National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Ambulatory Care and Surgery (1)
- Blood Thinners (1)
- Cardiovascular Conditions (2)
- Children/Adolescents (3)
- Communication (1)
- Critical Care (2)
- Diagnostic Safety and Quality (2)
- Elderly (2)
- Electronic Health Records (EHRs) (1)
- Emergency Department (9)
- (-) Emergency Medical Services (EMS) (24)
- Emergency Preparedness (1)
- Evidence-Based Practice (2)
- Falls (1)
- Guidelines (1)
- Healthcare Cost and Utilization Project (HCUP) (2)
- Healthcare Costs (1)
- Healthcare Delivery (2)
- Healthcare Utilization (3)
- Health Information Exchange (HIE) (1)
- Health Information Technology (HIT) (1)
- Health Services Research (HSR) (3)
- Heart Disease and Health (1)
- Hospitalization (2)
- Injuries and Wounds (3)
- Intensive Care Unit (ICU) (1)
- Medicaid (1)
- Medical Devices (1)
- Medicare (1)
- Medication (4)
- Mortality (1)
- Opioids (1)
- Outcomes (1)
- Patient-Centered Outcomes Research (2)
- Patient Safety (2)
- Payment (1)
- Policy (1)
- Prevention (1)
- Primary Care (1)
- Quality of Care (1)
- Racial and Ethnic Minorities (1)
- Respiratory Conditions (1)
- Risk (1)
- Rural Health (1)
- Sex Factors (1)
- Shared Decision Making (1)
- Social Determinants of Health (1)
- Surgery (1)
- Telehealth (1)
- Training (3)
- Trauma (2)
- Workflow (1)
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 24 of 24 Research Studies DisplayedChou R, Korthuis PT, McCarty D
Management of suspected opioid overdose with naloxone in out-of-hospital settings: a systematic review.
This review synthesized evidence on 1) the effects of naloxone route of administration and dosing for suspected opioid overdose in out-of-hospital settings on mortality, reversal of overdose, and harms, and 2) the need for transport to a health care facility. It concluded that higher-concentration intranasal naloxone (2 mg/mL) seems to have efficacy similar to that of intramuscular naloxone for reversal of opioid overdose, with no difference in adverse events.
AHRQ-funded; 290201500009I.
Citation: Chou R, Korthuis PT, McCarty D .
Management of suspected opioid overdose with naloxone in out-of-hospital settings: a systematic review.
Ann Intern Med 2017 Dec 19;167(12):867-75. doi: 10.7326/m17-2224.
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Keywords: Emergency Medical Services (EMS), Evidence-Based Practice, Medication, Opioids, Patient-Centered Outcomes Research
Raven MC, Guzman D, Chen AH
Out-of-network emergency department use among managed Medicaid beneficiaries.
The researchers examined factors associated with out-of-network ED use among Medicaid beneficiaries. They concluded that there are a number of factors related to out-of-network ED use, including the proximity and density of out-of-network EDs, race and ethnicity, a prior history of out-of-network ED use, and individuals' connection to primary care.
AHRQ-funded; HS021700.
Citation: Raven MC, Guzman D, Chen AH .
Out-of-network emergency department use among managed Medicaid beneficiaries.
Health Serv Res 2017 Dec;52(6):2156-74. doi: 10.1111/1475-6773.12604.
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Keywords: Emergency Department, Emergency Medical Services (EMS), Medicaid, Primary Care, Social Determinants of Health
Juriga LL, Murray DJ, Boulet JR
Simulation and the diagnostic process: a pilot study of trauma and rapid response teams.
Simulation can be used to recreate conditions that engage teams in the diagnostic process. In contrast to most instruction about diagnostic error, teams learn through realistic experiences and receive timely feedback about their decision-making skills. The purpose of this study was to assess how trauma teams (TrT) and pediatric rapid response teams (RRT) managed scenarios that included a diagnostic error.
AHRQ-funded; HS022265; HS018731.
Citation: Juriga LL, Murray DJ, Boulet JR .
Simulation and the diagnostic process: a pilot study of trauma and rapid response teams.
Diagnosis 2017 Nov 27;4(4):241-49. doi: 10.1515/dx-2017-0010..
Keywords: Diagnostic Safety and Quality, Emergency Medical Services (EMS), Injuries and Wounds, Training, Trauma
Branzetti JB, Adedipe AA, Gittinger MJ
Randomised controlled trial to assess the effect of a Just-in-Time training on procedural performance: a proof-of-concept study to address procedural skill decay.
