toolkit collects demographic information for patients, relevant score test measures, and information on disability, treatment, and outcomes. Basic descriptive data gathered via the toolkits is provided and their utility in collecting patient data in a manner that supports both quality clinical care and research initiatives demonstrated. Quality improvement projects and current research initiatives using the toolkit are also discussed.
AHRQ-funded; HS024057.
Citation: Simon KC, Munson R, Ong A .
Design and implementation of structured clinical documentation support tools for treating stroke patients.
J Stroke Cerebrovasc Dis 2019 May;28(5):1229-35. doi: 10.1016/j.jstrokecerebrovasdis.2019.01.011..
Keywords: Electronic Health Records (EHRs), Evidence-Based Practice, Guidelines, Health Information Technology (HIT), Stroke, Tools & Toolkits
Simon KC, Yucus C, Castle J
Building of EMR tools to support quality and research in a memory disorders clinic.
This article describes the development of a customized EMR toolkit that standardizes patient data collection with hundreds of discrete fields, supports Best Practices for treating patients with memory disorders, and also supports practice-based research. The toolkit was successfully implemented to support Best Practices in the care of patients with memory disorders. Applications are also discussed. Data collection is ongoing, but the authors anticipate that the toolkit will generate data that allows for descriptive and hypothesis-driven research as well as quality improvement among patients seen in memory clinics.
AHRQ-funded; HS024057.
Citation: Simon KC, Yucus C, Castle J .
Building of EMR tools to support quality and research in a memory disorders clinic.
Front Neurol 2019 Mar 7;10:161. doi: 10.3389/fneur.2019.00161..
Keywords: Dementia, Electronic Health Records (EHRs), Health Information Technology (HIT), Neurological Disorders, Quality of Care, Quality Improvement, Tools & Toolkits
Kwan BM, Fernald D, Ferrarone P
Implementation and evaluation of a laboratory safety process improvement toolkit.
This study evaluated the quality and usefulness of the revised version of the AHRQ toolkit “Improving Your Office Testing Process”. The toolkit is designed to help primary care practices standardize their laboratory testing processes. Researchers evaluated 2 primary practices. Nineteen clinicians and staff provided survey data. The toolkit was given a positive rating by staff who thought it was easy to use and helped improve the quality improvement (QI) infrastructure.
AHRQ-funded; 233201500025I.
Citation: Kwan BM, Fernald D, Ferrarone P .
Implementation and evaluation of a laboratory safety process improvement toolkit.
J Am Board Fam Med 2019 Mar-Apr;32(2):136-45. doi: 10.3122/jabfm.2019.02.180109..
Keywords: Primary Care, Tools & Toolkits, Diagnostic Safety and Quality, Quality Improvement, Quality of Care
Sheridan SL, Donahue KE, Brenner AT
Beginning with high value care in mind: a scoping review and toolkit to support the content, delivery, measurement, and sustainment of high value care.
The purpose of this review was to create a shared vision for the content, delivery, measurement, and sustainment of patient-centered, high-value care by creating a toolkit for system leaders. The toolkit was developed by translating included evidence into simple, actionable briefs on key topics and added resources. Although potential users have reported that the toolkit is likely to be globally useful, the authors note that it needs comparison to other approaches.
AHRQ-funded; 233201500024I.
Citation: Sheridan SL, Donahue KE, Brenner AT .
Beginning with high value care in mind: a scoping review and toolkit to support the content, delivery, measurement, and sustainment of high value care.
Patient Educ Couns 2019 Feb;102(2):238-52. doi: 10.1016/j.pec.2018.05.014..
Keywords: Healthcare Delivery, Patient-Centered Healthcare, Tools & Toolkits
Meyers S, Claire Simon K, Bergman-Bock S
Structured clinical documentation to improve quality and support practice-based research in headache.
