National Healthcare Quality and Disparities Report
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Topics
- Access to Care (1)
- Adverse Events (4)
- Ambulatory Care and Surgery (2)
- Blood Clots (1)
- Blood Pressure (2)
- Cancer: Colorectal Cancer (1)
- Cardiovascular Conditions (3)
- Care Coordination (2)
- Care Management (1)
- Catheter-Associated Urinary Tract Infection (CAUTI) (2)
- Central Line-Associated Bloodstream Infections (CLABSI) (2)
- Children's Health Insurance Program (CHIP) (6)
- Children/Adolescents (12)
- Chronic Conditions (2)
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- Community-Based Practice (1)
- Comparative Effectiveness (3)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (4)
- Critical Care (7)
- Data (1)
- Diabetes (2)
- Diagnostic Safety and Quality (1)
- Disparities (1)
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- Education: Patient and Caregiver (3)
- Elderly (1)
- Electronic Health Records (EHRs) (5)
- Emergency Department (2)
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- Healthcare-Associated Infections (HAIs) (8)
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- Medication: Safety (1)
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- Nursing Homes (5)
- Organizational Change (2)
- Outcomes (4)
- Pain (1)
- Palliative Care (2)
- Patient-Centered Healthcare (3)
- Patient-Centered Outcomes Research (2)
- Patient and Family Engagement (1)
- Patient Experience (3)
- Patient Safety (18)
- Policy (3)
- Practice Improvement (1)
- Practice Patterns (1)
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- Primary Care (6)
- Primary Care: Models of Care (1)
- Provider: Health Personnel (1)
- Provider Performance (5)
- Public Health (1)
- Public Reporting (6)
- Quality Improvement (9)
- Quality Indicators (QIs) (5)
- Quality Measures (16)
- (-) Quality of Care (74)
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- Shared Decision Making (5)
- Surgery (6)
- TeamSTEPPS (1)
- Telehealth (2)
- Urinary Tract Infection (UTI) (2)
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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
51 to 74 of 74 Research Studies DisplayedCottrell EK, O'Brien K, Curry M
Understanding safety in prehospital emergency medical services for children.
This paper adds to the qualitative understanding of the nature of and contributors to safety events in the prehospital emergency care of children. The findings of this study suggest that factors at the systems, team, child/family, and individual provider level system contribute to errors in prehospital emergency care. These factors may be modifiable through interventions and systems improvements.
AHRQ-funded; HS019456.
Citation: Cottrell EK, O'Brien K, Curry M .
Understanding safety in prehospital emergency medical services for children.
Prehosp Emerg Care 2014 Jul-Sep;18(3):350-8. doi: 10.3109/10903127.2013.869640.
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Keywords: Care Management, Children/Adolescents, Emergency Medical Services (EMS), Quality of Care, Patient Safety
Arora VM, Berhie S, Horwitz LI
Using standardized videos to validate a measure of handoff quality: the handoff mini-clinical examination exercise.
The researchers report the results of the development of a shorter Handoff Mini-Clinical Examination Exercise (CEX), along with the formal establishment of its construct validity, namely its ability to distinguish between levels of performance in 3 domains of handoff quality. They were able to demonstrate evidence that the Handoff Mini-CEX can draw reliable and valid conclusions regarding handoff performance by physicians in U.S. hospitals.
AHRQ-funded; HS018278
Citation: Arora VM, Berhie S, Horwitz LI .
Using standardized videos to validate a measure of handoff quality: the handoff mini-clinical examination exercise.
J Hospital Med. 2014 Jul;9(7):441-6. doi: 10.1002/jhm.2185.
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Keywords: Provider Performance, Quality Measures, Quality Improvement, Quality of Care, Education: Continuing Medical Education, Patient Safety
Edelson DP, Yuen TC, Mancini ME
Hospital cardiac arrest resuscitation practice in the United States: a nationally representative survey.
The authors describe variance in in-hospital cardiac arrest (IHCA) resuscitation care among hospitals. Their survey of 100 hospitals found wide variability among hospitals and practices for resuscitation care in the U.S. with opportunities for improvement, for example, in training.
AHRQ-funded; HS020416
Citation: Edelson DP, Yuen TC, Mancini ME .
