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
1 to 25 of 71 Research Studies DisplayedO'Leary KJ, Johnson JK, Williams MV
Effect of complementary interventions to redesign care on teamwork and quality for hospitalized medical patients: a pragmatic controlled trial.
The objective of this pragmatic controlled trial was to evaluate the effect of interventions to redesign hospital care delivery on teamwork and patient outcomes. Survey participants were healthcare professionals and hospitalized medical patients in medical units at four U.S. hospitals. The results showed that the median teamwork climate score was higher after the intervention among nurses, but that interventions to redesign care for hospitalized patients were not associated with improved patient outcomes.
AHRQ-funded; HS02564.
Citation: O'Leary KJ, Johnson JK, Williams MV .
Effect of complementary interventions to redesign care on teamwork and quality for hospitalized medical patients: a pragmatic controlled trial.
Ann Intern Med 2023 Nov; 176(11):1456-64. doi: 10.7326/m23-0953..
Keywords: Teams, Inpatient Care, Hospitals, Quality of Care, Outcomes
Silver CM, Yang AD, Shan Y
Changes in surgical outcomes in a Statewide Quality Improvement Collaborative with introduction of simultaneous, comprehensive interventions.
Researchers investigated whether a comprehensive quality improvement program implemented simultaneously across hospitals at the formation of a quality improvement collaborative (QIC) would improve patient outcomes. They analyzed risk-adjusted rates of postoperative morbidity and mortality for patients who had undergone surgery at hospitals in the Illinois Surgical Quality Improvement Collaborative (ISQIC); analyses compared ISQIC hospitals with hospitals in the NSQIP Participant Use File (PUF). Although complication rates decreased at both ISQIC and PUF hospitals, findings showed that participation in ISQIC was associated with a significantly greater improvement in death or serious morbidity. The researchers concluded that these results emphasize the potential of QICs to improve patient outcomes.
AHRQ-funded; HS024516.
Citation: Silver CM, Yang AD, Shan Y .
Changes in surgical outcomes in a Statewide Quality Improvement Collaborative with introduction of simultaneous, comprehensive interventions.
J Am Coll Surg 2023 Jul 1; 237(1):128-38. doi: 10.1097/xcs.0000000000000679..
Keywords: Surgery, Outcomes, Quality Improvement, Quality of Care, Hospitals
Lake ET, Staiger D, Smith JG
The association of missed nursing care with very low birthweight infant outcomes.
This study examined the association of missed nursing care and health outcomes of very low birthweight (VLBW) infants in neonatal intensive care units (NICUs). The authors used 2016 hospital administrative discharge abstracts for VLBW newborns (n = 7,595) and NICU registered nurse survey responses (n = 6,963) from the National Database of Nursing Quality Indicators. Mortality, morbidity, and length of stay (LOS) was examined in 190 sample hospitals from 19 states in all regions. There was a significant association between higher odds of bloodstream infection and longer LOS, but not mortality or severe intraventricular hemorrhage and missed nursing care.
AHRQ-funded; HS024918.
Citation: Lake ET, Staiger D, Smith JG .
The association of missed nursing care with very low birthweight infant outcomes.
Med Care Res Rev 2023 Jun; 80(3):293-302. doi: 10.1177/10775587221150950..
Keywords: Healthcare Cost and Utilization Project (HCUP), Quality Indicators (QIs), Nursing, Newborns/Infants, Outcomes, Healthcare Utilization, Quality of Care
Ferucci ED, Day GM, Choromanski TL
Outcomes and quality of care in rheumatoid arthritis with or without video telemedicine follow-up visits.
This study’s objective was to evaluate outcomes and quality of care for rheumatoid arthritis (RA) in patients seen by video telemedicine compared to in-person only. Individuals in the Alaska Tribal Health System who were diagnosed with RA were recruited when seeing a rheumatologist either in person or by video telemedicine. Participants completed a Routine Assessment of Patient Index Data 3 (RAPID3) questionnaire and a telephone medicine perception survey at the start of the survey. They also agreed to medical record review. The authors repeated the surveys by telephone and at 6 and 12 months, and medical record abstraction was performed at 12 months for quality measures. By the end of the 12-month period, about half of the 122 RA participants (52%) had ever used telemedicine for RA. Higher RAPID3 score and functional status were associated with the telemedicine group, with no statistically significant change over the 12-month period. The only quality measure that differed between the two groups at 12 months was the proportion of visits in which disease activity was documented, but it was not significantly after multivariate analysis.
