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Research Studies is a monthly compilation of research articles funded by AHRQ or authored by AHRQ researchers and recently published in journals or newsletters.
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1 to 25 of 199 Research Studies Displayed
Miller-Rosales C, Lewis VA, Shortell SM
Adoption of patient engagement strategies by physician practices in the United States.
Researchers analyzed data collected from the National Survey of Healthcare Organizations and Systems (NSHOS) on physician practice adoption of patient engagement strategies. They found modest adoption of shared decision-making and motivational interviewing, and low adoption of shared medical appointments. They noted that risk-based payment reform has the potential to motivate greater practice-level patient engagement, but the extent to which it occurs may depend on internal practice capabilities.
AHRQ-funded; HS024075.
Citation:
Miller-Rosales C, Lewis VA, Shortell SM .
Adoption of patient engagement strategies by physician practices in the United States.
Med Care 2022 Sep;60(9):691-99. doi: 10.1097/mlr.0000000000001748..
Keywords:
Patient and Family Engagement, Provider: Physician, Decision Making
Mitchell JM, Gresenz CR
The influence of practice structure on urologists' treatment of men with low-risk prostate cancer.
Researchers examined the influence of type of practice structure, and by implication the financial incentives associated with each structure, on treatment received among men newly diagnosed with low-risk prostate cancer. They found that physician practice structure attributes were significantly associated with type of treatment received but few studies controlled for such factors. Their findings - coupled with the observation that urologist practice structure shifted substantially over this time period due to mergers of small urology groups - provided one explanation for the limited uptake of active surveillance among men with low-risk disease in the US.
AHRQ-funded; HS024972.
Citation:
Mitchell JM, Gresenz CR .
The influence of practice structure on urologists' treatment of men with low-risk prostate cancer.
Med Care 2022 Sep;60(9):665-72. doi: 10.1097/mlr.0000000000001746..
Keywords:
Cancer: Prostate Cancer, Cancer, Practice Patterns, Men's Health, Provider: Physician
Livaudais M, Deng D, Frederick T
Perceived value of the electronic health record and its association with physician burnout.
The objective of this study was to investigate how seniority/years of practice, gender, and screened burnout status were associated with opinions of electronic health record (EHR) use on quality, cost, and efficiency of care. Ambulatory primary care and subspecialty clinicians at three different institutions were surveyed. Findings showed that burnout status was significantly associated with clinicians' perceived value of EHR technologies, while years of practice and gender were not.
AHRQ-funded; HS022065.
Citation:
Livaudais M, Deng D, Frederick T .
Perceived value of the electronic health record and its association with physician burnout.
Appl Clin Inform 2022 Aug;13(4):778-84. doi: 10.1055/s-0042-1755372..
Keywords:
Electronic Health Records (EHRs), Health Information Technology (HIT), Burnout, Provider: Physician
Hughes DT, Reyes-Gastelum D, Ward KC DT, Reyes-Gastelum D, Ward KC
Barriers to the use of active surveillance for thyroid cancer results of a physician survey.
This study’s aim was to determine physician-reported use of and barriers to active surveillance for thyroid cancer. Surgeons and endocrinologists who were identified by thyroid cancer patients from the SEER registries of Georgia and Los Angeles County were surveyed between 2018 and 2019. Of the 654 eligible physicians identified, 448 responded to the survey. The majority (76%) believed that active surveillance was an appropriate management option, but only 44% provided that surveillance. Physicians who stated that active surveillance was appropriate management but did not use it tended to have more years in practice (>10 years) and higher patient volume (11-30 patients per year or >50 patients per year) compared to doctors with less than 10 years in practice, with no significant difference in seeing 31 to 50 patients. Barriers reported to active surveillance included patients that did not want it (80.3%), loss to follow-up concern (78.4%), more patient worry (57.6%), and malpractice lawsuit concern (50.9%).
AHRQ-funded; HS024512.
Citation:
Hughes DT, Reyes-Gastelum D, Ward KC DT, Reyes-Gastelum D, Ward KC .
