National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Events (2)
- Cardiovascular Conditions (1)
- Care Coordination (1)
- Care Management (1)
- Children/Adolescents (1)
- Chronic Conditions (1)
- (-) Communication (20)
- Comprehensive Unit-based Safety Program (CUSP) (1)
- Critical Care (2)
- Electronic Health Records (EHRs) (1)
- Emergency Department (1)
- Healthcare Delivery (4)
- Health Information Technology (HIT) (3)
- Hospitals (2)
- Implementation (1)
- Inpatient Care (2)
- Intensive Care Unit (ICU) (3)
- Labor and Delivery (1)
- Maternal Care (2)
- Newborns/Infants (1)
- Outcomes (1)
- Patient-Centered Healthcare (1)
- Patient and Family Engagement (1)
- Patient Safety (4)
- Pregnancy (1)
- Primary Care (5)
- Primary Care: Models of Care (2)
- Provider (3)
- Provider: Nurse (1)
- Provider: Physician (2)
- Quality Improvement (1)
- Quality of Care (2)
- Simulation (2)
- Surgery (3)
- Surveys on Patient Safety Culture (1)
- (-) Teams (20)
- TeamSTEPPS (2)
- Training (1)
- Transitions of Care (2)
- Women (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 20 of 20 Research Studies DisplayedWooldridge AR, Carayon P, Hoonakker P
Team cognition in handoffs: relating system factors, team cognition functions and outcomes in two handoff processes.
This study investigated how team cognition occurs in care transitions from operating room (OR) to intensive care unit (ICU) and then sought to understand how the sociotechnical system and team cognition are related. The authors conducted the study in an academic, Level 1 trauma center in the Midwestern US. Semi-structured interviews were conducted with 28 healthcare workers that included physicians (surgery, anesthesia, pediatric critical care) and nurses (OR, ICU). Three cognition functions in hand-offs were described by participants: (1) information exchange, (2) assessment, and (3) planning and decision making; information exchange was mentioned most. Inter-professional handoffs facilitated information exchange but included large teams with diverse backgrounds communicating that can decrease efficiency. Intra-professional handoffs decreased team size and role diversity, which may simplify communication but can increase information loss. Participants in inter-professional handoffs reflected on outcomes significantly more in relation to system factors and team cognition, while participants in intra-professional handoffs discussed handoffs as a task.
AHRQ-funded; HS023837.
Citation: Wooldridge AR, Carayon P, Hoonakker P .
Team cognition in handoffs: relating system factors, team cognition functions and outcomes in two handoff processes.
Hum Factors 2024 Jan; 66(1):271-93. doi: 10.1177/00187208221086342..
Keywords: Teams, Transitions of Care, Communication
Stierman EK, O'Brien BT, Stagg J
AHRQ Author: Fabiyi CA, Chew E, Harding B, Mistry KB
Statewide perinatal quality improvement, teamwork, and communication activities in Oklahoma and Texas.
The objective of this study was to describe perinatal quality improvement activities, specifically the implementation of Alliance for Innovation on Maternal Health (AIM) patient safety bundles and use of teamwork and communication tools in obstetric units. Researchers conducted a survey of AIM-enrolled hospitals in Oklahoma and Texas and gathered data on obstetric unit organization and QI processes. Their findings showed that adoption of QI processes varied and also highlighted the need to reinforce support for rural obstetric units, which often face greater barriers to implementing patient safety and QI processes than urban units. The researchers concluded that this has implications for implementing future perinatal QI initiatives.
AHRQ-authored; AHRQ-funded; 233201500020I.
Citation: Stierman EK, O'Brien BT, Stagg J .
Statewide perinatal quality improvement, teamwork, and communication activities in Oklahoma and Texas.
Qual Manag Health Care 2023 Jul-Sep; 32(3):177-88. doi: 10.1097/qmh.0000000000000407..
Keywords: Quality Improvement, Teams, Communication, Maternal Care, Quality of Care
Pestka DL, Paterson NL, Benedict KA
Delivering care to high-cost high-need patients: lessons learned in the development of a complex care primary care team.
