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- Adverse Events (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 16 of 16 Research Studies DisplayedManojlovich M, Harrod M, Hofer T
Factors influencing physician responsiveness to nurse-initiated communication: a qualitative study.
How quickly physicians respond to communications from bedside nurses is important for the delivery of safe inpatient care. Delays in physician responsiveness can impede care or contribute to patient harm. Understanding contributory factors to physician responsiveness can provide insights to promote timely physician response, possibly improving communication to ensure safe patient care. The purpose of this study was to describe the factors contributing to physician responsiveness to text or numeric pages, telephone calls and face-to-face messages delivered by nurses on adult general care units.
Citation: Manojlovich M, Harrod M, Hofer T .
Factors influencing physician responsiveness to nurse-initiated communication: a qualitative study.
BMJ Qual Saf 2021 Sep;30(9):747-54. doi: 10.1136/bmjqs-2020-011441..
Keywords: Provider: Physician, Provider: Nurse, Communication, Inpatient Care
Kelly MM, Smith CA, Hoonakker PLT
Stakeholder perspectives in anticipation of sharing physicians' notes with parents of hospitalized children.
Researchers sought to elicit stakeholder perspectives on the anticipated benefits and challenges of sharing hospital physicians' admission and daily progress notes with parents at the bedside during their child's hospitalization and to identify strategies to aid implementation of inpatient note sharing. Focus groups with 34 stakeholders at a children's hospital were conducted. The researchers identified four anticipated benefits of sharing inpatient notes, five expected challenges, and three suggested implementation strategies.
Citation: Kelly MM, Smith CA, Hoonakker PLT .
Stakeholder perspectives in anticipation of sharing physicians' notes with parents of hospitalized children.
Acad Pediatr 2021 Mar;21(2):259-64. doi: 10.1016/j.acap.2020.11.018..
Keywords: Children/Adolescents, Inpatient Care, Electronic Health Records (EHRs), Health Information Technology (HIT), Communication, Clinician-Patient Communication
McAlearney AS, Walker DM, Gaughan A
Helping patients be better patients: a qualitative study of perceptions about inpatient portal use.
This qualitative study looked at perceptions about inpatient portal use and its impact on patient experience and the care process. The authors interviewed 120 patients and 433 care team members across a seven-hospital academic medical center that offers an inpatient portal to hospitalized patients. Care team members felt the inpatient portal helped patients be “better patients” by improving their ability to be informed about their health and enabling them to be more involved in the care process. The care team members suggested portal use could be improved by addressing challenges with tablet administration, use of the patient education feature, and the functionality of the scheduling feature.
AHRQ-funded; HS024379; HS024091.
Citation: McAlearney AS, Walker DM, Gaughan A .
Helping patients be better patients: a qualitative study of perceptions about inpatient portal use.
Telemed J E Health 2020 Sep;26(9):1184-87. doi: 10.1089/tmj.2019.0198..
Keywords: Telehealth, Health Information Technology (HIT), Patient and Family Engagement, Clinician-Patient Communication, Communication, Inpatient Care, Hospitals
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
Khan A, Yin HS, Brach C
AHRQ Author: Brach C
Association between parent comfort with English and adverse events among hospitalized children.
The purpose of this study was to examine the association between parents’ limited comfort with English (LCE) and adverse events in a cohort of hospitalized children. Participants included Arabic-, Chinese-, English-, and Spanish-speaking parents of patients 17 years and younger in the pediatric units of seven North American hospitals. Findings showed that hospitalized children of parents expressing LCE were twice as likely to experience harms due to medical care. Targeted strategies are needed to improve communication and safety for this vulnerable group of children.
AHRQ-authored; AHRQ-funded; HS022986.
Citation: Khan A, Yin HS, Brach C .
Association between parent comfort with English and adverse events among hospitalized children.
JAMA Pediatr 2020 Dec;174(12):e203215. doi: 10.1001/jamapediatrics.2020.3215..
Keywords: Children/Adolescents, Caregiving, Cultural Competence, Clinician-Patient Communication, Communication, Adverse Events, Patient Safety, Inpatient Care, Hospitalization
Choe AY, Unaka NI, Schondelmeyer AC
Inpatient communication barriers and drivers when caring for limited english proficiency children.
The authors identified barriers to and drivers of effective interpreter service use when caring for hospitalized limited English proficiency (LEP) children from the perspectives of pediatric medical providers and interpreters. Using Group Level Assessment, they found that participants identified unique barriers and drivers that impact communication with LEP patients and their families during hospitalization. They suggested that future directions include exploring the perspective of LEP families and utilizing team-based and family-centered communication strategies to standardize and improve communication practices.
