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Search All Research Studies
Topics
- Adverse Events (1)
- Ambulatory Care and Surgery (1)
- Catheter-Associated Urinary Tract Infection (CAUTI) (1)
- Communication (1)
- Critical Care (1)
- Decision Making (1)
- Electronic Health Records (EHRs) (1)
- Emergency Department (2)
- Emergency Medical Services (EMS) (1)
- Healthcare-Associated Infections (HAIs) (1)
- Healthcare Delivery (2)
- Health Information Technology (HIT) (2)
- Hospital Discharge (1)
- Hospitals (3)
- Inpatient Care (1)
- Labor and Delivery (1)
- Newborns/Infants (1)
- Nursing (2)
- (-) Patient Safety (13)
- Provider (3)
- Provider: Clinician (1)
- Provider: Health Personnel (1)
- Provider: Nurse (3)
- Provider: Physician (2)
- Quality Improvement (2)
- Quality of Care (2)
- Surgery (2)
- Transitions of Care (2)
- Urinary Tract Infection (UTI) (1)
- (-) Workflow (13)
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 13 of 13 Research Studies DisplayedBourgoin A, Balaban R, Hochman M
AHRQ Author: Perfetto D, Hogan EM
Improving quality and safety for patients after hospital discharge: primary care as the lead integrator in postdischarge care transitions.
The purpose of this study was to explain primary care-based transition workflow processes for hospitalized patients. The researchers conducted interviews with primary care thought leaders, staff at 9 primary care sites, community agency staff, and recently discharged patients. The researchers found that primary care postdischarge workflows vary across the different settings, rarely include communications with the patient or the inpatient team during the hospitalization and vary widely across settings. The researchers recommended the use of principles for primary care practices to encourage active participation in the full spectrum of postdischarge care, from admission through the first postdischarge visit to primary care.
AHRQ-authored; AHRQ-funded; 233201500019I/HHSP23337002T.
Citation: Bourgoin A, Balaban R, Hochman M .
Improving quality and safety for patients after hospital discharge: primary care as the lead integrator in postdischarge care transitions.
J Ambul Care Manage 2022 Oct-Dec;45(4):310-20. doi: 10.1097/jac.0000000000000433..
Keywords: Quality of Care, Patient Safety, Hospital Discharge, Transitions of Care, Hospitals, Workflow
Burden A, Potestio C, Pukenas E
Influence of perioperative handoffs on complications and outcomes.
The authors describe the perioperative environment, calling it dynamic and complex, and indicate that there are multiple distractions that can interfere with effective communication and safe patient care. They discuss various aspects involved in handoffs, concluding that an institutional culture that highlights the importance of patient safety and that encourages team collaboration has demonstrated that harm can be decreased and patient safety can be improved.
AHRQ-funded; HS026158.
Citation: Burden A, Potestio C, Pukenas E .
Influence of perioperative handoffs on complications and outcomes.
Adv Anesth 2021 Dec;39:133-48. doi: 10.1016/j.aan.2021.07.008..
Keywords: Patient Safety, Transitions of Care, Workflow
Herrick HM, Lorch S, Hsu JY
Impact of flow disruptions in the delivery room.
The goal of this study was to identify the impact of flow disruptions during neonatal resuscitation and to determine their association with key process and outcome measures. Delivery-room resuscitations of neonates less 32 weeks gestational age were video recorded for observation. Results showed that flow disruptions occurred frequently during neonatal resuscitation and recommendations included measuring flow disruptions as a feasible method to assess the impact of human factors in the delivery room and to identify modifiable factors and practices to improve patient care.
AHRQ-funded; HS023538; HS026491; HS026625; HS023806.
Citation: Herrick HM, Lorch S, Hsu JY .
Impact of flow disruptions in the delivery room.
Resuscitation 2020 May;150:29-35. doi: 10.1016/j.resuscitation.2020.02.037.
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Keywords: Workflow, Labor and Delivery, Newborns/Infants, Patient Safety, Healthcare Delivery, Quality Improvement, Quality of Care
Manojlovich M, Ameling JM, Forman J
Contextual barriers to communication between physicians and nurses about appropriate catheter use.
This study identified contextual barriers to communication between physicians and nurses that contribute to inappropriate use of catheters and increased risk of health care-associated infections. The researchers conducted individual and small-group semistructured interviewed with physicians and nurses in a progressive care unit of an academic hospital. Common barriers included workflow misalignment between clinicians, issues with electronic medical records and pagers, and strained relationships between clinicians.
