National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Events (6)
- Ambulatory Care and Surgery (1)
- Blood Clots (1)
- Burnout (1)
- Central Line-Associated Bloodstream Infections (CLABSI) (1)
- Children/Adolescents (7)
- Chronic Conditions (1)
- Clinical Decision Support (CDS) (1)
- Communication (4)
- Community-Based Practice (1)
- Comparative Effectiveness (3)
- Data (4)
- Diabetes (1)
- Diagnostic Safety and Quality (1)
- Education: Continuing Medical Education (1)
- Elderly (2)
- Electronic Health Records (EHRs) (1)
- Emergency Department (2)
- Emergency Medical Services (EMS) (1)
- Evidence-Based Practice (2)
- Genetics (1)
- Guidelines (2)
- Healthcare-Associated Infections (HAIs) (2)
- Healthcare Cost and Utilization Project (HCUP) (1)
- Healthcare Costs (3)
- Healthcare Delivery (6)
- Health Information Technology (HIT) (1)
- Health Services Research (HSR) (5)
- Hospital Discharge (5)
- Hospital Readmissions (1)
- Hospitals (8)
- Imaging (3)
- Implementation (2)
- Intensive Care Unit (ICU) (1)
- Learning Health Systems (1)
- Long-Term Care (3)
- Maternal Care (1)
- Medical Errors (3)
- Medicare (4)
- Medication (2)
- Mortality (1)
- Nursing Homes (4)
- Obesity (1)
- Organizational Change (4)
- Outcomes (5)
- Pain (1)
- Palliative Care (2)
- Patient-Centered Healthcare (1)
- Patient-Centered Outcomes Research (5)
- Patient Experience (2)
- Patient Safety (11)
- Payment (9)
- Policy (7)
- Practice Improvement (1)
- Practice Patterns (2)
- Pressure Ulcers (2)
- Prevention (5)
- Primary Care (6)
- Provider Performance (8)
- Public Reporting (5)
- (-) Quality Improvement (51)
- Quality Indicators (QIs) (1)
- Quality Measures (2)
- Quality of Care (27)
- Racial and Ethnic Minorities (3)
- Registries (2)
- Research Methodologies (2)
- Shared Decision Making (2)
- Stress (1)
- Surgery (6)
- Teams (2)
- Training (1)
- Transitions of Care (1)
- Workflow (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 51 Research Studies DisplayedScally CP, Yin H, Birkmeyer JD
Comparing perioperative processes of care in high and low mortality centers performing pancreatic surgery.
The researchers compared high and low mortality hospitals in order to identify differences in patient care impacting safety. They concluded that high and low mortality hospitals both have high compliance with common quality measures; however, high mortality hospitals performed worse in other areas of perioperative care, indicating possible targets for quality improvement efforts.
AHRQ-funded; HS020937.
Citation: Scally CP, Yin H, Birkmeyer JD .
Comparing perioperative processes of care in high and low mortality centers performing pancreatic surgery.
J Surg Oncol 2015 Dec;112(8):866-71. doi: 10.1002/jso.24085.
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Keywords: Surgery, Mortality, Quality Improvement, Outcomes, Patient Safety
Kronick R, Casalino LP, Bindman AB
AHRQ Author: Kronick R
Apple pickers or federal judges: strong versus weak incentives in physician payment.
The authors provide an introduction for five papers commissioned by AHRQ focusing on incentives for physicians that are featured in this special issue of Health Services Research. These papers concentrate on suggesting a conceptual framework for the use of financial incentives in health care, key implications of the evidence to date on pay for performance and public reporting in health care and several related topics.
AHRQ-authored.
Citation: Kronick R, Casalino LP, Bindman AB .
Apple pickers or federal judges: strong versus weak incentives in physician payment.
Health Serv Res 2015 Dec;50 Suppl 2:2049-56. doi: 10.1111/1475-6773.12424.
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Keywords: Payment, Provider Performance, Policy, Health Services Research (HSR), Quality of Care, Healthcare Costs, Quality Improvement
Berenson RA, Rice T
Beyond measurement and reward: methods of motivating quality improvement and accountability.
