National Healthcare Quality and Disparities Report
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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 65 of 65 Research Studies DisplayedAbelson JS, Chait A, Shen MJ
Coping strategies among colorectal cancer patients undergoing surgery and the role of the surgeon in mitigating distress: a qualitative study.
This study researched the role that surgeons can play in managing stress in patients undergoing colorectal cancer surgery. Patients were interviewed in-depth using open-ended questions. While patients did not believe surgeons are responsible for helping them cope, they do believe that they can play a role in managing their distress.
AHRQ-funded; HS000066.
Citation: Abelson JS, Chait A, Shen MJ .
Coping strategies among colorectal cancer patients undergoing surgery and the role of the surgeon in mitigating distress: a qualitative study.
Surgery 2019 Feb;165(2):461-68. doi: 10.1016/j.surg.2018.06.005..
Keywords: Cancer: Colorectal Cancer, Clinician-Patient Communication, Provider: Physician, Stress, Surgery
Shubeck SP, Kanters AE, Dimick JB
Surgeon leadership style and risk-adjusted patient outcomes.
The goal of this study was to determine if individual surgeons' personality traits and related leadership behaviors – such as participation in continuing education, effective self-reflection, and openness to feedback – correlated with patient-level outcomes after bariatric surgery. Surgeons from the Michigan Bariatric Surgery Collaborative (MBSC) were administered the Life Styles Inventory (LSI) assessment, the results of which were then collapsed into three styles corresponding with particular patterns of individual thinking and behavior: constructive, passive/defensive, and aggressive/defensive. Patient-level risk-adjusted rates of complications after bariatric surgery were then used to quantify the impact surgeon style had on post-operative outcomes. The results of the study demonstrate that surgeons' leadership styles are correlated with surgical outcomes for their individual patients.
AHRQ-funded; HS023597.
Citation: Shubeck SP, Kanters AE, Dimick JB .
Surgeon leadership style and risk-adjusted patient outcomes.
Surg Endosc 2019 Feb;33(2):471-74. doi: 10.1007/s00464-018-6320-z.
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Keywords: Education: Continuing Medical Education, Patient Safety, Outcomes, Provider: Physician, Surgery
Sheetz KH, Ibrahim AM, Regenbogen SE
Surgeon experience and Medicare expenditures for laparoscopic compared to open colectomy.
This population-based study examined whether surgeon experience with laparoscopy influenced payments for laparoscopy versus open surgery colectomies. The study used 182,852 national Medicare beneficiaries undergoing colectomies between 2010 and 2012. Surgeons with the most laparoscopic experience did experience an average payment savings of $5456 per patient in laparoscopic versus open cases. For surgeons in the lowest quartile of experience there was no difference.
AHRQ-funded; HS023597.
Citation: Sheetz KH, Ibrahim AM, Regenbogen SE .
Surgeon experience and Medicare expenditures for laparoscopic compared to open colectomy.
Ann Surg 2018 Dec;268(6):1036-42. doi: 10.1097/sla.0000000000002312..
Keywords: Elderly, Surgery, Medicare, Healthcare Costs, Provider: Physician
Horwood CR, Moffatt-Bruce SD, Fitzgerald M
A qualitative analysis of clinical decompensation in the surgical patient: perceptions of nurses and physicians.
This study is a quantitative analysis of nurse and physician perception of clinical decompensation in postsurgical patients. The study aims to assess how nurses and physicians perceive early warning signs that predict clinical decompensation, changes in clinical acuity, and the need for escalation of care. Many areas showed strong agreement, but there were differences between nurses and physicians in primary indicators of patient stability. There were also differences in the methods and frequency used to monitor medically unstable patients.
AHRQ-funded; HS024379.
Citation: Horwood CR, Moffatt-Bruce SD, Fitzgerald M .
A qualitative analysis of clinical decompensation in the surgical patient: perceptions of nurses and physicians.
Surgery 2018 Dec;164(6):1311-15. doi: 10.1016/j.surg.2018.06.006..
Keywords: Adverse Events, Health Status, Provider: Clinician, Provider: Nurse, Provider: Physician, Surgery
Blay E, Engelhardt KE, Hewitt DB
Evaluation of reasons why surgical residents exceeded 2011 duty hour requirements when offered flexibility: a FIRST Trial analysis.
