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Search All Research Studies
Topics
- Adverse Events (1)
- Caregiving (1)
- Central Line-Associated Bloodstream Infections (CLABSI) (2)
- Children/Adolescents (4)
- Clinician-Patient Communication (4)
- (-) Communication (16)
- Critical Care (7)
- Decision Making (1)
- Diagnostic Safety and Quality (1)
- Electronic Health Records (EHRs) (2)
- Emergency Department (1)
- Evidence-Based Practice (2)
- Guidelines (1)
- Healthcare-Associated Infections (HAIs) (2)
- Healthcare Delivery (2)
- Health Information Technology (HIT) (3)
- Hospitals (2)
- Implementation (1)
- Inpatient Care (1)
- (-) Intensive Care Unit (ICU) (16)
- Nursing (1)
- Organizational Change (1)
- Patient and Family Engagement (2)
- Patient Experience (2)
- Patient Safety (4)
- Prevention (1)
- Provider (1)
- Provider: Clinician (1)
- Quality Improvement (1)
- Quality of Care (3)
- Simulation (1)
- Surgery (2)
- Teams (3)
- Telehealth (1)
- Transitions of Care (1)
- Trauma (1)
- 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 16 of 16 Research Studies DisplayedBoltey EM, Wright N, Mosley EA
Exploring the process of information sharing in an adult intensive care unit: an ethnographic study.
The purpose of this study was to examine how the process of information sharing takes place in the ICU from the perspectives of the professional team and family members. The researchers conducted ethnographic fieldwork focusing on behaviors and interactions of the interprofessional team and family members. Fieldwork of 17.5 observation hours, 6 shadowing sessions, and 12 semi-structured interviews with 17 total participants took place in a 20-bed medical ICU from May 2016 - October 2016. Three themes about the information sharing process were identified: 1) family factors influence information sharing; 2) clinician strategies can support engagement in the process of information sharing; and 3) the process of information sharing allows for trust building between ICU team and families. The researchers concluded that information sharing is a critical process that may act as a stimulus for effective ICU engagement with the patient and family.
AHRQ-funded; HS024552.
Citation: Boltey EM, Wright N, Mosley EA .
Exploring the process of information sharing in an adult intensive care unit: an ethnographic study.
J Interprof Care 2022 Mar-Apr;36(2):168-76. doi: 10.1080/13561820.2021.1899147..
Keywords: Intensive Care Unit (ICU), Clinician-Patient Communication, Patient and Family Engagement, Communication, Critical Care
Cifra Cifra, CL Dukes, KC Ayres, et al.
Referral communication for pediatric intensive care unit admission and the diagnosis of critically ill children: a pilot ethnography.
This pilot study’s goal was to determine the feasibility of using focused ethnography to understand the relationship between referral communication and the diagnostic process for critically ill children. Findings showed that focused ethnography in the pediatric intensive care unit is feasible to investigate relationships between clinician referral communication and the diagnostic process for critically ill children.
AHRQ-funded; HS026965.
Citation: Cifra Cifra, CL Dukes, KC Ayres, et al..
Referral communication for pediatric intensive care unit admission and the diagnosis of critically ill children: a pilot ethnography.
J Crit Care 2021 Jun;63:246-49. doi: 10.1016/j.jcrc.2020.09.011..
Keywords: Children/Adolescents, Communication, Critical Care, Intensive Care Unit (ICU), Diagnostic Safety and Quality
Krupp A, Di Martino M, Chung W
Communication and role clarity inform TeleICU use: a qualitative analysis of opportunities and barriers in an established program using AACN framework.
This study is a qualitative analysis of opportunities and barriers to tele-intensive care unit (teleICU) use. The authors sought to explore if novel ways to utilize teleICU services can emerge within an established, consulting-style teleICU model considering the program’s flexible, provider-driven operation. This study used semi-structured interviews from a convenience sample of ICU (n = 19) and teleICU (n = 13) nurses. Interviews were analyzed to identify themes that describe their experiences with teleICU using a deductive codebook developed from the American Association of Critical Care Nurses (AACN) statement on teleICU nursing. Three themes identified by the nurses were: 1) unique teleICU knowledge, including systems thinking and technological skills, 2) the teleICU partnership supported quality improvement initiatives, and 3) elements of the work environment influenced perceptions of teleICU and its use. When effective communication and role clarity were not present, teleICU was variable.
AHRQ-funded; HS026372.
Citation: Krupp A, Di Martino M, Chung W .
Communication and role clarity inform TeleICU use: a qualitative analysis of opportunities and barriers in an established program using AACN framework.
