National Healthcare Quality and Disparities Report
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Topics
- Adverse Events (2)
- Caregiving (1)
- Care Management (1)
- Catheter-Associated Urinary Tract Infection (CAUTI) (1)
- Central Line-Associated Bloodstream Infections (CLABSI) (1)
- Children/Adolescents (5)
- Clinician-Patient Communication (1)
- Communication (2)
- COVID-19 (3)
- Critical Care (13)
- Decision Making (1)
- Diagnostic Safety and Quality (1)
- Elderly (2)
- Electronic Health Records (EHRs) (1)
- Emergency Department (1)
- Evidence-Based Practice (1)
- Healthcare-Associated Infections (HAIs) (2)
- Healthcare Costs (2)
- Healthcare Delivery (5)
- Healthcare Utilization (1)
- Health Information Technology (HIT) (2)
- Hospitalization (7)
- (-) Hospitals (28)
- Implementation (1)
- Infectious Diseases (3)
- Injuries and Wounds (1)
- Inpatient Care (5)
- (-) Intensive Care Unit (ICU) (28)
- Medical Errors (1)
- Medicare (2)
- Methicillin-Resistant Staphylococcus aureus (MRSA) (1)
- Mortality (4)
- Neonatal Intensive Care Unit (NICU) (2)
- Neurological Disorders (2)
- Newborns/Infants (5)
- Outcomes (5)
- Patient-Centered Outcomes Research (5)
- Patient and Family Engagement (1)
- Patient Experience (1)
- Patient Safety (4)
- Payment (1)
- Prevention (2)
- Provider Performance (1)
- Public Health (1)
- Racial and Ethnic Minorities (1)
- Respiratory Conditions (3)
- Risk (1)
- Sepsis (2)
- Teams (2)
- Transitions of Care (1)
- Urinary Tract Infection (UTI) (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 25 of 28 Research Studies DisplayedKannan S, Song Z
Changes in out-of-pocket costs for US hospital admissions between December and January every year.
Out-of-pocket costs for ICU care may be large at the beginning of the year due to high insurance deductibles that reset every year for US patients, and the expensive nature of ICU care. The purpose of this cross-sectional study was to explore cost-sharing changes from December to January for ICU admissions and non -ICU admissions among adults with employer-sponsored insurance. Among aggregate ICU hospitalizations, total cost-sharing averaged $1079 in December and $1871 in January, a 73.4% increase. Among non-ICU hospitalizations, total cost-sharing averaged $1043 in December and $1683 in January, a 61.3% increase. These increases and differences between ICU and non-ICU hospitalizations were greater among patients with high deductible health plans (HDHPs). For patients with HDHPs requiring an ICU stay, cost-sharing averaged $3093 per hospitalization in January vs $1301 in December.
AHRQ-funded; HS024072.
Citation: Kannan S, Song Z .
Changes in out-of-pocket costs for US hospital admissions between December and January every year.
JAMA Health Forum 2023 May 5; 4(5):e230784. doi: 10.1001/jamahealthforum.2023.0784..
Keywords: Healthcare Costs, Hospitals, Hospitalization, Intensive Care Unit (ICU)
Valley TS, Schutz A, Miller J
Hospital factors that influence ICU admission decision-making: a qualitative study of eight hospitals.
In order to understand factors influencing how intensive care unit (ICU) admission decisions are made, researchers conducted qualitative analysis of eight U.S. hospitals. Semi-structured, one-on-one interviews with 87 participants were supplemented by site visits and clinical observations. Four hospital-level factors were identified which influenced ICU admission decisionmaking. The researchers concluded that healthcare systems should evaluate use of ICU care and establish institutional patterns to ensure that ICU admission decisions are patient-centered as well as account for resources and hospital-specific constraints.
AHRQ-funded; HS028038.
Citation: Valley TS, Schutz A, Miller J .
Hospital factors that influence ICU admission decision-making: a qualitative study of eight hospitals.
Intensive Care Med 2023 May; 49(5):505-16. doi: 10.1007/s00134-023-07031-w..
