National Healthcare Quality and Disparities Report
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Topics
- Adverse Drug Events (ADE) (2)
- Adverse Events (14)
- Antibiotics (2)
- Arthritis (2)
- Blood Thinners (2)
- Cancer (3)
- Cardiovascular Conditions (6)
- Caregiving (1)
- Catheter-Associated Urinary Tract Infection (CAUTI) (3)
- Central Line-Associated Bloodstream Infections (CLABSI) (1)
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- Comparative Effectiveness (5)
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- Healthcare Cost and Utilization Project (HCUP) (2)
- Health Services Research (HSR) (1)
- Heart Disease and Health (2)
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- Infectious Diseases (1)
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- Inpatient Care (4)
- Intensive Care Unit (ICU) (2)
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- Outcomes (11)
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- (-) Patient-Centered Outcomes Research (46)
- Patient Experience (1)
- (-) Patient Safety (46)
- Practice Patterns (2)
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- Provider: Physician (1)
- Provider Performance (1)
- Quality Improvement (13)
- Quality Indicators (QIs) (2)
- Quality Measures (2)
- Quality of Care (14)
- Registries (1)
- Rehabilitation (1)
- Research Methodologies (1)
- Respiratory Conditions (2)
- Risk (4)
- Stroke (1)
- Substance Abuse (1)
- Surgery (16)
- Teams (1)
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- Treatments (1)
- Urinary Tract Infection (UTI) (3)
- Women (2)
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 25 of 46 Research Studies DisplayedHu QL, Grant MC, Hornor MA
Technical evidence review for emergency major abdominal operation conducted for the AHRQ Safety Program for Improving Surgical Care and Recovery.
This technical evidence review focuses on the use of enhanced recovery pathways (ERPs) for emergency major abdominal surgery conducted for the AHRQ Safety Program for Improving Surgical Care and Recovery (ISCR). This national ERP initiative is funded by AHRQ and implemented in 2017 through a collaboration with American College of Surgeons, and Johns Hopkins Medicine Armstrong Institute for Patient Safety and Quality. Five common emergency general surgery (EGS) procedures were focused on: perforated peptic ulcer repair, colectomy, lysis of adhesions, small bowel resection, and exploratory laparotomy. The authors identified seventeen candidate components for emergency major abdominal ERP. The components span the continuum of care from preoperative setting to hospital discharge. For every component they conducted a systematic literature review to find relevant studies. Each component was examined for rationale, evidence, and summary and recommendations. Many were supported by evidence and guidelines specific to their particular operation. Key gaps in literature were highlighted, specifically lack of evidence specific to these operations across many ERP processes.
AHRQ-funded; 233201500020I.
Citation: Hu QL, Grant MC, Hornor MA .
Technical evidence review for emergency major abdominal operation conducted for the AHRQ Safety Program for Improving Surgical Care and Recovery.
J Am Coll Surg 2020 Dec;231(6):743-64.e5. doi: 10.1016/j.jamcollsurg.2020.08.772..
Keywords: Evidence-Based Practice, Surgery, Patient Safety, Quality Improvement, Quality of Care, Patient-Centered Outcomes Research
Mangrum R, Stewart MD, Gifford DR
Omissions of care in nursing homes: a uniform definition for research and quality improvement.
The goal of this study was to create a uniform definition of omission of care in US nursing homes. Lack of a uniform definition has made efforts to prevent them challenging. Subject matter experts and a broad range of nursing home stakeholders were brought together in iterative rounds of engagement to identify key concepts and aspects of omissions of care and develop a consensus-based definition. The concise definition decided on was: “Omissions of care in nursing homes encompass situations when care–either clinical or nonclinical–is not provided for a resident and results in additional monitoring or intervention or increases the risk of an undesirable or adverse physical, emotional, or psychosocial outcome for the resident."
AHRQ-funded; 233201500014I.
Citation: Mangrum R, Stewart MD, Gifford DR .
