National Healthcare Quality and Disparities Report
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Search All Research Studies
Topics
- Adverse Events (1)
- (-) Ambulatory Care and Surgery (5)
- Antibiotics (1)
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- Children/Adolescents (1)
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- Clinical Decision Support (CDS) (3)
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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 5 of 5 Research Studies DisplayedShi Y, Amill-Rosario A, Rudin RS
Barriers to using clinical decision support in ambulatory care: do clinics in health systems fare better?
In this study, the investigators quantified the use of clinical decision support (CDS) and the specific barriers reported by ambulatory clinics and examined whether CDS utilization and barriers differed based on clinics' affiliation with health systems, providing a benchmark for future empirical research and policies related to this topic.
AHRQ-funded; HS024067.
Citation: Shi Y, Amill-Rosario A, Rudin RS .
Barriers to using clinical decision support in ambulatory care: do clinics in health systems fare better?
J Am Med Inform Assoc 2021 Jul 30;28(8):1667-75. doi: 10.1093/jamia/ocab064..
Keywords: Clinical Decision Support (CDS), Decision Making, Ambulatory Care and Surgery, Health Information Technology (HIT), Health Systems
Curran RL, Kukhareva PV, Taft T
Integrated displays to improve chronic disease management in ambulatory care: a SMART on FHIR application informed by mixed-methods user testing.
This study’s objective was to evaluate a novel electronic health record (EHR) add-on application for chronic disease management that uses an integrated display to decrease user cognitive load, improve efficiency, and support clinical decision making. The authors designed an application using the technology framework known as SMART on FHIR (Substitutable Medical Applications and Reusable Technologies on Fast Healthcare Interoperability Resources). They used mixed methods to obtain user feedback on a prototype to support ambulatory providers managing chronic obstructive pulmonary disease. Two patient scenarios were presented to the participants using the regular EHR with and without access to their prototype. Results measured was the percentage of expert-recommended ideal care tasks completed. Timing, keyboard and mouse use, and participant surveys were also collected. The 13 participants complete more recommended care using the prototype (81% vs 48%) and recommended tasks per minute over long sessions. Keystrokes per task were also lower with the prototype (6 vs 18). While there was a learning curve for this application, it will increase efficiency and patient care with practice.
AHRQ-funded; HS026198.
Citation: Curran RL, Kukhareva PV, Taft T .
Integrated displays to improve chronic disease management in ambulatory care: a SMART on FHIR application informed by mixed-methods user testing.
J Am Med Inform Assoc 2020 Aug;27(8):1225-34. doi: 10.1093/jamia/ocaa099..
Keywords: Chronic Conditions, Electronic Health Records (EHRs), Health Information Technology (HIT), Care Management, Ambulatory Care and Surgery, Clinical Decision Support (CDS), Decision Making
Links AR, Callon W, Wasserman C
Surgeon use of medical jargon with parents in the outpatient setting.
This study analyzed the use of unexplained medical jargon with parents whose children have sleep-disordered breathing and their consultations with otolaryngologists in a pediatric surgical setting. Participants (64 parents and 8 otolaryngologists) completed questionnaires that evaluated demographics, clinical features and parental role in decision-making. Unexplained medical jargon was commonly used by physicians (mean total utterances per visit = 28.9) while parents used jargon a mean of 4.3 times. Clinicians used more jargon when they felt that parents had greater involvement in decision-making or when parents used more jargon themselves. These results will be incorporated into communication training for clinicians.
AHRQ-funded; HS022932.
Citation: Links AR, Callon W, Wasserman C .
Surgeon use of medical jargon with parents in the outpatient setting.
Patient Educ Couns 2019 Jun;102(6):1111-18. doi: 10.1016/j.pec.2019.02.002..
Keywords: Ambulatory Care and Surgery, Caregiving, Children/Adolescents, Clinician-Patient Communication, Communication, Decision Making, Education: Patient and Caregiver, Provider, Provider: Physician
Chua KP, Fischer MA, Linder JA
Appropriateness of outpatient antibiotic prescribing among privately insured US patients: ICD-10-CM based cross sectional study.
This study used ICD-10 codes to determine the appropriateness of outpatient antibiotic prescriptions filled in privately insured patients in the US. Determinations were made based on diagnosis whether the prescriptions were “appropriate”, “potentially appropriate”, “inappropriate”, or no diagnosis code found. Among a cohort of over 19 million, only 12.8% were deemed appropriate, 23.2% were inappropriate, 35.5% potentially inappropriate, and 28.% not associated with a diagnosis code.
AHRQ-funded; HS024930; 233201500020I.
Citation: Chua KP, Fischer MA, Linder JA .
Appropriateness of outpatient antibiotic prescribing among privately insured US patients: ICD-10-CM based cross sectional study.
BMJ 2019 Jan 16;364:k5092. doi: 10.1136/bmj.k5092..
Keywords: Ambulatory Care and Surgery, Antibiotics, Decision Making, Health Insurance, Medication
Aldina S, Goldhaber-Fiebert SN, Hannenberg AA
Factors associated with the use of cognitive aids in operating room crises: a cross-sectional study of US hospitals and ambulatory surgical centers.
This study examined organizational context and implementation process factors influencing the use of cognitive aids for OR crises. It found that small facility size was associated with a fourfold increase in the odds of a facility reporting more successful implementation. Completing more implementation steps was also significantly associated with more successful implementation.
AHRQ-funded; HS024235.
Citation: Aldina S, Goldhaber-Fiebert SN, Hannenberg AA .
Factors associated with the use of cognitive aids in operating room crises: a cross-sectional study of US hospitals and ambulatory surgical centers.
Implement Sci 2018 Mar 26;13(1):50. doi: 10.1186/s13012-018-0739-4.
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Keywords: Adverse Events, Ambulatory Care and Surgery, Patient Safety, Quality Improvement, Quality of Care, Hospitals, Decision Making, Clinical Decision Support (CDS)