National Healthcare Quality and Disparities Report
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Search All Research Studies
Topics
- Access to Care (1)
- Brain Injury (1)
- Children/Adolescents (1)
- Clinical Decision Support (CDS) (2)
- Critical Care (1)
- (-) Decision Making (13)
- Education: Continuing Medical Education (1)
- Emergency Department (6)
- (-) Emergency Medical Services (EMS) (13)
- Evidence-Based Practice (1)
- Guidelines (1)
- Healthcare Utilization (1)
- Health Information Technology (HIT) (1)
- Health Services Research (HSR) (2)
- Hospitals (1)
- Imaging (3)
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- Nursing (1)
- Patient-Centered Healthcare (2)
- Policy (2)
- Practice Patterns (2)
- Provider (1)
- Substance Abuse (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 13 of 13 Research Studies DisplayedMistry B, Stewart De Ramirez S, Kelen G
Accuracy and reliability of emergency department triage using the emergency severity index: an international multicenter assessment.
This study assessed the accuracy and variability of triage score assignment by emergency department (ED) nurses using the Emergency Severity Index (ESI) in 3 countries. It found that the concordance of nurse-assigned ESI score with reference standard was universally poor and variability was high. Although the ESI is the most popular ED triage tool in the United States and is increasingly used worldwide, its findings point to a need for more reliable ED triage tools.
AHRQ-funded; HS023641.
Citation: Mistry B, Stewart De Ramirez S, Kelen G .
Accuracy and reliability of emergency department triage using the emergency severity index: an international multicenter assessment.
Ann Emerg Med 2018 May;71(5):581-87.e3. doi: 10.1016/j.annemergmed.2017.09.036.
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Keywords: Decision Making, Emergency Department, Emergency Medical Services (EMS), Health Information Technology (HIT), Nursing
Schoenfeld EM, Goff SL, Elia TR
A qualitative analysis of attending physicians' use of shared decision-making: implications for resident education.
This study explored emergency medicine (EM) attending physicians' use of shared decision-making (SDM) in the context of their experience as former residents and current educators and assessed the implications of these findings on learning opportunities for residents. The investigators concluded that a constellation of factors may diminish opportunities for residents to acquire and practice SDM skills. Further research should explore residents' perspectives, address the modifiable obstacles identified, and examine whether these issues generalize to other specialties.
AHRQ-funded; HS024311.
Citation: Schoenfeld EM, Goff SL, Elia TR .
A qualitative analysis of attending physicians' use of shared decision-making: implications for resident education.
J Grad Med Educ 2018 Feb;10(1):43-50. doi: 10.4300/jgme-d-17-00318.1..
Keywords: Decision Making, Education: Continuing Medical Education, Emergency Medical Services (EMS), Provider
Probst MA, Kanzaria HK, Schoenfeld EM
Shared decisionmaking in the emergency department: a guiding framework for clinicians.
The authors developed a simple framework to illustrate how shared decisionmaking should be approached in clinical practice. They believe it should be the preferred or default approach to decisionmaking, except in clinical situations in which 3 factors interfere. These 3 factors are lack of clinical uncertainty or equipoise, patient decisionmaking ability, and time, all of which can render shared decisionmaking infeasible. The authors next discuss how to address each factor.
AHRQ-funded; HS021271; HS024311.
Citation: Probst MA, Kanzaria HK, Schoenfeld EM .
Shared decisionmaking in the emergency department: a guiding framework for clinicians.
Ann Emerg Med 2017 Nov;70(5):688-95. doi: 10.1016/j.annemergmed.2017.03.063.
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Keywords: Decision Making, Emergency Department, Emergency Medical Services (EMS), Evidence-Based Practice, Guidelines
Melnick ER, Probst MA, Schoenfeld E
Development and testing of shared decision making interventions for use in emergency care: a research agenda.
This article provides background on decision aids and the conclusions of the 2016 Academic Emergency Medicine consensus conference SDM in practice work group regarding "Shared Decision Making in the Emergency Department: Development of a Policy-Relevant, Patient-Centered Research Agenda."
AHRQ-funded; HS021271; HS024311.