Hospital cardiac arrest resuscitation practice in the United States: a nationally representative survey.
J Hosp Med. 2014 Jun;9(6):353-7. doi: 10.1002/jhm.2174..
Keywords: Cardiovascular Conditions, Hospitalization, Quality of Care, Inpatient Care
Wang JJ, Winther CH, Cha J
Patient-centered medical home and quality measurement in small practices.
In this retrospective cohort study, the investigators sought to assess performance on quality measures among small primary care practices that recently adopted an electronic health record (EHR), and how performance differs between practices that have achieved patient-centered medical home (PCMH) recognition and those that have not. They found that among small practices that have adopted EHRs, practices with PCMH recognition consistently outperformed practices without recognition on 5 out of 7 clinical quality measures over the 2-year study period.
AHRQ-funded; HS019164.
Citation: Wang JJ, Winther CH, Cha J .
Patient-centered medical home and quality measurement in small practices.
Am J Manag Care 2014 Jun;20(6):481-9.
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Keywords: Electronic Health Records (EHRs), Quality of Care, Patient-Centered Healthcare, Primary Care, Quality Measures
Paddock SM
Statistical benchmarks for health care provider performance assessment: a comparison of standard approaches to a hierarchical Bayesian histogram-based method.
The author compares histogram-based statistical benchmarking to other more widely used statistical benchmarking methods to demonstrate whether and how their performance differs, both in terms of setting a performance benchmark and also in terms of which providers are identified as exceeding the performance benchmark. Her study uses publicly available data from 3,240 hospitals on two process-of-care measures.
AHRQ-funded; HS021860
Citation: Paddock SM .
Statistical benchmarks for health care provider performance assessment: a comparison of standard approaches to a hierarchical Bayesian histogram-based method.
Health Serv Res. 2014 Jun;49(3):1056-73. doi: 10.1111/1475-6773.12149..
Keywords: Quality of Care, Quality Measures, Provider Performance
Dixon BE, Vreeman DJ, Grannis SJ
The long road to semantic interoperability in support of public health: experiences from two states.
This article illustrates the current state of semantic interoperability using a case example drawn from public health and discusses three policy strategies for strengthening interoperability. It also presents recommendations for improving the use of clinical data and information for public health, including disease surveillance, community assessment and measurement of care quality.
AHRQ-funded; HS020909
Citation: Dixon BE, Vreeman DJ, Grannis SJ .
The long road to semantic interoperability in support of public health: experiences from two states.
J Biomed Inform. 2014 Jun;49:3-8. doi: 10.1016/j.jbi.2014.03.011..
Keywords: Public Health, Data, 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: Shared Decision Making, Critical Care, Quality of Care, Healthcare Costs
Longo DR, Woolf HS
Rethinking the information priorities of patients.
Efforts have intensified to provide consumers with online data tools and consumer reports that offer profiles and statistics for evaluating specialists, hospitals, and other clinical facilities. In this article, the authors examine two key questions: what should these resources look like and do patients really want them?
AHRQ-funded; HS021902
Citation: Longo DR, Woolf HS .
Rethinking the information priorities of patients.
JAMA. 2014 May 14;311(18):1857-8. doi: 10.1001/jama.2014.3038..
Keywords: Education: Patient and Caregiver, Shared Decision Making, Quality of Care, Health Information Technology (HIT), Web-Based
Hays RD, Berman LJ, Kanter MH
Evaluating the psychometric properties of the CAHPS Patient-Centered Medical Home survey.
This study surveyed Medicare beneficiaries to evaluate the reliability and validity of a new five-item care coordination measure. The composite score had a strong unique association with the CAHPS global rating of health care, after controlling for the CAHPS core composite scores.
AHRQ-funded; HS016980
Citation: Hays RD, Berman LJ, Kanter MH .
Evaluating the psychometric properties of the CAHPS Patient-Centered Medical Home survey.
Clin Ther. 2014 May;36(5):689-696.e1. doi: 10.1016/j.clinthera.2014.04.004..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Quality of Care, Medicare, Patient Experience, Patient-Centered Healthcare
Mutter R, Clancy C
AHRQ Author: Mutter R, Clancy C
Investing in emergency medicine to improve health care for all Americans: the role of the Agency for Healthcare Research and Quality.