Barriers to the use of active surveillance for thyroid cancer results of a physician survey.
Ann Surg 2022 Jul 1;276(1):e40-e47. doi: 10.1097/sla.0000000000004417..
Keywords:
Cancer, Provider: Physician
Semere W, Cemballi AG, Schillinger D
"We need to bring them out from the shadows:" a qualitative study of safety net physician leaders' perspectives on caregivers.
The purpose of the study was to examine the perspectives of physician leaders on methods and priorities for interacting with patient caregivers. The researchers interviewed 15 primary care physicians from 3 California safety net systems, all of whom were in care management leadership, to evaluate their experiences managing complex patients with caregivers. Interview transcripts were analyzed using thematic analysis, and a research team approach was utilized to derive major themes. The themes included: challenges uncovering caregiver identities, engaging caregivers in patient care, recognizing variation in caregivers' roles, adapting visit communication strategies to include caregivers, and caring for the caregiver. The study concluded that health systems do not tend to recognize caregiver participation in patient care, must overcome language and literacy barriers when attempting to include caregivers in visit communications; all these issues create challenges when attempting to engage caregivers. The researchers advised that outcomes for patients could be improved if methods and processes were developed to identify and communicate with caregivers.
AHRQ-funded; HS027844; HS022408.
Citation:
Semere W, Cemballi AG, Schillinger D .
"We need to bring them out from the shadows:" a qualitative study of safety net physician leaders' perspectives on caregivers.
Patient Educ Couns 2022 Jun;105(6):1663-70. doi: 10.1016/j.pec.2021.10.019..
Keywords:
Caregiving, Safety Net, Provider: Physician
Cross WF, West JC, Crean HF
Measurement of primary care providers' suicide prevention skills following didactic education.
This study’s objective was to determine if didactic training by medical residents and nurse practitioner (NP) trainees increased their skills to assess and manage patients’ suicidal ideation, intent, and behaviors. Online didactic training was provided to 127 medical resident and NP trainees followed by a standardized patient interaction conducted to assess demonstrated suicide prevention skills (i.e., assessment of risk factors, protective factors, suicidal ideation and behavior, safety planning). Participants demonstrated only about half of the possible total skills in most domains and were least competent in assessing potential risk for suicide. Residents were rated significantly higher than NPs on observed skills.
AHRQ-funded; HS024224.
Citation:
Cross WF, West JC, Crean HF .
Measurement of primary care providers' suicide prevention skills following didactic education.
Suicide Life Threat Behav 2022 Jun;52(3):373-82. doi: 10.1111/sltb.12827..
Keywords:
Behavioral Health, Primary Care, Prevention, Education: Continuing Medical Education, Provider: Physician, Training
Valdez S, Jacobson M
Assessing the quality of SK&A's office-based physician database for identifying oncologists.
Investigators assessed the quality of SK&A's office-based physician database by capturing oncologists who bill the Medicare fee-for-service program. Using 2017 data, they found that nearly 74% of the oncologists in Medicare claims can be found in the SK&A data, with higher rates when weighted by patients, service volume, or spending.
AHRQ-funded; HS000046.
Citation:
Valdez S, Jacobson M .
Assessing the quality of SK&A's office-based physician database for identifying oncologists.
Med Care Res Rev 2022 Apr;79(2):317-27. doi: 10.1177/10775587211013628..
Keywords:
Medicare, Provider: Physician
Post B, Nallamothu BK, Hollenbeck B
Hospital-cardiologist integration often occurs without a practice acquisition.
This study’s objective was to determine how much of the increase in hospital-cardiologist integration comes from acquisition of physician practices compared to individual employment decisions. Data from 2011 to 2018 was used from the American Medical Association Masterfile and Medicare. In 2011 18% of cardiologists were integrated, which rose to 25% in 2016. It was found that 48% of integrations occurred without acquisitions and that physicians who had completed residencies in the past 5 years had higher rates of integration that increased over time. Rates of early career physicians joining hospital systems also rose from 25% to 32% during that time period.
AHRQ-funded; HS025707.
