National Healthcare Quality and Disparities Report
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Topics
- Adverse Events (2)
- Alcohol Use (1)
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- Blood Clots (1)
- Caregiving (1)
- Care Management (1)
- Central Line-Associated Bloodstream Infections (CLABSI) (1)
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- Surgery (1)
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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 14 of 14 Research Studies DisplayedJenkins JL, Hsu EB, Zhang A
Current evidence for infection prevention and control interventions in emergency medical services: a scoping review.
This study’s aim was to summarize current evidence from the United States on the effectiveness of practices and interventions for preventing, recognizing, and controlling occupationally acquired infectious diseases in Emergency Medical Service (EMS) clinicians. A database search was conducted for literature published January 2006 through March 15, 2022 to search for studies in the United States that involved EMS clinicians and firefighters, reported on one or more workplace practices or interventions that prevented or controlled infectious diseases, and included outcome measures. Eleven observational studies reported on infection prevention and control (IPC) practices providing evidence that hand hygiene, standard precautions, mandatory vaccine policies, and on-site vaccine clinics are effective. Less frequent handwashing and less frequent hand hygiene after glove use were positively correlated with nasal colonization of Methicillin-resistant Staphylococcus aureus (MRSA). Lack of personal protective equipment (PPE) or PPE breach were correlated with higher severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seropositivity and virus 2 (SARS-CoV-2) seropositivity. Workers were more likely to be vaccinated against influenza if their employer offered the vaccine. Vaccination rates for H1N1 influenza increased with the use of active, targeted education modules.
AHRQ-funded; 75Q80120D00003.
Citation: Jenkins JL, Hsu EB, Zhang A .
Current evidence for infection prevention and control interventions in emergency medical services: a scoping review.
Prehosp Disaster Med 2023 Jun; 38(3):371-77. doi: 10.1017/s1049023x23000389..
Keywords: COVID-19, Emergency Department, Evidence-Based Practice, Prevention, Public Health, Infectious Diseases
Holland JE, Varni SE, Pulcini CD
Assessing the relationship between well-care visit and emergency department utilization among adolescents and young adults.
This study investigated the association between adolescent and young adult (AYA) well-care visits and emergency department (ED) utilization. Vermont’s all-payer claims data for 2018 was used to evaluate visits for 49,089 AYAs (aged 12-21 years) with a health-care claim. Nearly half (49%) of AYAs who engaged with the health-care system did not have a well-care visit in 2018. Those AYAs had 24% greater odds of going to the ED at least once in 2018, controlling for age, sex, insurance type, and medical complexity. Late adolescents and young adults (aged 18-21) who did not attend a well-care visit had 47% greater odds of ED visits, middle adolescents (15-17 years) had 9% greater odds, and early adolescents (12-14 years) had 16% greater odds.
AHRQ-funded; HS024575.
Citation: Holland JE, Varni SE, Pulcini CD .
Assessing the relationship between well-care visit and emergency department utilization among adolescents and young adults.
J Adolesc Health 2022 Jan;70(1):64-69. doi: 10.1016/j.jadohealth.2021.08.011..
Keywords: Children/Adolescents, Young Adults, Emergency Department, Healthcare Utilization, Medicaid, Prevention
Serina P, Lo AX, Kocherginsky M
The clinical frailty scale and health services use for older adults in the emergency department.
The 2013 consensus geriatric emergency department (GED) guidelines, endorsed by the American Geriatrics Society and other professional societies, recommend “routine screening for all older adult patients at higher risk for adverse outcomes.” However, current screening tools are not predictive of health services use. In this study, the investigators evaluated whether CFS may be a useful ED screening tool by examining its association with health services use for older adults.
AHRQ-funded; HS026489.
Citation: Serina P, Lo AX, Kocherginsky M .
The clinical frailty scale and health services use for older adults in the emergency department.
J Am Geriatr Soc 2021 Mar;69(3):837-39. doi: 10.1111/jgs.16937..
Keywords: Elderly, Emergency Department, Screening, Prevention
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.
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Keywords: Emergency Department, Injuries and Wounds, Prevention, Quality Improvement, Quality of Care, Domestic Violence, Behavioral Health
Burner E, Zhang M, Terp S
Feasibility and acceptability of a text message-based intervention to reduce overuse of alcohol in emergency department patients: controlled proof-of-concept trial.
