National Healthcare Quality and Disparities Report
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Topics
- Adverse Events (1)
- Anxiety (1)
- Asthma (3)
- Behavioral Health (2)
- Care Management (1)
- (-) Children/Adolescents (12)
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- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (1)
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- Diagnostic Safety and Quality (2)
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- Patient-Centered Outcomes Research (2)
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- (-) Quality Improvement (12)
- Quality Indicators (QIs) (1)
- Quality Measures (2)
- Quality of Care (9)
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- Screening (1)
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- Surgery (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 12 of 12 Research Studies DisplayedLiu FF, Lew A, Andes E
Implementation strategies for depression and anxiety screening in a pediatric cystic fibrosis center: a quality improvement project.
The objective of this study was to share key strategies that led to successful mental health screening (MHS) implementation in one pediatric cystic fibrosis center and to report implementation and screening outcomes. Results showed that leveraging coproduction to address stakeholder needs led to successful implementation of a sustainable MHS process.
AHRQ-funded; HS026393.
Citation: Liu FF, Lew A, Andes E .
Implementation strategies for depression and anxiety screening in a pediatric cystic fibrosis center: a quality improvement project.
Pediatr Pulmonol 2020 Dec;55(12):3328-36. doi: 10.1002/ppul.24951..
Keywords: Children/Adolescents, Respiratory Conditions, Chronic Conditions, Depression, Anxiety, Behavioral Health, Screening, Implementation, Quality Improvement, Quality of Care, Diagnostic Safety and Quality
Harder VS, Shaw JS, McCulloch CE
Statewide asthma learning collaborative participation and asthma-related emergency department use.
This study looked at outcomes from participation of pediatric practices in a quality improvement (QI) collaborative to decrease asthma-related emergency department (ED) visits. A statewide network of practices participated in the collaborative from 2015 to 2016. Asthma-related ED visit rates per 100 child-years for children ages 3 to 21 was evaluated using the state’s all-payer claims databases. The authors found that in the postintervention year (2017) participating practices’ ED visit rate decreased by 5.8 per 100 child-years, compared to an increase of 1.8 per 100 child-years in non-participating practices. There were no statistically significant differences in asthma-related ED visit rates during 2016, which indicated that it took some time for QI elements to be successfully implemented in pediatric practices.
AHRQ-funded; HS025297.
Citation: Harder VS, Shaw JS, McCulloch CE .
Statewide asthma learning collaborative participation and asthma-related emergency department use.
Pediatrics 2020 Dec;146(6):e20200213. doi: 10.1542/peds.2020-0213..
Keywords: Children/Adolescents, Asthma, Emergency Department, Quality Improvement, Quality of Care, Primary Care, Guidelines
Luo B, McLoone M, Rasooly IR
Analysis: protocol for a new method to measure physiologic monitor alarm responsiveness.
A team of researchers including biomedical engineers, human factors engineers, information technology specialists, nurses, physicians, facilitators from a hospital’s simulation center, clinical informaticians, and hospital administrative leadership worked with three units at a pediatric hospital to design and conduct simulations on newly implemented monitoring technology that will be used for patient critical alarms. The system was tested using a simulation with existing hospital technology to transmit an unambiguously critical alarm that appeared to originate from an actual patient to the nurse’s mobile device, with discreet observers measuring responses.
AHRQ-funded; HS026620.
Citation: Luo B, McLoone M, Rasooly IR .
Analysis: protocol for a new method to measure physiologic monitor alarm responsiveness.
Biomed Instrum Technol 2020 Nov/Dec;54(6):389-96. doi: 10.2345/0899-8205-54.6.389..
Keywords: Children/Adolescents, Hospitals, Simulation, Quality Improvement, Quality of Care, Patient Safety, Health Information Technology (HIT)
Scott HF, Brilli RJ, Paul R
Evaluating pediatric sepsis definitions designed for electronic health record extraction and multicenter quality improvement.
The purpose of this study was to describe the Children's Hospital Association's Improving Pediatric Sepsis Outcomes sepsis definitions and to evaluate the definition using a published framework. The investigators concluded that the Improving Pediatric Sepsis Outcomes Sepsis definitions demonstrated feasibility for large-scale data abstraction. When operationalized, these definitions enabled multicenter identification and data aggregation, indicating practical utility for quality improvement.
AHRQ-funded; HS025696.
Citation: Scott HF, Brilli RJ, Paul R .
Evaluating pediatric sepsis definitions designed for electronic health record extraction and multicenter quality improvement.