Citation: Melnick ER, Probst MA, Schoenfeld E .
Development and testing of shared decision making interventions for use in emergency care: a research agenda.
Acad Emerg Med 2016 Dec;23(12):1346-53. doi: 10.1111/acem.13045.
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Keywords: Decision Making, Emergency Department, Emergency Medical Services (EMS), Patient-Centered Healthcare, Policy
Dodd KW, Berman A, Brown J
Funding research in emergency department shared decision making: a summary of the 2016 Academic Emergency Medicine Consensus Conference Panel Discussion.
This article summarizes a panel discussion of funding priorities and examples of successfully funded projects related to shared decision making in emergency medicine. The discussion was part of the 2016 Academic Emergency Medicine Consensus Conference, "Shared Decision Making in the Emergency Department: Development of a Policy-relevant Patient-centered Research Agenda."
AHRQ-funded; HS024172.
Citation: Dodd KW, Berman A, Brown J .
Funding research in emergency department shared decision making: a summary of the 2016 Academic Emergency Medicine Consensus Conference Panel Discussion.
Acad Emerg Med 2016 Dec;23(12):1340-45. doi: 10.1111/acem.13063.
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Keywords: Emergency Department, Decision Making, Emergency Medical Services (EMS), Health Services Research (HSR)
Grudzen CR, Anderson JR, Carpenter CR
The 2016 Academic Emergency Medicine Consensus Conference, Shared Decision Making in the Emergency Department: Development of a Policy-relevant Patient-centered Research Agenda May 10, 2016, New Orleans, LA.
The authors described the current state of shared decision making in the emergency department context and provided an overview of the conference. They explained that the results of the conference published in the same journal issue provided an essential summary of the future research priorities for shared decision making to increase quality of care and patient-centered outcomes.
AHRQ-funded; HS024172.
Citation: Grudzen CR, Anderson JR, Carpenter CR .
The 2016 Academic Emergency Medicine Consensus Conference, Shared Decision Making in the Emergency Department: Development of a Policy-relevant Patient-centered Research Agenda May 10, 2016, New Orleans, LA.
Acad Emerg Med 2016 Dec;23(12):1313-19. doi: 10.1111/acem.13047.
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Keywords: Decision Making, Emergency Department, Emergency Medical Services (EMS), Patient-Centered Healthcare, Policy
Bonafide CP, Roland D, Brady PW
Rapid response systems 20 years later: new approaches, old challenges.
In this article, the authors propose a set of recommendations for a research agenda aimed at pursuing the work of optimizing the identification of deteriorating children. They recommend that the second generation of pediatric rapid response systems continue to build on past achievements while further optimizing use of the data, tools, and people available at the bedside to take the next leap forward.
AHRQ-funded; HS023827.
Citation: Bonafide CP, Roland D, Brady PW .
Rapid response systems 20 years later: new approaches, old challenges.
JAMA Pediatr 2016 Aug;170(8):729-30. doi: 10.1001/jamapediatrics.2016.0398.
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Keywords: Children/Adolescents, Clinical Decision Support (CDS), Decision Making, Emergency Medical Services (EMS), Hospitals
Melnick ER, O'Brien EG, Kovalerchik O
The association between physician empathy and variation in imaging use.
This paper's objective was to describe empathy in a cohort of emergency physicians and evaluate its association with CT utilization. The authors found that, on the four psychometric scales used, performance was not predictive of risk-adjusted CT utilization in the emergency department. They concluded that the underlying physician-based factors that mediate interphysician variation remain to be clearly identified.
AHRQ-funded; HS021271.
Citation: Melnick ER, O'Brien EG, Kovalerchik O .
The association between physician empathy and variation in imaging use.
Acad Emerg Med 2016 Aug;23(8):895-904. doi: 10.1111/acem.13017.
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Keywords: Decision Making, Emergency Medical Services (EMS), Healthcare Utilization, Imaging, Practice Patterns
Melnick ER, Shafer K, Rodulfo N
Understanding overuse of computed tomography for minor head injury in the emergency department: a triangulated qualitative study.