The purpose of this study was to evaluate the impact of a novel Just-in-Time (JIT) intervention on transvenous pacemaker (TVP) placement during a simulated patient event. The authors concluded that a JIT intervention improved procedure performance, suggesting a role for JIT interventions in rarely performed procedures.
AHRQ-funded; HS020295
Citation: Branzetti JB, Adedipe AA, Gittinger MJ .
Randomised controlled trial to assess the effect of a Just-in-Time training on procedural performance: a proof-of-concept study to address procedural skill decay.
BMJ Qual Saf 2017 Nov;26(11):881-91. doi: 10.1136/bmjqs-2017-006656..
Keywords: Medical Devices, Patient Safety, Surgery, Training, Emergency Medical Services (EMS)
Probst MA, Kanzaria HK, Schoenfeld EM
Shared decisionmaking in the emergency department: a guiding framework for clinicians.
The authors developed a simple framework to illustrate how shared decisionmaking should be approached in clinical practice. They believe it should be the preferred or default approach to decisionmaking, except in clinical situations in which 3 factors interfere. These 3 factors are lack of clinical uncertainty or equipoise, patient decisionmaking ability, and time, all of which can render shared decisionmaking infeasible. The authors next discuss how to address each factor.
AHRQ-funded; HS021271; HS024311.
Citation: Probst MA, Kanzaria HK, Schoenfeld EM .
Shared decisionmaking in the emergency department: a guiding framework for clinicians.
Ann Emerg Med 2017 Nov;70(5):688-95. doi: 10.1016/j.annemergmed.2017.03.063.
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Keywords: Shared Decision Making, Emergency Department, Emergency Medical Services (EMS), Evidence-Based Practice, Guidelines
Zachrison KS, Hayden EM, Schwamm LH
Characterizing New England emergency departments by telemedicine use.
The primary objective of this study was to describe the prevalence of telemedicine use in New England EDs and the clinical applications of use. It concluded that telemedicine is commonly used in New England EDs. In 2014, use was more common among rural EDs and EDs with limited neurology consultant availability. In contrast, telemedicine use was less common among very low-volume EDs.
AHRQ-funded; HS024561.
Citation: Zachrison KS, Hayden EM, Schwamm LH .
Characterizing New England emergency departments by telemedicine use.
West J Emerg Med 2017 Oct;18(6):1055-60. doi: 10.5811/westjem.2017.8.34880.
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Keywords: Emergency Department, Emergency Medical Services (EMS), Healthcare Delivery, Health Services Research (HSR), Telehealth
Patterson BW, Smith MA, Repplinger MD
Using chief complaint in addition to diagnosis codes to identify falls in the emergency department.
The researchers compared incidence of falls in an emergency department (ED) cohort using a traditional International Classification of Diseases, Ninth Revision (ICD-9) code-based scheme and an expanded definition that included chief complaint information. They concluded that identifying individuals in the ED who have fallen based on diagnosis codes underestimates the true burden of falls.
AHRQ-funded; HS024558.
Citation: Patterson BW, Smith MA, Repplinger MD .
Using chief complaint in addition to diagnosis codes to identify falls in the emergency department.
J Am Geriatr Soc 2017 Sep;65(9):E135-E40. doi: 10.1111/jgs.14982.
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Keywords: Falls, Emergency Medical Services (EMS), Emergency Department
Newgard CD, Platts-Mills TF
Can an out-of-hospital medication history save lives for injured older adults?
In this issue of Annals, Nishijima et al present a much-needed study evaluating the use of anticoagulation and antiplatelet medications as an additional triage criterion to aid in the identification of older adults with intracranial hemorrhage. The authors believe that the new study helps fill a critical void in suggesting that a targeted medication history, formally integrated as a field triage criterion, may be useful in identifying high-risk older adults.
AHRQ-funded; HS023796.
Citation: Newgard CD, Platts-Mills TF .
Can an out-of-hospital medication history save lives for injured older adults?
Ann Emerg Med 2017 Aug;70(2):139-41. doi: 10.1016/j.annemergmed.2017.02.005.
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Keywords: Blood Thinners, Elderly, Emergency Medical Services (EMS), Injuries and Wounds, Medication
Tiase VL, Crouch B, Bennett H
Descriptive analysis of communication patterns between a local poison control center and community emergency departments.
This study leverages a commercial call recording system to gain insight into the intensity and volume of communication between a poison control center and two rural emergency departments.
AHRQ-funded; HS021472.
Citation: Tiase VL, Crouch B, Bennett H .
