National Healthcare Quality and Disparities Report
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Topics
- Adverse Events (7)
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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 75 of 103 Research Studies DisplayedLarsen GY, Brilli R, Macias CG
Development of a quality improvement learning collaborative to improve pediatric sepsis outcomes.
Researchers developed a multicenter quality improvement learning collaborative of US children's hospitals. They created a key driver diagram (KDD) with the aim of reducing both the sepsis-attributable mortality and the incidence of hospital-onset sepsis in children. The KDD primary drivers focused on improving the following: treatment of infection; recognition, diagnosis, and treatment of sepsis; de-escalation of unnecessary care; engagement of patients and families; and methods to optimize performance. The Children's Hospital Association Improving Pediatric Sepsis Outcomes collaborative aims to improve sepsis outcomes through collaborative learning and reliable implementation of evidence-based interventions.
AHRQ-funded; HS025696.
Citation: Larsen GY, Brilli R, Macias CG .
Development of a quality improvement learning collaborative to improve pediatric sepsis outcomes.
Pediatrics 2021 Jan;147(1). doi: 10.1542/peds.2020-1434..
Keywords: Children/Adolescents, Sepsis, Outcomes, Quality Improvement, Quality of Care, Education: Continuing Medical Education
Soylu TG, Cuellar AE, Goldberg DG
Engagement of small to medium-sized primary care practices in quality improvement efforts.
Engaging primary care practices in quality improvement (QI) efforts has been challenging. This study examined the association between practice readiness and practice characteristics and engagement during a targeted QI effort. The study analyzed cross-sectional data collected by the Heart of Virginia Health care, a cardiovascular disease QI intervention study with 195 practices. The investigators concluded that clinicians and leadership involvement in QI efforts was critical. They indicated that the findings suggested QI plans should involve clinicians and leaders early in the process to foster commitment, establish practice readiness, and sustain improvement efforts.
AHRQ-funded; HS023913.
Citation: Soylu TG, Cuellar AE, Goldberg DG .
Engagement of small to medium-sized primary care practices in quality improvement efforts.
J Am Board Fam Med 2021 Jan-Feb;34(1):40-48. doi: 10.3122/jabfm.2021.01.200153..
Keywords: Primary Care, Quality Improvement, Quality of Care, Provider
Hanlon JT, Perera S, Schweon S
Improvements in antibiotic appropriateness for cystitis in older nursing home residents: a quality improvement study with randomized assignment.
This study evaluated the impact of an educational quality improvement initiative on the appropriateness of antibiotic prescribing restricted to uncomplicated cystitis in older noncatheterized nursing home residents. This 1-year case-control study used 25 participating nursing homes that were randomized to the intervention or usual care group by strata that included state, urban/rural status, bed size, and geographic separation. A total of 75 cases of cystitis were found in the intervention groups and 92 in the control groups. The intervention group had a nonsignificant 21% reduction in the risk of antibiotic prescribing. There was a favorable comparison in appropriateness of duration. However, the intervention group had more problems with drug-drug interactions than the control group (8% vs 1%). There were also more problems with dosage in the intervention group. Both groups had similar rates of problems with choice or effectiveness (44% vs 45%). The most common antibiotic class that was prescribed inappropriately was quinolones.
AHRQ-funded; R18 HS023779.
Citation: Hanlon JT, Perera S, Schweon S .
Improvements in antibiotic appropriateness for cystitis in older nursing home residents: a quality improvement study with randomized assignment.
J Am Med Dir Assoc 2021 Jan;22(1):173-77. doi: 10.1016/j.jamda.2020.07.040..
Keywords: Elderly, Nursing Homes, Long-Term Care, Antibiotics, Medication, Quality Improvement, Quality of Care, Urinary Tract Infection (UTI), Shared Decision Making
Quigley DD, McCleskey SG
Improving care experiences for patients and caregivers at end of life: a systematic review.
End-of-life care is increasing as the US population ages. Approaches to providing high-quality end-of-life care vary across setting, diseases, and populations. Several data collection tools measure patient and/or caregiver care experiences at end of life and can be used for quality improvement. Previous reviews examined palliative care improvements or available measures but none explicitly on improving care experiences. In this study, the researchers reviewed literature on improving patient and/or caregiver end-of-life care experiences.
AHRQ-funded; HS025920.
Citation: Quigley DD, McCleskey SG .
