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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 5 of 5 Research Studies DisplayedBlike GT, Perreard IM, McGovern KM
A pragmatic method for measuring inpatient complications and complication-specific mortality.
This study’s objective was to develop hospital-level metrics of major complications associated with mortality that allows for the identification of opportunities for improvement and to improve upon current metrics for failure to rescue (i.e., death from serious but treatable complications.). The authors used AHRQ metrics as the basis for identifying specific complications related to major organ system morbidity associated with death. Using component ICD, 10th Revision codes, complication-specific occurrence rates, observed mortality, and risk-adjusted mortality indices were calculated for the study institution and 182 peer organizations. Statistically significant differences in the study hospital occurrence rates and associated mortality rates compared with peer institutions were shown with the complication-specific method. Use of a monthly control-chart presentation of these metrics provides assessment of hospital-level interventions to prevent complications and/or reduce failure to rescue deaths.
AHRQ-funded; HS024403.
Citation: Blike GT, Perreard IM, McGovern KM .
A pragmatic method for measuring inpatient complications and complication-specific mortality.
J Patient Saf 2022 Oct 1;18(7):659-66. doi: 10.1097/pts.0000000000000984..
Keywords: Inpatient Care, Adverse Events, Patient Safety
Halvorson EE, Thurtle DP, Easter A
Disparities in adverse event reporting for hospitalized children.
The authors compared the adverse event (AE) rate identified by voluntary event reporting (VER) with that identified using the Global Assessment of Pediatric Patient Safety (GAPPS) between hospitalized children by weight category, race, and English proficiency. In the population studied, they identified 288 total AEs, 270 by the GAPPS and 18 by VER. They found a disparity in AE reporting for children with limited English proficiency, with fewer AEs by VER compared with no difference in AEs by GAPPS. They identified no disparities by weight category or race. They concluded that voluntary event reporting may systematically underreport AEs in hospitalized children with limited English proficiency.
AHRQ-funded; HS026038.
Citation: Halvorson EE, Thurtle DP, Easter A .
Disparities in adverse event reporting for hospitalized children.
J Patient Saf 2022 Sep 1;18(6):e928-e33. doi: 10.1097/pts.0000000000001049..
Keywords: Children/Adolescents, Disparities, Adverse Events, Medical Errors, Patient Safety, Hospitals, Hospitalization, Inpatient Care
Mercer AN, Mauskar S, Baird J
Family safety reporting in hospitalized children with medical complexity.
This prospective cohort study was conducted to evaluate safety concerns from families of hospitalized children with medical complexity (CMC) who are at high risk of medical errors. This survey was done predischarge with English- and Spanish-speaking parents/staff of hospitalized CMC on 5 units caring for complex care patients at a tertiary care children's hospital. A total of 155 parents and 214 staff completed surveys, with 43% (n = 66) having ≥1 hospital safety concerns, totaling 115 concerns (1-6 concerns each). A physician review found that 69% of concerns were medical errors, and 22% nonsafety-related quality issues. Most parents (68%) reported concerns to staff, particularly bedside nurses, but only 32% of parents recalled being told how to report safety concerns. Higher education and longer length of stay were associated with family safety concerns.
AHRQ-funded; HS025781.
Citation: Mercer AN, Mauskar S, Baird J .
Family safety reporting in hospitalized children with medical complexity.
Pediatrics 2022 Aug 1; 150(2):e2021055098. doi: 10.1542/peds.2021-055098..
Keywords: Children/Adolescents, Family Health and History, Chronic Conditions, Patient Safety, Medical Errors, Adverse Events, Inpatient Care
Eldridge N, Wang Y, Metersky M
AHRQ Author: Eldridge N, Perdue-Puli J, Brady PJ, Grace E, Rodrick D
Trends in adverse event rates in hospitalized patients, 2010-2019.
This AHRQ-authored serial cross-sectional study’s objective was to determine the change in the rate of adverse events in hospitalized patients from 2010 to 2019. The study used data from the Medicare Patient Safety Monitoring System and included 244,542 adult patients hospitalized in 3156 acute care hospitals across 4 condition groups: acute myocardial infarction (17%), heart failure (17%) pneumonia (21%), major surgical procedures (22%), and all other conditions (22%). Information on adverse events collected included 21 measures across 4 adverse event domains: adverse drug events, hospital-acquired infections, adverse events after a procedure, and general adverse events such as pressure ulcers and falls. The study sample included 190,286 hospital discharges in the combined 4 condition-based groups and 54,256 hospital discharges for all other conditions. From 2010 to 2019, the total change for adverse events per 1000 discharges for acute myocardial infarction decreased from 218 to 139, from 168 to 116 for heart failure, from 195 to 119 for pneumonia, and from 204 to 130 for major surgical procedures. The rate for all other conditions remained unchanged at 70 adverse events per 1000 discharges.
AHRQ-authored; AHRQ-funded; 290201800005C.
Citation: Eldridge N, Wang Y, Metersky M .
Trends in adverse event rates in hospitalized patients, 2010-2019.
JAMA 2022 Jul 12;328(2):173-83. doi: 10.1001/jama.2022.9600..
Keywords: Adverse Events, Patient Safety, Hospitals, Inpatient Care
Khan A, Baird J, Kelly MM
Family safety reporting in medically complex children: parent, staff, and leader perspectives.
This qualitative study examined parent, staff, and hospital leader perspectives about family safety reporting in children with medical complexity (CMC) to inform future interventions. The study was conducted at 2 tertiary care children’s hospitals with dedicated inpatient complex care services. Hour-long semi-structured, individual interviews were conducted with English and Spanish-speaking parents of CMC, physicians, nurses, and hospital leaders. A total of 80 participants (34 parents, 19 nurses and allied health professionals, 11 physicians, and 16 hospital leaders) were interviewed. Four themes related to family safety reporting emerged: (1) unclear, nontransparent, and variable existing processes, (2) a continuum of staff and leadership buy-in, (3) a family decision-making calculus about whether to report, and (4) misaligned staff and parent priorities and expectations. The authors also identified potential strategies for engaging families and staff in family reporting.
AHRQ-funded; HS025781.
Citation: Khan A, Baird J, Kelly MM .
Family safety reporting in medically complex children: parent, staff, and leader perspectives.
Pediatrics 2022 Jun; 149(6). doi: 10.1542/peds.2021-053913..
Keywords: Children/Adolescents, Family Health and History, Chronic Conditions, Provider: Physician, Patient Safety, Medical Errors, Adverse Events, Inpatient Care