National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Blood Clots (1)
- Children/Adolescents (1)
- Clinical Decision Support (CDS) (1)
- Diabetes (1)
- Diagnostic Safety and Quality (1)
- Electronic Health Records (EHRs) (2)
- Emergency Department (2)
- Evidence-Based Practice (1)
- Healthcare-Associated Infections (HAIs) (1)
- Healthcare Costs (1)
- Healthcare Delivery (1)
- Health Information Technology (HIT) (2)
- Hospital Readmissions (1)
- Hospitals (3)
- Medicare (2)
- Outcomes (1)
- Patient-Centered Outcomes Research (1)
- Patient Safety (4)
- Payment (2)
- Practice Patterns (1)
- Prevention (2)
- (-) Provider Performance (14)
- Public Reporting (1)
- (-) Quality Improvement (14)
- Quality Indicators (QIs) (3)
- Quality Measures (2)
- Quality of Care (11)
- Respiratory Conditions (1)
- Stroke (1)
- Surgery (1)
- Teams (1)
- Training (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 14 of 14 Research Studies DisplayedGriffey RT, Schneider RM, Sharp BR
Description and yield of current quality and safety review in selected US academic emergency departments.
This study examined the impact of current quality and safety reviews used in US academic emergency departments (EDs). The authors hypothesized that current protocols are decades old and inefficient with low yield for identifying patient harm. They conducted a prospective observational study at five academic EDs for a 12-month procedure. Sites used the Institute for Healthcare Improvement’s definition in defining an adverse event and a modified National Coordinating Council for Medication Error Reporting and Prevention (MERP) Index for severity grading of events. They reviewed a total of 4735 cases and identified 381 events, of which 287 were near-misses, and 94 had adverse events (AEs). The overall AE rate was 1.99% (1.24-3.47%) across all sites. Quality concern rate (events without harms) was 6.06% (5.42-6.78%). Forty-seven percent of cases used 72 hour returns as their referral source but with only a 0.81% yield in identifying harm. Other referral sources also had similar low yields. External referrals in the 94 AE cases accounted for 41.49% of cases. The authors concluded that new approaches to quality and safety review in the ED are needed to optimize yield and efficiency for identifying harms and areas for improvement.
AHRQ-funded; HS025052.
Citation: Griffey RT, Schneider RM, Sharp BR .
Description and yield of current quality and safety review in selected US academic emergency departments.
J Patient Saf 2020 Dec;16(4):e245-e49. doi: 10.1097/pts.0000000000000379..
Keywords: Emergency Department, Patient Safety, Quality Improvement, Quality of Care, Provider Performance
Robbins j, McAlearney AS
Toward a high-performance management system in health care, part 5: how high-performance work practices facilitate speaking up in health care organizations.
Employees' reluctance to speak up about problems and/or make suggestions for improvement is a noted barrier to quality and patient safety improvement in health care organizations. High-performance work practices (HPWPs) offer a framework for considering how management practices can encourage speaking up in these organizations. In this study, the investigators aimed to explore how implementation of HPWPs in U.S. health care organizations could facilitate or remove barriers to speaking up.
AHRQ-funded; 290200600022.
Citation: Robbins j, McAlearney AS .
Toward a high-performance management system in health care, part 5: how high-performance work practices facilitate speaking up in health care organizations.
Health Care Manage Rev 2020 Oct/Dec;45(4):278-89. doi: 10.1097/hmr.0000000000000228..
Keywords: Quality Improvement, Quality of Care, Patient Safety, Provider Performance
Costar DM, Hall KK
Improving team performance and patient safety on the job through team training and performance support tools: a systematic review.
This systematic review’s objective was to identify recent studies that implemented practices to improve teamwork in health care and were associated with positive improvements on the job. Two databases were searched to identify relevant articles published between 2008 and 2018. Twenty articles were selected for inclusion. Across studies, measures assessing teamwork skills on the job were most often collected and sustained improvements were shown for up to 12 months. Evidence of improved clinical practices and increased patient safety was found in both studies team training interventions, as well as those that introduced performance support tools. All studies were conducted in hospitals with very few studies found in other health care settings such as office-based care.
AHRQ-funded; HHSP233201500013I.
Citation: Costar DM, Hall KK .
Improving team performance and patient safety on the job through team training and performance support tools: a systematic review.
J Patient Saf 2020 Sep;16(3S Suppl 1):S48-s56. doi: 10.1097/pts.0000000000000746..
Keywords: Teams, Patient Safety, Training, Patient Safety, Provider Performance, Quality Improvement, Quality of Care
Colton K, Richards CT, Pruitt PB
Early stroke recognition and time-based emergency care performance metrics for intracerebral hemorrhage.