Omissions of care in nursing homes: a uniform definition for research and quality improvement.
J Am Med Dir Assoc 2020 Nov;21(11):1587-91.e2. doi: 10.1016/j.jamda.2020.08.016..
Keywords: Elderly, Nursing Homes, Long-Term Care, Quality Improvement, Quality of Care, Medical Errors, Adverse Events, Patient Safety, Risk, Patient-Centered Outcomes Research
Yao X, Inselman JW, Ross JS
Comparative effectiveness and safety of oral anticoagulants across kidney function in patients with atrial fibrillation.
Patients with atrial fibrillation and severely decreased kidney function were excluded from the pivotal non-vitamin K antagonist oral anticoagulants (NOAC) trials, thereby raising questions about comparative safety and effectiveness in patients with reduced kidney function. This study aimed to compare oral anticoagulants across the range of kidney function in patients with atrial fibrillation.
AHRQ-funded; HS025517; HS025164; HS025402; HS022882; HS024075.
Citation: Yao X, Inselman JW, Ross JS .
Comparative effectiveness and safety of oral anticoagulants across kidney function in patients with atrial fibrillation.
Circ Cardiovasc Qual Outcomes 2020 Oct;13(10):e006515. doi: 10.1161/circoutcomes.120.006515..
Keywords: Kidney Disease and Health, Cardiovascular Conditions, Blood Thinners, Medication, Medication: Safety, Patient Safety, Comparative Effectiveness, Patient-Centered Outcomes Research, Evidence-Based Practice, Outcomes
Shoemaker-Hunt SJ, Wyant BE
The effect of opioid stewardship interventions on key outcomes: a systematic review.
In this study, the investigators sought to identify potential patient safety practices to reduce high-risk opioid prescribing. They conducted a systematic review of the literature to identify opioid stewardship (OS) strategies implemented in primary care and other settings. The investigators concluded that the strength of the evidence was low to moderate that OS efforts decreased numbers of opioid prescriptions, proportion of patients on long-term opioids, or days' supply. The strength of the evidence for OS initiatives producing significant reductions in opioid dosages was moderate.
AHRQ-funded; 233201500013I.
Citation: Shoemaker-Hunt SJ, Wyant BE .
The effect of opioid stewardship interventions on key outcomes: a systematic review.
J Patient Saf 2020 Sep;16(3S Suppl 1):S36-s41. doi: 10.1097/pts.0000000000000710..
Keywords: Opioids, Medication, Medication: Safety, Patient Safety, Evidence-Based Practice, Patient-Centered Outcomes Research, Substance Abuse, Prevention
Villa Zapata L, Hansten PD, Panic J
Risk of bleeding with exposure to warfarin and nonsteroidal anti-inflammatory drugs: a systematic review and meta-analysis.
Warfarin use can trigger the occurrence of bleeding independently or as a result of a drug-drug interaction when used in combination with nonsteroidal anti-inflammatory drugs (NSAIDs). This article examines the risk of bleeding in individuals exposed to concomitant warfarin and NSAID compared with those taking warfarin alone. The investigators concluded that risk of bleeding was significantly increased among persons taking warfarin and a NSAID or COX-2 inhibitor together as compared with taking warfarin alone.
AHRQ-funded; HS025984.
Citation: Villa Zapata L, Hansten PD, Panic J .
Risk of bleeding with exposure to warfarin and nonsteroidal anti-inflammatory drugs: a systematic review and meta-analysis.
Thromb Haemost 2020 Jul;120(7):1066-74. doi: 10.1055/s-0040-1710592..
Keywords: Blood Thinners, Medication, Medication: Safety, Risk, Adverse Drug Events (ADE), Adverse Events, Patient Safety, Evidence-Based Practice, Patient-Centered Outcomes Research, Outcomes
Meddings J, Greene MT, Ratz D
Multistate programme to reduce catheter-associated infections in intensive care units with elevated infection rates.
