National Healthcare Quality and Disparities Report
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- Transitions of Care (33)
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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
1276 to 1293 of 1293 Research Studies DisplayedMoga DC, Carnahan RM, Lund BC
Risks and benefits of bladder antimuscarinics among elderly residents of Veterans Affairs Community Living Centers.
This study evaluated the risks and benefits of drugs to reduce urinary incontinence that were used by elderly VA nursing home residents. It found that the use of these drugs, known as bladder antimuscarinics, resulted in improved continence rates and better social engagement but also led to a higher risk of fractures in new users.
AHRQ-funded; HS016094
Citation: Moga DC, Carnahan RM, Lund BC .
Risks and benefits of bladder antimuscarinics among elderly residents of Veterans Affairs Community Living Centers.
J Am Med Dir Assoc. 2013 Oct;14(10):749-60. doi: 10.1016/j.jamda.2013.03.008..
Keywords: Elderly, Medication, Medication: Safety, Nursing Homes, Long-Term Care, Injuries and Wounds, Patient Safety
Jacob JT, Kasali A, Steinberg JP
http://journals.sagepub.com/doi/abs/10.1177/193758671300701S07
The role of the hospital environment in preventing healthcare-associated infections caused by pathogens transmitted through the air.
This review assesses and synthesizes available evidence in the infection control and healthcare design literature on strategies using the built environment to reduce the transmission of pathogens in the air that cause healthcare-associated infections (HAIs). It found that current evidence is limited by the complexity of the interactions between pathogens and potential hosts, and in the methods used to assess impact of these strategies.
AHRQ-funded; 290201000024I.
Citation: Jacob JT, Kasali A, Steinberg JP .
The role of the hospital environment in preventing healthcare-associated infections caused by pathogens transmitted through the air.
HERD 2013 Oct;7(1 suppl):74-98..
Keywords: Healthcare-Associated Infections (HAIs), Patient Safety, Quality of Care
Steinberg JP, Denham ME, Zimring C
https://www.researchgate.net/publication/276382905/download
The role of the hospital environment in the prevention of healthcare-associated infections by contact transmission.
The authors describe the role of the hospital environment in the spread of pathogens by direct and indirect contact. In addition, the prevention of transmission through interventions involving the built environment is discussed. They conclude that enhanced environmental cleaning including touchless technologies and self-cleaning surfaces can reduce environmental contamination and may prevent infections.
AHRQ-funded; 290201000024I.
Citation: Steinberg JP, Denham ME, Zimring C .
The role of the hospital environment in the prevention of healthcare-associated infections by contact transmission.
HERD 2013 Oct;7(1 suppl):46-73..
Keywords: Healthcare-Associated Infections (HAIs), Infectious Diseases, Hospitals, Prevention, Patient Safety
Denham ME, Kasali A, Steinberg JP
http://journals.sagepub.com/doi/abs/10.1177/193758671300701S08
The role of water in the transmission of healthcare-associated infections: opportunities for intervention through the environment.
The purpose of this review was to assess and synthesize available evidence in the infection control and healthcare design literature on strategies using the built environment to reduce the transmission of pathogens in water that cause healthcare-associated infections (HAIs). It determined that current evidence clearly identifying the environment’s role in the chain of infection is limited.
AHRQ-funded; 290201000024I.
Citation: Denham ME, Kasali A, Steinberg JP .
The role of water in the transmission of healthcare-associated infections: opportunities for intervention through the environment.
HERD 2013 Oct;7(1 suppl):99-126..
Keywords: Healthcare-Associated Infections (HAIs), Patient Safety, Quality of Care
Hall KK, Kamerow DB
http://journals.sagepub.com/doi/abs/10.1177/193758671300701S03
Understanding the role of facility design in the acquisition and prevention of healthcare-associated infections.
