National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (1)
- Adverse Events (3)
- Ambulatory Care and Surgery (1)
- Behavioral Health (3)
- Blood Clots (1)
- Blood Pressure (1)
- Cardiovascular Conditions (10)
- Caregiving (1)
- Care Management (1)
- Catheter-Associated Urinary Tract Infection (CAUTI) (1)
- Central Line-Associated Bloodstream Infections (CLABSI) (1)
- Children/Adolescents (2)
- Chronic Conditions (1)
- Communication (3)
- Comparative Effectiveness (2)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (1)
- COVID-19 (1)
- Critical Care (3)
- Decision Making (1)
- Diagnostic Safety and Quality (1)
- Domestic Violence (1)
- Education: Patient and Caregiver (1)
- Electronic Health Records (EHRs) (2)
- Emergency Department (2)
- Evidence-Based Practice (12)
- Falls (3)
- Guidelines (2)
- Healthcare-Associated Infections (HAIs) (7)
- Healthcare Delivery (5)
- Health Information Technology (HIT) (1)
- Heart Disease and Health (4)
- Hospitalization (2)
- Hospitals (4)
- Implementation (3)
- Infectious Diseases (2)
- Injuries and Wounds (1)
- Inpatient Care (2)
- Intensive Care Unit (ICU) (3)
- Kidney Disease and Health (1)
- Medical Errors (1)
- Medication (2)
- Medication: Safety (1)
- Newborns/Infants (1)
- Nursing (1)
- Nursing Homes (1)
- Opioids (1)
- Orthopedics (1)
- Outcomes (3)
- Patient-Centered Healthcare (3)
- Patient-Centered Outcomes Research (7)
- Patient Safety (10)
- Payment (1)
- Practice Improvement (3)
- Practice Patterns (1)
- Pressure Ulcers (1)
- (-) Prevention (31)
- Primary Care (11)
- Primary Care: Models of Care (1)
- Provider (1)
- Provider: Nurse (1)
- Provider Performance (1)
- Quality Improvement (23)
- Quality Indicators (QIs) (4)
- Quality Measures (2)
- (-) Quality of Care (31)
- Risk (1)
- Skin Conditions (1)
- Substance Abuse (1)
- Surgery (2)
- Tobacco Use (1)
- Urinary Tract Infection (UTI) (1)
- Web-Based (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 25 of 31 Research Studies DisplayedKrauss DM, Molefe A, Hung L
AHRQ Author: Henderson S, Miller M
Emergent themes from a quality improvement programme for CLABSI/CAUTI prevention in ICUs amid the COVID-19 pandemic.
In this study, researchers summarized themes for maintaining infection prevention activities learned from the implementation of a quality improvement (QI) program during the COVID-19 pandemic. They concluded that future shocks such as the pandemic must be anticipated, and the healthcare system must be resilient to the resulting disruptions to healthcare-associated infection prevention activities. Their study encountered four themes for successful maintenance of infection prevention activities during the current pandemic: the value of a pre-existing infection prevention infrastructure; a flexibility in approach; broad buy-in for maintaining QI programs; and the facilitation of idea-sharing.
AHRQ-authored; AHRQ-funded; 233201500016I.
Citation: Krauss DM, Molefe A, Hung L .
Emergent themes from a quality improvement programme for CLABSI/CAUTI prevention in ICUs amid the COVID-19 pandemic.
BMJ Open Qual 2022 Nov;11(4):e001926. doi: 10.1136/bmjoq-2022-001926..
Keywords: COVID-19, Central Line-Associated Bloodstream Infections (CLABSI), Catheter-Associated Urinary Tract Infection (CAUTI), Healthcare-Associated Infections (HAIs), Quality Improvement, Quality of Care, Critical Care, Intensive Care Unit (ICU), Prevention, Urinary Tract Infection (UTI), Infectious Diseases
Cohen DJ, Sweeney SM, Miller WL
Improving smoking and blood pressure outcomes: the interplay between operational changes and local context.