Improving care experiences for patients and caregivers at end of life: a systematic review.
Am J Hosp Palliat Care 2021 Jan;38(1):84-93. doi: 10.1177/1049909120931468..
Keywords: Palliative Care, Caregiving, Patient Experience, Quality Improvement, Quality of Care
Marshall TL, Ipsaro AJ, Le M
Increasing physician reporting of diagnostic learning opportunities.
This study investigated methods to improve physician reporting of diagnostic errors at the pediatric division of a hospital. In that pediatric hospital medicine (PHM) division only 1 diagnostic-related safety event was reported in the preceding 4 years. The authors aimed to improve attending physician reporting of suspected diagnostic errors from 0 to 2 per 100 PHM patient admissions within 6 months. The improvement team used the Model for Improvement and used the term diagnostic learning opportunity (DLO) with clinicians as opposed to diagnostic error to lessen the stigma. They developed an electronic reporting form and encouraged its use through reminders, scheduled reflection time, and monthly progress reports. Over the course of 13 weeks, there was an increase from 0 to 1.6 per patient admission reports files. Most events (66%) were true diagnostic errors.
AHRQ-funded; HS023827.
Citation: Marshall TL, Ipsaro AJ, Le M .
Increasing physician reporting of diagnostic learning opportunities.
Pediatrics 2021 Jan;147(1). doi: 10.1542/peds.2019-2400..
Keywords: Children/Adolescents, Diagnostic Safety and Quality, Medical Errors, Adverse Events, Patient Safety, Hospitals, Quality Improvement, Quality of Care
Gaughan AA, Walker DM, DePuccio MJ
Rewarding and recognizing frontline staff for success in infection prevention.
This article discusses how managers can use reward and recognition programs as motivational tools to sustain frontline healthcare-associated infection (HAI) prevention. Data from interviews with hospital managers and frontline staff at 18 US hospitals were used to identify these tools.
AHRQ-funded; HS024958.
Citation: Gaughan AA, Walker DM, DePuccio MJ .
Rewarding and recognizing frontline staff for success in infection prevention.
Am J Infect Control 2021 Jan;49(1):123-25. doi: 10.1016/j.ajic.2020.06.208..
Keywords: Healthcare-Associated Infections (HAIs), Infectious Diseases, Prevention, Quality Improvement, Quality of Care
Russo E, Sittig DF, Murphy DR
Challenges in patient safety improvement research in the era of electronic health records.
The researchers used a case study involving a project on missed or delayed follow-up of test results to discuss real-world challenges in using electronic health records data for patient safety research. They suggested that many current data access and security policies and procedures must be rewritten and standardized across health care organization sin order to advance progress toward safer health care.
AHRQ-funded; HS022901.
Citation: Russo E, Sittig DF, Murphy DR .
Challenges in patient safety improvement research in the era of electronic health records.
Healthc 2016 Dec;4(4):285-90. doi: 10.1016/j.hjdsi.2016.06.005.
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Keywords: Electronic Health Records (EHRs), Health Services Research (HSR), Health Information Technology (HIT), Patient Safety, Quality Improvement
Burstein PD, Zalenski DM, Edwards JL
Changing labor and delivery practice: focus on achieving practice and documentation standardization with the goal of improving neonatal outcomes.
The researchers established a multifactorial shoulder dystocia response and management protocol to promote sustainable practice change. In the first year, there was a threefold increase in shoulder dystocia reporting, which continued in years 2 and 3. In the first year, 96 percent of clinicians completed all training elements. Overall teams reached a 99 percent adoption rate of the shoulder dystocia protocol.
AHRQ-funded; HS019608.
Citation: Burstein PD, Zalenski DM, Edwards JL .
Changing labor and delivery practice: focus on achieving practice and documentation standardization with the goal of improving neonatal outcomes.
Health Serv Res 2016 Dec;51 Suppl 3:2472-86. doi: 10.1111/1475-6773.12589.
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Keywords: Labor and Delivery, Newborns/Infants, Adverse Events, Quality Improvement, Quality of Care, Patient Safety, Patient-Centered Outcomes Research, Outcomes, Guidelines, Evidence-Based Practice, Pregnancy, Teams
Wandling MW, Minami CA, Johnson JK
Development of a conceptual model for surgical quality improvement collaboratives: facilitating the implementation and evaluation of collaborative quality improvement.