Citation:
Post B, Nallamothu BK, Hollenbeck B .
Hospital-cardiologist integration often occurs without a practice acquisition.
Health Serv Res 2022 Apr;57(2):333-39. doi: 10.1111/1475-6773.13929..
Keywords:
Hospitals, Provider: Physician, Healthcare Delivery, Workforce
Metersky ML, Eldridge N, Wang Y
Rates of adverse events in hospitalized patients after summer-time resident changeover in the United States: is there a July effect?
This retrospective analysis aimed to determine whether patients in teaching hospitals are at greater risk of suffering from an adverse event during the July/August summer trainee changeover period. The Medicare Patient Safety Monitoring System was used to extract data on hospital admissions from 2010 to 2017 for acute myocardial infarction, heart failure, pneumonia, or a major surgical procedure. Adverse event rates in July and August were compared with the rest of the year. Hospitals were classified into major teaching, minor teaching, or nonteaching. The authors included 185,652 hospital admissions. The adjusted odds ratios (ORs) of suffering from at least one adverse event was not significantly different at any of the hospital types.
AHRQ-authored; AHRQ-funded; 290201800005C.
Citation:
Metersky ML, Eldridge N, Wang Y .
Rates of adverse events in hospitalized patients after summer-time resident changeover in the United States: is there a July effect?
J Patient Saf 2022 Apr 1;18(3):253-59. doi: 10.1097/pts.0000000000000887..
Keywords:
Adverse Events, Patient Safety, Provider: Physician
Jindal M, Mistry KB, McRae A
"It makes me a better person and doctor": a qualitative study of residents' perceptions of a curriculum addressing racism.
The purpose of this study was to explore how pediatric residents perceive the impact of a curriculum addressing racism on their knowledge, motivation, skills and behaviors and investigate the contextual factors that promote or impede the curriculum's effectiveness. Semi structured interviews were conducted at two academic medical centers among pediatric residents. Findings showed that medical education addressing racism can facilitate the perceived acquisition of foundational knowledge regarding race and racism, motivation and skill-building to combat racism, and action planning aimed at improving patient care.
AHRQ-authored.
Citation:
Jindal M, Mistry KB, McRae A .
"It makes me a better person and doctor": a qualitative study of residents' perceptions of a curriculum addressing racism.
Acad Pediatr 2022 Mar;22(2):332-41. doi: 10.1016/j.acap.2021.12.012..
Keywords:
Education: Curriculum, Education: Continuing Medical Education, Racial / Ethnic Minorities, Provider: Physician
Kanters AE, Evilsizer SK, Regenbogen SE
Correlation of colorectal surgical skill with patient outcomes: a cautionary tale.
Some have proposed that video-based skill assessments be used as a way to measure technical skills, quality improvement, and credentialing in colorectal surgeons and other practitioners. However, it must first be determined whether video-based assessments can accurately predict patient outcomes. The researchers assembled a panel of 10 peer surgeons to evaluate videos of minimally invasive colectomy procedures submitted by 21 surgeons. Each surgeon submitted one video, and the videos were edited to highlight key steps in the procedure. The panel and the surgeon participants were all associated with the Michigan Surgical Quality Collaborative. The panel used a validated American Society of Colon and Rectal Surgeons assessment instrument to rate the surgeon’s skills. The surgeon’s ratings were then linked to a validated registry of surgical outcomes, and the researchers assessed the relationship between skill level and risk-adjusted complication rates. The researchers found that after risk-adjustment there was no statistically significant difference in complication rates between the bottom (17.5%) and top (16.8%) quartile surgeons (p=0.41). The study concluded that there was no correlation between video-based peer rating of minimally invasive colectomy and postoperative complications among specialty surgeons, and that caution should be used when utilizing video review in credentialing.
AHRQ-funded; HS025365.
Citation:
Kanters AE, Evilsizer SK, Regenbogen SE .
Correlation of colorectal surgical skill with patient outcomes: a cautionary tale.
Dis Colon Rectum 2022 Mar;65(3):444-51. doi: 10.1097/dcr.0000000000002124..