AHRQ-funded; HS024540.
Citation: Ferucci ED, Day GM, Choromanski TL .
Outcomes and quality of care in rheumatoid arthritis with or without video telemedicine follow-up visits.
Arthritis Care Res 2022 Mar;74(3):484-92. doi: 10.1002/acr.24485..
Keywords: Arthritis, Chronic Conditions, Telehealth, Health Information Technology (HIT), Quality of Care, Outcomes
de Loizaga SR, Schneider K, Beck AF
Socioeconomic impact on outcomes during the first year of life of patients with single ventricle heart disease: an analysis of the National Pediatric Cardiology Quality Improvement Collaborative Registry.
In a retrospective cohort analysis of infants enrolled in the National Pediatric Cardiology Improvement Collaborative, researchers investigated the impact of community-level deprivation on morbidity and mortality for infants with single ventricle heart disease in the first year of life. They found that community deprivation was associated with mortality and length of stay for patients with single ventricle congenital heart disease. While patients near the mean deprivation index had a higher hazard of one year mortality compared to those at the extremes of the deprivation index, length of stay and deprivation index were linearly associated, demonstrating the complex nature of socioeconomic factors.
AHRQ-funded; HS021114.
Citation: de Loizaga SR, Schneider K, Beck AF .
Socioeconomic impact on outcomes during the first year of life of patients with single ventricle heart disease: an analysis of the National Pediatric Cardiology Quality Improvement Collaborative Registry.
Pediatr Cardiol 2022 Mar;43(3):605-15. doi: 10.1007/s00246-021-02763-2..
Keywords: Children/Adolescents, Social Determinants of Health, Quality Improvement, Quality of Care, Cardiovascular Conditions, Registries, Outcomes
Franklin PD, Bond CP, Rothrock NE
Strategies for effective implementation of patient-reported outcome measures in arthroplasty practice.
This study’s goal was to synthesize patient-reported outcome measure (PROM) implementation strategies that are successfully used by hundreds of arthroplasty surgeons and early PROM-adopter clinical systems. The authors developed guidelines to inform clinical care, drive quality-improvement activities, and support reporting for payer-sponsored incentives. They also outlined future research that is needed to define methods for optimal patient engagement, technology infrastructure, and operational systems to seamlessly integrate PROM collection in clinical care.
AHRQ-funded; HS018910.
Citation: Franklin PD, Bond CP, Rothrock NE .
Strategies for effective implementation of patient-reported outcome measures in arthroplasty practice.
J Bone Joint Surg Am 2021 Dec 15;103(24):e97. doi: 10.2106/jbjs.20.02072..
Keywords: Patient-Centered Outcomes Research, Orthopedics, Quality Improvement, Quality of Care, Evidence-Based Practice, Implementation, Outcomes
Jiang DH, Mundell BF, Shah ND
Impact of high deductible health plans on diabetes care quality and outcomes: systematic review.
The authors sought to provide a systematic literature review of the impact of high deductible health plans (HDHPs) on the utilizations of services required for optimal management of diabetes and subsequent health outcomes. They found that, although HDHPs reduce some health care utilization and costs, they appear to do so at the expense of limiting high-value care and medication adherence.
AHRQ-funded; HS025517; HS024075; HS025164; HS025402.
Citation: Jiang DH, Mundell BF, Shah ND .
Impact of high deductible health plans on diabetes care quality and outcomes: systematic review.
Endocr Pract 2021 Nov;27(11):1156-64. doi: 10.1016/j.eprac.2021.07.001..
Keywords: Health Insurance, Diabetes, Chronic Conditions, Outcomes, Quality of Care, Patient-Centered Outcomes Research
Delaney LD, Howard R, Palazzolo K
Outcomes of a presurgical optimization program for elective hernia repairs among high-risk patients.
