National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Behavioral Health (1)
- Burnout (1)
- Cardiovascular Conditions (2)
- Care Coordination (1)
- Central Line-Associated Bloodstream Infections (CLABSI) (1)
- Children/Adolescents (2)
- Clinician-Patient Communication (3)
- (-) Communication (19)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (1)
- Critical Care (1)
- Education: Continuing Medical Education (1)
- Emergency Medical Services (EMS) (1)
- Evidence-Based Practice (4)
- Falls (1)
- Guidelines (2)
- Healthcare-Associated Infections (HAIs) (1)
- Healthcare Delivery (2)
- Health Information Technology (HIT) (1)
- Health Services Research (HSR) (1)
- Heart Disease and Health (2)
- Hospital Discharge (1)
- Hospitals (4)
- Implementation (3)
- Intensive Care Unit (ICU) (1)
- Labor and Delivery (1)
- Maternal Care (1)
- Newborns/Infants (1)
- Nursing Homes (2)
- Organizational Change (1)
- Patient-Centered Healthcare (2)
- Patient-Centered Outcomes Research (2)
- Patient and Family Engagement (1)
- Patient Experience (2)
- Patient Safety (3)
- Practice Improvement (1)
- Prevention (3)
- Primary Care (4)
- Provider (2)
- (-) Quality Improvement (19)
- Quality of Care (16)
- Stress (1)
- Teams (1)
- TeamSTEPPS (1)
- Telehealth (1)
- Training (1)
- Transitions of Care (3)
- Workflow (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 19 of 19 Research Studies DisplayedStierman EK, O'Brien BT, Stagg J
AHRQ Author: Fabiyi CA, Chew E, Harding B, Mistry KB
Statewide perinatal quality improvement, teamwork, and communication activities in Oklahoma and Texas.
The objective of this study was to describe perinatal quality improvement activities, specifically the implementation of Alliance for Innovation on Maternal Health (AIM) patient safety bundles and use of teamwork and communication tools in obstetric units. Researchers conducted a survey of AIM-enrolled hospitals in Oklahoma and Texas and gathered data on obstetric unit organization and QI processes. Their findings showed that adoption of QI processes varied and also highlighted the need to reinforce support for rural obstetric units, which often face greater barriers to implementing patient safety and QI processes than urban units. The researchers concluded that this has implications for implementing future perinatal QI initiatives.
AHRQ-authored; AHRQ-funded; 233201500020I.
Citation: Stierman EK, O'Brien BT, Stagg J .
Statewide perinatal quality improvement, teamwork, and communication activities in Oklahoma and Texas.
Qual Manag Health Care 2023 Jul-Sep; 32(3):177-88. doi: 10.1097/qmh.0000000000000407..
Keywords: Quality Improvement, Teams, Communication, Maternal Care, Quality of Care
Quigley DD, Qureshi N, Palimaru A
Content and actionability of recommendations to providers after shadow coaching.
This paper examined the content of the recommendations given to shadow-coached providers aimed at improving provider-patient interactions, to characterize these recommendations, and to examine their actionability. Using CAHPS data, the study’s findings showed that patient experience surveys were effective at identifying where improvement is needed but are not always informative enough to instruct providers on how to modify and improve their interactions with patients. Analyzing the feedback given to coached providers as part of an effective shadow-coaching program provides details about implementation on shadow-coaching feedback.
AHRQ-funded; HS025920.
Citation: Quigley DD, Qureshi N, Palimaru A .
Content and actionability of recommendations to providers after shadow coaching.
Qual Manag Health Care 2022 Oct-Dec;31(4):199-209. doi: 10.1097/qmh.0000000000000354..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient Experience, Quality Improvement, Quality of Care, Practice Improvement, Clinician-Patient Communication, Communication
Lieu TA, Warton EM, Levan C
Association of medical assistant-supported virtual rooming with successful video visit connections.
The purpose of this study was to systematically evaluate medical assistant-supported virtual rooming for physician video visits to address the digital divide which exists in physician video visit availability and accessibility for patients who have lower socioeconomic status (SES), low English proficiency, or are African American or Black or Latino. The study found that of the 114,214 video visits with successful connections, 14.2% had low neighborhood SES, 3.6% needed interpreters, 20.1% were Latino, and 7.9% were African American or Black. African American or Black race, Latino ethnicity, needing an interpreter, and living in a low SES neighborhood were associated with a lower likelihood of connecting. The researchers concluded that medical assistant–supported virtual rooming was associated with successful video visit connections in this diverse population. High medical assistant supported rooming rates were associated with larger connection improvements for patients at higher risk of not connecting, including those with lower SES, of Latino ethnicity or African American or Black race, or needing interpreters.