AHRQ-funded; HS025138.
Citation: Choe AY, Unaka NI, Schondelmeyer AC .
Inpatient communication barriers and drivers when caring for limited english proficiency children.
J Hosp Med 2019 Oct;14(10):607-13. doi: 10.12788/jhm.3240..
Keywords: Clinician-Patient Communication, Communication, Cultural Competence, Children/Adolescents, Inpatient Care, Patient and Family Engagement, Caregiving
Roche SD, Reichheld AM, Demosthenes N
Measuring the quality of inpatient specialist consultation in the intensive care unit: Nursing and family experiences of communication.
The purpose of this study was to document the receipt of communication by nurses and family members regarding consultations performed on their patient or loved one, and to quantify how this impacted their overall perceptions of the quality of specialty care. The investigators found that most ICU families and nurses had no interaction with specialist providers. They concluded that nurses' frequent exclusion from conversations about specialty care may pose safety risks and increase the likelihood of mixed messages for patients and families, most of whom desire some interaction with specialists.
AHRQ-funded; K08 HS024288.
Citation: Roche SD, Reichheld AM, Demosthenes N .
Measuring the quality of inpatient specialist consultation in the intensive care unit: Nursing and family experiences of communication.
PLoS One 2019 Apr 11;14(4):e0214918. doi: 10.1371/journal.pone.0214918..
Keywords: Clinician-Patient Communication, Communication, Quality of Care, Intensive Care Unit (ICU), Patient Experience, Inpatient Care
Sieck CJ, Walker DM, Hefner JL
Understanding secure messaging in the inpatient environment: a new avenue for communication and patient engagement.
Patient portals, and the secure messaging feature in particular, have been studied in the outpatient setting, but research in the inpatient setting is relatively less mature. In this study, the investigators analyzed and categorized messages sent within an inpatient portal to understand the topics discussed in secure messaging in the inpatient environment. They concluded that their analysis of secure message content suggested certain message types and topics such as Alerts/Requests and Questions about symptoms and treatment plans were particularly important to patients.
AHRQ-funded; HS024091; HS024349; HS024379.
Citation: Sieck CJ, Walker DM, Hefner JL .
Understanding secure messaging in the inpatient environment: a new avenue for communication and patient engagement.
Appl Clin Inform 2018 Oct;9(4):860-68. doi: 10.1055/s-0038-1675814..
Keywords: Clinician-Patient Communication, Communication, Electronic Health Records (EHRs), Health Information Technology (HIT), Inpatient Care, Patient and Family Engagement
Hefner JL, Sieck CJ, McAlearney AS
Training to optimize collaborative use of an inpatient portal.
Inpatient portals are an emerging technology that can facilitate collaborative interactions between patients and care teams, but little is known about how organizations attempt to implement and facilitate inpatient portal use for their providers. The investigators found that interviews with 220 care team members and 4 IT staff identified 3 new areas of training needed to optimize inpatient portal implementation and use that extend beyond training to use other technologies.
AHRQ-funded; HS024379; HS024091; HS024767.
Citation: Hefner JL, Sieck CJ, McAlearney AS .
Training to optimize collaborative use of an inpatient portal.
Appl Clin Inform 2018 Jul;9(3):558-64. doi: 10.1055/s-0038-1666993..
Keywords: Health Information Technology (HIT), Clinician-Patient Communication, Communication, Inpatient Care
Jones CD, Burke RE
Web exclusive. Annals for Hospitalists Inpatient Notes - getting past the "black box"-opportunities for hospitalists to improve postacute care transitions.
In this article, the authors outline 3 key problems in postacute care (PAC) transitions and offer potential solutions. They assert that improving hospitalists' knowledge of PAC, improving communication after hospital discharge, and creating mechanisms for feedback to hospitalists are all possible ways of getting past the PAC “black box.”
AHRQ-funded; HS024569.
Citation: Jones CD, Burke RE .
Web exclusive. Annals for Hospitalists Inpatient Notes - getting past the "black box"-opportunities for hospitalists to improve postacute care transitions.
Ann Intern Med 2018 May 15;168(10):H02 - H03. doi: 10.7326/m18-0940..
Keywords: Communication, Hospital Discharge, Inpatient Care, Transitions of Care
Parker MW, Carroll M, Bolser B
Implementation of a communication bundle for high-risk patients.
This study occurs in a large pediatric hospital with a history of success in decreasing unrecognized deterioration, in which patients at higher risk of deterioration are termed "watchers." Because communication errors often contribute to unrecognized deterioration, clear and timely communication of watcher status to all team members and contingency planning was desired. The researchers sought to increase the percentage of eligible watchers with a complete communication, teamwork, and planning bundle within 2 hours of identification from 28% to 80%.
