Search all AHRQ sites
Menu
SHARE:
AHRQ Research Studies
Sign up: 
AHRQ Research Studies Email updates
Research Studies is a monthly compilation of research articles funded by AHRQ or authored by AHRQ researchers and recently published in journals or newsletters.
Results
1 to 25 of 174 Research Studies DisplayedWilliams PH, Gilmartin HM, Leonard C
The influence of the Rural Transitions Nurse Program for veterans on healthcare utilization costs.
This study’s objective was to examine changes from pre- to post-hospitalization in total, inpatient, and outpatient 30-day healthcare utilization costs for Veterans Affairs Healthcare System Rural Transitions Nurse Program (TNP) enrollees compared to controls. Although findings showed no difference in change in total costs between veterans enrolled in TNP and controls, TNP was associated with a smaller increase in direct inpatient medical costs and a larger increase in direct outpatient medical costs, suggesting a shifting of costs from the inpatient to outpatient setting.
AHRQ-funded; HS024569.
Citation: Williams PH, Gilmartin HM, Leonard C .
The influence of the Rural Transitions Nurse Program for veterans on healthcare utilization costs.
J Gen Intern Med 2022 Nov;37(14):3529-34. doi: 10.1007/s11606-022-07401-y..
Keywords: Rural Health, Veterans, Nursing, Transitions of Care, Healthcare Utilization, Healthcare Costs
Harrison JD, Sudore RL, Auerbach AD
Automated telephone follow-up programs after hospital discharge: do older adults engage with these programs?
The purpose of this study was to examine whether and how older adults experience automated post-hospital discharge telephone follow-up programs and characterize the prevalence of patient-reported post-discharge issues. Eighteen thousand and seventy-six patients, all part of a post-hospital discharge program between May 1, 2018 and April 30, 2019, were included and categorized into age groups. The study found that more patients 65-84 years old were reached compared to patients 64 years old or less (84.3% compared to 78.9%). Patients aged 85 or older were more likely to have questions about their follow-up plans and require assistance scheduling appointments compared to those 64 years old or less (19.0% vs. 11.9%). The researchers concluded that post-hospital automated telephone calls are effective at reaching older adults.
AHRQ-funded; HS026383.
Citation: Harrison JD, Sudore RL, Auerbach AD .
Automated telephone follow-up programs after hospital discharge: do older adults engage with these programs?
J Am Geriatr Soc 2022 Oct;70(10):2980-87. doi: 10.1111/jgs.17939..
Keywords: Elderly, Patient and Family Engagement, Hospital Discharge, Transitions of Care, Telehealth, Health Information Technology (HIT)
Alagoz E, Saucke M, Arroyo N
Communication during interhospital transfers of emergency general surgery patients: a qualitative study of challenges and opportunities.
This study’s objective was to understand the nature of and challenges to communication between referring (RP) and accepting (AP) providers transferring emergency general surgery (EGS) patients from the transfer center nurse’s (TCN) perspective. Worse outcomes have been shown to be experienced by transferred EGS patients than directly admitted patients. The authors interviewed 17 transfer center nurses (TCNs) at an academic medical center regarding (in)efficient and (in)effective communication between RPs and APs. The in-person interviews were recorded, transcribed and managed in NVivo. Four researchers developed a codebook, which was then co-coded with the transcripts. A consensus was developed to discuss emergency themes and arrive at higher-level concepts. Issues relating to ineffective communication included RPs that provided incomplete information because of a lack of necessary infrastructure, personnel, or technical knowledge; competing clinical demands; or a fear of the transfer request being rejected. Inefficient communication resulted from RPs being unfamiliar with the information APs expected and the lack of a structured process to share information and communication also failed when providers disagreed about the necessity of the transfer.
AHRQ-funded; HS025224.
Citation: Alagoz E, Saucke M, Arroyo N .
Communication during interhospital transfers of emergency general surgery patients: a qualitative study of challenges and opportunities.
J Patient Saf 2022 Oct 1;18(7):711-16. doi: 10.1097/pts.0000000000000979..