AHRQ-funded; HS025189.
Citation: Lieu TA, Warton EM, Levan C .
Association of medical assistant-supported virtual rooming with successful video visit connections.
JAMA Intern Med 2022 Jun;182(6):680-82. doi: 10.1001/jamainternmed.2022.1032..
Keywords: Quality Improvement, Quality of Care, Telehealth, Health Information Technology (HIT), Clinician-Patient Communication, Communication, Healthcare Delivery
Chilakamarri P, Finn EB, Sather J
Failure mode and effect analysis: engineering safer neurocritical care transitions.
Investigators presented failure mode and effect analysis (FMEA) as a systems-engineering methodology to be applied to neurocritical care transitions to reduce failures in communication and improve patient safety. They described their local implementation of FMEA to improve the safety of inter-hospital transfer for patients with intracerebral and subarachnoid hemorrhage as evidence of success. They found that application of the FMEA approach yielded meaningful and sustained process change for patients with neurocritical care needs.
AHRQ-funded; HS023554.
Citation: Chilakamarri P, Finn EB, Sather J .
Failure mode and effect analysis: engineering safer neurocritical care transitions.
Neurocrit Care 2021 Aug;35(1):232-40. doi: 10.1007/s12028-020-01160-6..
Keywords: Patient Safety, Transitions of Care, Critical Care, Communication, Quality Improvement, Quality of Care
Campbell Britton M, Petersen-Pickett J, Hodshon B
Mapping the care transition from hospital to skilled nursing facility.
Researchers used process mapping to illustrate the sequence of events involved with hospital discharge and admission to a skilled nursing facility (SNF). These transitions are often associated with breakdowns in communication that may place patients at risk for adverse events. A quality improvement (QI) team worked with frontline staff at an academic medical center and two local SNFs in the northeastern United States. The final process map included care management, medicine, nursing, admissions and physical therapy service staff. The process map showed numerous activities that need to be coordinated between care teams, and highlighted specific opportunities for improving communication between different teams.
AHRQ-funded; HS023554.
Citation: Campbell Britton M, Petersen-Pickett J, Hodshon B .
Mapping the care transition from hospital to skilled nursing facility.
J Eval Clin Pract 2020 Jun;26(3):786-90. doi: 10.1111/jep.13238..
Keywords: Transitions of Care, Care Coordination, Quality Improvement, Communication, Hospital Discharge, Hospitals, Nursing Homes, Quality of Care
McHugh M, Brown T, Walunas TL
Contrasting perspectives of practice leaders and practice facilitators may be common in quality improvement initiatives.
The authors sought to identify patterns of contrasting perspectives on implementation issues between practice leaders and their practice facilitators as well as factors that may contribute to them. Through individual interviews, they found that turnover of staff was frequently reported in dyads with contrasting perspectives. They recommended that planners of quality improvement initiatives using practice facilitation consider taking steps to minimize contrasting perspectives by addressing turnover challenges and encouraging opportunities to share perspectives.
AHRQ-funded; HS023921.
Citation: McHugh M, Brown T, Walunas TL .
Contrasting perspectives of practice leaders and practice facilitators may be common in quality improvement initiatives.
J Healthc Qual 2020 May/Jun;42(3):e32-e38. doi: 10.1097/jhq.0000000000000223..
Keywords: Primary Care, Quality Improvement, Quality of Care, Implementation, Communication, Provider
Fisher KA, Gallagher TH, Smith KM
Communicating with patients about breakdowns in care: a national randomised vignette-based survey.
This study examined the impact of an apology when problems occur in patient care breakdowns occur at hospitals. Breakdowns included slow response to call bell, rude aide, and unanswered questions. A national online survey of 1188 adults aged 35 years or older were sampled from an online panel representative of the entire US population, created and maintained by GfK. Twice as many participants receiving an in-depth prompt about care breakdowns would recommend the hospital compared with those receiving no prompt (18.4% vs 8.8%). Almost three times as many participants who received a full apology would probably/definitely recommend the hospital compared with those receiving no apology (34.1% vs 13.6%). The survey also asked whether the respondent would speak up, with feeling upset being a strong determinant of greater intent to speak up.
AHRQ-funded; HS024596; HS022757.
Citation: Fisher KA, Gallagher TH, Smith KM .
Communicating with patients about breakdowns in care: a national randomised vignette-based survey.