The article examines public policies designed to improve quality and accountability that do not rely on financial incentives and public reporting of provider performance. It concludes that public policies related to quality improvement should focus more on methods of enhancing professional intrinsic motivation, while recognizing the potential role of organizations to actively promote and facilitate that motivation.
AHRQ-funded
Citation: Berenson RA, Rice T .
Beyond measurement and reward: methods of motivating quality improvement and accountability.
Health Serv Res 2015 Dec;50 Suppl 2:2155-86. doi: 10.1111/1475-6773.12413.
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Keywords: Quality Improvement, Policy, Provider Performance, Quality of Care, Payment
Hempel S, Shekelle PG, Liu JL
Development of the Quality Improvement Minimum Quality Criteria Set (QI-MQCS): a tool for critical appraisal of quality improvement intervention publications.
This study developed and psychometrically tested a critical appraisal instrument, the QI Minimum Quality Criteria Set (QI-MQCS) for assessing QI-specific features of quality improvement (QI) publications. The critical appraisal instrument is accompanied by a user manual detailing What to consider, Where to look, and How to rate.
AHRQ-funded; HS018139.
Citation: Hempel S, Shekelle PG, Liu JL .
Development of the Quality Improvement Minimum Quality Criteria Set (QI-MQCS): a tool for critical appraisal of quality improvement intervention publications.
BMJ Qual Saf 2015 Dec;24(12):796-804. doi: 10.1136/bmjqs-2014-003151.
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Keywords: Evidence-Based Practice, Health Services Research (HSR), Quality Improvement
Layton TJ, Ryan AM
Higher incentive payments in Medicare Advantage's pay-for-performance program did not improve quality but did increase plan offerings.
The researchers evaluated the effects of the size of financial bonuses on quality of care and the number of plan offerings in the Medicare Advantage Quality Bonus Payment Demonstration. They concluded that at great expense to Medicare, double bonuses in the Medicare Advantage Quality Bonus Payment Demonstration were not associated with improved quality but were associated with more plan offerings.
AHRQ-funded; HS018546.
Citation: Layton TJ, Ryan AM .
Higher incentive payments in Medicare Advantage's pay-for-performance program did not improve quality but did increase plan offerings.
Health Serv Res 2015 Dec;50(6):1810-28. doi: 10.1111/1475-6773.12409..
Keywords: Medicare, Payment, Provider Performance, Health Services Research (HSR), Quality Improvement, Quality of Care
Nembhard IM, Morrow CT, Bradley EH
Implementing role-changing versus time-changing innovations in health care: differences in helpfulness of staff improvement teams, management, and network for learning.
This paper examined the hypothesis that the degree to which access to groups that can alter organizational learning depends on innovation type. Team representativeness and network membership were positively associated with implementing role-changing practices; while senior management engagement was positively associated with implementing time-changing practices. The authors concluded that these findings advance implementation science by explaining mixed results across past studies, that the nature of change for workers alters potential facilitators' effects on implementation.
AHRQ-funded; HS018987.
Citation: Nembhard IM, Morrow CT, Bradley EH .
Implementing role-changing versus time-changing innovations in health care: differences in helpfulness of staff improvement teams, management, and network for learning.
Med Care Res Rev 2015 Dec;72(6):707-35. doi: 10.1177/1077558715592315.
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Keywords: Healthcare Delivery, Quality Improvement, Organizational Change, Teams, Quality of Care, Learning Health Systems, Implementation
Blackmore CC, Castro A
Improving the quality of imaging in the emergency department.
The six-tier efficacy hierarchy of Fryback and Thornbury enables understanding of the value of imaging on multiple levels, ranging from technical efficacy to medical decision-making and higher-level patient and societal outcomes. In this article, the authors elucidate the Fryback and Thornbury framework to define the value of imaging in the ED and to relate emergency imaging to the IOM quality domains.
AHRQ-funded; HS023498.
