National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Access to Care (2)
- Cancer (2)
- Caregiving (2)
- Children/Adolescents (3)
- Clinician-Patient Communication (2)
- Communication (3)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (7)
- Decision Making (2)
- Digestive Disease and Health (1)
- Education: Patient and Caregiver (1)
- Elderly (2)
- Electronic Health Records (EHRs) (2)
- Evidence-Based Practice (2)
- Healthcare Costs (1)
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- Home Healthcare (1)
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- Hospital Readmissions (1)
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- Inpatient Care (1)
- Maternal Care (1)
- Medical Errors (1)
- Medicare (1)
- Medication (1)
- Neonatal Intensive Care Unit (NICU) (1)
- Newborns/Infants (1)
- Nutrition (2)
- Opioids (1)
- Orthopedics (1)
- Outcomes (2)
- Pain (1)
- Palliative Care (1)
- Patient-Centered Healthcare (3)
- Patient-Centered Outcomes Research (7)
- Patient and Family Engagement (1)
- (-) Patient Experience (26)
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- Patient Self-Management (1)
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- Provider: Pharmacist (1)
- Quality Improvement (3)
- Quality Measures (4)
- Quality of Care (9)
- Quality of Life (1)
- Racial and Ethnic Minorities (1)
- Skin Conditions (1)
- Sleep Problems (1)
- Social Determinants of Health (1)
- Surgery (3)
- Telehealth (1)
- Training (1)
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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
1 to 25 of 26 Research Studies DisplayedGalbraith AA, Meyers DJ, Ross-Degnan D
Long-term impact of a postdischarge community health worker intervention on health care costs in a safety-net system.
This study evaluated the impact of a patient navigator (PN) intervention on health system costs in the 180 days after discharge for high-risk patients in a safety-net system. Total costs per patient over the 180 days postindex discharge for those aged >/=60 years were significantly lower for PN patients compared to controls ($5,676 vs. $7,640); differences for patients aged <60 ($9,942 vs. $9,046) or for the entire cohort ($7,092 vs. $7,953) were not significant.
AHRQ-funded; HS020628.
Citation: Galbraith AA, Meyers DJ, Ross-Degnan D .
Long-term impact of a postdischarge community health worker intervention on health care costs in a safety-net system.
Health Serv Res 2017 Dec;52(6):2061-78. doi: 10.1111/1475-6773.12790.
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Keywords: Healthcare Costs, Patient Experience, Hospital Readmissions
Aslakson R, Dy SM, Wilson RF
Patient and caregiver-reported assessment tools for palliative care: summary of the 2017 AHRQ Technical Brief.
This paper summarizes palliative care assessment tools completed by or with patients or caregivers, and identifies needs for future tool development and evaluation. It concluded that few to no tools address the spiritual, ethical, or cultural domains or patient-reported experience with end of life care. While some data exists on psychometric properties of tools, the responsiveness of different tools to change and/or comparisons between tools have not been evaluated.
AHRQ-funded; 290201500006I.
Citation: Aslakson R, Dy SM, Wilson RF .
Patient and caregiver-reported assessment tools for palliative care: summary of the 2017 AHRQ Technical Brief.
J Pain Symptom Manage 2017 Dec;54(6):961-72.e16. doi: 10.1016/j.jpainsymman.2017.04.022.
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Keywords: Caregiving, Evidence-Based Practice, Palliative Care, Patient Experience, Patient-Centered Outcomes Research
Tamirisa NP, Goodwin JS, Kandalam A
Patient and physician views of shared decision making in cancer.
The aim of the study was to explore patient and physician perceptions of shared decision making in clinical encounters for cancer care. Among the study’s multiple conclusions was that most physicians reported providing patients with written information, however, most patients reported that written information was too detailed and felt that the physicians did not assess the level of information they wished to receive.
AHRQ-funded; HS022134.
Citation: Tamirisa NP, Goodwin JS, Kandalam A .
Patient and physician views of shared decision making in cancer.
Health Expect 2017 Dec;20(6):1248-53. doi: 10.1111/hex.12564..
Keywords: Cancer, Decision Making, Patient-Centered Healthcare, Patient Experience, Clinician-Patient Communication
Gadepalli SK, Canvasser J, Eskenazi Y
Roles and experiences of parents in necrotizing enterocolitis: an international survey of parental perspectives of communication in the NICU.
The purpose of this study was to characterize parental perceptions of communication and support they were given about necrotizing enterocolitis (NEC). The authors suggest that areas for quality improvement include better communication and collaboration with parents through early engagement in NEC prevention using modalities beyond verbal instruction.
AHRQ-funded; HS022908.