BMJ Qual Saf 2020 Apr;29(4):313-19. doi: 10.1136/bmjqs-2019-009712..
Keywords: Clinician-Patient Communication, Communication, Patient Experience, Patient and Family Engagement, Quality Improvement, Quality of Care, Hospitals
Xie A, Woods-Hill CZ, Berenholtz SM
Use of human factors and ergonomics to disseminate health care quality improvement programs.
Human factors and ergonomics (HFE) is recognized as a key systems engineering approach to improve health care quality and safety. In this article, the authors suggest that HFE can play an important role in the dissemination of quality improvement programs across diverse health care settings. They suggest that to achieve this, health care organizations need to build capacity by leveraging HFE expertise and develop tools that guide local adaptation of interventions developed for large-scale quality initiatives.
AHRQ-funded; HS025642; HS025238.
Citation: Xie A, Woods-Hill CZ, Berenholtz SM .
Use of human factors and ergonomics to disseminate health care quality improvement programs.
Qual Manag Health Care 2019 Apr/Jun;28(2):117-18. doi: 10.1097/qmh.0000000000000211..
Keywords: Quality Improvement, Quality of Care, Communication, Provider
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
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
Lapcharoensap W, Lee HC
Tackling quality improvement in the delivery room.
Implementation of standardized practices in the delivery room fosters a safe environment to ensure that newborn infants are cared for optimally. This article discusses how the delivery room is a unique environment and presents examples on how to approach delivery room quality improvement (QI). Key areas of potential focus for teams pursuing delivery QI include thermal regulation, optimizing respiratory support, and facilitating team communication.
AHRQ-funded; HS023506.
Citation: Lapcharoensap W, Lee HC .
Tackling quality improvement in the delivery room.
Clin Perinatol 2017 Sep;44(3):663-81. doi: 10.1016/j.clp.2017.05.003.
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Keywords: Communication, Labor and Delivery, Newborns/Infants, Quality Improvement, Patient Safety
Forman-Hoffman VL, Middleton JC, McKeeman JL
Quality improvement, implementation, and dissemination strategies to improve mental health care for children and adolescents: a systematic review.
The researchers describe the process by which they created an online interactive community resources map for use in the Connect for Health randomized controlled trial. The trial was conducted in the 6 pediatric practices that cared for the highest percentage of children with overweight or obesity. Parents and community partners identified several community resources that could help support behavior change.
AHRQ-funded; 290201200008I.
Citation: Forman-Hoffman VL, Middleton JC, McKeeman JL .
Quality improvement, implementation, and dissemination strategies to improve mental health care for children and adolescents: a systematic review.
Implement Sci 2017 Jul 24;12(1):93. doi: 10.1186/s13012-017-0626-4.
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Keywords: Children/Adolescents, Communication, Behavioral Health, Quality of Care, Quality Improvement
Natafgi N, Zhu X, Baloh J
Critical access hospital use of TeamSTEPPS to implement shift-change handoff communication.
Implementation of handoff as part of TeamSTEPPS initiatives for improving shift-change communication is examined via qualitative analysis of on-site interviews and process observations in 8 critical access hospitals. Comparing implementation attributes and handoff performance across hospitals shows that the purpose of implementation did not differentiate between high and low performance, but facilitators and barriers did.
AHRQ-funded; HS018396.
Citation: Natafgi N, Zhu X, Baloh J .
Critical access hospital use of TeamSTEPPS to implement shift-change handoff communication.
J Nurs Care Qual 2017 Jan/Mar;32(1):77-86. doi: 10.1097/ncq.0000000000000203.
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Keywords: Communication, Patient Safety, Quality Improvement, TeamSTEPPS, Transitions of Care
Linzer M, Poplau S, Grossman E
A cluster randomized trial of interventions to improve work conditions and clinician burnout in primary care: results from the Healthy Work Place (HWP) Study.
This study aimed to assess if improvements in work conditions reduce clinician stress and burnout. It found that burnout was more likely to improve with workflow interventions and with targeted QI projects than in controls. Also, interventions in communication or workflow led to greater improvements in clinician satisfaction.
AHRQ-funded; HS018160.
Citation: Linzer M, Poplau S, Grossman E .
A cluster randomized trial of interventions to improve work conditions and clinician burnout in primary care: results from the Healthy Work Place (HWP) Study.
J Gen Intern Med 2015 Aug;30(8):1105-11. doi: 10.1007/s11606-015-3235-4..
Keywords: Burnout, Stress, Primary Care, Workflow, Quality Improvement, Quality of Care, Communication
Morrato EH, Rabin B, Proctor J
Bringing it home: expanding the local reach of dissemination and implementation training via a university-based workshop.
