National Healthcare Quality and Disparities Report
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Topics
- Asthma (1)
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- Children/Adolescents (6)
- Chronic Conditions (2)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (1)
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- (-) Emergency Department (11)
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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 11 of 11 Research Studies DisplayedHoffmann JA, Johnson JK, Pergjika A
Development of quality measures for pediatric agitation management in the emergency department.
This study’s objective was to develop quality measures for pediatric emergency department (ED) agitation management informed by multidisciplinary perspectives. A multidisciplinary panel was created to develop quality measures for pediatric ED agitation management through the modified Delphi method. The panelists included 36 physicians, nurses, social workers, security, child life specialists, hospital data analysts, and parents. Measures were ranked by panelists in importance and feasibility on a 9-point scale during 2 survey rounds, with a teleconference discussion between surveys. Consensus was defined at >75% of panelists ranking a quality measure greater or equal to 7 in importance and median feasibility of greater or equal to 4. Consensus was reached on 20 quality measures that incorporated multidisciplinary perspectives.
AHRQ-funded; HS026385.
Citation: Hoffmann JA, Johnson JK, Pergjika A .
Development of quality measures for pediatric agitation management in the emergency department.
J Healthc Qual 2022 Jul-Aug;44(4):218-29. doi: 10.1097/jhq.0000000000000339..
Keywords: Children/Adolescents, Quality Measures, Quality Indicators (QIs), Quality of Care, Emergency Department
Probst MA, Janke AT, Haimovich AD
Development of a novel emergency department quality measure to reduce very low-risk syncope hospitalizations.
The purpose of this study was to develop a new quality measure to apply with very low risk adult emergency department patients under 50 years of age and with no history of heart disease presenting with syncope. The study found that of the 3,292 patients meeting the study criteria, .46% suffered serious adverse events within 30 days after discharge. When the criteria were applied to the 2019 Nationwide Emergency Department Sample (NEDS) to assess its potential effect (assessing for hospital-level factors associated with hospitalization variation), of the 566,031 patients meeting the criteria, 2.7% were hospitalized. The researchers identified factors associated with increased hospitalization rates, which included a yearly ED volume of more than 80,000 and metropolitan teaching status. The study concluded that the novel syncope quality measure developed by the researchers can evaluate variation in low-value hospitalizations for unexplained syncope.
AHRQ-funded; HS022882.
Citation: Probst MA, Janke AT, Haimovich AD .
Development of a novel emergency department quality measure to reduce very low-risk syncope hospitalizations.
Ann Emerg Med 2022 Jun;79(6):509-17. doi: 10.1016/j.annemergmed.2022.03.008..
Keywords: Emergency Department, Quality Measures, Hospitalization, Quality Indicators (QIs), Quality of Care
Parast L, Burkhart Q, Bardach NS
Development and testing of an emergency department quality measure for pediatric suicidal ideation and self-harm.
The authors sought to develop and test a new quality measure assessing timeliness of follow-up mental health care for youth presenting to the emergency department (ED) with suicidal ideation or self-harm. Using Medicaid administrative data, they concluded that this new ED quality measure may be useful for monitoring and improving the quality of care for this vulnerable population; however, they recommended future work in order to establish the measure's predictive validity using more prevalent outcomes such as recurrence of suicidal ideation or deliberate self-harm.
AHRQ-funded; HS025291.
Citation: Parast L, Burkhart Q, Bardach NS .
Development and testing of an emergency department quality measure for pediatric suicidal ideation and self-harm.
Acad Pediatr 2022 Apr;22(3s):S92-s99. doi: 10.1016/j.acap.2021.03.005..
Keywords: Children/Adolescents, Emergency Department, Behavioral Health, Quality Measures, Quality Indicators (QIs), Quality of Care
Cabana MD, Robinson K, Plavin J
Partnering to improve pediatric asthma quality.