This study identified conditions and operational changes linked to improvements in smoking and blood pressure (BP) outcomes in primary care using samples and interviews from a subset of 104 practices participating in EvidenceNOW, a multisite cardiovascular disease prevention initiative. The authors calculated Clinical Quality Measure improvements, with targets of 10-point or greater absolute improvements in the proportion of patients with smoking screening, and if relevant, counseling and the proportion of hypertensive patients with adequately controlled BP. Primary care staff were surveyed and interviewed. In clinician-owned practices, implementing a workflow to routinely screen and counsel patients on smoking cessation resources, or implementing a documentation change or a referral to a resource alone led to an improvement of at least 10 points in the smoking outcome. These improvements did not occur though in health- or hospital system-owned practices or in Federally Qualified Health Centers. BP outcome improved by at least 10 points among solo practices after medical assistants learned how to take an accurate BP. Among larger, clinician-owned practices, BP outcomes improvement took place when staff took a second BP measurement after the first measurement was elevated and when staff learned where to document this information in the electronic health record. For larger and health- and hospital system-owned practices, 50 or more hours of facilitation was needed to improve BP outcomes.
AHRQ-funded; HS023940.
Citation: Cohen DJ, Sweeney SM, Miller WL .
Improving smoking and blood pressure outcomes: the interplay between operational changes and local context.
Ann Fam Med 2021 May-Jun;19(3):240-48. doi: 10.1370/afm.2668..
Keywords: Blood Pressure, Tobacco Use, Primary Care, Quality Improvement, Cardiovascular Conditions, Quality of Care, Evidence-Based Practice, Patient-Centered Outcomes Research, Prevention, Outcomes
Anderson KE, Alexander GC, Niles L
Quality of preventive and chronic illness care for insured adults with opioid use disorder.
Investigators sought to measure quality of non-opioid use disorder (OUD) preventive and chronic illness care and care coordination for individuals with OUD compared with individuals without OUD. They used deidentified data on outpatients throughout the United States from claims for commercially insured and Medicare Advantage enrollees aged 18 years or older with diagnosis codes for OUD. They found that individuals with OUD have moderately lower quality of care across preventive and chronic illness care and care coordination for non-OUD care compared with individuals without OUD. They recommended more attention to measurement and improvement of non-OUD care for these individuals.
AHRQ-funded; HS000029.
Citation: Anderson KE, Alexander GC, Niles L .
Quality of preventive and chronic illness care for insured adults with opioid use disorder.
JAMA Netw Open 2021 Apr;4(4):e214925. doi: 10.1001/jamanetworkopen.2021.4925..
Keywords: Opioids, Medication, Substance Abuse, Quality Indicators (QIs), Quality of Care, Behavioral Health, Chronic Conditions, Prevention
Solberg LI, Kuzel A, Parchman ML
A taxonomy for external support for practice transformation.
There is no commonly accepted comprehensive framework for describing the practical specifics of external support for practice change. In this study, the researchers’goal was to develop a taxonomy that could be used by both external groups or researchers and health care leaders. The leaders of 8 grants from Agency for Research and Quality for the EvidenceNOW study of improving cardiovascular preventive services in over 1500 primary care practices nationwide worked collaboratively over 18 months to develop descriptions of key domains that might comprehensively characterize any external support intervention.
AHRQ-funded; HS023940.
Citation: Solberg LI, Kuzel A, Parchman ML .
A taxonomy for external support for practice transformation.
J Am Board Fam Med 2021 Jan-Feb;34(1):32-39. doi: 10.3122/jabfm.2021.01.200225..
Keywords: Primary Care, Healthcare Delivery, Cardiovascular Conditions, Evidence-Based Practice, Prevention, Quality Improvement, Practice Improvement, Quality of Care
Gaughan AA, Walker DM, DePuccio MJ
Rewarding and recognizing frontline staff for success in infection prevention.
This article discusses how managers can use reward and recognition programs as motivational tools to sustain frontline healthcare-associated infection (HAI) prevention. Data from interviews with hospital managers and frontline staff at 18 US hospitals were used to identify these tools.
AHRQ-funded; HS024958.
Citation: Gaughan AA, Walker DM, DePuccio MJ .
Rewarding and recognizing frontline staff for success in infection prevention.
