National Healthcare Quality and Disparities Report
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Topics
- Access to Care (1)
- Behavioral Health (1)
- Burnout (2)
- Care Coordination (1)
- Central Line-Associated Bloodstream Infections (CLABSI) (1)
- Children/Adolescents (1)
- Communication (1)
- Depression (1)
- Education: Continuing Medical Education (1)
- Electronic Health Records (EHRs) (2)
- Emergency Department (1)
- Healthcare-Associated Infections (HAIs) (1)
- Healthcare Delivery (2)
- Health Information Technology (HIT) (2)
- Health Services Research (HSR) (1)
- (-) Hospitals (20)
- Inpatient Care (2)
- Newborns/Infants (1)
- Nursing (2)
- Organizational Change (1)
- Outcomes (1)
- Patient Safety (8)
- Policy (1)
- Prevention (1)
- (-) Provider (20)
- Provider: Clinician (1)
- Provider: Health Personnel (1)
- Provider: Nurse (8)
- Provider: Physician (9)
- Provider Performance (1)
- Quality Improvement (1)
- Quality of Care (3)
- Rural Health (2)
- Stress (1)
- Surgery (5)
- Teams (3)
- Transitions of Care (2)
- Workflow (1)
- Workforce (5)
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 20 of 20 Research Studies DisplayedCohen C, Baird M, Koirola N
The surgical and anesthesia workforce and provision of surgical services in rural communities: a mixed-methods examination.
This mixed-methods study described the distribution of the surgical and anesthesia workforce and qualitatively explored how such workforce and other factors influenced rural hospitals' provision of surgical services. Using American Hospital Association survey data, the researchers found that within rural counties, 55.1% had no surgeon, 81.2% had no anesthesiologist, and 58.1% had no Certified Registered Nurse Anesthetist. While rural hospitals reported meeting community needs for elective and noncomplex surgeries, these hospitals continued to face significant challenges providing subspecialty surgeries, emergency surgeries, and 24-hour obstetrical services.
AHRQ-funded; HS023009.
Citation: Cohen C, Baird M, Koirola N .
The surgical and anesthesia workforce and provision of surgical services in rural communities: a mixed-methods examination.
J Rural Health 2021 Jan;37(1):45-54. doi: 10.1111/jrh.12417..
Keywords: Rural Health, Access to Care, Surgery, Workforce, Provider: Physician, Provider: Nurse, Provider, Hospitals
O'Leary KJ, Manojlovich M, Johnson JK
A multisite study of interprofessional teamwork and collaboration on general medical services.
This multisite study of four mid-sized hospitals measured teamwork climate of nurses, nurse assistants, and physicians working on general medical services. Teamwork climate scores for 380 participants (80 hospitalists, 13 resident physicians, 193 nurses, and 94 nurses) were measured using the Safety Attitudes Questionnaire. Hospitalists had the highest median teamwork climate score and nurses had the lowest, but it was not a statistically significant difference. A higher percentage of hospitalists (63.3%) rated the quality of collaboration with nurses as high or very high, but only 48.7% of nurses rated the collaboration with hospitalists as high or very high. There were significant differences in perceptions of teamwork climate across sites and across professional categories.
AHRQ-funded; HS025649.
Citation: O'Leary KJ, Manojlovich M, Johnson JK .
A multisite study of interprofessional teamwork and collaboration on general medical services.
Jt Comm J Qual Patient Saf 2020 Dec;46(12):667-72. doi: 10.1016/j.jcjq.2020.09.009..
Keywords: Teams, Hospitals, Patient Safety, Provider: Clinician, Provider: Physician, Provider: Nurse, Provider
Shubeck SP, Newman EA, Vitous CA
Hiring practices of US academic surgery departments-challenges and opportunities for more inclusive hiring.
To increase workforce diversity among academic medical centers, the Association of American Medical Colleges recommends multiple inclusive strategies for evaluating and hiring candidates. The objective of this study was to determine (1) usual and inclusive hiring practices used among academic surgery departments and (2) the barriers to utilization of inclusive hiring practices. The investigators concluded that many chairs rely heavily on internal hires or trusted networks, which may limit both demographic and cognitive diversity.
AHRQ-funded; HS026030.
Citation: Shubeck SP, Newman EA, Vitous CA .
Hiring practices of US academic surgery departments-challenges and opportunities for more inclusive hiring.
J Surg Res 2020 Oct;254:23-30. doi: 10.1016/j.jss.2020.03.054..
Keywords: Surgery, Provider: Physician, Provider, Workforce, Hospitals
Ellis RJ, Yuce TK, Hewitt DB
National evaluation of patient preferences in selecting hospitals and health care providers.
