National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
Data
- Data Infographics
- Data Visualizations
- Data Tools
- Data Innovations
- All-Payer Claims Database
- Healthcare Cost and Utilization Project (HCUP)
- Medical Expenditure Panel Survey (MEPS)
- AHRQ Quality Indicator Tools for Data Analytics
- State Snapshots
- United States Health Information Knowledgebase (USHIK)
- Data Sources Available from AHRQ
Search All Research Studies
Topics
- Care Coordination (1)
- Caregiving (1)
- Children/Adolescents (1)
- Clinician-Patient Communication (7)
- (-) Communication (15)
- Comparative Effectiveness (1)
- Cultural Competence (1)
- Decision Making (2)
- Diagnostic Safety and Quality (1)
- Education: Continuing Medical Education (1)
- Education: Patient and Caregiver (1)
- Electronic Health Records (EHRs) (1)
- (-) Emergency Department (15)
- Emergency Medical Services (EMS) (2)
- Healthcare Delivery (2)
- Health Information Exchange (HIE) (1)
- Health Information Technology (HIT) (3)
- Health Services Research (HSR) (1)
- Hospital Discharge (1)
- Hospitals (1)
- Imaging (1)
- Intensive Care Unit (ICU) (1)
- Newborns/Infants (2)
- Nursing (1)
- Opioids (1)
- Pain (1)
- Patient-Centered Healthcare (3)
- Patient-Centered Outcomes Research (2)
- Patient and Family Engagement (1)
- Patient Safety (1)
- Provider (2)
- Provider: Clinician (1)
- Provider: Health Personnel (1)
- Provider: Physician (1)
- Rural Health (1)
- Simulation (1)
- Surgery (1)
- Teams (1)
- Transitions of Care (1)
- Trauma (1)
- Vulnerable Populations (1)
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 15 of 15 Research Studies DisplayedDoty AM, Rising KL, Hsiao T
"Unfortunately, I don't have an answer for you": how resident physicians communicate diagnostic uncertainty to patients during emergency department discharge.
This study’s objective was to describe how emergency medicine resident physicians discuss diagnostic uncertainty during a simulated emergency department (ED) discharge discussion. Most residents in the simulation explained the evaluation revealed no cause for symptoms, noted concerning diagnoses that were excluded, and acknowledged both symptoms and patients’ feelings. However, 28% of residents did not discuss diagnostic uncertainty in any form. All residents were reassuring. Those who did discuss diagnostic uncertainty used explicit and implicit language with similar frequency.
AHRQ-funded; HS025651.
Citation: Doty AM, Rising KL, Hsiao T .
"Unfortunately, I don't have an answer for you": how resident physicians communicate diagnostic uncertainty to patients during emergency department discharge.
Patient Educ Couns 2022 Jul;105(7):2053-57. doi: 10.1016/j.pec.2021.12.002..
Keywords: Clinician-Patient Communication, Emergency Department, Communication, Diagnostic Safety and Quality
Meisel ZF, Shofer F, Dolan A
AHRQ Author: Rhodes KV
A multicentered randomized controlled trial comparing the effectiveness of pain treatment communication tools in emergency department patients with back or kidney stone pain.
The purpose of this trial was to compare the effectiveness of three approaches for communicating opioid risk during an emergency department visit for a common painful condition. Participants were adult patients with kidney stone or musculoskeletal back pain, randomly assigned to one of three risk communication strategies: a personalized probabilistic risk visual aid, a visual aid and video narrative, or general risk information. Findings showed that an emergency medicine communication tool incorporating probabilistic risk and patient narratives was more effective than general information in mitigating preferences for opioids in the treatment of pain but was not more effective with respect to opioid use or risk recall.
AHRQ-authored.
Citation: Meisel ZF, Shofer F, Dolan A .
A multicentered randomized controlled trial comparing the effectiveness of pain treatment communication tools in emergency department patients with back or kidney stone pain.