Citation: Blackmore CC, Castro A .
Improving the quality of imaging in the emergency department.
Acad Emerg Med 2015 Dec;22(12):1385-92. doi: 10.1111/acem.12816.
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Keywords: Shared Decision Making, Emergency Department, Imaging, Quality Improvement
Fernandez R, Grand JA
Leveraging social science-healthcare collaborations to improve teamwork and patient safety.
This article highlights guiding team science principles from the organizational psychology literature that can be applied to the study of teams in healthcare. The authors' goal is to provide some common language and understanding around teams and teamwork. Additionally, they hope to impart an appreciation for the potential synergy present within clinician-social scientist collaborations.
AHRQ-funded; HS020295; HS022458.
Citation: Fernandez R, Grand JA .
Leveraging social science-healthcare collaborations to improve teamwork and patient safety.
Curr Probl Pediatr Adolesc Health Care 2015 Dec;45(12):370-7. doi: 10.1016/j.cppeds.2015.10.005.
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Keywords: Patient Safety, Teams, Quality Improvement, Quality of Care, Medical Errors, Adverse Events
Lepore M, Leland NE
Nursing homes that increased the proportion of Medicare days saw gains in quality outcomes for long-stay residents.
The authors examined nationwide facility-level nursing home data for the period 2007-2010. They found that increasing the proportion of Medicare-covered patient days in a nursing home was significantly associated with improvements in the quality of daily pain, pressure ulcers, and performing activities of daily living.
AHRQ-funded; HS022907.
Citation: Lepore M, Leland NE .
Nursing homes that increased the proportion of Medicare days saw gains in quality outcomes for long-stay residents.
Health Aff 2015 Dec;34(12):2121-8. doi: 10.1377/hlthaff.2015.0303.
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Keywords: Long-Term Care, Medicare, Nursing Homes, Patient-Centered Outcomes Research, Quality Improvement
Berdahl C, Schuur JD, Fisher NL
Policy measures and reimbursement for emergency medical imaging in the era of payment reform: proceedings from a panel discussion of the 2015 Academic Emergency Medicine Consensus Conference.
In May 2015, Academic Emergency Medicine convened a consensus conference titled "Diagnostic Imaging in the Emergency Department: A Research Agenda to Optimize Utilization." As part of the conference, a panel of health care policy leaders and emergency physicians discussed the effect of the Affordable Casre Act and other quality programs on ED diagnostic imaging. This article discusses the content of the panel's presentations.
AHRQ-funded; HS023498.
Citation: Berdahl C, Schuur JD, Fisher NL .
Policy measures and reimbursement for emergency medical imaging in the era of payment reform: proceedings from a panel discussion of the 2015 Academic Emergency Medicine Consensus Conference.
Acad Emerg Med 2015 Dec;22(12):1393-9. doi: 10.1111/acem.12829.
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Keywords: Emergency Department, Healthcare Costs, Payment, Policy, Imaging, Policy, Quality Improvement
Schlesinger M, Grob R, Shaller D
Using patient-reported information to improve clinical practice.
The purposes of this study were to assess what is known about the relationship between patient experience measures and incentives designed to improve care, and to identify how public policy and medical practices can promote patient-valued outcomes in health systems with strong financial incentives. It concluded that unless public policies are attentive to patients' perspectives, stronger financial incentives for clinicians can threaten aspects of care that patients most value.
AHRQ-funded.
Citation: Schlesinger M, Grob R, Shaller D .
Using patient-reported information to improve clinical practice.
Health Serv Res 2015 Dec;50 Suppl 2:2116-54. doi: 10.1111/1475-6773.12420.
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Keywords: Quality Improvement, Quality of Care, Patient Experience, Provider Performance, Policy, Payment, Public Reporting
Cutting EM, Overby CL, Banchero M
Using workflow modeling to identify areas to improve genetic test processes in the University of Maryland Translational Pharmacogenomics Project.
