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AHRQ Research Studies Date
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- 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
1 to 15 of 15 Research Studies DisplayedYe S, Li D, Yu T
The impact of surgical volume on hospital ranking using the standardized infection ratio.
Researchers investigated the effect of surgical volume on the accuracy of identifying poorly performing hospitals. Their research was based on the standardized infection ratio, and they applied their proposed method to data from HCA Healthcare from 2014-2016 on surgical site infections in colon surgery patients. They concluded that minimum surgical volumes and predicted events criteria are required to make hospital evaluation reliable, and that these criteria may vary by overall prevalence and between-hospital variability.
AHRQ-funded; HS027791.
Citation: Ye S, Li D, Yu T .
The impact of surgical volume on hospital ranking using the standardized infection ratio.
Sci Rep 2023 May 10; 13(1):7624. doi: 10.1038/s41598-023-33937-y..
Keywords: Hospitals, Surgery, Healthcare-Associated Infections (HAIs), Provider Performance, Quality of Care
Schlick CJR, Huang R, Brajcich BC
Unbundling bundles: evaluating the association of individual colorectal surgical site infection reduction bundle elements on infection rates in a statewide collaborative.
The purpose of this study was to evaluate the association of individual surgical site infection reduction bundle elements with infection rates. Focusing on patients who had elective colorectal resections at participating hospitals from 2016 to 2017, findings showed that bundle elements had varying association with infection reduction. Recommendations included implementation of colorectal surgical site infection reduction bundles in order to focus on the specific elements associated with low surgical site infections.
AHRQ-funded; HS024516.
Citation: Schlick CJR, Huang R, Brajcich BC .
Unbundling bundles: evaluating the association of individual colorectal surgical site infection reduction bundle elements on infection rates in a statewide collaborative.
Dis Colon Rectum 2022 Aug;65(8):1052-61. doi: 10.1097/dcr.0000000000002223..
Keywords: Surgery, Healthcare-Associated Infections (HAIs), Quality Improvement, Quality of Care
Zhu Y, Simon GJ, Wick EC
Applying machine learning across sites: external validation of a surgical site infection detection algorithm.
Surgical complications have tremendous consequences and costs. Complication detection is important for quality improvement, but traditional manual chart review is burdensome. Automated mechanisms are needed to make this more efficient. The purpose of the study was to understand the generalizability of a machine learning algorithm between sites; automated surgical site infection (SSI) detection algorithms developed at one center were tested at another distinct center.
AHRQ-funded; HS024532.
Citation: Zhu Y, Simon GJ, Wick EC .
Applying machine learning across sites: external validation of a surgical site infection detection algorithm.
J Am Coll Surg 2021 Jun;232(6):963-71.e1. doi: 10.1016/j.jamcollsurg.2021.03.026..
Keywords: Healthcare-Associated Infections (HAIs), Surgery, Adverse Events, Diagnostic Safety and Quality, Electronic Health Records (EHRs), Health Information Technology (HIT), Quality Improvement, Quality of Care
Aasen DM, Bronsert Rozeboom, PD
Relationships between predischarge and postdischarge infectious complications, length of stay, and unplanned readmissions in the ACS NSQIP database.
This study looked at the relationships between predischarge and postdischarge infectious complications, length of stay, and unplanned hospital readmissions after surgery. Data from the American College of Surgeons National Surgical Quality Improvement database from 2012 to 2017 across nine surgical specialties was used to analyze 30-day postoperative infectious complications including sepsis, surgical site infections, pneumonia, and urinary tract infections. Postoperative infectious complications were identified in 5.2% of cases, of which 59.8% were postdischarge. The specific postdischarge complications identified were 73.4% of surgical site infections, 34.9% of sepsis cases, 26.5% of pneumonia cases, and 53.2% of urinary tract infections. These postoperative infections were associated with an increased risk of readmission. Most infections were diagnosed postdischarge. The trend towards shorter length of stays postoperation also contribute to the increase in infections detected after discharge and the rate of unplanned related postoperative readmissions.
AHRQ-funded; HS026019.
Citation: Aasen DM, Bronsert Rozeboom, PD .
Relationships between predischarge and postdischarge infectious complications, length of stay, and unplanned readmissions in the ACS NSQIP database.
Surgery 2021 Feb;169(2):325-32. doi: 10.1016/j.surg.2020.08.009..
Keywords: Hospital Readmissions, Adverse Events, Healthcare-Associated Infections (HAIs), Infectious Diseases, Quality Improvement, Quality of Care, Surgery
Bucher BT, Shi J, Ferraro JP
Portable automated surveillance of surgical site infections using natural language processing: development and validation.
The authors presented the development and validation of a portable natural language processing (NLP) approach for automated surveillance of surgical site infections (SSIs). Patient clinical text notes from EHRs following surgical procedures from two independent healthcare systems were abstracted. The authors found that automated surveillance of SSIs can be achieved using NLP of clinical notes with high sensitivity and specificity.
AHRQ-funded; HS025776.
Citation: Bucher BT, Shi J, Ferraro JP .
