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Topics
- Access to Care (1)
- 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 14 of 14 Research Studies DisplayedKimmey L, Furukawa MF, Jones DJ
AHRQ Author: Furukawa MF
Geographic variation in the consolidation of physicians into health systems, 2016-18.
The authors asked the following questions: To what extent does consolidation of physicians into vertically integrated health systems vary across markets, and how did that change from 2016 to 2018? In this article, they used AHRQ data on health systems and commercial data on physician-system affiliation to describe metropolitan statistical area-level physician consolidation and to identify differences by region and metropolitan statistical area size.
AHRQ-authored; AHRQ-funded; 290201600001C.
Citation: Kimmey L, Furukawa MF, Jones DJ .
Geographic variation in the consolidation of physicians into health systems, 2016-18.
Health Aff 2021 Jan;40(1):165-69. doi: 10.1377/hlthaff.2020.00812..
Keywords: Health Systems, Provider: Physician, Provider, Healthcare Delivery
Jones AE, King JB, Kim K
The role of clinical pharmacy anticoagulation services in direct oral anticoagulant monitoring.
The objective of this study was to describe direct oral anticoagulant (DOAC) management in patients who were and were not managed by an anticoagulation management service (AMS). Subjects were patients with atrial fibrillation at the University of Utah Health (UUH) who received DOAC therapy. Results showed that patients managed by AMS providers were more complex and had more frequent encounters regarding their DOAC therapy than those managed by non-AMS providers. However, there was evidence of duplicative DOAC therapy management efforts. No difference between AMS and non-AMS groups in the composite clinical endpoint was detected.
AHRQ-funded; HS026156.
Citation: Jones AE, King JB, Kim K .
The role of clinical pharmacy anticoagulation services in direct oral anticoagulant monitoring.
J Thromb Thrombolysis 2020 Oct;50(3):739-45. doi: 10.1007/s11239-020-02064-0..
Keywords: Blood Thinners, Medication, Provider: Pharmacist, Provider, Care Management, Healthcare Delivery
Manojlovich M, Harrod M, Hofer TP
Using qualitative methods to explore communication practices in the context of patient care rounds on general care units.
This study examined communication practices between nurses and physicians in general care units at 4 Midwestern hospitals. A total of 163 physicians, registered nurses, and nurse practitioners participated. The researchers observed and shadowed clinicians during rounds and other times during a 2 week period as well as conducting interviews and holding focus groups. Workflow differences affected rounds and subsequently communication practices. Good rapport between physicians and nurses contributed to nurse participation during rounds. Lower rapport made some nurses feel uncomfortable accompanying physicians during rounds unless invited.
AHRQ-funded; HS022305.
Citation: Manojlovich M, Harrod M, Hofer TP .
Using qualitative methods to explore communication practices in the context of patient care rounds on general care units.
J Gen Intern Med 2020 Mar;35(3):839-45. doi: 10.1007/s11606-019-05580-9..
Keywords: Communication, Provider: Physician, Provider: Nurse, Provider, Hospitals, Teams, Inpatient Care, Healthcare Delivery
Squires A, Miner S, Liang E
How language barriers influence provider workload for home health care professionals: A secondary analysis of interview data.
Increasingly, patients with limited English proficiency are accessing home health care services in the United States. Few studies have examined how language barriers influence provider role implementation or workload in the home health care setting. The objective of this study was to explore home health care professionals' perspectives about how workload changes from managing language barriers influence quality and safety in home health care.
AHRQ-funded; HS023593.
Citation: Squires A, Miner S, Liang E .
How language barriers influence provider workload for home health care professionals: A secondary analysis of interview data.
Int J Nurs Stud 2019 Nov;99:103394. doi: 10.1016/j.ijnurstu.2019.103394..
Keywords: Home Healthcare, Cultural Competence, Communication, Provider, Healthcare Delivery
Hoonakker PLT, Wooldridge AR, Hose BZ
Information flow during pediatric trauma care transitions: things falling through the cracks.
In order to investigate information flow during pediatric trauma care transitions, researchers interviewed 18 clinicians about communication and coordination between the emergency department, operating room, and pediatric intensive care unit, then surveyed the clinicians about patient safety during these transitions. They found that, despite the fact that the many services and units involved in pediatric trauma cooperate well together during trauma cases, important patient care information is often lost when transitioning patients between units. To manage the transition of this fragile and complex population better, they recommend finding ways to manage the information flow during these transitions better by, for instance, providing technological support to ensure shared mental models.
