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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 10 of 10 Research Studies DisplayedMilliren CE, Bailey G, Graham DA
Relationships between pediatric safety indicators across a national sample of pediatric hospitals: dispelling the myth of the "safest" hospital.
This observational study aimed to explore the covariance of pediatric hospital quality indicators and evaluate the use of a single composite score. Pediatric hospital performance across 13 safety indicators were extracted from the Pediatric Health Information System, a comparative database of children’s hospitals in the U.S. Patients discharged from 36 hospitals from 2016 to 2019 were included. The authors investigated relationships among patient safety measures from AHRQ pediatric quality indicators and Center for Medicare and Medicaid Services hospital-acquired conditions. They identified 5 orthogonal variance components accounting for 68% of variation in pediatric hospital quality indicators. The ranking comparison and summary found greater within-hospital variation compared with between-hospital variation. They observed discordant rankings among commonly used summary measures and concluded that these measures demonstrate at least 2 underlying variance components.
AHRQ-funded; HS026246.
Citation: Milliren CE, Bailey G, Graham DA .
Relationships between pediatric safety indicators across a national sample of pediatric hospitals: dispelling the myth of the "safest" hospital.
J Patient Saf 2022 Jun 1;18(4):e741-e46. doi: 10.1097/pts.0000000000000938..
Keywords: Children/Adolescents, Quality Indicators (QIs), Quality Measures, Patient Safety, Hospitals, Quality of Care
Leyenaar JK, Esporas M, Mangione-Smith R
How does pediatric quality measure development reflect the real world needs of hospitalized children?
This study examined to what extent do the Pediatric Quality Measures Program (PQMP) reflect the real world needs of hospitalized children. The authors discussed recent advances in pediatric quality measurement in the context of the current epidemiology of pediatric hospitalization in the US. The history of PQMP is discussed, including AHRQ’s role from 2011 to 2016 as the manager of cooperative agreement grants to seven academic medical centers to develop the initial set of evidence-based quality measures designed to improve children’s quality of care. During the second phase (2016 to 2020), 6 institutions were funded to implement and disseminate these quality measures, with a goal of determining their feasibility and usability. The majority of these measures were developed at large children’s hospitals. However, 20% of children live in rural areas not near a children’s hospital. Among all general hospitals that admit children, 80% have pediatric volumes of less than 375 hospitalizations per year. Unique strategies will be needed to evaluate healthcare quality at these hospitals. The role of interhospital transfer to larger children’s hospitals is also discussed and how it impacts quality of care.
AHRQ-funded; HS025291.
Citation: Leyenaar JK, Esporas M, Mangione-Smith R .
How does pediatric quality measure development reflect the real world needs of hospitalized children?
Acad Pediatr 2022 Apr;22(3s):S70-s72. doi: 10.1016/j.acap.2021.01.019..
Keywords: Children/Adolescents, Quality Measures, Quality Improvement, Quality of Care, Quality Indicators (QIs), Hospitals
Quigley DD, Slaughter ME, Gidengil C
Usefulness of child HCAHPS survey data for improving inpatient pediatric care experiences.
Quality improvement (QI) requires data, indicators, and national benchmarks. Knowledge about the usefulness of Child Hospital Consumer Assessment of Healthcare Providers and Systems (Child HCAHPS) data are lacking. In this study the investigators examined quality leader and frontline staff perceptions about patient experience measurement and use of Child HCAHPS data for QI. The investigators surveyed children's hospital leaders and staff about their use of Child HCAHPS for QI, including measures from other studies. They compared scale and item means for leaders and staff and compared means to other studies.
AHRQ-funded; HS025920.
Citation: Quigley DD, Slaughter ME, Gidengil C .
Usefulness of child HCAHPS survey data for improving inpatient pediatric care experiences.
Hosp Pediatr 2021 Oct;11(10):e199-e214. doi: 10.1542/hpeds.2020-004283..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Children/Adolescents, Hospitals, Patient Experience, Quality Improvement, Quality Measures, Quality of Care
Bryan MA, Tyler A, Zhou C
Associations between quality measures and outcomes for children hospitalized with bronchiolitis.
The authors used adherence to the Pediatric Respiratory Illness Measurement System (PRIMES) indicators to evaluate the strength of associations for individual indicators with length of stay (LOS) and cost for bronchiolitis. They found that three indicators were significantly associated with shorter LOS and lower cost, while two underuse indicators were associated with higher cost. They concluded that a subset of PRIMES quality indicators for bronchiolitis were strongly associated with improved outcomes and can serve as important measures for future quality improvement efforts.
AHRQ-funded; HS026512.
Citation: Bryan MA, Tyler A, Zhou C .
Associations between quality measures and outcomes for children hospitalized with bronchiolitis.
Hosp Pediatr 2020 Nov;10(11):932-40. doi: 10.1542/hpeds.2020-0175..
Keywords: Children/Adolescents, Respiratory Conditions, Hospitals, Quality Indicators (QIs), Quality Measures, Quality of Care
Marcin JP, Romano PS, Dayal P
Provider-level and hospital-level factors and process measures of quality care delivered in pediatric emergency departments.