As part of a population health-focused primary care transformation, in 2019 a health system in Minnesota developed a primary care team to exclusively care for high-cost high-need patients. Through its development and implementation, the team has discovered several key lessons in delivering care to complex patients. In this paper, the authors discuss lessons learned from their research.
AHRQ-funded; HS026379.
Citation: Pestka DL, Paterson NL, Benedict KA .
Delivering care to high-cost high-need patients: lessons learned in the development of a complex care primary care team.
J Prim Care Community Health 2021 Jan-Dec;12:21501327211023888. doi: 10.1177/21501327211023888..
Keywords: Primary Care, Primary Care: Models of Care, Healthcare Delivery, Teams, Communication, Implementation
Frasier LL, Pavuluri Quamme SR, Wiegmann D
Evaluation of intraoperative hand-off frequency, duration, and context: a mixed methods analysis.
The authors sought a better understanding of the coordination and impact of intraoperative hand-offs. They found that intraoperative hand-offs were frequent and not well coordinated with intraoperative events including counts and other hand-offs. Anchoring and announced hand-offs occurred in a small proportion of cases. They recommended that future work focus on optimizing timing, content, and participation in intraoperative hand-offs.
AHRQ-funded; HS022403.
Citation: Frasier LL, Pavuluri Quamme SR, Wiegmann D .
Evaluation of intraoperative hand-off frequency, duration, and context: a mixed methods analysis.
J Surg Res 2020 Dec;256:124-30. doi: 10.1016/j.jss.2020.06.007..
Keywords: Surgery, Transitions of Care, Communication, Teams
Rozenfeld RA, Nannicelli AP, Brown AR
Verbal communication during airway management and emergent endotracheal intubation: observations of team behavior among multi-institutional pediatric intensive care unit in situ simulations.
The objective of this study was to assess health-care teams' verbal communication, an observable teamwork behavior, during simulations involving pediatric emergency airway management and intubation. The investigators found that no uniform statement was identified to declare an airway emergency among the care teams. Preintubation medication dosages were not consistently included in intubation medication orders, and frequently, there were multiple requests to obtain medications.
AHRQ-funded; HS017909.
Citation: Rozenfeld RA, Nannicelli AP, Brown AR .
Verbal communication during airway management and emergent endotracheal intubation: observations of team behavior among multi-institutional pediatric intensive care unit in situ simulations.
J Patient Saf 2020 Sep;16(3):e114-e19. doi: 10.1097/pts.0000000000000272..
Keywords: Children/Adolescents, Intensive Care Unit (ICU), Critical Care, Teams, Communication, Simulation
Lee YSH, King MD, Anderson D
The how matters: how primary care provider communication with team relates to patients' disease management.
This study examined how primary care provider (PCP)-team communication relates to patients’ disease management. A longitudinal study was conducted of how 3 aspects of PCP-care team communication including participation, time spent listening, an uninterrupted speaking length relate to disease management of patients with hypertension or diabetes. The study recruited 27 PCPs and 98 team members serving 18,067 patients with hypertension and 8354 patients with diabetes affiliated with a federally qualified health center with 12 practice sites. Data was collected using sociometric sensors worn by PCPs and team members, surveys on patient-PCP communication, and electronic records which extracted PCP and patient characteristics. Results showed that PCPs participated in 75% of care team conversations, spent 56% of conversation time listening, and had an average uninterrupted speaking length of 2.42 seconds. Greater PCP participation, listening, and length of uninterrupted time speaking were associated with significantly higher odds that their patients had controlled hypertension and diabetes.
AHRQ-funded; HS016978.
Citation: Lee YSH, King MD, Anderson D .
The how matters: how primary care provider communication with team relates to patients' disease management.
Med Care 2020 Jul;58(7):643-50. doi: 10.1097/mlr.0000000000001342..
Keywords: Primary Care, Communication, Teams, Provider, Quality of Care
Mastrianni A, Kulp L, Mapelli E
Understanding digital checklist use through team communication.
Introducing technology support in a complex, team-based work setting requires a study of teamwork effects on technology use. In this paper, the investigators present their initial analysis of team communications in a trauma resuscitation setting, where they deployed a digital checklist to support trauma team leaders in guiding patient care. They discuss design implications for checklist design for dynamic, team-based activities.