The authors characterize the HAI-Design project and discuss briefly each paper in this issue. These papers highlight how the built environment can impact patient safety through the use of a specific and high-impact example: healthcare-associated infections. The overall goal is to identify design strategies that appear to be effective in interrupting pathogen transmission and reducing HAIs.
AHRQ-funded; 290201000024I.
Citation: Hall KK, Kamerow DB .
Understanding the role of facility design in the acquisition and prevention of healthcare-associated infections.
HERD 2013 Oct;7(1 suppl):13-17..
Keywords: Healthcare-Associated Infections (HAIs), Patient Safety, Quality of Care
Hong AL, Sawyer MD, Shore A
Decreasing central-line-associated bloodstream infections in Connecticut intensive care units.
This study demonstrated that the Comprehensive Unit-based Safety Program, a multifaceted approach to prevent central line-associated bloodstream infections (CLABSIs) could be implemented in Connecticut (following successful implementation in Michigan). The program was associated with a reduction in CLABSI rates in Connecticut, even though the State’s baseline CLABSI rate was already low.
AHRQ-funded; 290200600022
Citation: Hong AL, Sawyer MD, Shore A .
Decreasing central-line-associated bloodstream infections in Connecticut intensive care units.
J Healthc Qual. 2013 Sep-Oct;35(5):78-87. doi: 10.1111/j.1945-1474.2012.00210.x..
Keywords: Comprehensive Unit-based Safety Program (CUSP), Healthcare-Associated Infections (HAIs), Central Line-Associated Bloodstream Infections (CLABSI), Patient Safety, Quality of Care
Paez K, Roper RA, Andrews RM
AHRQ Author: Roper RA, Andrews RM
Health information technology and hospital patient safety: a conceptual model to guide research.
The authors developed a conceptual model to guide research in sorting out the complex relationships between health information technology (HIT) and the quality and safety of care. They found the model difficult to operationalize because available HIT adoption data did not characterize features and extent of usage, and patient safety measures did not elucidate the process failures leading to safety-related outcomes. Their findings illustrated the critical need for collecting data that are germane to HIT and the possible mechanisms by which HIT may affect inpatient safety.
AHRQ-authored; AHRQ-funded.
Citation: Paez K, Roper RA, Andrews RM .
Health information technology and hospital patient safety: a conceptual model to guide research.
Jt Comm J Qual Patient Saf 2013 Sep;39(9):415-25.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Health Information Technology (HIT), Hospitals, Quality of Care, Patient Safety
Radecki RP
Letter by Radecki regarding article, "safety of thrombolysis in stroke mimics: results from a multicenter cohort study".
In this letter commenting on an article on the treatment of stroke mimics, the author asserts that the difficult question of the acceptable rate of misdiagnosis remains. He suggests that patients undergoing thrombolytic therapy for acute ischemic stroke have confirmatory testing such as an MRI with diffusion-weighted sequences and that the incidence of neuroimaging negative events be reported.
AHRQ-funded; HS017586
Citation: Radecki RP .
Letter by Radecki regarding article, "safety of thrombolysis in stroke mimics: results from a multicenter cohort study".
Stroke. 2013 Sep;44(9):e105. doi: 10.1161/STROKEAHA.113.002040..
Keywords: Stroke, Decision Making, Patient Safety, Blood Clots
Fitzgibbons Jr RJ, Ramanan B, Arya S
Long-term results of a randomized controlled trial of a nonoperative strategy (watchful waiting) for men with minimally symptomatic inguinal hernias.
This study of 254 men with minimally symptomatic inguinal hernia who were assigned to watchful waiting (WW) found that WW is a reasonable and safe strategy. However, the study which followed these patients for up to 11.5 years found that symptoms usually progressed and an operation was eventually needed, with 79 percent of men older than 65 and 62 percent of younger men receiving surgical repair.
AHRQ-funded; HS09860
Citation: Fitzgibbons Jr RJ, Ramanan B, Arya S .