The authors sought to create a conceptual model of a surgical quality improvement (QI) collaborative to facilitate the development, implementation, and systematic evaluation of the Illinois Surgical Quality Improvement Collaborative (ISQIC). Their conceptual model has facilitated the ongoing evaluation of ISQIC and can be similarly used by others.
AHRQ-funded; HS024516; HS000078.
Citation: Wandling MW, Minami CA, Johnson JK .
Development of a conceptual model for surgical quality improvement collaboratives: facilitating the implementation and evaluation of collaborative quality improvement.
JAMA Surg 2016 Dec;151(12):1181-83. doi: 10.1001/jamasurg.2016.2817.
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Keywords: Quality Improvement, Surgery
Nuckols TK, Keeler E, Morton SC
Economic evaluation of quality improvement interventions for bloodstream infections related to central catheters: a systematic review.
The authors systematically reviewed economic evaluations of QI interventions designed to prevent central-line-associated bloodstream infections (CLABSI) and catheter-related bloodstream infections (CRBSI) in acute care hospitals. They concluded that interventions related to central venous catheters were, on average, associated with 57% fewer bloodstream infections and substantial savings to hospitals. Larger initial investments may be associated with greater savings.
AHRQ-funded.
Citation: Nuckols TK, Keeler E, Morton SC .
Economic evaluation of quality improvement interventions for bloodstream infections related to central catheters: a systematic review.
JAMA Intern Med 2016 Dec;176(12):1843-54. doi: 10.1001/jamainternmed.2016.6610.
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Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Healthcare Costs, Quality Improvement
Yazdany J, Bansback N, Clowse M
Rheumatology informatics system for effectiveness: a national informatics-enabled registry for quality improvement.
The authors reported on the Rheumatology Informatics System for Effectiveness (RISE) registry's architecture and initial data and demonstrated how RISE is being used to improve care quality. They concluded that RISE provides critical infrastructure for improving care quality in rheumatology and is a unique data source to generate new knowledge.
AHRQ-funded; HS024412.
Citation: Yazdany J, Bansback N, Clowse M .
Rheumatology informatics system for effectiveness: a national informatics-enabled registry for quality improvement.
Arthritis Care Res 2016 Dec;68(12):1866-73. doi: 10.1002/acr.23089.
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Keywords: Quality of Care, Health Information Technology (HIT), Quality Improvement, Registries, Arthritis
Beckman MG, Abe K, Barnes K
AHRQ Author: Brady PJ
Strategies and partnerships toward prevention of healthcare-associated venous thromboembolism.
This issue of the Journal of Hospital Medicine showcases the initiatives of several of the CDC’s healthcare-associated venous thromboembolism (HA-VTE) prevention champions. The CDC and AHRQ are partnering to disseminate and promote these best practices. In addition to this challenge, the CDC, AHRQ and the Joint Commission Center for Transforming Healthcare are working on activities and programs dedicated to improving prevention of HA-VTE. They are summarized in the article.
AHRQ-authored.
Citation: Beckman MG, Abe K, Barnes K .
Strategies and partnerships toward prevention of healthcare-associated venous thromboembolism.
J Hosp Med 2016 Dec;11 Suppl 2:S5-s7. doi: 10.1002/jhm.2659.
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Keywords: Prevention, Blood Clots, Quality Improvement, Guidelines, Adverse Events
Adams DR, Flores A, Coltri A
A missed opportunity to improve patient satisfaction? Patient perceptions of inpatient communication with their primary care physician.
Patient satisfaction could be driven by patient perception of hospital team communication with their primary care physician (PCP). A retrospective mixed methods approach was used to characterize the relationship between patient satisfaction and patient perception of hospital team-PCP communication.
AHRQ-funded; HS010597l; HS016967.
Citation: Adams DR, Flores A, Coltri A .
A missed opportunity to improve patient satisfaction? Patient perceptions of inpatient communication with their primary care physician.
Am J Med Qual 2016 Nov;31(6):568-76. doi: 10.1177/1062860615593339..
Keywords: Care Coordination, Hospitals, Patient Experience, Primary Care, Quality Improvement
Jensen RE, Snyder CF, Basch E
All together now: findings from a PCORI workshop to align patient-reported outcomes in the electronic health record.