Descriptive analysis of communication patterns between a local poison control center and community emergency departments.
2017 IEEE International Conference on Healthcare Informatics (ICHI) 2017 Aug:574. doi: 10.1109/ICHI.2017.89.
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Keywords: Communication, Emergency Department, Emergency Medical Services (EMS), Rural Health
Robinson M, Greenhawt M, Stukus DR
Factors associated with epinephrine administration for anaphylaxis in children before arrival to the emergency department.
Researchers evaluated factors associated with anaphylaxis management before arrival at the emergency department (ED) or urgent care center (UCC). Reactions occurring at home were less likely to be treated with epinephrine compared with reactions occurring at school. The odds of receiving epinephrine before arrival at the ED or UCC were significantly lower with a 2-organ system or 3-organ system presentation compared with 1-organ system involvement.
AHRQ-funded; HS024599.
Citation: Robinson M, Greenhawt M, Stukus DR .
Factors associated with epinephrine administration for anaphylaxis in children before arrival to the emergency department.
Ann Allergy Asthma Immunol 2017 Aug;119(2):164-69. doi: 10.1016/j.anai.2017.06.001.
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Keywords: Children/Adolescents, Emergency Medical Services (EMS), Healthcare Utilization, Medication, Patient-Centered Outcomes Research
Brown SM, Duggal A, Hou PC
Nonlinear imputation of PaO2/FIO2 from SpO2/FIO2 among mechanically ventilated patients in the ICU: a prospective, observational study.
The objective of the study was to validate the superiority of nonlinear imputation of PaO2/FIO2 (a clinical indicator of hypoxaemia) among mechanically ventilated patients and understand what factors influence the accuracy of imputation. It concluded that in mechanically ventilated patients, nonlinear imputation of PaO2/FIO2 from SpO2/FIO2 seems accurate, especially for moderate-severe hypoxemia. Linear and log-linear imputations cannot be recommended.
AHRQ-funded; HS021456.
Citation: Brown SM, Duggal A, Hou PC .
Nonlinear imputation of PaO2/FIO2 from SpO2/FIO2 among mechanically ventilated patients in the ICU: a prospective, observational study.
Crit Care Med 2017 Aug;45(8):1317-24. doi: 10.1097/ccm.0000000000002514.
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Keywords: Diagnostic Safety and Quality, Respiratory Conditions, Intensive Care Unit (ICU), Emergency Medical Services (EMS)
Geri G, Fahrenbruch C, Meischke H
Effects of bystander CPR following out-of-hospital cardiac arrest on hospital costs and long-term survival.
In this paper, the investigators evaluated bystander cardiopulmonary resuscitation (CPR), hospital-based costs, and long-term survival following out-of-hospital cardiac arrest (OHCA) in order to assess the potential cost-effectiveness of bystander CPR.
AHRQ-funded; HS021658.
Citation: Geri G, Fahrenbruch C, Meischke H .
Effects of bystander CPR following out-of-hospital cardiac arrest on hospital costs and long-term survival.
Resuscitation 2017 Jun;115:129-34. doi: 10.1016/j.resuscitation.2017.04.016..
Keywords: Cardiovascular Conditions, Emergency Medical Services (EMS), Healthcare Costs, Outcomes
Nuckols TK, Fingar KR, Barrett M
AHRQ Author: Steiner CA, Stocks C, Owens PL
The shifting landscape in utilization of inpatient, observation, and emergency department services across payers.
Using data from four states from AHRQ’s Healthcare Cost and Utilization Project, this study compared the payer-specific population-based rates of adults using inpatient, observation, and emergency department (ED) services for 10 common medical conditions in 2009 and in 2013. Inpatient admissions declined, and care shifted toward treat-and-release observation stays and ED visits. The percentage of hospitalizations that began with an observation stay increased.
AHRQ-authored.
Citation: Nuckols TK, Fingar KR, Barrett M .
The shifting landscape in utilization of inpatient, observation, and emergency department services across payers.
J Hosp Med 2017 Jun;12(6):443-46. doi: 10.12788/jhm.2751.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Emergency Medical Services (EMS), Healthcare Utilization, Hospitalization, Payment
Benda NC, Fairbanks RJ, Fairbanks RJ
Are you paying attention? Related guidance on how concepts of attention may inform effective time sharing of tasks in emergency medicine.
The authors respond to an earlier article providing a thoughtful introduction to the importance of teaching effective task switching in emergency medicine. Their letter introduces the concept of attention, provides examples of tasks that can be most safely and effectively time shared, and notes that these principles must be considered in designing tools for the time sharing and rapid switching of tasks necessary in the ED environment.