Citation: Gadepalli SK, Canvasser J, Eskenazi Y .
Roles and experiences of parents in necrotizing enterocolitis: an international survey of parental perspectives of communication in the NICU.
Adv Neonatal Care 2017 Dec;17(6):489-98. doi: 10.1097/anc.0000000000000438..
Keywords: Communication, Newborns/Infants, Neonatal Intensive Care Unit (NICU), Newborns/Infants, Patient Experience, Patient and Family Engagement
Lowry C, Orr K, Embry B
Primary care scribes: writing a new story for safety net clinics.
The researchers conducted an evaluation of trained volunteer scribes for primary care clinics serving a diverse, low-income population in a US safety net system, which implemented a new EHR between 2011 and 2014. In a safety net primary care system, trained volunteer scribes were associated with improved clinician efficiency and experience and no difference in patient satisfaction.
AHRQ-funded; HS022561; HS023558.
Citation: Lowry C, Orr K, Embry B .
Primary care scribes: writing a new story for safety net clinics.
BMJ Open Qual 2017 Oct 25;6(2):e000124. doi: 10.1136/bmjoq-2017-000124.
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Keywords: Electronic Health Records (EHRs), Patient Experience, Primary Care, Health Information Technology (HIT), Workflow
Sakaguchi-Tang DK, Bosold AL, Choi YK
Patient portal use and experience among older adults: systematic review.
The aim of this review was to assess the existing research landscape related to patient portal and electronic personal health records (ePHRs) use and experience among older adults and to understand the benefits and barriers to older adults' use and adoption of patient portals and ePHRs. Overall, it found 2 main barriers to use: (1) privacy and security and (2) access to and ability to use technology and the Internet.
AHRQ-funded; HS022106.
Citation: Sakaguchi-Tang DK, Bosold AL, Choi YK .
Patient portal use and experience among older adults: systematic review.
JMIR Med Inform 2017 Oct 16;5(4):e38. doi: 10.2196/medinform.8092.
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Keywords: Elderly, Electronic Health Records (EHRs), Patient Experience, Web-Based
Ndumele CD, Cohen MS, Cleary PD
Association of state access standards with accessibility to specialists for Medicaid managed care enrollees.
The researchers compared ratings of access to specialists for adult Medicaid and commercial enrollees before and after the implementation of specialty access standards. Overall, there was no significant improvement in timely access to specialty services for Medicaid managed care enrollees in the period following implementation of standard(s) nor was there any impact of access standards on insurance-based disparities in access.
AHRQ-funded; HS016978; HS017589.
Citation: Ndumele CD, Cohen MS, Cleary PD .
Association of state access standards with accessibility to specialists for Medicaid managed care enrollees.
JAMA Intern Med 2017 Oct;177(10):1445-51. doi: 10.1001/jamainternmed.2017.3766.
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Keywords: Access to Care, Consumer Assessment of Healthcare Providers and Systems (CAHPS), Quality of Care, Health Insurance, Patient Experience
Fisher KA, Mazor KM
Patient and family complaints in cancer care: what can we learn from the tip of the iceberg?
This paper comments on the Mack et al. article “Evaluation of Patient and Family Outpatient Complaints as a Strategy to Prioritize Efforts to Improve Cancer Care Delivery”, published in 2017 in The Joint Commission Journal on Quality and Patient Safety, in which Mack et al. categorized all complaints filed at a large outpatient cancer center during a two-year period, put forth a preliminary rating system for assessing complaint severity, and catalogued the actions taken in response to the complaints.
AHRQ-funded; HS024596; HS022757.
Citation: Fisher KA, Mazor KM .
Patient and family complaints in cancer care: what can we learn from the tip of the iceberg?
Jt Comm J Qual Patient Saf 2017 Oct;43(10):495-97. doi: 10.1016/j.jcjq.2017.07.003..
Keywords: Cancer, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Patient Experience, Patient Safety, Quality of Care, Quality Improvement
Ehlers AP, Khor S, Cizik AM
Use of patient-reported outcomes and satisfaction for quality assessments.
This study investigated the relationship between PROs and satisfaction among spine surgery patients. The authors hypothesized that there would be significant disparities between patient satisfaction and PROs at the 1-year postoperative time point. The study found that overall, patients undergoing elective lumbar spine surgery reported being satisfied with outcomes, but the reported responses in PROs were much more variable.
AHRQ-funded; HS020025.
Citation: Ehlers AP, Khor S, Cizik AM .
Use of patient-reported outcomes and satisfaction for quality assessments.
Am J Manag Care 2017 Oct;23(10):618-22..
