National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Burnout (4)
- Children/Adolescents (1)
- Chronic Conditions (1)
- Communication (2)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (1)
- Electronic Health Records (EHRs) (2)
- Electronic Prescribing (E-Prescribing) (1)
- Emergency Department (1)
- Evidence-Based Practice (1)
- Health Information Technology (HIT) (2)
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- Provider (7)
- (-) Provider: Clinician (11)
- Provider: Health Personnel (1)
- Provider: Nurse (5)
- Provider: Physician (8)
- Quality Improvement (1)
- Quality of Care (2)
- Risk (1)
- Sickle Cell Disease (1)
- Social Determinants of Health (1)
- Stress (1)
- Transitions of Care (1)
- Urban Health (1)
- Workforce (3)
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 11 of 11 Research Studies DisplayedGoodwin JS, Agrawal P, Li S
Growth of physicians and nurse practitioners practicing full time in nursing homes.
This retrospective cohort study examined the growth of physicians and nurse practitioners (NPs) and physician assistants (PAs) who work full time in nursing homes, and to assess resident and nursing home characteristics associated with receiving care from full-time providers. Researchers looked at a 20% national sample of Medicare data on long-term care residents in 2008 and 2018 and the physicians, NPs, and PAs who submitted charges for services rendered in nursing homes. Full-time nursing home providers increased from 26% in 2008 to 44.6% in 2017. The largest increase from 2008 to 2017 was in NPs with 1986 total in 2008 increasing 44.6% in 2017. Residents with an NP primary care provider were 23 times more likely to have a full-time provider. Residents who received care from both a physician and an NP or PA increased from 33.5% in 2008 to 62.5% in 2018. There was large variation in the percentage of residents with full-time providers, with 5.72% of residents in the bottom quintile of facilities to 91.4% in the top quintile.
AHRQ-funded; HS020642.
Citation: Goodwin JS, Agrawal P, Li S .
Growth of physicians and nurse practitioners practicing full time in nursing homes.
J Am Med Dir Assoc 2021 Dec;22(12):2534-39.e6. doi: 10.1016/j.jamda.2021.06.019..
Keywords: Nursing Homes, Long-Term Care, Provider: Clinician, Provider: Physician, Provider: Nurse, Workforce
Enayat M, Farahani NZ, Chaudhry AP
Incorporating RTLS-based spatiotemporal information in studying physical activities of clinical staff.
This research used Real-Time location systems (RTLS) to study the amount of physical activity exerted by physicians, residents, nurses, and staff in the emergency department (ED). The goal of this research is to examine how low and high physical activity can affect the physical and mental health of clinicians, which can lead to fatigue and burnout. The authors used one year worth of raw RFID data that covers the movement records of 38 physicians, 13 residents, 163 nurses, and 33 staff in the ED. They compared results to the values reported in the literature and showed despite the low spatial resolution of RTLS, their non-invasive estimations were closely comparable to the ones measured by Fitbit or other wearable pedometers.
AHRQ-funded; HS026622.
Citation: Enayat M, Farahani NZ, Chaudhry AP .
Incorporating RTLS-based spatiotemporal information in studying physical activities of clinical staff.
Annu Int Conf IEEE Eng Med Biol Soc 2021 Nov;2021:2386-91. doi: 10.1109/embc46164.2021.9630597..
Keywords: Provider: Physician, Provider: Clinician, Stress, Burnout
Kandrack R, Barnes H, Martsolf GR
Nurse practitioner scope of practice regulations and nurse practitioner supply.
This study’s objective was to estimate associations between adopting full nurse practitioner (NP) scope of practice (SOP) and improved access to care. The authors used county-level data to estimate the association between adopting full NP SOP and NP supply in general, and in rural and health professional shortage area-designed counties specifically. They estimated positive associations, although the relationship was only statistically significant in health professional shortage areas.
AHRQ-funded; HS000032.
Citation: Kandrack R, Barnes H, Martsolf GR .
Nurse practitioner scope of practice regulations and nurse practitioner supply.
Med Care Res Rev 2021 Jun;78(3):208-17. doi: 10.1177/1077558719888424..
