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Search All Research Studies
Topics
- Adverse Events (1)
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- (-) Care Management (15)
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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 15 of 15 Research Studies DisplayedSiddique SM, Tipton K, Leas B
Interventions to reduce hospital length of stay in high-risk populations: a systematic review.
Many strategies to reduce hospital length of stay (LOS) have been implemented, but few studies have evaluated hospital-led interventions focused on high-risk populations. The Agency for Healthcare Research and Quality (AHRQ) Learning Health System panel commissioned this study to further evaluate system-level interventions for LOS reduction. The objective of this study was to identify and synthesize evidence regarding potential systems-level strategies to reduce LOS for patients at high risk for prolonged LOS.
AHRQ-funded; 75Q80120D00002.
Citation: Siddique SM, Tipton K, Leas B .
Interventions to reduce hospital length of stay in high-risk populations: a systematic review.
JAMA Netw Open 2021 Sep;4(9):e2125846. doi: 10.1001/jamanetworkopen.2021.25846..
Keywords: Learning Health Systems, Health Systems, Evidence-Based Practice, Hospital Discharge, Risk, Inpatient Care, Care Management
Kohn R, Harhay MO, Bayes B
Influence of bedspacing on outcomes of hospitalised medicine service patients: a retrospective cohort study.
The objective of this cohort study was to assess the association of bedspacing with patient-centered outcomes among United States patients admitted to general medicine services. The study compared internal medicine, family medicine and geriatric service patients who were bedspaced versus cohorted for the entirety of their hospital stay within three large, urban hospitals. Findings showed that bedspacing was associated with adverse patient-centered outcomes. Recommendations for future work included a need to confirm these findings, to understand mechanisms contributing to adverse outcomes, and to identify factors that mitigate these adverse effects in order to provide high-value, patient-centered care to hospitalized patients.
AHRQ-funded; HS026372.
Citation: Kohn R, Harhay MO, Bayes B .
Influence of bedspacing on outcomes of hospitalised medicine service patients: a retrospective cohort study.
BMJ Qual Saf 2021 Feb;30(2):116-22. doi: 10.1136/bmjqs-2019-010675..
Keywords: Patient-Centered Outcomes Research, Outcomes, Inpatient Care, Hospitals, Healthcare Delivery, Care Management, Adverse Events
Cotter JM, Tyler A, Reese J
Steroid variability in pediatric inpatient asthmatics: survey on provider preferences of dexamethasone versus prednisone.
This study looked at pediatric emergency department (ED) inpatient use of dexamethasone versus prednisone by providers for asthma treatment. A survey was distributed to providers who care for inpatient asthmatics. Ninety-two providers completed the survey. When patients received dexamethasone in the ED, 44% continued dexamethasone, 14% switched to prednisone, 2% stopped steroid use, and 40% said it depended on the circumstances. Hospitalists were significantly more likely to continue dexamethasone than pulmonologists (61% versus 15%). Switching to prednisone included factors such as severity of exacerbation (73%) and asthma history (47%). Just over half of providers (5f1%) felt uncomfortable using dexamethasone because of “minimal data to support [its] use inpatient.”
AHRQ-funded; HS026512.
Citation: Cotter JM, Tyler A, Reese J .
Steroid variability in pediatric inpatient asthmatics: survey on provider preferences of dexamethasone versus prednisone.
J Asthma 2020 Sep;57(9):942-48. doi: 10.1080/02770903.2019.1622713..
Keywords: Children/Adolescents, Asthma, Respiratory Conditions, Medication, Inpatient Care, Care Management, Hospitalization, Emergency Department, Practice Patterns, Provider: Physician, Provider
Kaiser SV, Jennings B, Rodean J
Pathways for improving inpatient pediatric asthma care (PIPA): a multicenter, national study.
This study examined whether implementation of a pathway strategy for inpatient pediatric asthma patients improve outcomes for these patients. Outcomes measured included length of stay (LOS), early administration of metered-dose inhalers, screening for secondhand tobacco exposure and referral to cessation resources, and 7-day hospital readmissions or emergency revisits. Eighty-five hospitals were enrolled and 68 completed the study with (n=12,013) admissions. Pathways were associated with increases in early administration of metered-dose inhalers, and referral to smoking cessation resources, but no statistically significant changes in the other outcomes were observed. Most hospitals did improve in at least one outcome.
AHRQ-funded; HS024592; HS024554.
Citation: Kaiser SV, Jennings B, Rodean J .
Pathways for improving inpatient pediatric asthma care (PIPA): a multicenter, national study.
Pediatrics 2020 Jun;145(6):e20193026. doi: 10.1542/peds.2019-3026..