The goal of this paper was to report key findings from a 2013 Patient-Centered Outcomes Research Institute workshop on patient-reported outcomes, to report a summary of actions that followed from the workshop, and to present resulting recommendations that address patient, clinical and research/quality improvement barriers to regular use.
AHRQ-funded; HS000029.
Citation: Jensen RE, Snyder CF, Basch E .
All together now: findings from a PCORI workshop to align patient-reported outcomes in the electronic health record.
J Comp Eff Res 2016 Nov;5(6):561-67. doi: 10.2217/cer-2016-0026.
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Keywords: Comparative Effectiveness, Electronic Health Records (EHRs), Evidence-Based Practice, Patient-Centered Outcomes Research, Quality Improvement
Bishai D, Sherry M, Pereira CC
Development and usefulness of a district health systems tool for performance improvement in essential public health functions in Botswana and Mozambique.
This study describes the development of a self-audit tool for public health and the associated methodology for implementing a district health system self-audit tool that can provide quantitative data on how district governments perceive their performance of the essential public health functions. It found that instant feedback from the audit was a feature that 100 percent of pilot respondents found most useful.
AHRQ-funded; HS000029.
Citation: Bishai D, Sherry M, Pereira CC .
Development and usefulness of a district health systems tool for performance improvement in essential public health functions in Botswana and Mozambique.
J Public Health Manag Pract 2016 Nov-Dec;22(6):586-96. doi: 10.1097/phh.0000000000000407.
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Keywords: Health Systems, Public Health, Quality Improvement
Bilimoria KY, Barnard C
The new CMS Hospital Quality Star Ratings: the stars are not aligned.
This viewpoint paper discussed the Overall Hospital Quality Star Ratings, released by the Centers for Medicare and Medicaid Services, including issues concerning stakeholders. The authors recommended continuing vigorous work to improve the availability of meaningful measures. They concluded that current hospital rating systems do not provide comprehensive, relevant, accessible information, and current composites may mislead patients, payers, and hospitals; however, opportunities to provide meaningful hospital quality report cards are within reach.
AHRQ-funded; HS021857; HS024516.
Citation: Bilimoria KY, Barnard C .
The new CMS Hospital Quality Star Ratings: the stars are not aligned.
JAMA 2016 Nov 1;316(17):1761-62. doi: 10.1001/jama.2016.13679.
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Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Quality of Care, Hospitals, Quality Improvement, Quality Measures
Parchman ML, Fagnan LJ, Dorr DA
Study protocol for "Healthy Hearts Northwest": a 2 x 2 randomized factorial trial to build quality improvement capacity in primary care.
The researchers describe the protocol of the "Healthy Hearts Northwest" (H2N) study, a randomized trial designed to address to quality improvement (QI) capacity within smaller primary care practices while improving risk factors for cardiovascular disease. The study is utilizing a two-by-two factorial design to assess four different combinations of practice support: practice facilitation (PF) alone, PF with educational outreach, PF with shared learning opportunities, or PF with both.
AHRQ-funded; HS023908.
Citation: Parchman ML, Fagnan LJ, Dorr DA .
Study protocol for "Healthy Hearts Northwest": a 2 x 2 randomized factorial trial to build quality improvement capacity in primary care.
Implement Sci 2016 Oct 13;11(1):138.
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Keywords: Primary Care, Evidence-Based Practice, Quality Improvement, Patient-Centered Outcomes Research, Cardiovascular Conditions
Bishop TF, Ryan AM, Chen MA
A randomized, controlled trial of a shared panel management program for small practices.
This study’s objective was to determine whether a shared panel management program was effective at improving quality of care for patients with uncontrolled chronic disease. It found that a shared, low-intensity panel management program run by a city health department did not improve quality of care for patients with chronic illnesses and lapses in care.
AHRQ-funded; HS018546; HS018275.
Citation: Bishop TF, Ryan AM, Chen MA .
A randomized, controlled trial of a shared panel management program for small practices.
Health Serv Res 2016 Oct;51(5):1796-813. doi: 10.1111/1475-6773.12455.
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Keywords: Chronic Conditions, Quality Improvement, Quality of Care, Health Information Technology (HIT)
Friedberg MW, Rodriguez HP, Martsolf GR
Measuring workplace climate in community clinics and health centers.
The authors assessed the psychometric properties of a survey instrument combining items from several existing surveys of workplace climate and generated a shorter instrument for future use. They concluded that survey instruments designed to measure workplace climate have substantial overlap, and the set they identified might help target and tailor clinics' quality improvement efforts.