Keywords: Provider: Nurse, Provider: Clinician, Workforce, Policy
Goldberg DG, Soylu TG, Kitsantas P
Burnout among primary care providers and staff: evaluating the association with practice adaptive reserve and individual behaviors.
The purpose of this study was to examine the association between practice adaptive reserve (PAR) and individual behavioral response to change and burnout among healthcare professionals in primary care. Using data from the EvidenceNOW Heart of Virginia Healthcare initiative, the study’s findings showed that, as organizational capacity for change increased, burnout in healthcare professionals decreased by 51%. As healthcare professionals showed improved response toward change, burnout decreased by 84%. Increased hours of work per week was associated with higher odds of burnout across healthcare professional groups.
AHRQ-funded; HS023913.
Citation: Goldberg DG, Soylu TG, Kitsantas P .
Burnout among primary care providers and staff: evaluating the association with practice adaptive reserve and individual behaviors.
J Gen Intern Med 2021 May;36(5):1222-28. doi: 10.1007/s11606-020-06367-z..
Keywords: Burnout, Primary Care, Provider: Nurse, Provider: Clinician, Provider: Physician, Provider
Kandaswamy S, Pruitt Z, Kazi S
Clinician perceptions on the use of free-text communication orders.
The aim of this study was to investigate (1) why ordering clinicians use free-text orders to communicate medication information; (2) what risks physicians and nurses perceive when free-text orders are used for communicating medication information; and (3) how electronic health records (EHRs) could be improved to encourage the safe communication of medication information. The investigators concluded that clinicians' use of free-text orders as a workaround to insufficient structured order entry can create unintended patient safety risks.
AHRQ-funded; HS025136; HS024755.
Citation: Kandaswamy S, Pruitt Z, Kazi S .
Clinician perceptions on the use of free-text communication orders.
Appl Clin Inform 2021 May;12(3):484-94. doi: 10.1055/s-0041-1731002..
Keywords: Electronic Prescribing (E-Prescribing), Health Information Technology (HIT), Electronic Health Records (EHRs), Medication: Safety, Medication, Patient Safety, Communication, Provider: Clinician, Provider, Risk
Willard-Grace R, Knox M, Huang B
Primary care clinician burnout and engagement association with clinical quality and patient experience.
Burnout and engagement are commonly conceptualized as opposite ends of a spectrum, and there is concern that high clinician burnout and lack of engagement may adversely impact patient care. In this study, the investigators matched self-reported data on burnout and engagement for 182 primary care clinicians with data on clinical quality (cancer screenings, hypertension and diabetes control) and patient experience (Clinician and Group Survey-Consumer Assessment of Healthcare Providers and Systems [CG-CAHPS] communication scores, overall rating, and likelihood to recommend the clinic).
AHRQ-funded; HS026067.
Citation: Willard-Grace R, Knox M, Huang B .
Primary care clinician burnout and engagement association with clinical quality and patient experience.
J Am Board Fam Med 2021 May-Jun;34(3):542-52. doi: 10.3122/jabfm.2021.03.200515..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Burnout, Patient Experience, Patient and Family Engagement, Provider: Clinician, Provider: Physician, Quality of Care, Provider: Nurse, Provider: Health Personnel
Dymek C, Kim B, Melton GB
AHRQ Author: Dymek C, Hsiao CJ
Building the evidence-base to reduce electronic health record-related clinician burden.
This paper looks at the evidence-base to reduce electronic health record-related (EHR-related) clinician burden. Evidence-based informatics approaches, pragmatic next steps, and future research directions are presented to improve three of the highest contributors to EHR burden: documentation, chart review, and inbox tasks. Perspectives are also offered on how EHR vendors, healthcare system leaders, and policymakers can play an integral role to make EHR easier to use.
AHRQ-authored; AHRQ-funded; HS027363.
Citation: Dymek C, Kim B, Melton GB .
Building the evidence-base to reduce electronic health record-related clinician burden.
J Am Med Inform Assoc 2021 Apr 23;28(5):1057-61. doi: 10.1093/jamia/ocaa238..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Burnout, Evidence-Based Practice, Provider: Clinician, Provider: Physician, Provider
Fekieta R, Rosenberg A, Jenq GY
A new tool to assess clinician experience with patient care transitions.