Keywords: Patient-Centered Outcomes Research, Patient Experience, Quality of Care, Surgery, Outcomes, Orthopedics
Waljee JF, Dimick JB
Do patient-reported outcomes correlate with clinical outcomes following surgery?
This study examines whether patient-reported outcomes (PROs) correlate with clinical outcomes following surgery. PROs are distinct from clinical outcomes and represent a potential indicator of performance that can be targeted to improve quality of care. Future studies that examine the influence of measurement techniques, case mix, and disease characteristics on PROs will inform efforts to routinely and efficiently integrate these critical outcomes into existing strategies to capture treatment effectiveness and quality of care for surgical conditions.
AHRQ-funded; HS023313.
Citation: Waljee JF, Dimick JB .
Do patient-reported outcomes correlate with clinical outcomes following surgery?
Adv Surg 2017 Sep;51(1):141-50. doi: 10.1016/j.yasu.2017.03.011..
Keywords: Quality of Care, Outcomes, Patient-Centered Outcomes Research, Surgery, Patient Experience, Quality Measures
Attanasio L, Kozhimannil KB
Health care engagement and follow-up after perceived discrimination in maternity care.
The authors sought to determine if perceived discrimination during the birth hospitalization is associated with postpartum follow-up care. Using data from the Listening to Mothers III survey, they found that women who experienced perceived discrimination (race/ethnicity, insurance type, difference of opinion with provider about care) had more than twice the odds of postpartum visit nonattendance, after adjusting for socioeconomic and medical characteristics.
AHRQ-funded; HS024215.
Citation: Attanasio L, Kozhimannil KB .
Health care engagement and follow-up after perceived discrimination in maternity care.
Med Care 2017 Sep;55(9):830-33. doi: 10.1097/mlr.0000000000000773.
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Keywords: Access to Care, Maternal Care, Patient Experience, Racial and Ethnic Minorities, Social Determinants of Health
Hatfield LA, Zaslavsky AM
Implications of variation in the relationships between beneficiary characteristics and Medicare Advantage CAHPS measures.
The researchers studied how differences in quality score adjustments across Medicare Advantage contracts change comparisons for individuals and contracts. They found that, for average consumers, standard adjustment is sufficient to represent variation in contract quality standardized to a common population. For people with characteristics far from average, personalized reporting using their characteristics and contract-specific coefficients can substantially change the expected quality measures across contracts.
AHRQ-funded; HS016978.
Citation: Hatfield LA, Zaslavsky AM .
Implications of variation in the relationships between beneficiary characteristics and Medicare Advantage CAHPS measures.
Health Serv Res 2017 Aug;52(4):1310-29. doi: 10.1111/1475-6773.12544.
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Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Medicare, Health Status, Patient Experience, Quality of Care, Quality Improvement, Quality Measures
Fisher K, Smith K, Gallagher T
We want to know: eliciting hospitalized patients' perspectives on breakdowns in care.
Researchers interviewed a broad sample of patients during hospitalization and postdischarge to elicit patient perspectives on breakdowns in care. When asked directly, almost 4 out of 10 hospitalized patients reported a breakdown in their care. Patient- perceived breakdowns in care are frequently associated with perceived harm, illustrating the importance of detecting and addressing these events.
AHRQ-funded; HS024596; HS022757.
Citation: Fisher K, Smith K, Gallagher T .
We want to know: eliciting hospitalized patients' perspectives on breakdowns in care.
J Hosp Med 2017 Aug;12(8):603-09. doi: 10.12788/jhm.2783.
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Keywords: Communication, Quality of Care, Inpatient Care, Patient Experience, Patient-Centered Outcomes Research
Khatri N, Gupta V, Varma A
The relationship between HR capabilities and quality of patient care: the mediating role of proactive work behaviors.
The researchers developed a multidimensional construct of human resource (HR) capabilities and tested its relationship with quality of patient care using a national sample of U.S. hospitals. Their analyses using structural equation modeling suggest that the positive relationship of HR capabilities with quality of patient care is mediated by proactive behaviors of health care workers. Implications of the study findings for research and practice are discussed.
AHRQ-funded; HS017549.
Citation: Khatri N, Gupta V, Varma A .
The relationship between HR capabilities and quality of patient care: the mediating role of proactive work behaviors.
Hum Resour Manage 2017 Jul-Aug;56(4):673-91. doi: 10.1002/hrm.21794.
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Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Hospitals, Quality of Care, Patient Experience, Patient Experience
Lee JS, Hu HM, Brummett CM
Postoperative opioid prescribing and the pain scores on Hospital Consumer Assessment of Healthcare Providers and Systems Survey.
