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
AHRQ Research Studies Date
Topics
- Access to Care (417)
- Adverse Drug Events (ADE) (321)
- Adverse Events (739)
- Alcohol Use (61)
- Ambulatory Care and Surgery (205)
- Antibiotics (249)
- Antimicrobial Stewardship (157)
- Anxiety (48)
- Arthritis (131)
- Asthma (122)
- Autism (31)
- Back Health and Pain (58)
- Behavioral Health (702)
- Blood Clots (63)
- Blood Pressure (133)
- Blood Thinners (79)
- Brain Injury (64)
- Breast Feeding (18)
- Burnout (64)
- Cancer (789)
- Cancer: Breast Cancer (197)
- Cancer: Cervical Cancer (21)
- Cancer: Colorectal Cancer (116)
- Cancer: Lung Cancer (83)
- Cancer: Ovarian Cancer (9)
- Cancer: Prostate Cancer (108)
- Cancer: Skin Cancer (15)
- Cardiovascular Conditions (712)
- Care Coordination (105)
- Caregiving (224)
- Care Management (226)
- Case Study (101)
- Catheter-Associated Urinary Tract Infection (CAUTI) (55)
- Centers for Education and Research on Therapeutics (CERTs) (12)
- Central Line-Associated Bloodstream Infections (CLABSI) (61)
- Children's Health Insurance Program (CHIP) (40)
- Children/Adolescents (1548)
- Chronic Conditions (700)
- Clinical Decision Support (CDS) (200)
- Clinician-Patient Communication (282)
- Clostridium difficile Infections (55)
- Colonoscopy (37)
- Communication (384)
- Community-Acquired Infections (60)
- Community-Based Practice (152)
- Community Partnerships (18)
- Comparative Effectiveness (463)
- Complementary and Alternative Medicine (23)
- Comprehensive Unit-based Safety Program (CUSP) (9)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (85)
- COVID-19 (315)
- Critical Care (220)
- Cultural Competence (64)
- Data (174)
- Dementia (102)
- Dental and Oral Health (66)
- Depression (237)
- Diabetes (370)
- Diagnostic Safety and Quality (547)
- Dialysis (24)
- Digestive Disease and Health (111)
- Disabilities (74)
- Disparities (451)
- Domestic Violence (30)
- Ear Infections (5)
- Education (30)
- Education: Academic (26)
- Education: Continuing Medical Education (159)
- Education: Curriculum (23)
- Education: Patient and Caregiver (231)
- Elderly (944)
- Electronic Health Records (EHRs) (730)
- Electronic Prescribing (E-Prescribing) (26)
- Emergency Department (562)
- Emergency Medical Services (EMS) (163)
- Emergency Preparedness (26)
- Evidence-Based Practice (934)
- Eye Disease and Health (36)
- Falls (85)
- Family Health and History (71)
- Genetics (96)
- Guidelines (364)
- Healthcare-Associated Infections (HAIs) (420)
- Healthcare Cost and Utilization Project (HCUP) (370)
- Healthcare Costs (788)
- Healthcare Delivery (548)
- Healthcare Utilization (385)
- Health Information Exchange (HIE) (51)
- Health Information Technology (HIT) (1430)
- Health Insurance (434)
- Health Literacy (126)
- Health Promotion (79)
- Health Services Research (HSR) (327)
- Health Status (132)
- Health Systems (104)
- Heart Disease and Health (452)
- Hepatitis (41)
- Home Healthcare (141)
- Hospital Discharge (220)
- Hospitalization (534)
- Hospital Readmissions (323)
- Hospitals (759)
- Human Immunodeficiency Virus (HIV) (255)
- Imaging (246)
- Implementation (193)
- Infectious Diseases (260)
- Influenza (42)
- Injuries and Wounds (207)
- Inpatient Care (221)
- Intensive Care Unit (ICU) (267)
- Kidney Disease and Health (199)
- Labor and Delivery (106)
- Learning Health Systems (47)
- Lifestyle Changes (135)
- Long-Term Care (226)
- Low-Income (171)
- Maternal Care (182)
- Medicaid (359)
- Medical Devices (71)
- Medical Errors (205)
- Medical Expenditure Panel Survey (MEPS) (190)
- Medical Liability (26)
- Medicare (575)
- Medication (1684)
- Medication: Safety (232)
- Men's Health (54)
- Methicillin-Resistant Staphylococcus aureus (MRSA) (73)
- Mortality (398)
- Neonatal Intensive Care Unit (NICU) (43)
- Neurological Disorders (197)
- Newborns/Infants (259)
- Nursing (113)
- Nursing Homes (327)
- Nutrition (135)
- Obesity (251)
- Obesity: Weight Management (105)
- Opioids (303)
- Organizational Change (73)
- Orthopedics (107)
- Osteoporosis (30)
- Outcomes (801)
- Pain (208)
- Palliative Care (138)
- Patient-Centered Healthcare (456)
- Patient-Centered Outcomes Research (1035)