The objective of this study was to determine whether process measures of quality of care delivered to patients receiving care in children's hospital emergency departments were associated with physician-level or hospital-level factors. Subjects were children under 18 years old who presented to any of the 12 emergency departments that participated in the Pediatric Emergency Care Applied Research Network (PECARN).he researchers found that process measures of quality of care delivered to children was higher among patients treated at freestanding children's hospitals but lower among patients treated at higher volume emergency departments.
AHRQ-funded; HS019712.
Citation: Marcin JP, Romano PS, Dayal P .
Provider-level and hospital-level factors and process measures of quality care delivered in pediatric emergency departments.
Acad Pediatr 2020 May-Jun;20(4):524-31. doi: 10.1016/j.acap.2019.11.007..
Keywords: Children/Adolescents, Emergency Department, Hospitals, Quality Measures, Quality of Care
Feng JY, Toomey SL, Elliott MN
Factors associated with family experience in pediatric inpatient care.
Researchers assessed which aspects of pediatric inpatient experience have the strongest relationships with parents' willingness to recommend a hospital. Their cross-sectional study examined surveys completed by parents of children hospitalized at hospitals using the Child Hospital Consumer Assessment of Healthcare Providers and Systems Survey. They found that child comfort and nurse-parent communication showed the strongest relationships with willingness to recommend, followed by preparing to leave the hospital, doctor-parent communication, and keeping parents informed. They recommended improvement efforts focusing on creating an age-appropriate environment, improving the effectiveness of provider interactions, and engaging parents to share their values and concerns.
AHRQ-funded; HS020513; HS025299.
Citation: Feng JY, Toomey SL, Elliott MN .
Factors associated with family experience in pediatric inpatient care.
Pediatrics 2020 Mar;145(3): e20191264. doi: 10.1542/peds.2019-1264..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Children/Adolescents, Quality Measures, Quality of Care, Inpatient Care, Patient Experience, Hospitals, Hospitalization, Patient and Family Engagement, Clinician-Patient Communication
Desai AD, Starmer AJ
Process metrics and outcomes to inform quality improvement in pediatric hospital medicine.
This article provides an overview of the selection, development, and use of process and outcome measures for pediatric hospital medicine quality improvement initiatives. It reviews commonly used categories of process and outcome measures, provides a list of common sources and repositories of previously validated measures, and provides a blueprint for the development of novel measures.
AHRQ-funded; HS024299.
Citation: Desai AD, Starmer AJ .
Process metrics and outcomes to inform quality improvement in pediatric hospital medicine.
Pediatr Clin North Am 2019 Aug;66(4):725-37. doi: 10.1016/j.pcl.2019.03.002..
Keywords: Children/Adolescents, Hospitals, Quality of Care, Quality Improvement, Quality Measures, Outcomes, Patient-Centered Outcomes Research
Kaiser SV, Lam R, Joseph GB
Limitations of using pediatric respiratory illness readmissions to compare hospital performance.
Researcher sought to determine if a National Quality Forum (NQF)-endorsed measure for pediatric lower respiratory illness (LRI) 30-day readmission rates can meaningfully identify high- and low-performing hospitals. Subjects were children with LRI (bronchiolitis, influenza, or pneumonia as primary diagnosis, or with an LRI as a secondary diagnosis with a primary diagnosis of respiratory failure, sepsis, bacteremia, or asthma) from all hospital admissions in California from 2012 to 2014. The researchers were unable to identify meaningful variation in hospital performance without broadening the metric definition and merging multiple years of data. They recommend that utilizers of pediatric-quality measures consider modifying metrics to better evaluate the quality of pediatric care at low-volume hospitals.
AHRQ-funded; HS024385; HS022835; HS024592; HS025297.
Citation: Kaiser SV, Lam R, Joseph GB .
Limitations of using pediatric respiratory illness readmissions to compare hospital performance.
J Hosp Med 2018 Nov;13(11):737-42. doi: 10.12788/jhm.2988..
Keywords: Children/Adolescents, Respiratory Conditions, Provider Performance, Hospital Readmissions, Hospitals, Quality Indicators (QIs), Quality Measures, 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
Connor JA, Larson C, Baird J
Use of a pediatric cardiovascular nursing consortium for development and evaluation of quality measures: The C4-MNP experience.
The authors aimed to identify and develop standardized measures representative of pediatric nursing care of the cardiovascular patient for benchmarking within freestanding children's hospitals. The Consortium of Congenital Cardiac Care-Measurement of Nursing Practice members developed quality measures within working groups and then individually critiqued all drafted measures. The process resulted in 10 measures eligible for testing. The Consortium will continue with implementation and testing of each measure, supporting the development of benchmarks and the evaluation of the association of the measures with patient outcomes.
AHRQ-funded; HS000063.
Citation: Connor JA, Larson C, Baird J .
Use of a pediatric cardiovascular nursing consortium for development and evaluation of quality measures: The C4-MNP experience.
J Pediatr Nurs 2016 Sep-Oct;31(5):471-7. doi: 10.1016/j.pedn.2016.04.010.
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Keywords: Children/Adolescents, Cardiovascular Conditions, Nursing, Quality Measures, Hospitals