The researchers sought to evaluate the association between the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) pain measures and postoperative opioid prescribing in surgical patients, which accounts for nearly 40 percent of surgical prescriptions. They found that postoperative opioid prescribing was not correlated with HCAHPS pain measures.
AHRQ-funded; HS023313.
Citation: Lee JS, Hu HM, Brummett CM .
Postoperative opioid prescribing and the pain scores on Hospital Consumer Assessment of Healthcare Providers and Systems Survey.
JAMA 2017 May 16;317(19):2013-15. doi: 10.1001/jama.2017.2827.
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Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Hospitals, Opioids, Pain, Patient Experience
Abujarad F, Alfano S, Bright TJ
AHRQ Author: Bright TJ
Building an informed consent tool starting with the patient: the patient-centered Virtual Multimedia Interactive Informed Consent (VIC).
This paper describes how the authors designed, developed, and evaluated an mHealth tool for advancing the informed consent process. Their tool enables the informed consent process to be performed on tablets (e.g., iPads) utilizing virtual coaching with text-to-speech automated translation as well as an interactive multimedia elements (e.g., graphics, video clips, animations, presentations, etc.). They present the Used-Centered Design approach they adopted to develop the tool and the results of the different methods used during the development of the tool.
AHRQ-authored; AHRQ-funded; HS023987.
Citation: Abujarad F, Alfano S, Bright TJ .
Building an informed consent tool starting with the patient: the patient-centered Virtual Multimedia Interactive Informed Consent (VIC).
AMIA Annu Symp Proc 2017 Apr 16;2017:374-83..
Keywords: Health Information Technology (HIT), Health Literacy, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Patient Experience, Telehealth
Buys DR, Campbell AD, Godfryd A
Meals enhancing nutrition after discharge: findings from a pilot randomized controlled trial.
This pilot study's objective was to evaluate the feasibility of conducting a randomized controlled trial assessing a post-discharge home-delivered meal program's impact on older adults' nutritional intake and hospital readmissions and to assess patient acceptability and satisfaction with the program. It found that participants were overwhelmingly satisfied (82 percent to 100 percent satisfied or very satisfied) with staff performance, meal quality, and delivery processes.
AHRQ-funded; HS013852.
Citation: Buys DR, Campbell AD, Godfryd A .
Meals enhancing nutrition after discharge: findings from a pilot randomized controlled trial.
J Acad Nutr Diet 2017 Apr;117(4):599-608. doi: 10.1016/j.jand.2016.11.005.
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Keywords: Nutrition, Patient Experience, Elderly, Home Healthcare, Hospital Discharge
Toomey SL, Elliott MN, Zaslavsky AM
Variation in family experience of pediatric inpatient care as measured by child HCAHPS.
Making national comparisons of family experience of inpatient pediatric care has been limited by the lack of a publicly available survey. A new survey developed by AHRQ and the Centers for Medicare & Medicaid Services makes use of 18 measures. It found that family experience of pediatric inpatient care shows substantial room for improvement and varies considerably across hospitals and measures.
AHRQ-funded; HS020513.
Citation: Toomey SL, Elliott MN, Zaslavsky AM .
Variation in family experience of pediatric inpatient care as measured by child HCAHPS.
Pediatrics 2017 Apr;139(4):e20163372. doi: 10.1542/peds.2016-3372.
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Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Children/Adolescents, Patient Experience, Patient Experience, Quality of Care
Martino SC, Shaller D, Schlesinger M
CAHPS and comments: how closed-ended survey questions and narrative accounts interact in the assessment of patient experience.
The authors investigated whether content from patient narratives explains variation in patients' primary care provider (PCP) ratings beyond information from the closed-ended questions of CAHPS Clinician and Group Survey and whether the relative placement of closed- and open-ended survey questions affects either the content of narratives or the CAHPS composite scores. They found that incorporating a protocol for eliciting narratives into a patient experience survey resulted in minimal distortion of patient feedback, and narratives from sicker patients helped explain variation in provider ratings.
AHRQ-funded; HS016980; HS016978; HS021858.
Citation: Martino SC, Shaller D, Schlesinger M .
CAHPS and comments: how closed-ended survey questions and narrative accounts interact in the assessment of patient experience.
J Patient Exp 2017 Mar;4(1):37-45. doi: 10.1177/2374373516685940.
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Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient Experience, Primary Care, Quality of Care, Quality Measures
Sisic M, Kirby JS, Boyal S
Development of a quality-of-life measure for hidradenitis suppurativa.