Am J Infect Control 2021 Jan;49(1):123-25. doi: 10.1016/j.ajic.2020.06.208..
Keywords: Healthcare-Associated Infections (HAIs), Infectious Diseases, Prevention, Quality Improvement, Quality of Care
Mueller KL, Naganathan S, Griffey RT
Counseling on Access to Lethal Means-Emergency Department (CALM-ED): a quality improvement program for firearm injury prevention.
The authors evaluated the feasibility of the Counseling on Access to Lethal Means intervention in the Emergency Department (CALM-ED) by non-physician personnel. Their quality improvement study was conducted in an urban, academic ED with over 90,000 annual patient visits, and considered adult patients who were discharged after presenting to the ED with a suicidal crisis. They found that an ED-based CALM quality-improvement intervention was feasible for implementation by non-physician personnel and was well received by patients and families. They concluded that the intervention has the potential to help saves lives at times of suicide crisis.
AHRQ-funded; HS025052.
Citation: Mueller KL, Naganathan S, Griffey RT .
Counseling on Access to Lethal Means-Emergency Department (CALM-ED): a quality improvement program for firearm injury prevention.
West J Emerg Med 2020 Aug 20;21(5):1123-30. doi: 10.5811/westjem.2020.5.46952.
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Keywords: Emergency Department, Injuries and Wounds, Prevention, Quality Improvement, Quality of Care, Domestic Violence, Behavioral Health
Baernholdt M, Yan G, Hinton ID
Effect of preventive care interventions on pressure ulcer rates in a national sample of rural and urban nursing units: Longitudinal associations over 4 years.
This study looked at the effects of nursing care interventions aimed at preventing pressure ulcers in rural and urban hospitals over a 4-year period. This longitudinal study used unit-level data from the National Database of Nursing Quality Indicators 2010-2013. The authors analyzed 5761 units (332 rural and 5429 urban) in 772 hospitals (89 rural and 683 urban) that reported ulcer rates in two or more quarters. Outcomes from use of a three-care intervention combination was measured with decreases in pressure ulcers shown from any of those interventions (patients receiving skin assessment on admission, receiving risk assessment on admission, and receiving any risk assessment before the pressure ulcer). An increase in RN skill mix and two nurse outcomes (increase in job satisfaction and intent-to-stay) also led to decreases in ulcer rates.
AHRQ-funded; HS023147.
Citation: Baernholdt M, Yan G, Hinton ID .
Effect of preventive care interventions on pressure ulcer rates in a national sample of rural and urban nursing units: Longitudinal associations over 4 years.
Int J Nurs Stud 2020 May;105:103455. doi: 10.1016/j.ijnurstu.2019.103455..
Keywords: Pressure Ulcers, Prevention, Skin Conditions, Nursing, Practice Patterns, Provider: Nurse, Provider, Quality Indicators (QIs), Quality Measures, Quality of Care
Persell SD, Liss DT, Walunas TL
Effects of 2 forms of practice facilitation on cardiovascular prevention in primary care: a practice-randomized, comparative effectiveness trial.
Effective quality improvement (QI) strategies are needed for small practices. The objective of this study was to compare practice facilitation implementing point-of-care (POC) QI strategies alone versus facilitation implementing point-of-care plus population management (POC+PM) strategies on preventive cardiovascular care. The investigators concluded that facilitator-led QI promoting population management approaches plus POC improvement strategies was not clearly superior to POC strategies alone.
AHRQ-funded; HS023921.
Citation: Persell SD, Liss DT, Walunas TL .
Effects of 2 forms of practice facilitation on cardiovascular prevention in primary care: a practice-randomized, comparative effectiveness trial.
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Keywords: Cardiovascular Conditions, Prevention, Primary Care: Models of Care, Primary Care, Comparative Effectiveness, Patient-Centered Outcomes Research, Evidence-Based Practice, Quality Improvement, Quality of Care, Care Management, Healthcare Delivery
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)
Sweeney SM, Hemler JR, Baron AN
Dedicated workforce required to support large-scale practice improvement.
