National Healthcare Quality and Disparities Report
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Topics
- Adverse Drug Events (ADE) (1)
- Adverse Events (2)
- Cardiovascular Conditions (1)
- Caregiving (1)
- Children/Adolescents (1)
- Clinical Decision Support (CDS) (1)
- Clinician-Patient Communication (1)
- COVID-19 (1)
- Decision Making (1)
- Elderly (2)
- (-) Electronic Health Records (EHRs) (14)
- Emergency Department (2)
- Healthcare Utilization (1)
- Health Information Technology (HIT) (11)
- Home Healthcare (2)
- (-) Hospitalization (14)
- Hospital Readmissions (3)
- Hospitals (2)
- Inpatient Care (2)
- Medication (1)
- Medication: Safety (1)
- Patient-Centered Outcomes Research (1)
- Patient and Family Engagement (2)
- Patient Experience (2)
- Patient Safety (2)
- Pneumonia (1)
- Prevention (2)
- Quality Improvement (1)
- Quality Indicators (QIs) (1)
- Quality of Care (1)
- Risk (6)
- Web-Based (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 14 of 14 Research Studies DisplayedHobensack M, Ojo M, Barrón Y
Documentation of hospitalization risk factors in electronic health records (EHRs): a qualitative study with home healthcare clinicians.
The objectives of this study were to identify risk factors that home healthcare clinicians associate with patient deterioration and to understand clinicians’ response to and documentation of these risk factors. The authors interviewed multidisciplinary home healthcare clinicians and used directed content analysis to identify risk factors for deterioration. A total of 79 risk factors were identified by the clinicians, who responded most often by communicating with the prescribing provider or following up with patients and caregivers. Clinicians also acknowledged that social factors played a role in deterioration risk. The authors noted that, since most risk factors were documented in clinical notes, methods such as natural language processing are needed to extract them. They concluded that by providing a comprehensive list of risk factors grounded in clinician expertise and mapped to standardized terminologies, the results of their study supported the development of an early warning system for patient deterioration.
AHRQ-funded; HS027742.
Citation: Hobensack M, Ojo M, Barrón Y .
Documentation of hospitalization risk factors in electronic health records (EHRs): a qualitative study with home healthcare clinicians.
J Am Med Inform Assoc 2022 Apr 13;29(5):805-12. doi: 10.1093/jamia/ocac023..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Home Healthcare, Risk, Hospitalization
Kamran F, Tang S, Otles E
Early identification of patients admitted to hospital for covid-19 at risk of clinical deterioration: model development and multisite external validation study.
The authors sought to create and validate a simple and transferable machine learning model from electronic health record data to accurately predict clinical deterioration in patients with COVID-19 across institutions, through use of a novel paradigm for model development and code sharing. They determined that a model to predict clinical deterioration was developed rapidly in response to the COVID-19 pandemic at a single hospital, was applied externally without the sharing of data, and performed well across multiple medical centers, patient subgroups, and time periods, showing its potential as a tool for use in optimizing healthcare resources.
AHRQ-funded; HS028038.
Citation: Kamran F, Tang S, Otles E .
Early identification of patients admitted to hospital for covid-19 at risk of clinical deterioration: model development and multisite external validation study.
BMJ 2022 Feb 17;376:e068576. doi: 10.1136/bmj-2021-068576..
Keywords: COVID-19, Hospitalization, Risk, Electronic Health Records (EHRs), Health Information Technology (HIT)
Topaz M, Woo K, Ryvicker M
Home healthcare clinical notes predict patient hospitalization and emergency department visits.
About 30% of home healthcare patients are hospitalized or visit an emergency department (ED) during a home healthcare (HHC) episode. Novel data science methods are increasingly used to improve identification of patients at risk for negative outcomes. The aim of the study was to identify patients at heightened risk hospitalization or ED visits using HHC narrative data (clinical notes).
AHRQ-funded; HS027742.
Citation: Topaz M, Woo K, Ryvicker M .
Home healthcare clinical notes predict patient hospitalization and emergency department visits.
Nurs Res 2020 Nov/Dec;69(6):448-54. doi: 10.1097/nnr.0000000000000470..
Keywords: Elderly, Home Healthcare, Emergency Department, Hospitalization, Risk, Electronic Health Records (EHRs), Health Information Technology (HIT)
Cochran AL, Rathouz PJ, Kocher KE
A latent variable approach to potential outcomes for emergency department admission decisions.
The authors sought to provide a general framework to evaluate admission decisions from electronic healthcare records. They estimated that while admitting a patient with higher latent needs reduced the 30-day risk of revisiting the emergency department or later being admitted through the emergency department by over 79%, admitting a patient with lower latent needs actually increased these 30-day risks by 3.0% and 7.6%, respectively.
AHRQ-funded; HS024160.
Citation: Cochran AL, Rathouz PJ, Kocher KE .
A latent variable approach to potential outcomes for emergency department admission decisions.