The authors evaluated the feasibility of evidence-based patient optimization before surgery by implementing a low-cost preoperative optimization clinic. They found that a hernia optimization clinic safely improved management of high-risk patients and increased operative yield for the institution. They concluded that their results represented an opportunity to create sustainable and scalable models that provide longitudinal care and optimize patients to improve outcomes of hernia repair.
AHRQ-funded; HS025778.
Citation: Delaney LD, Howard R, Palazzolo K .
Outcomes of a presurgical optimization program for elective hernia repairs among high-risk patients.
JAMA Netw Open 2021 Nov;4(11):e2130016. doi: 10.1001/jamanetworkopen.2021.30016..
Keywords: Surgery, Risk, Evidence-Based Practice, Quality Improvement, Quality of Care, Outcomes
Cardell CF, Knapp L, Cohen ME
Successful implementation of enhanced recovery in elective colorectal surgery is variable and dependent on the local environment.
This study looked at the results of a national colorectal enhanced recovery program (ERP) to improve patient outcomes. A total of 207 hospitals participated between 2017 and 2020. Quantitative (patient-level process and outcome) and qualitative (survey and structured interviews with hospital teams) data were collected and analyzed. Results shows that 62 hospitals were characterized as High Performance, and 52 as High Improvement. High Performance hospitals were larger with more annual colorectal surgeries. Fewer barriers to staff-buy-in and competing priorities, and more experience with standardized perioperative care were also characteristics of High Performance hospitals. High Improvement hospitals had lower baseline process measure (PM) adherence and less experience with perioperative care but had positive trends in annual patient outcomes such as annual morbidity, readmission, and prolonged length of stay compared to Low Improvement Hospitals.
AHRQ-funded; 233201500020I.
Citation: Cardell CF, Knapp L, Cohen ME .
Successful implementation of enhanced recovery in elective colorectal surgery is variable and dependent on the local environment.
Ann Surg 2021 Oct 1;274(4):605-12. doi: 10.1097/sla.0000000000005069..
Keywords: Surgery, Quality Improvement, Quality of Care, Outcomes, Patient-Centered Outcomes Research, Provider Performance
Barbash IJ, Davis BS, Yabes JG
Treatment patterns and clinical outcomes after the introduction of the Medicare Sepsis Performance Measure (SEP-1).
This study evaluated the effect of Severe Sepsis and Septic Shock Early Management Bundle (SEP-1) on treatment patterns and patient outcomes. Findings showed that, two years after its implementation, SEP-1 was associated with variable changes in process measures, with the greatest effect being an increase in lactate measurement within 3 hours of sepsis onset. There were small increases in antibiotic administration and fluid administration, a small increase in ICU admissions, and no changes in mortality or discharge to home.
Citation: Barbash IJ, Davis BS, Yabes JG .
Treatment patterns and clinical outcomes after the introduction of the Medicare Sepsis Performance Measure (SEP-1).
Ann Intern Med 2021 Jul;174(7):927-35. doi: 10.7326/m20-5043..
Keywords: Sepsis, Medicare, Outcomes, Quality Measures, Quality of Care
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
Paul R, Niedner M, Brilli R
Metric development for the multicenter Improving Pediatric Sepsis Outcomes (IPSO) Collaborative.
A 56 US hospital collaborative, Improving Pediatric Sepsis Outcomes (IPSO), has developed variables, metrics and a data analysis plan to track quality improvement (QI)-based patient outcomes over time. Improving Pediatric Sepsis Outcomes expands on previous pediatric sepsis QI efforts by improving electronic data capture and uniformity across sites. This paper describes the metric development for the multicenter IPSO Collaborative.
AHRQ-funded; HS025696.
Citation: Paul R, Niedner M, Brilli R .
Metric development for the multicenter Improving Pediatric Sepsis Outcomes (IPSO) Collaborative.
Pediatrics 2021 May;147(5):e2020017889. doi: 10.1542/peds.2020-017889..
Keywords: Children/Adolescents, Sepsis, Quality Improvement, Quality of Care, Outcomes, Patient-Centered Outcomes Research, Evidence-Based Practice
Meyers DJ, Trivedi AN, Wilson IB, DJ, Trivedi AN, Wilson IB
Higher Medicare Advantage Star Ratings are associated with improvements In patient outcomes.