Facilitation is an effective approach for helping practices implement sustainable evidence-based practice improvements. Few studies examine the facilitation infrastructure and support needed for large-scale dissemination and implementation initiatives. In this paper, the authors discuss a project by the Agency for Health care Research and Quality in which it funded 7 Cooperatives, each of which worked with over 200 primary care practices to rapidly disseminate and implement improvements in cardiovascular preventive care.
AHRQ-funded; HS023940.
Citation: Sweeney SM, Hemler JR, Baron AN .
Dedicated workforce required to support large-scale practice improvement.
J Am Board Fam Med 2020 Mar-Apr;33(2):230-39. doi: 10.3122/jabfm.2020.02.190261..
Keywords: Practice Improvement, Primary Care, Cardiovascular Conditions, Healthcare Delivery, Quality Improvement, Quality of Care, Prevention, Implementation, Evidence-Based Practice
Stoops C, Stone S, Evans E
Baby NINJA (Nephrotoxic Injury Negated by Just-in-Time Action): reduction of nephrotoxic medication-associated acute kidney injury in the neonatal intensive care unit.
The purpose of this study was to test if acute kidney injury (AKI) is preventable in patients in the neonatal intensive care unit and if infants at high-risk of nephrotoxic medication-induced AKI can be identified using a systematic surveillance program previously used in the pediatric non-intensive care unit setting. The authors concluded that a systematic surveillance program to identify high-risk infants can prevent nephrotoxic-induced AKI and has the potential to prevent short and long-term consequences of AKI in critically ill infants.
AHRQ-funded; HS023763.
Citation: Stoops C, Stone S, Evans E .
Baby NINJA (Nephrotoxic Injury Negated by Just-in-Time Action): reduction of nephrotoxic medication-associated acute kidney injury in the neonatal intensive care unit.
J Pediatr 2019 Dec;215:223-28.e6. doi: 10.1016/j.jpeds.2019.08.046..
Keywords: Newborns/Infants, Medication, Medication: Safety, Patient Safety, Kidney Disease and Health, Intensive Care Unit (ICU), Critical Care, Quality Improvement, Quality of Care, Prevention, Adverse Drug Events (ADE), Adverse Events
Jones KJ, Skinner A, Venema D
Evaluating the use of multiteam systems to manage the complexity of inpatient falls in rural hospitals.
Researchers evaluated the implementation and outcomes of evidence-based fall-risk-reduction processes when those processes are implemented using a multiteam system (MTS) structure. They found that multiteam systems that effectively coordinate fall-risk-reduction processes may improve the capacity of hospitals to manage the complex patient, environmental, and system factors that result in falls.
AHRQ-funded; HS024630; HS021429.
Citation: Jones KJ, Skinner A, Venema D .
Evaluating the use of multiteam systems to manage the complexity of inpatient falls in rural hospitals.
Health Serv Res 2019 Oct;54(5):994-1006. doi: 10.1111/1475-6773.13186..
Keywords: Falls, Hospitals, Inpatient Care, Quality of Care, Quality Improvement, Patient Safety, Prevention, Risk
Klock M, Kang H, Gon Y
Scoring patient fall reports using quality rubric and machine learning.
Employing AHRQ’s rubric for assessing the quality of fall reports, the authors compared three different machine-learning models and identified the most effective method for scoring fall reports. They intend that their study results will be applicable in healthcare facilities to score reports during reporting for reporters to improve report quality. Their ultimate goal is to increase learning from fall reports for better prevention of patient falls.
AHRQ-funded; HS022895.
Citation: Klock M, Kang H, Gon Y .
Scoring patient fall reports using quality rubric and machine learning.
Stud Health Technol Inform 2019 Aug 21;264:639-43. doi: 10.3233/shti190301..
Keywords: Falls, Patient Safety, Prevention, Quality of Care, Quality Improvement
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
Bundy DG, Singh H, Stein RE
The design and conduct of Project RedDE: a cluster-randomized trial to reduce diagnostic errors in pediatric primary care.