This article provides a description of the portfolio of emergency care-related activities that AHRQ sponsors. The discussion includes these areas: conduct of research; tool development; quality indicators; data and analytic capacity; and training of young investigators.
AHRQ-authored.
Citation: Mutter R, Clancy C .
Investing in emergency medicine to improve health care for all Americans: the role of the Agency for Healthcare Research and Quality.
Ann Emerg Med 2014 May;63(5):580-3. doi: 10.1016/j.annemergmed.2013.06.021.
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Keywords: Emergency Department, Quality of Care, Health Services Research (HSR), Quality Improvement, TeamSTEPPS
Ant Ozok A, Wu H, Garrido M
Usability and perceived usefulness of personal health records for preventive health care: a case study focusing on patients' and primary care providers' perspectives.
The purpose of this study was to evaluate the usefulness of a specific patient-centered information technology (Personal Health Record) in improving awareness (for the patients) and compliance with (for both patients and providers) preventive care guidelines. The results were that patients found the tailored health recommendations useful and the PHR easy to understand and use.
AHRQ-funded; HS018762
Citation: Ant Ozok A, Wu H, Garrido M .
Usability and perceived usefulness of personal health records for preventive health care: a case study focusing on patients' and primary care providers' perspectives.
Appl Ergon. 2014 May;45(3):613-28. doi: 10.1016/j.apergo.2013.09.005..
Keywords: Electronic Health Records (EHRs), Quality of Care, Prevention, Primary Care, Web-Based
Leotsakos A, Zheng H, Croteau R
Standardization in patient safety: the WHO High 5s project.
This paper reports on a global safety initiative of the World Health Organization to facilitate development, implementation, and evaluation of Standard Operating Protocols (SOPs) within a global learning community. Thus far, 3 SOPs—correct surgery, medication reconciliation, concentrated injectable medicines—have been developed, implemented and evaluated in hospitals in 7 participating countries.
AHRQ-funded; 290201200006C
Citation: Leotsakos A, Zheng H, Croteau R .
Standardization in patient safety: the WHO High 5s project.
Int J Qual Health Care. 2014 Apr;26(2):109-16. doi: 10.1093/intqhc/mzu010..
Keywords: Patient Safety, Quality of Care, Surgery, Medication: Safety, Healthcare-Associated Infections (HAIs)
Weissman JS, López L, Schneider EC
The association of hospital quality ratings with adverse events.
The researchers used a survey of 2,582 patients hospitalized at 16 acute care Massachusetts hospitals to understand how patient-reported quality is related to adverse events (AEs). Although patients with AEs rated hospital quality lower than others, patients with AEs who experienced ‘service recovery’ rated their quality of care at levels similar to those not experiencing AEs.
AHRQ-funded
Citation: Weissman JS, López L, Schneider EC .
The association of hospital quality ratings with adverse events.
Int J Qual Health Care. 2014 Apr;26(2):129-35. doi: 10.1093/intqhc/mzt092..
Keywords: Adverse Events, Quality of Care, Hospitals, Patient Experience, Patient Safety, Quality Indicators (QIs), Quality Measures
Navar-Boggan AM, Fanaroff A, Swaminathan A
The impact of a measurement and feedback intervention on blood pressure control in ambulatory cardiology practice.
This study evaluated the impact of a targeted provider feedback intervention on rates of blood pressure control. Providers received quarterly provider-specific reports over a period of one year for a group of 300 patients treated in outpatient cardiology clinic practices. These reports as a stand-alone intervention did not affect overall BP control rates in cardiology clinics.
AHRQ-funded; HS021092
Citation: Navar-Boggan AM, Fanaroff A, Swaminathan A .
The impact of a measurement and feedback intervention on blood pressure control in ambulatory cardiology practice.
Am Heart J. 2014 Apr;167(4):466-71. doi: 10.1016/j.ahj.2013.12.015..
Keywords: Blood Pressure, Ambulatory Care and Surgery, Diabetes, Chronic Conditions, Quality Measures, Quality of Care
Arkin N, Lee PH, McDonald K
Association of Nurse-to-Patient Ratio with mortality and preventable complications following aortic valve replacement.
