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
AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (15)
- Adverse Events (16)
- Ambulatory Care and Surgery (4)
- Antibiotics (7)
- Antimicrobial Stewardship (4)
- Arthritis (1)
- Asthma (2)
- Autism (2)
- Behavioral Health (4)
- Blood Clots (2)
- Blood Pressure (7)
- Blood Thinners (3)
- Brain Injury (5)
- Burnout (1)
- Cancer (2)
- Cancer: Cervical Cancer (1)
- Cancer: Colorectal Cancer (1)
- Cardiovascular Conditions (7)
- Care Management (3)
- Catheter-Associated Urinary Tract Infection (CAUTI) (1)
- Children/Adolescents (24)
- Chronic Conditions (8)
- (-) Clinical Decision Support (CDS) (199)
- Clinician-Patient Communication (2)
- Colonoscopy (1)
- Communication (3)
- Community-Acquired Infections (1)
- Comparative Effectiveness (2)
- COVID-19 (3)
- Critical Care (1)
- Data (4)
- Decision Making (79)
- Dementia (1)
- Depression (2)
- Diabetes (2)
- Diagnostic Safety and Quality (18)
- Digestive Disease and Health (2)
- Disabilities (1)
- Disparities (1)
- Domestic Violence (1)
- Ear Infections (1)
- Education: Continuing Medical Education (1)
- Elderly (6)
- Electronic Health Records (EHRs) (39)
- Electronic Prescribing (E-Prescribing) (3)
- Emergency Department (15)
- Emergency Medical Services (EMS) (4)
- Evidence-Based Practice (20)
- Falls (6)
- Genetics (3)
- Guidelines (6)
- Healthcare-Associated Infections (HAIs) (3)
- Healthcare Cost and Utilization Project (HCUP) (1)
- Healthcare Costs (4)
- Healthcare Delivery (3)
- Healthcare Utilization (2)
- Health Information Exchange (HIE) (1)
- Health Information Technology (HIT) (128)
- Health Services Research (HSR) (2)
- Health Systems (2)
- Heart Disease and Health (7)
- Hepatitis (1)
- Home Healthcare (1)
- Hospital Discharge (1)
- Hospitalization (5)
- Hospital Readmissions (1)
- Hospitals (11)
- Human Immunodeficiency Virus (HIV) (2)
- Imaging (8)
- Implementation (4)
- Infectious Diseases (3)
- Influenza (1)
- Injuries and Wounds (5)
- Inpatient Care (6)
- Intensive Care Unit (ICU) (2)
- Kidney Disease and Health (3)
- Long-Term Care (1)
- Medicaid (1)
- Medical Errors (8)
- Medical Expenditure Panel Survey (MEPS) (1)
- Medication (40)
- Medication: Safety (8)
- Mortality (1)
- Neurological Disorders (3)
- Newborns/Infants (2)
- Nursing (2)
- Nursing Homes (2)
- Nutrition (1)
- Obesity (2)
- Obesity: Weight Management (1)
- Opioids (3)
- Orthopedics (2)
- Outcomes (4)
- Pain (4)
- Patient-Centered Healthcare (10)
- Patient-Centered Outcomes Research (16)
- Patient Adherence/Compliance (1)
- Patient and Family Engagement (1)
- Patient Safety (33)
- Patient Self-Management (1)
- Pneumonia (2)
- Practice Patterns (5)
- Pregnancy (2)
- Pressure Ulcers (2)
- Prevention (13)
- Primary Care (13)
- Primary Care: Models of Care (1)
- Provider (3)
- Provider: Clinician (2)
- Provider: Health Personnel (2)
- Provider: Nurse (2)
- Provider: Pharmacist (1)
- Provider: Physician (3)
- Provider Performance (1)
- Public Health (1)
- Public Reporting (1)
- Quality Improvement (5)
- Quality Indicators (QIs) (1)
- Quality Measures (3)
- Quality of Care (6)
- Racial and Ethnic Minorities (2)
- Registries (1)
- Research Methodologies (1)
- Respiratory Conditions (6)
- Risk (12)
- Rural/Inner-City Residents (1)
- Rural Health (1)
- Screening (6)
- Sepsis (5)
- Substance Abuse (1)
- Surgery (6)
- Telehealth (1)
- Tobacco Use (1)
- Tobacco Use: Smoking Cessation (1)
- Tools & Toolkits (3)
- Training (1)
- Transplantation (4)
- Trauma (1)
- Urinary Tract Infection (UTI) (1)
- Vaccination (2)
- Web-Based (1)
- Women (2)
- Workflow (3)
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
51 to 75 of 199 Research Studies DisplayedGreenberg JK, Ahluwalia R, Hill M
Development and external validation of the KIIDS-TBI tool for managing children with mild traumatic brain injury and intracranial injuries.