The purpose of this article was to explore the need for partnering between emergency departments (Eds) and primary care physicians (PCPs) to improve asthma quality measures, practice level improvements for both PCPs and EDs, and ultimately improve outcomes for children with asthma. Proper and timely management of asthma is thought to prevent ED visits, and the responsibility for addressing improvements in PCP performance should be shared by the PCP practices and health care payors and plans. The ability to measure the drivers of asthma-related visits to the ED may be outside of what a PCP practice can address, and so practices must be able to partner with health plans to successfully measure and develop system-wide interventions for quality and outcomes improvement. Although a child’s asthma may be managed in their PCP office, treatment of asthma issues often takes place in an ED setting or urgent care clinic that may be completely isolated from the patient’s PCP provider and system. Health plans can fill in the missing pieces to provide feedback on performance which can reduce ED visits, improve medication adherence and management, and provide actionable and timely data about hospital visits and discharge to PCP practices for quality improvements. Social determinants and comorbidities play a role in addressing ED visits for asthma. Health plan, public health systems, and provider coordination, integration, and partnerships are required to effectively address those issues and improve outcomes. The authors conclude that a systems approach and thoughtful partnerships across disciplines will be required beyond the PCP practice level to improve the outcomes of children with asthma.
AHRQ-funded; HS025297.
Citation: Cabana MD, Robinson K, Plavin J .
Partnering to improve pediatric asthma quality.
Acad Pediatr 2022 Apr;22(3S):S73-S75. doi: 10.1016/j.acap.2021.06.013..
Keywords: Children/Adolescents, Asthma, Chronic Conditions, Emergency Department, Quality Measures, Quality Improvement, Quality of Care
Marcin JP, Romano PS, Dayal P
Provider-level and hospital-level factors and process measures of quality care delivered in pediatric emergency departments.
The objective of this study was to determine whether process measures of quality of care delivered to patients receiving care in children's hospital emergency departments were associated with physician-level or hospital-level factors. Subjects were children under 18 years old who presented to any of the 12 emergency departments that participated in the Pediatric Emergency Care Applied Research Network (PECARN).he researchers found that process measures of quality of care delivered to children was higher among patients treated at freestanding children's hospitals but lower among patients treated at higher volume emergency departments.
AHRQ-funded; HS019712.
Citation: Marcin JP, Romano PS, Dayal P .
Provider-level and hospital-level factors and process measures of quality care delivered in pediatric emergency departments.
Acad Pediatr 2020 May-Jun;20(4):524-31. doi: 10.1016/j.acap.2019.11.007..
Keywords: Children/Adolescents, Emergency Department, Hospitals, Quality Measures, Quality of Care
Kocher KE, Arora R, Bassin BS
Baseline performance of real-world clinical practice within a statewide emergency medicine quality network: the Michigan Emergency Department Improvement Collaborative (MEDIC).
The Michigan Emergency Department Improvement Collaborative (MEDIC) has baseline performance data to identify practice variation across 15 diverse emergency departments on key emergency care quality indicators. The authors assessed MEDIC quality measures and found that performance varied greatly, with demonstrated opportunity for improvement. They conclude that MEDIC provides a robust platform for emergency physician engagement across emergency department practice settings to improve care and is a model for other states.
AHRQ-funded; HS024160.
Citation: Kocher KE, Arora R, Bassin BS .
Baseline performance of real-world clinical practice within a statewide emergency medicine quality network: the Michigan Emergency Department Improvement Collaborative (MEDIC).
Ann Emerg Med 2020 Feb;75(2):192-205. doi: 10.1016/j.annemergmed.2019.04.033..
Keywords: Emergency Department, Quality Improvement, Quality Indicators (QIs), Quality Measures, Quality of Care, Imaging, Diagnostic Safety and Quality
Arthur KC, Mangione-Smith R, Burkhart Q
Quality of care for children with medical complexity: an analysis of continuity of care as a potential quality indicator.
The objective of this study was to examine the relationship between continuity of care for children with medical complexity (CMC) and emergency department (ED) utilization, care coordination quality, and family effects related to care coordination. The investigators measured ED utilization and primary care continuity with the Bice-Boxerman continuity of care index for 1477 CMC using administrative data from Minnesota and Washington state Medicaid agencies. They concluded that continuity of care holds promise as a quality measure for CMC because of its association with lower ED utilization and more frequent receipt of care coordination.
AHRQ-funded; HS020506.
Citation: Arthur KC, Mangione-Smith R, Burkhart Q .
Quality of care for children with medical complexity: an analysis of continuity of care as a potential quality indicator.
Acad Pediatr 2018 Aug;18(6):669-76. doi: 10.1016/j.acap.2018.04.009..
