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
- Adverse Events (2)
- Behavioral Health (1)
- Burnout (5)
- Care Coordination (1)
- Caregiving (1)
- Children/Adolescents (1)
- Clinician-Patient Communication (1)
- Communication (1)
- Depression (1)
- Diabetes (1)
- Education: Continuing Medical Education (7)
- Elderly (2)
- Electronic Health Records (EHRs) (3)
- Emergency Department (4)
- Evidence-Based Practice (1)
- Guidelines (2)
- Healthcare Costs (1)
- Healthcare Delivery (1)
- Health Information Technology (HIT) (3)
- Health Services Research (HSR) (1)
- Health Status (1)
- Hospital Discharge (1)
- Hospitals (1)
- Infectious Diseases (1)
- Medicare (1)
- Medication (2)
- Nursing Homes (1)
- Obesity (1)
- Opioids (1)
- Organizational Change (1)
- Outcomes (1)
- Patient-Centered Healthcare (1)
- Patient and Family Engagement (1)
- Patient Safety (5)
- Practice Patterns (2)
- Primary Care (3)
- Provider (17)
- Provider: Clinician (6)
- Provider: Nurse (2)
- Provider: Pharmacist (2)
- (-) Provider: Physician (24)
- Provider Performance (2)
- Quality of Care (1)
- Shared Decision Making (2)
- Simulation (1)
- Stress (1)
- Surgery (8)
- Teams (1)
- Training (1)
- Vaccination (1)
- Workflow (3)
- Workforce (2)
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
1 to 24 of 24 Research Studies DisplayedEdwards ST, Marino M, Balasubramanian BA
Burnout among physicians, advanced practice clinicians and staff in smaller primary care practices.
The purpose of this study was to examine the association between physician-, advanced practice clinician- and staff-reported burnout and specific structural, organizational, and contextual characteristics of smaller primary care practices. Results showed that burnout is prevalent among physicians, advanced practice clinicians, and staff in smaller primary care practices. Members of solo practices less commonly report burnout, while members of health system-owned practices and Federally Qualified Health Centers more commonly report burnout, suggesting that practice level autonomy may be a critical determinant.
AHRQ-funded; HS023940.
Citation: Edwards ST, Marino M, Balasubramanian BA .
Burnout among physicians, advanced practice clinicians and staff in smaller primary care practices.
J Gen Intern Med 2018 Dec;33(12):2138-46. doi: 10.1007/s11606-018-4679-0..
Keywords: Burnout, Primary Care, Provider: Physician, Provider: Clinician, Provider
Sheetz KH, Ibrahim AM, Regenbogen SE
Surgeon experience and Medicare expenditures for laparoscopic compared to open colectomy.
This population-based study examined whether surgeon experience with laparoscopy influenced payments for laparoscopy versus open surgery colectomies. The study used 182,852 national Medicare beneficiaries undergoing colectomies between 2010 and 2012. Surgeons with the most laparoscopic experience did experience an average payment savings of $5456 per patient in laparoscopic versus open cases. For surgeons in the lowest quartile of experience there was no difference.
AHRQ-funded; HS023597.
Citation: Sheetz KH, Ibrahim AM, Regenbogen SE .
Surgeon experience and Medicare expenditures for laparoscopic compared to open colectomy.
Ann Surg 2018 Dec;268(6):1036-42. doi: 10.1097/sla.0000000000002312..
Keywords: Elderly, Surgery, Medicare, Healthcare Costs, Provider: Physician
Horwood CR, Moffatt-Bruce SD, Fitzgerald M
A qualitative analysis of clinical decompensation in the surgical patient: perceptions of nurses and physicians.
This study is a quantitative analysis of nurse and physician perception of clinical decompensation in postsurgical patients. The study aims to assess how nurses and physicians perceive early warning signs that predict clinical decompensation, changes in clinical acuity, and the need for escalation of care. Many areas showed strong agreement, but there were differences between nurses and physicians in primary indicators of patient stability. There were also differences in the methods and frequency used to monitor medically unstable patients.
AHRQ-funded; HS024379.
Citation: Horwood CR, Moffatt-Bruce SD, Fitzgerald M .
A qualitative analysis of clinical decompensation in the surgical patient: perceptions of nurses and physicians.
