National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Blood Clots (1)
- Cancer (1)
- Cardiovascular Conditions (2)
- Care Coordination (1)
- Care Management (1)
- Children/Adolescents (1)
- Comparative Effectiveness (1)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (1)
- Data (1)
- Elderly (1)
- Electronic Health Records (EHRs) (2)
- Evidence-Based Practice (2)
- Healthcare-Associated Infections (HAIs) (1)
- Healthcare Delivery (1)
- Health Information Technology (HIT) (2)
- Health Insurance (1)
- Health Literacy (1)
- Health Systems (1)
- Heart Disease and Health (1)
- Hospital Readmissions (2)
- Hospitals (7)
- Medicare (2)
- Medication (1)
- Nursing Homes (1)
- Obesity (1)
- Outcomes (2)
- Patient-Centered Outcomes Research (3)
- Patient Experience (1)
- Patient Safety (7)
- Payment (1)
- Primary Care (2)
- Primary Care: Models of Care (1)
- Provider (1)
- Provider: Physician (1)
- Provider Performance (4)
- Quality Improvement (7)
- (-) Quality Indicators (QIs) (16)
- Quality Measures (9)
- Quality of Care (16)
- Research Methodologies (1)
- Risk (2)
- Sepsis (1)
- Surgery (3)
- Surveys on Patient Safety Culture (1)
- Tools & Toolkits (1)
- Transitions of Care (1)
- Workforce (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 16 of 16 Research Studies DisplayedSheetz KH, Dimick JB, Nathan H
Centralization of high-risk cancer surgery within existing hospital systems.
Centralization is often proposed as a strategy to improve the quality of certain high-risk health care services. In this study, the investigators evaluated the extent to which existing hospital systems centralize high-risk cancer surgery and whether centralization is associated with short-term clinical outcomes. The investigators concluded that greater centralization of complex cancer surgery within existing hospital systems was associated with better outcomes.
AHRQ-funded; HS023597.
Citation: Sheetz KH, Dimick JB, Nathan H .
Centralization of high-risk cancer surgery within existing hospital systems.
J Clin Oncol 2019 Dec 1;37(34):3234-42. doi: 10.1200/jco.18.02035..
Keywords: Surgery, Cancer, Risk, Hospitals, Health Systems, Quality Improvement, Quality Indicators (QIs), Quality of Care, Outcomes
Mixon AS, Smith GR, Mallouk M
Design of MARQUIS2: study protocol for a mentored implementation study of an evidence-based toolkit to improve patient safety through medication reconciliation.
The first Multi-center Medication Reconciliation Quality Improvement Study (MARQUIS1) demonstrated that implementation of a medication reconciliation best practices toolkit decreased total unintentional medication discrepancies in five hospitals. In this study, the investigators sought to implement the MARQUIS toolkit in more diverse hospitals, incorporating lessons learned from MARQUIS1.
AHRQ-funded; HS023757; HS025486.
Citation: Mixon AS, Smith GR, Mallouk M .
Design of MARQUIS2: study protocol for a mentored implementation study of an evidence-based toolkit to improve patient safety through medication reconciliation.
BMC Health Serv Res 2019 Sep 11;19(1):659. doi: 10.1186/s12913-019-4491-5.
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Keywords: Evidence-Based Practice, Medication, Patient Safety, Quality of Care, Quality Improvement, Quality Indicators (QIs), Quality Measures, Tools & Toolkits
Knierim KE, Hall TL, Dickinson LM
Primary care practices' ability to report electronic clinical quality measures in the EvidenceNOW Southwest Initiative to Improve Heart Health.
The objective of this study was to determine how quickly primary care practices can report electronic clinical quality measures (eCQMs) and to identify the practice characteristics associated with faster reporting. Examining the EvidenceNOW Southwest initiative, the researchers’ results showed that the time to report eCQMs varied by measure and practice type, with very few practices reporting quickly. Additional support for practices to succeed in new programs that require eCQM reporting was recommended.
AHRQ-funded; HS023904.
Citation: Knierim KE, Hall TL, Dickinson LM .
Primary care practices' ability to report electronic clinical quality measures in the EvidenceNOW Southwest Initiative to Improve Heart Health.
JAMA Netw Open 2019 Aug 2;2(8):e198569. doi: 10.1001/jamanetworkopen.2019.8569..
Keywords: Primary Care, Quality Indicators (QIs), Quality Measures, Quality Improvement, Quality of Care, Heart Disease and Health, Cardiovascular Conditions, Patient-Centered Outcomes Research, Evidence-Based Practice, Electronic Health Records (EHRs), Health Information Technology (HIT)
Barbash IJ, Davis B, Kahn JM
National performance on the Medicare SEP-1 sepsis quality measure.