AHRQ’s Safety Program for ICUs aimed to reduce central line-associated bloodstream infection (CLABSI) and catheter-associated urinary tract infection (CAUTI) in intensive care units with elevated rates. Included hospitals had at least one adult intensive care unit with elevated CLABSI or CAUTI rates. The investigators targeted intensive care units with elevated catheter infection rates but yielded no statistically significant reduction in CLABSI, CAUTI or catheter utilization in the first two of six planned cohorts. Improvements in the interventions based on lessons learned from these initial cohorts are being applied to subsequent cohorts.
AHRQ-funded; 233201500016I.
Citation: Meddings J, Greene MT, Ratz D .
Multistate programme to reduce catheter-associated infections in intensive care units with elevated infection rates.
BMJ Qual Saf 2020 May;29(5):418-29. doi: 10.1136/bmjqs-2019-009330..
Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Infectious Diseases, Patient Safety, Urinary Tract Infection (UTI), Intensive Care Unit (ICU), Hospitals, Evidence-Based Practice, Patient-Centered Outcomes Research, Inpatient Care, Critical Care
Dhruva SS, Ross JS, Mortazavi BJ
Association of use of an intravascular microaxial left ventricular assist device vs intra-aortic balloon pump with in-hospital mortality and major bleeding among patients with acute myocardial infarction complicated by cardiogenic shock.
This study examines outcomes among patients undergoing percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) complicated by cardiogenic shock. Two interventions are compared: intravascular microaxial left ventricular assist devices (LVADs) versus intra-aortic balloon pumps (IABPs). The American College of Cardiology’s National Cardiovascular Data Registry was used to identify patients with AMI complicated by cardiogenic shock from hospitals participating in the CathPCI and Chest Pain-MI registries and identified 28,304 patients. Over the study period (2015 to 2017), LVAD was used in 6.2% of patients and IABP in 29.9%. LVAD was shown to have higher rates of in-hospital death and major bleeding complications compared to IABP.
AHRQ-funded; HS022882; HS025402; HS025517; HS026379.
Citation: Dhruva SS, Ross JS, Mortazavi BJ .
Association of use of an intravascular microaxial left ventricular assist device vs intra-aortic balloon pump with in-hospital mortality and major bleeding among patients with acute myocardial infarction complicated by cardiogenic shock.
JAMA 2020 Feb 25;323(8):734-45. doi: 10.1001/jama.2020.0254..
Keywords: Medical Devices, Heart Disease and Health, Cardiovascular Conditions, Mortality, Adverse Events, Registries, Patient Safety, Patient-Centered Outcomes Research, Evidence-Based Practice
Grant MC, Gibbons MM, Ko CY
Evidence review conducted for the AHRQ Safety Program for Improving Surgical Care and Recovery: focus on anesthesiology for gynecologic surgery.
This paper is an evidence review of enhanced recovery after surgery (ERAS) protocols for gynecologic surgery that will be used as part of AHRQ’s Safety Program for Improving Surgical Care and Recovery. This initiative was developed in partnership with the American College of Surgeons and the Johns Hopkins Medicine Armstrong Institute for Patient Safety and Quality. The authors conducted a literature review of the various anesthesia components which may influence outcomes and facilitate recovery after gynecological surgery. They included interventions for preoperative, intraoperative, and postoperative phases of care and then summarized the best available evidence for ERAS for gynecological surgery. The best evidence was summarized for recommendations to be used in the initiative.
Citation: Grant MC, Gibbons MM, Ko CY .
Evidence review conducted for the AHRQ Safety Program for Improving Surgical Care and Recovery: focus on anesthesiology for gynecologic surgery.
AHRQ-funded; 233201500020I..
Keywords: Patient Safety, Surgery, Quality Improvement, Quality of Care, Evidence-Based Practice, Patient-Centered Outcomes Research, Women
Leary JC, Walsh KE, Morin RA
Quality and safety of pediatric inpatient care in community hospitals: a scoping review.