This study compared time for early stroke recognition for intracerebral hemorrhage for hospitals with and without stroke teams. An observational cohort study was conducted at an urban comprehensive stroke center from 2009 to 2017 with 204 cases included. Stroke team activation resulted in faster emergency care compared to no activation. This process resulted in shorter onset-to-arrival times, higher NIH Stroke Scale scores, and higher Glasgow Coma Scale scores.
AHRQ-funded; HS023437.
Citation: Colton K, Richards CT, Pruitt PB .
Early stroke recognition and time-based emergency care performance metrics for intracerebral hemorrhage.
J Stroke Cerebrovasc Dis 2020 Feb;29(2):104552. doi: 10.1016/j.jstrokecerebrovasdis.2019.104552..
Keywords: Stroke, Emergency Department, Provider Performance, Diagnostic Safety and Quality, Quality Improvement, Quality Indicators (QIs), Patient-Centered Outcomes Research, Outcomes, Quality of Care, Evidence-Based Practice, Hospitals
Dowding D, Merrill J, Russell D
Using feedback intervention theory to guide clinical dashboard design.
The provision of feedback to clinicians and organizations on the quality of care they provide is thought to influence clinician and organizational behavior leading to care improvements. Clinical Dashboards use data visualization techniques to provide feedback to individuals on their performance compared to quality metrics. In this paper the authors outline a theoretical approach to the design of a clinical dashboard; Feedback Intervention Theory (FIT).
AHRQ-funded; HS023855.
Citation: Dowding D, Merrill J, Russell D .
Using feedback intervention theory to guide clinical dashboard design.
AMIA Annu Symp Proc 2018 Dec 5;2018:395-403..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Provider Performance, Quality of Care, Quality Improvement
Kaiser SV, Lam R, Joseph GB
Limitations of using pediatric respiratory illness readmissions to compare hospital performance.
Researcher sought to determine if a National Quality Forum (NQF)-endorsed measure for pediatric lower respiratory illness (LRI) 30-day readmission rates can meaningfully identify high- and low-performing hospitals. Subjects were children with LRI (bronchiolitis, influenza, or pneumonia as primary diagnosis, or with an LRI as a secondary diagnosis with a primary diagnosis of respiratory failure, sepsis, bacteremia, or asthma) from all hospital admissions in California from 2012 to 2014. The researchers were unable to identify meaningful variation in hospital performance without broadening the metric definition and merging multiple years of data. They recommend that utilizers of pediatric-quality measures consider modifying metrics to better evaluate the quality of pediatric care at low-volume hospitals.
AHRQ-funded; HS024385; HS022835; HS024592; HS025297.
Citation: Kaiser SV, Lam R, Joseph GB .
Limitations of using pediatric respiratory illness readmissions to compare hospital performance.
J Hosp Med 2018 Nov;13(11):737-42. doi: 10.12788/jhm.2988..
Keywords: Children/Adolescents, Respiratory Conditions, Provider Performance, Hospital Readmissions, Hospitals, Quality Indicators (QIs), Quality Measures, Quality of Care, Quality Improvement
Fraze TK, Lewis VA, Tierney E
Quality of care improves for patients with diabetes in Medicare shared savings accountable care organizations: organizational characteristics associated with performance.
This study analyzed secondary data retrospectively to examine Medicare Shared Savings Program (MSSP) Accountable Care Organizations’ performance on diabetes metrics in the first 2 years of ACO contracts in order to determine how ACO organizational characteristics - such as composition, staffing, care management, and experiences with health reform - were associated with quality of care delivered to patients with diabetes.
AHRQ-funded; HS024075.
Citation: Fraze TK, Lewis VA, Tierney E .
Quality of care improves for patients with diabetes in Medicare shared savings accountable care organizations: organizational characteristics associated with performance.
Popul Health Manag 2018 Oct;21(5):401-08. doi: 10.1089/pop.2017.0102..
Keywords: Diabetes, Quality of Care, Medicare, Provider Performance, Quality Improvement
Quinn CM, Bilimoria KY, Chung JW
Creating individual surgeon performance assessments in a statewide hospital surgical quality improvement collaborative.
In this study, the investigators sought to create surgeon-level comparative assessments within the Illinois Surgical Quality Improvement Collaborative. The investigators found that few individual surgeon performance outliers could be detected in NSQIP clinical registry data for a statewide hospital collaborative over a 30-month period using postoperative patient outcomes. The authors suggest that low surgeon-specific case volumes and minimal variance between surgeons may limit the utility of American College of Surgeons NSQIP outcomes measures for individual profiling.
AHRQ-funded; HS024516.
Citation: Quinn CM, Bilimoria KY, Chung JW .
Creating individual surgeon performance assessments in a statewide hospital surgical quality improvement collaborative.
J Am Coll Surg 2018 Sep;227(3):303-12.e3. doi: 10.1016/j.jamcollsurg.2018.06.002..