AHRQ-funded; HS022542.
Citation: Benda NC, Fairbanks RJ, Fairbanks RJ .
Are you paying attention? Related guidance on how concepts of attention may inform effective time sharing of tasks in emergency medicine.
Ann Emerg Med 2017 May;69(5):669-70. doi: 10.1016/j.annemergmed.2017.01.027.
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Keywords: Workflow, Emergency Medical Services (EMS), Emergency Department, Patient Safety
Martsolf G, Fingar KR, Coffey R
AHRQ Author: Elixhauser A
Association between the opening of retail clinics and low-acuity emergency department visits.
This study assessed whether the opening of retail clinics near emergency departments (ED) is associated with decreased ED utilization for low-acuity conditions. It concluded that with increased patient demand resulting from the expansion of health insurance coverage, retail clinics may emerge as an important care location, but to date, they have not been associated with a meaningful reduction in low-acuity ED visits.
AHRQ-authored; AHRQ-funded.
Citation: Martsolf G, Fingar KR, Coffey R .
Association between the opening of retail clinics and low-acuity emergency department visits.
Ann Emerg Med 2017 Apr;69(4):397-403.e5. doi: 10.1016/j.annemergmed.2016.08.462.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Healthcare Utilization, Emergency Medical Services (EMS), Health Services Research (HSR), Ambulatory Care and Surgery
Everson J, Kocher KE, Adler-Milstein J
Health information exchange associated with improved emergency department care through faster accessing of patient information from outside organizations.
This study assessed whether electronic health information exchange (HIE) is associated with improved emergency department (ED) care processes and utilization through more timely clinician viewing of information from outside organizations. It concluded that the relationship between HIE and improved care processes and reduced utilization in the ED is mediated by faster accessing of information from outside organizations.
AHRQ-funded; HS024160.
Citation: Everson J, Kocher KE, Adler-Milstein J .
Health information exchange associated with improved emergency department care through faster accessing of patient information from outside organizations.
J Am Med Inform Assoc 2017 Apr 1;24(e1):e103-e10. doi: 10.1093/jamia/ocw116.
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Keywords: Electronic Health Records (EHRs), Emergency Department, Emergency Medical Services (EMS), Quality of Care, Health Information Exchange (HIE)
Venkatesh AK, Mei H, Kocher KE
Identification of emergency department visits in Medicare administrative claims: approaches and implications.
The researchers sought to construct an operational definition for ED visitation using a comprehensive Medicare data set and to compare this definition to existing operational definitions used by researchers and policymakers. They concluded that current operational definitions of ED visitation using administrative claims produce different estimates of ED visitation based on the underlying assumptions applied to billing data and data set availability.
AHRQ-funded; HS024160.
Citation: Venkatesh AK, Mei H, Kocher KE .
Identification of emergency department visits in Medicare administrative claims: approaches and implications.
Acad Emerg Med 2017 Apr;24(4):422-31. doi: 10.1111/acem.13140.
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Keywords: Emergency Medical Services (EMS), Medicare, Policy, Elderly, Hospitalization
Clark LN, Benda NC, Hegde S
Usability evaluation of an emergency department information system prototype designed using cognitive systems engineering techniques.
This article presents an evaluation of novel display concepts for an emergency department information system (EDIS) designed using cognitive systems engineering methods. It concluded that nurse and provider roles had significantly different perceptions of the usability and usefulness of certain EDIS components, suggesting that they have different information needs while working.
AHRQ-funded; HS022542; HS020433.
Citation: Clark LN, Benda NC, Hegde S .
Usability evaluation of an emergency department information system prototype designed using cognitive systems engineering techniques.
Appl Ergon 2017 Apr;60:356-65. doi: 10.1016/j.apergo.2016.12.018.
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Keywords: Health Information Technology (HIT), Emergency Department, Emergency Medical Services (EMS), Health Information Technology (HIT)
Cicero MX, Whitfill T, Munjal K
60 seconds to survival: a pilot study of a disaster triage video game for prehospital providers.
The researchers hypothesized that players of the video game "60 Seconds to Survival" (60S) would have greater improvements in disaster triage accuracy compared to control subjects who did not play 60S. The video game intervention demonstrated a significant improvement in accuracy from baseline to time 2 while the control did not.
AHRQ-funded; HS022837.
Citation: Cicero MX, Whitfill T, Munjal K .
60 seconds to survival: a pilot study of a disaster triage video game for prehospital providers.
