National Healthcare Quality and Disparities Report
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Search All Research Studies
Topics
- (-) Ambulatory Care and Surgery (8)
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 8 of 8 Research Studies DisplayedHood-Medland EA, White AEC, Kravitz RL
Agenda setting and visit openings in primary care visits involving patients taking opioids for chronic pain.
This study looked at primary care visit opening styles to assess use of agenda and non-agenda setting visit openings and their effects on participant experience with patients taking opioids for chronic pain. The study analyzed 83 video-recorded US primary care visits at a single academic medical center in California. A total of 49 family medicine and internal resident physicians and 83 patients were filmed. The authors developed a coding scheme that assessed the presence of agenda setting, distinct visit opening styles, and the number of total topics, major topics, surprise patient topics, and returns to prior topics discusses. They identified 2 visit opening styles with agenda setting (agenda eliciting, agenda reframing) and 3 non-agenda opening styles (open-ended question, patient launch, physician launch). Only 11% of visits included agenda setting and was associated with fewer surprise patient topics than visits without agenda setting.
AHRQ-funded; HS022236.
Citation: Hood-Medland EA, White AEC, Kravitz RL .
Agenda setting and visit openings in primary care visits involving patients taking opioids for chronic pain.
BMC Fam Pract 2021 Jan 4;22(1):4. doi: 10.1186/s12875-020-01317-4..
Keywords: Primary Care, Opioids, Medication, Pain, Chronic Conditions, Clinician-Patient Communication, Communication, Ambulatory Care and Surgery
Lafferty M, Fauer A, Wright N
Causes and consequences of chemotherapy delays in ambulatory oncology practices: a multisite qualitative study.
The purpose of this study was to examine the causes and consequences of chemotherapy treatment delays and possible solutions to improve quality of care. The authors identified four primary themes from the analysis that affect delays. They suggest future investigations to examine nurses' communication practices in the context of timely chemotherapy administration since communication and documentation technologies within healthcare settings continuously evolve.
AHRQ-funded; HS024914.
Citation: Lafferty M, Fauer A, Wright N .
Causes and consequences of chemotherapy delays in ambulatory oncology practices: a multisite qualitative study.
Oncol Nurs Forum 2020 Jul 1;47(4):417-27. doi: 10.1188/20.Onf.417-427..
Keywords: Treatments, Cancer, Ambulatory Care and Surgery, Quality of Care, Clinician-Patient Communication, Communication, Provider: Nurse, Provider, Nursing, Chronic Conditions
Ike B, Baldwin LM, Sutton S
Staff and clinician work-life perceptions after implementing systems-based improvements to opioid management.
The authors assessed the impact of implementing the Six Building Blocks on the work-life of primary care providers and staff. Six rural and rural-serving primary care organizations implemented the Six Building Blocks, with assistance from practice facilitators, clinical experts, and informatics specialists. The authors found that clinicians and staff reported improvement in their work-life after implementing the Six Building Blocks Program to improve opioid medication management and recommended further research on patient experiences specific to practice redesign programs.
AHRQ-funded; HS023750.
Citation: Ike B, Baldwin LM, Sutton S .
Staff and clinician work-life perceptions after implementing systems-based improvements to opioid management.
J Am Board Fam Med 2019 Sep-Oct;32(5):715-23. doi: 10.3122/jabfm.2019.05.190027.
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Keywords: Opioids, Pain, Chronic Conditions, Primary Care: Models of Care, Primary Care, Care Management, Ambulatory Care and Surgery, Quality Improvement, Medication, Provider, Clinician-Patient Communication
Grout RW, Cheng ER, Aalsma MC
Let them speak for themselves: improving adolescent self-report rate on pre-visit screening.
This study examined the effect of an automated alert during electronic pre-visit electronic tablet screening on the adolescent self-report rate at pediatric ambulatory clinics. The goal was to increase self-reporting as opposed to parents or caregivers filling out the screening information.bAn interventional study was conducted over a 16 month period. Preintervention rates were low for adolescents, with parents or caregivers completing the pre-visit reports at a high rate. After intervention, self-reporting by younger adolescents nearly doubled and among older adolescents the stable baseline rate of 53.6% increased by 9.2 absolute percentage points.
AHRQ-funded; HS017939; HS018453; HS020640; HS022681.
Citation: Grout RW, Cheng ER, Aalsma MC .
Let them speak for themselves: improving adolescent self-report rate on pre-visit screening.