Keywords:
Surgery, Provider: Physician, Provider Performance, Digestive Disease and Health, Outcomes
Rodriguez HP, Ciemins EL, Rubio K
Physician practices with robust capabilities spend less on Medicare beneficiaries than more limited practices.
Researchers used data from the 2017 National Survey of Healthcare Organizations and Systems to examine the association of practice-level capabilities with process measures of quality, utilization, and spending. They found that quality and utilization did not differ by practice-level capabilities. Physician practice locations with robust capabilities spent less on Medicare fee-for-service beneficiaries but delivered quality of care comparable to the quality delivered in locations with low or mixed capabilities.
AHRQ-funded; HS024075.
Citation:
Rodriguez HP, Ciemins EL, Rubio K .
Physician practices with robust capabilities spend less on Medicare beneficiaries than more limited practices.
Health Aff 2022 Mar;41(3):414-23. doi: 10.1377/hlthaff.2021.00302..
Keywords:
Healthcare Costs, Medicare, Provider: Physician
Ray KN, Bohnhoff JC, Schweiberger K
Use of telemedicine for initial outpatient subspecialist consultative visit: a national survey of general pediatricians and pediatric subspecialists.
The authors performed a survey of general pediatricians and pediatric subspecialists about the use of telemedicine for patients newly referred for pediatric subspecialty care. They found that 76% of respondents thought telemedicine should be offered for some and 11% thought telemedicine should be offered for all initial subspecialist visits. Factors perceived to reduce the appropriateness of telemedicine for subspecialty consultation included the need for interpreter services and a prior history of frequent no-shows. They further found that responses from generalists and subspecialists rarely differed significantly.
AHRQ-funded; HS026393.
Citation:
Ray KN, Bohnhoff JC, Schweiberger K .
Use of telemedicine for initial outpatient subspecialist consultative visit: a national survey of general pediatricians and pediatric subspecialists.
Healthc 2022 Mar;10(1):100600. doi: 10.1016/j.hjdsi.2021.100600..
Keywords:
Children/Adolescents, Telehealth, Health Information Technology (HIT), Provider: Physician, Ambulatory Care and Surgery
Crist K, Lafferty M, Umberfield E
Which factors promote shared understanding between physicians and nurses in inpatient oncology care settings?: A qualitative exploration.
This qualitative secondary analysis was conducted to identify factors that contribute to shared understanding between physicians and nurses from video-recorded conversations that occurred between them during inpatient rounds on oncology units. Four factors emerged as contributors to shared understanding: engagement, clarification, confirmation, and resolution. These factors occurred in sequence with engagement occurring first and resolution occurring last, as the closure of a communication exchange. A greater awareness of body language and positioning at the start of a communication exchange may increase the effectiveness of nurse-physician communication.
AHRQ-funded; HS022305.
Citation:
Crist K, Lafferty M, Umberfield E .
Which factors promote shared understanding between physicians and nurses in inpatient oncology care settings?: A qualitative exploration.
Cancer Nurs 2022 Mar-Apr;45(2):E338-E44. doi: 10.1097/ncc.0000000000000959..
Keywords:
Communication, Provider: Physician, Provider: Nurse
Markovitz AA, Ryan AM, Peterson TA
ACO awareness and perceptions among specialists versus primary care physicians: a survey of a large Medicare Shared Savings program.
This research letter describes a survey that was conducted to compare accountable care organization (ACO) awareness and perceptions among specialists versus primary care physicians (PCPs). The survey was administered in 2018 to clinicians in the Physician Organization of Michigan ACO, which was the largest Medicare Shared Savings Program (MSSP) in Michigan and among the ten largest nationally at the time. The analysis focused on 1022 non-pediatrician physician respondents practicing within 10 provider organizations. Physician respondents included PCPs (23%) and specialists (77%). The most common specialty was internal medicine (20%), followed by surgeons (14%). Specialists were less likely to be aware of ACO participation and incentives. They were also 25% less likely to know they were in an ACO compared to PCPs. In addition, specialists were 18% less likely to know their ACO was accountable for both spending and quality or that their ACO had lowered spending in the previous year. This difference in perception may help to explain ACOs’ modest impact on spending and quality.
