National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (1)
- Adverse Events (4)
- (-) Ambulatory Care and Surgery (15)
- Antibiotics (1)
- Antimicrobial Stewardship (1)
- Cancer (1)
- Children/Adolescents (1)
- Clinical Decision Support (CDS) (2)
- Communication (1)
- Diagnostic Safety and Quality (2)
- Education: Patient and Caregiver (2)
- Electronic Health Records (EHRs) (4)
- Healthcare-Associated Infections (HAIs) (2)
- Health Information Technology (HIT) (4)
- Hospitals (1)
- Injuries and Wounds (1)
- Medical Errors (1)
- Opioids (1)
- Organizational Change (1)
- Patient and Family Engagement (1)
- (-) Patient Safety (15)
- Payment (1)
- Prevention (1)
- Primary Care: Models of Care (1)
- Provider (1)
- Provider: Clinician (1)
- Provider: Health Personnel (1)
- Provider Performance (1)
- Quality Improvement (3)
- Quality Indicators (QIs) (1)
- Quality of Care (2)
- Risk (1)
- Rural/Inner-City Residents (1)
- Shared Decision Making (1)
- Surgery (3)
- Urban Health (1)
- Vulnerable Populations (1)
- Workflow (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 15 of 15 Research Studies DisplayedAncker JS, Stabile C, Carter J
Informing, reassuring, or alarming? Balancing patient needs in the development of a postsurgical symptom reporting system in cancer.
After ambulatory surgeries, patients who recover at home have multiple questions about wound healing, symptoms and medication side effects, and recovery expectations. In this study, the investigators conducted user testing and rapid application development of a symptom reporting system that supports home-based recovery by inviting patients to self-report symptoms in the days after surgery and receive an immediate feedback report giving context for their reported symptoms.
AHRQ-funded; HS021531.
Citation: Ancker JS, Stabile C, Carter J .
Informing, reassuring, or alarming? Balancing patient needs in the development of a postsurgical symptom reporting system in cancer.
AMIA Annu Symp Proc 2018 Dec 5;2018:166-74..
Keywords: Adverse Events, Ambulatory Care and Surgery, Cancer, Education: Patient and Caregiver, Health Information Technology (HIT), Patient Safety, Surgery
Khoong EC, Cherian R, Rivadeneira NA
Accurate measurement In California's safety-net health systems has gaps and barriers.
The purpose of this study was to measure California’s pay-for-performance program in safety-net hospitals. Results showed both suboptimal performance in aspects of ambulatory safety and questionable reliability in data reporting. Health care systems that lack seamlessly integrated electronic health records and patient registries encountered barriers to reporting reliable ambulatory safety data, precluding accurate performance measurement in many areas. The authors recommended that policymakers and safety advocates support the development of information systems and measures that facilitate the accurate ascertainment of the health systems, patients, and clinical tasks at greatest risk for ambulatory safety failures.
AHRQ-funded; HS024412; HS024426.
Citation: Khoong EC, Cherian R, Rivadeneira NA .
Accurate measurement In California's safety-net health systems has gaps and barriers.
Health Aff 2018 Nov;37(11):1760-69. doi: 10.1377/hlthaff.2018.0709..
Keywords: Ambulatory Care and Surgery, Electronic Health Records (EHRs), Health Information Technology (HIT), Patient Safety, Provider Performance, Quality Indicators (QIs), Payment
Karavite DJ, Miller MW, Ramos MJ
User testing an information foraging tool for ambulatory surgical site infection surveillance.
Surveillance for surgical site infections (SSIs) after ambulatory surgery in children requires a detailed manual chart review to assess criteria defined by the National Health and Safety Network. Electronic health records (EHRs) impose an inefficient search process. Using text mining and business intelligence software, the authors developed an information foraging application, the SSI Workbench, to visually present which postsurgical encounters included SSI-related terms and synonyms, antibiotic, and culture orders. This study compares the Workbench and EHR.
AHRQ-funded; HS020921.