Researchers characterized national performance on the sepsis measure known as SEP-1. They found that the majority of eligible hospitals reported SEP-1 data, and overall bundle compliance was highly variable. Further, SEP-1 performance was associated with structural hospital characteristics and performance on other measures of hospital quality, providing preliminary support for SEP-1 performance as a marker of timely hospital sepsis care.
AHRQ-funded; HS025455.
Citation: Barbash IJ, Davis B, Kahn JM .
National performance on the Medicare SEP-1 sepsis quality measure.
Crit Care Med 2019 Aug;47(8):1026-32. doi: 10.1097/ccm.0000000000003613..
Keywords: Sepsis, Quality Indicators (QIs), Quality Measures, Quality of Care, Hospitals, Provider Performance
Li Y, Cen X, Cai X
Perceived patient safety culture in nursing homes associated with "Nursing Home Compare" performance indicators.
This study examined the association between the use of “Nursing Home Compare” performance indicators and improved patient safety culture in nursing homes. A survey was conducted in 2017 using AHRQ’s Survey on Patient Safety Culture for Nursing Homes which collects data on 12 core domains of safety culture scores. Out of 2254 nursing homes sampled, there was a response rate of 36%. It was found that for every 10 percentage points increase in overall positive response rate for safety culture, there was an association with 0.56 fewer health care deficiencies, 0.74 fewer substantiated complaints, reduced fines by $2285.20, and 20% increased odds of being designed as 4-star or 5-star.
AHRQ-funded; HS024923.
Citation: Li Y, Cen X, Cai X .
Perceived patient safety culture in nursing homes associated with "Nursing Home Compare" performance indicators.
Med Care 2019 Aug;57(8):641-47. doi: 10.1097/mlr.0000000000001142..
Keywords: Surveys on Patient Safety Culture, Patient Safety, Nursing Homes, Quality Indicators (QIs), Quality Measures, Quality of Care, Provider Performance
Ouayogode MH, Mainor AJ, Meara E
Association between care management and outcomes among patients with complex needs in Medicare accountable care organizations.
This study compared the performance of accountable care organizations (ACOS) for prevention quality indicator admissions and 30-day all-cause readmissions including hospitalization and emergency department visits, evaluation and management visits in ambulatory settings, median annual spending, lower median health care contact days and lower continuity-of-care-index for Medicare patients. This cross-sectional study surveyed 244 Medicare Shared Savings Program ACOs in the 2017-2018 National Survey of ACOs (of 351 Medicare ACO respondents conducted from July 20, 2017, to February 15, 2018 that was linked to 2016 Medicare administrative claims data. The study population included Medicare beneficiaries 66 years or older who were defined as having complex needs with higher costs because of frailty or 2 or more chronic conditions. There was not found to be much difference in quality between the lowest and top tertiles for care management and coordination activities.
AHRQ-funded; HS024075.
Citation: Ouayogode MH, Mainor AJ, Meara E .
Association between care management and outcomes among patients with complex needs in Medicare accountable care organizations.
JAMA Netw Open 2019 Jul 3;2(7):e196939. doi: 10.1001/jamanetworkopen.2019.6939..
Keywords: Care Management, Elderly, Medicare, Outcomes, Patient-Centered Outcomes Research, Quality of Care, Quality Indicators (QIs)
Sankaran R, Sukul D, Nuliyalu U
Changes in hospital safety following penalties in the US Hospital Acquired Condition Reduction Program: retrospective cohort study.
This study evaluated the association between hospital penalization in the US Hospital Acquired Condition Reduction Program (HACRP) and changes in clinical outcomes. Out of the total of 724 hospitals were penalized in fiscal year 2015, 708 were included in the study. The majority of the penalized hospitals were large teaching institutions and have a greater share of low-income patients than non-penalized hospitals. After penalization, there was a non-significant change in hospital acquired conditions, 30-day readmission rates, and 30-day mortality. This might mean that disparities in care could be exacerbated.
AHRQ-funded; HS026244.
Citation: Sankaran R, Sukul D, Nuliyalu U .
Changes in hospital safety following penalties in the US Hospital Acquired Condition Reduction Program: retrospective cohort study.
BMJ 2019 Jul 3;366:l4109. doi: 10.1136/bmj.l4109..
