National Healthcare Quality and Disparities Report
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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 25 of 48 Research Studies DisplayedSchnipper JL, Raffel KE, Keniston A
Achieving diagnostic excellence through prevention and teamwork (ADEPT) study protocol: a multicenter, prospective quality and safety program to improve diagnostic processes in medical inpatients.
This paper describes the protocol for a study that will build surveillance for hospital diagnostic errors into usual care, benchmark diagnostic performance across sites, pilot test interventions, and evaluate the program's impact on diagnostic error rates. The authors will test achieving diagnostic excellence through prevention and teamwork (ADEPT), a multicenter, real-world quality and safety program utilizing interrupted time-series techniques to evaluate outcomes. They will use a randomly sampled population of medical patients hospitalized at 16 US hospitals who died, were transferred to intensive care, or had a rapid response during the hospitalization. There will be surveillance for diagnostic errors on 10 events per month per site using a previously established two-person adjudication process. With guidance from national experts in quality and safety, study sites will report and benchmark diagnostic error rates, share lessons regarding underlying causes, and design, implement, and pilot test interventions using both Safety I and Safety II approaches aimed at patients, providers, and health systems. The primary outcome sought after will be the number of diagnostic errors per patient, using segmented multivariable regression to evaluate change in y-intercept and change in slope after initiation of the program.
AHRQ-funded; HS029366.
Citation: Schnipper JL, Raffel KE, Keniston A .
Achieving diagnostic excellence through prevention and teamwork (ADEPT) study protocol: a multicenter, prospective quality and safety program to improve diagnostic processes in medical inpatients.
J Hosp Med 2023 Dec; 18(12):1072-81. doi: 10.1002/jhm.13230..
Keywords: Diagnostic Safety and Quality, Patient Safety, Quality of Care, Hospitals, Inpatient Care
O'Halloran A, Lockwood J, Sosa T
How do we detect and respond to clinical deterioration in hospitalized children? Results of the Pediatric Care BefOre Deterioration Events (CODE) survey.
This study’s objective was to describe systems to detect/respond to deteriorating hospitalized children at Pediatric Resuscitation Quality Collaborative (pediRES-Q) institutions. The authors performed a cross-sectional survey of pediRES-Q leaders utilizing expert validation and cognitive interviews, with 30 centers (88%) responding. Most institutions (93%) used ≥1 system to detect deterioration: most commonly, early warning scores (83%), watcher lists (55%), and proactive surveillance teams (31%). Most (90%) collect relevant data, including number of rapid responses (88%), arrests outside intensive care units (100%), and serious safety events (88%).
AHRQ-funded; HS026975.
Citation: O'Halloran A, Lockwood J, Sosa T .
How do we detect and respond to clinical deterioration in hospitalized children? Results of the Pediatric Care BefOre Deterioration Events (CODE) survey.
J Hosp Med 2023 Dec; 18(12):1102-08. doi: 10.1002/jhm.13224..
Keywords: Children/Adolescents, Inpatient Care
O'Leary KJ, Johnson JK, Williams MV
Effect of complementary interventions to redesign care on teamwork and quality for hospitalized medical patients: a pragmatic controlled trial.
The objective of this pragmatic controlled trial was to evaluate the effect of interventions to redesign hospital care delivery on teamwork and patient outcomes. Survey participants were healthcare professionals and hospitalized medical patients in medical units at four U.S. hospitals. The results showed that the median teamwork climate score was higher after the intervention among nurses, but that interventions to redesign care for hospitalized patients were not associated with improved patient outcomes.
AHRQ-funded; HS02564.
Citation: O'Leary KJ, Johnson JK, Williams MV .
Effect of complementary interventions to redesign care on teamwork and quality for hospitalized medical patients: a pragmatic controlled trial.
Ann Intern Med 2023 Nov; 176(11):1456-64. doi: 10.7326/m23-0953..
Keywords: Teams, Inpatient Care, Hospitals, Quality of Care, Outcomes
Kieren MQ, Kelly MM, Garcia MA
Parent experiences with the process of sharing inpatient safety concerns for children with medical complexity: a qualitative analysis.