AHRQ-funded; HS023827.
Citation: Parker MW, Carroll M, Bolser B .
Implementation of a communication bundle for high-risk patients.
Hosp Pediatr 2017 Sep;7(9):523-29. doi: 10.1542/hpeds.2016-0170..
Keywords: Children/Adolescents, Communication, Healthcare Delivery, Hospitals, Inpatient Care
Berger ZD, Boss EF, Beach MC
Communication behaviors and patient autonomy in hospital care: a qualitative study.
Researchers conducted an observational study of patient-doctor communication on an inpatient medicine service among 18 hospitalized patients and 9 physicians. They concluded that shared decision-making may not be the norm in hospital care. Although physicians do explain treatment plans, many hospitalized patients do not understand enough to share in decisions. When patients do assert their opinion, it can result in conflict.
AHRQ-funded; HS022932.
Citation: Berger ZD, Boss EF, Beach MC .
Communication behaviors and patient autonomy in hospital care: a qualitative study.
Patient Educ Couns 2017 Aug;100(8):1473-81. doi: 10.1016/j.pec.2017.03.006.
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Keywords: Communication, Shared Decision Making, Inpatient Care, Clinician-Patient Communication
Luxenberg A, Chan B, Khanna R
Efficiency and interpretability of text paging communication for medical inpatients: a mixed-methods analysis.
The purpose of this analysis was to investigate text page message content and structure, focusing on efficiency and safety. The authors analyzed the messages generated at an academic tertiary care hospital sent or received by hospital staff via an internal service, including those relating to the care of specific patients. While most messages were nonurgent, those that were lacked consistent language to indicate urgency. The authors conclude that text paging has significant limitations for real-time communication in acute-care settings, and their data should be a basis to inform the development of guidelines on the effective, efficient use of text paging.
AHRQ-funded; HS023558.
Citation: Luxenberg A, Chan B, Khanna R .
Efficiency and interpretability of text paging communication for medical inpatients: a mixed-methods analysis.
JAMA Intern Med 2017 Aug;177(8):1218-20. doi: 10.1001/jamainternmed.2017.2133..
Keywords: Communication, Inpatient Care, Hospitals, Patient Safety
Fisher K, Smith K, Gallagher T
We want to know: eliciting hospitalized patients' perspectives on breakdowns in care.
Researchers interviewed a broad sample of patients during hospitalization and postdischarge to elicit patient perspectives on breakdowns in care. When asked directly, almost 4 out of 10 hospitalized patients reported a breakdown in their care. Patient- perceived breakdowns in care are frequently associated with perceived harm, illustrating the importance of detecting and addressing these events.
AHRQ-funded; HS024596; HS022757.
Citation: Fisher K, Smith K, Gallagher T .
We want to know: eliciting hospitalized patients' perspectives on breakdowns in care.
J Hosp Med 2017 Aug;12(8):603-09. doi: 10.12788/jhm.2783.
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Keywords: Communication, Quality of Care, Inpatient Care, Patient Experience, Patient-Centered Outcomes Research
Michelson KA, Ho T, Pelletier A
A mobile, collaborative, real time task list for inpatient environments.
The researchers created a mobile, collaborative, real-time task list application on the iOS platform. They then described their experience designing and piloting the application with an inpatient pediatric ward team at an academic pediatric hospital. They found that physicians preferred the immediacy and familiarity of paper, and did not experience an efficiency benefit when using the electronic tasklist.
AHRQ-funded; HS000063.
Citation: Michelson KA, Ho T, Pelletier A .
A mobile, collaborative, real time task list for inpatient environments.
Appl Clin Inform 2015 Nov 18;6(4):677-83. doi: 10.4338/aci-2015-05-cr-0050.
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Keywords: Care Management, Communication, Health Information Technology (HIT), Inpatient Care, Health Information Technology (HIT)
Dykes PC, Stade D, Dalal A
Strategies for managing mobile devices for use by hospitalized inpatients.
The authors implemented the PROSPECT (Promoting Respect and Ongoing Safety through Patient-centeredness, Engagement, Communication and Technology) project at Brigham and Women's Hospital. The goal of PROSPECT is to transform the hospital environment by providing a suite of e-tools to facilitate teamwork. In this paper, the authors described decisions and challenges faced and related the strategies used and lessons learned.
AHRQ-funded; HS023535.
Citation: Dykes PC, Stade D, Dalal A .
Strategies for managing mobile devices for use by hospitalized inpatients.
AMIA Annu Symp Proc 2015 Nov 5;2015:522-31.
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Keywords: Communication, Inpatient Care, Patient and Family Engagement, Patient Safety, Teams