This study's objectives were to develop a new risk model with improved sensitivity compared to the CHIIDA model for the post-neuroimaging management of children with mild traumatic brain injuries (mTBI) and intracranial injuries and further to validate externally the new model and CHIIDA model in a multicenter data set. Findings showed that the KIIDS-TBI model had high sensitivity and moderate specificity for risk stratifying children with mTBI and intracranial injuries. The researchers concluded that the use of their clinical decision support tool may help improve the safe, resource-efficient management of this important patient population.
AHRQ-funded; HS027075.
Citation: Greenberg JK, Ahluwalia R, Hill M .
Development and external validation of the KIIDS-TBI tool for managing children with mild traumatic brain injury and intracranial injuries.
Acad Emerg Med 2021 Dec;28(12):1409-20. doi: 10.1111/acem.14333..
Keywords: Children/Adolescents, Brain Injury, Clinical Decision Support (CDS), Decision Making, Health Information Technology (HIT)
Salwei ME, Carayon P, Hoonakker PLT
Workflow integration analysis of a human factors-based clinical decision support in the emergency department.
Numerous challenges with the implementation, acceptance, and use of health IT are related to poor usability and a lack of integration of the technologies into clinical workflow, and have, therefore, limited the potential of these technologies to improve patient safety. In this paper, the investigators propose a definition and conceptual model of health IT workflow integration. Using interviews of 12 emergency department (ED) physicians, they identified 134 excerpts of barriers and facilitators to workflow integration of a human factors (HF)-based clinical decision support (CDS) implemented in the ED.
AHRQ-funded; HS022086.
Citation: Salwei ME, Carayon P, Hoonakker PLT .
Workflow integration analysis of a human factors-based clinical decision support in the emergency department.
Appl Ergon 2021 Nov;97:103498. doi: 10.1016/j.apergo.2021.103498..
Keywords: Emergency Department, Workflow, Clinical Decision Support (CDS), Health Information Technology (HIT), Implementation
Reese TJ, Del Fiol G, Morgan K
A shared decision-making tool for drug interactions between warfarin and nonsteroidal anti-inflammatory drugs: design and usability study.
Exposure to life-threatening drug-drug interactions (DDIs) occurs despite the widespread use of clinical decision support. The DDI between warfarin and nonsteroidal anti-inflammatory drugs is common and potentially life-threatening. Patients can play a substantial role in preventing harm from DDIs; however, the current model for DDI decision-making is clinician centric. This study aimed to design and examine the usability of DDInteract, a tool to support shared decision-making (SDM) between a patient and provider for the DDI between warfarin and nonsteroidal anti-inflammatory drugs.
AHRQ-funded; HS026198.
Citation: Reese TJ, Del Fiol G, Morgan K .
A shared decision-making tool for drug interactions between warfarin and nonsteroidal anti-inflammatory drugs: design and usability study.
JMIR Hum Factors 2021 Oct 26;8(4):e28618. doi: 10.2196/28618..
Keywords: Blood Thinners, Medication: Safety, Medication, Clinical Decision Support (CDS), Decision Making, Electronic Health Records (EHRs), Health Information Technology (HIT), Adverse Drug Events (ADE), Adverse Events, Patient Safety
Dutta S, McEvoy DS, Stump T
Clinical decision support reduces unnecessary tetanus vaccinations in the emergency department.
The authors implemented a clinical decision support alert in the electronic health record that warned providers when ordering a tetanus vaccine if a prior one had been given within 10 years and studied its efficacy to reduce potentially unnecessary vaccines in the ED. They found that a clinical decision support alert that warns ED clinicians that a patient may have an up-to-date tetanus vaccination status reduced potentially unnecessary vaccinations.
AHRQ-funded; HS027170.
