National Healthcare Quality and Disparities Report
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Topics
- Adverse Events (1)
- Cardiovascular Conditions (1)
- Diagnostic Safety and Quality (1)
- Digestive Disease and Health (1)
- Education: Continuing Medical Education (1)
- Emergency Department (1)
- Evidence-Based Practice (1)
- Heart Disease and Health (1)
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- Long-Term Care (1)
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- Newborns/Infants (1)
- Nursing Homes (1)
- Obesity (2)
- Obesity: Weight Management (1)
- (-) Outcomes (14)
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- Patient Safety (2)
- Pregnancy (1)
- Provider (1)
- Provider: Physician (4)
- (-) Provider Performance (14)
- Quality Improvement (5)
- Quality Indicators (QIs) (2)
- Quality Measures (4)
- Quality of Care (7)
- Stroke (1)
- Surgery (8)
- Women (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 14 of 14 Research Studies DisplayedKanters AE, Evilsizer SK, Regenbogen SE
Correlation of colorectal surgical skill with patient outcomes: a cautionary tale.
Some have proposed that video-based skill assessments be used as a way to measure technical skills, quality improvement, and credentialing in colorectal surgeons and other practitioners. However, it must first be determined whether video-based assessments can accurately predict patient outcomes. The researchers assembled a panel of 10 peer surgeons to evaluate videos of minimally invasive colectomy procedures submitted by 21 surgeons. Each surgeon submitted one video, and the videos were edited to highlight key steps in the procedure. The panel and the surgeon participants were all associated with the Michigan Surgical Quality Collaborative. The panel used a validated American Society of Colon and Rectal Surgeons assessment instrument to rate the surgeon’s skills. The surgeon’s ratings were then linked to a validated registry of surgical outcomes, and the researchers assessed the relationship between skill level and risk-adjusted complication rates. The researchers found that after risk-adjustment there was no statistically significant difference in complication rates between the bottom (17.5%) and top (16.8%) quartile surgeons (p=0.41). The study concluded that there was no correlation between video-based peer rating of minimally invasive colectomy and postoperative complications among specialty surgeons, and that caution should be used when utilizing video review in credentialing.
AHRQ-funded; HS025365.
Citation: Kanters AE, Evilsizer SK, Regenbogen SE .
Correlation of colorectal surgical skill with patient outcomes: a cautionary tale.
Dis Colon Rectum 2022 Mar;65(3):444-51. doi: 10.1097/dcr.0000000000002124..
Keywords: Surgery, Provider: Physician, Provider Performance, Digestive Disease and Health, Outcomes
Thelen AE, Kendrick DE, Chen X
Novel method to link surgical trainee performance data to patient outcomes.
A significant roadblock in surgical education research has been the inability to compare trainee performance to the outcomes of those surgeons after they enter independent practice. In this study, the investigators described the feasibility of an innovative method to link trainee performance data with patient outcomes. They indicated that this innovation could enable future research investigating the relationship between surgical trainee performance and patient outcomes in independent practice.
AHRQ-funded; HS027653.
Citation: Thelen AE, Kendrick DE, Chen X .
Novel method to link surgical trainee performance data to patient outcomes.
Am J Surg 2021 Dec;222(6):1072-78. doi: 10.1016/j.amjsurg.2021.10.018..
Keywords: Surgery, Education: Continuing Medical Education, Provider Performance, Provider: Physician, Outcomes
Cardell CF, Knapp L, Cohen ME
Successful implementation of enhanced recovery in elective colorectal surgery is variable and dependent on the local environment.
This study looked at the results of a national colorectal enhanced recovery program (ERP) to improve patient outcomes. A total of 207 hospitals participated between 2017 and 2020. Quantitative (patient-level process and outcome) and qualitative (survey and structured interviews with hospital teams) data were collected and analyzed. Results shows that 62 hospitals were characterized as High Performance, and 52 as High Improvement. High Performance hospitals were larger with more annual colorectal surgeries. Fewer barriers to staff-buy-in and competing priorities, and more experience with standardized perioperative care were also characteristics of High Performance hospitals. High Improvement hospitals had lower baseline process measure (PM) adherence and less experience with perioperative care but had positive trends in annual patient outcomes such as annual morbidity, readmission, and prolonged length of stay compared to Low Improvement Hospitals.
AHRQ-funded; 233201500020I.
Citation: Cardell CF, Knapp L, Cohen ME .
Successful implementation of enhanced recovery in elective colorectal surgery is variable and dependent on the local environment.
Ann Surg 2021 Oct 1;274(4):605-12. doi: 10.1097/sla.0000000000005069..
Keywords: Surgery, Quality Improvement, Quality of Care, Outcomes, Patient-Centered Outcomes Research, Provider Performance
Greenberg CC, Byrnes ME, Engler TA
Association of a statewide surgical coaching program with clinical outcomes and surgeon perceptions.
Investigators assessed risk-adjusted outcomes and participant perceptions following a statewide coaching program for bariatric surgeons. They found that this surgical coaching program was perceived as valuable and surgeons reported numerous practice changes. Additionally, operative times improved, but there was no significant improvement in risk-adjusted outcomes.
