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Search All Research Studies
Topics
- Ambulatory Care and Surgery (1)
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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 10 of 10 Research Studies DisplayedBaughman KR, Ludwick R, Jarjoura D
Multi-site study of provider self-efficacy and beliefs in explaining judgments about need and responsibility for advance care planning.
This study’s objective was to examine the impact of advance care planning (ACP) self-efficacy and beliefs in explaining skilled nursing facility (SNF) provider judgements about resident need and provider responsibility for initiating ACP conversations. This observational multi-site study anonymously surveyed 348 registered nurses, LPNs, and social workers within 29 SNFs. Providers who had more negative beliefs about ACP were less likely to judge residents in need of ACP and less likely to feel responsible for ensuring that ACP occurred. Providers with higher self-efficacy for ACP were more likely to feel responsible for ensuring ACP conversations.
AHRQ-funded; HS022162.
Citation: Baughman KR, Ludwick R, Jarjoura D .
Multi-site study of provider self-efficacy and beliefs in explaining judgments about need and responsibility for advance care planning.
Am J Hosp Palliat Care 2021 Nov;38(11):1276-81. doi: 10.1177/1049909120979977..
Keywords: Care Management, Shared Decision Making
Manges KA, Wallace AS, Groves PS
Ready to go home? Assessment of shared mental models of the patient and discharging team regarding readiness for hospital discharge.
A critical task of the inpatient interprofessional team is readying patients for discharge. Assessment of shared mental model (SMM) convergence can determine how much team members agree about patient discharge readiness and how their mental models align with the patient's self-assessment. The objective of this study was to determine the convergence of interprofessional team SMMs of hospital discharge readiness and identify factors associated with these assessments.
AHRQ-funded; HS026116.
Citation: Manges KA, Wallace AS, Groves PS .
Ready to go home? Assessment of shared mental models of the patient and discharging team regarding readiness for hospital discharge.
J Hosp Med 2021 Jun;16(6):326-32. doi: 10.12788/jhm.3464..
Keywords: Hospital Discharge, Teams, Care Management, Shared Decision Making, Hospitals
Curran RL, Kukhareva PV, Taft T
Integrated displays to improve chronic disease management in ambulatory care: a SMART on FHIR application informed by mixed-methods user testing.
This study’s objective was to evaluate a novel electronic health record (EHR) add-on application for chronic disease management that uses an integrated display to decrease user cognitive load, improve efficiency, and support clinical decision making. The authors designed an application using the technology framework known as SMART on FHIR (Substitutable Medical Applications and Reusable Technologies on Fast Healthcare Interoperability Resources). They used mixed methods to obtain user feedback on a prototype to support ambulatory providers managing chronic obstructive pulmonary disease. Two patient scenarios were presented to the participants using the regular EHR with and without access to their prototype. Results measured was the percentage of expert-recommended ideal care tasks completed. Timing, keyboard and mouse use, and participant surveys were also collected. The 13 participants complete more recommended care using the prototype (81% vs 48%) and recommended tasks per minute over long sessions. Keystrokes per task were also lower with the prototype (6 vs 18). While there was a learning curve for this application, it will increase efficiency and patient care with practice.
AHRQ-funded; HS026198.
Citation: Curran RL, Kukhareva PV, Taft T .
Integrated displays to improve chronic disease management in ambulatory care: a SMART on FHIR application informed by mixed-methods user testing.
J Am Med Inform Assoc 2020 Aug;27(8):1225-34. doi: 10.1093/jamia/ocaa099..
Keywords: Chronic Conditions, Electronic Health Records (EHRs), Health Information Technology (HIT), Care Management, Ambulatory Care and Surgery, Clinical Decision Support (CDS), Shared Decision Making
Anagnostou A, Hourihane JO, Greenhawt M
The role of shared decision making in pediatric food allergy management.
Shared decision making was first highlighted in a report by the Institute of Medicine in 2001. The primary aim of this initiative was to improve the quality of care provided to patients in the United States by creating a health care system that is safe, effective, efficient, and equitable. For the purposes of this review, the investigators discussed different areas of food allergy management within a single complex case, focusing on the role of shared decision making.
AHRQ-funded; HS024599.
Citation: Anagnostou A, Hourihane JO, Greenhawt M .
The role of shared decision making in pediatric food allergy management.
J Allergy Clin Immunol Pract 2020 Jan;8(1):46-51. doi: 10.1016/j.jaip.2019.09.004..
Keywords: Children/Adolescents, Shared Decision Making, Chronic Conditions, Care Management
Schroeder AD, Tubre DJ, Fitzgibbons RJ
Watchful waiting for inguinal hernia.
In this article, the authors examine the available evidence regarding nonoperative treatment or ‘‘watchful waiting’’ of inguinal hernias. The goal was to develop evidence-based recommendations to provide patients with inguinal hernia the treatment strategy that will maximize benefit while minimizing potential risks.