AHRQ-funded; HS024385.
Citation: Manojlovich M, Ameling JM, Forman J .
Contextual barriers to communication between physicians and nurses about appropriate catheter use.
Am J Crit Care 2019 Jul;28(4):290-98. doi: 10.4037/ajcc2019372..
Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Communication, Healthcare-Associated Infections (HAIs), Patient Safety, Provider, Provider: Nurse, Provider: Physician, Urinary Tract Infection (UTI), Workflow
Joseph A, Khoshkenar A, Taaffe KM
Minor flow disruptions, traffic-related factors and their effect on major flow disruptions in the operating room.
This study researched the impact of minor flow disruptions (FDs) on operating room (OR) flow and how it contributes to an increase in serious adverse events. The rate of minor FDs increases the rate of major FDs. More major and minor FDs occur in the anesthesia area than in all other OR areas. They concluded that room design and layout issues contribute to those FDs and that is an important consideration in OR design.
AHRQ-funded; HS024380.
Citation: Joseph A, Khoshkenar A, Taaffe KM .
Minor flow disruptions, traffic-related factors and their effect on major flow disruptions in the operating room.
BMJ Qual Saf 2019 Apr;28(4):276-83. doi: 10.1136/bmjqs-2018-007957.
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Keywords: Adverse Events, Healthcare Delivery, Patient Safety, Surgery, Workflow
McGrath SP, Perreard IM, Garland MD
Improving patient safety and clinician workflow in the general care setting with enhanced surveillance monitoring.
This researched analyzed the impact of implementing an improved clinical monitoring system with enhanced surveillance. This enhanced monitoring system was shown to improve patient safety and clinical workflow in inpatient hospital settings. After implementation higher staff satisfaction was shown and reduced average vital signs data collection time by 28%. It improved the availability and accuracy of patient information. However, there was little or no impact on clinical alarms.
AHRQ-funded; HS024403.
Citation: McGrath SP, Perreard IM, Garland MD .
Improving patient safety and clinician workflow in the general care setting with enhanced surveillance monitoring.
IEEE J Biomed Health Inform 2019 Mar;23(2):857-66. doi: 10.1109/jbhi.2018.2834863..
Keywords: Hospitals, Inpatient Care, Patient Safety, Provider: Clinician, Quality Improvement, Workflow
Rosen MA, Dietz AS, Lee N
Sensor-based measurement of critical care nursing workload: Unobtrusive measures of nursing activity complement traditional task and patient level indicators of workload to predict perceived exertion.
The purpose of this study was to establish the validity of sensor-based measures of work processes for predicting perceived mental and physical exertion of critical care nurses. Environmental sensors worn by staff in a surgical intensive care unit captured work process data. Nurses rated their mental and physical exertion for each four-hour block, and recorded patient and staffing-level workload factors. Analysis of this data yielded highly predictive models of critical care nursing workload to generate insights into workflow and work design. The researchers conclude that sensor-based measures are a viable complement to traditional task demand measures of workload.
AHRQ-funded; HS023553.
Citation: Rosen MA, Dietz AS, Lee N .
Sensor-based measurement of critical care nursing workload: Unobtrusive measures of nursing activity complement traditional task and patient level indicators of workload to predict perceived exertion.
PLoS One 2018 Oct 12;13(10):e0204819. doi: 10.1371/journal.pone.0204819..
Keywords: Critical Care, Nursing, Provider: Nurse, Patient Safety, Workflow
Fong A, Ratwani RM
Understanding emergency medicine physicians multitasking behaviors around interruptions.
Interruptions can adversely impact human performance, particularly in fast-paced and high-risk environments such as the emergency department (ED). In this paper, the investigators present a comprehensive framework for understanding interruptions that is composed of three phases, each with multiple levels: interruption start transition, interruption engagement, and interruption end transition. This three-phase framework is not constrained to discrete task transitions, providing a robust method to categorize multitasking behaviors around interruptions. They apply this framework in categorizing 457 interruption episodes.
AHRQ-funded; HS022362.
Citation: Fong A, Ratwani RM .
Understanding emergency medicine physicians multitasking behaviors around interruptions.