- Patient Adherence/Compliance (229)
- Patient and Family Engagement (275)
- Patient Experience (258)
- Patient Safety (1296)
- Patient Self-Management (140)
- Payment (201)
- Pneumonia (83)
- Policy (431)
- Practice-Based Research Network (PBRN) (16)
- Practice Improvement (34)
- Practice Patterns (305)
- Pregnancy (289)
- Pressure Ulcers (28)
- Prevention (794)
- Primary Care (719)
- Primary Care: Models of Care (86)
- Provider (299)
- Provider: Clinician (67)
- Provider: Health Personnel (91)
- Provider: Nurse (112)
- Provider: Pharmacist (99)
- Provider: Physician (237)
- Provider: Physician Assistant (1)
- Provider Performance (199)
- Public Health (183)
- Public Reporting (40)
- Quality Improvement (552)
- Quality Indicators (QIs) (138)
- Quality Measures (228)
- Quality of Care (992)
- Quality of Life (199)
- Racial and Ethnic Minorities (749)
- Registries (146)
- Rehabilitation (61)
- Research Methodologies (419)
- Respiratory Conditions (369)
- Risk (757)
- Rural/Inner-City Residents (23)
- Rural Health (133)
- Screening (457)
- Sepsis (140)
- Sex Factors (67)
- Sexual Health (126)
- Shared Decision Making (583)
- Sickle Cell Disease (49)
- Simulation (49)
- Skin Conditions (121)
- Sleep Problems (70)
- Social Determinants of Health (356)
- Social Media (46)
- Social Stigma (53)
- Stress (71)
- Stroke (162)
- Substance Abuse (300)
- Surgery (1115)
- Surveys on Patient Safety Culture (13)
- System Design (15)
- Teams (138)
- TeamSTEPPS (17)
- Telehealth (258)
- Tobacco Use (83)
- Tobacco Use: Smoking Cessation (22)
- Tools & Toolkits (49)
- Training (143)
- Transitions of Care (192)
- Transplantation (141)
- Trauma (104)
- Treatments (185)
- U.S. Preventive Services Task Force (USPSTF) (217)
- Uninsured (80)
- Urban Health (92)
- Urinary Tract Infection (UTI) (70)
- Vaccination (159)
- Vitamins and Supplements (10)
- Vulnerable Populations (229)
- Web-Based (84)
- Women (545)
- Workflow (66)
- Workforce (89)
- Young Adults (85)
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
76 to 100 of 12169 Research Studies DisplayedLi J
Home health agencies with high quality of patient care star ratings reduced short-term hospitalization rates and increased days independently at home.
Accurate Medicare Quality of Patient Care home health star ratings are crucial to helping patients find high-quality care, yet critics of these ratings indicate that they are not valid. The purpose of this retrospective study was to assess whether using the highest-rated home health agency available in a ZIP code improves outcomes. The researchers included 1,870,080 Medicare fee-for-service beneficiaries using home health care from July 2015 through July 2016 in the United States. The study found that treatment by the highest-rated agencies available decreased risks of hospitalization, emergency department use, and institutionalization during the initial episode, and increased days independently at home by 2.6% or 3.75 days in the 180 days after the end of the initial episode. Treatment effects were stronger for agencies that were above-average, had 1 or more stars than the next-best agency, and nonrural residents. Effects were positive for both postacute and community-entry patients.
AHRQ-funded; HS026836.
Citation: Li J .
Home health agencies with high quality of patient care star ratings reduced short-term hospitalization rates and increased days independently at home.
Med Care 2024 Jan; 62(1):11-20. doi: 10.1097/mlr.0000000000001930..
Keywords: Home Healthcare, Quality of Care, Hospitalization, Provider Performance
Donnelly JP, Seelye SM, Kipnis P
Impact of reducing time-to-antibiotics on sepsis mortality, antibiotic use, and adverse events.
Researchers estimated benefits and harms of shortened time-to-antibiotics for sepsis. Their simulation study used a cohort of over 1.5 million hospitalizations via emergency department with more than two systemic inflammatory response syndrome criteria. The results showed that impacts of faster time-to-antibiotics for sepsis varied markedly across simulated hospital types; however, even in worst-case scenarios, new antibiotic-associated adverse events were rare.