Citation: Karavite DJ, Miller MW, Ramos MJ .
User testing an information foraging tool for ambulatory surgical site infection surveillance.
Appl Clin Inform 2018 Oct;9(4):791-802. doi: 10.1055/s-0038-1675179..
Keywords: Surgery, Ambulatory Care and Surgery, Children/Adolescents, Electronic Health Records (EHRs), Health Information Technology (HIT), Healthcare-Associated Infections (HAIs), Patient Safety
Grundmeier RW, Xiao R, Ross RK
Grundmeier RW, Xiao R, Ross RK, Ramos MJ, Karavite DJ, Michel JJ, Gerber JS, et al. Identifying surgical site infections in electronic health data using predictive models,.
The objective of this study was to prospectively derive and validate a prediction rule for detecting cases warranting investigation for surgical site infections (SSI) after ambulatory surgery. The investigators concluded that electronic health record data can facilitate SSI surveillance with adequate sensitivity and positive predictive value.
AHRQ-funded; HS020921.
Citation: Grundmeier RW, Xiao R, Ross RK .
Grundmeier RW, Xiao R, Ross RK, Ramos MJ, Karavite DJ, Michel JJ, Gerber JS, et al. Identifying surgical site infections in electronic health data using predictive models,.
J Am Med Inform Assoc 2018 Sep;25(9):1160-66. doi: 10.1093/jamia/ocy075..
Keywords: Healthcare-Associated Infections (HAIs), Injuries and Wounds, Surgery, Electronic Health Records (EHRs), Health Information Technology (HIT), Risk, Patient Safety, Adverse Events, Ambulatory Care and Surgery
Ricciardi R, Shofer M
AHRQ Author: Ricciardi R, Shofer M.
Moving patient safety into ambulatory settings and beyond.
This paper discusses patient safety across various clinical settings, the importance of patient and family engagement, and innovations in patient safety such as the Patient Safety Learning Laboratories.
AHRQ-authored.
Citation: Ricciardi R, Shofer M .
Moving patient safety into ambulatory settings and beyond.
J Nurs Care Qual 2018 Jul/Sep;33(3):195-99. doi: 10.1097/ncq.0000000000000329.
Keywords: Ambulatory Care and Surgery, Patient and Family Engagement, Patient Safety
Keller SC, Tamma PD, Cosgrove SE
AHRQ Author: Miller MA
Ambulatory antibiotic stewardship through a human factors engineering approach: a systematic review.
The authors conducted a systematic review to identify controlled interventions and qualitative studies of ambulatory antibiotic stewardship (AS) interventions and determine whether and how they incorporated principles from a human factors engineering model, the Systems Engineering Initiative for Patient Safety 2.0 model. They concluded that studies have not focused on clinic-wide approaches to AS.
AHRQ-authored; AHRQ-funded; 233201500020I.
Citation: Keller SC, Tamma PD, Cosgrove SE .
Ambulatory antibiotic stewardship through a human factors engineering approach: a systematic review.
J Am Board Fam Med 2018 May-Jun;31(3):417-30. doi: 10.3122/jabfm.2018.03.170225.
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Keywords: Antibiotics, Clinical Decision Support (CDS), Primary Care: Models of Care, Ambulatory Care and Surgery, Patient Safety
Aldina S, Goldhaber-Fiebert SN, Hannenberg AA
Factors associated with the use of cognitive aids in operating room crises: a cross-sectional study of US hospitals and ambulatory surgical centers.
This study examined organizational context and implementation process factors influencing the use of cognitive aids for OR crises. It found that small facility size was associated with a fourfold increase in the odds of a facility reporting more successful implementation. Completing more implementation steps was also significantly associated with more successful implementation.
AHRQ-funded; HS024235.
Citation: Aldina S, Goldhaber-Fiebert SN, Hannenberg AA .
Factors associated with the use of cognitive aids in operating room crises: a cross-sectional study of US hospitals and ambulatory surgical centers.
Implement Sci 2018 Mar 26;13(1):50. doi: 10.1186/s13012-018-0739-4.