This study’s aim was to conduct a scoping review and synthesize literature on the quality and safety of pediatric inpatient care in nonpediatric hospitals in the United States. A systematic literature review was performed in October 2016 to identify pediatric studies that reported on safety, effectiveness, efficiency, timeliness, patient-centeredness, or equity set. A total of 44 articles were included using inclusion criteria. There was a moderate or high risk of bias for 72% of the studies. This study shows there is very limited research currently and would benefit from more multicenter collaborations.
AHRQ-funded; HS024133.
Citation: Leary JC, Walsh KE, Morin RA .
Quality and safety of pediatric inpatient care in community hospitals: a scoping review.
J Hosp Med 2019 Nov 1;14(10):694-703. doi: 10.12788/jhm.3268..
Keywords: Patient-Centered Outcomes Research, Evidence-Based Practice, Children/Adolescents, Inpatient Care, Hospitals, Patient Safety, Quality of Care
Balk EM, Adam GP, Corsi K
Adverse events associated with nonsurgical treatments for urinary incontinence in women: a systematic review.
Investigators systematically reviewed nonsurgical interventions for urgency, stress, or mixed urinary incontinence (UI) in women, focusing on adverse events (AEs). They found that behavioral therapies and neuromodulation have a low risk of adverse events, while anticholinergics and alpha agonists have high rates of dry mouth and constitutional effects. Further, onabotulinum toxin A (BTX) is associated with UTIs and voiding dysfunction, and periurethral bulking agents are associated with erosion and voiding dysfunction. They concluded that these AEs should be considered when selecting appropriate UI treatment options, noting that AE reporting is inconsistent and that AE rates across studies tended to vary widely.
AHRQ-funded; 290201500002.
Citation: Balk EM, Adam GP, Corsi K .
Adverse events associated with nonsurgical treatments for urinary incontinence in women: a systematic review.
J Gen Intern Med 2019 Aug;34(8):1615-25. doi: 10.1007/s11606-019-05028-0.
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Keywords: Adverse Events, Patient Safety, Women, Evidence-Based Practice, Patient-Centered Outcomes Research
Grant MC, Gibbons M M, Ko CY
Evidence review conducted for the Agency for Healthcare Research and Quality Safety Program for Improving Surgical Care and Recovery: focus on anesthesiology for bariatric surgery.
The authors conducted an evidence review to select anesthetic interventions that positively influence outcomes and facilitate recovery after bariatric surgery. They summarize the best available evidence to recommend the anesthetic components of care for enhanced recovery after bariatric surgery. The concluded that there is evidence in the literature, and from society guidelines, to support AHRQ’s Safety Program for Improving Surgical Care and Recovery goals for bariatric surgery.
AHRQ-funded; 233201500020I.
Citation: Grant MC, Gibbons M M, Ko CY .
Evidence review conducted for the Agency for Healthcare Research and Quality Safety Program for Improving Surgical Care and Recovery: focus on anesthesiology for bariatric surgery.
Anesth Analg 2019 Jul;129(1):51-60. doi: 10.1213/ane.0000000000003696..
Keywords: Evidence-Based Practice, Medication, Obesity, Outcomes, Patient-Centered Outcomes Research, Patient Safety, Quality Improvement, Surgery
Ban KA, Gibbons MM, Ko CY
Evidence review conducted for the Agency for Healthcare Research and Quality Safety Program for Improving
This evidence review was conducted for AHRQ in partnership with the American College of Surgeons and the Johns Hopkins Armstrong Institute for Patient Safety and Quality who have developed the Safety Program for Improving Surgical Care and Recovery (ISCR). This national effort will disseminate best practices in perioperative care to more than 750 hospitals across multiple procedures in the next 5 years. This evidence-based review is focused on improving patient safety of anesthesiology for colorectal (CR) surgery. Components reviewed included carbohydrate loading, reduced fasting, multimodal preanesthesia medicine, antibiotic prophylaxis, normothermia, blood transfusion, intraoperative fluid management/goal-directed fluid therapy, a standardized intraoperative anesthesia pathway, and standard postoperative multimodal analgesic regiments. The results of this review will be used to develop an evidence-based CR protocol for implementation.