Stat Med 2019 Sep 10;38(20):3911-35. doi: 10.1002/sim.8210..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Emergency Department, Clinical Decision Support (CDS), Decision Making, Hospitalization
Kelly MM, Thurber AS, Coller RJ
Parent perceptions of real-time access to their hospitalized child's medical records using an inpatient portal: a qualitative study.
In this study, the authors’ objectives were to identify why parents used an inpatient portal application on a tablet computer during their child's hospitalization and identify their perspectives of ways to optimize the technology. The investigators concluded that providing parents with real-time clinical information during their child's hospitalization using an inpatient portal may enhance their ability to engage in caregiving tasks critical to ensuring inpatient care quality and safety.
Citation: Kelly MM, Thurber AS, Coller RJ .
Parent perceptions of real-time access to their hospitalized child's medical records using an inpatient portal: a qualitative study.
Hosp Pediatr 2019 Apr;9(4):273-80. doi: 10.1542/hpeds.2018-0166..
Keywords: Children/Adolescents, Caregiving, Hospitalization, Electronic Health Records (EHRs), Health Information Technology (HIT), Clinician-Patient Communication
Masterson Creber RM, Grossman LV, Ryan B
Engaging hospitalized patients with personalized health information: a randomized trial of an inpatient portal.
This study examined the effects of an inpatient portal intervention on patient activation, patient satisfaction, patient engagement with health information, and 30-day hospital admissions. A randomized trial was conducted from March 2014 to May 2017 with 426 English- or Spanish-speaking patients from 2 cardiac medical-surgical units at an urban academic medical center. Patients were randomized into 3 groups: 1) usual care, 2) tablet with general Internet access, and 3) tablet with an inpatient portal. There was a difference in patient activation between the 3 groups, but the inpatient portal group had lower 30-day hospital admissions. There was also a difference with patient engagement with health information between the inpatient portal and tablet-only groups.
AHRQ-funded; HS021816.
Citation: Masterson Creber RM, Grossman LV, Ryan B .
Engaging hospitalized patients with personalized health information: a randomized trial of an inpatient portal.
J Am Med Inform Assoc 2019 Feb;26(2):115-23. doi: 10.1093/jamia/ocy146..
Keywords: Patient and Family Engagement, Electronic Health Records (EHRs), Health Information Technology (HIT), Hospitalization, Patient Experience, Inpatient Care
Prey JE, Polubriaginof F, Grossman LV
Engaging hospital patients in the medication reconciliation process using tablet computers.
Researchers conducted a pilot study to determine whether patients’ use of an electronic home medication review tool on a table computer could improve medication safety before or after hospitalization. Patients were randomized to the tool and out of 76 patients approached, 65 participated. About three-quarters (74%) made changes to their home medication list. Out of that total, 74% of the changes identified had a significant or greater potential severity, and 49% had a greater than 50-50 chance of harm. This medication reconciliation tool showed great potential to improve medication safety during and after hospitalization.
AHRQ-funded; HS021816.
Citation: Prey JE, Polubriaginof F, Grossman LV .
Engaging hospital patients in the medication reconciliation process using tablet computers.
J Am Med Inform Assoc 2018 Nov;25(11):1460-69. doi: 10.1093/jamia/ocy115..
Keywords: Adverse Drug Events (ADE), Adverse Events, Electronic Health Records (EHRs), Health Information Technology (HIT), Hospitalization, Hospitals, Medication, Medication: Safety, Patient and Family Engagement, Patient Safety, Prevention
Bhise V, Sittig DF, Vaghani V
An electronic trigger based on care escalation to identify preventable adverse events in hospitalised patients.
Researchers refined the methods of the Institute of Healthcare Improvement's Global Trigger Tool application and leveraged electronic health record data to improve detection of preventable adverse events, including diagnostic errors. In the studied sample, preventable adverse events were identified, including adverse drug events, patient falls, procedure-related complications, and hospital-associated infections. The authors concluded that such e-triggers can help overcome limitations of currently available methods to detect preventable harm in hospitalized patients.
AHRQ-funded; HS022087; HS023602.
Citation: Bhise V, Sittig DF, Vaghani V .
An electronic trigger based on care escalation to identify preventable adverse events in hospitalised patients.
BMJ Qual Saf 2018 Mar;27(3):241-46. doi: 10.1136/bmjqs-2017-006975..
Keywords: Adverse Events, Electronic Health Records (EHRs), Health Information Technology (HIT), Hospitalization, Hospitals, Patient Safety, Prevention, Quality of Care, Quality Improvement, Quality Indicators (QIs)
Kan HJ, Kharrazi H, Leff B
Defining and assessing geriatric risk factors and associated health care utilization among older adults using claims and electronic health records.
This study used electronic health records (EHRs) to identify patients with factors associated with geriatric risk for hospitalization among older adults. Prevalence was estimated using claims, structured EHRs, and unstructured EHRs. Odds were calculated on the occurrence of hospitalizations for patients with 1 or 2 and greater risk factors.
AHRQ-funded; HS000029.
Citation: Kan HJ, Kharrazi H, Leff B .