Surgery 2018 Dec;164(6):1311-15. doi: 10.1016/j.surg.2018.06.006..
Keywords: Adverse Events, Health Status, Provider: Clinician, Provider: Nurse, Provider: Physician, Surgery
Lybarger KJ, Ostendorf M, Riskin E
Asynchronous speech recognition affects physician editing of notes.
Clinician progress notes are an important record for care and communication, but there is a perception that electronic notes take too long to write and may not accurately reflect the patient encounter, threatening quality of care. Automatic speech recognition (ASR) has the potential to improve clinical documentation process; however, ASR inaccuracy and editing time are barriers to wider use. In this study, the investigators hypothesized that automatic text processing technologies could decrease editing time and improve note quality.
AHRQ-funded; HS023631.
Citation: Lybarger KJ, Ostendorf M, Riskin E .
Asynchronous speech recognition affects physician editing of notes.
Appl Clin Inform 2018 Oct;9(4):782-90. doi: 10.1055/s-0038-1673417..
Keywords: Provider: Physician, Provider, Electronic Health Records (EHRs), Health Information Technology (HIT)
Fong A, Ratwani RM
Understanding emergency medicine physicians multitasking behaviors around interruptions.
Interruptions can adversely impact human performance, particularly in fast-paced and high-risk environments such as the emergency department (ED). In this paper, the investigators present a comprehensive framework for understanding interruptions that is composed of three phases, each with multiple levels: interruption start transition, interruption engagement, and interruption end transition. This three-phase framework is not constrained to discrete task transitions, providing a robust method to categorize multitasking behaviors around interruptions. They apply this framework in categorizing 457 interruption episodes.
AHRQ-funded; HS022362.
Citation: Fong A, Ratwani RM .
Understanding emergency medicine physicians multitasking behaviors around interruptions.
Acad Emerg Med 2018 Oct;25(10):1164-68. doi: 10.1111/acem.13496..
Keywords: Emergency Department, Workflow, Patient Safety, Provider: Physician, Provider
Cofer KD, Hollis RH, Goss L
Burnout is associated with emotional intelligence but not traditional job performance measurements in surgical residents.
The purpose of this study was to evaluate whether burnout was associated with emotional intelligence and job performance in surgical residents. The investigators found that burnout was present in surgery residents and was associated with emotional intelligence. There was no association of burnout with United States Medical Licensing Examination scores, American Board of Surgery In-Training Exam percentile, or surgical milestones. The investigators suggested that traditional methods of assessing resident performance may not be capturing burnout and strategies to reduce burnout should consider targeting emotional intelligence.
AHRQ-funded; HS023009.
Citation: Cofer KD, Hollis RH, Goss L .
Burnout is associated with emotional intelligence but not traditional job performance measurements in surgical residents.
J Surg Educ 2018 Sep - Oct;75(5):1171-79. doi: 10.1016/j.jsurg.2018.01.021..
Keywords: Burnout, Education: Continuing Medical Education, Provider, Provider: Physician, Provider Performance
Blay E, Engelhardt KE, Hewitt DB
Evaluation of reasons why surgical residents exceeded 2011 duty hour requirements when offered flexibility: a FIRST Trial analysis.
This study’s objective was to examine the reasons why residents exceeded a 24-hour call during their daily shift. Residents in the flexible arm of the Flexibility in Duty Hour Requirement for Surgical Trainees (FIRST) trial were surveyed anonymously. All clinical general surgery residents taking the 2017 American Board of Surgery In-Training Examination were included in the survey. There was a very high response rate (99.2%) which included 1838 of 1852 general surgery residents in the FIRST trial. Of those who responded, 21.7% indicated their programs expected them to stay longer. A large majority (78.1%) indicated they wanted to stay longer with only 7.4% reporting coercion from attending surgeons, and 9.3% reporting coercion from senior residents.
AHRQ-funded; HS000078.
Citation: Blay E, Engelhardt KE, Hewitt DB .
Evaluation of reasons why surgical residents exceeded 2011 duty hour requirements when offered flexibility: a FIRST Trial analysis.
JAMA Surg 2018 Sep;153(9):860-62. doi: 10.1001/jamasurg.2018.1047.
