National Healthcare Quality and Disparities Report
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Search All Research Studies
AHRQ Research Studies Date
Topics
- Adverse Events (3)
- Ambulatory Care and Surgery (2)
- Catheter-Associated Urinary Tract Infection (CAUTI) (1)
- Central Line-Associated Bloodstream Infections (CLABSI) (1)
- Children/Adolescents (1)
- Clinical Decision Support (CDS) (1)
- Clostridium difficile Infections (1)
- Communication (1)
- Data (1)
- Decision Making (1)
- Diagnostic Safety and Quality (2)
- Electronic Health Records (EHRs) (11)
- Evidence-Based Practice (1)
- (-) Healthcare-Associated Infections (HAIs) (18)
- (-) Health Information Technology (HIT) (18)
- Hospitals (2)
- Implementation (1)
- Infectious Diseases (1)
- Injuries and Wounds (5)
- Nursing (2)
- Patient-Centered Outcomes Research (1)
- Patient Safety (6)
- Pressure Ulcers (2)
- Public Health (1)
- Quality Improvement (3)
- Quality of Care (4)
- Registries (1)
- Respiratory Conditions (1)
- Risk (2)
- Surgery (9)
- Telehealth (2)
- 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 18 of 18 Research Studies DisplayedSkube SJ, Hu Z, Simon GJ
Accelerating surgical site infection abstraction with a semi-automated machine-learning approach.
The purpose of this study was to test a supervised machine learning algorithm developed for testing surgical site infection (SSI) on performing semi-automated SSI abstraction, and to demonstrate that a semi-automated approach to health data abstraction provides a high level of accuracy and significant efficiencies. The researchers evaluated data from 6,188 patients in a 2011-2013 dataset and 5,132 patients in a 2015-2015 dataset. The study concluded that very good performance is achieved using the semi-automated machine learning-aided SSI abstraction, which also accelerates the abstraction process.
AHRQ-funded; HS024532.
Citation: Skube SJ, Hu Z, Simon GJ .
Accelerating surgical site infection abstraction with a semi-automated machine-learning approach.
Ann Surg 2022 Jul 1;276(1):180-85. doi: 10.1097/sla.0000000000004354..
Keywords: Healthcare-Associated Infections (HAIs), Surgery, Health Information Technology (HIT)
Zhu Y, Simon GJ, Wick EC
Applying machine learning across sites: external validation of a surgical site infection detection algorithm.
Surgical complications have tremendous consequences and costs. Complication detection is important for quality improvement, but traditional manual chart review is burdensome. Automated mechanisms are needed to make this more efficient. The purpose of the study was to understand the generalizability of a machine learning algorithm between sites; automated surgical site infection (SSI) detection algorithms developed at one center were tested at another distinct center.
AHRQ-funded; HS024532.
Citation: Zhu Y, Simon GJ, Wick EC .
Applying machine learning across sites: external validation of a surgical site infection detection algorithm.
J Am Coll Surg 2021 Jun;232(6):963-71.e1. doi: 10.1016/j.jamcollsurg.2021.03.026..
Keywords: Healthcare-Associated Infections (HAIs), Surgery, Adverse Events, Diagnostic Safety and Quality, Electronic Health Records (EHRs), Health Information Technology (HIT), Quality Improvement, Quality of Care
Thate JA, Couture B, Schnock KO
Information needs and the use of documentation to support collaborative decision-making: implications for the reduction of central line-associated blood stream infections.
It is clear that interdisciplinary communication and collaboration have the potential to mitigate healthcare-associated harm, yet there is limited research on how communication through documentation in the patient record can support collaborative decision making. Understanding what information is needed to support collaborative decision making is necessary to design electronic health information systems that facilitate effective communication and, ultimately, safe care. To explore this issue, the investigators focused on information needs related to central venous catheter management and the prevention of central line-associated blood stream infections.
AHRQ-funded; HS0235335.
Citation: Thate JA, Couture B, Schnock KO .
Information needs and the use of documentation to support collaborative decision-making: implications for the reduction of central line-associated blood stream infections.
Comput Inform Nurs 2020 Nov 2;39(4):208-14. doi: 10.1097/cin.0000000000000683..
Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Decision Making, Communication, Electronic Health Records (EHRs), Health Information Technology (HIT), Nursing
Bucher BT, Shi J, Ferraro JP
Portable automated surveillance of surgical site infections using natural language processing: development and validation.
The authors presented the development and validation of a portable natural language processing (NLP) approach for automated surveillance of surgical site infections (SSIs). Patient clinical text notes from EHRs following surgical procedures from two independent healthcare systems were abstracted. The authors found that automated surveillance of SSIs can be achieved using NLP of clinical notes with high sensitivity and specificity.
AHRQ-funded; HS025776.