Citation: Dutta S, McEvoy DS, Stump T .
Clinical decision support reduces unnecessary tetanus vaccinations in the emergency department.
Ann Emerg Med 2021 Sep;78(3):370-80. doi: 10.1016/j.annemergmed.2021.02.021..
Keywords: Clinical Decision Support (CDS), Decision Making, Vaccination, Health Information Technology (HIT)
Dorr DA, D'Autremont C, Pizzimenti C
Assessing data adequacy for high blood pressure clinical decision support: a quantitative analysis.
This study examined guideline-based high blood pressure (HBP) and hypertension recommendations and evaluated the suitability and adequacy of the data and logic required for a Fast Healthcare Interoperable Resources-based, patient-facing clinical decision support HBP application. Findings showed that data quality from the electronic health record required to implement recommendations for HBP was highly inconsistent, reflecting a fragmented health care system and incomplete implementation of standard terminologies and workflows. Although imperfect, data were deemed adequate for two test use cases.
AHRQ-funded; HS026849.
Citation: Dorr DA, D'Autremont C, Pizzimenti C .
Assessing data adequacy for high blood pressure clinical decision support: a quantitative analysis.
Appl Clin Inform 2021 Aug;12(4):710-20. doi: 10.1055/s-0041-1732401..
Keywords: Blood Pressure, Clinical Decision Support (CDS), Decision Making, Electronic Health Records (EHRs), Health Information Technology (HIT), Health Information Technology (HIT)
Marin JR, Rodean J, Mannix RC
Association of clinical guidelines and decision support with CT use in pediatric mild traumatic brain injury.
The objective of this study was to examine whether the presence of clinical guidelines and clinical decision support (CDS) for mild traumatic brain injury (mTBI) were associated with lower head computed tomography (CT) use. The investigators concluded that clinical guidelines for mTBI, and particularly CDS, were associated with lower rates of head CT use without adverse clinical outcomes.
AHRQ-funded; HS026006.
Citation: Marin JR, Rodean J, Mannix RC .
Association of clinical guidelines and decision support with CT use in pediatric mild traumatic brain injury.
J Pediatr 2021 Aug;235:178-83.e1. doi: 10.1016/j.jpeds.2021.04.026..
Keywords: Children/Adolescents, Clinical Decision Support (CDS), Decision Making, Health Information Technology (HIT), Brain Injury, Guidelines, Evidence-Based Practice, Imaging
Soares WE, Knee A, Gemme SR
SC, et al. A prospective evaluation of Clinical HEART score agreement, accuracy, and adherence in emergency department chest pain patients.
The HEART score is a risk stratification aid that may safely reduce chest pain admissions for emergency department patients. However, differences in interpretation of subjective components potentially alters the performance of the score. In this study, the investigators compared agreement between HEART scores determined during clinical practice with research-generated scores and estimated their accuracy in predicting 30-day major adverse cardiac events.
AHRQ-funded; HS024815.
Citation: Soares WE, Knee A, Gemme SR .
SC, et al. A prospective evaluation of Clinical HEART score agreement, accuracy, and adherence in emergency department chest pain patients.
Ann Emerg Med 2021 Aug;78(2):231-41. doi: 10.1016/j.annemergmed.2021.03.024..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Emergency Department, Diagnostic Safety and Quality, Clinical Decision Support (CDS), Health Information Technology (HIT)
Shi 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
Strasberg HR, Rhodes B, Del Fiol G
Contemporary clinical decision support standards using Health Level Seven International Fast Healthcare Interoperability Resources.
To facilitate the development of standards-based clinical decision support (CDS) systems, the investigators reviewed the current set of CDS standards that were based on Health Level Seven International Fast Healthcare Interoperability Resources (FHIR). The investigators conclude that widespread adoption of these standards may help reduce healthcare variability, improve healthcare quality, and improve patient safety.
AHRQ-funded; HS026198.
Citation: Strasberg HR, Rhodes B, Del Fiol G .
Contemporary clinical decision support standards using Health Level Seven International Fast Healthcare Interoperability Resources.
J Am Med Inform Assoc 2021 Jul 30;28(8):1796-806. doi: 10.1093/jamia/ocab070..
