National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
Data
- Data Infographics
- Data Visualizations
- Data Tools
- Data Innovations
- All-Payer Claims Database
- Healthcare Cost and Utilization Project (HCUP)
- Medical Expenditure Panel Survey (MEPS)
- AHRQ Quality Indicator Tools for Data Analytics
- State Snapshots
- United States Health Information Knowledgebase (USHIK)
- Data Sources Available from AHRQ
Search All Research Studies
Topics
- Anxiety (1)
- (-) Behavioral Health (8)
- Children/Adolescents (4)
- Chronic Conditions (1)
- Communication (1)
- Community-Based Practice (1)
- Depression (1)
- Diagnostic Safety and Quality (1)
- Domestic Violence (1)
- Education: Continuing Medical Education (1)
- Emergency Department (2)
- Implementation (1)
- Injuries and Wounds (1)
- Organizational Change (1)
- Prevention (1)
- Primary Care (1)
- Provider: Health Personnel (1)
- (-) Quality Improvement (8)
- Quality of Care (6)
- Racial and Ethnic Minorities (1)
- Respiratory Conditions (1)
- Screening (1)
- Tobacco Use (1)
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 8 of 8 Research Studies DisplayedHoffman JA, Pergjika A, Liu L
Standardizing and improving care for pediatric agitation management in the emergency department.
In the U.S., pediatric mental health emergency department (ED) visits are increasing, with a greater number of visits involving the prescription of medication for acute agitation. Well timed, consistent application of behavioral strategies and medications may decrease the need for physical restraint of pediatric patients. The purpose of this study was to standardize agitation management in a pediatric ED and decrease pediatric patient time in physical restraints. From September 2020 to August 2021, researchers implemented a quality improvement initiative followed by a 6-month maintenance period. A barrier evaluation discovered that agitation triggers were not adequately recognized, there were few activities provided for children during lengthy ED visits, ED staff did not have confidence in techniques for verbally deescalating events, choices for medication were not consistent, and medication administered took time to take effect. Consecutive interventions included the development of a pathway and order set for agitation care, optimization of workflows for child life and psychiatry, implementation of personalized de-escalation plans, and adding the medication droperidol to the ED formulary. The measures utilize din the study included standardization of medication choice for severe agitation and time in physical restraints. The study found that during the intervention and maintenance components, there were 129 ED visits with medication administered for severe agitation and 10 ED visits where physical restraints were used. Among ED visits with medication given for severe agitation, there was an increase from 8% to 88% in standardized medication choice (olanzapine or droperidol), and a decrease in mean minutes in physical restraints from 173 to 71.
AHRQ-funded; HS026385.
Citation: Hoffman JA, Pergjika A, Liu L .
Standardizing and improving care for pediatric agitation management in the emergency department.
Pediatrics 2023 Jul 1; 152(1). doi: 10.1542/peds.2022-059586..
Keywords: Children/Adolescents, Emergency Department, Behavioral Health, Quality Improvement, Quality of Care
Richards JE, Yarborough BJH, Holden E
Implementation of suicide risk estimation analytics to support mental health care for quality improvement.
The purpose of this mixed-methods quality improvement study was to examine and describe the use of estimation analytics to enhance existing suicide prevention practices during routine mental health specialty engagements. The study found that during the 3.5 month observation period there were 4,789 patient engagements by 1939 patients. This included 161 engagements newly identified by suicide risk estimation analytics. The researchers reported that the engagement-based risk identifications did not consistently trigger additional suicide risk assessment as intended. During newly identified engagements: 57 patients reported frequent suicidal ideation and, as per preexisting workflow, 54 completed a Columbia-Suicide Severity Rating Scale (C-SSRS); 75 patients reported no or infrequent suicidal ideation, but only 10 completed a C-SSRS, per new workflow; 29 patients did not answer the Patient Health Questionnaire-9 (PHQ-9), and only 1 patient completed a C-SSRS, per new workflow. The providers interviewed (n = 8) reported important implementation concerns, including 1) lack of follow-up, 2) electronic health record- (EHR-) related inefficiencies, and 3) reliability and accuracy of the trigger. The patients interviewed (n = 20) repeated concerns about reliability and accuracy of estimation analytics. In addition, providers described concerns about access to care and potential liability associated with known suicide risk. Patients repeated the provider concerns about access and reported fears about identification of suicide risk resulting in coercive care. The researchers conclude that this unique quality improvement study underscores important implications for health care organizations considering implementation of estimation analytics to support engagement-based identification of suicide risk.
AHRQ-funded; HS026369.
Citation: Richards JE, Yarborough BJH, Holden E .
Implementation of suicide risk estimation analytics to support mental health care for quality improvement.
JAMA Netw Open 2022 Dec;5(12):e2247195. doi: 10.1001/jamanetworkopen.2022.47195..
Keywords: Behavioral Health, Quality Improvement, Quality of Care
Liu FF, Lew A, Andes E
Implementation strategies for depression and anxiety screening in a pediatric cystic fibrosis center: a quality improvement project.
The objective of this study was to share key strategies that led to successful mental health screening (MHS) implementation in one pediatric cystic fibrosis center and to report implementation and screening outcomes. Results showed that leveraging coproduction to address stakeholder needs led to successful implementation of a sustainable MHS process.