Keywords: Intensive Care Unit (ICU), Hospitals, Decision Making, Hospitalization
Doherty JR, Schaefer A, Goodman DC
Texas hospital's perspectives about NICU performance measures: a mixed-methods study.
This exploratory mixed-methods study was conducted to determine Texas hospital leaders’ perspectives about neonatal intensive care (NICU) performance measures. First a survey was sent along with a copy of the Dartmouth Atlas of Neonatal Intensive Care to clinical and administrative leaders of 150 NICUs in Texas. The authors asked respondents to review the chapter that reported Texas-specific results and respond to a variety of open and closed-ended questions about the overall usefulness of the report. Secondly, they conducted semistructured qualitative interviews with a subset of survey respondents to better understand their perspectives. There was a 50% survey response rate. Respondents generally found the report to be interesting and useful, and 87.7% of all respondents reported being in favor of receiving future reports with their own hospital's data benchmarked against other anonymous NICU peers. All measures in the Atlas were considered favorably. The respondents also felt that a report with performance data would serve as a mechanism to drive change by identifying opportunities for improvement.
AHRQ-funded; HS024075.
Citation: Doherty JR, Schaefer A, Goodman DC .
Texas hospital's perspectives about NICU performance measures: a mixed-methods study.
Qual Manag Health Care 2023 Jan-Mar;32(1):8-15. doi: 10.1097/qmh.0000000000000347..
Keywords: Newborns/Infants, Intensive Care Unit (ICU), Critical Care, Provider Performance, Hospitals
Levinson Z, Cantor J, Williams MV
The association of strained ICU capacity with hospital patient racial and ethnic composition and federal relief during the COVID-19 pandemic.
Investigators sought to identify the association between strained intensive care unit (ICU) capacity during the COVID-19 pandemic and hospital racial and ethnic patient composition, federal pandemic relief, and other hospital characteristics. They found that hospitals with large Black patient shares experienced greater strain during the pandemic. These hospitals received more federal relief; however, funding was not targeted overall toward hospitals with high ICU occupancy rates.
AHRQ-funded; HS024067.
Citation: Levinson Z, Cantor J, Williams MV .
The association of strained ICU capacity with hospital patient racial and ethnic composition and federal relief during the COVID-19 pandemic.
Health Serv Res 2022 Dec;57(Suppl 2):279-90. doi: 10.1111/1475-6773.14028..
Keywords: COVID-19, Intensive Care Unit (ICU), Critical Care, Racial and Ethnic Minorities, Hospitals
Wayne MT, Seelye S, Molling D
Variation in U.S. hospital practices for bronchoscopy in the intensive care unit.
The authors sought to measure bronchoscopy rates among mechanically ventilated ICU patients and to assess for variation across hospitals. In this cohort of over 150 diverse hospitals across the United States, they found that nearly 4% of mechanically ventilated ICU patients underwent bronchoscopy, representing a more than 20-fold variation in its use, which was only minimally attenuated after adjusting for patient and hospital characteristics. They recommended future studies to understand the drivers and impact of this variation on patient outcomes.
AHRQ-funded; HS028038.
Citation: Wayne MT, Seelye S, Molling D .
Variation in U.S. hospital practices for bronchoscopy in the intensive care unit.
Ann Am Thorac Soc 2022 Jun;19(6):1061-65. doi: 10.1513/AnnalsATS.202110-1141RL..
Keywords: Hospitals, Intensive Care Unit (ICU), Critical Care, Respiratory Conditions
Michelson KA, Rees CA, Sarathy J
Interregional transfers for pandemic surges.
Hospital inpatient and intensive care unit (ICU) bed shortfalls may arise due to regional surges in volume. In this study, the investigators sought to determine how interregional transfers could alleviate bed shortfalls during a pandemic, using estimates of past and projected inpatient and ICU cases of coronavirus disease 2019 (COVID-19) from 4 February 2020 to 1 October 2020.
AHRQ-funded; HS026503.
Citation: Michelson KA, Rees CA, Sarathy J .
Interregional transfers for pandemic surges.
Clin Infect Dis 2021 Dec 6;73(11):e4103-e10. doi: 10.1093/cid/ciaa1549..