Keywords: Health Insurance, Healthcare-Associated Infections (HAIs), Hospitals, Medicare, Patient Safety, Provider Performance, Payment, Quality of Care, Quality Indicators (QIs)
Ward ST, Dimick JB, Zhang W
Association between hospital staffing models and failure to rescue.
The purpose of this study was to identify hospital staffing models associated with failure to rescue (FTR) rates at low- and high-performing hospitals. The investigators concluded that low FTR hospitals had significantly more staffing resources than high FTR hospitals. They indicated that although hiring additional staff may be beneficial, there remain significant financial limitations for many hospitals to implement robust staffing models.
AHRQ-funded; HS023621; HS024403.
Citation: Ward ST, Dimick JB, Zhang W .
Association between hospital staffing models and failure to rescue.
Ann Surg 2019 Jul;270(1):91-94. doi: 10.1097/sla.0000000000002744..
Keywords: Patient Safety, Hospitals, Workforce, Quality Indicators (QIs), Quality Improvement, Quality of Care, Healthcare Delivery
Nakamura MM, Toomey SL, Zaslavsky AM
Potential impact of initial clinical data on adjustment of pediatric readmission rates.
This study investigated whether the addition of adding initial clinical data to adjust for case-mix (differences in patient populations) improved prediction of pediatric readmissions. Thirty-day readmissions were examined using claims and electronic records for patients aged 18 and younger who were admitted to 3 children’s hospitals from February 2011 to February 2014. The Pediatric All-Condition Readmission Measure was used and started with a model including age, gender, chronic conditions, and primary diagnosis. Initial vital sign and laboratory data was added to see if it improved model performance. Greater readmission risk was found if there was a low red blood cell count and mean corpuscular hemoglobin concentration and high red cell distribution risk. However, it did not provide more than minimal improvement in performance.
AHRQ-funded; HS020513; HS025299.
Citation: Nakamura MM, Toomey SL, Zaslavsky AM .
Potential impact of initial clinical data on adjustment of pediatric readmission rates.
Acad Pediatr 2019 Jul;19(5):589-98. doi: 10.1016/j.acap.2018.09.006..
Keywords: Children/Adolescents, Hospital Readmissions, Risk, Quality Indicators (QIs), Quality Measures, Quality of Care
Brega AG, Hamer MK, Albright K
AHRQ Author: Brach C
Organizational health literacy: quality improvement measures with expert consensus.
The investigators sought to identify and evaluate existing organizational health literacy (OHL)-related quality improvement (QI) measures. They identified 22 OHL-related QI measures that have the support of experts in the field, and recommended additional measure development and testing. However, they note that their Consensus OHL QI Measures are appropriate for immediate use.
AHRQ-authored; AHRQ-funded; 233201500025I.
Citation: Brega AG, Hamer MK, Albright K .
Organizational health literacy: quality improvement measures with expert consensus.
Health Lit Res Pract 2019 Jul 1;3(2):e127-e46. doi: 10.3928/24748307-20190503-01..
Keywords: Health Literacy, Quality of Care, Quality Improvement, Quality Indicators (QIs), Quality Measures
Vergis A, Hardy K, Stogryn S
Fellow and attending surgeon operative notes are deficient in reporting established quality indicators for Roux-en-y gastric bypass: a preliminary retrospective analysis of operative dictation.
This retrospective analysis investigated the completeness of reporting documentation for Roux-en-Y Gastric Bypass (RYGB) surgery. A total of 40 bariatric fellow and 40 attending RYGB narrative reports were analyzed. Fellows had a mean completion rate of 66.4% compared to 61.5% for attendings. Fellows also did a better job of completing subsections, with the exception of closure details. This information is important to communicating operative events and can make an impact on patient safety and quality.
AHRQ-funded; HS018546.
Citation: Vergis A, Hardy K, Stogryn S .
Fellow and attending surgeon operative notes are deficient in reporting established quality indicators for Roux-en-y gastric bypass: a preliminary retrospective analysis of operative dictation.
Cureus 2019 Apr 24;11(4):e4535. doi: 10.7759/cureus.4535..
Keywords: Obesity, Quality of Care, Quality Indicators (QIs), Patient Safety, Provider, Provider: Physician, Surgery
Cefalu MS, Elliott MN, Setodji CM
Hospital quality indicators are not unidimensional: a reanalysis of Lieberthal and Comer.
The objective of this study was to evaluate the dimensionality of hospital quality indicators treated as unidimensional in a prior publication. The investigators found that there were four underlying dimensions of hospital quality: patient experience, mortality, and two clinical process dimensions. They concluded that hospital quality should be measured using a variety of indicators reflecting different dimensions of quality.
AHRQ-funded; HS016980; HS016978.