This study examined patient views of public databases for hospital quality. Interviews and focus groups were conducted at local outpatient clinics as well as a national administered survey on an anonymous digital platform. A 42% response rate was received (4672 responses). Measures patients considered most important were hospital reputation, physician experience, and primary care recommendations. Unimportant factors included guideline adherence, hospital academic affiliation, and morbidity and mortality outcome measures. This was true irrespective of age, sex, education status, or income of the respondent.
AHRQ-funded; HS023011; HS026385; HS021857; HS000078.
Citation: Ellis RJ, Yuce TK, Hewitt DB .
National evaluation of patient preferences in selecting hospitals and health care providers.
Med Care 2020 Oct;58(10):867-73. doi: 10.1097/mlr.0000000000001374..
Keywords: Hospitals, Quality of Care, Provider
Pruitt LCC, Skarda DE, Barnhart DC
Impact of consolidation of cases on post-operative outcomes for index pediatric surgery cases.
The effect of the consolidation of neonatal pediatric surgical cases to limited surgeons within a hospital is unknown. In this retrospective cohort study, the authors elected to model the distribution of complex neonatal procedures using an economic measure of market concentration, the Herfindahl-Hirschmann Index (HHI), and study its effect on outcomes of index pediatric surgical operations.
AHRQ-funded; HS025776.
Citation: Pruitt LCC, Skarda DE, Barnhart DC .
Impact of consolidation of cases on post-operative outcomes for index pediatric surgery cases.
J Pediatr Surg 2020 Jun;55(6):1048-52. doi: 10.1016/j.jpedsurg.2020.02.044..
Keywords: Newborns/Infants, Surgery, Hospitals, Provider: Physician, Provider
Manojlovich M, Harrod M, Hofer TP
Using qualitative methods to explore communication practices in the context of patient care rounds on general care units.
This study examined communication practices between nurses and physicians in general care units at 4 Midwestern hospitals. A total of 163 physicians, registered nurses, and nurse practitioners participated. The researchers observed and shadowed clinicians during rounds and other times during a 2 week period as well as conducting interviews and holding focus groups. Workflow differences affected rounds and subsequently communication practices. Good rapport between physicians and nurses contributed to nurse participation during rounds. Lower rapport made some nurses feel uncomfortable accompanying physicians during rounds unless invited.
AHRQ-funded; HS022305.
Citation: Manojlovich M, Harrod M, Hofer TP .
Using qualitative methods to explore communication practices in the context of patient care rounds on general care units.
J Gen Intern Med 2020 Mar;35(3):839-45. doi: 10.1007/s11606-019-05580-9..
Keywords: Communication, Provider: Physician, Provider: Nurse, Provider, Hospitals, Teams, Inpatient Care, Healthcare Delivery
Krein SL, Kuhn L, Ratz D
Use of designated nurse PICC teams and CLABSI prevention practices among U.S. hospitals: a survey-based study.
The authors identified the prevalence of and factors associated with having a designated nurse peripherally inserted central catheter (PICC) team among U.S. acute care hospitals. They found that nurse PICC teams inserted PICCs in more than 60% of U.S. hospitals during the study period. Moreover, certain practices to prevent central line-associated bloodstream infection, including maximum sterile barrier precautions, chlorhexidine gluconate for insertion site antisepsis, and facility-wide insertion checklists were regularly used by a higher percentage of hospitals with nurse PICC teams compared with those without. They concluded that nurse PICC teams play an integral role in PICC use at many hospitals and that use of such teams may promote key practices to prevent complications.
AHRQ-funded; HS022835.
Citation: Krein SL, Kuhn L, Ratz D .
Use of designated nurse PICC teams and CLABSI prevention practices among U.S. hospitals: a survey-based study.
J Patient Saf 2019 Dec;15(4):293-95. doi: 10.1097/pts.0000000000000246..
Keywords: Nursing, Teams, Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Inpatient Care, Hospitals, Patient Safety, Prevention, Provider: Nurse, Provider
Germack HD, Kandrack R, Martsolf GR
When rural hospitals close, the physician workforce goes.
Researchers examined the relationship between rural hospital closures and the supply of physicians across different specialties in the years leading up to and after a closure. They observed significant annual reductions in the supply of general surgeons in the years leading up to a closure. They also found that rural hospital closures were associated with immediate and persistent decreases in the supply of surgical specialists and long-term decreases in the supply of physicians across multiple specialties. Because this decrease could lead to reduced access to care for rural residents, they recommended that future policy efforts focus on supporting and maintaining health care delivery models that do not depend on hospitals.
AHRQ-funded; HS000032.
Citation: Germack HD, Kandrack R, Martsolf GR .
When rural hospitals close, the physician workforce goes.