Keywords: Clinical Decision Support (CDS), Electronic Health Records (EHRs), Health Information Technology (HIT)
Orenstein EW, ElSayed-Ali O, Kandaswamy S
Evaluation of a clinical decision support strategy to increase seasonal influenza vaccination among hospitalized children before inpatient discharge.
The authors’ goal was to design and evaluate a clinical decision support (CDS) strategy to increase the proportion of eligible hospitalized children who receive a seasonal influenza vaccine prior to inpatient discharge. They found that a user-centered CDS may be associated with significantly improved influenza vaccination rates among hospitalized children.
AHRQ-funded; HS027689.
Citation: Orenstein EW, ElSayed-Ali O, Kandaswamy S .
Evaluation of a clinical decision support strategy to increase seasonal influenza vaccination among hospitalized children before inpatient discharge.
JAMA Netw Open 2021 Jul;4(7):e2117809. doi: 10.1001/jamanetworkopen.2021.17809..
Keywords: Children/Adolescents, Influenza, Vaccination, Clinical Decision Support (CDS), Health Information Technology (HIT), Hospital Discharge
Campbell NL, Holden RJ, Tang Q
Multicomponent behavioral intervention to reduce exposure to anticholinergics in primary care older adults.
This study tested the effectiveness of a multicomponent behavioral intervention to reduce the use of high-risk anticholinergic medications in primary care older adults. Ten primary care clinics within Eskenazi Health in Indianapolis were selected to test the intervention. The intervention included provider- and patient-focused components. The provider-focused component was a computerized decision support system alerting the presence of a high-risk anticholinergic and offering dose- and indication-specific alternatives; while the patient-focused component was a story-based video providing education and modeling an interaction with a healthcare provider. The intervention occurred from April 2019 through March 2020. A total of 552 older adults had primary care visits during the study period. Only 3 out of 259 provider-focused alerts led to a medication change. Of the 276 staff alerts, 4.7% were confirmed to activate the patient-focused intervention.
AHRQ-funded; P30HS024384.
Citation: Campbell NL, Holden RJ, Tang Q .
Multicomponent behavioral intervention to reduce exposure to anticholinergics in primary care older adults.
J Am Geriatr Soc 2021 Jun;69(6):1490-99. doi: 10.1111/jgs.17121..
Keywords: Elderly, Medication, Primary Care, Clinical Decision Support (CDS), Decision Making
Li M, Morey DA, Rayo MF
Symbiotic design application in healthcare: preventing hospital acquired infections.
The purpose of this study was to describe the researchers’ experience with the early development stages of an AI-enabled clinical decision support (CDS) tool for hospital-acquired infection (HAI) prevention. The study focuses on three central principles of a symbiotic design process that the researchers have determined to be vital for aligning goals, priorities, mental models, and techniques among a multidisciplinary team: 1) recurrent bottom-up feedback, 2) continual model alignment, and 3) openness to co-direction. The study explores the successes and challenges encountered by the team during the process and discusses how those experiences can impact the design of human-machine teams.
AHRQ-funded; HS027200.
Citation: Li M, Morey DA, Rayo MF .
Symbiotic design application in healthcare: preventing hospital acquired infections.
Proc Int Symp Hum Factors Ergon Healthc 2021 Jun;10(1):211-16. doi: 10.1177/2327857921101138..
Keywords: Research Methodologies, Clinical Decision Support (CDS), Health Information Technology (HIT)
Greenberg JK, Otun A, Nasraddin A
Electronic clinical decision support for children with minor head trauma and intracranial injuries: a sociotechnical analysis.
This paper discusses the development of an evidence-based clinical decision support (CDS) for management of children with minor head trauma (MHT) and evaluates the sociotechnical environment impacting the implementation of electronic CDS, including workflow and communication, institutional culture, and hardware and software infrastructure. Semi-structured qualitative focus group interviews were conducted with 28 physicians and four information technology specialists between March and May 2020. Five primary themes were identified through inductive thematic analysis: 1) clinical impact; 2) stakeholders and users; 3) tool content; 4) clinical practice integration; and 5) post-implementation evaluation measures. Participants generally supported CDS use to determine an appropriate level-of-care. However, some had mixed feelings regarding how the tool could best be used by neurosurgeons versus non-neurosurgeons. Feedback helped refine the tool content and highlighted potential technical and workflow barriers to address prior to implementation.