AHRQ-funded; HS026057.
Citation: Mastrianni A, Kulp L, Mapelli E .
Understanding digital checklist use through team communication.
Ext Abstr Hum Factors Computing Syst 2020 Apr;2020. doi: 10.1145/3334480.3382817.
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Keywords: Teams, Communication, Health Information Technology (HIT)
Manojlovich M, Harrod M, Hofer TP
Using qualitative methods to explore communication practices in the context of patient care rounds on general care units.
This study examined communication practices between nurses and physicians in general care units at 4 Midwestern hospitals. A total of 163 physicians, registered nurses, and nurse practitioners participated. The researchers observed and shadowed clinicians during rounds and other times during a 2 week period as well as conducting interviews and holding focus groups. Workflow differences affected rounds and subsequently communication practices. Good rapport between physicians and nurses contributed to nurse participation during rounds. Lower rapport made some nurses feel uncomfortable accompanying physicians during rounds unless invited.
AHRQ-funded; HS022305.
Citation: Manojlovich M, Harrod M, Hofer TP .
Using qualitative methods to explore communication practices in the context of patient care rounds on general care units.
J Gen Intern Med 2020 Mar;35(3):839-45. doi: 10.1007/s11606-019-05580-9..
Keywords: Communication, Provider: Physician, Provider: Nurse, Provider, Hospitals, Teams, Inpatient Care, Healthcare Delivery
Kim LY, Giannitrapani KF, Huynh AK
What makes team communication effective: a qualitative analysis of interprofessional primary care team members' perspectives.
This paper describes the elements of effective communication as perceived by members of interprofessional patient-centered medical home primary care teams and identified elements of effective communication that have persisted over time. Nine elements of effective communication emerged: shared knowledge, situation/goal awareness, problem-solving, mutual respect, transparency, timeliness, frequency, consistency, and parsimony. Recommendations included comprehensive quality improvement efforts incorporating a variety of strategies to facilitate communication of pertinent patient information in a brief and concise manner.
AHRQ-funded; HS000046.
Citation: Kim LY, Giannitrapani KF, Huynh AK .
What makes team communication effective: a qualitative analysis of interprofessional primary care team members' perspectives.
J Interprof Care 2019 Nov-Dec;33(6):836-38. doi: 10.1080/13561820.2019.1577809..
Keywords: Teams, Communication, Primary Care: Models of Care, Primary Care, Patient-Centered Healthcare
Kahwati LC, Sorensen AV, Teixeira-Poit S
AHRQ Author: Mistry KB
Impact of the Agency for Healthcare Research and Quality's Safety Program for Perinatal Care.
The purpose of this study was to describe the Safety Program for Perinatal Care (SPPC) implementation experience and evaluate the short-term impact on labor and delivery (L&D) unit patient safety culture, processes, and adverse events. SPPC implementation by L&D units were supported sing a program toolkit, trainings, and technical assistance. Researchers then evaluated the program using a pre-post, mixed-methods design. Changes in safety and quality were measured using the Modified Adverse Outcome Index (MAOI) and other perinatal care indicators. Findings showed that SPPC had a favorable impact on unit patient safety culture and processes, but mixed short-term impact on maternal and neonatal adverse events.
AHRQ-authored; AHRQ-funded; 2902010000241.
Citation: Kahwati LC, Sorensen AV, Teixeira-Poit S .
Impact of the Agency for Healthcare Research and Quality's Safety Program for Perinatal Care.
Jt Comm J Qual Patient Saf 2019 Apr;45(4):231-40. doi: 10.1016/j.jcjq.2018.11.002..
Keywords: Adverse Events, Communication, Comprehensive Unit-based Safety Program (CUSP), Labor and Delivery, Maternal Care, Newborns/Infants, Outcomes, Patient Safety, Pregnancy, Simulation, Surveys on Patient Safety Culture, Teams, TeamSTEPPS, Training, Women
Frasier LL, Pavuluri Quamme SR, Ma Y
Familiarity and communication in the operating room.