Keywords: COVID-19, Hospitals, Public Health, Intensive Care Unit (ICU), Critical Care
Anesi GL, Jablonski J, Harhay MO
Characteristics, outcomes, and trends of patients with COVID-19-related critical illness at a learning health system in the United States.
This study’s objective is to describe the epidemiology of COVID-19-related critical illness, including trends in outcomes and care delivery, using five hospitals within the University of Pennsylvania Health System as a setting. Findings showed that, among patients with COVID-19-related critical illness admitted to ICUs of a learning health system in the United States, mortality seemed to decrease over time despite stable patient characteristics. Recommendations included further studies to confirm this result and to investigate causal mechanisms.
AHRQ-funded; HS026372.
Citation: Anesi GL, Jablonski J, Harhay MO .
Characteristics, outcomes, and trends of patients with COVID-19-related critical illness at a learning health system in the United States.
Ann Intern Med 2021 May;174(5):613-21. doi: 10.7326/m20-5327..
Keywords: COVID-19, Critical Care, Intensive Care Unit (ICU), Mortality, Hospitals, Outcomes, Infectious Diseases
Haidari ES, Lee HC, Illuzzi JL
Hospital variation in admissions to neonatal intensive care units by diagnosis severity and category.
The objective of this study was to examine interhospital variation in admissions to neonatal intensive care units (NICU) and reasons for the variation. 2010-2012 linked birth certificate and hospital discharge data from 35 hospitals in California on live births at 35-42 weeks gestation and ≥1500 g birth weight were used. The authors concluded that interhospital variation in NICU admissions is mostly driven by admissions for mild diagnoses.
AHRQ-funded; HS023801.
Citation: Haidari ES, Lee HC, Illuzzi JL .
Hospital variation in admissions to neonatal intensive care units by diagnosis severity and category.
J Perinatol 2021 Mar;41(3):468-77. doi: 10.1038/s41372-020-00775-z..
Keywords: Newborns/Infants, Intensive Care Unit (ICU), Hospitalization, Hospitals
Anesi GL, Chelluri J, Qasim ZA
Association of an emergency department-embedded critical care unit with hospital outcomes and intensive care unit use.
The purpose of this study was to evaluate the potential impact of an emergency department-embedded critical care unit (CCU) at the Hospital of the University of Pennsylvania among patients with sepsis and acute respiratory failure (ARF) admitted from the emergency department to a medical ward or ICU from January 2016 to December 2017. Findings showed that the emergency department-embedded CCU was not associated with clinical outcomes among patients admitted with sepsis or ARF. Among less sick patients with sepsis, the emergency department-embedded CCU was initially associated with reduced rates of direct ICU admission from the emergency department. Further research was recommended to further evaluate the impact and utility of the emergency department-embedded CCU model.
AHRQ-funded; HS026372.
Citation: Anesi GL, Chelluri J, Qasim ZA .
Association of an emergency department-embedded critical care unit with hospital outcomes and intensive care unit use.
Ann Am Thorac Soc 2020 Dec;17(12):1599-609. doi: 10.1513/AnnalsATS.201912-912OC..
Keywords: Emergency Department, Critical Care, Intensive Care Unit (ICU), Hospitals, Sepsis, Respiratory Conditions, Outcomes, Patient-Centered Outcomes Research, Healthcare Delivery
Bowman JA, Nuño M, Jurkovich GJ
Association of hospital-level intensive care unit use and outcomes in older patients with isolated rib fractures.
Researchers characterized interhospital variability in intensive care unit (ICU) vs non-ICU admission of older patients with isolated rib fractures and evaluated whether greater hospital-level use of ICU admission is associated with improved outcomes. This study included trauma patients who were admitted to trauma centers participating in the National Trauma Data Bank. The researchers found that admission location of older patients with isolated rib fractures was variable across hospitals, but hospitalization at a center with greater ICU use was associated with improved outcomes. They recommended that hospitals with low ICU use admit more such patients to an ICU.
AHRQ-funded; HS022236.
Citation: Bowman JA, Nuño M, Jurkovich GJ .
Association of hospital-level intensive care unit use and outcomes in older patients with isolated rib fractures.