.
.
Keywords: Surgery, Provider: Physician, Education: Continuing Medical Education, Provider
Simpkin AL, Khan A, West DC
Stress from uncertainty and resilience among depressed and burned out residents: a cross-sectional study.
This study examined how stress from uncertainty is related to resilience among medical residents and whether those attributes are related to depression and burnout. The investigators surveyed 86 residents in pediatric residency programs from 4 urban freestanding children’s hospitals in North America in 2015. They used the Physicians’ Reaction to Uncertainty Scale to measure stress from uncertainty, the 14-item Resilience Scale to measure uncertainty, the Harvard National Depression Scale for depression, and the Maslach Burnout Inventory for burnout. There was a response rate of 58.1%. Five residents met depression criteria, and 15 residents met the burnout criteria. Depressed and burned out residents both had higher mean levels of stress compared to residents who neither depressed nor burned out.
AHRQ-funded; HS022986.
Citation: Simpkin AL, Khan A, West DC .
Stress from uncertainty and resilience among depressed and burned out residents: a cross-sectional study.
Acad Pediatr 2018 Aug;18(6):698-704. doi: 10.1016/j.acap.2018.03.002..
Keywords: Burnout, Stress, Depression, Provider: Physician, Behavioral Health, Provider, Education: Continuing Medical Education, Hospitals
Shah PD, Calo WA, Marciniak MW
Support for pharmacist-provided HPV vaccination: national surveys of U.S. physicians and parents.
Cancer Epidemiol Biomarkers Prev 2018 Aug;27(8):970-78. doi: 10.1158/1055-9965.Epi-18-0380.
State laws about pharmacists providing human papillomavirus (HPV) vaccines vary considerably, limiting many pharmacists' ability to provide this important cancer prevention service. In this study, the investigators characterized physician and parent support for pharmacist-provided HPV vaccination for adolescents who are past due for vaccination. The authors concluded that to increase support for HPV vaccination services, pharmacists should raise awareness about their immunization training and standardize vaccination protocols that ensure coordination with primary care.
State laws about pharmacists providing human papillomavirus (HPV) vaccines vary considerably, limiting many pharmacists' ability to provide this important cancer prevention service. In this study, the investigators characterized physician and parent support for pharmacist-provided HPV vaccination for adolescents who are past due for vaccination. The authors concluded that to increase support for HPV vaccination services, pharmacists should raise awareness about their immunization training and standardize vaccination protocols that ensure coordination with primary care.
AHRQ-funded; HS000032.
Citation: Shah PD, Calo WA, Marciniak MW .
Support for pharmacist-provided HPV vaccination: national surveys of U.S. physicians and parents.
Cancer Epidemiol Biomarkers Prev 2018 Aug;27(8):970-78. doi: 10.1158/1055-9965.Epi-18-0380..
Keywords: Caregiving, Children/Adolescents, Infectious Diseases, Provider, Provider: Pharmacist, Provider: Physician, Vaccination
Shubeck SP, Kanters AE, Sandhu G
Dynamics within peer-to-peer surgical coaching relationships: early evidence from the Michigan Bariatric Surgical Collaborative.
Through a qualitative thematic analysis, the investigators sought to determine if surgeons could comfortably and effectively transition to a co-learner dynamic for effective peer coaching. The investigators suggest that their qualitative analysis demonstrates that surgeons naturally and effectively assume co-learner roles when participating in an early surgical coaching experience.
AHRQ-funded; HS000053; HS023597.
Citation: Shubeck SP, Kanters AE, Sandhu G .
Dynamics within peer-to-peer surgical coaching relationships: early evidence from the Michigan Bariatric Surgical Collaborative.
Surgery 2018 Aug;164(2):185-88. doi: 10.1016/j.surg.2018.03.009..
Keywords: Provider: Physician, Surgery
Jones LK, Jennings BM, Higgins MK
Ethological observations of social behavior in the operating room.
This study used ethological observation techniques, recording live all social behavior to document the full range of behavior of operating room teams. The study focused on examining the hierarchical, mixed-gender aspects of clinical teams.
AHRQ-funded; HS023403.
Citation: Jones LK, Jennings BM, Higgins MK .
Ethological observations of social behavior in the operating room.