Crit Care Med 2020 Oct;48(10):e916-e26. doi: 10.1097/ccm.0000000000004505..
Keywords: Children/Adolescents, Electronic Health Records (EHRs), Health Information Technology (HIT), Sepsis, Quality Improvement, Quality of Care
Kaiser SV, Johnson MD, Walls TA
Pathways to improve pediatric asthma care: a multisite, national study of emergency department asthma pathway implementation.
This quality improvement study’s aim was to determine the effects of pediatric asthma pathway implementation in a diverse, national sample of emergency departments (EDs). Desired outcomes included systemic corticosteroid administration within 60 minutes (primary), assessment of severity at ED triage, chest radiograph use, hospital admission or transfer for higher level of care, and ED length of stay. Charts were reviewed each month by EDs for children ages 2-17 years with a primary diagnosis of asthma. A total of 83 EDs were enrolled, with 37 of them children’s hospitals, and 46 community hospitals. Seventy-three percent completed the study (n = 22,963). There was a significant increase in systematic corticosteroid administration within 60 minutes of arrival as well as increased odds of severity assessment at triage and decreased rate of change in odds of hospital admission/transfer. Chest radiograph or ED length of stay was not associated with pathway implementation.
AHRQ-funded; HS024592.
Citation: Kaiser SV, Johnson MD, Walls TA .
Pathways to improve pediatric asthma care: a multisite, national study of emergency department asthma pathway implementation.
J Pediatr 2020 Aug;223:100-07.e2. doi: 10.1016/j.jpeds.2020.02.080..
Keywords: Children/Adolescents, Emergency Department, Asthma, Quality Improvement, Quality of Care, Care Management, Healthcare Delivery, Patient-Centered Outcomes Research, Evidence-Based Practice, Outcomes
Kaiser SV, Lam Cabana, MD
Best practices in implementing inpatient pediatric asthma pathways: a qualitative study.
The objective of this study was to identify potential best practices in pathway implementation. Building upon a previous observational study in which the researchers identified higher and lower performing children's hospitals based on hospital-level changes in asthma patient length of stay after implementation of a pathway, they conducted semi-structured interviews with a sample of healthcare providers involved in pathway implementation at these hospitals. They identified several potential best practices to support pathway implementation. They recommended that hospitals implementing pathways consider applying these strategies to ensure success in improving quality of asthma care for children.
AHRQ-funded; HS024592.
Citation: Kaiser SV, Lam Cabana, MD .
Best practices in implementing inpatient pediatric asthma pathways: a qualitative study.
J Asthma 2020 Jul;57(7):744-54. doi: 10.1080/02770903.2019.1606237..
Keywords: Children/Adolescents, Asthma, Respiratory Conditions, Hospitals, Inpatient Care, Guidelines, Evidence-Based Practice, Implementation, Quality Improvement, Quality of Care
Dadlez NM, Adelman J, Bundy DG
Contributing factors for pediatric ambulatory diagnostic process errors: Project RedDE.
This study examined root causes of three common pediatric diagnostic errors by having 31 practices enrolled in a national QI collaborative perform monthly “mini-RCAs” (mini root cause analyses). The diagnoses errors studied were missed adolescent depression, missed elevated blood pressure, and missed actionable laboratory values. Twenty-eight practices submitted 184 mini-RCAs with the most common causes being patient volume (adolescent depression and elevated BP), inadequate staffing (adolescent depression), clinic milieu (elevated BP), written communication and provider knowledge (actionable laboratory values), and electronic health records (EHRs) – (elevated BP and actionable laboratory values). The median number of mini-RCAs submitted was 6.
AHRQ-funded; HS024538; HS024713; HS026121.
Citation: Dadlez NM, Adelman J, Bundy DG .
Contributing factors for pediatric ambulatory diagnostic process errors: Project RedDE.
Pediatr Qual Saf 2020 May-Jun;5(3):e299. doi: 10.1097/pq9.0000000000000299..
Keywords: Children/Adolescents, Diagnostic Safety and Quality, Quality Improvement, Quality of Care, Medical Errors, Adverse Events, Patient Safety
Desai AD, Zhou C, Simon TD
Validation of a parent-reported hospital-to-home transition experience measure.