JAMA Netw Open 2020 Nov 2;3(11):e2026500. doi: 10.1001/jamanetworkopen.2020.26500..
Keywords: Elderly, Injuries and Wounds, Intensive Care Unit (ICU), Hospitals, Patient-Centered Outcomes Research, Outcomes, Mortality
Anesi GL, Chowdhury M, Small DS GL, Chowdhury M, Small DS
Association of a novel index of hospital capacity strain with admission to intensive care units.
Researchers sought to develop a novel composite strain index and measure its association with intensive care unit (ICU) admission decisions and hospital outcomes.
AHRQ-funded; HS026372.
Citation: Anesi GL, Chowdhury M, Small DS GL, Chowdhury M, Small DS .
Association of a novel index of hospital capacity strain with admission to intensive care units.
Ann Am Thorac Soc 2020 Nov;17(11):1440-47. doi: 10.1513/AnnalsATS.202003-228OC.
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Keywords: Intensive Care Unit (ICU), Hospitals, Healthcare Delivery
Lake ET, Smith JG, Staiger DO
Measuring parent satisfaction with care in neonatal intensive care units: the EMPATHIC-NICU-USA questionnaire.
This study’s objective was to adapt the Netherlands-developed parent satisfaction questionnaire on neonatal and pediatric intensive care units EMPATHIC for USA use and translation into English. The researchers selected the EMPATHIC-30 questionnaire due to its’ shorter length and availability of a validated Spanish-language version. Six items from the EMPATHIC-N survey were also added, two of which were split into separate items creating a new EMPATHIC-38 survey which was adapted to USA English. The survey was then tested with NICU and PICU parents. Data from 282 parents (61% White, 61% Black, and 20% Hispanic) was used as a test. Results were positive and indicated acceptable reliability.
Citation: Lake ET, Smith JG, Staiger DO .
Measuring parent satisfaction with care in neonatal intensive care units: the EMPATHIC-NICU-USA questionnaire.
Front Pediatr 2020 Oct 6;8:541573. doi: 10.3389/fped.2020.541573.
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Keywords: Newborns/Infants, Neonatal Intensive Care Unit (NICU), Intensive Care Unit (ICU), Patient Experience, Hospitals
Lindell RB, Nishisaki A, Weiss SL
Risk of mortality in immunocompromised children with severe sepsis and septic shock.
This study’s objective was to assess the risk of mortality for immunocompromised children admitted to the hospital with septic shock or sepsis. This retrospective multicenter cohort study used eighty-three centers in the Virtual Pediatric systems database. The cohort included children admitted to the pediatric intensive care unit (PICU) with severe sepsis or septic shock from 2012-2016. Across 83 centers, 10,768 PICU admissions with an International Classification of Diseases, 9th Revision, Clinical Modification code for severe sepsis or septic shock were identified; with 3,021 of these patients (28%) having an immunocompromised diagnosis. PICU mortality rates varied widely by center, and those centers with a higher mean number of sepsis patients per month in a center had a lower PICU mortality rate. Multiple prior malignancies, hemophagocytic lymphohistiocytosis, congenital immunodeficiency, and hematopoietic cell transplant are conditions independently associated with an increased odds of PICU mortality in children with severe sepsis or septic shock.
AHRQ-funded; HS024511; HS026939; HS021583; HS022464.
Citation: Lindell RB, Nishisaki A, Weiss SL .
Risk of mortality in immunocompromised children with severe sepsis and septic shock.
Crit Care Med 2020 Jul;48(7):1026-33. doi: 10.1097/ccm.0000000000004329..
Keywords: Children/Adolescents, Mortality, Sepsis, Risk, Intensive Care Unit (ICU), Hospitalization, Hospitals
Sun Y, Guo F, Kaffashi F
INSMA: an integrated system for multimodal data acquisition and analysis in the intensive care unit.
In this paper, the investigators proposed a multimodal data acquisition and analysis system called INSMA, with the ability to acquire, store, process, and visualize multiple types of data from the Philips IntelliVue patient monitor. They also discussed how the acquired data could be used for patient state tracking. INSMA is being tested in the ICU at University Hospitals Cleveland Medical Center.