Keywords: Children/Adolescents, Asthma, Respiratory Conditions, Inpatient Care, Patient-Centered Outcomes Research, Outcomes, Hospitalization, Care Management
Bonafide CP, Xiao R, Brady PW
Prevalence of continuous pulse oximetry monitoring in hospitalized children with bronchiolitis not requiring supplemental oxygen.
This study examined the use of continuous pulse oximetry monitoring in hospitalized children with bronchiolitis who do not require supplemental oxygen. US national guidelines discourage the use but the practice was found to be still fairly widespread. The researchers conducted a multicenter, cross-sectional study of pediatric wards in 56 US and Canadian hospitals in the Pediatric Research in Inpatient Settings Network from December 2018 through March 2019. Patients aged 8 weeks through 23 months were included as a convenience sample. Overall usage was found to be 46% ranging from 6% to 82%.
AHRQ-funded; HS026763.
Citation: Bonafide CP, Xiao R, Brady PW .
Prevalence of continuous pulse oximetry monitoring in hospitalized children with bronchiolitis not requiring supplemental oxygen.
JAMA 2020 Apr 21;323(15):1467-77. doi: 10.1001/jama.2020.2998..
Keywords: Children/Adolescents, Respiratory Conditions, Inpatient Care, Hospitalization, Care Management, Evidence-Based Practice
Kreutzer L, Yang AD, Sansone C
Barriers to providing VTE chemoprophylaxis to hospitalized patients: a nursing-focused qualitative evaluation.
This study analyzed barriers for administration of VTE chemoprophylaxis to hospitalized patients from nurses. Researchers conducted 14 focus group interviews with nurses from five inpatient units to assess their perceptions of barriers to administration of VTE chemoprophylaxis. Barriers included nurses’ misconceptions that patients did not require chemoprophylaxis, their uncertainty when counseling patients on the importance of chemoprophylaxis, and a lack of comparative data regarding specific refusal rates.
AHRQ-funded; HS024516.
Citation: Kreutzer L, Yang AD, Sansone C .
Barriers to providing VTE chemoprophylaxis to hospitalized patients: a nursing-focused qualitative evaluation.
J Hosp Med 2019 Nov 1;14(10):668-72. doi: 10.12788/jhm.3290..
Keywords: Blood Clots, Patient Safety, Prevention, Inpatient Care, Care Management, Nursing
Chan CW, Green LV, Lekwijit S
Assessing the impact of service level when customer needs are uncertain: an empirical investigation of hospital step-down units.
In this study, the authors focused on estimating costs and benefits in a complex healthcare setting where the major differentiation among server types is the intensity of the service provided. They used data from ten hospitals and found that a step-down unit may be a cost-effective way to treat patients when used for those who are post-intensive care unit. However, they also found that the impact of step-down-unit care is more nuanced for patients admitted from the emergency department and may result in increased mortality risk and hospital length of stay for patients who should be treated in the intensive care unit. The authors recommended more study in this area.
AHRQ-funded; HS018480.
Citation: Chan CW, Green LV, Lekwijit S .
Assessing the impact of service level when customer needs are uncertain: an empirical investigation of hospital step-down units.
Management Science 2019 Feb;65(2):751-75. doi: 10.1287/mnsc.2017.2974..
Keywords: Care Management, Healthcare Costs, Healthcare Delivery, Hospitals, Inpatient Care
Wang D, Ing C, Blinderman CD
Latent class analysis of specialized palliative care needs in adult intensive care units from a single academic medical center.
The purpose of this study was to use latent class analysis to separate ICU patients into different classes of palliative care needs, and to determine if these classes differ in their resource requirements. Using information from ICU patients who received specialized palliative care, researchers extracted reason(s) for consultation from the initial note and entered it into a latent class analysis model to generate mutually exclusive patient classes. Four classes were identified: Pain and Symptom Management, Goals of Care and Advance Directives (GCAD), All Needsand Supportive Care. GCAD patients were least likely to be high utilizers.
AHRQ-funded; HS022941.
Citation: Wang D, Ing C, Blinderman CD .
Latent class analysis of specialized palliative care needs in adult intensive care units from a single academic medical center.
J Pain Symptom Manage 2019 Jan;57(1):73-78. doi: 10.1016/j.jpainsymman.2018.10.270..
Keywords: Care Management, Inpatient Care, Intensive Care Unit (ICU), Palliative Care
Shuman CJ, Xie XJ, Herr KA
Sustainability of evidence-based acute pain management practices for hospitalized older adults.
This article reported on the sustainability of evidence-based acute pain management practices in hospitalized older adults following testing of a multifaceted Translating Research Into Practice (TRIP) implementation intervention. Results revealed most evidence-based acute pain management practices were sustained for 18 months following implementation.
AHRQ-funded; HS010482.
Citation: Shuman CJ, Xie XJ, Herr KA .
Sustainability of evidence-based acute pain management practices for hospitalized older adults.
West J Nurs Res 2018 Dec;40(12):1749-64. doi: 10.1177/0193945917738781..