This paper discusses the results of Project RedDE, which was a virtual collaborative quality improvement study to reduce diagnostic errors in pediatric primary care practices. Forty-three practices were initially recruited, with a total of 31 practices left at the end due to practice dropout and two participating practices merging. This study was a randomized controlled trial targeting three common diagnostic errors (missed diagnoses of adolescent depression, abnormal blood pressure, and lack of followup for abnormal laboratory results). Contamination across study groups was a recurring problem, but risk mitigations were used. Electronic health records contributed to teams’ success.
AHRQ-funded; HS203608.
Citation: Bundy DG, Singh H, Stein RE .
The design and conduct of Project RedDE: a cluster-randomized trial to reduce diagnostic errors in pediatric primary care.
Clin Trials 2019 Apr;16(2):154-64. doi: 10.1177/1740774518820522..
Keywords: Adverse Events, Children/Adolescents, Diagnostic Safety and Quality, Medical Errors, Prevention, Primary Care, Quality of Care, Quality Improvement
Admon AJ, Gupta A, Williams M
Appraising the evidence supporting Choosing Wisely(R) recommendations.
This study’s objective was to appraise the evidence supporting the Choosing Wisely® campaign initiated by the American Board of Internal Medicine (ABIM) Foundation to advance dialogue on prevention of unnecessary medical tests, treatments, and procedures. The authors extracted all 320 recommendations that were published through August 2014. The recommendations were then categorized by evidence strength and then a sample of referenced clinical practice guidelines (CPGs) using the validated Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument. Overall, 70.3% of recommendations cited CPGs, whereas 22.2% cited primary research as their highest evidence level. Hospital medicine recommendations cited CPGs 90% of the time. However, the median overall score using AGREE II was 54.2% and even for hospital medicine-referenced CPGs was 58.3%.
AHRQ-funded; HS020672.
Citation: Admon AJ, Gupta A, Williams M .
Appraising the evidence supporting Choosing Wisely(R) recommendations.
J Hosp Med 2018 Oct;13(10):688-91. doi: 10.12788/jhm.2964..
Keywords: Decision Making, Evidence-Based Practice, Guidelines, Prevention, Quality of Care, Quality Improvement
Baldwin LM, Fischer MA, Powell J
Virtual educational outreach intervention in primary care based on the principles of academic detailing.
This paper describes the efforts of the Healthy Hearts Northwest (H2N) EvidenceNOW cooperative in providing virtual outreach intervention in primary care based on the principles of academic detailing (AD). EvidenceNOW is AHRQ’s initiative to fund seven regional cooperatives to identify and implement effective strategies to improve the quality of cardiovascular care in communities across the United States. The H2N network covers three states: Oregon, Washington, and Idaho. For this initiative they recruited 259 primary care practices that had 10 full-time or fewer providers and met stage 1 electronic health record meaningful use criteria. The aim was to increase adoption of the four ABCS of heart disease prevention: Aspirin use by high-risk individuals, Blood pressure control, Cholesterol management, and Smoking cessation. Due to the long distances and staffing limitations H2N decided to develop an educational outreach program using virtual visits instead of the traditional AD program structure. The findings and outcomes of this program is described in detail in this paper.
AHRQ-funded; HS023236; HS023908.
Citation: Baldwin LM, Fischer MA, Powell J .
Virtual educational outreach intervention in primary care based on the principles of academic detailing.
J Contin Educ Health Prof 2018 Fall;38(4):269-75. doi: 10.1097/ceh.0000000000000224..
Keywords: Cardiovascular Conditions, Heart Disease and Health, Evidence-Based Practice, Primary Care, Quality Improvement, Quality of Care, Patient-Centered Outcomes Research, Outcomes, Prevention
Ciolino JD, Jackson KL, Liss DT
Design of Healthy Hearts in the Heartland (H3): a practice-randomized, comparative effectiveness study.
The Healthy Hearts in the Heartland (H3) study is part of a nationwide effort, EvidenceNOW, seeking to better understand the ability of small primary care practices to improve "ABCS" clinical quality measures: appropriate Aspirin therapy, Blood pressure control, Cholesterol management, and Smoking cessation. In this paper, the authors describe the design and randomization of the H3 study.
AHRQ-funded; HS023921.
