National Healthcare Quality and Disparities Report
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Search All Research Studies
Topics
- Adverse Events (1)
- (-) Clinical Decision Support (CDS) (6)
- Decision Making (2)
- Evidence-Based Practice (1)
- Falls (1)
- Health Information Technology (HIT) (3)
- Hospitals (1)
- Infectious Diseases (1)
- Injuries and Wounds (1)
- (-) Inpatient Care (6)
- Medication (3)
- Opioids (1)
- Patient Safety (4)
- Prevention (1)
- Risk (2)
- Surgery (1)
- Tools & Toolkits (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 6 of 6 Research Studies DisplayedRolfzen ML, Wick A, Mascha EJ
Best Practice Alerts Informed by Inpatient Opioid Intake to Reduce Opioid Prescribing after Surgery (PRIOR): a cluster randomized multiple crossover trial.
This study tested the hypothesis that a decision-support tool embedded in electronic health records (EHRs) leads clinicians to prescribe fewer opioids at discharge after inpatient surgery. Over 21,000 surgical inpatient discharges in a cluster randomized multiple crossover trial in four Colorado hospitals were included. The results indicated that within the context of vigorous opioid education and awareness efforts a decision-support tool incorporated into EHRs did not reduce discharge opioid prescribing for postoperative patients. The authors concluded that opioid prescribing alerts might be valuable in other contexts.
AHRQ-funded; HS027795.
Citation: Rolfzen ML, Wick A, Mascha EJ .
Best Practice Alerts Informed by Inpatient Opioid Intake to Reduce Opioid Prescribing after Surgery (PRIOR): a cluster randomized multiple crossover trial.
Anesthesiology 2023 Aug 1; 139(2):186-96. doi: 10.1097/aln.0000000000004607..
Keywords: Opioids, Medication, Surgery, Inpatient Care, Clinical Decision Support (CDS), Health Information Technology (HIT)
Nanji KC, Seger DL, Slight SP
Medication-related clinical decision support alert overrides in inpatients.
This study examined the use of medical-related clinical decision support alert overrides by clinicians in hospital inpatient settings. Overall, almost three-quarters of alerts were overridden, with 40% of them not being appropriate. The majority of overrides dealing with duplicate drug, patient allergy or formulary substitution alerts were appropriate but very few for renal- or age-based were. The authors concluded that research should be done to optimize alert types and frequencies to reduce alarm fatigue.
AHRQ-funded; HS024764.
Citation: Nanji KC, Seger DL, Slight SP .
Medication-related clinical decision support alert overrides in inpatients.
J Am Med Inform Assoc 2018 May;25(5):476-81. doi: 10.1093/jamia/ocx115..
Keywords: Clinical Decision Support (CDS), Decision Making, Health Information Technology (HIT), Inpatient Care, Medication
Dykes PC, Duckworth M, Cunningham S
Pilot testing Fall TIPS (Tailoring Interventions for Patient Safety): a patient-centered fall prevention toolkit.
Patient falls during an acute hospitalization cause injury, reduced mobility, and increased costs. The laminated paper Fall TIPS Toolkit (Fall TIPS) provides clinical decision support at the bedside by linking each patient's fall risk assessment with evidence-based interventions. The investigators examined strategies to integrate this evidence into clinical practice. They concluded that engaging hospital and clinical leadership is critical in translating evidence-based care into clinical practice. They address and detail barriers to adoption of the protocol to provide guidance for spread to other institutions.
AHRQ-funded; HS025128.
Citation: Dykes PC, Duckworth M, Cunningham S .
Pilot testing Fall TIPS (Tailoring Interventions for Patient Safety): a patient-centered fall prevention toolkit.
Jt Comm J Qual Patient Saf 2017 Aug;43(8):403-13. doi: 10.1016/j.jcjq.2017.05.002..
Keywords: Clinical Decision Support (CDS), Decision Making, Evidence-Based Practice, Falls, Hospitals, Injuries and Wounds, Inpatient Care, Patient Safety, Prevention, Risk, Tools & Toolkits
Roosan D, Weir C, Samore M
Identifying complexity in infectious diseases inpatient settings: an observation study.
This study sought to identify specific complexity-contributing factors in the infectious disease domain and the relationship with the complexity perceived by clinicians. Its factor analysis revealed three factors explaining 47 percent of total variance, namely task interaction and goals, urgency and acuity, and psychosocial behavior. A linear regression analysis showed no statistically significant association between complexity perceived by the physicians and objective complexity.
AHRQ-funded; HS023349.
Citation: Roosan D, Weir C, Samore M .
Identifying complexity in infectious diseases inpatient settings: an observation study.
J Biomed Inform 2017 Jul;71s:S13-s21. doi: 10.1016/j.jbi.2016.10.018.
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Keywords: Clinical Decision Support (CDS), Infectious Diseases, Inpatient Care, Patient Safety
Le P, Martinez KA, Pappas MA
A decision model to estimate a risk threshold for venous thromboembolism prophylaxis in hospitalized medical patients.
To determine a threshold for prophylaxis based on risk of venous thromboembolism, the researchers constructed a decision model with a decision-tree following patients for 3 months after hospitalization, and a lifetime Markov model with 3-month cycles. They found that the prophylaxis threshold was relatively insensitive to low-molecular-weight heparin cost and bleeding risk, but very sensitive to patient age and life expectancy.
AHRQ-funded; HS022883.
Citation: Le P, Martinez KA, Pappas MA .
A decision model to estimate a risk threshold for venous thromboembolism prophylaxis in hospitalized medical patients.
J Thromb Haemost 2017 Jun;15(6):1132-41. doi: 10.1111/jth.13687.
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Keywords: Adverse Events, Clinical Decision Support (CDS), Inpatient Care, Patient Safety, Risk
Her QL, Amato MG, Seger DL
The frequency of inappropriate nonformulary medication alert overrides in the inpatient setting.
The purpose of this study was to quantify the frequency of inappropriate nonformulary medication (NFM) alert overrides in the inpatient setting and provide insight on how the design of formulary alerts could be improved. The study found that approximately 1 in 5 NFM alert overrides are overridden inappropriately.
AHRQ-funded; HS021094.
Citation: Her QL, Amato MG, Seger DL .
The frequency of inappropriate nonformulary medication alert overrides in the inpatient setting.
J Am Med Inform Assoc 2016 Sep;23(5):924-33. doi: 10.1093/jamia/ocv181..
Keywords: Clinical Decision Support (CDS), Health Information Technology (HIT), Inpatient Care, Medication, Patient Safety