AHRQ-funded; HS026725.
Citation: Donnelly JP, Seelye SM, Kipnis P .
Impact of reducing time-to-antibiotics on sepsis mortality, antibiotic use, and adverse events.
Ann Am Thorac Soc 2024 Jan; 21(1):94-101. doi: 10.1513/AnnalsATS.202306-505OC..
Keywords: Antibiotics, Medication, Sepsis, Mortality
Kaufman BG, Holland DE, Vanderboom CE
Implementation costs of technology-enhanced transitional palliative care for rural caregivers.
Rural FCG experience higher levels of burden accessing coordinated care for their loved ones during and after hospitalization than urban family caregivers (FCG). The role of technology-enhanced transitional palliative care (TPC) on caregiver outcomes is currently being assessed in a randomized control trial. The purpose of this study was to assess resource use and health system costs of this FCG-focused TPC intervention and potential Medicare reimbursement mechanisms. The researchers randomized rural caregivers of hospitalized patients into an 8-week intervention which included video visits conducted by a registered nurse certified in palliative care, and supplemented with phone calls and texts (n = 215), or attentional control. The researchers estimated labor costs for a registered nurse and compared to scenario analyses utilizing a nurse practitioner or social worker wages. Medicare reimbursement scenarios included Transitional Care Management (TCM) and Chronic Care Management (CCM) CPT codes. The researchers found the base case, TPC cost was $395 per FCG conducted by a registered nurse, compared to $337 and $585 if conducted by a social worker or nurse practitioner, respectively. Reimbursement in the CCM-only scenario was $348 and $274 for complex and non-complex patients, respectively. Average Medicare reimbursement in the TCM-only scenario was $322 and $260 for high or moderate complexity patients, respectively. Reimbursement in the TCM+CCM scenario was $496 and $397, for high/complex and moderate/non-complex patients, respectively.
AHRQ-funded; HS026379.
Citation: Kaufman BG, Holland DE, Vanderboom CE .
Implementation costs of technology-enhanced transitional palliative care for rural caregivers.
Am J Hosp Palliat Care 2024 Jan; 41(1):38-44. doi: 10.1177/10499091231156145..
Keywords: Rural Health, Caregiving, Palliative Care, Health Information Technology (HIT)
Eliason EL, Agostino J, Vivier P
Infant health care disruptions by race and ethnicity, income, and insurance during the COVID-19 pandemic.
This cross-sectional study examined the impact that the COVID-19 pandemic had on infant health care, and broke it down by race and ethnicity, income, and insurance type. This study used the Pregnancy Risk Assessment Monitoring System COVID-19 supplement with data from 29 jurisdictions to examine infant health care disruptions due to the pandemic: 1) well visits/checkups canceled or delayed, 2) well visits/checkups changed to virtual appointments, and 3) postponed immunizations. The authors found that among 12,053 parental respondents with infants born from April to December 2020, 7.25% reported cancelations or delays in infant well visits/checkups, 5.49% reported changes to virtual infant care appointments, and 5.33% reported postponing immunizations, with significant differences by race and ethnicity, income, and insurance type. They found higher odds of canceling/delaying visits and postponing immunizations among non-Hispanic Black infants and infants whose parents were uninsured or had Medicaid-paid deliveries. The odds of switching to virtual appointments was also significantly higher among Hispanic infants and infants whose parents had Medicaid-paid deliveries.
AHRQ-funded; HS000011.
Citation: Eliason EL, Agostino J, Vivier P .
Infant health care disruptions by race and ethnicity, income, and insurance during the COVID-19 pandemic.
Acad Pediatr 2024 Jan-Feb; 24(1):105-10. doi: 10.1016/j.acap.2023.07.005..
Keywords: Newborns/Infants, Racial and Ethnic Minorities, COVID-19, Access to Care, Uninsured, Health Insurance, Healthcare Delivery
Cohen TN, Berdahl CT, Coleman BL
Medication safety event reporting: Factors that contribute to safety events during times of organizational stress.
This study’s objective was to understand the insights conveyed in hospital incident reports about how work system factors affected medication safety during a coronavirus disease-2019 (COVID-19) surge. The authors randomly selected 100 medication safety incident reports from an academic medical center (December 2020 to January 2021), identified near misses and errors, and classified contributing work system factors using the Human Factors Analysis and Classification System-Healthcare. Results showed that among 35 near misses/errors, incident reports described contributing factors (mean 1.3/report) involving skill-based errors (n = 20), communication (n = 8), and tools/technology (n = 4). Seven of these events were linked to COVID-19.
AHRQ-funded; HS027455.
Citation: Cohen TN, Berdahl CT, Coleman BL .