The authors developed a brief survey to gauge clinician experience with patient care transfers that occur within a hospital. They found that, overall, the survey was feasible to implement and was built to optimize content, construct, and response process validity. Survey results drove practical improvement work, such as informing a verbal transfer protocol to improve nursing preparedness to receive patients on general medicine units. They concluded that, as a practical tool, the survey and its results can help hospital administrators to focus on categories of transfer activities that are most problematic for clinicians and to track trends for quality improvement.
AHRQ-funded; HS023554.
Citation: Fekieta R, Rosenberg A, Jenq GY .
A new tool to assess clinician experience with patient care transitions.
Qual Manag Health Care 2021 Apr-Jun;30(2):87-96. doi: 10.1097/qmh.0000000000000290..
Keywords: Transitions of Care, Quality Improvement, Quality of Care, Provider: Clinician, Provider
Friese CR, Mendelsohn-Victor K, Medvec BR
Factors associated with job satisfaction in medical oncology practices: results from a multisite survey.
This is a job satisfaction survey of clinicians from 29 ambulatory medical oncology practices conducted in 2017. The survey also examined clinician-to-clinician communication, and perceptions of patient safety. Of the 280 clinicians who responded, 85% reported that they were very satisfied or satisfied with their current position. Patient safety and accuracy of clinician communication were positively associated with job satisfaction.
AHRQ-funded; HS024914.
Citation: Friese CR, Mendelsohn-Victor K, Medvec BR .
Factors associated with job satisfaction in medical oncology practices: results from a multisite survey.
J Nurs Adm 2021 Apr;51(4):200-05. doi: 10.1097/nna.0000000000000998..
Keywords: Provider: Clinician, Provider: Physician, Provider: Nurse, Provider, Communication
Gettel CJ, Canavan ME, D'Onofrio G
Who provides what care? An analysis of clinical focus among the national emergency care workforce.
This study looked at the clinical focus of emergency department (ED) workers using the 2017 Medicare Public Use Files for clinicians receiving reimbursement for emergency care Evaluation & Management (E/M) services for Medicare fee-for-service Part B. Clinicians were categorized as EM physicians, non-EM physicians, and advanced practice providers (APPs). Of the 65,710 unique clinicians providing care, 59.4% were classified as EM physicians, 12.4% as non-EM physicians, and 28.5% as APPs. EM physicians have twice as much clinician median focus in comparison to EM physicians providing emergency care (92.8% vs 45.2) and APPs are focused 100%.
AHRQ-funded; HS023614.
Citation: Gettel CJ, Canavan ME, D'Onofrio G .
Who provides what care? An analysis of clinical focus among the national emergency care workforce.
Am J Emerg Med 2021 Apr;42:228-32. doi: 10.1016/j.ajem.2020.11.069..
Keywords: Emergency Department, Workforce, Provider: Physician, Provider: Clinician, Provider, Medicare
Loo S, Brochier A, Wexler MG
Addressing unmet basic needs for children with sickle cell disease in the United States: clinic and staff perspectives.
The purpose of this study was to assess pediatric hematology clinic staff's perspectives regarding barriers and facilitators in addressing unmet basic needs for children with sickle cell disease. Six focus groups were held at urban pediatric hematology clinics in the Northeastern region of the U.S. Four themes emerged: families of children with SCD have numerous unmet basic needs; clinic staff felt they had a role to play in addressing these needs; staff felt their ability to address these needs depended upon caregivers' capacity to act on staff recommendations; clinic staff's ability to address these needs was limited by organizational and systemic factors beyond their control. These findings have important implications for how best to address adverse social determinants of health for this vulnerable pediatric population so that urban-based pediatric hematology clinics can more equitably support families.
AHRQ-funded; HS022242.
Citation: Loo S, Brochier A, Wexler MG .
Addressing unmet basic needs for children with sickle cell disease in the United States: clinic and staff perspectives.
BMC Health Serv Res 2021 Jan 12;21(1):55. doi: 10.1186/s12913-020-06055-y..
Keywords: Children/Adolescents, Sickle Cell Disease, Chronic Conditions, Social Determinants of Health, Provider: Clinician, Provider: Physician, Provider, Urban Health