Proc Natl Acad Sci U S A 2018 Jul 17;115(29):7575-80. doi: 10.1073/pnas.1716883115..
Keywords: Patient Safety, Surgery, Provider: Physician, Provider
Denton CA, Soni HC, Kannampallil TG
Emergency physicians' perceived influence of EHR use on clinical workflow and performance metrics.
In this article, the authors investigated the perceived effects of electronic health record (EHR) use on clinical workflow and meaningful use (MU) performance metrics. The investigators concluded that physicians' perception of EHRs was likely to influence their practices. They suggested that with negative perceptions of EHR usability problems, positive aspects of EHR use, including the influence on MU performance metrics, may be overridden.
AHRQ-funded; HS022670.
Citation: Denton CA, Soni HC, Kannampallil TG .
Emergency physicians' perceived influence of EHR use on clinical workflow and performance metrics.
Appl Clin Inform 2018 Jul;9(3):725-33. doi: 10.1055/s-0038-1668553..
Keywords: Electronic Health Records (EHRs), Emergency Department, Health Information Technology (HIT), Workflow, Provider: Physician, Provider
Huber MT, Ham SA, Qayyum M
Association between job factors, burnout, and preference for a new job: a nationally representative physician survey.
Investigators used an experimental vignette to test associations between physician demographics, salary, and working with exemplary colleagues on the likelihood of preferring a new job among burned out and non-burned out physicians in various specialties. They found that, among burned out physicians, the opportunity for better salary and colleagues made them more likely to prefer a new job compared to non-burned out physicians, with change in salary associated with the greatest difference. They recommended focusing on improving physician-colleague relationships to improve job retention.
AHRQ-funded; HS000078.
Citation: Huber MT, Ham SA, Qayyum M .
Association between job factors, burnout, and preference for a new job: a nationally representative physician survey.
J Gen Intern Med 2018 Jun;33(6):789-91. doi: 10.1007/s11606-018-4412-z..
Keywords: Burnout, Workforce, Provider: Physician, Provider
Yeo HL, Abelson JS, Symer MM
Association of time to attrition in surgical residency with individual resident and programmatic factors.
Attrition in general surgery residency remains high, and attrition that occurs in the later years is the most worrisome. Although several studies have retrospectively investigated the timing of attrition, no study to date has prospectively evaluated a national cohort of residents to understand which residents are at risk for attrition and at what point during residency. The purpose of this study was to prospectively evaluate individual resident and programmatic factors associated with the timing of attrition during general surgery residency.
AHRQ-funded; HS000066.
Citation: Yeo HL, Abelson JS, Symer MM .
Association of time to attrition in surgical residency with individual resident and programmatic factors.
JAMA Surg 2018 Jun;153(6):511-17. doi: 10.1001/jamasurg.2017.6202.
.
.
Keywords: Education: Continuing Medical Education, Provider, Provider: Physician, Surgery
Barsuk JH, Cohen ER, Williams MV
Simulation-based mastery learning for thoracentesis skills improves patient outcomes: a randomized trial.
Physicians-in-training often perform bedside thoracenteses in academic medical centers, and complications are more common among less experienced clinicians. Simulation-based mastery learning (SBML) is one potential solution to this problem. This study evaluated the effects of a randomized trial of thoracentesis SBML on patient complications: iatrogenic pneumothorax, hemothorax, and reexpansion pulmonary edema.
AHRQ-funded; HS021202.
Citation: Barsuk JH, Cohen ER, Williams MV .
Simulation-based mastery learning for thoracentesis skills improves patient outcomes: a randomized trial.
Acad Med 2018 May;93(5):729-35. doi: 10.1097/acm.0000000000001965..
Keywords: Education: Continuing Medical Education, Patient Safety, Provider, Provider: Physician, Simulation, Training
Greenberg CC, Ghousseini HN, Pavuluri Quamme SR
A statewide surgical coaching program provides opportunity for continuous professional development.
Researchers sought to develop and evaluate a video-based coaching program for board-eligible/certified surgeons. They found that, overall, participants were satisfied with their experience and found the coaching program valuable. Future research to evaluate the impact of coaching on practice change and patient outcomes is recommended.
AHRQ-funded; HS022403.