AHRQ-funded; HS020120.
Citation: Friedberg MW, Rodriguez HP, Martsolf GR .
Measuring workplace climate in community clinics and health centers.
Med Care 2016 Oct;54(10):944-9. doi: 10.1097/mlr.0000000000000585.
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Keywords: Community-Based Practice, Provider, Organizational Change, Quality Improvement, Quality of Care, Practice Improvement
Brady J
AHRQ Author: Brady, J.
Why we study disparities: the human stories behind the data.
AHRQ’s Quality and Disparities Report demonstrates that great progress has been made in improving quality in the last decade—but the persistence of disparities means that this progress is uneven. The next step in improving quality should be to focus on disparities in quality as a way to drive improvement more efficiently.
AHRQ-authored.
Citation: Brady J .
Why we study disparities: the human stories behind the data.
J Nurs Care Qual 2016 Jul-Sep;31(3):197-200. doi: 10.1097/ncq.0000000000000188.
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Keywords: Disparities, Quality of Care, Quality Improvement
Diehl A, Yang T, Speck K
AHRQ Author: Battles J
Evaluating the accuracy of sampling strategies for estimation of compliance rate for ventilator-associated pneumonia process measures.
The researchers evaluated the accuracy of sampling strategies to estimate monthly compliance rates with ventilator-associated pneumonia prevention measures. They concluded that sampling process measures intermittently rather than continually can yield accurate estimates of process measure performance rates.
AHRQ-authored; AHRQ-funded; 290201000027I; 29032002T.
Citation: Diehl A, Yang T, Speck K .
Evaluating the accuracy of sampling strategies for estimation of compliance rate for ventilator-associated pneumonia process measures.
Infect Control Hosp Epidemiol 2016 Sep;37(9):1037-43. doi: 10.1017/ice.2016.136.
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Keywords: Comprehensive Unit-based Safety Program (CUSP), Healthcare-Associated Infections (HAIs), Pneumonia, Quality Improvement, Quality Measures
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
Farrow NE, Lau BD, JohnBull EA
Is the meaningful use venous thromboembolism VTE-6 measure meaningful? A retrospective analysis of one hospital's VTE-6 cases.
The researchers assessed the validity of the Meaningful Use VTE-6 measure by reviewing the quality of venous thromboembolism (VTE) prophylaxis provided to patients. Sixty percent of the patients identified as having sustained potentially preventable VTE were false positives. For the remaining forty percent, VTE was considered to be truly potentially preventable and those patients therefore provided targets for quality improvement measures.
AHRQ-funded; HS017952.
Citation: Farrow NE, Lau BD, JohnBull EA .
Is the meaningful use venous thromboembolism VTE-6 measure meaningful? A retrospective analysis of one hospital's VTE-6 cases.
Jt Comm J Qual Patient Saf 2016 Sep;42(9):410-6.
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Keywords: Blood Clots, Quality Improvement, Quality Measures, Quality Measures, Electronic Health Records (EHRs)
Abrahamson K, Davila H, Rehkamp N
Is there a business case for nursing home quality improvement?
The objective of this study was to investigate the economic or business perspective surrounding QI participation by exploring nursing home leader perceptions regarding market-based motivations for improvements, or a business case for engaging in a quality improvement project.
AHRQ-funded; HS018464.
Citation: Abrahamson K, Davila H, Rehkamp N .
Is there a business case for nursing home quality improvement?
Nurs Econ 2016 Sep-Oct;34(5):224-9, 35..
Keywords: Long-Term Care, Nursing Homes, Quality Improvement
Cleary PD
Evolving concepts of patient-centered care and the assessment of patient care experiences: optimism and opposition.
Improving the infrastructure supporting certain aspects of care may have broad effects because system changes can influence multiple outcomes. Thus, rather than detract from general quality improvement efforts, making changes that facilitate patient-centered care may lead to broader improvements. There is good reason to be optimistic that our health care system will increasingly be "patient centered."
AHRQ-funded; HS016978.
Citation: Cleary PD .
Evolving concepts of patient-centered care and the assessment of patient care experiences: optimism and opposition.
J Health Polit Policy Law 2016 Aug;41(4):675-96. doi: 10.1215/03616878-3620881.
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Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient-Centered Healthcare, Patient Experience, Quality of Care, Quality Improvement