Long-term results of a randomized controlled trial of a nonoperative strategy (watchful waiting) for men with minimally symptomatic inguinal hernias.
Ann Surg. 2013 Sep;258(3):508-15. doi: 10.1097/SLA.0b013e3182a19725..
Keywords: Surgery, Men's Health, Quality of Care, Patient Safety, Decision Making
Brewer BB, Verran JA
Measuring nursing unit environments with four composite measure.
This article describes a research study that developed four unit-level composite measures reflecting the work environment of nurses. These four measures (originally measured with 14 instruments) enhance the interpretation of environmental factors that have the greatest impact on patient outcomes.
AHRQ-funded; HS011973
Citation: Brewer BB, Verran JA .
Measuring nursing unit environments with four composite measure.
Nurs Econ. 2013 Sep-Oct;31(5):241-9..
Keywords: Patient Safety, Nursing, Workforce
Pohl JM, Nath R, Zheng K
Use of a comprehensive patient safety tool in primary care practices.
This article describes experiences with the use of the Physician Practice Patient Safety Assessment tool in six safety net practices—three of which were primary care nurse-managed health centers and three were physician-led federally qualified health centers. The authors concluded that this tool has enormous relevance for primary care settings, especially those preparing themselves for patient-centered medical home status and meaningful use.
AHRQ-funded; HS017191.
Citation: Pohl JM, Nath R, Zheng K .
Use of a comprehensive patient safety tool in primary care practices.
J Am Assoc Nurse Pract 2013 Aug;25(8):415-8. doi: 10.1111/1745-7599.12021..
Keywords: Patient Safety, Primary Care, Patient-Centered Healthcare, Practice Patterns, Tools & Toolkits
Clancy CM
AHRQ Author: Clancy CM
Evidence-based toolkit helps organizations reduce patient falls.
This article describes an evidence-based hospital fall-prevention toolkit developed by AHRQ that helps clinicians negotiate the change process at their organization. It was created by a team with expertise both in fall prevention and in organizational change, including staff from the RAND Corporation, ECRI Institute, and Boston University.
AHRQ-authored.
Citation: Clancy CM .
Evidence-based toolkit helps organizations reduce patient falls.
J Nurs Care Qual 2013 Jul-Sep;28(3):195-7. doi: 10.1097/NCQ.0b013e318294a9d1.
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Keywords: Evidence-Based Practice, Falls, Tools & Toolkits, Patient Safety, Prevention
Huang SS, Septimus E, Kleinman K
Targeted versus universal decolonization to prevent ICU infection.
In this pragmatic, cluster-randomized trial the authors compared targeted versus universal decolonization of patients in intensive care units (ICUs) as strategies for preventing health care-associated infections, particularly those caused by methicillin-resistant Staphylococcus aureus (MRSA). They found that in routine ICU practice, universal decolonization was more effective than targeted decolonization or screening and isolation in reducing rates of MRSA clinical isolates and bloodstream infection from any pathogen.
AHRQ-funded; 290201000008I.
Citation: Huang SS, Septimus E, Kleinman K .
Targeted versus universal decolonization to prevent ICU infection.
N Engl J Med 2013 Jun 13;368(24):2255-65. doi: 10.1056/NEJMoa1207290..
Keywords: Comparative Effectiveness, Infectious Diseases, Healthcare-Associated Infections (HAIs), Methicillin-Resistant Staphylococcus aureus (MRSA), Intensive Care Unit (ICU), Patient-Centered Healthcare, Patient Safety, Prevention
Clancy C
AHRQ Author: Clancy C
AHRQ: CUSP – scaling up a safety framework.
In this article, the author describes the Comprehensive Unit-based Safety Program, or CUSP, toolkit and its role in addressing healthcare-associated infections (HAIs) and other patient safety factors. The author outlines the components of the core CUSP toolkit which help clinicians: learn about CUSP, assemble the team, engage senior executives, understand the science of safety, identify defects through “sensemaking”, implement teamwork and communications and apply CUSP.