Am J Disaster Med 2017 Spring;12(2):75-83. doi: 10.5055/ajdm.2017.0263.
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Keywords: Emergency Medical Services (EMS), Emergency Preparedness, Training
Corrado MM, Shi J, Wheeler KK
Emergency medical services (EMS) versus non-EMS transport among injured children in the United States.
This study assessed the proportions of injured children transported to trauma centers by different transportation modes and evaluated the effect of transportation mode on inter-facility transfer rates using the US national trauma registry. Over one third of US pediatric trauma patients used non-EMS transport to arrive at trauma centers. Moderate to severely injured children benefit from EMS transport and professional field triage.
AHRQ-funded; HS024263.
Citation: Corrado MM, Shi J, Wheeler KK .
Emergency medical services (EMS) versus non-EMS transport among injured children in the United States.
Am J Emerg Med 2017 Mar;35(3):475-78. doi: 10.1016/j.ajem.2016.11.059.
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Keywords: Emergency Medical Services (EMS), Children/Adolescents, Trauma, Critical Care
Ranney ML, Fletcher J, Alter H
A consensus-driven agenda for emergency medicine firearm injury prevention research.
In order to develop an evidence-based research agenda, the researchers identified fifty-nine final emergency medicine-relevant research questions, including questions that cut across all firearm injury topics and questions specific to self-directed violence (suicide and attempted suicide), intimate partner violence, peer (nonpartner) violence, mass violence, and unintentional ("accidental") injury. Some of these questions could be addressed through research conducted in emergency departments; others would require work in other settings.
AHRQ-funded; HS023901.
Citation: Ranney ML, Fletcher J, Alter H .
A consensus-driven agenda for emergency medicine firearm injury prevention research.
Ann Emerg Med 2017 Feb;69(2):227-40. doi: 10.1016/j.annemergmed.2016.08.454.
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Keywords: Emergency Medical Services (EMS), Prevention, Health Services Research (HSR), Injuries and Wounds
Musey PI, Jr., Kline JA
Do gender and race make a difference in acute coronary syndrome pretest probabilities in the emergency department?
The objective was to test for significant differences in subjective and objective pretest probabilities for acute coronary syndrome (ACS) in chest pain patients. Despite consistently estimating the risk for ACS to be lower for both females and minorities concordantly with calculated objective pretest assessments, there does not appear to have been any significant decrease in subsequent evaluation of these perceived lower-risk groups when radiation exposure and costs are taken into account.
AHRQ-funded; HS018519.
Citation: Musey PI, Jr., Kline JA .
Do gender and race make a difference in acute coronary syndrome pretest probabilities in the emergency department?
Acad Emerg Med 2017 Feb;24(2):142-51. doi: 10.1111/acem.13131.
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Keywords: Sex Factors, Racial and Ethnic Minorities, Cardiovascular Conditions, Emergency Medical Services (EMS)
de Cordova PB, Johansen ML, Martinez ME
Emergency department weekend presentation and mortality in patients with acute myocardial infarction.
The purpose of this research was to determine if weekend and holiday presentation is associated with increased mortality in EDs among patients with acute myocardial infarction (AMI) in New Jersey. It found that weekend/holiday presentation to the ED for AMI was associated with increased mortality. The effect may be related to the limited availability of resources on weekend/holidays compared to weekdays.
AHRQ-funded; HS024339.
Citation: de Cordova PB, Johansen ML, Martinez ME .
Emergency department weekend presentation and mortality in patients with acute myocardial infarction.
Nurs Res 2017 Jan/Feb;66(1):20-27. doi: 10.1097/nnr.0000000000000196.
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Keywords: Emergency Medical Services (EMS), Emergency Department, Mortality, Heart Disease and Health, Risk
Michelson KA, Bachur RG, Levy JA
The impact of critically ill children on paediatric ED medication timeliness.
The presence of critically ill patients may impact care for other ED patients. The researchers evaluated whether the presence of a critically ill child was associated with the time to (1) receipt of the first medication among other patients, and (2) administration of diagnosis-specific medications. They concluded that the presence of critically ill patients was associated with a delay in medication administration to others.
AHRQ-funded; HS000063.
Citation: Michelson KA, Bachur RG, Levy JA .
The impact of critically ill children on paediatric ED medication timeliness.
Emerg Med J 2017 Jan;34(1):8-12. doi: 10.1136/emermed-2016-205989.
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Keywords: Children/Adolescents, Critical Care, Medication, Emergency Medical Services (EMS), Healthcare Delivery