Keywords: Care Management, Elderly, Evidence-Based Practice, Inpatient Care, Pain, Implementation
Lifland B, Wright DR, Mangione-Smith R
The impact of an adolescent depressive disorders clinical pathway on healthcare utilization.
The purpose of this study was to examine the association between level of adherence to an adolescent depressive disorders inpatient clinical pathway with psychiatric patients’ length of stay (LOS), cost, and readmissions. Patients in the high-adherence category were found to have significantly longer LOS and higher costs when compared to those in the low-adherence category. The authors conclude that understanding which of the care processes within the pathway are most cost-effective for improving patient-centered outcomes requires further investigation.
AHRQ-funded; HS024299.
Citation: Lifland B, Wright DR, Mangione-Smith R .
The impact of an adolescent depressive disorders clinical pathway on healthcare utilization.
Adm Policy Ment Health 2018 Nov;45(6):979-87. doi: 10.1007/s10488-018-0878-6..
Keywords: Care Management, Children/Adolescents, Depression, Healthcare Costs, Healthcare Utilization, Hospital Readmissions, Hospitalization, Inpatient Care, Behavioral Health, Outcomes, Patient-Centered Outcomes Research
Semenkovich TR, Olsen MA, Puri V
Current state of empyema management.
The goal of this study was to examine current treatment practices and outcomes for inpatient treatment of empyema. A comprehensive, longitudinal data set from the New York State Inpatient Database, encompassing an entire state cohort of hospitalized patients, was used. The cohort included 4,095 patients who were undergoing intervention for primary empyema and were discharged 2009 to 2014 with chest tube, video-assisted thoracoscopic surgery (VATS) decortication and drainage, or open drainage and decortication. Patients were categorized into these three groups by definitive treatment during their initial hospitalization. The findings indicate that patients who were managed with chest tubes showed higher readmission and reintervention rates, suggesting that some of these patients may benefit from earlier definitive surgical intervention.
AHRQ-funded; HS019455.
Citation: Semenkovich TR, Olsen MA, Puri V .
Current state of empyema management.
Ann Thorac Surg 2018 Jun;105(6):1589-96. doi: 10.1016/j.athoracsur.2018.02.027..
Keywords: Care Management, Healthcare Cost and Utilization Project (HCUP), Inpatient Care, Outcomes, Respiratory Conditions
Bowen ME, Rumana U, Kilgore EA
A user-centered glucose-insulin data display for the inpatient setting.
Researchers sought to develop a set of user-centered displays of capillary glucose data and insulin dose to improve inpatient management of insulin-dependent diabetes. Their proposed conceptual data display prototype is designed to simplify the presentation and visualization of key information needed for treatment decisions. The goal is also to enhance clinician's ability to identify opportunities to optimize insulin dosing and decrease end users' cognitive load and error rates.
AHRQ-funded; HS022895.
Citation: Bowen ME, Rumana U, Kilgore EA .
A user-centered glucose-insulin data display for the inpatient setting.
Stud Health Technol Inform 2017;245:684-88.
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Keywords: Care Management, Diabetes, Health Information Technology (HIT), Inpatient Care, Patient Safety
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)
Maynard G, Kulasa K, Ramos P
Impact of a hypoglycemia reduction bundle and a systems approach to inpatient glycemic management.
In order to improve inpatient glycemic management in a 550-bed academic medical center, the researchers implemented a hypoglycemia reduction bundle, proactive surveillance of glycemic outliers, and an interdisciplinary data-driven approach to glycemic management. By using this approach with multiple mutually reinforcing interventions, they were able to cut severe inpatient hypoglycemia by more than half, while simultaneously improving glycemic control.
AHRQ-funded; HS020594
Citation: Maynard G, Kulasa K, Ramos P .
Impact of a hypoglycemia reduction bundle and a systems approach to inpatient glycemic management.
Endocr Pract. 2015 Apr;21(4):355-67. doi: 10.4158/ep14367.or..
Keywords: Care Management, Inpatient Care, Prevention
Banerjee T, Enayati M, Keller JM
Monitoring patients in hospital beds using unobtrusive depth sensors.
The researchers presented an approach for patient activity recognition in hospital rooms using depth data collected using a Kinect sensor. They described a technique to reduce false alerts such as pillows falling off the bed or equipment movement. They tested their algorithm on 96 hours obtained in two hospital rooms from the University of Missouri Hospital.
AHRQ-funded; HS018477.
Citation: Banerjee T, Enayati M, Keller JM .
Monitoring patients in hospital beds using unobtrusive depth sensors.
Conf Proc IEEE Eng Med Biol Soc 2014;2014:5904-7. doi: 10.1109/embc.2014.6944972.
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Keywords: Care Management, Inpatient Care, Health Information Technology (HIT), Patient Safety