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Keywords: Adverse Events, Ambulatory Care and Surgery, Patient Safety, Quality Improvement, Quality of Care, Hospitals, Shared Decision Making, Clinical Decision Support (CDS)
Sarkar U, McDonald K, Motala A
Pragmatic insights on patient safety priorities and intervention strategies in ambulatory settings.
In this article, the investigators (1) reviewed the methods and results for the key informant input process for a Technical Brief on ambulatory safety commissioned by the Agency for Healthcare Research and Quality (AHRQ), (2) summarized the key informant perspectives on ambulatory safety, (3) expanded on key informant input with specific recommendations for an ambulatory safety agenda, (4) reported on existing initiatives and progress related to key informant perspectives and our recommendations, and (5) proposed specific research and policy activities that would advance ambulatory safety.
AHRQ-funded; 290201500010I.
Citation: Sarkar U, McDonald K, Motala A .
Pragmatic insights on patient safety priorities and intervention strategies in ambulatory settings.
Jt Comm J Qual Patient Saf 2017 Dec;43(12):661-70. doi: 10.1016/j.jcjq.2017.06.009..
Keywords: Ambulatory Care and Surgery, Patient Safety, Quality of Care
Clarity C, Sarkar U, Lee J
Clinician perspectives on the management of abnormal subcritical tests in an urban academic safety-net health care system.
Missed or delayed follow-up of abnormal subcritical tests (tests that do not require immediate medical attention) can lead to poor patient outcomes. Safety-net health systems with limited resources and socially complex patients are vulnerable to safety gaps resulting from delayed management. In this study, clinician perspectives to identify system challenges, vulnerable situations, and potential solutions, were sought in focus groups.
AHRQ-funded; HS023558.
Citation: Clarity C, Sarkar U, Lee J .
Clinician perspectives on the management of abnormal subcritical tests in an urban academic safety-net health care system.
Jt Comm J Qual Patient Saf 2017 Oct;43(10):517-23. doi: 10.1016/j.jcjq.2017.05.007..
Keywords: Urban Health, Rural/Inner-City Residents, Diagnostic Safety and Quality, Patient Safety, Vulnerable Populations, Ambulatory Care and Surgery, Communication, Provider: Clinician
Arnold S
AHRQ Author: Arnold S
The imperative to address diagnostic safety.
Diagnostic errors are likely to impact most of us in our lifetime. The author discusses two studies pointing to the vastness of the challenge and the urgency to act now. He also discusses other aspects of this issue and highlights two current AHRQ dedicated research opportunities on diagnostic safety: one to look at the incidence and causes of diagnostic errors in ambulatory care, and the second to look at improvement strategies and interventions.
AHRQ-authored.
Citation: Arnold S .
The imperative to address diagnostic safety.
Diagnosis 2017 Jun 27;4(2):55-56. doi: 10.1515/dx-2017-0017.
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Keywords: Diagnostic Safety and Quality, Medical Errors, Ambulatory Care and Surgery, Patient Safety, Quality Improvement
McDonald KM, Su G, Lisker S
Implementation science for ambulatory care safety: a novel method to develop context-sensitive interventions to reduce quality gaps in monitoring high-risk patients.
The researchers aimed to demonstrate a novel method to identify common vulnerabilities across clinics and generate attributes for context-flexible population-level monitoring solutions for widespread implementation to improve quality. Using a National Academies framework and context-sensitivity theory, they identified common systems vulnerabilities and developed preliminary concepts for improving the robustness for monitoring patients with high-risk conditions ("design seeds" for potential solutions).
AHRQ-funded; HS023558.
Citation: McDonald KM, Su G, Lisker S .
Implementation science for ambulatory care safety: a novel method to develop context-sensitive interventions to reduce quality gaps in monitoring high-risk patients.
Implement Sci 2017 Jun 24;12(1):79. doi: 10.1186/s13012-017-0609-5.