AHRQ-funded; HS022860.
Citation: Sun Y, Guo F, Kaffashi F .
INSMA: an integrated system for multimodal data acquisition and analysis in the intensive care unit.
J Biomed Inform 2020 Jun;106:103434. doi: 10.1016/j.jbi.2020.103434..
Keywords: Intensive Care Unit (ICU), Health Information Technology (HIT), Hospitals
Cifra CL, Ten Eyck P, Dawson JD
Factors associated with diagnostic error on admission to a PICU: a pilot study.
This pilot retrospective cohort study examined errors in pediatric ICUs (PICUs) for children during the first 12 hours after PICU admission. A structured tool (Safer Dx) was used to identify diagnostic error in an academic tertiary institution. Out of 50 patients, 4 (8%) had diagnostic errors. The errors were in diagnoses of chronic ear infection, intracranial pressure (two cases), and Bartonella encephalitis. This pilot study will be expanded into a larger and more definitive multicenter study.
AHRQ-funded; HS022087.
Citation: Cifra CL, Ten Eyck P, Dawson JD .
Factors associated with diagnostic error on admission to a PICU: a pilot study.
Pediatr Crit Care Med 2020 May;21(5):e311-e15. doi: 10.1097/pcc.0000000000002257..
Keywords: Children/Adolescents, Diagnostic Safety and Quality, Medical Errors, Adverse Events, Patient Safety, Critical Care, Intensive Care Unit (ICU), Hospitals
Meddings J, Greene MT, Ratz D
Multistate programme to reduce catheter-associated infections in intensive care units with elevated infection rates.
AHRQ’s Safety Program for ICUs aimed to reduce central line-associated bloodstream infection (CLABSI) and catheter-associated urinary tract infection (CAUTI) in intensive care units with elevated rates. Included hospitals had at least one adult intensive care unit with elevated CLABSI or CAUTI rates. The investigators targeted intensive care units with elevated catheter infection rates but yielded no statistically significant reduction in CLABSI, CAUTI or catheter utilization in the first two of six planned cohorts. Improvements in the interventions based on lessons learned from these initial cohorts are being applied to subsequent cohorts.
AHRQ-funded; 233201500016I.
Citation: Meddings J, Greene MT, Ratz D .
Multistate programme to reduce catheter-associated infections in intensive care units with elevated infection rates.
BMJ Qual Saf 2020 May;29(5):418-29. doi: 10.1136/bmjqs-2019-009330..
Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Infectious Diseases, Patient Safety, Urinary Tract Infection (UTI), Intensive Care Unit (ICU), Hospitals, Evidence-Based Practice, Patient-Centered Outcomes Research, Inpatient Care, Critical Care
Law AC, Forbath N, O'Donoghue S
Hospital-level availability of prone positioning in Massachusetts ICUs.
The authors sought to evaluate the institutional availability of prone positioning (PP), for which prior studies have shown its underuse. They found that most hospitals they surveyed in Massachusetts were either unable, or not completely able, to offer PP routinely. They concluded that their finding of low uptake of an evidence-based intervention with a mortality benefit at an institutional level raises multiple questions for future investigation and suggests that attempts to implement PP among eligible patients will need to include consideration of hospital-level barriers.
AHRQ-funded; HS024288.
Citation: Law AC, Forbath N, O'Donoghue S .
Hospital-level availability of prone positioning in Massachusetts ICUs.
Am J Respir Crit Care Med 2020 Apr 15;201(8):1006-08. doi: 10.1164/rccm.201910-2097LE.
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Keywords: Intensive Care Unit (ICU), Inpatient Care, Hospitals, Respiratory Conditions
Khan SH, Xu C, Purpura R
Decreasing delirium through music: a randomized pilot trial.