AHRQ-funded; 233201500020I.
Citation: Ban KA, Gibbons MM, Ko CY .
Evidence review conducted for the Agency for Healthcare Research and Quality Safety Program for Improving
Anesth Analg 2019 May;128(5):879-89. doi: 10.1213/ane.0000000000003366..
Keywords: Evidence-Based Practice, Surgery, Quality Improvement, Quality of Care, Patient Safety, Patient-Centered Outcomes Research, Antibiotics, Medication, Medication: Safety
Soffin EM, Gibbons MM, Ko CY
Evidence review conducted for the Agency for Healthcare Research and Quality Safety program for improving surgical care and recovery: focus on anesthesiology for total hip arthroplasty.
Successes using enhanced recovery after surgery (ERAS) protocols for total hip arthroplasty (THA) are increasingly being reported. The Agency for Healthcare Research and Quality, in partnership with the American College of Surgeons and the Johns Hopkins Medicine Armstrong Institute for Patient Safety and Quality, has developed the Safety Program for Improving Surgical Care and Recovery. In this study, the investigators conducted an evidence review to select anesthetic interventions that positively influence outcomes and facilitate recovery after total hip arthroplasty (THA).
AHRQ-funded; 233201500020I.
Citation: Soffin EM, Gibbons MM, Ko CY .
Evidence review conducted for the Agency for Healthcare Research and Quality Safety program for improving surgical care and recovery: focus on anesthesiology for total hip arthroplasty.
Anesth Analg 2019 Mar;128(3):454-65. doi: 10.1213/ane.0000000000003663..
Keywords: Evidence-Based Practice, Patient-Centered Outcomes Research, Surgery, Patient Safety, Quality Improvement, Quality of Care
Hsu YJ, Kosinski AS, Wallace AS
Using a society database to evaluate a patient safety collaborative: the Cardiovascular Surgical Translational Study.
The authors assessed the utility of using external databases for quality improvement (QI) evaluations in the context of an innovative QI collaborative aimed to reduce three infections and improve patient safety across the cardiac surgery service line. They compared changes in each outcome between 15 intervention hospitals and 52 propensity score-matched hospitals, and found that improvement trends in several outcomes among the studied intervention hospitals were not statistically different from those in comparison hospitals. They conclude that using external databases may permit comparative effectiveness assessment by providing concurrent comparison groups, additional outcome measures, and longer follow-up.
AHRQ-funded; HS019934.
Citation: Hsu YJ, Kosinski AS, Wallace AS .
Using a society database to evaluate a patient safety collaborative: the Cardiovascular Surgical Translational Study.
J Comp Eff Res 2019 Jan;8(1):21-32. doi: 10.2217/cer-2018-0051..
Keywords: Patient Safety, Quality Improvement, Quality Indicators (QIs), Quality of Care, Surgery, Cardiovascular Conditions, Comparative Effectiveness, Data, Hospitals, Research Methodologies, Patient-Centered Outcomes Research
Hornor MA, Liu JY, Hu QL
Surgical technical evidence review for acute appendectomy conducted for the Agency for Healthcare Research and Quality Safety Program for Improving Surgical Care and Recovery.