This study’s objective was to examine the reasons why residents exceeded a 24-hour call during their daily shift. Residents in the flexible arm of the Flexibility in Duty Hour Requirement for Surgical Trainees (FIRST) trial were surveyed anonymously. All clinical general surgery residents taking the 2017 American Board of Surgery In-Training Examination were included in the survey. There was a very high response rate (99.2%) which included 1838 of 1852 general surgery residents in the FIRST trial. Of those who responded, 21.7% indicated their programs expected them to stay longer. A large majority (78.1%) indicated they wanted to stay longer with only 7.4% reporting coercion from attending surgeons, and 9.3% reporting coercion from senior residents.
AHRQ-funded; HS000078.
Citation: Blay E, Engelhardt KE, Hewitt DB .
Evaluation of reasons why surgical residents exceeded 2011 duty hour requirements when offered flexibility: a FIRST Trial analysis.
JAMA Surg 2018 Sep;153(9):860-62. doi: 10.1001/jamasurg.2018.1047.
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Keywords: Surgery, Provider: Physician, Education: Continuing Medical Education, Provider
Shubeck SP, Kanters AE, Sandhu G
Dynamics within peer-to-peer surgical coaching relationships: early evidence from the Michigan Bariatric Surgical Collaborative.
Through a qualitative thematic analysis, the investigators sought to determine if surgeons could comfortably and effectively transition to a co-learner dynamic for effective peer coaching. The investigators suggest that their qualitative analysis demonstrates that surgeons naturally and effectively assume co-learner roles when participating in an early surgical coaching experience.
AHRQ-funded; HS000053; HS023597.
Citation: Shubeck SP, Kanters AE, Sandhu G .
Dynamics within peer-to-peer surgical coaching relationships: early evidence from the Michigan Bariatric Surgical Collaborative.
Surgery 2018 Aug;164(2):185-88. doi: 10.1016/j.surg.2018.03.009..
Keywords: Provider: Physician, Surgery
Jones LK, Jennings BM, Higgins MK
Ethological observations of social behavior in the operating room.
This study used ethological observation techniques, recording live all social behavior to document the full range of behavior of operating room teams. The study focused on examining the hierarchical, mixed-gender aspects of clinical teams.
AHRQ-funded; HS023403.
Citation: Jones LK, Jennings BM, Higgins MK .
Ethological observations of social behavior in the operating room.
Proc Natl Acad Sci U S A 2018 Jul 17;115(29):7575-80. doi: 10.1073/pnas.1716883115..
Keywords: Patient Safety, Surgery, Provider: Physician, Provider
Yeo HL, Abelson JS, Symer MM
Association of time to attrition in surgical residency with individual resident and programmatic factors.
Attrition in general surgery residency remains high, and attrition that occurs in the later years is the most worrisome. Although several studies have retrospectively investigated the timing of attrition, no study to date has prospectively evaluated a national cohort of residents to understand which residents are at risk for attrition and at what point during residency. The purpose of this study was to prospectively evaluate individual resident and programmatic factors associated with the timing of attrition during general surgery residency.
AHRQ-funded; HS000066.
Citation: Yeo HL, Abelson JS, Symer MM .
Association of time to attrition in surgical residency with individual resident and programmatic factors.
JAMA Surg 2018 Jun;153(6):511-17. doi: 10.1001/jamasurg.2017.6202.
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Keywords: Education: Continuing Medical Education, Provider, Provider: Physician, Surgery
Greenberg CC, Ghousseini HN, Pavuluri Quamme SR
A statewide surgical coaching program provides opportunity for continuous professional development.
Researchers sought to develop and evaluate a video-based coaching program for board-eligible/certified surgeons. They found that, overall, participants were satisfied with their experience and found the coaching program valuable. Future research to evaluate the impact of coaching on practice change and patient outcomes is recommended.
AHRQ-funded; HS022403.
Citation: Greenberg CC, Ghousseini HN, Pavuluri Quamme SR .
A statewide surgical coaching program provides opportunity for continuous professional development.
Ann Surg 2018 May;267(5):868-73. doi: 10.1097/sla.0000000000002341..
Keywords: Education: Continuing Medical Education, Health Services Research (HSR), Patient Safety, Provider, Provider: Physician, Quality of Care, Surgery
Morris RS, Ruck JM, Conca-Cheng AM
Shared decision-making in acute surgical illness: the surgeon's perspective.
The authors sought to learn more about surgeons’ perceptions of shared decision-making in settings in which surgical patients have more comorbidities and are of an older age. In this article, they discussed the 6 majors themes that emerged (responsibility for the decision to operate, perceived futility, surgeon judgment, surgeon introspection, pressure to operate, and costs of the operation).
AHRQ-funded; HS024736.
Citation: Morris RS, Ruck JM, Conca-Cheng AM .
