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- Ambulatory Care and Surgery (1)
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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 11 of 11 Research Studies DisplayedUsher MC, Tignanelli CJ, Hilliard B
Responding to COVID-19 through interhospital resource coordination: a mixed-methods evaluation
Researchers sought to describe a novel hospital system approach to managing the COVID-19 pandemic, including multihospital coordination capability and transfer of COVID-19 patients to a single, dedicated hospital. They found that, with standardized communication, interhospital transfers were a safe and effective method of cohorting COVID-19 patients, were well-received by health care providers, and had the potential to improve care quality.
AHRQ-funded; HS026379; HS026732.
Citation: Usher MC, Tignanelli CJ, Hilliard B .
Responding to COVID-19 through interhospital resource coordination: a mixed-methods evaluation
J Patient Saf 2022 Jun 1;18(4):287-94. doi: 10.1097/pts.0000000000000916..
Keywords: COVID-19, Hospitals, Healthcare Delivery, Public Health, Care Coordination, Transitions of Care
Kranz AM, Steiner ED, Mitchell JM
School-based health services in Virginia and the COVID-19 pandemic.
The purpose of this study was to examine how the COVID-19 pandemic may have impacted the provision of school health services and related student needs. In May 2021, all 1178 Virginia public elementary schools received a web-based survey regarding the impact of the pandemic on school-based health services, with 65% of schools responding (N=767). Schools reported providing fewer school-based health services during the pandemic than before, with dental screenings declining the most (51% before vs 15% after). The study also reported that mental health as a top concern for students increased from 15% before the pandemic to 27% during the pandemic. The study concluded that schools reported providing fewer health services to students during pandemic in the 2020-2021 school year and increased concern about students' mental health.
AHRQ-funded; HS025430.
Citation: Kranz AM, Steiner ED, Mitchell JM .
School-based health services in Virginia and the COVID-19 pandemic.
J Sch Health 2022 May;92(5):436-44. doi: 10.1111/josh.13147..
Keywords: COVID-19, Children/Adolescents, Public Health, Healthcare Delivery, Community-Based Practice
Vranas KC, Golden SE, Mathews KS
The influence of the COVID-19 pandemic on ICU organization, care processes, and frontline clinician experiences: a qualitative study.
The COVID-19 pandemic resulted in unprecedented adjustments to intensive care unit (ICU) organization and care processes globally. The investigators examined if hospital emergency responses to the COVID-19 pandemic differed depending on hospital setting and explored which strategies worked well to mitigate strain as perceived by intensivists. The investigators concluded that their study demonstrated the importance of trust and transparency between frontline staff and hospital leadership as key components of effective emergency responses during public health crises.
AHRQ-funded; HS028038.
Citation: Vranas KC, Golden SE, Mathews KS .
The influence of the COVID-19 pandemic on ICU organization, care processes, and frontline clinician experiences: a qualitative study.
Chest 2021 Nov;160(5):1714-28. doi: 10.1016/j.chest.2021.05.041..
Keywords: COVID-19, Intensive Care Unit (ICU), Critical Care, Healthcare Delivery, Workforce, Public Health
Anesi GL, Kerlin MP
The impact of resource limitations on care delivery and outcomes: routine variation, the coronavirus disease 2019 pandemic, and persistent shortage.
Researchers discuss the impact of resource limitations on care delivery and outcomes. They conclude that the interaction between resource limitation and care delivery and outcomes is complex and incompletely understood. Further, the COVID-19 pandemic provides a learning opportunity for strain response during both pandemic and non-pandemic times.
AHRQ-funded; HS026372.
Citation: Anesi GL, Kerlin MP .
The impact of resource limitations on care delivery and outcomes: routine variation, the coronavirus disease 2019 pandemic, and persistent shortage.
Curr Opin Crit Care 2021 Oct 1;27(5):513-19. doi: 10.1097/mcc.0000000000000859..
Keywords: COVID-19, Public Health, Healthcare Delivery, Intensive Care Unit (ICU), Outcomes
Barbash IJ, Kahn JM
Fostering hospital resilience-lessons from COVID-19.
This article describes how hospitals can foster organizational resistance using lessons from the COVID-19 pandemic. They describe what resilience would look like including: 1) resilient hospitals would respond to a surge in COVID-19 cases in ways that ensure the delivery of high-quality care for patients with the disease; 2) resilient hospitals would response to COVID-19 surges in ways that preserve standards of care for patients without COVID-19; 3) resilient hospitals would preserve access to care for the entire community of patients they serve, including continuing elective surgeries and mitigating effects of health disparities; and 4) resilient hospitals would do all of this while protecting the well-being of frontline staff. Protection of front-line staff includes ensuring adequate personal protective equipment as well as through clear communication from leaders. Factors that foster resilience are described including well-developed, scalable clinical protocols, flexible electronic health records, and a supportive, interdisciplinary working environment in which all team members feel safe to raise concerns and share new ideas. Resilience might also be fostered among hospitals through their interactions.
AHRQ-funded; HS025455.
Citation: Barbash IJ, Kahn JM .
Fostering hospital resilience-lessons from COVID-19.
JAMA 2021 Aug 24; 326(8):693-94. doi: 10.1001/jama.2021.12484..
Keywords: COVID-19, Hospitals, Healthcare Delivery, Public Health
Hofstetter AM, Schaffer S
Childhood and adolescent vaccination in alternative settings.
This article reviews the unique advantages, challenges, and experiences regarding vaccine delivery in alternative settings, such as schools, emergency rooms, hospitals, and pharmacies. It describes the key components that each setting must possess as well as other important factors to consider when assessing the ability of each to deliver vaccines to the children and adolescents they serve. It is important to emphasize that these settings should not replace the medical home as the primary location for vaccination, but rather serve as a critical safety net for high-risk individuals and communities and in situations where access to traditional locations may be limited, such as during the COVID-19 pandemic.