Keywords: Care Coordination, Communication, Transitions of Care, Surgery
Bourgoin A, Balaban R, Hochman M
Improving quality and safety for patients after hospital discharge: primary care as the lead integrator in postdischarge care transitions.
The purpose of this study was to explain primary care-based transition workflow processes for hospitalized patients. The researchers conducted interviews with primary care thought leaders, staff at 9 primary care sites, community agency staff, and recently discharged patients. The researchers found that primary care postdischarge workflows vary across the different settings, rarely include communications with the patient or the inpatient team during the hospitalization and vary widely across settings. The researchers recommended the use of principles for primary care practices to encourage active participation in the full spectrum of postdischarge care, from admission through the first postdischarge visit to primary care.
AHRQ-authored; AHRQ-funded; 233201500019I/HHSP23337002T.
Citation: Bourgoin A, Balaban R, Hochman M .
Improving quality and safety for patients after hospital discharge: primary care as the lead integrator in postdischarge care transitions.
J Ambul Care Manage 2022 Oct-Dec;45(4):310-20. doi: 10.1097/jac.0000000000000433..
Keywords: Quality of Care, Patient Safety, Hospital Discharge, Transitions of Care, Hospitals, Workflow
Vaughn VM, Ratz D, Greene MT
Antibiotic stewardship strategies and their association with antibiotic overuse after hospital discharge: an analysis of the Reducing Overuse of Antibiotics at Discharge (ROAD) home framework.
Researchers sought to understand strategies to optimize antibiotic prescribing at discharge. Surveying Michigan hospitals on their antibiotic stewardship strategies for community-acquired pneumonia (CAP) and urinary tract infection (UTI), they found that the more stewardship strategies a hospital reported, the lower its antibiotic overuse at discharge.
AHRQ-funded; HS026530.
Citation: Vaughn VM, Ratz D, Greene MT .
Antibiotic stewardship strategies and their association with antibiotic overuse after hospital discharge: an analysis of the Reducing Overuse of Antibiotics at Discharge (ROAD) home framework.
Clin Infect Dis 2022 Sep 29;75(6):1063-72. doi: 10.1093/cid/ciac104..
Keywords: Antimicrobial Stewardship, Antibiotics, Medication, Hospital Discharge, Transitions of Care
Saxena FE, Bierman AS, Glazier RH
Association of Early Physician Follow-up With Readmission Among Patients Hospitalized for Acute Myocardial Infarction, Congestive Heart Failure, or Chronic Obstructive Pulmonary Disease.
Investigators assessed whether hospitalized patients with early physician follow-up after discharge had lower rates of overall and condition-specific readmissions within 30 days and 90 days of discharge. Studying adults in Ontario, Canada, with first admission for acute myocardial infarction, congestive heart failure, or chronic obstructive pulmonary disease, the findings suggested that early follow-up in conjunction with a comprehensive transitional care strategy for hospitalized patients with medically complex conditions coupled with ongoing effective chronic disease management may be associated with reduced 90-day readmissions.
AHRQ-authored.
Citation: Saxena FE, Bierman AS, Glazier RH .
Association of Early Physician Follow-up With Readmission Among Patients Hospitalized for Acute Myocardial Infarction, Congestive Heart Failure, or Chronic Obstructive Pulmonary Disease.
JAMA Netw Open 2022 Jul;5(7):e2222056. doi: 10.1001/jamanetworkopen.2022.22056..
Keywords: Hospital Readmissions, Hospitalization, Cardiovascular Conditions, Respiratory Conditions, Transitions of Care
Topham EW, Bristol A, Luther B
Caregiver inclusion in IDEAL discharge teaching: implications for transitions from hospital to home.
The purpose of this study was to explore perceptions of caregivers regarding their discharge preparation, focusing particular attention on whether and how they believed discharge preparation impacted post-discharge patient outcomes. Through interviews with four English-speaking caregivers, findings showed that, once home, the caregivers reported gaps in their knowledge of how to care for the patient, suggesting key gaps related to knowledge of warning signs and problems. Two of the four caregiver participants attributed a hospital readmission to post-discharge knowledge gaps. This study of caregiver experiences suggests that AHRQ’s IDEAL discharge planning strategy remains a useful and important framework for case managers to follow when providing discharge services.