AHRQ-funded; HS027075.
Citation: Greenberg JK, Otun A, Nasraddin A .
Electronic clinical decision support for children with minor head trauma and intracranial injuries: a sociotechnical analysis.
BMC Med Inform Decis Mak 2021 May 19;21(1):161. doi: 10.1186/s12911-021-01522-w.
.
.
Keywords: Children/Adolescents, Clinical Decision Support (CDS), Brain Injury, Health Information Technology (HIT), Evidence-Based Practice, Decision Making
Ridgway JP, Robicsek A, Shah N
A randomized controlled trial of an electronic clinical decision support tool for inpatient antimicrobial stewardship.
The weighted incidence syndromic combination antibiogram (WISCA) is an antimicrobial stewardship tool that utilizes electronic medical record data to provide real-time clinical decision support regarding empiric antibiotic prescription in the hospital setting. The aim of this study was to determine the impact of WISCA utilization for empiric antibiotic prescription on hospital length of stay (LOS).
AHRQ-funded; HS022283.
Citation: Ridgway JP, Robicsek A, Shah N .
A randomized controlled trial of an electronic clinical decision support tool for inpatient antimicrobial stewardship.
Clin Infect Dis 2021 May 4;72(9):e265-e71. doi: 10.1093/cid/ciaa1048..
Keywords: Antimicrobial Stewardship, Antibiotics, Medication, Clinical Decision Support (CDS), Decision Making, Health Information Technology (HIT)
Sick-Samuels AC, Linz M, Bergmann J
Diagnostic stewardship of endotracheal aspirate cultures in a PICU.
This study describes the development and impact of a clinical decision support algorithm to standardize the use of endotracheal aspirate cultures (EACs) from ventilated PICU patients in the evaluation of suspected ventilator-associated infections. Bacterial growth in EACs does not distinguish bacterial colonization from infection and may lead to overtreatment with antibiotics. The rate of EACs was compared pre- and postintervention. In the preintervention year there were 557 EACs over 5092 ventilator days. After introduction of the algorithm the rate went down to 234 EACs over 3654 ventilator days. There was a 41% decrease in the monthly rate of EACs. This intervention did not affect mortality, readmissions, or length of stay in ventilated PICU patients.
AHRQ-funded; HS025642.
Citation: Sick-Samuels AC, Linz M, Bergmann J .
Diagnostic stewardship of endotracheal aspirate cultures in a PICU.
Pediatrics 2021 May;147(5). doi: 10.1542/peds.2020-1634..
Keywords: Children/Adolescents, Intensive Care Unit (ICU), Clinical Decision Support (CDS), Decision Making, Healthcare-Associated Infections (HAIs), Diagnostic Safety and Quality
Kostick KM, Blumenthal-Barby JS
Avoiding "toxic knowledge": the importance of framing personalized risk information in clinical decision-making.
In this article, the authors discuss personalized risk information in clinical decision making, concluding that the framing of this information’s intended purpose at the patient level should be tailored to the decision-making context as a patient perceives it, which may vary from patient to patient.
AHRQ-funded; HS027784.
Citation: Kostick KM, Blumenthal-Barby JS .
Avoiding "toxic knowledge": the importance of framing personalized risk information in clinical decision-making.
Per Med 2021 Mar;18(2):91-95. doi: 10.2217/pme-2020-0174..
Keywords: Clinical Decision Support (CDS), Decision Making, Risk, Clinician-Patient Communication, Communication
Ruaño G, Tortora J, Robinson S
Subanalysis of the CYP-GUIDES trial: CYP2D6 functional stratification and operational timeline selection.
CYP-GUIDES (Cytochrome Psychotropic Genotyping Under Investigation for Decision Support) was a Randomized Controlled Trial comparing 2 outcomes in hospitalized patients with major depressive disorder treated according to the patient's CYP2D6 genotype and functional status versus standard psychotropic therapy. In this paper, the authors described a subanalysis of the CYP-GUIDES trial. They concluded that there was an effect of pharmacogenetic clinical decision support that reduced length of stay in patients with CYP2D6 subfunctional status and reduced prescribing of CYP2D6 substrate dependent drugs.
AHRQ-funded; HS022304
Citation: Ruaño G, Tortora J, Robinson S .
