National Healthcare Quality and Disparities Report
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Search All Research Studies
Topics
- Adverse Events (8)
- Caregiving (2)
- Children/Adolescents (2)
- (-) Clinician-Patient Communication (18)
- Communication (11)
- Critical Care (1)
- Cultural Competence (1)
- Disparities (1)
- Education: Continuing Medical Education (1)
- Education: Patient and Caregiver (2)
- Electronic Health Records (EHRs) (1)
- Evidence-Based Practice (1)
- Healthcare Delivery (1)
- Health Information Technology (HIT) (1)
- Health Literacy (1)
- Hospitalization (2)
- Hospitals (1)
- Inpatient Care (1)
- Medical Errors (6)
- Medical Liability (2)
- Medication (1)
- Medication: Safety (1)
- Opioids (1)
- Palliative Care (1)
- Patient-Centered Healthcare (2)
- Patient and Family Engagement (4)
- Patient Experience (2)
- (-) Patient Safety (18)
- Primary Care (1)
- Provider Performance (1)
- Quality of Care (1)
- Risk (1)
- Surgery (2)
- TeamSTEPPS (1)
- Tools & Toolkits (1)
- Training (2)
- Web-Based (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 18 of 18 Research Studies DisplayedShapiro J, Robins L, Galowitz P
Disclosure coaching: an ask-tell-ask model to support clinicians in disclosure conversations.
The authors developed an "Ask-Tell-Ask" model and materials to guide the disclosure coaching process. In this paper, they described a comprehensive approach to coaching developed over years of coaching experience that incorporates their model, its rationale, step-by-step coaching strategies and guidance, and organizational considerations regarding implementation of a coaching program to support patient-centered transparent communication after harmful events.
AHRQ-funded; HS019531.
Citation: Shapiro J, Robins L, Galowitz P .
Disclosure coaching: an ask-tell-ask model to support clinicians in disclosure conversations.
J Patient Saf 2021 Dec 1;17(8):e1364-e70. doi: 10.1097/pts.0000000000000491..
Keywords: Clinician-Patient Communication, Communication, Medical Liability, Patient Safety
Salzman DH, Rising KL, Cameron KA
Setting a minimum passing standard for the uncertainty communication checklist through patient and physician engagement.
Historically, medically trained experts have served as judges to establish a minimum passing standard (MPS) for mastery learning. As mastery learning expands from procedure-based skills to patient-centered domains, such as communication, there is an opportunity to incorporate patients as judges in setting the MPS. In this study, the investigators described their process of incorporating patients as judges to set the minimum passing standard (MPS) and compared the MPS set by patients and emergency medicine residency program directors (PDs).
AHRQ-funded; HS025651.
Citation: Salzman DH, Rising KL, Cameron KA .
Setting a minimum passing standard for the uncertainty communication checklist through patient and physician engagement.
J Grad Med Educ 2020 Feb;12(1):58-65. doi: 10.4300/jgme-d-19-00483.1..
Keywords: Clinician-Patient Communication, Communication, Patient and Family Engagement, Patient Safety, Education: Continuing Medical Education, Training, Provider Performance
McGovern KM, Wells EE, Landstrom GL
Understanding interpersonal and organizational dynamics among providers responding to crisis.
Patient rescue occurs in phases: recognizing the problem, communicating the concern, and treating the complication. To help improve rescue, the investigators sought to understand facilitators and barriers to managing postoperative complications, using a criterion-based sample from a large academic medical center. The study identified significant variation in communication processes across providers caring for surgical patients.
AHRQ-funded; HS024403.
Citation: McGovern KM, Wells EE, Landstrom GL .
Understanding interpersonal and organizational dynamics among providers responding to crisis.
Qual Health Res 2020 Feb;30(3):331-40. doi: 10.1177/1049732319866818..
Keywords: Surgery, Patient Safety, Adverse Events, Clinician-Patient Communication, Communication
McCarthy DM, Curtis LM, Courtney DM
A multifaceted intervention to improve patient knowledge and safe use of opioids: results of the ED EMC(2) randomized controlled trial.
Despite increased focus on opioid prescribing, little is known about the influence of prescription opioid medication information given to patients in the emergency department (ED). The objective of this study was to evaluate the effect of an Electronic Medication Complete Communication (EMC(2)) Opioid Strategy on patients' safe use of opioids and knowledge about opioids. The study found that the EMC(2) tools improved demonstrated safe dosing, but these benefits did not translate into actual use based on medication dairies. The text-messaging intervention did result in improved patient knowledge.