Medication safety event reporting: Factors that contribute to safety events during times of organizational stress.
J Nurs Care Qual 2024 Jan-Mar; 39(1):51-57. doi: 10.1097/ncq.0000000000000720..
Keywords: Medication: Safety, Medication, Patient Safety, COVID-19, Adverse Drug Events (ADE), Adverse Events, Medical Errors
Liu S, Matvekas A, Naimi T
Morphomics-informed population pharmacokinetic and physiologically-based pharmacokinetic modeling to optimize cefazolin surgical prophylaxis.
This study’s objective was to use algorithms that repurpose radiologic data into body composition (morphomics) to aid in informing dosing decisions for the antibiotic cefazolin for patients undergoing colorectal surgery who have obesity. This prospective study measured cefazolin plasma, fat, and colon tissue concentrations in these patients to develop a morphomics-informed population pharmacokinetic (PopPK) model to guide dose adjustments. A physiologically-based pharmacokinetic (PBPK) model was also constructed to inform tissue partitioning in 21 morbidly obese patients (body mass index ≥35 kg/m2 with one or more co-morbid conditions). Morphomics and pharmacokinetic data were available in 58 patients with a median weight of 95.9 kg and and 55 years, respectively. The plasma-to-subcutaneous fat partition coefficient was predicted to be 0.072 for the PopPK model and 0.060 for the PBPK model. Covariates of cefazolin exposure were identified as the estimated creatinine clearance (eCL(cr) ) and body depth at the third lumbar vertebra (body depth_L3). The authors concluded that kidney function and morphomics were more informative than body weight as covariates of cefazolin target site exposure. They advised that data from more diverse populations, consensus on target cefazolin exposure, and comparative studies are needed before a change in practice can be implemented.
AHRQ-funded; HS027183.
Citation: Liu S, Matvekas A, Naimi T .
Morphomics-informed population pharmacokinetic and physiologically-based pharmacokinetic modeling to optimize cefazolin surgical prophylaxis.
Pharmacotherapy 2024 Jan; 44(1):77-86. doi: 10.1002/phar.2878..
Keywords: Surgery, Antibiotics, Medication, Prevention, Obesity, Healthcare-Associated Infections (HAIs)
Scharp D, Hobensack M, Davoudi A
Natural language processing applied to clinical documentation in post-acute care settings: a scoping review.
The purpose of this scoping review was to assess the scope of the application of natural language processing to free-text clinical notes in post-acute care and provide a foundation for future natural language processing-based research in the same settings. The researchers searched PubMed, Cumulative Index of Nursing and Allied Health Literature, and Embase in February 2023. Twenty-one eligible studies. Almost all of which were conducted in home health care settings, had quantitative designs that utilized natural language processing applied to clinical documentation in post-acute care settings. Most studies extracted data from electronic health records to explore the risk for negative outcomes, including acute care utilization, medication errors, and suicide mortality. About half of the studies did not report age, sex, race, or ethnicity data or utilize standardized terminologies. Only 8 studies included variables from socio-behavioral domains. Most studies fulfilled all quality appraisal indicators.
AHRQ-funded; HS027742.
Citation: Scharp D, Hobensack M, Davoudi A .
Natural language processing applied to clinical documentation in post-acute care settings: a scoping review.
J Am Med Dir Assoc 2024 Jan; 25(1):69-83. doi: 10.1016/j.jamda.2023.09.006..
Keywords: Health Information Technology (HIT), Home Healthcare
Zamalin D, Hamlin Shults, J J
Predictors of making a referral to child protective services prior to expert consultation.
This study investigated factors affecting child protective services (CPS) referrals before consultation by a Child Abuse Pediatrician (CAP) for suspected cases of physical abuse in children under 5 years old. Analysis revealed that despite the CAP expressing low concern for abuse in 38% of cases, 61% received preconsultation referrals. Socioeconomic biases, particularly evident in referral rates based on insurance status, were found to influence referral decisions.
AHRQ-funded; HS028847.
Citation: Zamalin D, Hamlin Shults, J J .
Predictors of making a referral to child protective services prior to expert consultation.
Acad Pediatr 2024 Jan-Feb; 24(1):78-86. doi: 10.1016/j.acap.2023.05.002..
Keywords: Children/Adolescents, Domestic Violence, Vulnerable Populations
Goyal NK, Sood E, Gannon MA
Priorities for well child care of families affected by parental opioid use disorder.