AHRQ-authored.
Citation: Clancy C .
AHRQ: CUSP – scaling up a safety framework.
Patient Safety & Quality Healthcare 2013 May/Jun..
Keywords: Comprehensive Unit-based Safety Program (CUSP), Quality of Care, Healthcare-Associated Infections (HAIs), Patient Safety, Teams
Sokas R, Braun B, Chenven L
AHRQ Author: Hogan E
Frontline hospital workers and the worker safety/patient safety nexus.
This article reported on panels and small-group discussions from a day-long workshop held in Washington, D.C., on October 25, 2012, to explore whether and how hospital-based frontline health care workers (HCWs) affect patient safety and how they experience safety in their work settings. Conference sponsors included AHRQ, and workshop sessions focused on the intersection of worker safety and patient safety and on specific steps that health care institutions have used to implement a culture of safety in the workplace.
AHRQ-authored.
Citation: Sokas R, Braun B, Chenven L .
Frontline hospital workers and the worker safety/patient safety nexus.
Jt Comm J Qual Patient Saf 2013 Apr;39(4):185-92.
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Keywords: Provider, Organizational Change, Patient Safety, Hospitals
Hempel S, Newberry S, Wang Z
AHRQ Author: Spector WD
Hospital fall prevention: a systematic review of implementation, components, adherence, and effectiveness.
The authors sought to document systematically the implementation, components, comparators, adherence, and effectiveness of published fall prevention approaches in U.S. acute care hospitals. They found that most interventions included multiple components, and the pooled postintervention incidence rate ratio (IRR) was 0.77. They found no systematic association between implementation intensity, intervention complexity, comparator information, or adherence levels and IRR. They concluded that promising approaches exist, but better reporting of outcomes, implementation, adherence, intervention components, and comparison group information is necessary to establish evidence on how hospitals can successfully prevent falls.
AHRQ-authored; AHRQ-funded; 290201000017I.
Citation: Hempel S, Newberry S, Wang Z .
Hospital fall prevention: a systematic review of implementation, components, adherence, and effectiveness.
J Am Geriatr Soc 2013 Apr;61(4):483-94. doi: 10.1111/jgs.12169.
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Keywords: Adverse Events, Falls, Hospitals, Patient Safety, Prevention
O'Leary KJ, Devisetty VK, Patel AR
Comparison of traditional trigger tool to data warehouse based screening for identifying hospital adverse events.
This study compared a traditional trigger tool with an enterprise data warehouse (EDW) based screening method to detect hospital adverse events (AEs). The authors found relatively poor agreement between traditional trigger tool and EDW based screening with only approximately a third of all AEs detected by both methods. They recommended a combination of complementary methods as the optimal approach to detecting AEs among hospitalized patients.
AHRQ-funded; HS019630.
Citation: O'Leary KJ, Devisetty VK, Patel AR .
Comparison of traditional trigger tool to data warehouse based screening for identifying hospital adverse events.
BMJ Qual Saf 2013 Feb;22(2):130-8. doi: 10.1136/bmjqs-2012-001102.
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Keywords: Adverse Events, Hospitals, Medical Errors, Patient Safety, Quality Indicators (QIs)
Clancy CM
AHRQ Author: Clancy CM
New hospital readmission policy links financial and quality incentives.
This article describes AHRQ-related projects to reduce hospital readmissions, including Porject RED (Re-Engineered Discharge), Project BOOST (Better Outcomes for Older adults through Safe Transitions), and Patient Safety Organizations (PSOs).
AHRQ-authored.
Citation: Clancy CM .
New hospital readmission policy links financial and quality incentives.
J Nurs Care Qual 2013 Jan-Mar;28(1):1-4. doi: 10.1097/NCQ.0b013e3182725d82.
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Keywords: Elderly, Hospital Discharge, Patient Safety, Hospital Readmissions, Transitions of Care