This evidence review uses enhanced recovery pathways (ERPs) protocols developed for the AHRQ-funded Safety Program for Improving Surgical Care and Recovery (ISCR Program) to develop ERPs for acute appendectomy surgery. The authors classified appendicitis into uncomplicated (nonperforated) and complicated (perforated or gangrenous) to help with risk stratification. They identified 13 components for appendectomy for review. The processes are organized by perioperative phase, and each phase includes the rationale, evidence review, summary of guidelines, and a recommendation summary of the evidence for or against inclusion in the ERP. Preoperative management components included: education and counseling; preoperative antibiotics; initial nonsurgical management for perforated appendicitis with abscess or phlegmon, venous thromboembolism prophylaxis, delay for operation for 12-24 hours for uncomplicated appendicitis. Intraoperative management components include: laparoscopic surgical technique, peritoneal drain placement, urinary catheter placement, and prophylactic nasogastric tube insertion. Postoperative management components include same-day surgery discharge for uncomplicated appendicitis, antibiotics, early oral alimentation, and early mobilization. Of the ERPs reviewed: there was no evidence to support the routine use of abdominal drainage in patients undergoing appendectomies, urinary catheter insertion for laparoscopic surgery, use of prophylactic nasogastric tube placement, postoperative antibiotic use for uncomplicated appendicitis, and early oral alimentation for uncomplicated appendicitis.
AHRQ-funded.
Citation: Hornor MA, Liu JY, Hu QL .
Surgical technical evidence review for acute appendectomy conducted for the Agency for Healthcare Research and Quality Safety Program for Improving Surgical Care and Recovery.
J Am Coll Surg 2018 Dec;227(6):605-17.e2. doi: 10.1016/j.jamcollsurg.2018.09.024..
Keywords: Surgery, Quality Improvement, Quality of Care, Patient Safety, Evidence-Based Practice, Patient-Centered Outcomes Research, Outcomes
Burgermaster M, Murray M, Saiman L
Associations between enteral nutrition and acute respiratory infection among patients in New York metropolitan region pediatric long-term care facilities.
This study investigated the outcomes of children and a subsample of infants in pediatric long-term care facilities are need enteral nutrition (EN). Those patients who need EN had a higher risk of acute pediatric infection (ARI) and a lower odds of discharge than those who did not. Infants had a particular higher risk of comorbidities and infections when they were fed using percutaneous feeding tubes.
AHRQ-funded; HS021470.
Citation: Burgermaster M, Murray M, Saiman L .
Associations between enteral nutrition and acute respiratory infection among patients in New York metropolitan region pediatric long-term care facilities.
Nutr Clin Pract 2018 Dec;33(6):865-71. doi: 10.1002/ncp.10017..
Keywords: Children/Adolescents, Healthcare-Associated Infections (HAIs), Nutrition, Outcomes, Patient-Centered Outcomes Research, Patient Safety, Respiratory Conditions, Long-Term Care
Bardossy AC, Williams T, Jones K
Culturing practices and the care of the urinary catheter in reducing NHSN-defined catheter-associated urinary tract infections: the tale of two teaching hospitals.
This study compared 2 teaching hospitals’ intervention programs for preventing catheter-associated urinary tract infections (CAUTI). The comparisons were done in their adult intensive care units.
AHRQ-funded; 290201000025I; 29032001T.
Citation: Bardossy AC, Williams T, Jones K .
Culturing practices and the care of the urinary catheter in reducing NHSN-defined catheter-associated urinary tract infections: the tale of two teaching hospitals.
Infect Control Hosp Epidemiol 2018 Dec;39(12):1494-96. doi: 10.1017/ice.2018.251..
Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Healthcare-Associated Infections (HAIs), Intensive Care Unit (ICU), Patient-Centered Outcomes Research, Patient Safety, Urinary Tract Infection (UTI)
Krishnan S, Pappadis MR, Weller SC
Patient-centered mobility outcome preferences according to individuals with stroke and caregivers: a qualitative analysis.
This study explored the mobility-related preferences among stroke survivors and caregivers following post-acute rehabilitation at inpatient or skilled nursing facilities. Frequently mentioned outcome preferences by survivors were ability to walk (88 percent), move, and balance. They also wanted to acquire assistive devices to move independently. Caregivers were concerned with the survivor's safety and wanted them to drive (53 percent), prevent falls, have home accommodations, and transfer independently.