This study’s objective was to explore priorities for well childcare (WCC) visit content for women in treatment with opioid use disorder to inform primary care recommendations for this population. Eligible participants had children 2 years or younger and were English speaking. Among the 30 parent participants, they were overwhelmingly White (83%) and unmarried (90%). Thirteen clinicians participated, of whom 9 were attending physicians. Interviews were conducted with parents and clinicians which led to five emerging themes: (1) improving knowledge and confidence related to child development, behavior, and nutrition; (2) mitigating safety concerns; (3) addressing complex health and subspecialty needs through care coordination; (4) acknowledging parental health and wellbeing in the pediatric encounter; and (5) supporting health education and care related to neonatal opioid withdrawal syndrome. These issues were expressed as hard to address by parents and clinicians due to time constraints, social determinants of health, and significant informational needs.
AHRQ-funded; HS027399.
Citation: Goyal NK, Sood E, Gannon MA .
Priorities for well child care of families affected by parental opioid use disorder.
J Addict Med 2024 Jan-Feb; 18(1):48-54. doi: 10.1097/adm.0000000000001243..
Keywords: Opioids, Substance Abuse, Behavioral Health, Caregiving, Children/Adolescents
Cantor AG, Jungbauer RM, Skelly AC
Respectful maternity care : a systematic review.
The purpose of this systematic review was to collect information on definitions and valid measurements of respectful maternity care (RMC), its effectiveness for improving pregnant and postpartum maternal and infant health outcomes, and strategies for implementation. Frameworks for RMC were found to be well described but varied in definition. Evidence was lacking on the effectiveness of implementing RMC to improve any maternal or infant health outcome. Tools to measure RMC demonstrated consistency but lacked a gold standard; the authors conclude that further evaluation was needed before implementation in U.S. settings.
AHRQ-funded; 75Q80120D00006
Citation: Cantor AG, Jungbauer RM, Skelly AC .
Respectful maternity care : a systematic review.
Ann Intern Med 2024 Jan; 177(1):50-64. doi: 10.7326/m23-2676..
Keywords: Maternal Care, Women, Patient-Centered Outcomes Research, Evidence-Based Practice
Peaker B, Dooley C B, Peaker B, Dooley C C
AHRQ Author: Peaker B
Screening for syphilis in nonpregnant adolescents and adults.
This case study described a 42-year-old male presenting at the clinic with low back pain that had been radiating down his right leg for one week. Case study questions related to the USPSTF recommendation on Screening for Syphilis in Nonpregnant Adolescents and Adults addressed why this patient was at increased risk, whether screening should take place, and why the USPSTF does not recommend screening for all people.
AHRQ-authored.
Citation: Peaker B, Dooley C B, Peaker B, Dooley C C .
Screening for syphilis in nonpregnant adolescents and adults.
Am Fam Physician 2024 Jan; 109(1):79-80..
Keywords: U.S. Preventive Services Task Force (USPSTF), Screening, Evidence-Based Practice, Sexual Health, Children/Adolescents
Scaife JH, Bryce JR, Iantorno SE
Secondary undertriage of pediatric trauma patients across the United States emergency departments.
The term “Undertriage” refers to the treatment of patients at facilities lacking in the equipment needed to treat the patient's injuries appropriately. The purpose of this retrospective cohort study was to assess the relationship between patient and hospital characteristics and secondary undertriage in children after major trauma. The researchers utilized the 2019 Nationwide Emergency Department Sample and included patients aged less than 18 years of age if they presented to a Level 3 or non-trauma center (NTC) and were diagnosed with a traumatic injury with an injury severity score of greater than 15 based on International Classification of Diseases 10 codes. The study found that of 6,572 weighted patients, 15% were undertriaged. Undertriage was significantly associated with older age, metropolitan location, and major abdominal injuries. After multivariable adjustment, secondary undertriage was significantly associated with patients aged 6-10 years of age compared to patients aged 15-17 years, penetrating injury, major chest injury, and presentation at a teaching hospital.
AHRQ-funded; HS025776.
Citation: Scaife JH, Bryce JR, Iantorno SE .
Secondary undertriage of pediatric trauma patients across the United States emergency departments.
J Surg Res 2024 Jan; 293:37-45. doi: 10.1016/j.jss.2023.07.054..
Keywords: Healthcare Cost and Utilization Project (HCUP), Children/Adolescents, Emergency Department, Trauma, Injuries and Wounds
Cron DC, Braun HJ, Ascher NL
Sex-based disparities in access to liver transplantation for waitlisted patients with model for end-stage liver disease score of 40.