The researchers used information gained from focus groups in order to illustrate the current process of delivering genetic test results to clinicians. They proposed a business process model and notation (BPMN) representation of this process for a Translational Pharmacogenomics Project being implemented at the University of Maryland Medical Center. They found that the current process could be improved to reduce input errors, better inform and notify clinicians about the implications of certain genetic tests, and make results more easily understood. They demonstrated theiruse of BPMN to improve this important clinical process for CYP2C19 genetic testing.
AHRQ-funded; HS023390.
Citation: Cutting EM, Overby CL, Banchero M .
Using workflow modeling to identify areas to improve genetic test processes in the University of Maryland Translational Pharmacogenomics Project.
AMIA Annu Symp Proc 2015 Nov 5;2015:466-74.
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Keywords: Genetics, Diagnostic Safety and Quality, Medication, Workflow, Quality Improvement, Quality of Care, Organizational Change
Blecker S, Goldfeld K, Park H
Impact of an intervention to improve weekend hospital care at an academic medical center: an observational study.
The purpose of this study was to evaluate the impact of a weekend hospital intervention on processes of care and clinical outcomes. The multifaceted intervention included expanded weekend diagnostic services, improved weekend discharge processes, and increased physician and care management services on weekends. The intervention was associated with a reduction in length of stay and an increase in weekend discharges.
AHRQ-funded; HS023683.
Citation: Blecker S, Goldfeld K, Park H .
Impact of an intervention to improve weekend hospital care at an academic medical center: an observational study.
J Gen Intern Med 2015 Nov;30(11):1657-64. doi: 10.1007/s11606-015-3330-6.
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Keywords: Quality Improvement, Quality of Care, Hospitals, Hospital Discharge, Hospital Readmissions, Healthcare Delivery, Outcomes, Patient-Centered Outcomes Research
Chen LM, Meara E, Birkmeyer JD
Medicare's Bundled Payments for Care Improvement initiative: expanding enrollment suggests potential for large impact.
The researchers examined the cross-sectional association between Bundled Payments for Care Improvement (BPCI) participation and providers' structural and cost characteristics. Overall participation in BPCI increased from about 400 in October 2013 to more than 2000 in June 2014. The authors concluded that growing participation in BPCI suggests strong interest in bundled payments.
AHRQ-funded; HS020671.
Citation: Chen LM, Meara E, Birkmeyer JD .
Medicare's Bundled Payments for Care Improvement initiative: expanding enrollment suggests potential for large impact.
Am J Manag Care 2015 Nov;21(11):814-20.
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Keywords: Healthcare Costs, Payment, Medicare, Quality Improvement
Huang ES, Davis AM
Glycemic control in older adults with diabetes mellitus.
These comprehensive guidelines emphasize an individualized approach to diabetes care goals and treatment among adults. The glycemic control recommendations suggest a general goal for glycated hemoglobin (HbA1c) in older adults of 7.5 percent to 8.0 percent (level IA evidence). A target HbA1c level between 7.0 percent and 7.5 percent may be appropriate if it can be safely achieved in healthy older adults.
AHRQ-funded; HS018542.
Citation: Huang ES, Davis AM .
Glycemic control in older adults with diabetes mellitus.
JAMA 2015 Oct 13;314(14):1509-10. doi: 10.1001/jama.2015.8345..
Keywords: Diabetes, Guidelines, Patient-Centered Outcomes Research, Elderly, Quality Improvement
Ahmed S, Siegel CA, Melmed GY
Implementing quality measures for inflammatory bowel disease.
The author argues that implementation of quality measures may depend on the care setting and whether quality measurement and improvement can be incorporated into workflows and electronic medical records. He also asserts that collaborative networks, utilization of care pathways, and standardized treatment algorithms may represent avenues for wide-scale implementation of quality improvement.
AHRQ-funded; HS021747.
Citation: Ahmed S, Siegel CA, Melmed GY .
Implementing quality measures for inflammatory bowel disease.
Curr Gastroenterol Rep 2015 Apr;17(4):14. doi: 10.1007/s11894-015-0437-1..