Citation: Ciolino JD, Jackson KL, Liss DT .
Design of Healthy Hearts in the Heartland (H3): a practice-randomized, comparative effectiveness study.
Contemp Clin Trials 2018 Aug;71:47-54. doi: 10.1016/j.cct.2018.06.004..
Keywords: Cardiovascular Conditions, Comparative Effectiveness, Evidence-Based Practice, Heart Disease and Health, Prevention, Primary Care, Quality of Care, Quality Improvement, Outcomes, Patient-Centered Outcomes Research
Chou AF, Homco JB, Nagykaldi Z
Disseminating, implementing, and evaluating patient-centered outcomes to improve cardiovascular care using a stepped-wedge design: healthy hearts for Oklahoma.
The Healthy Hearts for Oklahoma (H2O) Study proposes to build a quality improvement (QI) infrastructure by (1) constructing a sustainable Oklahoma Primary Healthcare Improvement Collaborative (OPHIC) to support dissemination and implementation (D&I) of QI methods; and (2) providing QI support in primary care practices to better manage patients at risk for cardiovascular disease (CVD) events. H2O has 263 small primary care practices across Oklahoma that receive the bundled QI intervention to improve ABCS (aspirin therapy, blood pressure control, cholesterol management, and smoking cessation) performance. The infrastructure established as a result of this funding will help reach medically underserved Oklahomans, particularly among rural and tribal populations.
AHRQ-funded; HS023919.
Citation: Chou AF, Homco JB, Nagykaldi Z .
Disseminating, implementing, and evaluating patient-centered outcomes to improve cardiovascular care using a stepped-wedge design: healthy hearts for Oklahoma.
BMC Health Serv Res 2018 Jun 4;18(1):404. doi: 10.1186/s12913-018-3189-4.
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Keywords: Cardiovascular Conditions, Communication, Heart Disease and Health, Healthcare Delivery, Evidence-Based Practice, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Primary Care, Prevention, Quality of Care, Quality Improvement
Parast L, Bardach NS, Burkhart Q
Development of new quality measures for hospital-based care of suicidal youth.
This study researched the value of 4 new quality measures developed to assess hospital-based care for suicidal youth. The four quality measures focused on counseling caregivers about restricting access to lethal means of self-harm, and the benefits and risks of antidepressant medications. They were divided into measures for the emergency department (ED) and inpatient measures. Survey field tests were conducted with caregivers of youth who were admitted to the ED or inpatient care for suicidality at 1 of 2 children’s hospitals between July 2013 and June 2014. Most caregivers did receive counseling about restricting their child’s access to lethal means of self-harm and also reported higher rates of counseling of benefits on antidepressants both in the ED and in the inpatient setting than the risks.
AHRQ-funded; HS020506.
Citation: Parast L, Bardach NS, Burkhart Q .
Development of new quality measures for hospital-based care of suicidal youth.
Acad Pediatr 2018 Apr;18(3):248-55. doi: 10.1016/j.acap.2017.09.017..
Keywords: Caregiving, Children/Adolescents, Consumer Assessment of Healthcare Providers and Systems (CAHPS), Education: Patient and Caregiver, Emergency Department, Hospitalization, Hospitals, Inpatient Care, Behavioral Health, Prevention, Quality of Care, Quality Measures
Meyers D, Miller T, Genevro J
AHRQ Author: Meyers D, Miller T, Genevro J, Zhan C, De La Mare J, Fournier A, Bennett H, McNellis RJ
EvidenceNOW: Balancing primary care implementation and implementation research.
In 2015, AHRQ invested in the largest primary care research project in its history. EvidenceNOW is a $112 million effort to disseminate and implement patient-centered outcomes research evidence in more than 1,500 primary care practices and to study how quality-improvement support can build the capacity of primary care practices to understand and apply evidence. EvidenceNOW comprises 7 implementation research grants, each funded to provide external quality-improvement support to primary care practices to implement evidence-based cardiovascular care and to conduct rigorous internal evaluations of their work.
AHRQ-authored.
Citation: Meyers D, Miller T, Genevro J .
EvidenceNOW: Balancing primary care implementation and implementation research.