Citation: Bucher BT, Shi J, Ferraro JP .
Portable automated surveillance of surgical site infections using natural language processing: development and validation.
Ann Surg 2020 Oct;272(4):629-36. doi: 10.1097/sla.0000000000004133..
Keywords: Surgery, Healthcare-Associated Infections (HAIs), Electronic Health Records (EHRs), Health Information Technology (HIT), Quality Improvement, Quality of Care
Flores EJ, Jue JJ, Giradi G
AHRQ EPC series on Improving translation of evidence: use of a clinical pathway for C. difficile treatment to facilitate the translation of research findings into practice.
In this pilot study, findings from the 2016 AHRQ EPC report on Clostridioides difficile infection were translated into a treatment pathway and disseminated via a cloud-based platform and electronic health record (EHR). Results indicated that pathways can be an approach for disseminating AHRQ EPC report findings within health care systems, with reports including guideline and pathway syntheses. Embedding hyperlinks to pathway content within the EHR may be a viable and low-effort solution for promoting awareness of evidence-based resources.
AHRQ-funded.
Citation: Flores EJ, Jue JJ, Giradi G .
AHRQ EPC series on Improving translation of evidence: use of a clinical pathway for C. difficile treatment to facilitate the translation of research findings into practice.
Jt Comm J Qual Patient Saf 2019 Dec;45(12):822-28. doi: 10.1016/j.jcjq.2019.10.002..
Keywords: Implementation, Evidence-Based Practice, Infectious Diseases, Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Electronic Health Records (EHRs), Health Information Technology (HIT)
Yang H, Tourani R, Zhu Y
Strategies for building robust prediction models using data unavailable at prediction time.
Risk prediction models based on pre- and intraoperative data have been proposed to assess the risk of HAIs at the end of the surgery, but the performance of these models lag behind HAI detection models based on postoperative data. Postoperative data are more predictive than pre- or interoperative data but it is unavailable when the risk models are applied (end of surgery). The objective of this study was to examine whether such data can be used to improve the performance of the risk model.
AHRQ-funded; HS024532.
Citation: Yang H, Tourani R, Zhu Y .
Strategies for building robust prediction models using data unavailable at prediction time.
J Am Med Inform Assoc 2021 Dec 28;29(1):72-79. doi: 10.1093/jamia/ocab229..
Keywords: Healthcare-Associated Infections (HAIs), Risk, Health Information Technology (HIT)
Ji W, McKenna C, Ochoa A
Development and assessment of objective surveillance definitions for nonventilator hospital-acquired pneumonia.
The authors sought to propose and assess potentially objective, efficient, and reproducible surveillance definitions for non-ventilator hospital-acquired pneumonia (NV-HAP) using routine clinical data stored in electronic health record systems. They found that objective surveillance for NV-HAP using electronically computable definitions that incorporate common clinical criteria is feasible and generates incidence, mortality, and adjusted odds ratios for hospital mortality similar to estimates from manual surveillance. They concluded that these definitions have the potential to facilitate widespread, automated surveillance for NV-HAP and thus inform the development and evaluation of prevention programs.
AHRQ-funded; HS025008.
Citation: Ji W, McKenna C, Ochoa A .
Development and assessment of objective surveillance definitions for nonventilator hospital-acquired pneumonia.
JAMA Netw Open 2019 Oct 2;2(10):e1913674. doi: 10.1001/jamanetworkopen.2019.13674..
Keywords: Healthcare-Associated Infections (HAIs), Hospitals, Respiratory Conditions, Public Health, Electronic Health Records (EHRs), Health Information Technology (HIT)
Chai PR, Zhang H, Jambaulikar GD
An Internet of things buttons to measure and respond to restroom cleanliness in a hospital setting: descriptive study.
AHRQ-funded; HS024538; HS024713.
Citation: Chai PR, Zhang H, Jambaulikar GD .
An Internet of things buttons to measure and respond to restroom cleanliness in a hospital setting: descriptive study.
J Med Internet Res 2019 Jun 19;21(6):e13588. doi: 10.2196/13588..
Keywords: Hospitals, Health Information Technology (HIT), Patient Safety, Healthcare-Associated Infections (HAIs)
Jurewicz KA, Neyens DM, Catchpole K
Developing a 3D gestural interface for anesthesia-related human-computer interaction tasks using both experts and novices.
The purpose of this research was to compare gesture-function mappings for experts and novices using a 3D, vision-based, gestural input system when exposed to the same context of anesthesia tasks in the operating room (OR). Results showed that although domain expertise is influential when creating gesture-function mappings, both experts and novices should be able to use a gesture system intuitively, so development methods need to be refined for considering the needs of different user groups. Recommendations include the development of a touchless interface for perioperative anesthesia in order to reduce bacterial contamination.
AHRQ-funded; HS024380.