Subanalysis of the CYP-GUIDES trial: CYP2D6 functional stratification and operational timeline selection.
Psychiatry Res 2021 Mar;297:113571. doi: 10.1016/j.psychres.2020.113571..
Keywords: Clinical Decision Support (CDS), Depression, Genetics, Medication, Behavioral Health
Kane-Gill SL, Wong A, Culley CM
JA, et al. Transforming the medication regimen review process using telemedicine to prevent adverse events.
The objective of this study was to determine the impact of pharmacist-led telemedicine services on reducing high-risk medication adverse drug events (ADEs) for nursing home (NH) residents using medication reconciliation and prospective medication regimen reviews (MRRs) on admission plus ongoing clinical decision support alerts throughout the residents' stay. Studying residents in four NHs in Southwestern Pennsylvania, findings showed that the intervention group had a 92% lower incidence of alert-specific ADEs than usual care, and all-cause hospitalization was similar between groups, as were 30-day readmissions.
AHRQ-funded; HS02420.
Citation: Kane-Gill SL, Wong A, Culley CM .
JA, et al. Transforming the medication regimen review process using telemedicine to prevent adverse events.
J Am Geriatr Soc 2021 Feb;69(2):530-38. doi: 10.1111/jgs.16946..
Keywords: Medication: Safety, Medication, Adverse Drug Events (ADE), Adverse Events, Medical Errors, Patient Safety, Telehealth, Health Information Technology (HIT), Provider: Pharmacist, Provider, Clinical Decision Support (CDS), Prevention
Dulai PS, Singh S, Casteele NV
Development and validation of clinical scoring tool to predict outcomes of treatment with vedolizumab in patients with ulcerative colitis.
AHRQ-funded; HS021747.
Citation: Dulai PS, Singh S, Casteele NV .
Development and validation of clinical scoring tool to predict outcomes of treatment with vedolizumab in patients with ulcerative colitis.
Clin Gastroenterol Hepatol 2020 Dec;18(13):2952-61.e8. doi: 10.1016/j.cgh.2020.02.010..
Keywords: Clinical Decision Support (CDS), Digestive Disease and Health, Outcomes
Marafino BJ, Schuler A, Liu VX
Predicting preventable hospital readmissions with causal machine learning.
This study’s goal was to assess the feasibility and potential impact of predicting preventable hospital readmissions using causal machine learning applied to data from the implementation of a readmissions prevention intervention called the Transitions Program, which used electronic health records from Kaiser Permanent Northern California (KPNC). A total of 1,539,285 index hospitalizations meeting the inclusion criteria and occurring between June 2010 and December 2010 at 21 KPNC hospitals were analyzed. There was substantial heterogeneity in patients’ response to the intervention, with patients at somewhat lower risk appearing to have the largest predicted effects. The estimates appeared to be well calibrated. The results did suggest a mismatch between risk and treatment effects.
AHRQ-funded; HS022192.
Citation: Marafino BJ, Schuler A, Liu VX .
Predicting preventable hospital readmissions with causal machine learning.
Health Serv Res 2020 Dec;55(6):993-1002. doi: 10.1111/1475-6773.13586..
Keywords: Hospital Readmissions, Hospitals, Clinical Decision Support (CDS), Risk
Dykes PC, Burns Z, Adelman J
Evaluation of a patient-centered fall-prevention tool kit to reduce falls and injuries: a nonrandomized controlled trial.
The purpose of this study was to assess whether a fall-prevention tool kit that engages patients and families in the fall-prevention process throughout hospitalization is associated with reduced falls and injurious falls. Findings showed that, in this nonrandomized controlled trial, implementation of a fall-prevention tool kit was associated with a significant reduction in falls and related injuries. A patient-care team partnership appeared to be beneficial for prevention of falls and fall-related injuries.
AHRQ-funded; HS023535.
Citation: Dykes PC, Burns Z, Adelman J .
Evaluation of a patient-centered fall-prevention tool kit to reduce falls and injuries: a nonrandomized controlled trial.
JAMA Netw Open 2020 Nov 2;3(11):e2025889. doi: 10.1001/jamanetworkopen.2020.25889..