Keywords: Care Coordination, Children/Adolescents, Chronic Conditions, Emergency Department, Healthcare Utilization, Primary Care, Quality of Care, Quality Indicators (QIs), Quality Measures
Parast L, Bardach NS, Burkhart Q
Development of new quality measures for hospital-based care of suicidal youth.
This study researched the value of 4 new quality measures developed to assess hospital-based care for suicidal youth. The four quality measures focused on counseling caregivers about restricting access to lethal means of self-harm, and the benefits and risks of antidepressant medications. They were divided into measures for the emergency department (ED) and inpatient measures. Survey field tests were conducted with caregivers of youth who were admitted to the ED or inpatient care for suicidality at 1 of 2 children’s hospitals between July 2013 and June 2014. Most caregivers did receive counseling about restricting their child’s access to lethal means of self-harm and also reported higher rates of counseling of benefits on antidepressants both in the ED and in the inpatient setting than the risks.
AHRQ-funded; HS020506.
Citation: Parast L, Bardach NS, Burkhart Q .
Development of new quality measures for hospital-based care of suicidal youth.
Acad Pediatr 2018 Apr;18(3):248-55. doi: 10.1016/j.acap.2017.09.017..
Keywords: Caregiving, Children/Adolescents, Consumer Assessment of Healthcare Providers and Systems (CAHPS), Education: Patient and Caregiver, Emergency Department, Hospitalization, Hospitals, Inpatient Care, Behavioral Health, Prevention, Quality of Care, Quality Measures
Goldberg EM, Wilson T, Saucier C
Achieving the BpTRUth: emergency department hypertension screening and the Centers for Medicare & Medicaid Services quality measure.
The aims of this study were to (1) assess the reliability of ED triage blood pressure (BP) as a metric to establish when the CMS threshold (>/=120/80 mm Hg), and other clinically relevant BP thresholds (>/=140/90 and >/=160/100 mm Hg) have been met; and (2) determine whether correct identification varies by gender, race, or triage acuity. At the three suggested BP thresholds, 66.1 percent, 74.0 percent, and 88.8 percent of patients were confirmed to meet the CMS threshold, respectively. There were no differences by gender, race, or triage acuity.
AHRQ-funded; HS000011.
Citation: Goldberg EM, Wilson T, Saucier C .
Achieving the BpTRUth: emergency department hypertension screening and the Centers for Medicare & Medicaid Services quality measure.
J Am Soc Hypertens 2017 May;11(5):290-94. doi: 10.1016/j.jash.2017.03.003.
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Keywords: Blood Pressure, Emergency Department, Quality Measures, Screening, Diagnostic Safety and Quality, Quality of Care
Moy E, Coffey RM, Moore BJ
AHRQ Author: Moy E
Length of stay in EDs: variation across classifications of clinical condition and patient discharge disposition.
The researchers used a census of one state's data to measure length of emergency departments stays by patients' conditions and dispositions and exlore differences between means and medians as quality metrics. For the 10 most common diagnoses, patients with relatively minor injuries typically required the shortest mean stay (3 hours or less); conditions resulting in admission or transfer tended to be more serious, resulting in longer stays.
AHRQ-authored.
Citation: Moy E, Coffey RM, Moore BJ .
Length of stay in EDs: variation across classifications of clinical condition and patient discharge disposition.
Am J Emerg Med 2016 Jan;34(1):83-7. doi: 10.1016/j.ajem.2015.09.031..
Keywords: Healthcare Cost and Utilization Project (HCUP), Emergency Department, Quality Measures, Hospitalization, Quality of Care
Garg N, Kuperman G, Onyile A
Validating health information exchange (HIE) data for quality measurement across four hospitals.
The study objective was to validate the secondary use of HIE data for two emergency department (ED) quality measures: identification of frequent ED users and early (72-hour) ED returns in four hospitals. It found that there was no significant difference in the total counts for frequent ED users or early ED returns for any of the four hospitals.
AHRQ-funded; HS021261.
Citation: Garg N, Kuperman G, Onyile A .
Validating health information exchange (HIE) data for quality measurement across four hospitals.
AMIA Annu Symp Proc 2014 Nov 14;2014:573-9..
Keywords: Electronic Health Records (EHRs), Emergency Department, Quality of Care, Health Information Exchange (HIE), Quality Measures