Researchers examined CMS' five-star rating system for the overall quality of Medicare Advantage (MA) contracts. They found that enrollees experiencing a one-star MA rating increase were 20.8 percent less likely to leave their plan voluntarily to enroll in another plan or traditional Medicare. When hospitalized, enrollees were 3.4 percent more likely to use a higher-quality hospital and 2.6 percent less likely to be readmitted within ninety days. These findings suggest that MA star ratings may capture key domains of an MA plan's quality.
AHRQ-funded; HS027051.
Citation: Meyers DJ, Trivedi AN, Wilson IB, DJ, Trivedi AN, Wilson IB .
Higher Medicare Advantage Star Ratings are associated with improvements In patient outcomes.
Health Aff 2021 Feb;40(2):243-50. doi: 10.1377/hlthaff.2020.00845..
Keywords: Patient Experience, Provider Performance, Medicare, Quality Improvement, Quality of Care, Outcomes
Larsen GY, Brilli R, Macias CG
Development of a quality improvement learning collaborative to improve pediatric sepsis outcomes.
Researchers developed a multicenter quality improvement learning collaborative of US children's hospitals. They created a key driver diagram (KDD) with the aim of reducing both the sepsis-attributable mortality and the incidence of hospital-onset sepsis in children. The KDD primary drivers focused on improving the following: treatment of infection; recognition, diagnosis, and treatment of sepsis; de-escalation of unnecessary care; engagement of patients and families; and methods to optimize performance. The Children's Hospital Association Improving Pediatric Sepsis Outcomes collaborative aims to improve sepsis outcomes through collaborative learning and reliable implementation of evidence-based interventions.
AHRQ-funded; HS025696.
Citation: Larsen GY, Brilli R, Macias CG .
Development of a quality improvement learning collaborative to improve pediatric sepsis outcomes.
Pediatrics 2021 Jan;147(1). doi: 10.1542/peds.2020-1434..
Keywords: Children/Adolescents, Sepsis, Outcomes, Quality Improvement, Quality of Care, Education: Continuing Medical Education
Friese CR, Fauer AJ, Kuisell C
Patient-reported outcomes collected in ambulatory oncology practices: feasibility, patterns, and correlates.
The purpose of this study was to examine the feasibility of soliciting outcomes from adults who received chemotherapy treatment for cancer and to describe the patterns and correlates of patient-reported toxicities. Results determined that querying patients on chemotherapy treatment experiences and toxicities was feasible. Toxicity rates varied across practices, informing quality improvement. Toxicity severity and service use incidence exceed previously published trial data, particularly for pain, fatigue, and gastrointestinal issues. Open-text questions enabled exploration with newer treatment regimens.
AHRQ-funded; HS024914.
Citation: Friese CR, Fauer AJ, Kuisell C .
Patient-reported outcomes collected in ambulatory oncology practices: feasibility, patterns, and correlates.
Health Serv Res 2020 Dec;55(6):966-72. doi: 10.1111/1475-6773.13574..
Keywords: Ambulatory Care and Surgery, Cancer, Treatments, Quality of Care, Patient-Centered Outcomes Research, Outcomes
Brajcich BC, Bentrem DJ, Yang AD
Short-term risk of performing concurrent procedures with hepatic artery infusion pump placement.
This study’s objective was to characterize the short-term outcomes of concurrent surgery with hepatic artery infusion pump (HAIP) placement using data from the 2005-2017 ACS NSQIP dataset. Findings showed that HAIP placement is not associated with additional morbidity when performed with hepatic and/or colorectal surgery. Decisions regarding HAIP placement should consider the risks of concurrent operations as well as patient- and disease-specific factors.
AHRQ-funded; HS026385.
Citation: Brajcich BC, Bentrem DJ, Yang AD .
Short-term risk of performing concurrent procedures with hepatic artery infusion pump placement.
Ann Surg Oncol 2020 Dec;27(13):5098-106. doi: 10.1245/s10434-020-08938-0..
Keywords: Quality Improvement, Quality of Care, Surgery, Risk, Cancer, Outcomes
Leeds IL, Jones C, DiBrito SR
Delay in emergency hernia surgery is associated with worse outcomes.