Portable automated surveillance of surgical site infections using natural language processing: development and validation.
Ann Surg 2020 Oct;272(4):629-36. doi: 10.1097/sla.0000000000004133..
Keywords: Surgery, Healthcare-Associated Infections (HAIs), Electronic Health Records (EHRs), Health Information Technology (HIT), Quality Improvement, Quality of Care
Sheetz KH, Ryan A
Accuracy of quality measurement for the hospital acquired conditions reduction program.
Accuracy of quality measurement for the hospital acquired conditions reduction program.
AHRQ-funded; HS026244; HS000053.
Citation: Sheetz KH, Ryan A .
Accuracy of quality measurement for the hospital acquired conditions reduction program.
BMJ Qual Saf 2020 Jul;29(7):605-07. doi: 10.1136/bmjqs-2019-009747..
Keywords: Healthcare-Associated Infections (HAIs), Hospitals, Quality Measures, Quality Improvement, Quality of Care, Surgery, Infectious Diseases
Alfred M, Catchpole K, Huffer E
Work systems analysis of sterile processing: decontamination.
This study examined the work of sterile processing departments (SPDs) from a systems perspective. This paper reports the results of a work systems analysis that sought to identify the complex multilevel interdependencies that create performance variation and identify potential improvement interactions. The analysis was conducted at a 700-bed academic hospital with two reprocessing facilities decontaminating approximately 23,000 units each month. Mixed methods, including 56 hours of observations of work was done, as well as formal and informal interviews with relevant stakeholders and analysis of data collected about the system. The authors identified 21 different performance shaping factors, 30 potential failures, 16 types of process variance, and 10 outcome variances in decontamination. Approximately 2% of trays were returned to decontamination from assembly with 1% of surgical cases having decontamination problems.
AHRQ-funded; HS025538.
Citation: Alfred M, Catchpole K, Huffer E .
Work systems analysis of sterile processing: decontamination.
BMJ Qual Saf 2020 Apr;29(4):320-28. doi: 10.1136/bmjqs-2019-009422..
Keywords: Patient Safety, Quality Improvement, Quality of Care, Prevention, Surgery, Healthcare-Associated Infections (HAIs)
McGee MF, Kreutzer L, Quinn CM
Leveraging a comprehensive program to implement a colorectal surgical site infection reduction bundle in a statewide quality improvement collaborative.
This study’s objective was examine the implementation and associated clinical outcomes of a comprehensive colorectal surgical site infection (SSI) reduction bundle in a large statewide quality improvement collaborative. This multifaceted bundle includes guided implementation, data feedback, mentorship, process improvement training/coaching, and targeted-implementation toolkits. Bundle adherence outcomes were examined pre- and post-implementation. Among 32 hospitals, there was a 2.4-fold relative increase in patients completing at least 75% of bundle elements. The largest gains were in wound closure re-gowning/re-gloving, use of clean closing instruments, and preoperative chlorhexidine bathing. Adherence showed a significant decrease in superficial SSI rates.
AHRQ-funded; HS024516.
Citation: McGee MF, Kreutzer L, Quinn CM .
Leveraging a comprehensive program to implement a colorectal surgical site infection reduction bundle in a statewide quality improvement collaborative.
Ann Surg 2019 Oct;270(4):701-11. doi: 10.1097/sla.0000000000003524..
Keywords: Surgery, Healthcare-Associated Infections (HAIs), Patient Safety, Quality Improvement, Quality of Care
Calderwood MS, Yokoe DS, Murphy MV
Effectiveness of a multistate quality improvement campaign in reducing risk of surgical site infections following hip and knee arthroplasty.
The authors assessed the effect of a multistate quality improvement campaign to promote the adoption of evidence-based surgical site infection (SSI) prevention practices. Rates of SSI among Medicare beneficiaries undergoing hip and knee arthroplasty during pre-intervention and post-intervention in five states included in a multistate trial of the Project JOINTS campaign and five matched comparison states were analyzed. The authors found a larger reduction of SSI rates following hip and knee arthroplasty in intervention states than in the matched control states.
AHRQ-funded; HS021424.
Citation: Calderwood MS, Yokoe DS, Murphy MV .
Effectiveness of a multistate quality improvement campaign in reducing risk of surgical site infections following hip and knee arthroplasty.
BMJ Qual Saf 2019 May;28(5):374-81. doi: 10.1136/bmjqs-2018-007982..
Keywords: Healthcare-Associated Infections (HAIs), Surgery, Orthopedics, Quality Improvement, Quality of Care, Evidence-Based Practice, Prevention, Patient Safety
Skube SJ, Hu Z, Arsoniadis EG
Characterizing surgical site infection signals in clinical notes.
Building off of previous work for automated and semi-automated surgical site infections (SSIs) detection using expert-derived "strong features" from clinical notes, researchers hypothesized that additional SSI phrases may be contained in clinical notes. They systematically characterized phrases and expressions associated with SSIs. While 83 percent of expert-derived original terms overlapped with new terms and modifiers, an additional 362 modifiers associated with both positive and negative SSI signals were identified.
AHRQ-funded; HS024532.