Keywords: Quality Measures, Quality of Care, Quality Improvement, Electronic Health Records (EHRs), Health Information Technology (HIT)
Kamal AH, Harrison KL, Bakitas M
Improving the quality of palliative care through national and regional collaboration efforts.
The purpose of this paper was to review examples of quality-improvement collaborations in palliative care to understand the similarities, differences, and future directions of quality measurement and improvement strategies. These three examples showed areas of robust and growing quality-improvement collaboration in the field of palliative care: the Global Palliative Care Quality Alliance; Palliative Care Quality Network; and Project Educate, Nurture, Advise, Before Life Ends.
AHRQ-funded; HS023681.
Citation: Kamal AH, Harrison KL, Bakitas M .
Improving the quality of palliative care through national and regional collaboration efforts.
Cancer Control 2015 Oct;22(4):396-402. doi: 10.1177/107327481502200405.
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Keywords: Healthcare Delivery, Palliative Care, Quality of Care, Quality Improvement
McNamara ER, Kurtz MP, Schaeffer AJ
30-day morbidity after augmentation enterocystoplasty and appendicovesicostomy: a NSQIP pediatric analysis.
The researchers report 30-day outcomes from the first nationally based, prospectively assembled cohort of pediatric patients undergoing these complex pediatric urologic procedures. There were a total of 110 National Surgical Quality Improvement Program (NSQIP) complications seen in 87 patients. The most common complication was urinary tract infection. The composite measure of any 30- day event was seen in 27.8 percent of the cohort.
AHRQ-funded; HS000063.
Citation: McNamara ER, Kurtz MP, Schaeffer AJ .
30-day morbidity after augmentation enterocystoplasty and appendicovesicostomy: a NSQIP pediatric analysis.
J Pediatr Urol 2015 Aug;11(4):209.e1-6. doi: 10.1016/j.jpurol.2015.04.016..
Keywords: Children/Adolescents, Outcomes, Surgery, Adverse Events, Quality Improvement
Linzer M, Poplau S, Grossman E
A cluster randomized trial of interventions to improve work conditions and clinician burnout in primary care: results from the Healthy Work Place (HWP) Study.
This study aimed to assess if improvements in work conditions reduce clinician stress and burnout. It found that burnout was more likely to improve with workflow interventions and with targeted QI projects than in controls. Also, interventions in communication or workflow led to greater improvements in clinician satisfaction.
AHRQ-funded; HS018160.
Citation: Linzer M, Poplau S, Grossman E .
A cluster randomized trial of interventions to improve work conditions and clinician burnout in primary care: results from the Healthy Work Place (HWP) Study.
J Gen Intern Med 2015 Aug;30(8):1105-11. doi: 10.1007/s11606-015-3235-4..
Keywords: Burnout, Stress, Primary Care, Workflow, Quality Improvement, Quality of Care, Communication
Sundararajan V, Romano PS, Quan H
Capturing diagnosis-timing in ICD-coded hospital data: recommendations from the WHO ICD-11 topic advisory group on quality and safety.
The purpose of this project was to develop a consensus opinion regarding capturing diagnosis-timing in coded hospital data. The WHO Quality and Safety Topic Advisory Group has undertaken a narrative literature review, scanned national experiences focusing on countries currently using timing flags, and held a series of meetings to derive formal recommendations regarding diagnosis-timing reporting. This paper discusses their concerns and recommendations.
AHRQ-funded; HS020543.
Citation: Sundararajan V, Romano PS, Quan H .
Capturing diagnosis-timing in ICD-coded hospital data: recommendations from the WHO ICD-11 topic advisory group on quality and safety.
Int J Qual Health Care 2015 Aug;27(4):328-33. doi: 10.1093/intqhc/mzv037..
Keywords: Patient Safety, Quality of Care, Quality Improvement, Hospitals, Data
Mukamel DB, Ye Z, Glance LG
Does mandating nursing home participation in quality reporting make a difference? Evidence from Massachusetts.