This randomized controlled trial examined the use of music to decrease delirium in intensive care unit (ICU) patients. Patients were either provided personalized music (PM), slow-tempo music (STM), or an audiobook (for attention control). They were provided noise-cancelling headphones and used mp3 plays to listen to their music/audiobook for 1-hour sessions twice daily up to 7 days. Delirium and delirium severity were assessed twice daily using the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). Out of 1589 patients screen, 117 (7.4%) were eligible. Of those 52 were randomized between the three groups. Adherence was higher in the groups listening to music and 80% of patients surveyed rated the music as enjoyable. Median rates of delirium/coma-free days by day 7 was 2 for PM, 3 for STM, and 2 for AC. Medium delirium severity rates (from 1-7) was 5.5 for PM, 3.5 for STM, and 4 for AC.
AHRQ-funded; HS024384.
Citation: Khan SH, Xu C, Purpura R .
Decreasing delirium through music: a randomized pilot trial.
Am J Crit Care 2020 Mar 1;29(2):e31-e38. doi: 10.4037/ajcc2020175..
Keywords: Intensive Care Unit (ICU), Inpatient Care, Neurological Disorders, Prevention, Hospitals
Williams CN, Eriksson CO, Kirby A
Hospital mortality and functional outcomes in pediatric neurocritical care.
Pediatric neurocritical care (PNCC) outcomes research is scarce. In this study, the investigators aimed to expand knowledge about outcomes in PNCC by evaluating death and changes in Functional Status Scale (FSS) from baseline among PNCC diagnoses. The investigators concluded that PNCC patients had high rates of death and new disability at discharge, varying significantly between PNCC diagnoses. Multiple domains of disability were affected, underscoring the ongoing multidisciplinary health care needs of survivors.
AHRQ-funded; HS022981.
Citation: Williams CN, Eriksson CO, Kirby A .
Hospital mortality and functional outcomes in pediatric neurocritical care.
Hosp Pediatr 2019 Dec;9(12):958-66. doi: 10.1542/hpeds.2019-0173..
Keywords: Children/Adolescents, Newborns/Infants, Intensive Care Unit (ICU), Critical Care, Neurological Disorders, Mortality, Hospitals, Inpatient Care, Outcomes, Patient-Centered Outcomes Research
Anandaiah AM, Stevens JP, Sullivan AM
Implementation of a bundled consent process in the ICU: a single-center experience.
This study examined perceptions of internal medicine residents in the ICU of an urban academic medical center about using a bundled consent process with patients and their families. The bundled consent provides consent for all commonly performed procedures on a single form. It has been advocated as an efficient method, but there is little published literature about its use. Out of 164 internal residents surveyed, 102 completed the survey. The majority (78%) felt it scared or stressed families, and only 26% felt confident that they would obtain valid informed consent.
AHRQ-funded; HS024288.
Citation: Anandaiah AM, Stevens JP, Sullivan AM .
Implementation of a bundled consent process in the ICU: a single-center experience.
Crit Care Med 2019 Oct;47(10):1332-36. doi: 10.1097/ccm.0000000000003905..
Keywords: Implementation, Intensive Care Unit (ICU), Hospitals, Clinician-Patient Communication, Communication
Hussain FS, Sosa T, Ambroggio L
Emergency transfers: an important predictor of adverse outcomes in hospitalized children.
This case-control study aimed to determine the predictive validity of an emergency transfer (ET) for outcomes in a free-standing children's hospital. Controls were matched in terms of age, hospital unit, and time of year. Patients who experienced an ET had a significantly higher likelihood of in-hospital mortality (22% vs 9%), longer ICU length of stay (4.9 vs 2.2 days), and longer posttransfer length of stay (26.4 vs 14.7 days) compared with controls (P < .03 for each).
AHRQ-funded; HS023827.
Citation: Hussain FS, Sosa T, Ambroggio L .
Emergency transfers: an important predictor of adverse outcomes in hospitalized children.
J Hosp Med 2019 Aug;14(8):482-85. doi: 10.12788/jhm.3219..
Keywords: Transitions of Care, Children/Adolescents, Critical Care, Intensive Care Unit (ICU), Adverse Events, Outcomes, Patient-Centered Outcomes Research, Inpatient Care, Hospitalization, Hospitals, Healthcare Delivery
Barbash IJ, Wallace DJ, Kahn JM
Effects of changes in ICU bed supply on ICU utilization.