Citation: Skube SJ, Hu Z, Arsoniadis EG .
Characterizing surgical site infection signals in clinical notes.
Stud Health Technol Inform 2017;245:955-59.
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Keywords: Healthcare-Associated Infections (HAIs), Surgery, Injuries and Wounds, Patient Safety, Adverse Events, Quality Improvement, Quality of Care
Hu Z, Melton GB, Arsoniadis EG
Strategies for handling missing clinical data for automated surgical site infection detection from the electronic health record.
Proper handling of missing data is important for many secondary uses of electronic health record (EHR) data. Data imputation methods can be used to handle missing data, but their use for postoperative complication detection is unclear. Overall, models with missing data imputation almost always outperformed reference models without imputation that included only cases with complete data for detection of SSI overall achieving very good average area under the curve values.
AHRQ-funded; HS024532.
Citation: Hu Z, Melton GB, Arsoniadis EG .
Strategies for handling missing clinical data for automated surgical site infection detection from the electronic health record.
J Biomed Inform 2017 Apr;68:112-20. doi: 10.1016/j.jbi.2017.03.009.
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Keywords: Data, Electronic Health Records (EHRs), Healthcare-Associated Infections (HAIs), Registries, Surgery, Injuries and Wounds, Health Information Technology (HIT), Quality Improvement, Quality of Care, Adverse Events
Calderwood MS, Kleinman K, Huang SS
Surgical site infections: volume-outcome relationship and year-to-year stability of performance rankings.
The researchers evaluated the volume-outcome relationship as well as the year-to-year stability of performance rankings following coronary artery bypass graft (CABG) surgery and hip arthroplasty. They concluded that aggregate surgical site infection risk is highest in hospitals with low annual procedure volumes. Even for higher volume hospitals, year-to-year random variation makes past experience an unreliable estimator of current performance.
AHRQ-funded; HS021424.
Citation: Calderwood MS, Kleinman K, Huang SS .
Surgical site infections: volume-outcome relationship and year-to-year stability of performance rankings.
Med Care 2017 Jan;55(1):79-85. doi: 10.1097/mlr.0000000000000620.
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Keywords: Surgery, Healthcare-Associated Infections (HAIs), Adverse Events, Injuries and Wounds, Hospitals, Provider Performance, Quality Indicators (QIs), Quality of Care, Patient Safety, Elderly
Minami CA, Dahlke AR, Barnard C
Association between hospital characteristics and performance on the new hospital-acquired condition reduction program's surgical site infection measures.
This research letter evaluated the association between hospital characteristics and surgical site infection (SSI) measures. The authors found that hospitals with higher hospital quality summary scores were more frequently poor performers for SSI and had higher standardized infection ratios. Hospitals were more likely to be poor performers for colon SSI and hysterectomy SSI if they were a teaching hospital, safety-net hospital, or level I trauma center. Teaching hospitals were more likely to be poor performers for colorectal SSI, but the association was not as consistent for hysterectomy.
AHRQ-funded; HS021857.
Citation: Minami CA, Dahlke AR, Barnard C .
Association between hospital characteristics and performance on the new hospital-acquired condition reduction program's surgical site infection measures.
JAMA Surg 2016 Aug;151(8):777-9. doi: 10.1001/jamasurg.2016.0408.
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Keywords: Healthcare-Associated Infections (HAIs), Surgery, Injuries and Wounds, Adverse Events, Quality Measures, Hospitals, Quality of Care
Durkin MJ, Dicks KV, Baker AW
Postoperative infection in spine surgery: does the month matter?
The authors evaluated for seasonal variation of surgical site infection (SSI) following spine surgery in a network of nonteaching community hospitals. They found that the rate of SSI following fusion or spinal laminectomy/laminoplasty was higher during the summer in this network of community hospitals, most likely due to S. aureus rather than the July effect.
AHRQ-funded; HS023866.
Citation: Durkin MJ, Dicks KV, Baker AW .
Postoperative infection in spine surgery: does the month matter?
J Neurosurg Spine 2015 Jul;23(1):128-34. doi: 10.3171/2014.10.spine14559.
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Keywords: Surgery, Healthcare-Associated Infections (HAIs), Injuries and Wounds, Adverse Events, Patient Safety, Hospitals, Outcomes, Quality of Care
Leotsakos A, Zheng H, Croteau R
Standardization in patient safety: the WHO High 5s project.
This paper reports on a global safety initiative of the World Health Organization to facilitate development, implementation, and evaluation of Standard Operating Protocols (SOPs) within a global learning community. Thus far, 3 SOPs—correct surgery, medication reconciliation, concentrated injectable medicines—have been developed, implemented and evaluated in hospitals in 7 participating countries.
AHRQ-funded; 290201200006C
Citation: Leotsakos A, Zheng H, Croteau R .
Standardization in patient safety: the WHO High 5s project.
Int J Qual Health Care. 2014 Apr;26(2):109-16. doi: 10.1093/intqhc/mzu010..
Keywords: Patient Safety, Quality of Care, Surgery, Medication: Safety, Healthcare-Associated Infections (HAIs)