AHRQ-funded; HS026248.
Citation: Topham EW, Bristol A, Luther B .
Caregiver inclusion in IDEAL discharge teaching: implications for transitions from hospital to home.
Prof Case Manag 2022 Jul-Aug;27(4):181-93. doi: 10.1097/ncm.0000000000000563..
Keywords: Hospital Discharge, Transitions of Care, Caregiving
Giesler DL, Krein S, Brancaccio A
Reducing overuse of antibiotics at discharge home: a single-center mixed methods pilot study.
This article described a single-center, controlled pilot study of a pharmacist-facilitated antibiotic timeout prior to hospital discharge. The timeout addressed key elements of duration and was designed and implemented using iterative cycles with rapid feedback. The authors evaluated implementation outcomes related to feasibility, including usability, adherence, and acceptability. The pharmacists conducted 288 antibiotic timeouts with a mean duration of 2.5 minutes. Pharmacists recommended an antibiotic change in 25% of timeouts with 70% of recommended changes accepted by hospitalists. Barriers included unanticipated and weekend discharges. There were no differences in antibiotic use after discharge during the intervention compared to control services.
AHRQ-funded; HS026530.
Citation: Giesler DL, Krein S, Brancaccio A .
Reducing overuse of antibiotics at discharge home: a single-center mixed methods pilot study.
Am J Infect Control 2022 Jul;50(7):777-86. doi: 10.1016/j.ajic.2021.11.016..
Keywords: Antibiotics, Antimicrobial Stewardship, Medication, Hospital Discharge, Transitions of Care
May HP, Krauter AK, Finnie DM
Optimising transitions of care for acute kidney injury survivors: protocol for a mixed-methods study of nephrologist and primary care provider recommendations.
Gaps in proper kidney care after acute kidney injury (AKI) in hospital patients can contribute to long term complications for those individuals. The purpose of this study is to provide an in-depth assessment of nephrologists’ and primary care providers’ approaches to follow-up care after in-hospital acute kidney injury (AKI). The researchers will utilize a mixed-methods study to assess provider recommendations and decision-making for post-AKI care.
AHRQ-funded; HS028060.
Citation: May HP, Krauter AK, Finnie DM .
Optimising transitions of care for acute kidney injury survivors: protocol for a mixed-methods study of nephrologist and primary care provider recommendations.
BMJ Open 2022 Jun 22;12(6):e058613. doi: 10.1136/bmjopen-2021-058613..
Keywords: Kidney Disease and Health, Transitions of Care
Usher 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
Yu A, Jordan SR, Gilmartin H
"Our hands are tied until your doctor gets here": nursing perspectives on inter-hospital transfers.
The purpose of this study was to characterize the experiences of inpatient floor-level bedside nurses caring for inter-hospital transfer (IHT) patients and to identify care coordination challenges and solutions. Results from this study are mapped to AHRQ’s Care Coordination Measurement Framework domains of communication, assessing needs and goals, and negotiating accountability. Findings showed that three key themes characterized nurses' experiences with IHT related to these domains: challenges with information exchange and team communication during IHT, environmental and information preparation needed to anticipate transfers, and determining responsibility and care plans after the IHT patient has arrived at the accepting facility.
AHRQ-funded; HS023331.
Citation: Yu A, Jordan SR, Gilmartin H .
"Our hands are tied until your doctor gets here": nursing perspectives on inter-hospital transfers.
J Gen Intern Med 2022 May;37(7):1729-36. doi: 10.1007/s11606-021-07276-5..
Keywords: Transitions of Care, Hospitals, Provider: Nurse
Mitchell SE, Reichert M, Howard JM
Reducing readmission of hospitalized patients with depressive symptoms: a randomized trial.