AHRQ-funded; HS023837.
Citation: Hoonakker PLT, Wooldridge AR, Hose BZ .
Information flow during pediatric trauma care transitions: things falling through the cracks.
Intern Emerg Med 2019 Aug;14(5):797-805. doi: 10.1007/s11739-019-02110-7..
Keywords: Children/Adolescents, Communication, Emergency Department, Healthcare Delivery, Intensive Care Unit (ICU), Patient Safety, Provider, Provider: Clinician, Surgery, Transitions of Care, Trauma
Mueller SK, Schnipper JL
Physician perspectives on interhospital transfers.
This study examined physician perspectives of the common problems that occur during acute care hospital interhospital transfers. The process tends to be nonstandardized which creates a number of issues. These issues include: patients sometimes, frequently, or always arriving without required specialized care (56% of the time), arriving with unrealistic expectations of care (77.2% of responses), arrived more than 24 hours after accepted transfer in 80.1% of responses, and arrived without necessary transfer records 86.9% of the time. The last issue and also time of day of arrival many physicians felt posed a risk to the transferred patients.
AHRQ-funded; HS023331.
Citation: Mueller SK, Schnipper JL .
Physician perspectives on interhospital transfers.
J Patient Saf 2019 Jun;15(2):86-89. doi: 10.1097/pts.0000000000000312..
Keywords: Healthcare Delivery, Hospitals, Patient Safety, Provider, Provider: Physician, Transitions of Care
Jarrin OF, Pouladi FA, Madigan EA
International priorities for home care education, research, practice, and management: qualitative content analysis.
The purpose of this study was to articulate an international vision for the future of home care education, research, practice, and management shared by experienced home care nurses working in leadership roles. Four major themes emerged, in this qualitative study, reflecting international priorities for the future of home care education, research, practice, and management: 1) Build the evidence base for home care; 2) Design better systems of care; 3) Develop leaders at all levels; and 4) Address payment and policy issues.
AHRQ-funded; HS022406.
Citation: Jarrin OF, Pouladi FA, Madigan EA .
International priorities for home care education, research, practice, and management: qualitative content analysis.
Nurse Educ Today 2019 Feb;73:83-87. doi: 10.1016/j.nedt.2018.11.020..
Keywords: Education: Continuing Medical Education, Healthcare Delivery, Home Healthcare, Nursing, Provider
Auger KA, Shah SS, Tubbs-Cooley HL
Effects of a 1-time nurse-led telephone call after pediatric discharge: the H2O II randomized clinical trial.
The purpose of this study was to determine whether a single nurse-led telephone call after pediatric discharge decreased the 30-day reutilization rate for urgent care services and enhanced overall transition success. The investigators concluded that although postdischarge nurse contact did not decrease the reutilization rate of postdischarge urgent health care services, the method showed promise to bolster postdischarge education.
AHRQ-funded; HS024735.
Citation: Auger KA, Shah SS, Tubbs-Cooley HL .
Effects of a 1-time nurse-led telephone call after pediatric discharge: the H2O II randomized clinical trial.
JAMA Pediatr 2018 Sep;172(9):e181482. doi: 10.1001/jamapediatrics.2018.1482..
Keywords: Care Coordination, Children/Adolescents, Health Information Technology (HIT), Health Services Research (HSR), Healthcare Delivery, Healthcare Utilization, Hospital Discharge, Outcomes, Provider, Provider: Nurse, Telehealth, Transitions of Care
Kannampallil TG, Denton CA, Shapiro JS
Efficiency of emergency physicians: insights from an observational study using EHR log files.
The authors investigated the nature of electronic health records use and their effect on an emergency department's throughput and efficiency. They found that longer time spent on reviewing information on the electronic health record is potentially associated with decreased emergency department throughput efficiency. The authors also note that balancing between these competing goals is a challenge for physicians, and implications for patient safety are discussed.
AHRQ-funded; HS022670.
Citation: Kannampallil TG, Denton CA, Shapiro JS .
Efficiency of emergency physicians: insights from an observational study using EHR log files.
Appl Clin Inform 2018 Jan;9(1):99-104. doi: 10.1055/s-0037-1621705..
Keywords: Electronic Health Records (EHRs), Emergency Department, Healthcare Delivery, Health Information Technology (HIT), Provider, Provider: Physician
Kim LY, Rose DE, Soban LM
Primary care tasks associated with provider burnout: findings from a Veterans Health Administration survey.