Citation: Cefalu MS, Elliott MN, Setodji CM .
Hospital quality indicators are not unidimensional: a reanalysis of Lieberthal and Comer.
Health Serv Res 2019 Apr;54(2):502-08. doi: 10.1111/1475-6773.13056..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Hospitals, Patient Experience, Provider Performance, Quality of Care, Quality Indicators (QIs), Quality Measures
Blay E, Huang R, Chung JW
Evaluating the impact of the venous thromboembolism outcome measure on the PSI 90 composite quality metric.
Patient Safety Indicator (PSI) 90 is a composite measure widely used in federal pay-for-performance and public reporting programs. A component metric of PSI 90, venous thromboembolism (VTE) rate, has been shown to be subject to surveillance bias and not a valid measure for hospital quality comparisons. A study was conducted to examine how hospital PSI 90 scores would change if the VTE measure were removed from calculation of this composite measure.
AHRQ-funded; HS021857.
Citation: Blay E, Huang R, Chung JW .
Evaluating the impact of the venous thromboembolism outcome measure on the PSI 90 composite quality metric.
Jt Comm J Qual Patient Saf 2019 Mar;45(3):148-55. doi: 10.1016/j.jcjq.2018.08.009..
Keywords: Blood Clots, Patient Safety, Quality Measures, Quality Indicators (QIs), Quality of Care
Shah T, Patel-Teague S, Kroupa L
Impact of a national QI programme on reducing electronic health record notifications to clinicians.
In this study, the investigators evaluated the impact of a national, multicomponent, quality improvement (QI) programme designed to reduce low-value EHR notifications. The investigators found that, based on prior estimates on time to process notifications, this national QI programme potentially saved 1.5 hours per week per PCP to enable higher value work. The investigators also found that the number of daily notifications remained high, suggesting the need for additional multifaceted interventions and protected clinical time to help manage them.
AHRQ-funded; HS022087.
Citation: Shah T, Patel-Teague S, Kroupa L .
Impact of a national QI programme on reducing electronic health record notifications to clinicians.
BMJ Qual Saf 2019 Jan;28(1):10-14. doi: 10.1136/bmjqs-2017-007447..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Quality Indicators (QIs), Quality Improvement, Quality of Care, Primary Care, Primary Care: Models of Care
Gupta S, Zengul FD, Davlyatov GK
Reduction in hospitals' readmission rates: role of hospital-based skilled nursing facilities.
The purpose of this study was to examine the association between hospital-based skilled nursing facilities (HBSNFs) and hospitals' readmission rates. Data sources included the American Hospital Association Annual Survey, Area Health Resources Files, CMS Medicare cost reports and Hospital Compare. Results showed that the presence of HBSNFs was associated with lower readmission rates for acute myocardial infarction and pneumonia. Further, higher skilled nursing facilities to hospitals ratio were associated with lower readmission rates.
AHRQ-funded; HS023345.
Citation: Gupta S, Zengul FD, Davlyatov GK .
Reduction in hospitals' readmission rates: role of hospital-based skilled nursing facilities.
Inquiry 2019 Jan-Dec;56:46958018817994. doi: 10.1177/0046958018817994..
Keywords: Hospital Readmissions, Transitions of Care, Care Coordination, Hospitals, Quality Indicators (QIs), Quality Measures, Quality of Care
Hsu YJ, Kosinski AS, Wallace AS
Using a society database to evaluate a patient safety collaborative: the Cardiovascular Surgical Translational Study.
The authors assessed the utility of using external databases for quality improvement (QI) evaluations in the context of an innovative QI collaborative aimed to reduce three infections and improve patient safety across the cardiac surgery service line. They compared changes in each outcome between 15 intervention hospitals and 52 propensity score-matched hospitals, and found that improvement trends in several outcomes among the studied intervention hospitals were not statistically different from those in comparison hospitals. They conclude that using external databases may permit comparative effectiveness assessment by providing concurrent comparison groups, additional outcome measures, and longer follow-up.
AHRQ-funded; HS019934.
Citation: Hsu YJ, Kosinski AS, Wallace AS .
Using a society database to evaluate a patient safety collaborative: the Cardiovascular Surgical Translational Study.
J Comp Eff Res 2019 Jan;8(1):21-32. doi: 10.2217/cer-2018-0051..
Keywords: Patient Safety, Quality Improvement, Quality Indicators (QIs), Quality of Care, Surgery, Cardiovascular Conditions, Comparative Effectiveness, Data, Hospitals, Research Methodologies, Patient-Centered Outcomes Research