This study examined the validity of the Pediatric Transition Experience Measure (P-TEM), which is an 8-item, parent-reported measure that globally assesses hospital-to-home transition quality from discharge through follow-up compared to other validation measures. The other measures it was compared to included the 1) Child Hospital Consumer Assessment of Healthcare Providers and Systems Discharge Composite, 2) Center of Excellence on Quality of Care Measures for Children with Complex Needs parent-reported measures, 3) change in health-related quality of life from admission to postdischarge, and 4) 30-day emergency department revisits or readmissions. The P-TEM measure compared favorably with the Child Hospital Consumer Assessment of Healthcare Providers and Systems Discharge Composite measure and the other measures as well.
AHRQ-funded; HS024299.
Citation: Desai AD, Zhou C, Simon TD .
Validation of a parent-reported hospital-to-home transition experience measure.
Pediatrics 2020 Feb;145(2):pii: e20192150. doi: 10.1542/peds.2019-2150..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Children/Adolescents, Patient Experience, Transitions of Care, Hospital Discharge, Quality Improvement, Quality of Care, Quality Measures
Israel N, McMillen JC, Adams DR
Development of quality management capacity in child-serving nonprofit agencies.
In this study, the authors explored quality management capabilities and their development at nine different child serving agencies. Respondents described four emergent core quality management capabilities, although none of the nine agencies excelled at all four. The researchers discussed quality management capability and implications for research, policy, and practice.
AHRQ-funded; HS000084.
Citation: Israel N, McMillen JC, Adams DR .
Development of quality management capacity in child-serving nonprofit agencies.
Adm Policy Ment Health 2020 Jan;47(1):94-106. doi: 10.1007/s10488-019-00971-w..
Keywords: Children/Adolescents, Behavioral Health, Organizational Change, Quality Improvement, Quality of Care
Shaikh U, Nettiksimmons J, Joseph JG
Collaborative practice improvement for childhood obesity in rural clinics: the Healthy Eating Active Living Telehealth Community of Practice (HEALTH COP).
The authors assessed the impact of participation in a virtual quality improvement (QI) learning network on adherence to clinical guidelines for childhood obesity prevention in rural clinics. They found that children who received care from clinicians who led the implementation of the intervention at their clinic showed significant improvements in nutrition and physical activity. Virtual QI learning networks in geographically dispersed clinics can significantly increase clinicians' adherence to guidelines for childhood obesity and improve access to recommended care for rural and underserved children.
AHRQ-funded; HS018567.
Citation: Shaikh U, Nettiksimmons J, Joseph JG .
Collaborative practice improvement for childhood obesity in rural clinics: the Healthy Eating Active Living Telehealth Community of Practice (HEALTH COP).
Am J Med Qual 2014 Nov-Dec;29(6):467-75. doi: 10.1177/1062860613506252.
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Keywords: Children/Adolescents, Evidence-Based Practice, Health Information Technology (HIT), Lifestyle Changes, Nutrition, Obesity, Prevention, Quality Improvement, Rural Health, Telehealth
Shah RK, Stey AM, Jantana KR
Identification of opportunities for quality improvement and outcome measurement in pediatric otolaryngology.
This study evaluated perioperative outcomes in pediatric otolaryngology through analysis of records residing in the American College of Surgeons (ACS) National Surgical Quality Improvement Program (ACS-NSQIP) database. It found that although the overall rate of major postoperative morbidity in pediatric otolaryngology is low, the following areas may be targeted for targeted quality-improvement interventions: tracheostomy, airway reconstruction, mastoidectomy, and abscess drainage.
AHRQ-funded; HS022932
Citation: Shah RK, Stey AM, Jantana KR .
Identification of opportunities for quality improvement and outcome measurement in pediatric otolaryngology.
JAMA Otolaryngol Head Neck Surg. 2014 Nov;140(11):1019-26. doi: 10.1001/jamaoto.2014.2067..
Keywords: Surgery, Children/Adolescents, Quality Improvement, Outcomes, Patient-Centered Outcomes Research
Nakamura MM, Toomey SL, Zaslavsky AM
Measuring pediatric hospital readmission rates to drive quality improvement.
The investigators sought to describe the importance of readmissions in children and the challenges of developing readmission quality measures. They found that the policy focus on readmissions has motivated widespread efforts by hospitals and outpatient providers to evaluate and reengineer care processes.
AHRQ-funded; HS020513; HS020508.
Citation: Nakamura MM, Toomey SL, Zaslavsky AM .
Measuring pediatric hospital readmission rates to drive quality improvement.
Acad Pediatr 2014 Sep-Oct;14(5 Suppl):S39-46. doi: 10.1016/j.acap.2014.06.012.
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Keywords: Children/Adolescents, Quality Improvement, Quality Indicators (QIs), Quality Measures, Hospital Readmissions