AHRQ-funded; HS025615.
Citation:
Markovitz AA, Ryan AM, Peterson TA .
ACO awareness and perceptions among specialists versus primary care physicians: a survey of a large Medicare Shared Savings program.
J Gen Intern Med 2022 Feb;37(2):492-94. doi: 10.1007/s11606-020-06556-w..
Keywords:
Primary Care, Healthcare Costs, Medicare, Provider: Physician
Michelson KA, Cushing AM, Bucholz EM
Association of county-level availability of pediatricians with emergency department visits.
This study examined whether children in counties with more pediatricians had fewer emergency department (ED) visits. The authors conducted a cross-sectional study of all ED visits among children younger than 18 years from 6 states. Each additional pediatrician per 1000 children was associated with a 13.7% decrease in ED visits in the state-adjusted model. In the full model however, there was no association. Other factors such as presence of an urgent care facility, high socioeconomic status, urban status and higher proportions of White race and nonpublic insurance were also associated with decreased ED visit rates.
AHRQ-funded; HS026503.
Citation:
Michelson KA, Cushing AM, Bucholz EM .
Association of county-level availability of pediatricians with emergency department visits.
Pediatr Emerg Care 2022 Feb;38(2):e953-e57. doi: 10.1097/pec.0000000000002502..
Keywords:
Healthcare Cost and Utilization Project (HCUP), Emergency Department, Healthcare Utilization, Workforce, Provider: Physician, Rural Health
Marchese AL, Fine AM, Levy JA
Physician risk perception and testing behaviors for children with fever.
This study sought to determine whether physician risk perception was associated with the decision to obtain blood or imaging tests among children who present to the emergency department with fever. A retrospective, cross-section study was conducted at the Boston Children’s Hospital emergency department. Children aged 6 months to 18 years who presented with a fever from May 2014 to April 2019 were included. The authors assessed risk perception using 3 scales: the Risk Tolerance Scale (RTS), Stress from Uncertainty Scale (SUS), and Malpractice Fear Scale (MFS). Across 55 pediatric emergency physicians, there was no association found between risk perception and blood/imaging testing in febrile children for any of those scales.
AHRQ-funded; HS026503.
Citation:
Marchese AL, Fine AM, Levy JA .
Physician risk perception and testing behaviors for children with fever.
Pediatr Emerg Care 2022 Feb;38(2):e805-e10. doi: 10.1097/pec.0000000000002413..
Keywords:
Children/Adolescents, Provider: Physician, Emergency Department, Diagnostic Safety and Quality
Heiderscheit EA, Schlick CJR, Ellis RJ
Experiences of LGBTQ+ residents in US general surgery training programs.
The purpose of this study was to determine the national prevalence of mistreatment and poor well-being for lesbian, gay, bisexual, transgender, queer, and other sexual and gender minority (LGBTQ+) surgery residents compared with their non-LGBTQ+ peers. A voluntary, anonymous survey was conducted for clinically active general surgery residents training in accredited general surgery programs following their American Board of Surgery In-Training Examination. Findings showed that mistreatment was a common experience for LGBTQ+ surgery residents, with attending surgeons being the most common overall source. Increased suicidality among LGBTQ+ surgery residents was associated with this mistreatment. Recommendations included multifaceted interventions to develop safer and more inclusive learning environments.
AHRQ-funded; HS000078.
Citation:
Heiderscheit EA, Schlick CJR, Ellis RJ .
Experiences of LGBTQ+ residents in US general surgery training programs.
JAMA Surg 2022 Jan;157(1):23-32. doi: 10.1001/jamasurg.2021.5246..
Keywords:
Provider: Physician, Surgery, Training, Education: Continuing Medical Education
Reid RO, Tom AK, Ross RM
Physician compensation arrangements and financial performance incentives in US health systems.