The authors developed a proprietary toolkit to aid clinicians when creating clinical documentation in electronic medical records (EMRs). This toolkit will help clinicians provide discrete data and not unstructured free text which many clinicians enter into the EMR. The toolkit collects hundreds of fields of data and interprets score tests for a number of difference assessment tools for anxiety disorder, depression, migraine disability, and insomnia. The toolkit was used at 4346 initial patient visits as of April 1, 2018. The toolkit is being shared with other clinics as part of the Neurology Practice-Based Research Network.
AHRQ-funded; HS024057.
Citation: Meyers S, Claire Simon K, Bergman-Bock S .
Structured clinical documentation to improve quality and support practice-based research in headache.
Headache 2018 Sep;58(8):1211-18. doi: 10.1111/head.13348..
Keywords: Quality Improvement, Quality of Life, Tools & Toolkits, Neurological Disorders, Electronic Health Records (EHRs), Health Information Technology (HIT), Practice-Based Research Network (PBRN)
Eriksson CO, Ovregaard N, Hansen M
Reliability and usability of a 7-minute chart review tool to identify pediatric prehospital adverse safety events.
As part of a multiphase study, the authors developed and evaluated the reliability and usability of the pediatric prehospital safety event detection system (PEDS), a tool used to identify safety events in prehospital care. They concluded that the PEDS tool is the first chart review tool designed to identify safety events for children receiving prehospital care, and it displayed good usability and reliability in their study.
AHRQ-funded; HS022981.
Citation: Eriksson CO, Ovregaard N, Hansen M .
Reliability and usability of a 7-minute chart review tool to identify pediatric prehospital adverse safety events.
Hosp Pediatr 2018 Aug;8(8):494-98. doi: 10.1542/hpeds.2017-0155..
Keywords: Adverse Events, Children/Adolescents, Patient-Centered Healthcare, Patient Safety, Tools & Toolkits
Lambert-Kerzner A, Ford KL, Hammermeister KE
Assessment of attitudes towards future implementation of the "Surgical Risk Preoperative Assessment System" (SURPAS) tool: a pilot survey among patients, surgeons, and hospital administrators.
Implementation of the Surgical Risk Preoperative Assessment System (SURPAS), an innovative real time, universal, preoperative tool providing individualized risk assessment, may enhance informed consent and reduce adverse outcomes. To ensure optimal development and implementation of SURPAS the study authors performed an in-depth pre-implementation evaluation of SURPAS at an academic tertiary referral center in Colorado.
AHRQ-funded; HS024124.
Citation: Lambert-Kerzner A, Ford KL, Hammermeister KE .
Assessment of attitudes towards future implementation of the "Surgical Risk Preoperative Assessment System" (SURPAS) tool: a pilot survey among patients, surgeons, and hospital administrators.
Patient Saf Surg 2018 Jun 4;12:12. doi: 10.1186/s13037-018-0159-z..
Keywords: Health Information Technology (HIT), Quality Improvement, Risk, Surgery, Tools & Toolkits
Ray-Barruel G, Cooke M, Mitchell M
Implementing the I-DECIDED clinical decision-making tool for peripheral intravenous catheter assessment and safe removal: protocol for an interrupted time-series study.
This study aims to validate an evidence-based peripheral intravenous catheter (PIVC) assessment and decision-making tool called I-DECIDED and evaluate the effect of implementing this tool into acute hospital clinical practice.
AHRQ-funded; HS022835.
Citation: Ray-Barruel G, Cooke M, Mitchell M .
Implementing the I-DECIDED clinical decision-making tool for peripheral intravenous catheter assessment and safe removal: protocol for an interrupted time-series study.
BMJ Open 2018 Jun 4;8(6):e021290. doi: 10.1136/bmjopen-2017-021290..
Keywords: Clinical Decision Support (CDS), Decision Making, Patient Safety, Tools & Toolkits
Sun B, Lam D, Yang D
A machine learning approach to the accurate prediction of monitor units for a compact proton machine.
Physical phantom measurements are commonly employed to determine field-specific output factors (OFs) but are often subject to limited machine time, measurement uncertainties and intensive labor. The goal of this study was to develop a secondary check tool for output factors (OF) measurements and eventually eliminate patient-specific OF measurements. The study concluded that machine learning methods can be used to predict OF for double-scatter proton machines with greater prediction accuracy than the most popular semi-empirical prediction model.