The objective of this study was to determine association of sex with access to liver transplantation among candidates with the highest possible model for end-stage liver disease score (MELD 40). Using national transplant registry data, researchers compared liver offer acceptance and waitlist outcomes by sex for waitlisted liver transplant candidates who reached MELD 40. Results showed that even among candidates with high disease severity and equally high MELD scores, women have reduced access to liver transplantation and worse outcomes compared with men. The researchers concluded that policies addressing this disparity should consider factors beyond MELD score adjustments.
AHRQ-funded; HS028476.
Citation: Cron DC, Braun HJ, Ascher NL .
Sex-based disparities in access to liver transplantation for waitlisted patients with model for end-stage liver disease score of 40.
Ann Surg 2024 Jan; 279(1):112-18. doi: 10.1097/sla.0000000000005933..
Keywords: Disparities, Access to Care, Sex Factors, Transplantation
Oke I, Elze T, Miller JW
Surgical approach and reoperation risk in intermittent exotropia in the IRIS Registry.
This cohort study compared the 5-year reoperation rates for children with intermittent exotropia (IXT). Reoperation rates for children with IXT treated with horizontal muscle strabismus surgery using bilateral lateral rectus recession (BLR) vs unilateral lateral rectus recession with medial rectus resection (RR) were compared. The authors examined data obtained from the Intelligent Research in Sight (IRIS) Registry on 7482 children (age, <18 years) with IXT who underwent horizontal eye muscle strabismus surgery, excluding children undergoing initial surgeries involving 3 or more horizontal muscles, vertical muscles, or reoperations. Primary outcome was the adjusted cumulative incidence of repeat horizontal muscle surgery within 5 years after the initial surgery. BLR was performed more frequently than RR (85.3% vs 14.7%), especially in younger children. After data adjustment, the 5-year cumulative incidence of reoperation was 21.3%. The adjusted 5-year cumulative incidence of reoperation was higher for BLR than for RR. Unilateral lateral rectus recession with medial rectus resection was associated with a lower 5-year reoperation risk compared with BLR. Younger age at time of initial surgery was associated with a higher reoperation risk.
AHRQ-funded; HS000063.
Citation: Oke I, Elze T, Miller JW .
Surgical approach and reoperation risk in intermittent exotropia in the IRIS Registry.
JAMA Ophthalmol 2024 Jan; 142(1):48-52. doi: 10.1001/jamaophthalmol.2023.5288..
Keywords: Surgery, Risk
Wooldridge AR, Carayon P, Hoonakker P
Team cognition in handoffs: relating system factors, team cognition functions and outcomes in two handoff processes.
This study investigated how team cognition occurs in care transitions from operating room (OR) to intensive care unit (ICU) and then sought to understand how the sociotechnical system and team cognition are related. The authors conducted the study in an academic, Level 1 trauma center in the Midwestern US. Semi-structured interviews were conducted with 28 healthcare workers that included physicians (surgery, anesthesia, pediatric critical care) and nurses (OR, ICU). Three cognition functions in hand-offs were described by participants: (1) information exchange, (2) assessment, and (3) planning and decision making; information exchange was mentioned most. Inter-professional handoffs facilitated information exchange but included large teams with diverse backgrounds communicating that can decrease efficiency. Intra-professional handoffs decreased team size and role diversity, which may simplify communication but can increase information loss. Participants in inter-professional handoffs reflected on outcomes significantly more in relation to system factors and team cognition, while participants in intra-professional handoffs discussed handoffs as a task.
AHRQ-funded; HS023837.
Citation: Wooldridge AR, Carayon P, Hoonakker P .
Team cognition in handoffs: relating system factors, team cognition functions and outcomes in two handoff processes.
Hum Factors 2024 Jan; 66(1):271-93. doi: 10.1177/00187208221086342..
Keywords: Teams, Transitions of Care, Communication
Quinn M, Horowitz JK, Krein SL
The role of hospital-based vascular access teams and implications for patient safety: a multi-methods study.
The purpose of this study was to examine the roles, functions, and composition of vascular access teams (VATs) related to the use and management of PICC and midline catheters. The researchers administered an online survey of 62 hospitals participating in a quality improvement consortium and qualitative interviews with 74 hospital-based clinicians in 10 sites. The study found that more than 77% of hospitals had an on-site VAT. The average team size was seven nurses; their main function was device insertion. Findings from the interviews revealed variations in team characteristics and functions. Interviewees characterized the broad role that teams play in device insertion, care, and removal, and in educating/training hospital staff. The researchers found that teams' role in decision making, especially related to appropriate device selection, was limited an was met with physician resistance in some cases.
AHRQ-funded; HS025891.
Citation: Quinn M, Horowitz JK, Krein SL .
The role of hospital-based vascular access teams and implications for patient safety: a multi-methods study.