The objective of this study was to assess the feasibility of and patient satisfaction with a text-based mHealth extension of an emergency department (ED) screening program to reduce risky alcohol use in low-income, urban patients. A case-control study was designed using a SMS text message-capable phones to receive mROAD (mobilizing to Reduce Overuse of Alcohol in the ED), an SMS text message-based extension of the ED screening program. mROAD is a 7-day program of twice-daily SMS text messages based on the NIH Health Rethinking Drinking campaign. Of 1028 patients screened, 9.2% exhibited risky alcohol use based on the Alcohol Use Disorders Identification Test (AUDIT) in the ED. Almost a quarter of the patients did not have an SMS text-messaging capable phone, leaving 76% eligible patients. Changes in behavior were similar between the two groups. The number of drinking days reported in the prior 30 days decreased by 5 and the number of heavy drinking days decreased by 4.1. Patients reported an 11-point increase in motivation to change alcohol use via the Change Questionnaire.
AHRQ-funded; HS022402.
Citation: Burner E, Zhang M, Terp S .
Feasibility and acceptability of a text message-based intervention to reduce overuse of alcohol in emergency department patients: controlled proof-of-concept trial.
JMIR Mhealth Uhealth 2020 Jun 4;8(6):e17557. doi: 10.2196/17557..
Keywords: Alcohol Use, Substance Abuse, Emergency Department, Telehealth, Health Information Technology (HIT), Screening, Prevention
Haukoos JS, Lyons MS, Rothman RE
The evolving landscape of HIV screening in the emergency department.
This article is a summary of two studies that appear in the same edition of the journal. The two studies describe the value of using targeted vs. non-targeted screening for HIV in emergency departments (EDs). New diagnosis rates were relatively small, which suggested that the use of targeted screening may be need to be refined more in terms of selection criteria.
AHRQ-funded; HS021749.
Citation: Haukoos JS, Lyons MS, Rothman RE .
The evolving landscape of HIV screening in the emergency department.
Ann Emerg Med 2018 Jul;72(1):54-56. doi: 10.1016/j.annemergmed.2018.01.041..
Keywords: Diagnostic Safety and Quality, Emergency Department, Human Immunodeficiency Virus (HIV), Prevention, Screening
Murphy PB, Vogt KN, Lau BD
Venous thromboembolism prevention in emergency general surgery: a review.
Operatively and nonoperatively treated emergency general surgery patients are at a comparatively high risk of venous thromboembolism (VTE). This review found that, despite gaps in existing literature with respect to this increasing patient population, successful best practices can be applied. Best practices include assessment of VTE risk, optimal prophylaxis, and physician, nurse, and patient education regarding the use of mechanical and pharmacologic VTE prophylaxis and institutional policies.
AHRQ-funded; HS024547.
Citation: Murphy PB, Vogt KN, Lau BD .
Venous thromboembolism prevention in emergency general surgery: a review.
JAMA Surg 2018 May;153(5):479-86. doi: 10.1001/jamasurg.2018.0015..
Keywords: Blood Clots, Surgery, Emergency Department, Adverse Events, Prevention, Patient Safety
Patterson BW, Repplinger MD, Pulia MS
Using the Hendrich II Inpatient Fall Risk Screen to predict outpatient falls after emergency department visits.
This study examined the utility of using the Hendrich II Inpatient Fall Risk Screen to predict outpatient falls in elderly patients after emergency department (ED) visits. Individuals aged 65 and older seen in the ED from January 2013 to September 30, 2015 participated in the study. The Hendrich II screen was found to correlate with outpatient falls, but it is likely it would have little utility as a stand-alone fall screen. When the screen was combined with other potential confounders or predictors, the screen performed much better.
AHRQ-funded; HS024558.
Citation: Patterson BW, Repplinger MD, Pulia MS .
Using the Hendrich II Inpatient Fall Risk Screen to predict outpatient falls after emergency department visits.
J Am Geriatr Soc 2018 Apr;66(4):760-65. doi: 10.1111/jgs.15299..
Keywords: Elderly, Falls, Risk, Emergency Department, Electronic Health Records (EHRs), Health Information Technology (HIT), Prevention, Patient Safety, Adverse Events
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
Davies S, Schultz E, Raven M
AHRQ Author: Stocks C
Development and validation of the Agency for Healthcare Research and Quality Measures of Potentially Preventable Emergency Department (ED) Visits: the ED Prevention Quality Indicators for general health conditions.