This study examined physician compensation arrangements for primary care physicians (PCPs) and specialists among US health system-affiliated physician organizations (POs) and measured the portion of total physician compensation based on quality and cost performance. This study used a cross-sectional mixed-methods analysis of in-depth multimodal data (compensation document review, interviews with 40 PO leaders, and surveys conducted between November 2017 and July 2019) from 31 POs affiliated with 22 purposefully selected health systems in 4 states. The most common compensation arrangement was volume-based (68.2% mean for PCPs and 73.7% mean for specialists). Incentives for quality and cost performance were common, but compensation based on those were not common (9.0% mean for PCPs, 4.5% mean for specialists).
AHRQ-funded; HS024067.
Citation:
Reid RO, Tom AK, Ross RM .
Physician compensation arrangements and financial performance incentives in US health systems.
JAMA Health Forum 2022 Jan;3(1):e214634. doi: 10.1001/jamahealthforum.2021.4634..
Keywords:
Health Systems, Provider: Physician, Payment, Provider Performance
Goodwin JS, Agrawal P, Li S
Growth of physicians and nurse practitioners practicing full time in nursing homes.
This retrospective cohort study examined the growth of physicians and nurse practitioners (NPs) and physician assistants (PAs) who work full time in nursing homes, and to assess resident and nursing home characteristics associated with receiving care from full-time providers. Researchers looked at a 20% national sample of Medicare data on long-term care residents in 2008 and 2018 and the physicians, NPs, and PAs who submitted charges for services rendered in nursing homes. Full-time nursing home providers increased from 26% in 2008 to 44.6% in 2017. The largest increase from 2008 to 2017 was in NPs with 1986 total in 2008 increasing 44.6% in 2017. Residents with an NP primary care provider were 23 times more likely to have a full-time provider. Residents who received care from both a physician and an NP or PA increased from 33.5% in 2008 to 62.5% in 2018. There was large variation in the percentage of residents with full-time providers, with 5.72% of residents in the bottom quintile of facilities to 91.4% in the top quintile.
AHRQ-funded; HS020642.
Citation:
Goodwin JS, Agrawal P, Li S .
Growth of physicians and nurse practitioners practicing full time in nursing homes.
J Am Med Dir Assoc 2021 Dec;22(12):2534-39.e6. doi: 10.1016/j.jamda.2021.06.019..
Keywords:
Nursing Homes, Long-Term Care, Provider: Clinician, Provider: Physician, Provider: Nurse, Workforce
Thelen AE, Kendrick DE, Chen X
Novel method to link surgical trainee performance data to patient outcomes.
A significant roadblock in surgical education research has been the inability to compare trainee performance to the outcomes of those surgeons after they enter independent practice. In this study, the investigators described the feasibility of an innovative method to link trainee performance data with patient outcomes. They indicated that this innovation could enable future research investigating the relationship between surgical trainee performance and patient outcomes in independent practice.
AHRQ-funded; HS027653.
Citation:
Thelen AE, Kendrick DE, Chen X .
Novel method to link surgical trainee performance data to patient outcomes.
Am J Surg 2021 Dec;222(6):1072-78. doi: 10.1016/j.amjsurg.2021.10.018..
Keywords:
Surgery, Education: Continuing Medical Education, Provider Performance, Provider: Physician, Outcomes
Mueller SK, Shannon E, Dalal A
Patient and physician experience with interhospital transfer: a qualitative study.
This qualitative study explored patients’ and involved physicians’ experience with interhospital transfer (IHT) to understand specific factors that may impact the quality and safety of this care transition. Individual interviews were conducted with adult patients transferred to cardiology, general medicine, and oncology services at a tertiary care academic medical center, as well as their transferring physician, accepting attending physician, and accepting/admitting resident physician. Participants included 10 adults (6 cardiology, 2 medicine, and 2 oncology), 9 accepting attending physicians, 12 accepting and/or admitting resident physicians, and 5 transferring physicians. Emergent themes demonstrated that participants held a shared understanding for the reason for the transfer and relayed a general dissatisfaction regarding the timing and lack of advanced notification of transfer. The authors found distinct differences in IHT experience by stakeholder group - with physicians relaying discontent on intrahospital chains of communication and interhospital information exchange, and patient participants focused more readily on the physical aspects of IHT.