The purpose of this randomized controlled trial study was to assess whether post-discharge depression treatment will benefit hospitalized patients by reducing readmissions. Participants included hospitalized patients with a patient health questionnaire-9 score of 10 or higher. The researchers delivered the Re-Engineered Discharge (RED) and randomized participants to groups receiving RED-only or RED for Depression (RED-D), a 12-week post-discharge telehealth intervention. The study found that at 30 days, the intention-to-treat analysis showed no differences between RED-D vs RED-only in hospital readmission or reutilization. The intention-to-treat analysis also showed no differences at 90 days in readmission or reutilization. In the as-treated analysis, each additional RED-D session was associated with a decrease in 30- and 90-day readmissions. At 30 days, among 104 participants receiving 3 or more sessions, there were fewer readmissions compared with the control group. At 90 days, among 109 participants receiving 6 or more sessions, there were fewer readmissions. The study concluded that unplanned hospital use can be decreased with post-discharge treatment of depression and support for care transition.
AHRQ-funded; HS019700.
Citation: Mitchell SE, Reichert M, Howard JM .
Reducing readmission of hospitalized patients with depressive symptoms: a randomized trial.
Ann Fam Med 2022 May-Jun;20(3):246-54. doi: 10.1370/afm.2801..
Keywords: Depression, Behavioral Health, Hospital Readmissions, Hospital Discharge, Transitions of Care
Sharara SL, Arbaje AI, Cosgrove SE
The voice of the patient: patient roles in antibiotic management at the hospital-to-home transition.
The objective of this study was to characterize tasks required for patient-performed antibiotic medication management (MM) at the hospital-to-home transition, as well as barriers to and strategies for patient-led antibiotic MM. The overall goal was to understand patients' role in managing antibiotics at the hospital-to-home transition. The investigators concluded that there are many opportunities to improve patient-led antibiotic MM at the hospital-to-home transition.
AHRQ-funded; HS026995.
Citation: Sharara SL, Arbaje AI, Cosgrove SE .
The voice of the patient: patient roles in antibiotic management at the hospital-to-home transition.
J Patient Saf 2022 Apr 1;18(3):e633-e39. doi: 10.1097/pts.0000000000000899..
Keywords: Antibiotics, Antimicrobial Stewardship, Medication, Hospital Discharge, Transitions of Care, Patient Self-Management
Gilmartin HM, Warsavage T, Hines A
Effectiveness of the rural transitions nurse program for veterans: a multicenter implementation study.
This study evaluated the effectiveness of the rural Transitions Nurse Program (TNP), a program to help veterans transferred from rural areas to urban VA Medical Centers for care. A case-control study was conducted from April 2017 to September 2019 with 3001 veterans enrolled in TNP and 6002 matched controls. Interventions were led by a transition nurse who assessed discharge readiness, provided postdischarge communication with primary care providers (PCPs), and called the Veteran within 72 h of discharge home to assess needs, and encouraged follow-up appointment attendance. Controls had no change to their care. Primary outcomes evaluated were PCP visits within 14 days of discharge and all-cause 30-day readmissions, with secondary outcomes 30-day emergency department (ED) visits and 30-day mortality. Patients were matched by their length of stay, prior hospitalizations and PCP visits, urban/rural status, and 32 Elixhauser comorbidities. The veterans enrolled in TNP were more likely to see their PCP within 14 days of discharge than their matched controls. TNP enrollment was not associated with reduced 30-day ED visits or readmissions but was associated with reduced 30-day mortality.
AHRQ-funded; HS024569.
Citation: Gilmartin HM, Warsavage T, Hines A .
Effectiveness of the rural transitions nurse program for veterans: a multicenter implementation study.
J Hosp Med 2022 Mar;17(3):149-57. doi: 10.1002/jhm.12802..
Keywords: Veterans, Rural Health, Transitions of Care, Nursing, Healthcare Delivery
Fraiman YS, Stewart JE, Litt JS
Race, language, and neighborhood predict high-risk preterm infant follow up program participation.
This study investigated whether infants born to Black mothers, non-English speaking mothers, and mothers who live in “Very Low” Child Opportunity Index (COI) neighborhoods would have decreased odds of using the Infant Follow Up Program (IFUP) for their preterm infants after discharge from a NICU. A total of 477 infants eligible for IFUP between 2015 and June 2017 from a single large academic Level III NICU were included. Primary outcome considered was at least one visit to IFUP. Two hundred infants (41.9%) participated in IFUP, with the odds of participation lower for Black compared to white race, “Very Low” COI compared to “Very High”, and primary non-English speaking.