Citation: Jurewicz KA, Neyens DM, Catchpole K .
Developing a 3D gestural interface for anesthesia-related human-computer interaction tasks using both experts and novices.
Hum Factors 2018 Nov;60(7):992-1007. doi: 10.1177/0018720818780544..
Keywords: Health Information Technology (HIT), Healthcare-Associated Infections (HAIs), Patient Safety
Colborn KL, Bronsert M, Amioka E
Identification of surgical site infections using electronic health record data.
The objective of this study was to develop an algorithm for identifying surgical site infections (SSIs) using independent variables from electronic health record data and outcomes from the American College of Surgeons National Surgical Quality Improvement Program to supplement manual chart review. The investigators concluded that they identified a model that accurately identified SSIs. They indicated that the framework presented can be easily implemented by other American College of Surgeons National Surgical Quality Improvement Program-participating hospitals to develop models for enhancing surveillance of SSIs.
AHRQ-funded; HS026019.
Citation: Colborn KL, Bronsert M, Amioka E .
Identification of surgical site infections using electronic health record data.
Am J Infect Control 2018 Nov;46(11):1230-35. doi: 10.1016/j.ajic.2018.05.011..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Healthcare-Associated Infections (HAIs), Injuries and Wounds, Patient Safety, Surgery
Karavite DJ, Miller MW, Ramos MJ
User testing an information foraging tool for ambulatory surgical site infection surveillance.
Surveillance for surgical site infections (SSIs) after ambulatory surgery in children requires a detailed manual chart review to assess criteria defined by the National Health and Safety Network. Electronic health records (EHRs) impose an inefficient search process. Using text mining and business intelligence software, the authors developed an information foraging application, the SSI Workbench, to visually present which postsurgical encounters included SSI-related terms and synonyms, antibiotic, and culture orders. This study compares the Workbench and EHR.
AHRQ-funded; HS020921.
Citation: Karavite DJ, Miller MW, Ramos MJ .
User testing an information foraging tool for ambulatory surgical site infection surveillance.
Appl Clin Inform 2018 Oct;9(4):791-802. doi: 10.1055/s-0038-1675179..
Keywords: Surgery, Ambulatory Care and Surgery, Children/Adolescents, Electronic Health Records (EHRs), Health Information Technology (HIT), Healthcare-Associated Infections (HAIs), Patient Safety
Grundmeier RW, Xiao R, Ross RK
Grundmeier RW, Xiao R, Ross RK, Ramos MJ, Karavite DJ, Michel JJ, Gerber JS, et al. Identifying surgical site infections in electronic health data using predictive models,.
The objective of this study was to prospectively derive and validate a prediction rule for detecting cases warranting investigation for surgical site infections (SSI) after ambulatory surgery. The investigators concluded that electronic health record data can facilitate SSI surveillance with adequate sensitivity and positive predictive value.
AHRQ-funded; HS020921.
Citation: Grundmeier RW, Xiao R, Ross RK .
Grundmeier RW, Xiao R, Ross RK, Ramos MJ, Karavite DJ, Michel JJ, Gerber JS, et al. Identifying surgical site infections in electronic health data using predictive models,.
J Am Med Inform Assoc 2018 Sep;25(9):1160-66. doi: 10.1093/jamia/ocy075..
Keywords: Healthcare-Associated Infections (HAIs), Injuries and Wounds, Surgery, Electronic Health Records (EHRs), Health Information Technology (HIT), Risk, Patient Safety, Adverse Events, Ambulatory Care and Surgery
Gunter RL, Fernandes-Taylor S, Rahman S
Feasibility of an image-based mobile health protocol for postoperative wound monitoring.
Many surgical site infections (SSIs) develop in the postdischarge period and are inadequately recognized by patients. To address this, the authors developed a mobile health protocol of remote wound monitoring using smartphone technology. The current study aims to establish its feasibility among patients and providers. It found that participant and provider satisfaction was universally high.
AHRQ-funded; HS023395.
Citation: Gunter RL, Fernandes-Taylor S, Rahman S .
Feasibility of an image-based mobile health protocol for postoperative wound monitoring.
J Am Coll Surg 2018 Mar;226(3):277-86. doi: 10.1016/j.jamcollsurg.2017.12.013.
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Keywords: Healthcare-Associated Infections (HAIs), Surgery, Injuries and Wounds, Telehealth, Patient Safety, Health Information Technology (HIT)
Hu Z, Melton GB, Arsoniadis EG
Strategies for handling missing clinical data for automated surgical site infection detection from the electronic health record.
Proper handling of missing data is important for many secondary uses of electronic health record (EHR) data. Data imputation methods can be used to handle missing data, but their use for postoperative complication detection is unclear. Overall, models with missing data imputation almost always outperformed reference models without imputation that included only cases with complete data for detection of SSI overall achieving very good average area under the curve values.