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Keywords: Ambulatory Care and Surgery, Patient Safety, Quality Improvement
Hanauer DA, Branford GL, Greenberg G
Two-year longitudinal assessment of physicians' perceptions after replacement of a longstanding homegrown electronic health record: does a J-curve of satisfaction really exist?
This report describes a 2-year prospective, longitudinal survey of attending physicians in 3 clinical areas (family medicine, general pediatrics, internal medicine) who experienced a transition from a homegrown electronic health record (EHR) to a vendor EHR. The primary goal was to determine if perceptions followed a J-curve pattern in which they initially dropped but eventually surpassed baseline measures. A J-curve was not found for any measures, including workflow, safety, communication, and satisfaction.
AHRQ-funded; HS023613.
Citation: Hanauer DA, Branford GL, Greenberg G .
Two-year longitudinal assessment of physicians' perceptions after replacement of a longstanding homegrown electronic health record: does a J-curve of satisfaction really exist?
J Am Med Inform Assoc 2017 Apr 1;24(e1):e157-e65. doi: 10.1093/jamia/ocw077.
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Keywords: Electronic Health Records (EHRs), Provider: Health Personnel, Ambulatory Care and Surgery, Patient Safety, Workflow
Ducoffe AR, York A, Hu DJ
AHRQ Author: Perfetto D
National action plan for adverse drug event prevention: recommendations for safer outpatient opioid use.
This article focuses on recommendations from the Adverse Drug Events (ADE) Action Plan to help guide safer opioid use in healthcare delivery settings. Its aim is to discuss current federal methods in place to prevent opioid ADEs while also providing evidence to encourage providers and hospitals to innovate new systems and practices to increase prevention.
AHRQ-authored.
Citation: Ducoffe AR, York A, Hu DJ .
National action plan for adverse drug event prevention: recommendations for safer outpatient opioid use.
Pain Med 2016 Dec;17(12):2291-304. doi: 10.1093/pm/pnw106.
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Keywords: Prevention, Opioids, Patient Safety, Ambulatory Care and Surgery, Adverse Drug Events (ADE)
Hickner J, Smith SA, Yount N
Differing perceptions of safety culture across job roles in the ambulatory setting: analysis of the AHRQ Medical Office Survey on Patient Safety Culture.
This study examines differences in patient safety culture perceptions among providers, management and staff in a large national survey of safety culture in ambulatory practices in the USA. Its findings suggest that managers need to pay attention to the training needs of office staff, since this was an area with one of the greatest gaps in perceptions. In addition, both office managers and physicians need to encourage more open communication.
AHRQ-funded; 290200710024C.
Citation: Hickner J, Smith SA, Yount N .
Differing perceptions of safety culture across job roles in the ambulatory setting: analysis of the AHRQ Medical Office Survey on Patient Safety Culture.
BMJ Qual Saf 2016 Aug;25(8):588-94. doi: 10.1136/bmjqs-2014-003914.
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Keywords: Ambulatory Care and Surgery, Organizational Change, Patient Safety, Provider
Keller SC, Gurses AP, Abaje AI
Learning from the patient: Human factors engineering in outpatient parenteral antimicrobial therapy.
When used in hospital settings, many of the complex devices adapted for use in outpatient parenteral antimicrobial therapy (OPAT) can lead to errors that may lead to patient harm. To reduce complications from OPAT in the home, such as catheter-associated venous thromboembolism, adverse drug events, or other side effects of OPAT, the authors argue that we need to understand how OPAT is performed by patients and their caregivers and the ways in which human factors engineering can contribute to their reduction.
AHRQ-funded; HS022916.
Citation: Keller SC, Gurses AP, Abaje AI .
Learning from the patient: Human factors engineering in outpatient parenteral antimicrobial therapy.
Am J Infect Control 2016 Jul;44(7):758-60. doi: 10.1016/j.ajic.2016.01.010.
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Keywords: Adverse Events, Antimicrobial Stewardship, Education: Patient and Caregiver, Ambulatory Care and Surgery, Patient Safety