The Colorado Research in Implementation Science Program (CRISP) developed and delivered an introductory D&I workshop adapted from national programs to extend training reach and foster a local learning community for D&I. This paper describes the context of the local training environment, findings from a pre-workshop needs assessment survey, training design and structure, and post-workshop evaluation. Lessons learned may inform others intending to develop local D&I training workshop.
AHRQ-funded; HS021138.
Citation: Morrato EH, Rabin B, Proctor J .
Bringing it home: expanding the local reach of dissemination and implementation training via a university-based workshop.
Implement Sci 2015 Jul 4;10:94. doi: 10.1186/s13012-015-0281-6..
Keywords: Communication, Education: Continuing Medical Education, Evidence-Based Practice, Guidelines, Quality of Care, Quality Improvement, Training, Implementation
Nembhard IM, Labao I, Savage S
Breaking the silence: determinants of voice for quality improvement in hospitals.
The researchers examined the drivers of “voice” for health professionals in hospitals. “Voice” is understood as the discretionary communication of ideas, suggestions, concerns, or opinions about work-related issues with the intent to improve organizational or unit functioning. They found that factors related to individuals (e.g., tenure), work (e.g., work configuration), organizational context (e.g., culture), data (e.g., benchmarking), and the external environment (e.g., attention) influenced health professionals’ voice.
AHRQ-funded; HS018987.
Citation: Nembhard IM, Labao I, Savage S .
Breaking the silence: determinants of voice for quality improvement in hospitals.
Health Care Manage Rev 2015 Jul-Sep;40(3):225-36. doi: 10.1097/hmr.0000000000000028..
Keywords: Hospitals, Quality Improvement, Quality of Care, Communication, Organizational Change, Health Services Research (HSR)
Brady PW, Zix J, Brilli R
Developing and evaluating the success of a family activated medical emergency team: a quality improvement report.
The researchers aimed to develop a reliable process for family-activated medical emergency teams (METs) and to evaluate its effect on MET call rate and subsequent transfer to the intensive care unit (ICU). They found that children with family-activated METs were transferred to the ICU less commonly than those with clinician MET calls. Families, like clinicians, most commonly called MET for concerns of clinical deterioration; however, families also identified lack of response from clinicians and a dismissive interaction between team and family.
AHRQ-funded; HS021114.
Citation: Brady PW, Zix J, Brilli R .
Developing and evaluating the success of a family activated medical emergency team: a quality improvement report.
BMJ Qual Saf 2015 Mar;24(3):203-11. doi: 10.1136/bmjqs-2014-003001.
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Keywords: Communication, Emergency Medical Services (EMS), Hospitals, Children/Adolescents, Quality Improvement
Arling PA, Abrahamson K, Miech EJ
Communication and effectiveness in a US nursing home quality-improvement collaborative.
The investigators explored the relationship between changes in resident health outcomes, practitioner communication patterns, and practitioner perceptions of group effectiveness within a quality-improvement collaborative of nursing home clinicians. They found that reductions in fall rates were highest in facilities where respondents experienced the highest levels of communication with collaborative members outside of scheduled meetings. Clinician and practitioner observations were discussed.
AHRQ-funded; HS018464.
Citation: Arling PA, Abrahamson K, Miech EJ .
Communication and effectiveness in a US nursing home quality-improvement collaborative.
Nurs Health Sci 2014 Sep;16(3):291-7. doi: 10.1111/nhs.12098.
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Keywords: Communication, Falls, Nursing Homes, Quality of Care, Prevention, Quality Improvement
Rangachari P, Madaio M, Rethemeyer RK
Role of communication content and frequency in enabling evidence-based practices.
The study sought to promote central line bundle (CLB) implementation in a medical ICU and a pediatric ICU through periodic quality improvement (QI) interventions over a 52-week period. It found that proactive communications increased by 68 percent in the MICU and 61 percent in the PICU. During the same timeframe, both units increased CLB adherence to 100 percent. Both units also demonstrated statistically significant declines in catheter days.
AHRQ-funded; HS019785.
Citation: Rangachari P, Madaio M, Rethemeyer RK .
Role of communication content and frequency in enabling evidence-based practices.
Qual Manag Health Care 2014 Jan-Mar;23(1):43-58. doi: 10.1097/qmh.0000000000000017..
Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Communication, Evidence-Based Practice, Guidelines, Healthcare-Associated Infections (HAIs), Intensive Care Unit (ICU), Quality of Care, Quality Improvement