Am J Public Health 2022 Feb;112(S1):S45-s55. doi: 10.2105/ajph.2021.306511..
Keywords: Pain, Emergency Department, Education: Patient and Caregiver, Opioids, Comparative Effectiveness, Clinician-Patient Communication, Communication
Gutman CK, Lion KC, Fisher CL
Breaking through barriers: the need for effective research to promote language-concordant communication as a facilitator of equitable emergency care.
The authors discuss the issue of individuals with limited English proficiency (LEP) and the high risk for adverse outcomes in the US health care system, especially in the emergency department. They point out that, although professional language interpretation improves the quality of care for these patients, it remains underused. They find few examples in the literature of rigorous interventions to improve quality of care and outcomes for patients with LEP and urge further high-quality research to improve communication with patients with LEP along the continuum of emergency care in order to achieve equity in outcomes.
AHRQ-funded; HS026006.
Citation: Gutman CK, Lion KC, Fisher CL .
Breaking through barriers: the need for effective research to promote language-concordant communication as a facilitator of equitable emergency care.
J Am Coll Emerg Physicians Open 2022 Feb;3(1):e12639. doi: .
Keywords: Communication, Emergency Department, Cultural Competence, Clinician-Patient Communication
Aronson PL, Schaeffer P, Niccolai LM
Parents' perspectives on communication and shared decision making for febrile infants ≤60 days old.
This study examined parents’ perceptions of receiving and understanding information in the emergency department (ED) and their perspectives on shared decision making (SDM) in the management of febrile infants 60 days of age or less. The authors conducted semistructured interviews with 23 parents of febrile infants ≤60 days old evaluated in the pediatric ED at an urban, academic medical center. Themes for parents’ perspectives on SDM included: 1) giving parents the opportunity to express their opinions and concerns builds confidence in the decision making process, 2) parents’ preferences for participation in decision making vary considerably, and 3) different perceptions about risk influence parents’ preferences about having their infant undergo a lumbar puncture (LP). Parents valued risk and benefits of having their infant undergo an LP differently, which influences their preferences.
AHRQ-funded; HS026006.
Citation: Aronson PL, Schaeffer P, Niccolai LM .
Parents' perspectives on communication and shared decision making for febrile infants ≤60 days old.
Pediatr Emerg Care 2021 Dec;37(12):e1213-e19. doi: 10.1097/pec.0000000000001977..
Keywords: Newborns/Infants, Clinician-Patient Communication, Communication, Decision Making, Emergency Department
Schulson L, Lin MY, Paasche-Orlow MK
Limited English proficient patient visits and emergency department admission rates for ambulatory care sensitive conditions in California: a retrospective cohort study.
Little is known about the risk of admission for emergency department (ED) visits for ambulatory care sensitive conditions (ACSCs) by limited English proficient (LEP) patients. The objective of this study was to estimate admission rates from ED for ACSCs comparing LEP and English proficient (EP) patients and examine how these rates varied at hospitals with a high versus low proportion of LEP patients.
AHRQ-funded; HS022242.
Citation: Schulson L, Lin MY, Paasche-Orlow MK .
Limited English proficient patient visits and emergency department admission rates for ambulatory care sensitive conditions in California: a retrospective cohort study.
J Gen Intern Med 2021 Sep;36(9):2683-91. doi: 10.1007/s11606-020-06523-5..
Keywords: Emergency Department, Vulnerable Populations, Communication
Aronson PL, Politi MC, Schaeffer P
Development of an app to facilitate communication and shared decision-making with parents of febrile infants ≤ 60 days old.