The objective of this study was to develop a QoL instrument for hidradenitis suppurativa (HS-QoL) in accordance with recommended standards. : Concept elicitation interviews with patients with HS generated 12 themes. Most frequently reported were impacts on daily activities and symptoms due to HS. These themes, along with literature review and input from clinical experts, informed development of the HS-QoL-v1.
AHRQ-funded; HS024585.
Citation: Sisic M, Kirby JS, Boyal S .
Development of a quality-of-life measure for hidradenitis suppurativa.
J Cutan Med Surg 2017 Mar/Apr;21(2):152-55. doi: 10.1177/1203475416677721.
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Keywords: Patient Experience, Quality Measures, Quality of Life, Skin Conditions
Oladeru OA, Hamadu M, Cleary PD
House staff communication training and patient experience scores.
The purpose of this study was to assess whether communication training for housestaff via role-playing exercises (1) was well-received and (2) improved patient experience scores in housestaff clinics. Forty-four of a possible 45 housestaff (97.8%) participated, with 31 (70.5%) indicating that the role-playing exercise increased their perception of the 5-step strategy the study emphasized.
AHRQ-funded; HS016978.
Citation: Oladeru OA, Hamadu M, Cleary PD .
House staff communication training and patient experience scores.
J Patient Exp 2017 Mar 1;4(1):28-36. doi: 10.1177/2374373517694533..
Keywords: Communication, Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient Experience, Patient Experience, Training
Boss EF, Links AR, Saxton R
Parent experience of care and decision making for children who snore.
The researchers identified factors associated with parental experience and decision making in pediatric sleep-disordered breathing (SDB) and adenotonsillectomy (AT) surgery. They found that while clinical factors were influential for decision making, interpersonal factors helped parents feel comfortable and influenced their overall experience
AHRQ-funded; HS022932.
Citation: Boss EF, Links AR, Saxton R .
Parent experience of care and decision making for children who snore.
JAMA Otolaryngol Head Neck Surg 2017 Mar;143(3):218-25. doi: 10.1001/jamaoto.2016.2400.
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Keywords: Children/Adolescents, Sleep Problems, Caregiving, Patient Experience, Decision Making, Clinician-Patient Communication
Haldar S, Filipkowski A, Mishra SR
"Scared to go to the hospital": inpatient experiences with undesirable events.
Researchers surveyed pediatric inpatients and caregivers to understand their perspectives on undesirable events. By giving them an opportunity to use their own words to describe their experiences, they found a diverse array of undesirable events. Their qualitative analysis revealed four major types of events that patients and caregivers experienced: mismanagement, communication, policy, and lack of care coordination.
AHRQ-funded; HS022894.
Citation: Haldar S, Filipkowski A, Mishra SR .
"Scared to go to the hospital": inpatient experiences with undesirable events.
AMIA Annu Symp Proc 2017 Feb 10;2016:609-17.
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Keywords: Patient Experience, Children/Adolescents, Hospitalization, Patient Safety, Medical Errors
Kernodle AR, Frail CK, Gernant SA
Patients' experiences using a brief screening tool for medication-related problems in a community pharmacy setting.
The researchers explored patient perceptions and the practical implication of using a brief 9-item scale to screen for medication-related problems in community pharmacies. After interviewing 40 patients who completed the scale and reviewed its results with their pharmacist, they concluded that it may have value in increasing patients' understanding of and confidence in their medications, enhancing pharmacist-patient relationships, and identifying problems requiring additional interventions.
AHRQ-funded; HS022119.
Citation: Kernodle AR, Frail CK, Gernant SA .
Patients' experiences using a brief screening tool for medication-related problems in a community pharmacy setting.
J Pharm Pract 2017 Feb;30(1):49-57. doi: 10.1177/0897190015605015.
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Keywords: Medication, Patient Experience, Education: Patient and Caregiver, Provider: Pharmacist
Franklin PD
Research priorities for optimal use of patient-reported outcomes in quality and outcome improvement for total knee arthroplasty.
This paper uses the traditional quality management's framework of inputs (patients), processes (clinical care), and outcomes to outline priority research questions to learn how clinicians, hospital managers, and patients can interpret patient-reported outcomes to improve total knee arthroplasty care and outcomes. It concludes that research should identify best practices to minimize variation in a patient's health status before surgery.
AHRQ-funded; HS018910.
Citation: Franklin PD .
Research priorities for optimal use of patient-reported outcomes in quality and outcome improvement for total knee arthroplasty.
J Am Acad Orthop Surg 2017 Feb;25 Suppl 1:S51-s54. doi: 10.5435/jaaos-d-16-00632.
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Keywords: Patient-Centered Outcomes Research, Surgery, Quality Improvement, Patient Experience, Evidence-Based Practice