Acad Emerg Med 2018 Oct;25(10):1164-68. doi: 10.1111/acem.13496..
Keywords: Emergency Department, Workflow, Patient Safety, Provider: Physician, Provider
Bayramzadeh S, Joseph A, San D
The impact of operating room layout on circulating nurse's work patterns and flow disruptions: a behavioral mapping study.
The purpose of this study was to assess how the adjacencies of functionally different areas within operating rooms (ORs) can influence the circulating nurse's (CN) workflow patterns and disruptions. The investigators video recorded and thematically coded a convenience sample of 25 surgeries for CN's activities, locations, and flow disruptions. The investigators suggest that optimum adjacencies should be considered while designing ORs such that they are more efficient and safer.
AHRQ-funded; HS024380.
Citation: Bayramzadeh S, Joseph A, San D .
The impact of operating room layout on circulating nurse's work patterns and flow disruptions: a behavioral mapping study.
HERD 2018 Jul;11(3):124-38. doi: 10.1177/1937586717751124..
Keywords: Surgery, Workflow, Hospitals, Nursing, Provider: Nurse, Provider, Patient Safety
Borycki E, Senathirajah Y, Kushniruk AW
The future of mobile usability, workflow and safety testing.
In this paper, the authors outline a vision for the future of mobile usability, workflow and safety testing. The authors argue for the use of glasses that can audio and video record usability, workflow and safety data.
AHRQ-funded; HS023708.
Citation: Borycki E, Senathirajah Y, Kushniruk AW .
The future of mobile usability, workflow and safety testing.
Stud Health Technol Inform 2017;245:15-19..
Keywords: Health Information Technology (HIT), Patient Safety, Workflow
Benda NC, Fairbanks RJ, Fairbanks RJ
Are you paying attention? Related guidance on how concepts of attention may inform effective time sharing of tasks in emergency medicine.
The authors respond to an earlier article providing a thoughtful introduction to the importance of teaching effective task switching in emergency medicine. Their letter introduces the concept of attention, provides examples of tasks that can be most safely and effectively time shared, and notes that these principles must be considered in designing tools for the time sharing and rapid switching of tasks necessary in the ED environment.
AHRQ-funded; HS022542.
Citation: Benda NC, Fairbanks RJ, Fairbanks RJ .
Are you paying attention? Related guidance on how concepts of attention may inform effective time sharing of tasks in emergency medicine.
Ann Emerg Med 2017 May;69(5):669-70. doi: 10.1016/j.annemergmed.2017.01.027.
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Keywords: Workflow, Emergency Medical Services (EMS), Emergency Department, Patient Safety
Hanauer DA, Branford GL, Greenberg G
Two-year longitudinal assessment of physicians' perceptions after replacement of a longstanding homegrown electronic health record: does a J-curve of satisfaction really exist?
This report describes a 2-year prospective, longitudinal survey of attending physicians in 3 clinical areas (family medicine, general pediatrics, internal medicine) who experienced a transition from a homegrown electronic health record (EHR) to a vendor EHR. The primary goal was to determine if perceptions followed a J-curve pattern in which they initially dropped but eventually surpassed baseline measures. A J-curve was not found for any measures, including workflow, safety, communication, and satisfaction.
AHRQ-funded; HS023613.
Citation: Hanauer DA, Branford GL, Greenberg G .
Two-year longitudinal assessment of physicians' perceptions after replacement of a longstanding homegrown electronic health record: does a J-curve of satisfaction really exist?
J Am Med Inform Assoc 2017 Apr 1;24(e1):e157-e65. doi: 10.1093/jamia/ocw077.
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Keywords: Electronic Health Records (EHRs), Provider: Health Personnel, Ambulatory Care and Surgery, Patient Safety, Workflow
Butler KA, Mercer E, Bahrami A
Model checking for verification of interactive health IT systems.
The authors proposed to formalize the relationship between HIT and the conceptual work that increasingly typifies modern care. They demonstrated the method on a patient contact system to show that model checking is effective for interactive systems and that much of it can be automated.
AHRQ-funded; HS021233.
Citation: Butler KA, Mercer E, Bahrami A .
Model checking for verification of interactive health IT systems.
AMIA Annu Symp Proc 2015;2015:349-58.
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Keywords: Decision Making, Health Information Technology (HIT), Health Information Technology (HIT), Patient Safety, Workflow