AHRQ-funded; HS022888.
Citation: Sun B, Lam D, Yang D .
A machine learning approach to the accurate prediction of monitor units for a compact proton machine.
Med Phys 2018 May;45(5):2243-51. doi: 10.1002/mp.12842..
Keywords: Imaging, Patient Safety, Tools & Toolkits
Bartsch SM, Huang SS, McKinnell JA
The economic value of the Centers for Disease Control and Prevention carbapenem-resistant Enterobacteriaceae Toolkit.
The authors investigated whether and when economic benefits occur with the toolkit for carbapenem-resistant Enterobacteriaceae. Using their Regional Healthcare Ecosystem Analyst-generated agent-based model of all inpatient healthcare facilities, they identified cost savings in year 1 of implementation when hospitals acted independently and by year 3 if all hospitals collectively implemented the toolkit in a coordinated manner.
AHRQ-funded; HS023317.
Citation: Bartsch SM, Huang SS, McKinnell JA .
The economic value of the Centers for Disease Control and Prevention carbapenem-resistant Enterobacteriaceae Toolkit.
Infect Control Hosp Epidemiol 2018 May;39(5):516-24. doi: 10.1017/ice.2018.49.
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Keywords: Healthcare Costs, Patient Safety, Tools & Toolkits
Stockwell DC, Landrigan CP, Schuster MA
Using a pediatric trigger tool to estimate total harm burden hospital-acquired conditions represent.
The Centers for Medicare & Medicaid Services Partnership for Patients program identified 9 hospital-acquired conditions (HACs) for reduction, to make care safer, more reliable, and less costly. However, the proportion of inpatient pediatric harm represented by these HACs is unknown. The investigators conducted a retrospective review of 240 harms previously identified using the Pediatric All-Cause Harm Measurement Tool, a trigger tool that is applied to medical records to comprehensively identify harms.
AHRQ-funded; HS020513.
Citation: Stockwell DC, Landrigan CP, Schuster MA .
Using a pediatric trigger tool to estimate total harm burden hospital-acquired conditions represent.
Pediatr Qual Saf 2018 May-Jun;3(3):e081. doi: 10.1097/pq9.0000000000000081..
Keywords: Children/Adolescents, Healthcare-Associated Infections (HAIs), Patient Safety, Children/Adolescents, Tools & Toolkits
McArdle J, Sorensen A, Fowler CI
Strategies to improve management of shoulder dystocia under the AHRQ Safety Program for Perinatal Care.
The purpose of this study using TeamSTEPPS was to assess the implementation of safety strategies to improve management of births complicated by shoulder dystocia in labor and delivery units. Results suggested that successful management of shoulder dystocia requires a rapid, standardized, and coordinated response. The Safety Program for Perinatal Care strategies to increase safety of shoulder dystocia management are scalable, replicable, and adaptable to unit needs and circumstances.
AHRQ-funded; 2902010000241.
Citation: McArdle J, Sorensen A, Fowler CI .
Strategies to improve management of shoulder dystocia under the AHRQ Safety Program for Perinatal Care.
J Obstet Gynecol Neonatal Nurs 2018 Mar;47(2):191-201. doi: 10.1016/j.jogn.2017.11.014.
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Keywords: Labor and Delivery, Newborns/Infants, Pregnancy, Adverse Events, TeamSTEPPS, Injuries and Wounds, Care Management, Education: Continuing Medical Education, Training, Tools & Toolkits, Patient Safety, Nursing, Communication, Quality of Care
Stefanidis D
Developing a robust suturing assessment: validity evidence for the intracorporeal suturing assessment tool.
The purpose of this study was to validate a novel Intracorporeal Suturing Assessment Tool (ISAT) by comparing it with existing measures that have been reported to have validity evidence. The study found that the ISAT accurately assessed laparoscopic suturing skill related to other instruments. Unlike the generic Global Operative Assessment of Laparoscopic Skills (GOALS), ISAT includes specific information that can provide feedback on trainee suturing ability and targeted performance improvements.