AHRQ-funded; HS024532.
Citation: Hu Z, Melton GB, Arsoniadis EG .
Strategies for handling missing clinical data for automated surgical site infection detection from the electronic health record.
J Biomed Inform 2017 Apr;68:112-20. doi: 10.1016/j.jbi.2017.03.009.
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Keywords: Data, Electronic Health Records (EHRs), Healthcare-Associated Infections (HAIs), Registries, Surgery, Injuries and Wounds, Health Information Technology (HIT), Quality Improvement, Quality of Care, Adverse Events
Padula WV, Gibbons RD, Pronovost PJ
Using clinical data to predict high-cost performance coding issues associated with pressure ulcers: a multilevel cohort model.
Hospital-acquired pressure ulcers (HAPUs) have a mortality rate of 11.6 percent, are costly to treat, and result in Medicare reimbursement penalties. The study’s objective was to use electronic health records to predict pressure ulcers and to identify coding issues leading to penalties. Its analysis identified spinal cord injuries as high risk for HAPUs and as being often inappropriately coded without paralysis.
AHRQ-funded; HS023710.
Citation: Padula WV, Gibbons RD, Pronovost PJ .
Using clinical data to predict high-cost performance coding issues associated with pressure ulcers: a multilevel cohort model.
J Am Med Inform Assoc 2017 Apr 1;24(e1):e95-e102. doi: 10.1093/jamia/ocw118.
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Keywords: Pressure Ulcers, Healthcare-Associated Infections (HAIs), Electronic Health Records (EHRs), Health Information Technology (HIT)
Wiseman JT, Fernandes-Taylor S, Gunter R
Inter-rater agreement and checklist validation for postoperative wound assessment using smartphone images in vascular surgery.
The authors evaluated whether smartphone digital images can supplant in-person evaluation of postoperative vascular surgery wounds. They concluded that using smartphone digital images is a valid method for evaluating postoperative vascular surgery wounds and is comparable to in-person evaluation with regard to most wound characteristics. The inter-rater reliability for determining treatment recommendations was universally high.
AHRQ-funded; HS023395.
Citation: Wiseman JT, Fernandes-Taylor S, Gunter R .
Inter-rater agreement and checklist validation for postoperative wound assessment using smartphone images in vascular surgery.
J Vasc Surg Venous Lymphat Disord 2016 Jul;4(3):320-28.e2. doi: 10.1016/j.jvsv.2016.02.001.
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Keywords: Healthcare-Associated Infections (HAIs), Injuries and Wounds, Telehealth, Surgery, Health Information Technology (HIT), Diagnostic Safety and Quality
Stifter J, Yao Y, Lopez KD
Proposing a new conceptual model and an exemplar measure using health information: Technology to examine the impact of relational nurse continuity on hospital-acquired pressure ulcers.
The authors present a new conceptual model and an innovative use of health information technology to measure relational nurse continuity and to demonstrate the potential for bringing the results of big data science back to the bedside. Understanding the power of big data to address critical clinical issues may foster a new direction for nursing administration theory development.
AHRQ-funded; HS023072.
Citation: Stifter J, Yao Y, Lopez KD .
Proposing a new conceptual model and an exemplar measure using health information: Technology to examine the impact of relational nurse continuity on hospital-acquired pressure ulcers.
ANS Adv Nurs Sci 2015 Jul-Sep;38(3):241-51. doi: 10.1097/ans.0000000000000081.
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Keywords: Nursing, Pressure Ulcers, Quality of Care, Health Information Technology (HIT), Healthcare-Associated Infections (HAIs)
Baillie CA, Epps M, Hanish A
Usability and impact of a computerized clinical decision support intervention designed to reduce urinary catheter utilization and catheter-associated urinary tract infections.
The researchers evaluated the usability and effectiveness of a computerized clinical decision support (CDS) intervention aimed at reducing the duration of urinary tract catheterizations. They found that usability improved to 15% with the revised reminder. The catheter utilization ratio declined over the 3 time periods, as did CAUTIs per 1,000 patient-days. They concluded that the usability of the reminder was highly dependent on its user interface, with a homegrown version of the reminder resulting in higher impact than a stock reminder.
AHRQ-funded; HS016946.
Citation: Baillie CA, Epps M, Hanish A .
Usability and impact of a computerized clinical decision support intervention designed to reduce urinary catheter utilization and catheter-associated urinary tract infections.
Infect Control Hosp Epidemiol 2014 Sep;35(9):1147-55. doi: 10.1086/677630.
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Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Clinical Decision Support (CDS), Electronic Health Records (EHRs), Health Information Technology (HIT), Healthcare-Associated Infections (HAIs), Patient-Centered Outcomes Research, Urinary Tract Infection (UTI)