AHRQ-funded; HS023459.
Citation: McCarthy DM, Curtis LM, Courtney DM .
A multifaceted intervention to improve patient knowledge and safe use of opioids: results of the ED EMC(2) randomized controlled trial.
Acad Emerg Med 2019 Dec;26(12):1311-25. doi: 10.1111/acem.13860..
Keywords: Opioids, Medication, Medication: Safety, Patient Safety, Health Literacy, Education: Patient and Caregiver, Clinician-Patient Communication, Communication, Health Information Technology (HIT)
Gaufberg E, Olmsted MW, Bell SK
Third things as inspiration and artifact: a multi-stakeholder qualitative approach to understand patient and family emotions after harmful events.
The authors discuss an AHRQ conference held to establish a research agenda on patient and family emotional harm after medical errors. Topics include implications for quality and safety, educational innovation, and qualitative research.
AHRQ-funded; HS024463.
Citation: Gaufberg E, Olmsted MW, Bell SK .
Third things as inspiration and artifact: a multi-stakeholder qualitative approach to understand patient and family emotions after harmful events.
J Med Humanit 2019 Dec;40(4):489-504. doi: 10.1007/s10912-019-09563-z..
Keywords: Medical Errors, Adverse Events, Clinician-Patient Communication, Communication, Patient and Family Engagement, Patient Safety
Khan A, Yin HS, Brach C
AHRQ Author: Brach C
Association between parent comfort with English and adverse events among hospitalized children.
The purpose of this study was to examine the association between parents’ limited comfort with English (LCE) and adverse events in a cohort of hospitalized children. Participants included Arabic-, Chinese-, English-, and Spanish-speaking parents of patients 17 years and younger in the pediatric units of seven North American hospitals. Findings showed that hospitalized children of parents expressing LCE were twice as likely to experience harms due to medical care. Targeted strategies are needed to improve communication and safety for this vulnerable group of children.
AHRQ-authored; AHRQ-funded; HS022986.
Citation: Khan A, Yin HS, Brach C .
Association between parent comfort with English and adverse events among hospitalized children.
JAMA Pediatr 2020 Dec;174(12):e203215. doi: 10.1001/jamapediatrics.2020.3215..
Keywords: Children/Adolescents, Caregiving, Cultural Competence, Clinician-Patient Communication, Communication, Adverse Events, Patient Safety, Inpatient Care, Hospitalization
Dossett L, Miller J, Jagsi R
A modified communication and optimal resolution program for intersystem medical error discovery: protocol for an implementation study.
AHRQ’s Communication and Optimal Resolution (CANDOR) Toolkit facilitates transparent communication, error prevention, and achieving optimal resolution with patients and families; how medical errors should be addressed when they are discovered between systems-intersystem medical error discovery (IMED)-remains unclear. This study aims to develop and test implementation of a modified CANDOR process for application to IMED scenarios. Step 1 of aim 1 is currently underway. This work is expected to provide important insights into the potential utility of an implementation toolkit to improve transparent communication and optimal resolution of IMED scenarios.
AHRQ-funded; HS026030.
Citation: Dossett L, Miller J, Jagsi R .
A modified communication and optimal resolution program for intersystem medical error discovery: protocol for an implementation study.
JMIR Res Protoc 2019 Jul 2;8(7):e13396. doi: 10.2196/13396..
Keywords: Adverse Events, Communication, Clinician-Patient Communication, Medical Errors, Patient Safety, Tools & Toolkits
Khan A, Spector ND, Baird JD
Patient safety after implementation of a coproduced family centered communication programme: multicenter before and after intervention study.
The objective of this prospective, multicenter before and after intervention was to determine whether medical errors, family experience, and communication processes improved after implementation of the intervention to standardize the structure of healthcare provider-family communication on family centered rounds. The investigators concluded that although overall errors were unchanged, harmful medical errors decreased and family experience and communication processes improved.
AHRQ-funded; HS00063.
Citation: Khan A, Spector ND, Baird JD .
Patient safety after implementation of a coproduced family centered communication programme: multicenter before and after intervention study.
BMJ 2018 Dec 5;363:k4764. doi: 10.1136/bmj.k4764..