Researchers sought to evaluate the relationship between familiarity, communication rates, and communication ineffectiveness of health care providers in the operating room. They found that team members do not compensate for unfamiliarity by increasing their verbal communication, and dyad familiarity is not protective against ineffective communication. Cross-disciplinary communication remains vulnerable in the operating room, suggesting poor crosstalk across disciplines in the operative setting. They recommended further investigation to explore these relationships and identify effective interventions, ensuring that all team members have the necessary information to optimize their performance.
AHRQ-funded; HS022403.
Citation: Frasier LL, Pavuluri Quamme SR, Ma Y .
Familiarity and communication in the operating room.
J Surg Res 2019 Mar;235:395-403. doi: 10.1016/j.jss.2018.09.079..
Keywords: Communication, Patient Safety, Surgery, Teams, Provider: Physician, Provider
Lin W-T, Mayer C, Lee B-O
Validity and reliability of the Teamwork Evaluation of Non-Technical Skills tool.
This study evaluated the use of the assessment tool TENTS (Teamwork Evaluation of Non-Technical Skills) to measure effectiveness of different clinician teams. The tool measures communication, leadership, and crossmonitoring. Researchers used to tool to observe five different events: new admissions, transfers to and from other units, rapid response team events, morning rounds, and medical procedures.
AHRQ-funded; 290200600001I.
Citation: Lin W-T, Mayer C, Lee B-O .
Validity and reliability of the Teamwork Evaluation of Non-Technical Skills tool.
Aust J Adv Nurs 2019 Mar-May;36(3):29-38..
Keywords: Communication, Teams, TeamSTEPPS
Holtrop JS, Ruland S, Diaz S
Using social network analysis to examine the effect of care management structure on chronic disease management communication within primary care.
The investigators examined the communication regarding chronic disease care within 24 primary care practices in Michigan and Colorado. They sought to answer the following questions: Do care managers play a key role in chronic disease management in the practice? Does the prominence of the care manager's connectivity within the practice's communication network vary by the type of care management structure implemented? Using surveys, they found that social network analysis provided a useful means of examining chronic disease communication in practice, and highlighted the central role of care managers in this communication when their role structure supported such communication. They concluded that structuring care managers as embedded team members within the practice has important implications for their role in chronic disease communication within primary care.
AHRQ-funded; HS022690.
Citation: Holtrop JS, Ruland S, Diaz S .
Using social network analysis to examine the effect of care management structure on chronic disease management communication within primary care.
J Gen Intern Med 2018 May;33(5):612-20. doi: 10.1007/s11606-017-4247-z.
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Keywords: Care Management, Chronic Conditions, Communication, Primary Care, Teams
Everson J, Funk RJ, Kaufman SR
Repeated, close physician coronary artery bypass grafting teams associated with greater teamwork.
This study sought to determine whether observed patterns of physician interaction around shared patients are associated with higher levels of teamwork as perceived by physicians. It found that in hospitals where physicians repeatedly cared for patients with the same colleagues, physicians perceived better teamwork. When physicians who worked together also had other colleagues in common, the reported teamwork was stronger.
AHRQ-funded; HS024525; HS024728.
Citation: Everson J, Funk RJ, Kaufman SR .
Repeated, close physician coronary artery bypass grafting teams associated with greater teamwork.
Health Serv Res 2018 Apr;53(2):1025-41. doi: 10.1111/1475-6773.12703.
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Keywords: Cardiovascular Conditions, Care Coordination, Communication, Surgery, Teams
Artis KA, Dyer E, Mohan V
Accuracy of laboratory data communication on ICU daily rounds using an electronic health record.
The researchers created a robust but simple methodology to measure the prevalence of inaccurately communicated (misrepresented) data and to characterize data communication failures by type. They found that clinician laboratory data retrieval and communication during ICU rounds at their institution was poor, prone to omissions and inaccuracies, yet largely unrecognized by the rounding team.
AHRQ-funded; HS023793.
Citation: Artis KA, Dyer E, Mohan V .
Accuracy of laboratory data communication on ICU daily rounds using an electronic health record.
Crit Care Med 2017 Feb;45(2):179-86. doi: 10.1097/ccm.0000000000002060.