The purpose of this study was to examine hospital resources associated with patient outcomes for aortic valve replacement (AVR), including inpatient adverse events and mortality. The investigators found that the hospital volume-outcomes relationship was associated with mortality outcomes but not postoperative complications. They identified structural differences in hospital size, nurses-to-patient ratio, and nursing skill level indicative of high quality outcomes.
AHRQ-funded; HS018558.
Citation: Arkin N, Lee PH, McDonald K .
Association of Nurse-to-Patient Ratio with mortality and preventable complications following aortic valve replacement.
J Card Surg 2014 Mar;29(2):141-8. doi: 10.1111/jocs.12284..
Keywords: Adverse Events, Cardiovascular Conditions, Quality of Care, Mortality, Risk
Dougherty D, Chen X, Gray DT
AHRQ Author: Dougherty D, Gray DT
Child and adolescent health care quality and disparities: are we making progress?
The authors sought to examine trends over time in health care quality and disparities by race, Hispanic ethnicity, income, insurance, gender, rurality, and special health care needs. Using data from the 2011 National Healthcare Quality Report and Naitonal Healthcare Disparities Reprot, they found that there was some progress in health care quality and reducing disparities in children's health care quality from 2000 to 2009, but opportunities for targeting improvement strategies remain.
AHRQ-authored.
Citation: Dougherty D, Chen X, Gray DT .
Child and adolescent health care quality and disparities: are we making progress?
Acad Pediatr 2014 Mar-Apr;14(2):137-48. doi: 10.1016/j.acap.2013.11.008.
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Keywords: Children/Adolescents, Children's Health Insurance Program (CHIP), Disparities, Quality of Care
Battles JB, Farr SL, Weinberg DA
AHRQ Author: Battles JB
From research to nationwide implementation: the impact of AHRQ's HAI prevention program.
The authors sought to provide insight to AHRQ's healthcare-associated infection (HAI) prevention strategies by: first, discussing the context and structure of AHRQ's HAI research portfolio and funding decisions; secondly, describing the process of prevention practice implementation and lessons learned; and third, explaining the outcomes and national impact of the AHRQ program. Their paper described major contributions that have emerged from AHRQ-funded HAI projects.
AHRQ-authored.
Citation: Battles JB, Farr SL, Weinberg DA .
From research to nationwide implementation: the impact of AHRQ's HAI prevention program.
Med Care 2014 Feb;52(2 Suppl 1):S91-6. doi: 10.1097/mlr.0000000000000037.
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Keywords: Quality of Care, Healthcare-Associated Infections (HAIs), Quality Improvement, Patient Safety, Prevention
Blecker S, Agarwal SK, Chang PP
Quality of care for heart failure patients hospitalized for any cause.
This study sought to assess the quality of care for heart failure patients who are hospitalized for all causes. The investigators found that compared with individuals hospitalized with a principal diagnosis of heart failure, heart failure patients hospitalized for other causes were less likely to receive guideline recommended care.
AHRQ-funded; HS023683.
Citation: Blecker S, Agarwal SK, Chang PP .
Quality of care for heart failure patients hospitalized for any cause.
J Am Coll Cardiol 2014 Jan 21;63(2):123-30. doi: 10.1016/j.jacc.2013.08.1628..
Keywords: Cardiovascular Conditions, Heart Disease and Health, Hospitalization, Quality of Care
Kronick R, McKinney M
AHRQ Author: Kronick R
Ready to provide evidence for ‘making adjustments’ in Obamacare.
In this interview with Modern Healthcare, Richard Kronick, director of the Agency for Healthcare Research and Quality (AHRQ), states that his main objective for AHRQ is to produce evidence to improve the quality, safety, accessibility, and affordability of health care. He discusses several AHRQ programs and places them in the context of changes in the healthcare system triggered by Affordable Care Act.
AHRQ-authored
Citation: Kronick R, McKinney M .
Ready to provide evidence for ‘making adjustments’ in Obamacare.
Mod Healthc. 2014 Jan 6;44(1):28-9..