Health Aff 2019 Dec;38(12):2086-94. doi: 10.1377/hlthaff.2019.00916..
Keywords: Rural Health, Hospitals, Workforce, Provider: Physician, Provider
Kelly LA, McHugh MD, Aiken LH
Nurse Outcomes in Magnet(R) and non-magnet hospitals.
The goal of this study was to determine whether work environments, staffing, and nurse outcomes differ between Magnet and non-Magnet hospitals. Results demonstrated superior nurse work environments in Magnet hospitals compared with non-Magnet hospitals, with better work environments being associated with lower nurse job dissatisfaction and burnout. Three decades of evidence showing superior outcomes for Magnet hospitals place this organizational innovation into a class all of its own as best practice, deserving the attention of hospital leaders, nurses, and the public.
AHRQ-funded; HS017551.
Citation: Kelly LA, McHugh MD, Aiken LH .
Nurse Outcomes in Magnet(R) and non-magnet hospitals.
J Nurs Adm 2019 Oct;49(10S Suppl):S19-s24. doi: 10.1097/nna.0000000000000801..
Keywords: Burnout, Hospitals, Provider, Provider: Nurse, Workforce
Mueller SK, Schnipper JL
Physician perspectives on interhospital transfers.
This study examined physician perspectives of the common problems that occur during acute care hospital interhospital transfers. The process tends to be nonstandardized which creates a number of issues. These issues include: patients sometimes, frequently, or always arriving without required specialized care (56% of the time), arriving with unrealistic expectations of care (77.2% of responses), arrived more than 24 hours after accepted transfer in 80.1% of responses, and arrived without necessary transfer records 86.9% of the time. The last issue and also time of day of arrival many physicians felt posed a risk to the transferred patients.
AHRQ-funded; HS023331.
Citation: Mueller SK, Schnipper JL .
Physician perspectives on interhospital transfers.
J Patient Saf 2019 Jun;15(2):86-89. doi: 10.1097/pts.0000000000000312..
Keywords: Healthcare Delivery, Hospitals, Patient Safety, Provider, Provider: Physician, Transitions of Care
de Cordova PB, Rogowski J, Riman KA
Effects of public reporting legislation of nurse staffing: a trend analysis.
The authors examined nurse staffing trends after the New Jersey enactment of P.L.1971, c.136 (C.26:2 H-13) on January 24, 2005, mandating that all health care facilities compile, post, and report staffing information. They found that the number of patients per registered nurse decreased for ten specialties, and conclude that this indicates the importance of public reporting in improving patient safety.
AHRQ-funded; HS024339.
Citation: de Cordova PB, Rogowski J, Riman KA .
Effects of public reporting legislation of nurse staffing: a trend analysis.
Policy Polit Nurs Pract 2019 May;20(2):92-104. doi: 10.1177/1527154419832112..
Keywords: Hospitals, Patient Safety, Workforce, Policy, Provider, Provider: Nurse
Goldman MP, Wong AH, Bhatnagar A
Providers' perceptions of caring for pediatric patients in community hospital emergency departments: a mixed-methods analysis.
Approximately 90% of pediatric emergency care is provided in community emergency departments (CEDs) that care for both adults and children. Paradoxically, the majority of pediatric emergency medicine knowledge generation, quality improvement work, and clinical training occurs in children's hospitals. There is a paucity of information of perceptions on pediatric care from CED providers. The objective of this study was to explore interprofessional CED providers' perceptions of caring for pediatric patients.
AHRQ-funded; HS020286.
Citation: Goldman MP, Wong AH, Bhatnagar A .
Providers' perceptions of caring for pediatric patients in community hospital emergency departments: a mixed-methods analysis.
Acad Emerg Med 2018 Dec;25(12):1385-95. doi: 10.1111/acem.13509..
Keywords: Children/Adolescents, Emergency Department, Hospitals, Provider
Rolnick JA, Ryskina KL
The use of individual provider performance reports by US Hospitals.
In this study, the investigators examined overall trends in how hospitals use the electronic health record to track and provide feedback on provider performance. They used data from 2013 to 2015 from the American Hospital Association (AHA) Annual Survey Information Technology Supplement, which asked hospitals if they have used electronic data to create performance profiles. They linked these data to AHA Annual Survey responses for all general adult and pediatric hospitals and used Multivariable logistic regression to model the odds of use as a function of hospital characteristics.
AHRQ-funded; HS022198.
Citation: Rolnick JA, Ryskina KL .
The use of individual provider performance reports by US Hospitals.
J Hosp Med 2018 Aug;13(8):562-65. doi: 10.12788/jhm.2922..