BMC Health Serv Res 2021 Mar 25;21(1):277. doi: 10.1186/s12913-021-06287-6..
Keywords: Communication, Intensive Care Unit (ICU), Telehealth, Health Information Technology (HIT)
Rozenfeld RA, Nannicelli AP, Brown AR
Verbal communication during airway management and emergent endotracheal intubation: observations of team behavior among multi-institutional pediatric intensive care unit in situ simulations.
The objective of this study was to assess health-care teams' verbal communication, an observable teamwork behavior, during simulations involving pediatric emergency airway management and intubation. The investigators found that no uniform statement was identified to declare an airway emergency among the care teams. Preintubation medication dosages were not consistently included in intubation medication orders, and frequently, there were multiple requests to obtain medications.
AHRQ-funded; HS017909.
Citation: Rozenfeld RA, Nannicelli AP, Brown AR .
Verbal communication during airway management and emergent endotracheal intubation: observations of team behavior among multi-institutional pediatric intensive care unit in situ simulations.
J Patient Saf 2020 Sep;16(3):e114-e19. doi: 10.1097/pts.0000000000000272..
Keywords: Children/Adolescents, Intensive Care Unit (ICU), Critical Care, Teams, Communication, Simulation
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
Hoonakker PLT, Wooldridge AR, Hose BZ
Information flow during pediatric trauma care transitions: things falling through the cracks.
In order to investigate information flow during pediatric trauma care transitions, researchers interviewed 18 clinicians about communication and coordination between the emergency department, operating room, and pediatric intensive care unit, then surveyed the clinicians about patient safety during these transitions. They found that, despite the fact that the many services and units involved in pediatric trauma cooperate well together during trauma cases, important patient care information is often lost when transitioning patients between units. To manage the transition of this fragile and complex population better, they recommend finding ways to manage the information flow during these transitions better by, for instance, providing technological support to ensure shared mental models.
AHRQ-funded; HS023837.
Citation: Hoonakker PLT, Wooldridge AR, Hose BZ .
Information flow during pediatric trauma care transitions: things falling through the cracks.
Intern Emerg Med 2019 Aug;14(5):797-805. doi: 10.1007/s11739-019-02110-7..
Keywords: Children/Adolescents, Communication, Emergency Department, Healthcare Delivery, Intensive Care Unit (ICU), Patient Safety, Provider, Provider: Clinician, Surgery, Transitions of Care, Trauma
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
Roche SD, Reichheld AM, Demosthenes N
Measuring the quality of inpatient specialist consultation in the intensive care unit: Nursing and family experiences of communication.
The purpose of this study was to document the receipt of communication by nurses and family members regarding consultations performed on their patient or loved one, and to quantify how this impacted their overall perceptions of the quality of specialty care. The investigators found that most ICU families and nurses had no interaction with specialist providers. They concluded that nurses' frequent exclusion from conversations about specialty care may pose safety risks and increase the likelihood of mixed messages for patients and families, most of whom desire some interaction with specialists.
AHRQ-funded; K08 HS024288.
Citation: Roche SD, Reichheld AM, Demosthenes N .
Measuring the quality of inpatient specialist consultation in the intensive care unit: Nursing and family experiences of communication.
PLoS One 2019 Apr 11;14(4):e0214918. doi: 10.1371/journal.pone.0214918..
Keywords: Clinician-Patient Communication, Communication, Quality of Care, Intensive Care Unit (ICU), Patient Experience, Inpatient Care
Law AC, Roche S, Reichheld A
Failures in the respectful care of critically ill patients.
The emotional toll of critical illness on patients and their families can be profound and is emerging as an important target for value improvement. One source of emotional harm to patients and families may be care perceived as inadequately respectful. The prevalence and risk factors for types of emotional harms is under-studied. This prospective cohort study was conducted in nine ICUs at a tertiary care academic medical center in the United States.
AHRQ-funded; HS024288.
Citation: Law AC, Roche S, Reichheld A .
Failures in the respectful care of critically ill patients.
Jt Comm J Qual Patient Saf 2019 Apr;45(4):276-84. doi: 10.1016/j.jcjq.2018.05.008..
Keywords: Critical Care, Intensive Care Unit (ICU), Patient Experience, Clinician-Patient Communication, Communication
Artis KA, Dyer E, Mohan V
Accuracy of laboratory data communication on ICU daily rounds using an electronic health record.
The researchers created a robust but simple methodology to measure the prevalence of inaccurately communicated (misrepresented) data and to characterize data communication failures by type. They found that clinician laboratory data retrieval and communication during ICU rounds at their institution was poor, prone to omissions and inaccuracies, yet largely unrecognized by the rounding team.