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Keywords: Communication, Electronic Health Records (EHRs), Health Information Technology (HIT), Intensive Care Unit (ICU), Teams
Mueller SK, Schnipper JL, Giannelli K
Impact of regionalized care on concordance of plan and preventable adverse events on general medicine services.
This study regionalized 3 inpatient general medical teams to nursing units and examined the association with communication and preventable adverse events (AEs). It found that regionalization of care teams improved recognition of care team members, discussion of daily care plan, and agreement on estimated discharge date, but did not significantly improve nurse and physician concordance of the care plan or reduce the odds of preventable AEs.
AHRQ-funded; HS023331.
Citation: Mueller SK, Schnipper JL, Giannelli K .
Impact of regionalized care on concordance of plan and preventable adverse events on general medicine services.
J Hosp Med 2016 Sep;11(9):620-7. doi: 10.1002/jhm.2566.
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Keywords: Adverse Events, Communication, Hospitals, Patient Safety, Teams
Costa DK, Dammeyer J, White M
Interprofessional team interactions about complex care in the ICU: pilot development of an observational rating tool.
The purpose of this study was to examine the reliability of an observational rating tool to assess team interactions about the awakening and breathing coordination, delirium, and early mobility (ABCDE) bundle in one ICU. It provided pilot evidence of reliability of an observational rating tool to assess interprofessional team interactions about ABCDE.
AHRQ-funded; HS024552.
Citation: Costa DK, Dammeyer J, White M .
Interprofessional team interactions about complex care in the ICU: pilot development of an observational rating tool.
BMC Res Notes 2016 Aug 18;9:408. doi: 10.1186/s13104-016-2213-1.
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Keywords: Healthcare Delivery, Communication, Critical Care, Intensive Care Unit (ICU), Teams
Shoemaker SJ, Parchman ML, Fuda KK
AHRQ Author: Ricciardi
A review of instruments to measure interprofessional team-based primary care.
The study’s aims were to develop a conceptual framework of high-functioning primary care teams to identify and review instruments that measure the constructs identified in the framework. The majority of instruments were surveys, and the remainder were observational checklists. They addressed multiple constructs, most commonly communication, heedful interrelating , respectful interactions, and shared explicit goals.
AHRQ-authored.
Citation: Shoemaker SJ, Parchman ML, Fuda KK .
A review of instruments to measure interprofessional team-based primary care.
J Interprof Care 2016 Jul;30(4):423-32. doi: 10.3109/13561820.2016.1154023..
Keywords: Communication, Healthcare Delivery, Primary Care, Teams
Dykes PC, Stade D, Dalal A
Strategies for managing mobile devices for use by hospitalized inpatients.
The authors implemented the PROSPECT (Promoting Respect and Ongoing Safety through Patient-centeredness, Engagement, Communication and Technology) project at Brigham and Women's Hospital. The goal of PROSPECT is to transform the hospital environment by providing a suite of e-tools to facilitate teamwork. In this paper, the authors described decisions and challenges faced and related the strategies used and lessons learned.
AHRQ-funded; HS023535.
Citation: Dykes PC, Stade D, Dalal A .
Strategies for managing mobile devices for use by hospitalized inpatients.
AMIA Annu Symp Proc 2015 Nov 5;2015:522-31.
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Keywords: Communication, Inpatient Care, Patient and Family Engagement, Patient Safety, Teams
Nguyen V, Okafor N, Zhang J
Using TURF to understand the functions of interruptions.
TURF stands for Task, User, Representation, and Function (TURF) analyses. This paper explores interruptions as an emergent feature of communication in teams. The authors focus on emergency medicine as this complex environment requires team based concurrent management of multiple patients coping with limited resources in a life-critical and interruption-laden environment. They classify interruptions into those activities that support required work and those interruptions that create unnecessary breaks in workflow.
AHRQ-funded; HS021236; HS017586.
Citation: Nguyen V, Okafor N, Zhang J .
Using TURF to understand the functions of interruptions.
AMIA Annu Symp Proc 2014 Nov;2014:917-23..
Keywords: Communication, Emergency Department, Health Information Technology (HIT), Teams