AHRQ-funded; HS022134; HS024711.
Citation: Krishnan S, Pappadis MR, Weller SC .
Patient-centered mobility outcome preferences according to individuals with stroke and caregivers: a qualitative analysis.
Disabil Rehabil 2018 Jun;40(12):1401-09. doi: 10.1080/09638288.2017.1297855.
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Keywords: Caregiving, Patient-Centered Outcomes Research, Patient Safety, Rehabilitation, Stroke
Leonard CE, Brensinger CM, Aquilante CL
Comparative safety of sulfonylureas and the risk of sudden cardiac arrest and ventricular arrhythmia.
This study examined the association between individual antidiabetic sulfonylureas and outpatient-originating sudden cardiac arrest and ventricular arrhythmia (SCA/VA). It concluded that glyburide may be associated with a lower risk of SCA/VA than glipizide, consistent with a very small clinical trial suggesting that glyburide may reduce ventricular tachycardia and isolated ventricular premature complexes.
AHRQ-funded; HS023898.
Citation: Leonard CE, Brensinger CM, Aquilante CL .
Comparative safety of sulfonylureas and the risk of sudden cardiac arrest and ventricular arrhythmia.
Diabetes Care 2018 Apr;41(4):713-22. doi: 10.2337/dc17-0294.
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Keywords: Adverse Drug Events (ADE), Cardiovascular Conditions, Medication, Patient-Centered Outcomes Research, Patient Safety
Spatz ES, Wang Y, Beckman AL
Traditional Chinese medicine for acute myocardial infarction in western medicine hospitals in China.
This study examined the use of traditional Chinese medicine (TCM) in patients admitted for acute myocardial infarction (AMI) in China during the first 24 hours of hospitalization. The data came from the China Patient-centered Evaluative Assessment of Cardiac Events Retrospective Study of Acute Myocardial Infarction. A chart review was done of randomly sampled patients in 2001, 2006 and 2011 in 162 Western medicine hospitals across China. Nearly all (99%) hospitals used some form of TCM, with Salvia miltiorrhiza being the most commonly prescribed. This TCM treatment (and others) was used intravenously and use has increased over the span of the study, despite lack of evidence of benefit or harm.
AHRQ-funded; HS023000.
Citation: Spatz ES, Wang Y, Beckman AL .
Traditional Chinese medicine for acute myocardial infarction in western medicine hospitals in China.
Circ Cardiovasc Qual Outcomes 2018 Mar;11(3):e004190. doi: 10.1161/circoutcomes.117.004190..
Keywords: Adverse Events, Cardiovascular Conditions, Complementary and Alternative Medicine, Heart Disease and Health, Hospitals, Mortality, Outcomes, Patient-Centered Outcomes Research, Patient Safety, Practice Patterns, Risk
Childers CP, Siletz AE, Singer ES
Surgical technical evidence review for elective total joint replacement conducted for the AHRQ Safety Program for Improving Surgical Care and Recovery.
AHRQ, the American College of Surgeons, and the Johns Hopkins Medicine Armstrong Institute for Patent Safety and Quality have developed the Safety Program for Improving Surgical Care and Recovery - a national effort to catalyze implementation of practices to improve perioperative care and enhance recovery of surgical patients. This review synthesizes evidence that can be used to develop a protocol for elective total knee arthroplasty and total hip arthroplasty.
AHRQ-funded; 233201500020I.
Citation: Childers CP, Siletz AE, Singer ES .
Surgical technical evidence review for elective total joint replacement conducted for the AHRQ Safety Program for Improving Surgical Care and Recovery.
Geriatr Orthop Surg Rehabil 2018 Feb 12;9:2151458518754451. doi: 10.1177/2151458518754451.