AHRQ-funded; HS023793.
Citation: Artis KA, Dyer E, Mohan V .
Accuracy of laboratory data communication on ICU daily rounds using an electronic health record.
Crit Care Med 2017 Feb;45(2):179-86. doi: 10.1097/ccm.0000000000002060.
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Keywords: Communication, Electronic Health Records (EHRs), Health Information Technology (HIT), Intensive Care Unit (ICU), Teams
Segall N, Bennett-Guerrero E
ICU rounds: "What we've got here is failure to communicate".
Many of the decisions regarding critical care patients are made during patient rounds—approximately nine per patient— based on the premise that the data that inform the decisions are accurate and complete. The study by Artis et al in this issue challenges this premise. The authors discuss the article, its context and implications.
AHRQ-funded; HS023387.
Citation: Segall N, Bennett-Guerrero E .
ICU rounds: "What we've got here is failure to communicate".
Crit Care Med 2017 Feb;45(2):366-67. doi: 10.1097/ccm.0000000000002125.
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Keywords: Communication, Critical Care, Decision Making, Intensive Care Unit (ICU), Patient Safety
Costa DK, Dammeyer J, White M
Interprofessional team interactions about complex care in the ICU: pilot development of an observational rating tool.
The purpose of this study was to examine the reliability of an observational rating tool to assess team interactions about the awakening and breathing coordination, delirium, and early mobility (ABCDE) bundle in one ICU. It provided pilot evidence of reliability of an observational rating tool to assess interprofessional team interactions about ABCDE.
AHRQ-funded; HS024552.
Citation: Costa DK, Dammeyer J, White M .
Interprofessional team interactions about complex care in the ICU: pilot development of an observational rating tool.
BMC Res Notes 2016 Aug 18;9:408. doi: 10.1186/s13104-016-2213-1.
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Keywords: Healthcare Delivery, Communication, Critical Care, Intensive Care Unit (ICU), Teams
Abraham J, Kannampallil T, Brenner C
Characterizing the structure and content of nurse handoffs: a Sequential Conversational Analysis approach.
This paper describes Sequential Conversational Analysis (SCA) - a mixed-method approach integrating qualitative conversational analysis with quantitative sequential pattern analysis. This approach allows characterization of the nature of nurse handoff communication, highlighting the relationships underlying verbal content. The authors also discuss how SCA can help in understanding the dynamics of communication in other settings.
AHRQ-funded; HS017586.
Citation: Abraham J, Kannampallil T, Brenner C .
Characterizing the structure and content of nurse handoffs: a Sequential Conversational Analysis approach.
J Biomed Inform 2016 Feb;59:76-88. doi: 10.1016/j.jbi.2015.11.009.
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Keywords: Communication, Quality of Care, Intensive Care Unit (ICU), Nursing, Workflow
McElroy LM, Collins KM, Koller FL
Operating room to intensive care unit handoffs and the risks of patient harm.
The goal of this study was to assess systems and processes involved in the operating room(OR) to intensive care unit (ICU) handoff in an attempt to understand the criticality of specific steps of the handoff. In total, 81 process failures were identified, Process failures with the greatest risk of harm were lack of preliminary OR to ICU communication, team member absence during handoff communication, and transport equipment malfunction.
AHRQ-funded; HS000078.
Citation: McElroy LM, Collins KM, Koller FL .
Operating room to intensive care unit handoffs and the risks of patient harm.
Surgery 2015 Sep;158(3):588-94. doi: 10.1016/j.surg.2015.03.061..
Keywords: Intensive Care Unit (ICU), Patient Safety, Surgery, Communication, Adverse Events
Rangachari P, Madaio M, Rethemeyer RK
The evolution of knowledge exchanges enabling successful practice change in two intensive care units.
There are gaps in understanding the mechanisms by which top-down communications enable practice change. The authors sought to address these gaps in order to help identify evidence-based management strategies for successful practice change at the unit level. They found that both intensive care units studied experienced substantially improved outcomes and indicated a statistically significant increase in proactive communications. Early in the study, champions emerged within each unit to initiate process improvements. The authors concluded that the study helped to identify evidence-based management strategies for successful practice change at the unit level.
AHRQ-funded; HS019785.
Citation: Rangachari P, Madaio M, Rethemeyer RK .
The evolution of knowledge exchanges enabling successful practice change in two intensive care units.
Health Care Manage Rev 2015 Jan-Mar;40(1):65-78. doi: 10.1097/hmr.0000000000000001.
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Keywords: Intensive Care Unit (ICU), Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Critical Care, Communication, Evidence-Based Practice, Organizational Change, Prevention, Patient Safety
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