Shared decision-making in acute surgical illness: the surgeon's perspective.
J Am Coll Surg 2018 May;226(5):784-95. doi: 10.1016/j.jamcollsurg.2018.01.008.
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Keywords: Decision Making, Provider: Physician, Surgery
Varghese TK, Jr., Ghaferi AA
Cutting-edge efforts in surgical patient safety.
In October, 2015, the Surgical Outcomes Club convened a patient safety panel in Chicago, Illinois. The goal was to emphasize that patient safety efforts require a uniform, systematic, evidence-based approach. This article incorporates the major themes of the session—developing reliable measures of surgeon performance, real-world methods for continuous improvement and learning, and opportunities for incorporating the principles of implementation science into patient safety efforts.
AHRQ-funded; HS023621; HS024403.
Citation: Varghese TK, Jr., Ghaferi AA .
Cutting-edge efforts in surgical patient safety.
JAMA Surg 2017 Aug;152(8):719-20. doi: 10.1001/jamasurg.2017.0858.
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Keywords: Patient-Centered Outcomes Research, Surgery, Patient Safety, Evidence-Based Practice, Provider: Physician, Provider
Berian JR, Thomas JM, Minami CA
Evaluation of a novel mentor program to improve surgical care for US hospitals.
This study evaluated a novel mentor program for 27 US surgeons, charged with improving quality at their respective hospitals, having been paired 1:1 with 27 surgeon mentors through a state-wide quality improvement (QI) initiative. It found that mentorship played a vital role in advancing surgeon knowledge and engagement with QI in the Illinois Surgical Quality Improvement Collaborative.
AHRQ-funded; HS024516.
Citation: Berian JR, Thomas JM, Minami CA .
Evaluation of a novel mentor program to improve surgical care for US hospitals.
Int J Qual Health Care 2017 Apr 1;29(2):234-42. doi: 10.1093/intqhc/mzx005.
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Keywords: Hospitals, Quality Improvement, Patient Safety, Surgery, Quality of Care, Provider: Physician, Provider
Jones LK, Jennings BM, Goelz RM
An ethogram to quantify operating room behavior.
The researchers adopted a method from the field of ethology for observing and quantifying the interpersonal interactions of operating room (OR) team members. They found that the ethogram's high interobserver reliability indicates its utility for yielding largely objective, descriptive, quantitative data on OR behavior.
AHRQ-funded; HS023403.
Citation: Jones LK, Jennings BM, Goelz RM .
An ethogram to quantify operating room behavior.
Ann Behav Med 2016 Aug;50(4):487-96. doi: 10.1007/s12160-016-9773-0.
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Keywords: Communication, Provider: Physician, Provider, Surgery, Patient Safety
Abdelrahman AM, Bingener J, Yu D
Impact of single-incision laparoscopic cholecystectomy (SILC) versus conventional laparoscopic cholecystectomy (CLC) procedures on surgeon stress and workload: a randomized controlled trial.
The goal of this study was to compare surgeon stress and workload between single-incision laparoscopic cholecystectomy (SILC) and conventional laparoscopic cholecystectomy (CLC). It concluded that surgeon heart rate, salivary cortisol level, instrument usability, and Surg-TLX ratings indicate that SILC is significantly more stressful and physically demanding than the CLC.
AHRQ-funded; HS023146.
Citation: Abdelrahman AM, Bingener J, Yu D .
Impact of single-incision laparoscopic cholecystectomy (SILC) versus conventional laparoscopic cholecystectomy (CLC) procedures on surgeon stress and workload: a randomized controlled trial.
Surg Endosc 2016 Mar;30(3):1205-11. doi: 10.1007/s00464-015-4332-5.
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Keywords: Provider, Provider: Physician, Stress, Surgery
Collins CE, Pringle PL, Santry HP
Innovation or rebranding, acute care surgery diffusion will continue.
The researchers conducted a qualitative study comprising face-to-face interviews with senior surgeons responsible for acute care surgery (ACS) at 18 teaching hospitals chosen to ensure diversity of opinions and practice environment. Their analysis suggests that the implementation of ACS, whether a true health care delivery innovation or an innovative rebranding, fits into the Rogers’ diffusion of innovation theory.
AHRQ-funded; HS022694.
Citation: Collins CE, Pringle PL, Santry HP .
Innovation or rebranding, acute care surgery diffusion will continue.
J Surg Res 2015 Aug;197(2):354-62. doi: 10.1016/j.jss.2015.03.046..
Keywords: Surgery, Critical Care, Organizational Change, Provider: Physician