Keywords: Healthcare Costs, Quality of Care, Policy, Patient Safety
Arora VM, Reed DA, Fletcher KE
Building continuity in handovers with shorter residency duty hours.
The authors discuss how “continuity-enhanced handovers” differ from traditional handovers in several key aspects, including quality of information transferred, greater professional responsibility of senders and receivers, and a different philosophy of “coverage.” By reconceptualizing handover as a necessary bridge to continuity, and hence to safer patient care, this model of continuity-enhanced handovers has the potential to allay fears and improve patient care in an era of increasing fragmentation.
AHRQ-funded; HS018278.
Citation: Arora VM, Reed DA, Fletcher KE .
Building continuity in handovers with shorter residency duty hours.
BMC Med Educ 2014;14 Suppl 1:S16. doi: 10.1186/1472-6920-14-s1-s16..
Keywords: Quality of Care, Patient Safety, Care Coordination
Dimick JB, Birkmeyer NJ, Finks JF
Composite measures for profiling hospitals on bariatric surgery performance.
The study objective was to develop a novel composite measure for profiling hospital performance with bariatric surgery. Composite measures are much better at explaining hospital-level variation in serious complications and predicting future performance than other approaches. This study provides preliminary data that empirically weighted composite outcomes measures may be better than existing alternatives for selective referral and outcomes feedback programs.
AHRQ-funded; HS017765.
Citation: Dimick JB, Birkmeyer NJ, Finks JF .
Composite measures for profiling hospitals on bariatric surgery performance.
JAMA Surg 2014 Jan;149(1):10-6. doi: 10.1001/jamasurg.2013.4109..
Keywords: Adverse Events, Quality of Care, Hospitals
Kamal AH
Getting to proven: evaluating quality across all of palliative care.
In this letter, Kamal calls for the development of quality measures for palliative care, paying attention to procedures, multidisciplinary team members who perform multidomain assessments, the new settings of care where quality measurement should be tailored, and the care models that transition across generalist and specialist palliative care.
AHRQ-funded; HS022763.
Citation: Kamal AH .
Getting to proven: evaluating quality across all of palliative care.
J Pain Symptom Manage 2014 Jan;47(1):e1-2. doi: 10.1016/j.jpainsymman.2013.09.007.
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Keywords: Quality of Care, Health Services Research (HSR), Palliative Care, Quality Measures, Quality Measures
Kachalia A, Little A, Isavoran M
Greatest impact of safe harbor rule may be to improve patient safety, not reduce liability claims paid by physicians.
The Oregon Health Authority analyzed the potential for safe harbors to improve patient safety and the performance of the medical liability system, as well as legal challenges and stakeholder concerns that might arise with legislation enacting safe harbors. They found that such legislation would have changed the liability outcome in favor of the physician defendant in only 1 percent of 266 claims from the period 2002–09 that were reviewed.
AHRQ-funded; HS019535.
Citation: Kachalia A, Little A, Isavoran M .
Greatest impact of safe harbor rule may be to improve patient safety, not reduce liability claims paid by physicians.
Health Aff 2014 Jan;33(1):59-66. doi: 10.1377/hlthaff.2013.0834..
Keywords: Patient Safety, Medical Liability, Medical Errors, Quality of Care, Policy
Rangachari P, Madaio M, Rethemeyer RK
Role of communication content and frequency in enabling evidence-based practices.
The study sought to promote central line bundle (CLB) implementation in a medical ICU and a pediatric ICU through periodic quality improvement (QI) interventions over a 52-week period. It found that proactive communications increased by 68 percent in the MICU and 61 percent in the PICU. During the same timeframe, both units increased CLB adherence to 100 percent. Both units also demonstrated statistically significant declines in catheter days.
AHRQ-funded; HS019785.
Citation: Rangachari P, Madaio M, Rethemeyer RK .
Role of communication content and frequency in enabling evidence-based practices.
Qual Manag Health Care 2014 Jan-Mar;23(1):43-58. doi: 10.1097/qmh.0000000000000017..
Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Communication, Evidence-Based Practice, Guidelines, Healthcare-Associated Infections (HAIs), Intensive Care Unit (ICU), Quality of Care, Quality Improvement