Acad Pediatr 2019 Jul;19(5):581-88. doi: 10.1016/j.acap.2019.04.010..
Keywords: Children/Adolescents, Electronic Health Records (EHRs), Health Information Technology (HIT), Ambulatory Care and Surgery, Communication, Clinician-Patient Communication
Links AR, Callon W, Wasserman C
Surgeon use of medical jargon with parents in the outpatient setting.
This study analyzed the use of unexplained medical jargon with parents whose children have sleep-disordered breathing and their consultations with otolaryngologists in a pediatric surgical setting. Participants (64 parents and 8 otolaryngologists) completed questionnaires that evaluated demographics, clinical features and parental role in decision-making. Unexplained medical jargon was commonly used by physicians (mean total utterances per visit = 28.9) while parents used jargon a mean of 4.3 times. Clinicians used more jargon when they felt that parents had greater involvement in decision-making or when parents used more jargon themselves. These results will be incorporated into communication training for clinicians.
AHRQ-funded; HS022932.
Citation: Links AR, Callon W, Wasserman C .
Surgeon use of medical jargon with parents in the outpatient setting.
Patient Educ Couns 2019 Jun;102(6):1111-18. doi: 10.1016/j.pec.2019.02.002..
Keywords: Ambulatory Care and Surgery, Caregiving, Children/Adolescents, Clinician-Patient Communication, Communication, Shared Decision Making, Education: Patient and Caregiver, Provider, Provider: Physician
Grob R, Schlesinger M, Barre LR
What words convey: the potential for patient narratives to inform quality improvement.
This article explored the potential of systematically elicited narratives about experiences with outpatient care to enrich quality improvement. The authors concluded that attention to patient experience and rigorously elicited narratives hold substantial promise for improving quality and patients' experiences with care by making concrete what went wrong or right in domains covered by existing surveys, and by expanding our view of what aspects of care matter to patients as articulated in their own words and thus how care can be made more patient-centered.
AHRQ-funded; HS016978; HS016980; HS021858.
Citation: Grob R, Schlesinger M, Barre LR .
What words convey: the potential for patient narratives to inform quality improvement.
Milbank Q 2019 Mar;97(1):176-227. doi: 10.1111/1468-0009.12374..
Keywords: Ambulatory Care and Surgery, Clinician-Patient Communication, Patient Experience, Quality Improvement
Federman AD, Sanchez-Munoz A, Jandorf L
Patient and clinician perspectives on the outpatient after-visit summary: a qualitative study to inform improvements in visit summary design.
The researchers explored patients' and clinicians' perspectives on electronic health record (EHR)-generated outpatient after-visit summaries (AVSs) to inform efforts to maximize the document's utility. They learned that core themes included the use and purpose of the AVS, content modification and prioritization, formatting improvements, customization, privacy and accuracy concerns, and clinician workflow concerns.
AHRQ-funded; HS023844.
Citation: Federman AD, Sanchez-Munoz A, Jandorf L .
Patient and clinician perspectives on the outpatient after-visit summary: a qualitative study to inform improvements in visit summary design.
J Am Med Inform Assoc 2017 Apr;24(e1):e61-e68. doi: 10.1093/jamia/ocw106.
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Keywords: Electronic Health Records (EHRs), Ambulatory Care and Surgery, Primary Care, Clinician-Patient Communication, Education: Patient and Caregiver
Rangachari P, Mehta R, Rethemeyer RK
Short or long end of the lever? Associations between provider communication of the "asthma-action plan" and outpatient revisits for pediatric asthma.
This study addresses the gap in understanding the extent of leverage that healthcare providers may have in preventing hospital revisits for asthma through effective communication of the Asthma-Action Plan (AAP) in the outpatient setting. The Children's Hospital of Georgia survey results suggest limited potential of effective provider communication of AAP in reducing outpatient revisits for pediatric asthma and indicate a need for broader community-based interventions to address patient life variables impacting self-management and hospital revisits for pediatric asthma.
AHRQ-funded; HS019785.
Citation: Rangachari P, Mehta R, Rethemeyer RK .
Short or long end of the lever? Associations between provider communication of the "asthma-action plan" and outpatient revisits for pediatric asthma.
J Hosp Adm 2015 Oct;4(5):26-39. doi: 10.5430/jha.v4n5p26.
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Keywords: Asthma, Children/Adolescents, Ambulatory Care and Surgery, Clinician-Patient Communication, Patient Self-Management