Ann Fam Med 2018 Apr;16(Suppl 1):S5-s11. doi: 10.1370/afm.2196.
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Keywords: Cardiovascular Conditions, Communication, Evidence-Based Practice, Heart Disease and Health, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Prevention, Primary Care, Quality of Care, Quality Improvement, Implementation
Bhise V, Sittig DF, Vaghani V
An electronic trigger based on care escalation to identify preventable adverse events in hospitalised patients.
Researchers refined the methods of the Institute of Healthcare Improvement's Global Trigger Tool application and leveraged electronic health record data to improve detection of preventable adverse events, including diagnostic errors. In the studied sample, preventable adverse events were identified, including adverse drug events, patient falls, procedure-related complications, and hospital-associated infections. The authors concluded that such e-triggers can help overcome limitations of currently available methods to detect preventable harm in hospitalized patients.
AHRQ-funded; HS022087; HS023602.
Citation: Bhise V, Sittig DF, Vaghani V .
An electronic trigger based on care escalation to identify preventable adverse events in hospitalised patients.
BMJ Qual Saf 2018 Mar;27(3):241-46. doi: 10.1136/bmjqs-2017-006975..
Keywords: Adverse Events, Electronic Health Records (EHRs), Health Information Technology (HIT), Hospitalization, Hospitals, Patient Safety, Prevention, Quality of Care, Quality Improvement, Quality Indicators (QIs)
Ono SS, Crabtree BF, Hemler JR
Taking innovation to scale in primary care practices: the functions of health care extension.
Health care extension is an approach to providing external support to primary care practices with the aim of diffusing innovation. EvidenceNOW was launched to rapidly disseminate and implement evidence-based guidelines for cardiovascular preventive care in the primary care setting. This article describes how cooperatives varied in their approaches to extension and provides early empirical evidence that health care extension is a feasible and potentially useful approach for providing quality improvement.
AHRQ-funded; HS023940.
Citation: Ono SS, Crabtree BF, Hemler JR .
Taking innovation to scale in primary care practices: the functions of health care extension.
Health Aff 2018 Feb;37(2):222-30. doi: 10.1377/hlthaff.2017.1100.
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Keywords: Primary Care, Implementation, Cardiovascular Conditions, Evidence-Based Practice, Healthcare Delivery, Practice Improvement, Quality Improvement, Quality of Care, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Prevention
Tu JV, Maclagan LC, Ko DT
AHRQ Author: Bierman A
The Cardiovascular Health in Ambulatory Care Research Team performance indicators for the primary prevention of cardiovascular disease: a modified Delphi panel study.
The researchers developed a set of key performance indicators that can be used to measure and improve cardiovascular care in the primary care setting. A set of 28 indicators of primary prevention performance were identified, which were grouped into 5 domains: risk factor prevalence, screening, management, intermediate outcomes and long-term outcomes.
AHRQ-authored.
Citation: Tu JV, Maclagan LC, Ko DT .
The Cardiovascular Health in Ambulatory Care Research Team performance indicators for the primary prevention of cardiovascular disease: a modified Delphi panel study.
CMAJ Open 2017 Apr 25;5(2):E315-e21. doi: 10.9778/cmajo.20160139.
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Keywords: Cardiovascular Conditions, Quality of Care, Ambulatory Care and Surgery, Prevention, Quality Indicators (QIs)
Musuuza JS, Hundt AS, Zimbric M
Standardizing direct observation for assessing compliance to a daily chlorhexidine bathing protocol among hospitalized patients.
This paper describes the authors' experience training observers to conduct chlorhexidine gluconate bathing observations, and they present findings from pilot observations.
AHRQ-funded; HS024039.
Citation: Musuuza JS, Hundt AS, Zimbric M .
Standardizing direct observation for assessing compliance to a daily chlorhexidine bathing protocol among hospitalized patients.
Infect Control Hosp Epidemiol 2016 Dec;37(12):1516-18. doi: 10.1017/ice.2016.214.
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Keywords: Guidelines, Quality of Care, Healthcare-Associated Infections (HAIs), Patient Safety, Prevention