Citation: Greenberg CC, Ghousseini HN, Pavuluri Quamme SR .
A statewide surgical coaching program provides opportunity for continuous professional development.
Ann Surg 2018 May;267(5):868-73. doi: 10.1097/sla.0000000000002341..
Keywords: Education: Continuing Medical Education, Health Services Research (HSR), Patient Safety, Provider, Provider: Physician, Quality of Care, Surgery
Stevens H, Carlin AM, Ross R
Effect of surgeon age on bariatric surgery outcomes.
This study examined the effect of surgeon age on complication rates for bariatric surgery. A retrospective study was done with 71 surgeons in Michigan who participated in a statewide collaborative improvement program. Older surgeons performed more Roux-en Y Gastric Bypass (40%) and less sleeve gastrectomy (38.8%) than younger surgeons. There was not found to be any statistically significant differences in patient outcome between the two age groups.
AHRQ-funded; HS024403.
Citation: Stevens H, Carlin AM, Ross R .
Effect of surgeon age on bariatric surgery outcomes.
Ann Surg 2018 May;267(5):905-09. doi: 10.1097/sla.0000000000002297..
Keywords: Adverse Events, Obesity, Outcomes, Patient Safety, Provider, Provider: Physician, Provider Performance
Morris RS, Ruck JM, Conca-Cheng AM
Shared decision-making in acute surgical illness: the surgeon's perspective.
The authors sought to learn more about surgeons’ perceptions of shared decision-making in settings in which surgical patients have more comorbidities and are of an older age. In this article, they discussed the 6 majors themes that emerged (responsibility for the decision to operate, perceived futility, surgeon judgment, surgeon introspection, pressure to operate, and costs of the operation).
AHRQ-funded; HS024736.
Citation: Morris RS, Ruck JM, Conca-Cheng AM .
Shared decision-making in acute surgical illness: the surgeon's perspective.
J Am Coll Surg 2018 May;226(5):784-95. doi: 10.1016/j.jamcollsurg.2018.01.008.
.
.
Keywords: Shared Decision Making, Provider: Physician, Surgery
Hung DY, Harrison MI , Truong Q
AHRQ Author: Harrison MI
Experiences of primary care physicians and staff following lean workflow redesign.
The researchers examined the work experiences of primary care physicians and staff after implementing Lean-based workflow redesigns. They found that both physicians and nonphysician staff reported higher levels of engagement and teamwork after implementing redesigns. However, the subjects also experienced higher levels of burnout and perceptions of the workplace as stressful.
AHRQ-authored; AHRQ-funded; 290201000022I.
Citation: Hung DY, Harrison MI , Truong Q .
Experiences of primary care physicians and staff following lean workflow redesign.
BMC Health Serv Res 2018 Apr 10;18(1):274. doi: 10.1186/s12913-018-3062-5.
.
.
Keywords: Primary Care, Workflow, Burnout, Organizational Change, Provider: Physician, Teams
McCreedy EM, Kane RL, Gollust SE
Patient-centered guidelines for geriatric diabetes care: potential missed opportunities to avoid harm.
Clinicians strive to deliver individualized, patient-centered care. However, these intentions are understudied. This research explored how patient characteristics associated with a high risk-to-benefit ratio with hypoglycemia medications affected decision making by primary care clinicians. The investigators found that primary care clinicians often chose to intensify glycemic control despite individual patient factors that warranted higher glycemic targets based on existing guidelines.
AHRQ-funded; HS000011.
Citation: McCreedy EM, Kane RL, Gollust SE .
Patient-centered guidelines for geriatric diabetes care: potential missed opportunities to avoid harm.
J Am Board Fam Med 2018 Mar-Apr;31(2):192-200. doi: 10.3122/jabfm.2018.02.170141..
Keywords: Diabetes, Elderly, Patient-Centered Healthcare, Guidelines, Evidence-Based Practice, Shared Decision Making, Medication, Primary Care, Practice Patterns, Provider: Physician, Provider: Clinician, Provider
Feder SL, Britton MC, Chaudhry SI
"They need to have an understanding of why they're coming here and what the outcomes might be." Clinician perspectives on goals of care for patients discharged from hospitals to skilled nursing facilities.