Keywords: Adverse Events, Clinician-Patient Communication, Communication, Medical Errors, Patient and Family Engagement, Patient Safety
Grossman LV, Choi SW, Collins S
Implementation of acute care patient portals: recommendations on utility and use from six early adopters.
This paper provides recommendations on how to most effectively implement advanced features of acute care patient portals, including: (1) patient-provider communication, (2) care plan information, (3) clinical data viewing, (4) patient education, (5) patient safety, (6) caregiver access, and (7) hospital amenities. One specific recommendation was that stakeholders in acute care patient portals should consider the benefits and challenges of generic and structured electronic care team messaging.
AHRQ-funded; HS021816; HS023613; HS023535; HS024349.
Citation: Grossman LV, Choi SW, Collins S .
Implementation of acute care patient portals: recommendations on utility and use from six early adopters.
J Am Med Inform Assoc 2018 Apr;25(4):370-79. doi: 10.1093/jamia/ocx074.
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Keywords: Critical Care, Electronic Health Records (EHRs), Patient Safety, Clinician-Patient Communication, Web-Based
Khan A, Furtak SL, Melvin P
Parent-provider miscommunications in hospitalized children.
The objectives of this study were to: (1) examine characteristics of parent-provider miscommunications about hospitalized children; (2) describe associations among parent-provider miscommunications, parent-reported errors, and hospital experience; and (3) compare parent and attending physician reports of parent-provider miscommunications. The investigators found that parent-provider miscommunications were associated with parent-reported errors and suboptimal hospital experience. Parents reported parent-provider miscommunications more often than attending physicians did.
AHRQ-funded; HS022986; HS000063.
Citation: Khan A, Furtak SL, Melvin P .
Parent-provider miscommunications in hospitalized children.
Hosp Pediatr 2017 Sep;7(9):505-15. doi: 10.1542/hpeds.2016-0190..
Keywords: Adverse Events, Caregiving, Children/Adolescents, Clinician-Patient Communication, Communication, Hospitalization, Hospitals, Medical Errors, Patient Safety
Cox ED, Jacobsohn GC, Rajamanickam VP
A family-centered rounds checklist, family engagement, and patient safety: a randomized trial.
The researchers examined the impact of the family-centered rounds (FCRs) checklist intervention, a checklist and associated provider training, on performance of FCR elements, family engagement, and patient safety. They found that the performance of FCR checklist elements was enhanced by checklist implementation and associated with changes in family engagement and more positive perceptions of safety climate.
AHRQ-funded; HS018680.
Citation: Cox ED, Jacobsohn GC, Rajamanickam VP .
A family-centered rounds checklist, family engagement, and patient safety: a randomized trial.
Pediatrics 2017 May;139(5). doi: 10.1542/peds.2016-1688.
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Keywords: Quality of Care, Patient Safety, Patient and Family Engagement, Clinician-Patient Communication, Training
Nabozny MJ, Kruser JM, Steffens NM
Patient-reported limitations to surgical buy-in: a qualitative study of patients facing high-risk surgery.
The researchers characterized how patients buy-in to treatments beyond the operating room and what limits they would place on additional life-supporting treatments. Their recordings of patients' pre- and post-operative conversations with surgeons showed that patients expressed trust in their surgeon to make decisions about additional treatments if a serious complication occurred. However, patients expressed a preference for significant treatment limitations that were not discussed with their surgeon preoperatively.
AHRQ-funded; HS000078.
Citation: Nabozny MJ, Kruser JM, Steffens NM .
Patient-reported limitations to surgical buy-in: a qualitative study of patients facing high-risk surgery.
Ann Surg 2017 Jan;265(1):97-102. doi: 10.1097/sla.0000000000001645.
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Keywords: Surgery, Palliative Care, Risk, Clinician-Patient Communication, Patient Safety
Gallagher TH, Etchegaray JM, Bergstedt B
Improving communication and resolution following adverse events using a patient-created simulation exercise.
The HealthPact Patient and Family Advisory Council (PFAC) created and led a five-stage simulation exercise to help stakeholders understand what patients experience following an adverse event. Take-homes from these exercises included the fact that the response to adverse events can be complex, siloed, and uncoordinated. Participating in this simulation exercise led stakeholders and patient advocates to express interest in continued collaboration.
AHRQ-funded; HS019531.
Citation: Gallagher TH, Etchegaray JM, Bergstedt B .