J Hosp Med 2024 Jan; 19(1):13-23. doi: 10.1002/jhm.13253..
Keywords: Patient Safety, Inpatient Care, Cardiovascular Conditions
Balbin CA, Kawamoto K
The SIMPLE architectural pattern for integrating patient-facing apps into clinical workflows: desiderata and application for lung cancer screening.
To address the need for electronic health record (EHR) systems to accept the connection of any patient-facing digital health app using the SMART on FHIR standard, the authors proposed the Standards-based Implementation Maximizing Portability Leveraging the EHR (SIMPLE). SIMPLE’s architectural pattern was designed to meet several key requirements, such as not requiring patients to install new software; not retaining patient data outside of the EHR; leveraging existing personal health record (PHR) capabilities to optimize user experience; and maximizing portability.
AHRQ-funded; HS028791.
Citation: Balbin CA, Kawamoto K .
The SIMPLE architectural pattern for integrating patient-facing apps into clinical workflows: desiderata and application for lung cancer screening.
AMIA Annu Symp Proc 2024 Jan 11; 2023:844-53..
Keywords: Workflow, Health Information Technology (HIT), Cancer: Lung Cancer, Cancer, Screening
Cuca YP, Horvat C, Corless IB IB
The social, mental, and physical health impacts of the COVID-19 pandemic on people with HIV: protocol of an observational international multisite study.
The authors described the protocol for an international multisite observational study based on the SPIRIT guidelines to examine impact on the health and HIV outcomes for immunocompromised individuals such as people with HIV (PWH) from COVID-19 and from the strategies enacted to contain it. Investigators will recruit PWH to complete the study online or in-person. Study questions will address demographics, HIV continuum of care indicators, mental and social health, COVID-19 and vaccination knowledge, attitudes, behaviors, and fears; and overall outcomes. Results of this study can inform responses to future public health crises to minimize impacts on vulnerable populations such as PWH.
AHRQ-funded; HS028523.
Citation: Cuca YP, Horvat C, Corless IB IB .
The social, mental, and physical health impacts of the COVID-19 pandemic on people with HIV: protocol of an observational international multisite study.
J Assoc Nurses AIDS Care 2024 Jan-Feb; 35(1):60-74. doi: 10.1097/jnc.0000000000000444..
Keywords: COVID-19, Human Immunodeficiency Virus (HIV), Chronic Conditions
Berbakov ME, Hoffins EL, Stone JA
AHRQ-funded; HS028475.
A study team collaborated with Aurora Pharmacy, Inc. to develop Senior Safe, a community pharmacy-based intervention designed to increase awareness of safe over-the-counter medication use for older adults. Senior Safe was adapted through pilot testing and a randomized control trial before a finalized version was provided to Aurora Pharmacy to integrate into all its pharmacy sites. The authors concluded that this multiphase study illustrated that refining an intervention is possible and welcomed by pharmacy staff, but requires time, resources, and funds to create an impactful, sustainable community pharmacy intervention.
AHRQ-funded; HS024490; HS027737.
Citation: Berbakov ME, Hoffins EL, Stone JA .
AHRQ-funded; HS028475.
J Am Pharm Assoc 2024 Jan-Feb; 64(1):159-68. doi: 10.1016/j.japh.2023.11.009.
Keywords: Medication, Medication: Safety, Provider: Pharmacist, Patient Safety, Community-Based Practice
Hekman DJ, Barton HJ, Maru AP
Dashboarding to monitor machine-learning-based clinical decision support interventions.
This case report described the creation of a dashboard that allowed the intervention development team and operational stakeholders to identify potential issues that may require corrective action by bridging the monitoring gap between model outputs and patient outcomes. The authors proposed that monitoring machine-learning-based clinical decision support (ML-CDS) algorithms with regular dashboards that allow both context-level views of the system and drilled down views of specific components is a critical part of implementing these algorithms to ensure that these tools function appropriately within the broader care system.
AHRQ-funded; HS027735.
Citation: Hekman DJ, Barton HJ, Maru AP .
Dashboarding to monitor machine-learning-based clinical decision support interventions.
Appl Clin Inform 2024 Jan; 15(1):164-69. doi: 10.1055/a-2219-5175.
Keywords: Clinical Decision Support (CDS), Health Information Technology (HIT)
James TG, DeJonckheere M, Guetterman TC
Integrating transformative considerations and quantitative results through a participant selection joint display in explanatory sequential mixed methods studies.
This article presents a method of integrating transformative sampling considerations in explanatory sequential designs through a participant selection joint display in explanatory sequential mixed methods studies. The presented approach addressed concerns regarding transparency of research decisions in these studies, while providing a method of centering the transformative paradigm in mixed methods integration procedures.