AHRQ-funded; HS000063.
Citation: Fraiman YS, Stewart JE, Litt JS .
Race, language, and neighborhood predict high-risk preterm infant follow up program participation.
J Perinatol 2022 Feb;42(2):217-22. doi: 10.1038/s41372-021-01188-2..
Keywords: Newborns/Infants, Hospital Discharge, Transitions of Care, Racial / Ethnic Minorities
Hoonakker PLT, Hose BZ, Carayon P
Scenario-based evaluation of team health information technology to support pediatric trauma care transitions.
This study’s objective was to examine if the Teamwork Transition Technology (T(3)) supports teams and team cognition. Using a scenario-based mock-up methodology with 36 clinicians and staff from the different units and departments who are involved in pediatric trauma to examine T(3), results showed that most participants agreed that the technology helped to achieve the goals set out in the design phase. Respondents thought that T(3) organized and presented information in a different way that was helpful to them. The authors concluded that the results of their evaluation showed that participants agreed that T(3) does support them in their work and increases their situation awareness.
AHRQ-funded; HS023837.
Citation: Hoonakker PLT, Hose BZ, Carayon P .
Scenario-based evaluation of team health information technology to support pediatric trauma care transitions.
Appl Clin Inform 2022 Jan;13(1):218-29. doi: 10.1055/s-0042-1742368.
AHRQ-funded; HS023837..
AHRQ-funded; HS023837..
Keywords: Children/Adolescents, Transitions of Care, Health Information Technology (HIT), Teams, Trauma
Kennedy EE, Bowles KH, Aryal S
Systematic review of prediction models for postacute care destination decision-making.
This article reported a systematic review of studies containing development and validation of models predicting post-acute care destination after adult inpatient hospitalization, summarized clinical populations and variables, evaluated model performance, assessed risk of bias and applicability, and made recommendations to reduce bias in future models. Findings indicated that prediction modeling studies for post-acute care destinations were becoming more prolific in the literature, but model development and validation strategies were inconsistent, and performance was variable. Most models were developed using regression, but machine learning methods were increasing in frequency.
AHRQ-funded; HS026599; HS027742.
Citation: Kennedy EE, Bowles KH, Aryal S .
Systematic review of prediction models for postacute care destination decision-making.
J Am Med Inform Assoc 2021 Dec 28;29(1):176-86. doi: 10.1093/jamia/ocab197..
Keywords: Decision Making, Transitions of Care
Brajcich BC, Shallcross ML, Johnson JK
Barriers to post-discharge monitoring and patient-clinician communication: a qualitative study.
This study used semi-structured interviews and focus groups to identify barriers to post-discharge monitoring and patient-clinician communication. Participants were gastrointestinal surgery patients and clinicians, with a total of 15 patients and 17 clinicians. Four themes and four barriers were identified from patient and clinician interviews and focus groups. Patient-identified barriers included education and expectation setting, technology access and literacy, availability of resources and support, and misalignment of communication preferences. Clinician-identified barriers included health education, access to clinical team, healthcare practitioner time constraints, and care team experience and consistency.
AHRQ-funded; HS026385.
Citation: Brajcich BC, Shallcross ML, Johnson JK .
Barriers to post-discharge monitoring and patient-clinician communication: a qualitative study.
J Surg Res 2021 Dec;268:1-8. doi: 10.1016/j.jss.2021.06.032..
Keywords: Hospital Discharge, Clinician-Patient Communication, Care Management, Transitions of Care
Chhatre S, Malkowicz SB, Jayadevappa R
Continuity of care in acute survivorship phase, and short and long-term outcomes in prostate cancer patients.
This study examined the association between continuity of care and outcomes in Medicare beneficiaries with localized prostate cancer, and the moderating effect of race using SEER – Medicare data between 2000 and 2016. Continuity of care was defined as visits dispersion and density in the acute survivorship phase. Outcomes measured were emergency room visits, hospitalizations, and cost during the acute survivorship phase and mortality over the follow-up phase. Higher continuity of care was associated with improved outcomes. The interaction between race and continuity of care was significant.