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Keywords: Evidence-Based Practice, Orthopedics, Patient Safety, Surgery, Quality Improvement, Quality of Care, Patient-Centered Outcomes Research
Gingrich AA, Bateni SB, Monjazeb AM
Neoadjuvant radiotherapy is associated with R0 resection and improved survival for patients with extremity soft tissue sarcoma undergoing surgery: a national cancer database analysis.
Neoadjuvant radiotherapy (RT) is increasingly advocated for the management of soft tissue sarcoma (STS). This study sought to characterize the impact of neoadjuvant RT on rates of R0 resection and overall survival (OS) in extremity STS patients undergoing surgery. The authors concluded that preoperative RT independently predicts higher rates of R0 resection for patients with extremity STS undergoing surgical resection. Negative surgical margins and pre- or postoperative RT are associated with improved OS.
AHRQ-funded; HS022236.
Citation: Gingrich AA, Bateni SB, Monjazeb AM .
Neoadjuvant radiotherapy is associated with R0 resection and improved survival for patients with extremity soft tissue sarcoma undergoing surgery: a national cancer database analysis.
Ann Surg Oncol 2017 Oct;24(11):3252-63. doi: 10.1245/s10434-017-6019-8..
Keywords: Adverse Events, Cancer, Mortality, Patient-Centered Outcomes Research, Patient Safety
Fisher KA, Mazor KM
Patient and family complaints in cancer care: what can we learn from the tip of the iceberg?
This paper comments on the Mack et al. article “Evaluation of Patient and Family Outpatient Complaints as a Strategy to Prioritize Efforts to Improve Cancer Care Delivery”, published in 2017 in The Joint Commission Journal on Quality and Patient Safety, in which Mack et al. categorized all complaints filed at a large outpatient cancer center during a two-year period, put forth a preliminary rating system for assessing complaint severity, and catalogued the actions taken in response to the complaints.
AHRQ-funded; HS024596; HS022757.
Citation: Fisher KA, Mazor KM .
Patient and family complaints in cancer care: what can we learn from the tip of the iceberg?
Jt Comm J Qual Patient Saf 2017 Oct;43(10):495-97. doi: 10.1016/j.jcjq.2017.07.003..
Keywords: Cancer, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Patient Experience, Patient Safety, Quality of Care, Quality Improvement
Varghese TK, Jr., Ghaferi AA
Cutting-edge efforts in surgical patient safety.
In October, 2015, the Surgical Outcomes Club convened a patient safety panel in Chicago, Illinois. The goal was to emphasize that patient safety efforts require a uniform, systematic, evidence-based approach. This article incorporates the major themes of the session—developing reliable measures of surgeon performance, real-world methods for continuous improvement and learning, and opportunities for incorporating the principles of implementation science into patient safety efforts.
AHRQ-funded; HS023621; HS024403.
Citation: Varghese TK, Jr., Ghaferi AA .
Cutting-edge efforts in surgical patient safety.
JAMA Surg 2017 Aug;152(8):719-20. doi: 10.1001/jamasurg.2017.0858.
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Keywords: Patient-Centered Outcomes Research, Surgery, Patient Safety, Evidence-Based Practice, Provider: Physician, Provider
Eriksson CO, Stoner RC, Eden KB
The association between hospital capacity strain and inpatient outcomes in highly developed countries: a systematic review.
This systematic literature review sought to understand whether hospital capacity strain is associated with worse health outcomes for hospitalized patients and to evaluate benefits and harms of health system interventions to improve care quality during times of hospital capacity strain. It concluded that in highly developed countries, hospital capacity strain is associated with increased mortality and worsened health outcomes.
AHRQ-funded; HS022981.
Citation: Eriksson CO, Stoner RC, Eden KB .
The association between hospital capacity strain and inpatient outcomes in highly developed countries: a systematic review.
J Gen Intern Med 2017 Jun;32(6):686-96. doi: 10.1007/s11606-016-3936-3.
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Keywords: Hospitalization, Hospitals, Inpatient Care, Patient-Centered Outcomes Research, Patient Safety