AHRQ-funded; HS023331.
Citation:
Mueller SK, Shannon E, Dalal A .
Patient and physician experience with interhospital transfer: a qualitative study.
J Patient Saf 2021 Dec 1;17(8):e752-e57. doi: 10.1097/pts.0000000000000501..
Keywords:
Transitions of Care, Hospitals, Hospitalization, Provider: Physician, Patient Experience
Lafferty M, Harrod M, Krein S
It's like sending a message in a bottle: a qualitative study of the consequences of one-way communication technologies in hospitals.
Researchers examined how physicians and nurses use available communication technologies and identify the implications for communication and patient care based on the theory of workarounds. They found that one-way communication technologies created an environment where workarounds could flourish. By placing results within the context of the theory of workarounds, they extended what is known about why and how workarounds develop, and they offered strategies to minimize workarounds' adverse effects. They concluded that two-way communication technologies could minimize workarounds and gaps in information exchange and could reduce unnecessary interruptions and the potential for adverse events.
J Am Med Inform Assoc 2021 Nov 25;28(12):2601-07. doi: 10.1093/jamia/ocab191.
Citation:
Lafferty M, Harrod M, Krein S .
It's like sending a message in a bottle: a qualitative study of the consequences of one-way communication technologies in hospitals.
AHRQ-funded; HS022305..
Keywords:
Hospitals, Communication, Health Information Technology (HIT), Provider: Physician
Limes J, Callister C, Young E
A cross-sectional survey of internal medicine residents' knowledge, attitudes, and current practices regarding patient transitions to post-acute care.
This study’s aim was to assess internal medicine residents’ knowledge, attitudes, and current practice regarding patient transitions to post-acute care (PAC). The authors conducted a multi-site cross-sectional 36-question survey at 3 university-based Internal Medicine training programs in the United States. Of 482 residents, almost half (49%) responded. Only 31% of residents know how often patients received skilled therapists at skilled nursing facilities (SNFs) and 23% knew how frequently nursing services are provided. The majority of residents (79%) identified the discharge summary as the main way to communicate care instructions to the SNF, but only 55% reported always completing it prior to discharge. Upper-level residents were more likely to know how much therapy patients received at an SNF, but other resident knowledge about PAC did not vary by residency year. Residents who experienced a clinical rotation at a SNF had higher levels of knowledge compared to those who did not.
AHRQ-funded; HS024569.
Citation:
Limes J, Callister C, Young E .
A cross-sectional survey of internal medicine residents' knowledge, attitudes, and current practices regarding patient transitions to post-acute care.
J Am Med Dir Assoc 2021 Nov;22(11):2344-49. doi: 10.1016/j.jamda.2021.02.011..
Keywords:
Transitions of Care, Education: Continuing Medical Education, Provider: Physician
Enayat M, Farahani NZ, Chaudhry AP
Incorporating RTLS-based spatiotemporal information in studying physical activities of clinical staff.
This research used Real-Time location systems (RTLS) to study the amount of physical activity exerted by physicians, residents, nurses, and staff in the emergency department (ED). The goal of this research is to examine how low and high physical activity can affect the physical and mental health of clinicians, which can lead to fatigue and burnout. The authors used one year worth of raw RFID data that covers the movement records of 38 physicians, 13 residents, 163 nurses, and 33 staff in the ED. They compared results to the values reported in the literature and showed despite the low spatial resolution of RTLS, their non-invasive estimations were closely comparable to the ones measured by Fitbit or other wearable pedometers.
AHRQ-funded; HS026622.
Citation:
Enayat M, Farahani NZ, Chaudhry AP .
Incorporating RTLS-based spatiotemporal information in studying physical activities of clinical staff.
Annu Int Conf IEEE Eng Med Biol Soc 2021 Nov;2021:2386-91. doi: 10.1109/embc46164.2021.9630597..
Keywords:
Provider: Physician, Provider: Clinician, Stress, Burnout