The purpose of this study was to determine if the variation in timing of urgent surgery impacts surgical outcomes. The National Surgical Quality Improvement Program (NSQIP) database was searched for emergent surgeries in 2011-2016 for abdominal hernia resulting in obstruction or gangrene by primary post-op diagnosis. Findings showed that delayed surgery was associated with increased rates of major complications, longer operative times, longer postoperative lengths of stay, increased re-operations, increased readmissions, and increased 30-day mortality. Next-day surgery and surgery delayed more than one day were associated with increased odds of a major complication.
AHRQ-funded; HS024547.
Citation: Leeds IL, Jones C, DiBrito SR .
Delay in emergency hernia surgery is associated with worse outcomes.
Surg Endosc 2020 Oct;34(10):4562-73. doi: 10.1007/s00464-019-07245-4..
Keywords: Surgery, Quality Improvement, Quality of Care, Critical Care, Access to Care, Digestive Disease and Health, Outcomes
Kaiser SV, Johnson MD, Walls TA
Pathways to improve pediatric asthma care: a multisite, national study of emergency department asthma pathway implementation.
This quality improvement study’s aim was to determine the effects of pediatric asthma pathway implementation in a diverse, national sample of emergency departments (EDs). Desired outcomes included systemic corticosteroid administration within 60 minutes (primary), assessment of severity at ED triage, chest radiograph use, hospital admission or transfer for higher level of care, and ED length of stay. Charts were reviewed each month by EDs for children ages 2-17 years with a primary diagnosis of asthma. A total of 83 EDs were enrolled, with 37 of them children’s hospitals, and 46 community hospitals. Seventy-three percent completed the study (n = 22,963). There was a significant increase in systematic corticosteroid administration within 60 minutes of arrival as well as increased odds of severity assessment at triage and decreased rate of change in odds of hospital admission/transfer. Chest radiograph or ED length of stay was not associated with pathway implementation.
AHRQ-funded; HS024592.
Citation: Kaiser SV, Johnson MD, Walls TA .
Pathways to improve pediatric asthma care: a multisite, national study of emergency department asthma pathway implementation.
J Pediatr 2020 Aug;223:100-07.e2. doi: 10.1016/j.jpeds.2020.02.080..
Keywords: Children/Adolescents, Emergency Department, Asthma, Quality Improvement, Quality of Care, Care Management, Healthcare Delivery, Patient-Centered Outcomes Research, Evidence-Based Practice, Outcomes
Shappell CN, Klompas M, Rhee C
Surveillance strategies for tracking sepsis incidence and outcomes.
Sepsis is a leading cause of death and the target of intense efforts to improve recognition, management and outcomes. Accurate sepsis surveillance is essential to properly interpreting the impact of quality improvement initiatives, making meaningful comparisons across hospitals and geographic regions, and guiding future research and resource investments. In this review, the investigators discuss the advantages and limitations of different sepsis surveillance strategies and consider future directions.
AHRQ-funded; HS025008.
Citation: Shappell CN, Klompas M, Rhee C .
Surveillance strategies for tracking sepsis incidence and outcomes.
J Infect Dis 2020 Jul 21;222(Suppl 2):S74-s83. doi: 10.1093/infdis/jiaa102..
Keywords: Sepsis, Outcomes, Quality Improvement, Quality of Care
Coley RY, Boggs JM, Beck A
Defining success in measurement-based care for depression: a comparison of common metrics.
This study compared response and remission measures with effect size and severity-adjusted effect size (SAES) measures and examined the relationship between baseline symptom severity and treatment success for depression. Electronic records from two large integrated health systems were used to identify new psychotherapy episodes. Findings showed that response was preferable for comparing treatment outcomes, as it did not favor more or less baseline symptom severity, indicated clinically meaningful improvement, and was transparent and easy to calculate.
AHRQ-funded; HS026369.
Citation: Coley RY, Boggs JM, Beck A .
Defining success in measurement-based care for depression: a comparison of common metrics.
Psychiatr Serv 2020 Apr;71(4):312-18. doi: 10.1176/appi.ps.201900295..