Keywords: Quality of Care, Provider Performance, Quality Improvement, Surgery
Dowding D, Merrill JA
The development of heuristics for evaluation of dashboard visualizations.
Heuristic evaluation is used in human-computer interaction studies to assess the usability of information systems. This article develops a heuristic evaluation checklist that can be used to evaluate systems that produce information visualizations. The authors suggest that a checklist of usability heuristics for evaluating information visualization systems can contribute to assuring high quality in electronic data systems developed for health care.
AHRQ-funded; HS023855.
Citation: Dowding D, Merrill JA .
The development of heuristics for evaluation of dashboard visualizations.
Appl Clin Inform 2018 Jul;9(3):511-18. doi: 10.1055/s-0038-1666842..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Provider Performance, Quality of Care, Quality Improvement
Bowen ME, Bhat D, Fish J
Improving performance on preventive health quality measures using clinical decision support to capture care done elsewhere and patient exceptions.
This before-after study was conducted to examine the ability of clinical decision support (CDS) to improve performance on preventive quality measures, capture clinician-reported services completed elsewhere, and patient/medical exceptions and to describe their impact on quality measurement.
AHRQ-funded; HS022418.
Citation: Bowen ME, Bhat D, Fish J .
Improving performance on preventive health quality measures using clinical decision support to capture care done elsewhere and patient exceptions.
Am J Med Qual 2018 May/Jun;33(3):237-45. doi: 10.1177/1062860617732830..
Keywords: Clinical Decision Support (CDS), Prevention, Provider Performance, Quality Improvement, Quality Measures, Quality Measures
Catchpole K, Neyens DM, Abernathy J
Framework for direct observation of performance and safety in healthcare.
This viewpoint paper discusses non-participant direct observation of healthcare processes as a rich method for understanding safety and performance improvement. The authors suggest that as a prospective method for error prediction and modelling, observation can capture a broad range of performance issues that can be related to higher aspects of the system.
AHRQ-funded; HS024380.
Citation: Catchpole K, Neyens DM, Abernathy J .
Framework for direct observation of performance and safety in healthcare.
BMJ Qual Saf 2017 Dec;26(12):1015-21. doi: 10.1136/bmjqs-2016-006407..
Keywords: Healthcare Delivery, Patient Safety, Provider Performance, Quality Improvement
Paddock SM, Damberg CL, Yanagihara D
What role does efficiency play in understanding the relationship between cost and quality in physician organizations?
Previous studies demonstrate overuse of a narrow set of services, suggesting provider inefficiency, but existing studies neither quantify inefficiency more broadly nor assess its variation across physician organizations (POs). This study found that POs had substantial variation in efficiency, producing widely differing levels of quality for the same cost.
AHRQ-funded; HS021860.
Citation: Paddock SM, Damberg CL, Yanagihara D .
What role does efficiency play in understanding the relationship between cost and quality in physician organizations?
Med Care 2017 Dec;55(12):1039-45. doi: 10.1097/mlr.0000000000000823.
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Keywords: Practice Patterns, Healthcare Costs, Quality of Care, Quality Improvement, Payment, Provider Performance
Lau BD, Haut ER, Hobson DB
ICD-9 code-based venous thromboembolism performance targets fail to measure up.
Suboptimal prevention practices have prompted payers to consider hospital-associated Venous thromboembolism (VTE) as a potentially preventable condition for which financial incentives or penalties exist to drive practice improvement. The authors reviewed a subset of hospital-associated VTE that were identified by ICD-9 codes used by a state-run pay-for-performance quality improvement program and discuss their findings.
AHRQ-funded; HS017952.
Citation: Lau BD, Haut ER, Hobson DB .
ICD-9 code-based venous thromboembolism performance targets fail to measure up.
Am J Med Qual 2016 Sep;31(5):448-53. doi: 10.1177/1062860615583547.
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Keywords: Healthcare-Associated Infections (HAIs), Quality Indicators (QIs), Prevention, Hospitals, Quality Improvement, Blood Clots, Payment, Provider Performance
Coulam R, Kralewski J, Dowd B
The role of medical group practice administrators in the adoption and implementation of Medicare's physician quality reporting system.
The purpose of this study was to gain insights into the role these administrators play in quality assurance programs. It found that administrators conducted due diligence on Medicare's physician quality reporting system, influenced how the issue was presented to physicians for adoption, and managed implementation thereafter. Administrators' recommendations were heavily influenced by practice characteristics, financial incentives, and practice commitments to early adoption of quality improvement innovations.
AHRQ-funded; HS019964.
Citation: Coulam R, Kralewski J, Dowd B .
The role of medical group practice administrators in the adoption and implementation of Medicare's physician quality reporting system.
Health Care Manage Rev 2016 Apr-Jun;41(2):145-54. doi: 10.1097/hmr.0000000000000061.
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Keywords: Medicare, Provider Performance, Quality Improvement, Quality of Care, Public Reporting