AHRQ-funded; HS023597.
Citation: Greenberg CC, Byrnes ME, Engler TA .
Association of a statewide surgical coaching program with clinical outcomes and surgeon perceptions.
Ann Surg 2021 Jun;273(6):1034-39. doi: 10.1097/sla.0000000000004800..
Keywords: Surgery, Provider: Physician, Provider Performance, Outcomes
Meyers DJ, Trivedi AN, Wilson IB, DJ, Trivedi AN, Wilson IB
Higher Medicare Advantage Star Ratings are associated with improvements In patient outcomes.
Researchers examined CMS' five-star rating system for the overall quality of Medicare Advantage (MA) contracts. They found that enrollees experiencing a one-star MA rating increase were 20.8 percent less likely to leave their plan voluntarily to enroll in another plan or traditional Medicare. When hospitalized, enrollees were 3.4 percent more likely to use a higher-quality hospital and 2.6 percent less likely to be readmitted within ninety days. These findings suggest that MA star ratings may capture key domains of an MA plan's quality.
AHRQ-funded; HS027051.
Citation: Meyers DJ, Trivedi AN, Wilson IB, DJ, Trivedi AN, Wilson IB .
Higher Medicare Advantage Star Ratings are associated with improvements In patient outcomes.
Health Aff 2021 Feb;40(2):243-50. doi: 10.1377/hlthaff.2020.00845..
Keywords: Patient Experience, Provider Performance, Medicare, Quality Improvement, Quality of Care, Outcomes
Colton K, Richards CT, Pruitt PB
Early stroke recognition and time-based emergency care performance metrics for intracerebral hemorrhage.
This study compared time for early stroke recognition for intracerebral hemorrhage for hospitals with and without stroke teams. An observational cohort study was conducted at an urban comprehensive stroke center from 2009 to 2017 with 204 cases included. Stroke team activation resulted in faster emergency care compared to no activation. This process resulted in shorter onset-to-arrival times, higher NIH Stroke Scale scores, and higher Glasgow Coma Scale scores.
AHRQ-funded; HS023437.
Citation: Colton K, Richards CT, Pruitt PB .
Early stroke recognition and time-based emergency care performance metrics for intracerebral hemorrhage.
J Stroke Cerebrovasc Dis 2020 Feb;29(2):104552. doi: 10.1016/j.jstrokecerebrovasdis.2019.104552..
Keywords: Stroke, Emergency Department, Provider Performance, Diagnostic Safety and Quality, Quality Improvement, Quality Indicators (QIs), Patient-Centered Outcomes Research, Outcomes, Quality of Care, Evidence-Based Practice, Hospitals
Sheetz KH, Ibrahim AM, Nathan H
Variation in surgical outcomes across networks of the highest-rated US hospitals.
This longitudinal analysis of 87 hospitals in 1 of 16 networks who were affiliated with the US News & World Report Honor Roll hospitals discusses variation in surgical outcomes compared with their network affiliates. Data was used from Medicare beneficiaries who underwent colectomy, coronary artery bypass graft, or hip replacement between 2005 and 2014. Thirty-day postoperative complications, mortality, failure to rescue and readmissions were compared. Outcomes were not consistently better at Honor Roll hospitals compared with their network affiliates. Honor Roll hospitals had lower failure to rescue rates but higher complication rates.
AHRQ-funded; HS023597.
Citation: Sheetz KH, Ibrahim AM, Nathan H .
Variation in surgical outcomes across networks of the highest-rated US hospitals.
JAMA Surg 2019 Jun;154(6):510-15. doi: 10.1001/jamasurg.2019.0090..
Keywords: Surgery, Outcomes, Provider Performance, Hospitals, Quality of Care
Campbell KH, Illuzzi JL, Lee HC
Optimal maternal and neonatal outcomes and associated hospital characteristics.
The goal of this study was to examine hospital variation in both maternal and neonatal morbidities and to identify institutional characteristics associated with hospital performance in a combined measure of maternal and neonatal outcomes. The authors found that hospitals with low maternal morbidity rates may not have low neonatal morbidity rates and vice versa, highlighting the importance of assessing joint maternal-newborn outcomes in order to fully characterize a hospital's obstetrical performance.
AHRQ-funded; HS023801.
Citation: Campbell KH, Illuzzi JL, Lee HC .
Optimal maternal and neonatal outcomes and associated hospital characteristics.
Birth 2019 Jun;46(2):289-99. doi: 10.1111/birt.12400.
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Keywords: Hospitals, Newborns/Infants, Outcomes, Pregnancy, Provider Performance, Quality of Care, Women
Spatz ES
Fostering a culture to support surgical outcome measures.
This editorial comments on the relationship of surgical skills (referring to the gentleness, tissue exposure, instrument handling, time and motion, and flow of operation) and patient outcomes
AHRQ-funded; HS023000.
Citation: Spatz ES .
Fostering a culture to support surgical outcome measures.