AHRQ-funded; HS026393.
Citation: Liu FF, Lew A, Andes E .
Implementation strategies for depression and anxiety screening in a pediatric cystic fibrosis center: a quality improvement project.
Pediatr Pulmonol 2020 Dec;55(12):3328-36. doi: 10.1002/ppul.24951..
Keywords: Children/Adolescents, Respiratory Conditions, Chronic Conditions, Depression, Anxiety, Behavioral Health, Screening, Implementation, Quality Improvement, Quality of Care, Diagnostic Safety and Quality
Mueller KL, Naganathan S, Griffey RT
Counseling on Access to Lethal Means-Emergency Department (CALM-ED): a quality improvement program for firearm injury prevention.
The authors evaluated the feasibility of the Counseling on Access to Lethal Means intervention in the Emergency Department (CALM-ED) by non-physician personnel. Their quality improvement study was conducted in an urban, academic ED with over 90,000 annual patient visits, and considered adult patients who were discharged after presenting to the ED with a suicidal crisis. They found that an ED-based CALM quality-improvement intervention was feasible for implementation by non-physician personnel and was well received by patients and families. They concluded that the intervention has the potential to help saves lives at times of suicide crisis.
AHRQ-funded; HS025052.
Citation: Mueller KL, Naganathan S, Griffey RT .
Counseling on Access to Lethal Means-Emergency Department (CALM-ED): a quality improvement program for firearm injury prevention.
West J Emerg Med 2020 Aug 20;21(5):1123-30. doi: 10.5811/westjem.2020.5.46952.
.
.
Keywords: Emergency Department, Injuries and Wounds, Prevention, Quality Improvement, Quality of Care, Domestic Violence, Behavioral Health
Israel N, McMillen JC, Adams DR
Development of quality management capacity in child-serving nonprofit agencies.
In this study, the authors explored quality management capabilities and their development at nine different child serving agencies. Respondents described four emergent core quality management capabilities, although none of the nine agencies excelled at all four. The researchers discussed quality management capability and implications for research, policy, and practice.
AHRQ-funded; HS000084.
Citation: Israel N, McMillen JC, Adams DR .
Development of quality management capacity in child-serving nonprofit agencies.
Adm Policy Ment Health 2020 Jan;47(1):94-106. doi: 10.1007/s10488-019-00971-w..
Keywords: Children/Adolescents, Behavioral Health, Organizational Change, Quality Improvement, Quality of Care
Forman-Hoffman VL, Middleton JC, McKeeman JL
Quality improvement, implementation, and dissemination strategies to improve mental health care for children and adolescents: a systematic review.
The researchers describe the process by which they created an online interactive community resources map for use in the Connect for Health randomized controlled trial. The trial was conducted in the 6 pediatric practices that cared for the highest percentage of children with overweight or obesity. Parents and community partners identified several community resources that could help support behavior change.
AHRQ-funded; 290201200008I.
Citation: Forman-Hoffman VL, Middleton JC, McKeeman JL .
Quality improvement, implementation, and dissemination strategies to improve mental health care for children and adolescents: a systematic review.
Implement Sci 2017 Jul 24;12(1):93. doi: 10.1186/s13012-017-0626-4.
.
.
Keywords: Children/Adolescents, Communication, Behavioral Health, Quality of Care, Quality Improvement
Ford JH, 2nd, Oliver KA, Giles M
Maintenance of certification: how performance in practice changes improve tobacco cessation in addiction psychiatrists' practice.
This study reports on findings from a Maintenance of Certification (MOC) Performance in Practice (PIP) module designed and evaluated by addiction psychiatrists who are members of the American Academy of Addiction Psychiatry. It found that simple change projects designed to improve clinical practice led to substantial changes in self-reported chart documentation for the selected measure.
AHRQ-funded; HS021962.
Citation: Ford JH, 2nd, Oliver KA, Giles M .
Maintenance of certification: how performance in practice changes improve tobacco cessation in addiction psychiatrists' practice.
Am J Addict 2017 Jan;26(1):34-41. doi: 10.1111/ajad.12480.
.
.
Keywords: Behavioral Health, Education: Continuing Medical Education, Provider: Health Personnel, Quality Improvement, Tobacco Use
Patel SR, Gorritz M, Olfson M
Training community-based primary care physicians in the screening and management of mental health disorders among Latino primary care patients.
The researchers evaluated a quality improvement intervention to improve the screening and management (e.g., referral to psychiatric care) of common mental disorders in small independent Latino primary care practices. They concluded that improving the quality of mental health care in low-resourced primary care settings may require academic detailing and consultation/liaison psychiatric intervention supplemented with staff outreach to achieve meaningful improvement in the processes of care.
AHRQ-funded; HS021112.
Citation: Patel SR, Gorritz M, Olfson M .
Training community-based primary care physicians in the screening and management of mental health disorders among Latino primary care patients.
Gen Hosp Psychiatry 2016 Jan-Feb;38:71-8. doi: 10.1016/j.genhosppsych.2015.09.006.
.
.
Keywords: Community-Based Practice, Primary Care, Behavioral Health, Racial and Ethnic Minorities, Quality Improvement