The purpose of this study was to determine the relationship between intensive care unit (ICU) bed supply and ICU admission in US hospitals. Using a difference-in-differences approach, researchers compared the risk-adjusted probability of ICU admission at hospitals that increased their ICU bed supply over time with matched hospitals that did not. Subjects were three patient groups with a low likelihood of benefiting from ICU admission: low-severity patients with acute myocardial infarction and pulmonary embolism, and high-severity patients with metastatic cancer at the end of life. Results showed that increases in ICU bed supply were associated with inconsistent changes in the probability of ICU admission that varied across patient subgroups.
AHRQ-funded; HS025455.
Citation: Barbash IJ, Wallace DJ, Kahn JM .
Effects of changes in ICU bed supply on ICU utilization.
Med Care 2019 Jul;57(7):544-50. doi: 10.1097/mlr.0000000000001137..
Keywords: Intensive Care Unit (ICU), Critical Care, Healthcare Utilization, Hospitalization, Healthcare Delivery, Hospitals
Boltey EM, Iwashyna TJ, Hyzy RC
Ability to predict team members' behaviors in ICU teams is associated with routine ABCDE implementation.
In order to support coordination among ICU team members, researchers developed a shared mental model (SMM). After administering a survey at the 2016 MHA Keystone Center ICU workshop, different components of SMMs were measured using five items from a validated survey, each on a 5-point Likert scale. Self-reported routine ABCDE implementation was measured using a single item 4-point Likert scale, and the relationship between SMMs and routine ABCDE implementation measured using logistic regression. The majority of survey respondents reported using the ABCDE bundle routinely. Odds of reporting routine ABCDE implementation significantly decreased when clinicians agreed it was difficult to predict team members' behaviors. The researchers conclude that increased awareness of team members' behaviors may be a mechanism to improve the implementation of complex care bundles such as ABCDE.
AHRQ-funded; HS024552.
Citation: Boltey EM, Iwashyna TJ, Hyzy RC .
Ability to predict team members' behaviors in ICU teams is associated with routine ABCDE implementation.
J Crit Care 2019 Jun;51:192-97. doi: 10.1016/j.jcrc.2019.02.028..
Keywords: Care Management, Critical Care, Hospitals, Intensive Care Unit (ICU), Healthcare Delivery, Teams
Asan O, Scanlan MC, Crotty B
Parental perceptions of displayed patient data in a PICU: an example of unintentional empowerment.
The objective of this study was to explore the perceptions of parents of pediatric patients in a PICU regarding real-time open electronic health record data displayed in patient rooms. The investigators suggest that a new health information technology system providing continuous access to open electronic health record data may be an effective way to empower and engage parents in the PICU, but also note potential drawbacks.
AHRQ-funded; HS023626.
Citation: Asan O, Scanlan MC, Crotty B .
Parental perceptions of displayed patient data in a PICU: an example of unintentional empowerment.
Pediatr Crit Care Med 2019 May;20(5):435-41. doi: 10.1097/pcc.0000000000001895..
Keywords: Caregiving, Children/Adolescents, Communication, Electronic Health Records (EHRs), Health Information Technology (HIT), Hospitals, Intensive Care Unit (ICU), Patient and Family Engagement
Admon AJ, Wunsch H, Iwashyna TJ
Hospital contributions to variability in the use of ICUs among elderly Medicare recipients.
Hospitals vary widely in ICU admission rates across numerous medical diagnoses. In This retrospective cohort study examined the extent to which variability in ICU use is specific to individual diagnoses or is a function of the hospital, regardless of disease. The authors concluded that hospitals account for a significant proportion of variation independent of measured patient and hospital characteristics, suggesting the need for further work to evaluate the causes of variation at the hospital level and potential consequences of variation across hospitals.
AHRQ-funded; HS020672.
Citation: Admon AJ, Wunsch H, Iwashyna TJ .
Hospital contributions to variability in the use of ICUs among elderly Medicare recipients.
Crit Care Med 2017 Jan;45(1):75-84. doi: 10.1097/CCM.0000000000002025..
Keywords: Elderly, Hospitalization, Hospitals, Intensive Care Unit (ICU), Medicare