Circ Cardiovasc Qual Outcomes 2016 Jul;9(4):345-7. doi: 10.1161/circoutcomes.116.003038.
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Keywords: Outcomes, Provider Performance, Quality Measures, Surgery
Niknam BA, Arriaga AF, Rosenbaum PR
Adjustment for atherosclerosis diagnosis distorts the effects of percutaneous coronary intervention and the ranking of hospital performance.
The researchers investigated how adjustment for atherosclerosis affects rankings of hospitals that perform percutaneous coronary intervention (PCI). They found that atherosclerosis is almost always noted in patients with acute myocardial infarction (AMI) who undergo interventional cardiology but less often in medically managed patients, so adjustment for its notation likely removes part of the effect of interventional treatment. Thus, hospitals performing more extensive imaging and more PCIs have higher atherosclerosis diagnosis rates, making their patients appear healthier and artificially reducing the expected mortality rate against which they are benchmarked. The authors concluded that atherosclerosis adjustment is detrimental to hospitals providing more thorough AMI care.
AHRQ-funded; HS023560.
Citation: Niknam BA, Arriaga AF, Rosenbaum PR .
Adjustment for atherosclerosis diagnosis distorts the effects of percutaneous coronary intervention and the ranking of hospital performance.
J Am Heart Assoc 2018 May 25;7(11). doi: 10.1161/jaha.117.008366.
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Keywords: Cardiovascular Conditions, Outcomes, Heart Disease and Health, Provider Performance, Quality Measures
Stevens H, Carlin AM, Ross R
Effect of surgeon age on bariatric surgery outcomes.
This study examined the effect of surgeon age on complication rates for bariatric surgery. A retrospective study was done with 71 surgeons in Michigan who participated in a statewide collaborative improvement program. Older surgeons performed more Roux-en Y Gastric Bypass (40%) and less sleeve gastrectomy (38.8%) than younger surgeons. There was not found to be any statistically significant differences in patient outcome between the two age groups.
AHRQ-funded; HS024403.
Citation: Stevens H, Carlin AM, Ross R .
Effect of surgeon age on bariatric surgery outcomes.
Ann Surg 2018 May;267(5):905-09. doi: 10.1097/sla.0000000000002297..
Keywords: Adverse Events, Obesity, Outcomes, Patient Safety, Provider, Provider: Physician, Provider Performance
Varban OA, Greenberg CC, Schram J
Surgical skill in bariatric surgery: Does skill in one procedure predict outcomes for another?
Whether skill for one bariatric procedure can predict outcomes for another related procedure is unknown. This study found that video ratings of surgical skill with laparoscopic gastric bypass do not predict outcomes of laparoscopic sleeve gastrectomy. Evaluation of surgical skill with one procedure may not apply to other related procedures and may require independent assessment of surgical technical proficiency.
AHRQ-funded; R01 HS023597.
Citation: Varban OA, Greenberg CC, Schram J .
Surgical skill in bariatric surgery: Does skill in one procedure predict outcomes for another?
Surgery 2016 Nov;160(5):1172-81. doi: 10.1016/j.surg.2016.04.033.
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Keywords: Surgery, Obesity: Weight Management, Obesity, Outcomes, Provider Performance
Maggard-Gibbons M
The use of report cards and outcome measurements to improve the safety of surgical care: the American College of Surgeons National Surgical Quality Improvement Program.
This review summarized the history of American College of Surgeons National Surgical Quality Improvement Project and its components, and described the evidence that feeding outcomes back to providers, along with real-time comparisons with other hospital rates, leads to quality improvement, better patient outcomes, cost savings and overall improved patient safety.
AHRQ-funded; 2902007100621.
Citation: Maggard-Gibbons M .
The use of report cards and outcome measurements to improve the safety of surgical care: the American College of Surgeons National Surgical Quality Improvement Program.
BMJ Qual Saf 2014 Jul;23(7):589-99. doi: 10.1136/bmjqs-2013-002223..
Keywords: Quality Improvement, Quality Indicators (QIs), Quality Measures, Quality of Care, Surgery, Patient Safety, Outcomes, Patient-Centered Outcomes Research, Provider Performance
Werner RM, Konetzka RT, Kim MM
Quality improvement under nursing home compare: the association between changes in process and outcome measures.
The researchers tested the extent to which improvements in outcomes of care are explained by changes in nursing home processes. Of the 5 outcome measures examined, they found that only improvements in the percentage of nursing home residents in moderate or severe pain were associated with changes in nursing home processes of care. They concluded that understanding the mechanism behind improvements in nursing home outcomes may be key to successfully achieving broad quality improvements across nursing homes.
AHRQ-funded; HS021861.
Citation: Werner RM, Konetzka RT, Kim MM .
Quality improvement under nursing home compare: the association between changes in process and outcome measures.
Med Care 2013 Jul;51(7):582-8. doi: 10.1097/MLR.0b013e31828dbae4.
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Keywords: Nursing Homes, Long-Term Care, Quality Improvement, Quality Measures, Quality of Care, Provider Performance, Outcomes