Improving communication and resolution following adverse events using a patient-created simulation exercise.
Health Serv Res 2016 Dec;51 Suppl 3:2537-49. doi: 10.1111/1475-6773.12601.
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Keywords: Adverse Events, Clinician-Patient Communication, Medical Errors, Medical Liability, Patient-Centered Healthcare, Patient Safety
Krouss M, Croft L, Morgan DJ
Physician understanding and ability to communicate harms and benefits of common medical treatments.
The researchers evaluated physician understanding of harms and benefits of common tests and therapies. They found that most clinicians overestimate harms and benefits for most treatments. Likewise, most of the clinicians in our study reported rarely or never using statistical terms to explain treatment options to patients. However, they were interested in resources to improve understanding of treatment effect size.
AHRQ-funded; HS018111.
Citation: Krouss M, Croft L, Morgan DJ .
Physician understanding and ability to communicate harms and benefits of common medical treatments.
JAMA Intern Med 2016 Oct;176(10):1565-67. doi: 10.1001/jamainternmed.2016.5027.
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Keywords: Adverse Events, Communication, Education: Patient and Caregiver, Patient Safety, Clinician-Patient Communication
Robinson JD, Tate A, Heritage J
Agenda-setting revisited: when and how do primary-care physicians solicit patients' additional concerns?
The authors assessed the distribution, content, and effectiveness of physicians' post-chief-complaint, agenda-setting questions. They found that physicians' questions designed to solicit concerns additional to chief concerns occurred in only 32% of visits. Further, those that were formatted so as to allow for 'concerns' were significantly more likely to generate some type of agenda item.
AHRQ-funded; HS010922; HS013343.
Citation: Robinson JD, Tate A, Heritage J .
Agenda-setting revisited: when and how do primary-care physicians solicit patients' additional concerns?
Patient Educ Couns 2016 May;99(5):718-23. doi: 10.1016/j.pec.2015.12.009.
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Keywords: Communication, Primary Care, Patient-Centered Healthcare, Patient Safety, Clinician-Patient Communication
Melnick ER
How to make less more: empathy can fill the gap left by reducing unnecessary care.
The author argues that regardless of how overuse of medical services is curtailed, it must be replaced with empathic care. Empathy in patient care is the “cognitive attribute that involves an understanding of patients’ experiences, concerns, and perspectives combined with a capacity to communicate this understanding. Empathic engagement with patients has many benefits. Patients who are engaged by their clinician feel more informed, and more accurately understand the potential benefits and harms of appropriate clinical options.
AHRQ-funded; HS021271.
Citation: Melnick ER .
How to make less more: empathy can fill the gap left by reducing unnecessary care.
BMJ 2015 Nov 4;351:h5831. doi: 10.1136/bmj.h5831..
Keywords: Clinician-Patient Communication, Patient Safety, Patient Experience
Gallagher TH, Mazor KM
Taking complaints seriously: using the patient safety lens.
This editorial defined a patient safety lens that favors learning over protection. It listed five critical components of the patient safety lens and concluded that the first and most important step entails expanding our perspective beyond the technical execution of care to encompass and appreciate patients’ reports of their care experiences.
AHRQ-funded; HS022757.
Citation: Gallagher TH, Mazor KM .
Taking complaints seriously: using the patient safety lens.
BMJ Qual Saf 2015 Jun;24(6):352-5. doi: 10.1136/bmjqs-2015-004337.
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Keywords: Healthcare Delivery, Medical Errors, Patient Safety, Patient Experience, Clinician-Patient Communication
Wasserman M, Renfrew MR, Green AR
AHRQ Author: Brach C
Identifying and preventing medical errors in patients with limited English proficiency: key findings and tools for the field.
This article describes the development, content, and testing of two new evidence-based AHRQ tools for limited English proficiency (LEP) patient safety in the hospital setting. These tools contain recommendations to improve detection and prevention of medical errors across diverse populations and to improve team communication through incorporating interpreters in the care process.
AHRQ-authored
Citation: Wasserman M, Renfrew MR, Green AR .
Identifying and preventing medical errors in patients with limited English proficiency: key findings and tools for the field.
J Healthc Qual. 2014 May-Jun;36(3):5-16. doi: 10.1111/jhq.12065..
Keywords: Disparities, Evidence-Based Practice, Patient Safety, Clinician-Patient Communication, TeamSTEPPS