Keywords: Provider Performance, Quality of Care, Provider, Hospitals, Electronic Health Records (EHRs), Health Information Technology (HIT)
Simpkin AL, Khan A, West DC
Stress from uncertainty and resilience among depressed and burned out residents: a cross-sectional study.
This study examined how stress from uncertainty is related to resilience among medical residents and whether those attributes are related to depression and burnout. The investigators surveyed 86 residents in pediatric residency programs from 4 urban freestanding children’s hospitals in North America in 2015. They used the Physicians’ Reaction to Uncertainty Scale to measure stress from uncertainty, the 14-item Resilience Scale to measure uncertainty, the Harvard National Depression Scale for depression, and the Maslach Burnout Inventory for burnout. There was a response rate of 58.1%. Five residents met depression criteria, and 15 residents met the burnout criteria. Depressed and burned out residents both had higher mean levels of stress compared to residents who neither depressed nor burned out.
AHRQ-funded; HS022986.
Citation: Simpkin AL, Khan A, West DC .
Stress from uncertainty and resilience among depressed and burned out residents: a cross-sectional study.
Acad Pediatr 2018 Aug;18(6):698-704. doi: 10.1016/j.acap.2018.03.002..
Keywords: Burnout, Stress, Depression, Provider: Physician, Behavioral Health, Provider, Education: Continuing Medical Education, Hospitals
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
Yao Y, Ahn H, Stifter J
Continuity index measures in the acute care hospital setting: an analytic review and tests using electronic health record data and computer simulation.
This study examined continuity index measures in the acute care hospital setting. These measures can be used to examine the influence of nurse staffing patterns on patient outcomes. The researchers examined the behavior of continuity indexes as applied to clinical practice data that were collected with the Hands-On Automated Nursing Data System (HANDS) and data from computer simulation. The findings provided a deep understanding of the conceptual foundations and properties of various continuity measures.
AHRQ-funded; HS015054; HS023072.
Citation: Yao Y, Ahn H, Stifter J .
Continuity index measures in the acute care hospital setting: an analytic review and tests using electronic health record data and computer simulation.
J Nurs Meas 2018 Apr 1;26(1):20-35. doi: 10.1891/1061-3749.26.1.20..
Keywords: Transitions of Care, Care Coordination, Electronic Health Records (EHRs), Health Information Technology (HIT), Provider: Nurse, Provider, Hospitals, Outcomes
Baker LC, Bundorf MK, Devlin AM
Hospital ownership of physicians: hospital versus physician perspectives.
There has been significant interest from health services researchers and policy makers about recent trends in hospitals' ownership of physician practices, however, few studies have investigated the strengths and weaknesses of available data sources. In this article, the investigators compare results from two national surveys that have been used to assess ownership patterns, one of hospitals (the American Hospital Association survey) and one of physicians (the SK&A survey).
AHRQ-funded; HS024535.
Citation: Baker LC, Bundorf MK, Devlin AM .
Hospital ownership of physicians: hospital versus physician perspectives.
Med Care Res Rev 2018 Feb;75(1):88-99. doi: 10.1177/1077558716676018..
Keywords: Health Services Research (HSR), Hospitals, Provider
Berian JR, Thomas JM, Minami CA
Evaluation of a novel mentor program to improve surgical care for US hospitals.
This study evaluated a novel mentor program for 27 US surgeons, charged with improving quality at their respective hospitals, having been paired 1:1 with 27 surgeon mentors through a state-wide quality improvement (QI) initiative. It found that mentorship played a vital role in advancing surgeon knowledge and engagement with QI in the Illinois Surgical Quality Improvement Collaborative.
AHRQ-funded; HS024516.
Citation: Berian JR, Thomas JM, Minami CA .
Evaluation of a novel mentor program to improve surgical care for US hospitals.
Int J Qual Health Care 2017 Apr 1;29(2):234-42. doi: 10.1093/intqhc/mzx005.
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Keywords: Hospitals, Quality Improvement, Patient Safety, Surgery, Quality of Care, Provider: Physician, Provider
Smith SA, Yount N, Sorra J
Exploring relationships between hospital patient safety culture and Consumer Reports safety scores.
This study examines whether patient safety culture perceptions of U.S. hospital staff in a large national survey are related to publicly reported patient safety ratings of hospitals. It found a positive relationship between hospital staff perceptions of patient safety culture and the Consumer Reports Hospital Safety Score, which is a composite of patient experience and outcomes data from federal databases.
AHRQ-funded; 290201300003C.
Citation: Smith SA, Yount N, Sorra J .
Exploring relationships between hospital patient safety culture and Consumer Reports safety scores.
BMC Health Serv Res 2017 Feb 16;17(1):143. doi: 10.1186/s12913-017-2078-6.
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Keywords: Hospitals, Patient Safety, Provider, Provider: Health Personnel
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