Keywords: Depression, Behavioral Health, Patient-Centered Outcomes Research, Outcomes, Quality of Care, Quality Measures
Smith ME, Nuliyalu U, Dimick JB
Local referral of high-risk pancreatectomy patients to improve surgical outcomes and minimize travel burden.
Referring patients to high-quality hospitals for complex procedures may improve outcomes. This is most feasible within small geographic areas. However, access to specialized surgical procedures may be an implementation barrier. In this study, the investigators sought to determine the availability of high-quality hospitals performing pancreatectomy and the potential benefit and travel burden of referral within small geographic areas.
AHRQ-funded; HS024763.
Citation: Smith ME, Nuliyalu U, Dimick JB .
Local referral of high-risk pancreatectomy patients to improve surgical outcomes and minimize travel burden.
J Gastrointest Surg 2020 Apr;24(4):882-89. doi: 10.1007/s11605-019-04245-6..
Keywords: Surgery, Hospitals, Outcomes, Quality of Care
Colton K, Richards CT, Pruitt PB
Early stroke recognition and time-based emergency care performance metrics for intracerebral hemorrhage.
This study compared time for early stroke recognition for intracerebral hemorrhage for hospitals with and without stroke teams. An observational cohort study was conducted at an urban comprehensive stroke center from 2009 to 2017 with 204 cases included. Stroke team activation resulted in faster emergency care compared to no activation. This process resulted in shorter onset-to-arrival times, higher NIH Stroke Scale scores, and higher Glasgow Coma Scale scores.
AHRQ-funded; HS023437.
Citation: Colton K, Richards CT, Pruitt PB .
Early stroke recognition and time-based emergency care performance metrics for intracerebral hemorrhage.
J Stroke Cerebrovasc Dis 2020 Feb;29(2):104552. doi: 10.1016/j.jstrokecerebrovasdis.2019.104552..
Keywords: Stroke, Emergency Department, Provider Performance, Diagnostic Safety and Quality, Quality Improvement, Quality Indicators (QIs), Patient-Centered Outcomes Research, Outcomes, Quality of Care, Evidence-Based Practice, Hospitals
Sheetz 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
Keshvani N, Berger K, Gupta A
Improving respiratory rate accuracy in the hospital: a quality improvement initiative.
Researchers initiated a quality improvement (QI) initiative in hospitals to improve respiratory rate measurement accuracy. Time-keeping devices were added to vital sign carts and patient care assistants were retrained on a newly modified workflow that included concomitant respiratory rate (RR) measurement during automated blood pressure measurement. The median RR measurement rate increased postintervention. This intervention was associated with a 7.8% reduced incidence of tachypnea-specific systemic inflammatory response syndrome. This QI initiative was interdisciplinary, low-cost, and low-tech.
AHRQ-funded; HS022418.
Citation: Keshvani N, Berger K, Gupta A .
Improving respiratory rate accuracy in the hospital: a quality improvement initiative.
J Hosp Med 2019 Nov 1;14(10):673-77. doi: 10.12788/jhm.3232..
Keywords: Patient-Centered Outcomes Research, Quality Improvement, Inpatient Care, Diagnostic Safety and Quality, Hospitals, Quality of Care, Outcomes
Odell DD, Quinn CM, Matulewicz RS
Association between hospital safety culture and surgical outcomes in a statewide surgical quality improvement collaborative.
The "safety culture" within hospital systems is increasingly recognized as important to delivery of high-quality care. In this study, the investigators examined the safety culture in a statewide hospital quality improvement collaborative and its associations with surgical outcomes. The authors found, among other results that operating room safety culture scores were highest (97.7% positive) compared with the other domains, and ratings of hospital management were lowest (75.9% positive).
AHRQ-funded; HS024516.
Citation: Odell DD, Quinn CM, Matulewicz RS .
Association between hospital safety culture and surgical outcomes in a statewide surgical quality improvement collaborative.
J Am Coll Surg 2019 Aug;229(2):175-83. doi: 10.1016/j.jamcollsurg.2019.02.046..
Keywords: Hospitals, Patient Safety, Quality of Care, Quality Improvement, Outcomes, Surgery, Surveys on Patient Safety Culture