AHRQ-funded; HS027537.
Citation: James TG, DeJonckheere M, Guetterman TC .
Integrating transformative considerations and quantitative results through a participant selection joint display in explanatory sequential mixed methods studies.
J Mix Methods Res 2024 Jan; 18(1):14-30. doi: 10.1177/15586898221149470.
Keywords: Research Methodologies
Handley SC, Salazar EG, Kunz SN
Transfer patterns among infants born at 28 to 34 weeks' gestation.
The objective of this observational study was to examine transfer frequency, indication, timing, and trajectory among very and moderate preterm infants. Data was taken from the Vermont Oxford Network NICU admissions database, 2016-2021. The results showed that 4.3% of very and moderate preterm infants were transferred; the most common reason for transfer was growth or discharge planning, followed by medical and diagnostic services. The proportion of infants who were transferred decreased with increasing gestational age, as did the median age at time of transfer. The authors noted that this does not reflect immediate care needs after birth, but rather the provision of risk-appropriate care.
AHRQ-funded; HS025749.
Citation: Handley SC, Salazar EG, Kunz SN .
Transfer patterns among infants born at 28 to 34 weeks' gestation.
Pediatrics 2024 Jan 1; 153(2). doi: 10.1542/peds.2023-063118.
Keywords: Newborns/Infants
Geary CR, Hook M, Popejoy L
Ambulatory care coordination data gathering and use.
The purpose of this study was to identify information gathered and used to support care coordination in ambulatory settings. Survey respondents, most of whom were nurses, provided demographic information and their practice patterns, including use of electronic health records. Most described at least a partial use of electronic health records, but two respondents described paper documentation systems. The authors concluded that the responses demonstrated significant heterogeneity in ambulatory care coordination data usage, but noted that additional research is needed to identify common data elements to support knowledge development in the context of a learning health system.
AHRQ-funded; HS028000.
Citation: Geary CR, Hook M, Popejoy L .
Ambulatory care coordination data gathering and use.
Comput Inform Nurs 2024 Jan; 42(1):63-70. doi: 10.1097/cin.0000000000001069.
Keywords: Care Coordination, Ambulatory Care and Surgery, Electronic Health Records (EHRs), Health Information Technology (HIT)
Graaf G, Hughes PM, deJong NA
Family support services and reported parent coping among caregivers of children with emotional, behavioral, or developmental disorders.
Researchers examined the association of family support services with caregiver mental health and well-being, as well as caregiver coping, among families of children with special health care needs (CSHCN). Data was taken from the National Survey of Children's Health. Results showed that adequate care coordination was associated with higher rates of caregiver-reported positive coping for CSHCN caregivers who had no source of emotional support. Emotional support services were also associated with increased reports of positive coping. The researchers concluded that mobilization of resources that can aid caregivers in coordinating care and provide emotional support may play a key role in positive caregiver coping for families of CSHCN.
AHRQ-funded; HS000032.
Citation: Graaf G, Hughes PM, deJong NA .
Family support services and reported parent coping among caregivers of children with emotional, behavioral, or developmental disorders.
J Dev Behav Pediatr 2024 Jan; 45(1):e54-e62. doi: 10.1097/dbp.0000000000001230.
Keywords: Children/Adolescents, Caregiving, Disabilities, Behavioral Health
Jeffery AD, Reale C, Faiman J
Inpatient nurses' preferences and decisions with risk information visualization.
The purpose of this study was to explore the effect of 4 different risk information formats on inpatient nurses' preferences and decisions with an acute clinical deterioration decision-support system. The researchers implemented a comparative usability evaluation in which participants provided responses to multiple user interface options in a simulated setting. Qualitative data was collected using think aloud methods, asking participants which action they would perform after each time point in 3 different patient scenarios. The 6 participants preferred the probability format over relative risk ratios (n = 2), absolute differences (n = 2), and number of persons out of 100 (n = 0). Participants preferred average lines, having a trend graph to supplement the risk estimate, and consistent colors between trend graphs and possible actions. Participants did not prefer too much text information or the presence of confidence intervals. The utilization of the probability format was related with higher concordance in actions taken by participants compared to the other 3 risk information formats.
AHRQ-funded; HS026395.
Citation: Jeffery AD, Reale C, Faiman J .
Inpatient nurses' preferences and decisions with risk information visualization.
J Am Med Inform Assoc 2023 Dec 22; 31(1):61-69. doi: 10.1093/jamia/ocad209..
Keywords: Provider: Nurse, Clinical Decision Support (CDS), Health Information Technology (HIT)