This study’s aim was to develop and test a tool to engage parents of febrile infants 60 days or less of age evaluated in the emergency department (ED). The tool was designed to improve communication between parents and healthcare providers and to support shared decision-making (SDM) about whether to perform a lumbar puncture (LP) for infants 29 to 60 days of age. The authors conducted a multi-phase development and testing process including individual, semi-structured interviews with parents and clinicians; design of a “storyboard” of the tool with design impression testing; development of a software application prototype called e-Care; and usability testing of e-Care using qualitative assessment and the System Usability Scale (SUS). The authors interviewed 27 parents and 23 clinicians. After the interviews, they developed separate versions of e-Care for infants aged 28 days or less and 29 to 60 days of age in both English and Spanish. e-Care is divided into 4 sections: 1) homepage; 2) why testing is done; 3) what tests are done; and 4) what happens after testing. The mean SUS score given by parents and clinicians was 90.3 representing “excellent” usability.
AHRQ-funded; HS026006.
Citation: Aronson PL, Politi MC, Schaeffer P .
Development of an app to facilitate communication and shared decision-making with parents of febrile infants ≤ 60 days old.
Acad Emerg Med 2021 Jan;28(1):46-59. doi: 10.1111/acem.14082..
Keywords: Clinician-Patient Communication, Communication, Newborns/Infants, Caregiving, Decision Making, Patient and Family Engagement, Emergency Department, Health Information Technology (HIT)
Rising KL, Powell RE, Cameron KA
Development of the uncertainty communication checklist: a patient-centered approach to patient discharge from the emergency department.
Acad Med 2020 Jul;95(7):1026-34. doi: 10.1097/acm.0000000000003231.
AHRQ-funded; HS025651.
Citation: Rising KL, Powell RE, Cameron KA .
Development of the uncertainty communication checklist: a patient-centered approach to patient discharge from the emergency department.
Acad Med 2020 Jul;95(7):1026-34. doi: 10.1097/acm.0000000000003231..
Keywords: Patient-Centered Healthcare, Hospital Discharge, Emergency Department, Clinician-Patient Communication, Communication
McCarthy DM, Powell RE, Cameron KA
Simulation-based mastery learning compared to standard education for discussing diagnostic uncertainty with patients in the emergency department: a randomized controlled trial.
The purpose of this study was to evaluate the effectiveness of the Uncertainty Communication Education Module (UCEM) in improving physician communications. Patients' understanding of the care they received has implications for care quality, safety, and patient satisfaction, especially when they are discharged without a definitive diagnosis. Developing a patient-centered diagnostic uncertainty communication strategy will improve safety of acute care discharges. This trial has been designed to have a low-resource, scalable intervention that would allow for widespread dissemination and uptake.
AHRQ-funded; HS025651.
Citation: McCarthy DM, Powell RE, Cameron KA .
Simulation-based mastery learning compared to standard education for discussing diagnostic uncertainty with patients in the emergency department: a randomized controlled trial.
BMC Med Educ 2020 Feb 19;20(1):49. doi: 10.1186/s12909-020-1926-y..
Keywords: Education: Continuing Medical Education, Clinician-Patient Communication, Communication, Emergency Department, Simulation, Provider: Physician, Provider
Timbie JW, Kranz AM, Mahmud A
Federally qualified health center strategies for integrating care with hospitals and their association with measures of communication.
Federally qualified health centers have aligned clinical services and systems with local hospitals, but little is known about the specific care integration strategies health centers use or their impact on care. In this study, a research team examined the use of strategies by health centers to integrate care with hospitals and emergency departments (EDs) and their association with performance on measures of health center-hospital communication.
AHRQ-funded; HS024067.
Citation: Timbie JW, Kranz AM, Mahmud A .
Federally qualified health center strategies for integrating care with hospitals and their association with measures of communication.
Jt Comm J Qual Patient Saf 2019 Sep;45(9):620-28. doi: 10.1016/j.jcjq.2019.06.004..
Keywords: Patient-Centered Healthcare, Patient-Centered Outcomes Research, Hospitals, Communication, Emergency Department, Care Coordination, Healthcare Delivery
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
Benda N, Hettinger A, Bisantz A
Communication in the electronic age: an analysis of face-to-fact physician-nurse communication in the emergency department.