Keywords: Falls, Injuries and Wounds, Prevention, Tools & Toolkits, Patient and Family Engagement, Patient-Centered Healthcare, Clinical Decision Support (CDS), Hospitalization, Hospitals
Patterson ES, DiLoreto GN, Vanam R
Enhancing usefulness and usability of a clinical decision support prototype for antibiotic stewardship.
This paper describes a multi-method approach to improve clinical decision support (CDS) for antibiotic stewardship. A heuristic review was employed to generate recommendations to improve the usability of a prototype CDS in the hospital setting. The authors then engaged in a design improvement cycle in collaboration with software programmers that enhanced their prototype. The revised prototype was then demonstrated to physician and pharmacist subject matter experts in three walkthrough interviews. These interviews generated recommendations to improve the interface, functionality, and tailoring for groups of users. Common elements for the recommendations are discussed for models for using clinical decision support in general.
AHRQ-funded; HS024379.
Citation: Patterson ES, DiLoreto GN, Vanam R .
Enhancing usefulness and usability of a clinical decision support prototype for antibiotic stewardship.
Proc Int Symp Hum Factors Ergon Healthc 2020 Sep;9(1):61-65. doi: 10.1177/2327857920091034..
Keywords: Clinical Decision Support (CDS), Decision Making, Antimicrobial Stewardship, Antibiotics, Medication
Gale BM, Hall KK
The use of patient monitoring systems to improve sepsis recognition and outcomes: a systematic review.
This systematic review’s aim was to determine the impact of automated patient monitoring systems (PMSs) on sepsis recognition and outcomes. The review was conducted using articles published from 2008 through 2018. Nineteen articles were identified for inclusion with 4 systematic reviews and 15 individual studies. Study results for outcome measures were mixed, with more than half the studies showing a significant improvement in at least one outcome measure (eg mortality, intensive care unit length of stay, ICU transfer). Evidence for process measure improvement was of moderate strength across multiple hospital units.
AHRQ-funded; 233201500013I.
Citation: Gale BM, Hall KK .
The use of patient monitoring systems to improve sepsis recognition and outcomes: a systematic review.
J Patient Saf 2020 Sep;16(3S Suppl 1):S8-s11. doi: 10.1097/pts.0000000000000750..
Keywords: Clinical Decision Support (CDS), Sepsis, Diagnostic Safety and Quality, Screening, Outcomes, Patient-Centered Outcomes Research, Evidence-Based Practice
Joshi RP, Pejaver V, Hammarlund NE
A predictive tool for identification of SARS-CoV-2 PCR-negative emergency department patients using routine test results.
This retrospective case-control study investigated whether the use of a prediction tool based on complete blood count results and patient sex can better allocate testing for SARS-CoV-2 PCR testing in hospital emergency departments. Participants were emergency department patients who had concurrent complete blood counts and SARS-CoV-2 PCR testing in Northern California, Seattle, Washington, Chicago Illinois, and South Korea. A hypothetical scenario of 1000 patients requiring testing was developed, but in this scenario testing resources are limited to 60% of patients. This tool would allow a 33% increase in properly allocated resources.
AHRQ-funded; HS026385.
Citation: Joshi RP, Pejaver V, Hammarlund NE .
A predictive tool for identification of SARS-CoV-2 PCR-negative emergency department patients using routine test results.
J Clin Virol 2020 Aug;129:104502. doi: 10.1016/j.jcv.2020.104502..
Keywords: Emergency Department, COVID-19, Pneumonia, Respiratory Conditions, Diagnostic Safety and Quality, Clinical Decision Support (CDS)
Macheel C, Reicks P, Sybrant C
Clinical decision support intervention for rib fracture treatment.
The authors developed an evidence-based rib fracture protocol and clinical decision support intervention (CDSI) at their institution. The purpose of their study was to evaluate implementation and clinical outcomes using this CDSI. They found that the development and use of a CDSI resulted in improved provider delivery of evidence-based practice and was associated with reduced hospital length of stay.
AHRQ-funded; HS026379.
Citation: Macheel C, Reicks P, Sybrant C .
Clinical decision support intervention for rib fracture treatment.
J Am Coll Surg 2020 Aug;231(2):249-56.e2. doi: 10.1016/j.jamcollsurg.2020.04.023..
Keywords: Decision Making, Clinical Decision Support (CDS), Injuries and Wounds, Evidence-Based Practice