AHRQ-funded; HS022080.
Citation: Stefanidis D .
Developing a robust suturing assessment: validity evidence for the intracorporeal suturing assessment tool.
Surgery 2018 Mar;163(3):560-64. doi: 10.1016/j.surg.2017.10.029..
Keywords: Education: Continuing Medical Education, Tools & Toolkits, Training
Yawn BP, Wollan PC, Rank MA
Use of asthma APGAR tools in primary care practices: a cluster-randomized controlled trial.
The purpose of this study was to assess patient and practice outcomes after introducing the Asthma APGAR (Activities, Persistent, triGGers, Asthma medications, Response to therapy) tools into primary care practices. It concluded that introduction of the Asthma APGAR tools improves rates of asthma control; reduces asthma-related ED, urgent care, and hospital visits; and increases practices' adherence to asthma management guidelines.
AHRQ-funded; HS022126.
Citation: Yawn BP, Wollan PC, Rank MA .
Use of asthma APGAR tools in primary care practices: a cluster-randomized controlled trial.
Ann Fam Med 2018 Mar;16(2):100-10. doi: 10.1370/afm.2179.
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Keywords: Asthma, Patient-Centered Outcomes Research, Primary Care, Medical Expenditure Panel Survey (MEPS), Tools & Toolkits
Ye S, Leppin AL, Chan AY
An informatics approach to implement support for shared decision making for primary prevention statin therapy.
The study authors designed an informatics decision-support tool to facilitate use of the Mayo Clinic Statin Choice decision aid at the point-of-care and evaluated its impact. The investigators found that implementation of a point-of-care decision-support tool increased the usage of decision aids for primary prevention statin therapy. This effect does not appear to be mediated by any concomitant changes in physician attitude toward shared decision making.
AHRQ-funded; HS025198.
Citation: Ye S, Leppin AL, Chan AY .
An informatics approach to implement support for shared decision making for primary prevention statin therapy.
MDM Policy Pract 2018 Jan-Jun;3(1):2381468318777752. doi: 10.1177/2381468318777752..
Keywords: Decision Making, Health Information Technology (HIT), Medication, Prevention, Tools & Toolkits
Greenhawt M, DunnGalvin A
Preliminary psychometric analyses and clinical performance of a caregiver self-efficacy scale for food allergy self-management.
The researchers examined the preliminary reliability, validity, and clinical performance of a novel 8-item Food Allergy Self-Efficacy Questionnaire (FASEQ). They present preliminary evidence that the FASEQ is a valid tool to assess caregiver food allergy self-efficacy.
AHRQ-funded; HS024599.
Citation: Greenhawt M, DunnGalvin A .
Preliminary psychometric analyses and clinical performance of a caregiver self-efficacy scale for food allergy self-management.
Ann Allergy Asthma Immunol 2018 Jan;120(1):73-79. doi: 10.1016/j.anai.2017.09.060.
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Keywords: Caregiving, Nutrition, Patient Self-Management, Tools & Toolkits
Huang LC, Conley D, Lipsitz S
The Surgical Safety Checklist and teamwork coaching tools: a study of inter-rater reliability.
The authors assessed the inter-rater reliability (IRR) of two novel observation tools for measuring surgical safety checklist performance and teamwork. They found that both the Checklist Coaching Tool and the Surgical Teamwork Tool demonstrated substantial IRR and required limited training to use, indicating that both instruments may be used to observe checklist performance and teamwork in the operating room. They recommended that further refinement and calibration of observer expectations, particularly in rating teamwork, could improve the utility of the tools.
AHRQ-funded; HS019631.
Citation: Huang LC, Conley D, Lipsitz S .
The Surgical Safety Checklist and teamwork coaching tools: a study of inter-rater reliability.
BMJ Qual Saf 2014 Aug;23(8):639-50. doi: 10.1136/bmjqs-2013-002446.
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Keywords: Patient Safety, Surgery, Tools & Toolkits, Teams, Adverse Events, Medical Errors, Prevention