AHRQ-funded; HS025470.
Citation: Hofstetter AM, Schaffer S .
Childhood and adolescent vaccination in alternative settings.
Acad Pediatr 2021 May-Jun;21(4s):S50-s56. doi: 10.1016/j.acap.2021.02.001..
Keywords: Children/Adolescents, Vaccination, Healthcare Delivery, Public Health
Misra-Hebert AD, Ji X, Nowacki AS
Impact of the COVID-19 pandemic on healthcare workers' risk of infection and outcomes in a large, integrated health system.
Researchers assessed healthcare workers (HCW) risk for COVID-19 infection, hospitalization, and intensive care unit (ICU) admission. Participants were individuals who had tested for SARS-CoV-2 infection in a large academic healthcare system. The study found that, in a large healthcare system, HCW had similar odds for testing positive, but lower odds of hospitalization, compared to non-HCW. Patient-facing HCW had higher odds of a positive test.
AHRQ-funded; HS024128.
Citation: Misra-Hebert AD, Ji X, Nowacki AS .
Impact of the COVID-19 pandemic on healthcare workers' risk of infection and outcomes in a large, integrated health system.
J Gen Intern Med 2020 Nov;35(11):3293-301. doi: 10.1007/s11606-020-06171-9..
Keywords: COVID-19, Risk, Provider: Health Personnel, Public Health, Healthcare Delivery, Infectious Diseases
Auerbach A, O'Leary KJ, Greysen SR
Hospital ward adaptation during the COVID-19 pandemic: a national survey of academic medical centers.
The authors sought to characterize inpatient adaptations to care for non-ICU COVID-19 patients. They found that the COVID-19 pandemic has required medical wards to rapidly adapt with expanding use of respiratory isolation units and use of technology emerging as critical approaches. Reports of unrecognized or delayed diagnoses highlight how such adaptations may produce potential adverse effects on care.
AHRQ-funded; HS026383; HS026215; HS027369.
Citation: Auerbach A, O'Leary KJ, Greysen SR .
Hospital ward adaptation during the COVID-19 pandemic: a national survey of academic medical centers.
J Hosp Med 2020 Aug;15(8):483-88. doi: 10.12788/jhm.3476..
Keywords: COVID-19, Emergency Preparedness, Hospitals, Public Health, Healthcare Delivery, Inpatient Care
Khazanie P, Wynia MK, Dickert NW. P, Wynia MK, Dickert NW
Forced choices: ethical challenges in cardiology during the COVID-19 pandemic.
This article discusses the ethical dilemmas that cardiologists may face with cardiac patients due to the COVID-19 pandemic. The influx of patients threatens to exhaust resources in many hospitals and creates many challenges. These include determining the urgency of subacute and chronic cardiovascular diseases. Another challenge is critical care triage in cardiac patients. Protocols were developed during the 2009 H1N1 pandemic which are now adapted for the COVID-19 pandemic. The largest challenge has been interacting with patients and their families. A cardiac patient may not be able to go to an intensive care unit due to severe scarcity of beds and to minimize risks to them and the medical staff.
AHRQ-funded; R01 HS026081.
Citation: Khazanie P, Wynia MK, Dickert NW. P, Wynia MK, Dickert NW .
Forced choices: ethical challenges in cardiology during the COVID-19 pandemic.
Circulation 2020 Jul 21;142(3):194-96. doi: 10.1161/circulationaha.120.047681..
Keywords: COVID-19, Cardiovascular Conditions, Heart Disease and Health, Public Health, Healthcare Delivery
Shaker MS, Oppenheimer J, Grayson M
COVID-19: pandemic contingency planning for the allergy and immunology clinic.
In the event of a global infectious pandemic, drastic measures may be needed that limit or require adjustment of ambulatory allergy services. However, no rationale for how to prioritize service shut down and patient care exists. A consensus-based ad-hoc expert panel of allergy/immunology specialists from the United States and Canada developed a service and patient prioritization schematic to temporarily triage allergy/immunology services. This paper describes the process, recommendations and feedback.
AHRQ-funded; HS024599.
Citation: Shaker MS, Oppenheimer J, Grayson M .
COVID-19: pandemic contingency planning for the allergy and immunology clinic.
J Allergy Clin Immunol Pract 2020 May;8(5):1477-88.e5. doi: 10.1016/j.jaip.2020.03.012..
Keywords: COVID-19, Respiratory Conditions, Emergency Preparedness, Public Health, Healthcare Delivery, Ambulatory Care and Surgery, Infectious Diseases
Fraze T, Lewis VA, Rodriguez HP
Housing, transportation, and food: how ACOs seek to improve population health by addressing nonmedical needs of patients.
The authors examined how accountable care organizations (ACOs) addressed the nonmedical needs of their patients. They found that ACOs most commonly addressed the need for transportation, housing, and food insecurity, which they identified through the primary care visit or care transformation programs. They concluded that their findings offer insights into how health care organizations such as ACOs integrate themselves with nonmedical organizations.
AHRQ-funded; HS024792.
Citation: Fraze T, Lewis VA, Rodriguez HP .
Housing, transportation, and food: how ACOs seek to improve population health by addressing nonmedical needs of patients.
Health Aff 2016 Nov;35(11):2109-15. doi: 10.1377/hlthaff.2016.0727.
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Keywords: Social Determinants of Health, Patient-Centered Healthcare, Health Insurance, Healthcare Delivery, Primary Care, Public Health