AHRQ-funded; HS024106.
Citation: Chhatre S, Malkowicz SB, Jayadevappa R .
Continuity of care in acute survivorship phase, and short and long-term outcomes in prostate cancer patients.
Prostate 2021 Dec;81(16):1310-19. doi: 10.1002/pros.24228..
Keywords: Cancer: Prostate Cancer, Cancer, Transitions of Care
Burden A, Potestio C, Pukenas E
Influence of perioperative handoffs on complications and outcomes.
The authors describe the perioperative environment, calling it dynamic and complex, and indicate that there are multiple distractions that can interfere with effective communication and safe patient care. They discuss various aspects involved in handoffs, concluding that an institutional culture that highlights the importance of patient safety and that encourages team collaboration has demonstrated that harm can be decreased and patient safety can be improved.
AHRQ-funded; HS026158.
Citation: Burden A, Potestio C, Pukenas E .
Influence of perioperative handoffs on complications and outcomes.
Adv Anesth 2021 Dec;39:133-48. doi: 10.1016/j.aan.2021.07.008..
Keywords: Patient Safety, Transitions of Care, Workflow
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
Kunz SN, Helkey D, Zitnik M
Quantifying the variation in neonatal transport referral patterns using network analysis.
This retrospective study evaluated the association of neonatal patient characteristics with quantitative differences in neonatal transport networks. Data was analyzed for infants <28 days of age acutely transported within California from 2008 to 2012. The authors analyzed 34,708 acute transfers, representing 1594 unique transfer routes between 271 hospitals. They found greater degrees of regionalization for preterm and surgical patients compared to term infants and those transported for medical reasons.
AHRQ-funded; HS025749.
Citation: Kunz SN, Helkey D, Zitnik M .
Quantifying the variation in neonatal transport referral patterns using network analysis.
J Perinatol 2021 Dec;41(12):2795-803. doi: 10.1038/s41372-021-01091-w..
Keywords: Newborns/Infants, Hospitals, Transitions of Care
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
Werner NE, Rutkowski RA, Krause S
Disparate perspectives: exploring healthcare professionals' misaligned mental models of older adults' transitions of care between the emergency department and skilled nursing facility.
Care transitions that occur across healthcare system boundaries represent a unique challenge for maintaining high quality care and patient safety, as these systems are typically not aligned to perform the care transition process. In this article, the investigators explored healthcare professionals' mental models of older adults' transitions between the emergency department (ED) and skilled nursing facility (SNF).
AHRQ-funded; HS026624.
Citation: Werner NE, Rutkowski RA, Krause S .
Disparate perspectives: exploring healthcare professionals' misaligned mental models of older adults' transitions of care between the emergency department and skilled nursing facility.
Appl Ergon 2021 Oct;96:103509. doi: 10.1016/j.apergo.2021.103509..
Keywords: Elderly, Transitions of Care, Emergency Department, Nursing Homes, Healthcare Delivery
Parikh K, Richmond M, Lee M
Outcomes from a pilot patient-centered hospital-to-home transition program for children hospitalized with asthma.
The purpose of this study was to evaluate a multi-component hospital-to-home (H2H) transition program for children hospitalized with an asthma exacerbation. A pilot prospective randomized clinical trial of guideline-based asthma care with and without a patient-centered multi-component H2H program was conducted among children enrolled in K-8(th) grade on Medicaid hospitalized for an asthma exacerbation. The investigators concluded that the pilot data suggested that comprehensive care coordination initiated during the inpatient stay was feasible and acceptable.
AHRQ-funded; HS024554.
Citation: Parikh K, Richmond M, Lee M .
Outcomes from a pilot patient-centered hospital-to-home transition program for children hospitalized with asthma.
J Asthma 2021 Oct;58(10):1384-94. doi: 10.1080/02770903.2020.1795877..
Keywords: Children/Adolescents, Patient-Centered Healthcare, Transitions of Care, Asthma, Hospital Discharge, Care Coordination, Chronic Conditions