The purpose of this study was to investigate (1) the extent to which primary care providers (PCPs) share responsibility for 14 discrete primary care tasks with other team members, and (2) which, if any, of the primary care tasks performed by the PCPs (without reliance on team members) are associated with PCP burnout.
AHRQ-funded; HS000046.
Citation: Kim LY, Rose DE, Soban LM .
Primary care tasks associated with provider burnout: findings from a Veterans Health Administration survey.
J Gen Intern Med 2018 Jan;33(1):50-56. doi: 10.1007/s11606-017-4188-6..
Keywords: Healthcare Delivery, Health Services Research (HSR), Patient-Centered Healthcare, Primary Care, Provider, Workforce
Ray KN, Martsolf GR, Mehrotra A
Trends in visits to specialist physicians involving nurse practitioners and physician assistants, 2001 to 2013.
The purpose of this study is to examine trends in specialist physician visits where nurse practitioners (NPs) and physician assistants (PAs) provide care, based on the hypothesis that NPs and PAs provide care to patients of specialist physicians in increasing numbers, primarily for routine follow-up visits. Using the National Ambulatory Medical Care Survey (NAMCS) information on samples office visits, researchers identified visits to specialist physicians, divided these into surgical and medical specialists and examined unadjusted trends from 2001 - 2013 in the percentage of visits with NP or PA involvement. Visit characteristics associated with higher likelihood of NP or PA involvement were examined.
AHRQ-funded; HS022989.
Citation: Ray KN, Martsolf GR, Mehrotra A .
Trends in visits to specialist physicians involving nurse practitioners and physician assistants, 2001 to 2013.
JAMA Intern Med 2017 Aug;177(8):1213-16. doi: 10.1001/jamainternmed.2017.1630..
Keywords: Access to Care, Ambulatory Care and Surgery, Healthcare Delivery, Primary Care, Provider
Werner NE, Gurses AP, Leff B
Improving care transitions across healthcare settings through a human factors approach.
This article describes how a systems' approach known as Human Factors and Ergonomics can complement and further strengthen efforts to improve care transitions.
AHRQ-funded; HS022916.
Citation: Werner NE, Gurses AP, Leff B .
Improving care transitions across healthcare settings through a human factors approach.
J Healthc Qual 2016 Nov/Dec;38(6):328-43. doi: 10.1097/jhq.0000000000000025.
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Keywords: Healthcare Delivery, Provider, Hospital Discharge, Patient Safety, Transitions of Care
Tucker CM, Wall WA, Wippold G
Development of an inventory for health-care office staff to self-assess their patient-centered cultural sensitivity.
The researchers sought to determine the psychometric properties of the Tucker-Culturally Sensitive Health Care Office Staff Inventory-Self-Assessment Form (T-CSHCOSI-SAF). They found that this inventory has 2 factors with high internal consistency reliability. They concluded that the T-CSHCOSI-SAF is a useful inventory for health-care office staff to assess their own level of patient-centered cultural sensitivity and that it can be used in the development and implementation of trainings to promote patient-centered cultural sensitivity of health-care office staff.
AHRQ-funded; HS013151; HS010726.
Citation: Tucker CM, Wall WA, Wippold G .
Development of an inventory for health-care office staff to self-assess their patient-centered cultural sensitivity.
Health Serv Res Manag Epidemiol 2016 Apr 27;3. doi: 10.1177/2333392816629600.
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Keywords: Healthcare Delivery, Cultural Competence, Patient-Centered Healthcare, Primary Care, Provider
Pylypchuk Y, Sarpong E
AHRQ Author: Pylypchuk Y, Sarpong E
Nurse practitioners and their effects on visits to primary care physicians.
The researchers examined the effects of visits to nurse practitioners (NPs) on the demand for primary care physician services. Using a system of simultaneous equations where states’ education requirements for NPs are an identifying exclusion restriction, they found that patients who visit an NP are significantly less likely to visit PCPs, and to receive prescribed medication, medical check-up, and diagnosis from PCPs.
AHRQ-authored
Citation: Pylypchuk Y, Sarpong E .
Nurse practitioners and their effects on visits to primary care physicians.
B E J Econom Anal Policy 2015 Apr;15(2):837–64..
Keywords: Healthcare Delivery, Education: Continuing Medical Education, Primary Care, Provider, Workforce