The objective was to identify nonclinical, human factors that promote or inhibit the appropriate use of computed tomography (CT) in patients presenting to the emergency department (ED) with minor head injury. Five core domains emerged from the analysis: establishing trust, anxiety (patient and provider), constraints related to ED practice, the influence of others, and patient expectations.
AHRQ-funded; HS021271.
Citation: Melnick ER, Shafer K, Rodulfo N .
Understanding overuse of computed tomography for minor head injury in the emergency department: a triangulated qualitative study.
Acad Emerg Med 2015 Dec;22(12):1474-83. doi: 10.1111/acem.12824.
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Keywords: Emergency Medical Services (EMS), Imaging, Brain Injury, Decision Making, Health Services Research (HSR)
Melnick ER, Keegan J, Taylor RA
Redefining overuse to include costs: a decision analysis for computed tomography in minor head injury.
This study was conducted to (1) determine the testing threshold for head computed tomography (CT) in minor head injury in the emergency department using decision analysis with and without costs included in the analysis. If only effectiveness is considered, current clinical decision rules might not provide a sufficient degree of certainty to ensure identification of all patients for whom the benefits of CT outweigh its risks.
AHRQ-funded; HS021271.
Citation: Melnick ER, Keegan J, Taylor RA .
Redefining overuse to include costs: a decision analysis for computed tomography in minor head injury.
Jt Comm J Qual Patient Saf 2015 Jul;41(7):313-22..
Keywords: Clinical Decision Support (CDS), Decision Making, Imaging, Emergency Medical Services (EMS)
Smith RJ, Kilaru AS, Perrone J
How, why, and for whom do emergency medicine providers use prescription drug monitoring programs?
The authors examined how emergency physicians use Prescription Drug Monitoring Programs (PDMPs), for which patients, and for what reasons. They found that providers use the information in PDMPs to alter clinical decisions and guide opioid prescribing patterns. Physicians used the databases additionally for improving their ability to facilitate discussions on addiction and for providing patient education. The authors recommended minimizing administrative barriers to PDMP access and suggested that alternative PDMP uses be further studied to determine their appropriateness and potentially expand their role in clinical practice.
AHRQ-funded; HS021956.
Citation: Smith RJ, Kilaru AS, Perrone J .
How, why, and for whom do emergency medicine providers use prescription drug monitoring programs?
Pain Med 2015 Jun;16(6):1122-31. doi: 10.1111/pme.12700.
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Keywords: Decision Making, Emergency Medical Services (EMS), Medication, Practice Patterns, Substance Abuse
Courtney DM, Mills AM, Marin JR
To test or not to test ... decision analysis of decision support.
In this article, the authors comment on a study by Troyer and colleagues in the same issue that presents a provocative decision analysis study exploring the cost and benefits associated with a web-based quantitative pretest probability calculator. Their discussion centers around the decision to test or not test in the emergency department setting for a condition. Such decisions are among the most consequential that physicians make and often hinge on advanced imaging.
AHRQ-funded; HS023498.
Citation: Courtney DM, Mills AM, Marin JR .
To test or not to test ... decision analysis of decision support.
Acad Emerg Med 2015 May;22(5):594-6. doi: 10.1111/acem.12663..
Keywords: Decision Making, Emergency Department, Emergency Medical Services (EMS)
Myers SR, Salhi RA, Lerner EB
A pilot study describing access to emergency care in two states using a model emergency care categorization system.
To improve regionalization of care and patient decisions when seeking emergency care, the researchers surveyed emergency departments (EDs) in 2 States. They found that 25 percent provided advanced care, 10.5 percent comprehensive care, and 1.6 percent pediatric critical care. Overall, 75.1 percent of the population could reach advanced or comprehensive ED within 60 minutes by ground transportation.
AHRQ-funded; HS017960; HS018604
Citation: Myers SR, Salhi RA, Lerner EB .
A pilot study describing access to emergency care in two states using a model emergency care categorization system.
Acad Emerg Med. 2013 Sep;20(9):894-903. doi: 10.1111/acem.12208..
Keywords: Emergency Medical Services (EMS), Access to Care, Critical Care, Decision Making