National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Children/Adolescents (2)
- Communication (1)
- Comparative Effectiveness (2)
- (-) Critical Care (11)
- Decision Making (2)
- Healthcare Costs (2)
- Hospital Discharge (1)
- Hospitalization (1)
- Inpatient Care (1)
- Intensive Care Unit (ICU) (5)
- Patient Safety (5)
- Primary Care (1)
- Provider Performance (1)
- Quality Improvement (3)
- (-) Quality of Care (11)
- Registries (1)
- Sepsis (1)
- Simulation (2)
- Surgery (2)
- Telehealth (2)
- Transitions of Care (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 11 of 11 Research Studies DisplayedChilakamarri P, Finn EB, Sather J
Failure mode and effect analysis: engineering safer neurocritical care transitions.
Investigators presented failure mode and effect analysis (FMEA) as a systems-engineering methodology to be applied to neurocritical care transitions to reduce failures in communication and improve patient safety. They described their local implementation of FMEA to improve the safety of inter-hospital transfer for patients with intracerebral and subarachnoid hemorrhage as evidence of success. They found that application of the FMEA approach yielded meaningful and sustained process change for patients with neurocritical care needs.
AHRQ-funded; HS023554.
Citation: Chilakamarri P, Finn EB, Sather J .
Failure mode and effect analysis: engineering safer neurocritical care transitions.
Neurocrit Care 2021 Aug;35(1):232-40. doi: 10.1007/s12028-020-01160-6..
Keywords: Patient Safety, Transitions of Care, Critical Care, Communication, Quality Improvement, Quality of Care
Murray DJ, Boulet JR, Boyle WA
Competence in decision making: setting performance standards for critical care.
Health care professionals must be able to make frequent and timely decisions that can alter the illness trajectory of intensive care patients. A competence standard for this ability is difficult to establish yet assuring practitioners can make appropriate judgments is an important step in advancing patient safety. In this study, the investigators hypothesized that simulation could be used effectively to assess decision-making competence.
AHRQ-funded; HS022265.
Citation: Murray DJ, Boulet JR, Boyle WA .
Competence in decision making: setting performance standards for critical care.
Anesth Analg 2021 Jul 1;133(1):142-50. doi: 10.1213/ane.0000000000005053..
Keywords: Critical Care, Decision Making, Intensive Care Unit (ICU), Simulation, Provider Performance, Patient Safety, Quality of Care
Colman N, Newman JW, Nishisaki A
Translational simulation improves compliance with the NEAR4KIDS Airway Safety Bundle in a single-center PICU.
This single-center retrospective review discusses a translational simulation conducted to improve compliance with the National Emergency Airway Registry for Children (NEAR4KIDS) Airway Safety Quality Improvement (QI) bundle to improve the safety of tracheal intubations. The simulation was implemented between March and December 2018. Bundle adherence was assessed 12 months before simulation and 9 months after. Primary outcomes measures were compliance with the bundle and utilization of apneic oxygenation and secondary outcomes was the occurrence of adverse tracheal intubation-associated events. Preintervention bundle compliance was 66%, which increased to 93.7% after the simulation intervention. Adherence to apneic oxygenation was 27.9% before the intervention and increased to 77.9% after. There was no difference in the occurrence of tracheal intubation events.
AHRQ-funded; HS024511.
Citation: Colman N, Newman JW, Nishisaki A .
Translational simulation improves compliance with the NEAR4KIDS Airway Safety Bundle in a single-center PICU.
Pediatr Qual Saf 2021 May-Jun;6(3):e409. doi: 10.1097/pq9.0000000000000409..
Keywords: Children/Adolescents, Intensive Care Unit (ICU), Critical Care, Registries, Simulation, Patient Safety, Quality Improvement, Quality of Care
Nishisaki A, Lee A, Li S
Sustained improvement in tracheal intubation safety across a 15-center quality-improvement collaborative: an interventional study from the national emergency airway registry for children investigators.
The authors sought to evaluate the effect of a tracheal intubation safety bundle on adverse tracheal intubation-associated events across 15 PICUs. The safety bundle included a quarterly site benchmark performance reports and an airway safety checklist consisting of preprocedure risk factor, approach, and role planning, preprocedure bedside "time-out," and immediate postprocedure debriefing. The authors found that effective implementation of a quality-improvement bundle was associated with a decrease in the adverse tracheal intubation-associated event that was sustained for 24 months.
AHRQ-funded; HS021583; HS022464; HS024511.
Citation: Nishisaki A, Lee A, Li S .
Sustained improvement in tracheal intubation safety across a 15-center quality-improvement collaborative: an interventional study from the national emergency airway registry for children investigators.
Crit Care Med 2021 Feb;49(2):250-60. doi: 10.1097/ccm.0000000000004725..
Keywords: Children/Adolescents, Intensive Care Unit (ICU), Critical Care, Patient Safety, Quality Improvement, Quality of Care
Berner ES, Burkhardt JH, Panjamapirom A
Cost implications of human and automated follow-up in ambulatory care.
This study tracked costs associated with using nurse-initiated telephone calls or interactive voice response (IVR) over the first two years of followup for a practice assumed to have 4800 acute care patient visits per year. For the first two years, costs were approximately the same but, in subsequent years, IVR followup is approximately $9000 per year less expensive than nurse followup.
AHRQ-funded; HS017060
Citation: Berner ES, Burkhardt JH, Panjamapirom A .