The researchers sought to develop and validate rates of potentially preventable emergency department (ED) visits as indicators of community health. ED Prevention Quality Indicators (PQI) rates varied widely across U.S. communities. Indicator rates were significantly associated with county-level poverty, median income, Medicaid insurance, and levels of uninsurance. A few indicators were significantly associated with PCP density, with higher rates in areas with greater density.
AHRQ-authored; AHRQ-funded; 2902012000031.
Citation: Davies S, Schultz E, Raven M .
Development and validation of the Agency for Healthcare Research and Quality Measures of Potentially Preventable Emergency Department (ED) Visits: the ED Prevention Quality Indicators for general health conditions.
Health Serv Res 2017 Oct;52(5):1667-84. doi: 10.1111/1475-6773.12687.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Emergency Department, Quality Indicators (QIs), Patient Safety, Prevention
Gernant SA, Snyder ME, Jaynes H
The effectiveness of pharmacist-provided telephonic medication therapy management on emergency department utilization in home health patients.
This article's objective is to evaluate the effectiveness of a telephonic medication therapy management (MTM) service on reducing emergency department utilization within a Medicare-insured home health population. The authors found that this pharmacist-delivered telephonic medication therapy management program did not decrease emergency department utilization overall but may further reduce the such risk among patients who are at lower risk of utilization.
AHRQ-funded; HS022119.
Citation: Gernant SA, Snyder ME, Jaynes H .
The effectiveness of pharmacist-provided telephonic medication therapy management on emergency department utilization in home health patients.
J Pharm Technol 2016 Oct 1;32(5):179-84. doi: 10.1177/8755122516660376.
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Keywords: Care Management, Emergency Department, Medication, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Prevention, Provider: Pharmacist, Provider
Yanagizawa-Drott L, Kurland L, Schuur JD
Infection prevention practices in Swedish emergency departments: results from a cross-sectional survey.
This study aimed to estimate the extent to which Swedish EDs have adopted evidence-based measures to prevent healthcare-associated infections (HAIs). It found that thirty-nine percent of EDs participate in a project to improve hand hygiene compliance. Staff hand hygiene compliance rates were audited at least monthly in 45 percent of EDs. Forty-three percent reported a compliance rate of 80 percent or more.
AHRQ-funded; HS021616; HS020013.
Citation: Yanagizawa-Drott L, Kurland L, Schuur JD .
Infection prevention practices in Swedish emergency departments: results from a cross-sectional survey.
Eur J Emerg Med 2015 Oct;22(5):338-42. doi: 10.1097/mej.0000000000000159..
Keywords: Emergency Department, Emergency Medical Services (EMS), Healthcare-Associated Infections (HAIs), Prevention, Risk
Theodoro D, Olsen MA, Warren DK
Emergency department central line-associated bloodstream infections (CLABSI) incidence in the era of prevention practices.
The incidence of central line–associated bloodstream infections (CLABSI) attributed to central venous catheters (CVCs) inserted in the emergency department (ED) is not widely reported. The goal of this study was to report the incidence of ED CLABSI. It concluded that the CLABSI rates in this academic medical center ED were in the range of those reported by the ICU.
AHRQ-funded; HS018092; HS019455.
Citation: Theodoro D, Olsen MA, Warren DK .
Emergency department central line-associated bloodstream infections (CLABSI) incidence in the era of prevention practices.
Acad Emerg Med 2015 Sep;22(9):1048-55. doi: 10.1111/acem.12744..
Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Emergency Department, Healthcare-Associated Infections (HAIs), Intensive Care Unit (ICU), Prevention
Rosenman MB, Szucs KA, Finnell SM
Nascent regional system for alerting infection preventionists about patients with multidrug-resistant gram-negative bacteria: implementation and initial results.
The authors sought to build and to begin evaluating a regional automated system to notify infection preventionists (IPs) when a patient with a history of gram-negative rod multidrug-resistant organism (GNRMDRO) is admitted to an emergency department (ED) or inpatient setting. They found it feasible to create a regional microbiology-based alert system and observed substantial crossover between institutions. They concluded that this system, if it contributes to timely isolation, may help reduce the spread of GNRMDROs.
AHRQ-funded; HS020014.
Citation: Rosenman MB, Szucs KA, Finnell SM .
Nascent regional system for alerting infection preventionists about patients with multidrug-resistant gram-negative bacteria: implementation and initial results.
Infect Control Hosp Epidemiol 2014 Oct;35 Suppl 3:S40-7. doi: 10.1086/677833.
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Keywords: Emergency Department, Infectious Diseases, Inpatient Care, Patient Safety, Prevention