This study investigated one of the mechanisms that may detract from the effectiveness of quality report cards: voluntary versus mandatory participation of nursing homes in public quality reporting. It found that once reporting became mandatory, nonvolunteers improved more than volunteers in all but 2 staffing measures.
AHRQ-funded; HS021844.
Citation: Mukamel DB, Ye Z, Glance LG .
Does mandating nursing home participation in quality reporting make a difference? Evidence from Massachusetts.
Med Care 2015 Aug;53(8):713-9. doi: 10.1097/mlr.0000000000000390..
Keywords: Nursing Homes, Long-Term Care, Public Reporting, Provider Performance, Quality Improvement, Quality of Care, Quality Indicators (QIs), Quality Measures, Elderly
Andrews RM, Schulman KA
AHRQ Author: Andrews RM
Enhancing the value of Statewide Hospital Discharge Data: improving clinical content and race-ethnicity data.
To foster successful approaches to enhancing state data, AHRQ awarded eight 3-year grants to explore methods to improve the clinical content and race/ethnicity information in these databases. This editorial announces an HSR Special Issue, sponsored by AHRQ, that focuses on the products and lessons learned from these grant projects. Seven articles cover background information on statewide hospital discharge data and the grant program aims, challenges, and lessons learned.
AHRQ-authored.
Citation: Andrews RM, Schulman KA .
Enhancing the value of Statewide Hospital Discharge Data: improving clinical content and race-ethnicity data.
Health Serv Res 2015 Aug;50 Suppl 1:1265-72. doi: 10.1111/1475-6773.12342..
Keywords: Healthcare Cost and Utilization Project (HCUP), Quality Improvement, Racial and Ethnic Minorities
Zingmond DS, Parikh P, Louie R
Improving hospital reporting of patient race and ethnicity--approaches to data auditing.
This study investigated new metrics to improve the reporting of patient race and ethnicity (R/E) by hospitals. It examined agreement between hospital reported R/E versus self-report among mothers delivering babies and a cancer cohort in California. It concluded that comparison between reported R/E and R/E estimates using zip code level data may be a reasonable first approach to evaluate and track hospital R/E reporting.
AHRQ-funded; HS019963.
Citation: Zingmond DS, Parikh P, Louie R .
Improving hospital reporting of patient race and ethnicity--approaches to data auditing.
Health Serv Res 2015 Aug;50 Suppl 1:1372-89. doi: 10.1111/1475-6773.12324..
Keywords: Racial and Ethnic Minorities, Hospitals, Hospital Discharge, Health Services Research (HSR), Registries, Quality Improvement, Quality of Care, Data
Healy MA, Krell RW, Abdelsattar ZM
Pancreatic resection results in a statewide surgical collaborative.
This study sought to investigate changes over time in adverse outcomes after pancreatectomy across hospitals with different caseloads in a statewide surgical collaborative. It concluded that participation in regional quality collaboratives by lower-volume hospitals can attenuate the volume–outcome relationship for pancreatic surgery.
AHRQ-funded; HS20937; HS000053.
Citation: Healy MA, Krell RW, Abdelsattar ZM .
Pancreatic resection results in a statewide surgical collaborative.
Ann Surg Oncol 2015 Aug;22(8):2468-74. doi: 10.1245/s10434-015-4529-9..
Keywords: Surgery, Patient Safety, Adverse Events, Hospitals, Quality Improvement, Quality of Care
Dimou FM, Riall TS
Pancreatic resection results in a statewide surgical collaborative.
The authors believe that participation in a regional quality improvement collaborative may provide an alternative model to improving outcomes for patients undergoing pancreatic resection. Furthermore, they argue that a procedure-specific collaborative could help hospitals and physicians improve outcomes for complex procedures such as pancreatic resection.
AHRQ-funded; HS022134.
Citation: Dimou FM, Riall TS .
Pancreatic resection results in a statewide surgical collaborative.
Ann Surg Oncol 2015 Aug;22(8):2462-3. doi: 10.1245/s10434-015-4536-x..
Keywords: Surgery, Patient-Centered Outcomes Research, Quality Improvement, Quality of Care