Cost implications of human and automated follow-up in ambulatory care.
Am J Manag Care. 2014 Nov;20(11 Spec No. 17):SP531-40..
Keywords: Healthcare Costs, Primary Care, Quality of Care, Critical Care
Cooke CR, Iwashyna TJ
Sepsis mandates: improving inpatient care while advancing quality improvement.
In light of improvements in the care of the acutely ill hospitalized patients and changes in the epidemiology of hospital care, the authors recommend new quality mandates focused on sepsis. These mandates should: (1) address the reality that sepsis is frequently underdiagnosed, (2) focus on catalyzing and aggregating local efforts for quality improvements, and (3) plan for a phased implementation, improving measures in select sites prior to national roll-out.
AHRQ-funded; HS020672
Citation: Cooke CR, Iwashyna TJ .
Sepsis mandates: improving inpatient care while advancing quality improvement.
JAMA. 2014 Oct 8;312(14):1397-8. doi: 10.1001/jama.2014.11350..
Keywords: Quality of Care, Hospitalization, Inpatient Care, Critical Care, Sepsis
Ramnath VR, Khazeni N
Centralized monitoring and virtual consultant models of tele-ICU care: a side-by-side review.
This side-by-side review directly compares the Centralized Monitoring and Virtual Consultant tele-ICU Models. The Centralized Monitoring tele-ICU Model showed improved mortality and/or length of stay and staff acceptance, particularly in rural or specific patient populations, but with high costs and unclear savings. The Virtual Consultant Model could not be adequately evaluated for effects on clinical outcomes or staff acceptance given minimal data; however, it can be both portable and implemented at a lower cost profile. Improved compliance with clinical practice guidelines was seen in both models. Further study is recommended.
AHRQ-funded; HS019816.
Citation: Ramnath VR, Khazeni N .
Centralized monitoring and virtual consultant models of tele-ICU care: a side-by-side review.
Telemed J E Health 2014 Oct;20(10):962-71. doi: 10.1089/tmj.2014.0024.
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Keywords: Critical Care, Comparative Effectiveness, Quality of Care, Intensive Care Unit (ICU), Telehealth
Ramnath VR, Ho L, Maggio LA
Centralized monitoring and virtual consultant models of tele-ICU care: a systematic review.
This systematic literature review compares the Centralized Monitoring and Virtual Consultant tele-ICU Models. Compared with the Virtual Consultant tele-ICU Model, studies addressing the Centralized Monitoring Model of tele-ICU care were greater in quantity and sample size, with qualitative conclusions of clinical outcomes, staff satisfaction and workload, and financial sustainability largely consistent with past systematic reviews.
AHRQ-funded; HS019816.
Citation: Ramnath VR, Ho L, Maggio LA .
Centralized monitoring and virtual consultant models of tele-ICU care: a systematic review.
Telemed J E Health 2014 Oct;20(10):936-61. doi: 10.1089/tmj.2013.0352.
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Keywords: Critical Care, Comparative Effectiveness, Quality of Care, Intensive Care Unit (ICU), Telehealth
Drake FT, Mottey NE, Farrokhi ET
Time to appendectomy and risk of perforation in acute appendicitis.
This study sought to determine whether there is an association between time and perforation after acute appendicitis patients arrive at the hospital. Using data on 7,505 patients treated at 52 hospitals, they found that there was no association between perforation and in-hospital time prior to surgery among adults treated with appendectomy.
AHRQ-funded; SCOAP-CERTAIN
Citation: Drake FT, Mottey NE, Farrokhi ET .
Time to appendectomy and risk of perforation in acute appendicitis.
JAMA Surg. 2014 Aug;149(8):837-44. doi: 10.1001/jamasurg.2014.77..
Keywords: Surgery, Quality of Care, Patient Safety, Critical Care
Gadzinski AJ, Dimick JB, Ye Z
Transfer rates and use of post-acute care after surgery at critical access vs non-critical access hospitals.
This study evaluated discharge practice patterns and use of post-acute care after surgical admissions at critical access hospitals (CAHs). It found that for each of six common surgical procedures, a greater proportion of patients was transferred to another hospital. However, the proportion of patients at CAHs using post-acute care is equal to or less than that of patients treated in non-CAHs.
AHRQ-funded; HS018346
Citation: Gadzinski AJ, Dimick JB, Ye Z .
Transfer rates and use of post-acute care after surgery at critical access vs non-critical access hospitals.
JAMA Surg. 2014 Jul;149(7):671-7. doi: 10.1001/jamasurg.2013.5694..
Keywords: Surgery, Critical Care, Hospital Discharge, Quality of Care
Admon AJ, Cooke CR
Will Choosing Wisely(R) improve quality and lower costs of care for patients with critical illness?
This article reports on a campaign by the American Board of Internal Medicine to improve care and lower costs by generating a “top five” list of expensive tests or treatments without known benefits. It offers several strategies for stakeholders to increase the impact of the critical care top-five list.
AHRQ-funded; HS020672
Citation: Admon AJ, Cooke CR .
Will Choosing Wisely(R) improve quality and lower costs of care for patients with critical illness?
Ann Am Thorac Soc. 2014 Jun;11(5):823-7. doi: 10.1513/AnnalsATS.201403-093OI..
Keywords: Decision Making, Critical Care, Quality of Care, Healthcare Costs