This study described the patterns and content of nurse to physician verbal conversations in three emergency departments (EDs) with electronic health records. It found that physician participants experienced significantly more communication events than nurse participants, while nurses initiated significantly more communication events than physicians. Most of the communication events occurred at the physician workstation followed by patient treatment areas.
AHRQ-funded; HS022542.
Citation: Benda N, Hettinger A, Bisantz A .
Communication in the electronic age: an analysis of face-to-fact physician-nurse communication in the emergency department.
Journal of Healthcare Informatics Research 2017 Dec;1(2):218-30.
.
.
Keywords: Communication, Electronic Health Records (EHRs), Provider: Health Personnel, Emergency Department, Nursing
Tiase VL, Crouch B, Bennett H
Descriptive analysis of communication patterns between a local poison control center and community emergency departments.
This study leverages a commercial call recording system to gain insight into the intensity and volume of communication between a poison control center and two rural emergency departments.
AHRQ-funded; HS021472.
Citation: Tiase VL, Crouch B, Bennett H .
Descriptive analysis of communication patterns between a local poison control center and community emergency departments.
2017 IEEE International Conference on Healthcare Informatics (ICHI) 2017 Aug:574. doi: 10.1109/ICHI.2017.89.
.
.
Keywords: Communication, Emergency Department, Emergency Medical Services (EMS), Rural Health
Sabbatini AK, Merck LH, Froemming AT
Optimizing patient-centered communication and multidisciplinary care coordination in emergency diagnostic imaging: a research agenda.
This article summarizes findings reached during the patient-centered outcomes session of the 2015 Academic Emergency Medicine consensus conference "Diagnostic Imaging in the Emergency Department: A Research Agenda to Optimize Utilization." The primary objective was to develop a research agenda focused on 1) defining component parts of the emergency diagnostic imaging care coordination process, 2) identifying gaps in communication that affect emergency diagnostic imaging, and 3) defining optimal methods of communication.
AHRQ-funded; HS022982.
Citation: Sabbatini AK, Merck LH, Froemming AT .
Optimizing patient-centered communication and multidisciplinary care coordination in emergency diagnostic imaging: a research agenda.
Acad Emerg Med 2015 Dec;22(12):1427-34. doi: 10.1111/acem.12826.
.
.
Keywords: Communication, Emergency Department, Health Services Research (HSR), Imaging, Patient-Centered Healthcare, Patient-Centered Outcomes Research
Cummins MR, Crouch BI, Del Fiol G
Information requirements for health information exchange supported communication between emergency departments and poison control centers.
The researchers analyzed audio recordings of current telephone-based communications between emergency departments (EDs) and poison control centers (PCCs) in order to describe the information requirements for health information exchange between PCCs and EDs. Their goal was to identify a focused subset of available health information, most relevant to emergency treatment of poison exposure, in order to support generalizable process re-design.
AHRQ-funded; HS018773.
Citation: Cummins MR, Crouch BI, Del Fiol G .
Information requirements for health information exchange supported communication between emergency departments and poison control centers.
AMIA Annu Symp Proc 2014 Nov 14;2014:449-56..
Keywords: Communication, Emergency Department, Emergency Medical Services (EMS), Health Information Exchange (HIE), Health Information Technology (HIT)
Nguyen V, Okafor N, Zhang J
Using TURF to understand the functions of interruptions.
TURF stands for Task, User, Representation, and Function (TURF) analyses. This paper explores interruptions as an emergent feature of communication in teams. The authors focus on emergency medicine as this complex environment requires team based concurrent management of multiple patients coping with limited resources in a life-critical and interruption-laden environment. They classify interruptions into those activities that support required work and those interruptions that create unnecessary breaks in workflow.
AHRQ-funded; HS021236; HS017586.
Citation: Nguyen V, Okafor N, Zhang J .
Using TURF to understand the functions of interruptions.
AMIA Annu Symp Proc 2014 Nov;2014:917-23..
Keywords: Communication, Emergency Department, Health Information Technology (HIT), Teams