AHRQ-funded; HS009860.
Citation: Schroeder AD, Tubre DJ, Fitzgibbons RJ .
Watchful waiting for inguinal hernia.
Adv Surg 2019 Sep;53:293-303. doi: 10.1016/j.yasu.2019.04.014.
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Keywords: Care Management, Evidence-Based Practice, Shared Decision Making
Harle CA, DiIulio J, Downs SM
Decision-centered design of patient information visualizations to support chronic pain care.
The objective of this study was to describe a decision-centered design process, and resultant interactive patient information displays, to support key clinical decision requirements in chronic noncancer pain care. Through critical decision method interviews and a half-day multidisciplinary design workshop, researchers designed an interactive prototype, the Chronic Pain Treatment Tracker. This prototype summarizes the current treatment plan, past treatment history, potential future treatments, and treatment options that require caution. The researchers concluded that the Chronic Pain Treatment Tracker presents clinicians with the information they need in a structure that promotes quick uptake, understanding, and action.
AHRQ-funded; HS023306.
Citation: Harle CA, DiIulio J, Downs SM .
Decision-centered design of patient information visualizations to support chronic pain care.
Appl Clin Inform 2019 Aug;10(4):719-28. doi: 10.1055/s-0039-1696668..
Keywords: Pain, Chronic Conditions, Shared Decision Making, Health Information Technology (HIT), Clinical Decision Support (CDS), Care Management, Healthcare Delivery
Militello LG, Anders S, Downs SM
Understanding how primary care clinicians make sense of chronic pain.
This research explored how primary care clinicians manage their patients with chronic noncancer pain. They conducted Critical Decision Method interviews with 10 clinicians about 30 individual patients. Findings suggested that clinicians should focus on supporting sensemaking in the content of clinical evidence rather than trying to provide them with rules.
AHRQ-funded; HS023306.
Citation: Militello LG, Anders S, Downs SM .
Understanding how primary care clinicians make sense of chronic pain.
Cogn Technol Work 2018 Nov;20(4):575-84. doi: 10.1007/s10111-018-0491-1..
Keywords: Pain, Chronic Conditions, Opioids, Medication, Shared Decision Making, Primary Care, Care Management
Hall SF, Wright NC, Wolinsky FD
The prevalence of overtreatment of osteoporosis: results from the PAADRN trial.
There is a robust body of literature addressing undertreatment in osteoporosis, but limited data addressing overtreatment. In this study, the investigators sought to understand overtreatment as this understanding is important to minimizing harm and decrease costs. The investigators found that in their sample of older adults, overuse of osteoporosis pharmacotherapy was only 8.1%. Nevertheless, they concluded, overtreatment exposed patients to possible risk with negligible chance of benefit and should be minimized.
AHRQ-funded; HS023009.
Citation: Hall SF, Wright NC, Wolinsky FD .
The prevalence of overtreatment of osteoporosis: results from the PAADRN trial.
Arch Osteoporos 2018 Sep 28;13(1):103. doi: 10.1007/s11657-018-0517-6..
Keywords: Osteoporosis, Shared Decision Making, Medication, Elderly, Patient-Centered Healthcare, Patient and Family Engagement, Care Management
Balentine CJ, Leverson G, Vanness DJ
Selecting post-acute care settings after abdominal surgery: are we getting it right?
Using Nationwide Inpatient Sample data, the authors investigated whether variation in post-acute care (PAC) services could be explained by surgeons discharging clinically similar patients to different PAC destinations. They found considerable potential for reducing variation in PAC use and costs by better understanding how surgeons make decisions about PAC placement.
AHRQ-funded; HS023009.
Citation: Balentine CJ, Leverson G, Vanness DJ .
Selecting post-acute care settings after abdominal surgery: are we getting it right?
Am J Surg 2018 Aug;216(2):260-66. doi: 10.1016/j.amjsurg.2017.08.043..
Keywords: Care Management, Shared Decision Making, Healthcare Cost and Utilization Project (HCUP), Surgery, Transitions of Care
Aalsma MC, Zerr AM, Etter DJ
Physician intervention to positive depression screens among adolescents in primary care.
The objective of this study was to determine the effectiveness of computer-based screening and physician feedback to guide adolescent depression management within primary care. The investigators found that when a computer-based decision support system algorithm focused on adolescent depression and was implemented in two primary care clinics, a majority of physicians utilized screening results to guide clinical care.
AHRQ-funded; HS022681.
Citation: Aalsma MC, Zerr AM, Etter DJ .
Physician intervention to positive depression screens among adolescents in primary care.
J Adolesc Health 2018 Feb;62(2):212-18. doi: 10.1016/j.jadohealth.2017.08.023..
Keywords: Care Management, Children/Adolescents, Shared Decision Making, Depression, Health Information Technology (HIT), Behavioral Health, Primary Care, Primary Care: Models of Care, Screening