This study examined how clinicians view goals of care (GoC) for hospitalized patients discharged to skilled nursing facilities (SNFs). A variety of clinicians were interviewed: 22% were nurses, 20% physicians, 15% from care management, and 15% from social services. Many respondents felt that patients and their families had unrealistic GoCs. However, conversations on GoCs were infrequent during hospitalizations which contribute to unrealistic expectations for SNF care and poor patient outcomes. The researchers recommend interventions to ensure that GoC conversations and are held regularly and in a timely manner before transfer occurs.
AHRQ-funded; HS023554.
Citation: Feder SL, Britton MC, Chaudhry SI .
"They need to have an understanding of why they're coming here and what the outcomes might be." Clinician perspectives on goals of care for patients discharged from hospitals to skilled nursing facilities.
J Pain Symptom Manage 2018 Mar;55(3):930-37. doi: 10.1016/j.jpainsymman.2017.10.013..
Keywords: Care Coordination, Clinician-Patient Communication, Communication, Hospital Discharge, Nursing Homes, Patient and Family Engagement, Provider: Clinician, Provider: Nurse, Provider: Physician
Leyenaar JK, Frintner MP
Graduating pediatric residents entering the hospital medicine workforce, 2006-2015.
This study analyzed the population of graduating pediatric residents entering the new subspecialty – pediatric hospital medicine (PHM). Data was analyzed from the American Academic of Pediatrics Annual Survey of Graduating Residents, 2006-2015. A total of 5969 graduates completed the survey, and 10.3% reported that they were entering PHM and 33.9% were reporting subspecialty fellowships. A multivariable analysis was done of the demographics, and a higher rate of residents entering PHM were female, to have children, to report that family factors limited their job selection, and to have higher levels of student debt than residents entering fellowships.
AHRQ-funded; HS024133.
Citation: Leyenaar JK, Frintner MP .
Graduating pediatric residents entering the hospital medicine workforce, 2006-2015.
Acad Pediatr 2018 Mar;18(2):200-07. doi: 10.1016/j.acap.2017.05.001..
Keywords: Education: Continuing Medical Education, Provider, Provider: Clinician, Provider: Physician, Workforce
Kannampallil TG, Denton CA, Shapiro JS
Efficiency of emergency physicians: insights from an observational study using EHR log files.
The authors investigated the nature of electronic health records use and their effect on an emergency department's throughput and efficiency. They found that longer time spent on reviewing information on the electronic health record is potentially associated with decreased emergency department throughput efficiency. The authors also note that balancing between these competing goals is a challenge for physicians, and implications for patient safety are discussed.
AHRQ-funded; HS022670.
Citation: Kannampallil TG, Denton CA, Shapiro JS .
Efficiency of emergency physicians: insights from an observational study using EHR log files.
Appl Clin Inform 2018 Jan;9(1):99-104. doi: 10.1055/s-0037-1621705..
Keywords: Electronic Health Records (EHRs), Emergency Department, Healthcare Delivery, Health Information Technology (HIT), Provider, Provider: Physician
Kim HS, McCarthy DM, Hoppe JA
Emergency department provider perspectives on benzodiazepine-opioid coprescribing: a qualitative study.
This study examined attitudes of emergency department residents, attending physicians, and pharmacists from three hospitals on coprescribing benzodiazepines and opioids. There is mounting evidence that this increases overdose risk. Focus groups were conducted using semistructured interviews which were audio-recorded and transcribed. Participants were reluctant to admit coprescribing and said when they did that specific discharge instructions were provided. The decision was also influenced by a provider’s belief in the efficacy of combination therapy as well as self-imposed pressure to escalate care or avoid hospital admission. They did not like the idea of using computerized alerts, but were support of pharmacist-assisted interventions.
AHRQ-funded; HS023011; HS000078.
Citation: Kim HS, McCarthy DM, Hoppe JA .
Emergency department provider perspectives on benzodiazepine-opioid coprescribing: a qualitative study.
Acad Emerg Med 2018 Jan;25(1):15-24. doi: 10.1111/acem.13273..
Keywords: Emergency Department, Guidelines, Medication, Opioids, Practice Patterns, Provider: Clinician, Provider: Pharmacist, Provider: Physician