Defining and assessing geriatric risk factors and associated health care utilization among older adults using claims and electronic health records.
Med Care 2018 Mar;56(3):233-39. doi: 10.1097/mlr.0000000000000865..
Keywords: Elderly, Hospitalization, Healthcare Utilization, Risk, Electronic Health Records (EHRs), Health Information Technology (HIT)
Huerta TR, McAlearney AS, Rizer MK
Introducing a patient portal and electronic tablets to inpatient care.
The researchers implemented a pilot inpatient portal (MyChart Bedside [Epic Systems]) using Android tablets to provide patients and their families and caregivers with an expected care plan each day, a roster of the care team, the ability to exchange secure messages with the care team, a way to write and save notes, and access to health information. They conducted the 90-day pilot program in 15 rooms on 1 patient unit in each of 2 hospitals and gave tablets to 179 patients. They found that patients wanted immediate access to laboratory results, that patients admitted for 1-2 days found the tablets less important, that those readmitted insisted on having a tablet, and that those with their own electronic devices were less likely to accept the tablet.
AHRQ-funded; HS024091.
Citation: Huerta TR, McAlearney AS, Rizer MK .
Introducing a patient portal and electronic tablets to inpatient care.
Ann Intern Med 2017 Dec 5;167(11):816-17. doi: 10.7326/m17-1766.
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Keywords: Health Information Technology (HIT), Hospitalization, Inpatient Care, Web-Based, Electronic Health Records (EHRs)
Makam AN, Nguyen OK, Clark C
Incidence, predictors, and outcomes of hospital-acquired anemia.
This study examined the incidence, predictors, and postdischarge outcomes associated with hospital-acquired anemia (HAA). Most patients with severe HAA (85 percent) underwent a major procedure, had a discharge diagnosis of hemorrhage, and/or a discharge diagnosis of hemorrhagic disorder. Severe HAA is associated with increased odds for 30-day mortality and readmission after discharge; however, it is uncertain whether severe HAA is preventable.
AHRQ-funded; HS022418.
Citation: Makam AN, Nguyen OK, Clark C .
Incidence, predictors, and outcomes of hospital-acquired anemia.
J Hosp Med 2017 May;12(5):317-22. doi: 10.12788/jhm.2723
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Keywords: Electronic Health Records (EHRs), Hospital Readmissions, Hospitalization, Patient-Centered Outcomes Research, Risk
Makam AN, Nguyen OK, Clark C
Predicting 30-day pneumonia readmissions using electronic health record data.
The objective of this study was to develop pneumonia-specific readmission risk-prediction models using EHR data from the first day and from the entire hospital stay ("full stay"). The investigators concluded that EHR data collected from the entire hospitalization can accurately predict readmission risk among patients hospitalized for pneumonia. They suggest that this approach outperforms a first-day pneumonia-specific model, the Centers for Medicare and Medicaid Services pneumonia model, and 2 commonly used pneumonia severity of illness scores.
AHRQ-funded; HS022418.
Citation: Makam AN, Nguyen OK, Clark C .
Predicting 30-day pneumonia readmissions using electronic health record data.
J Hosp Med 2017 Apr;12(4):209-16. doi: 10.12788/jhm.2711..
Keywords: Pneumonia, Hospital Readmissions, Hospitalization, Electronic Health Records (EHRs), Health Information Technology (HIT)
Nguyen OK, Makam AN, Clark C
Predicting all-cause readmissions using electronic health record data from the entire hospitalization: model development and comparison.
The purpose of this study was to develop an all-cause readmissions risk-prediction model incorporating electronic health record (EHR) data from the full hospital stay, and to compare "full-stay" model performance to a "first day" and 2 other validated models. It found that incorporating clinically granular EHR data from the full hospital stay modestly improves prediction of 30-day readmissions.
AHRQ-funded; HS022418.
Citation: Nguyen OK, Makam AN, Clark C .
Predicting all-cause readmissions using electronic health record data from the entire hospitalization: model development and comparison.
J Hosp Med 2016 Jul;11(7):473-80. doi: 10.1002/jhm.2568.
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Keywords: Electronic Health Records (EHRs), Hospital Readmissions, Hospitalization, Risk
Woollen J, Prey J, Wilcox L
Patient experiences using an inpatient personal health record.
Researchers investigated post-operative cardiac surgical patients' experience using an inpatient personal health record (PHR) on a tablet computer to increase engagement in their hospital care. They found that patients reported high satisfaction with being able to view their hospital medications and access educational materials related to their medical conditions. Patients also reported a desire to view daily progress reports about their hospital stay.
AHRQ-funded; HS021816.
Citation: Woollen J, Prey J, Wilcox L .
Patient experiences using an inpatient personal health record.
Appl Clin Inform 2016 Jun 1;7(2):446-60. doi: 10.4338/aci-2015-10-ra-0130.
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Keywords: Cardiovascular Conditions, Electronic Health Records (EHRs), Hospitalization, Patient Experience, Patient Experience