The objective of this study was to describe the process of identifying and reporting inpatient safety concerns from the perspective of parents of children with medical complexity (CMC). Researchers conducted a secondary analysis of qualitative data from semi-structured interviews with English and Spanish-speaking parents of CMC at two tertiary children's hospitals. The parents described a multi-step process of reporting their safety concerns and a spectrum of staff response and validation. The researchers concluded that their findings could inform family-centered interventions that support safety concern reporting in the inpatient setting.
AHRQ-funded; HS025781.
Citation: Kieren MQ, Kelly MM, Garcia MA .
Parent experiences with the process of sharing inpatient safety concerns for children with medical complexity: a qualitative analysis.
Acad Pediatr 2023 Nov-Dec; 23(8):1535-41. doi: 10.1016/j.acap.2023.06.008..
Keywords: Children/Adolescents, Patient Safety, Inpatient Care, Chronic Conditions
Lefrak L, Schaffer KE, Bohnert J
Blood culture procedures and practices in the neonatal intensive care unit: a survey of a large multicenter collaborative in California.
The objective of this Web-based survey was to describe variation in bedside and laboratory-level blood culture practices in neonatal intensive care units (NICUs). Participants were 28 NICUs in an antimicrobial stewardship quality improvement program in the California Perinatal Quality Care Collaborative. Results showed that recommended practices for blood culturing were not routinely performed. Most NICUs did not have a procedural competency, did not document sample volume, did not receive a culture contamination report, and/or did not require reporting to the provider if less than 1 mL of blood was drawn. Skin asepsis procedure varied across NICUs.
AHRQ-funded; HS026168.
Citation: Lefrak L, Schaffer KE, Bohnert J .
Blood culture procedures and practices in the neonatal intensive care unit: a survey of a large multicenter collaborative in California.
Infect Control Hosp Epidemiol 2023 Oct; 44(10):1576=81. doi: 10.1017/ice.2023.33..
Keywords: Newborns/Infants, Intensive Care Unit (ICU), Inpatient Care, Quality of Care
Aklilu AM, Kumar S, Yamamoto Y
Outcomes associated with sodium-glucose cotransporter-2 inhibitor use in acute heart failure hospitalizations complicated by AKI.
This retrospective study examined the association of sodium-glucose cotransporter-2 inhibitor (SGLT2i) use with patients who have KDIGO-defined acute kidney injury (AKI) during acute heart failure (AHF) hospitalizations and their kidney function recovery at 14 days and 30 days using time-varying multivariable Cox-regression analyses. The study looked at 3305 adults hospitalized across 5 Yale New Haven Health Systems between January 2020 and May 2022 with AHF complicated by KDIGO-defined AKI. Of those individuals hospitalized with AHF and AKI, 356 received SGLT2i following AKI diagnosis either as initiation or continuation. The rate of renal recovery was not significantly different among those exposed and unexposed to SGLT2i following AKI (adjusted HR 0.94). SGLT2i exposure was associated with lower risk of 30-day mortality (adjusted HR 0.45). Rates of renal recovery were similar between the exposed and nonexposed cohorts regardless of the proximity of SGLT2i exposure to AKI diagnosis.
AHRQ-funded; HS027626.
Citation: Aklilu AM, Kumar S, Yamamoto Y .
Outcomes associated with sodium-glucose cotransporter-2 inhibitor use in acute heart failure hospitalizations complicated by AKI.
Kidney360 2023 Oct; 4(10):1371-81. doi: 10.34067/kid.0000000000000250..
Keywords: Kidney Disease and Health, Heart Disease and Health, Cardiovascular Conditions, Inpatient Care, Medication, Outcomes
Smith K, Padmanabhan P, Chen A
The impacts of the 340B Program on health care quality for low-income patients.
This study’s objective was to assess the effects of hospital 340B eligibility on quality of inpatient care provided to Medicaid and uninsured patients and for all patients. HCUP State Inpatient Data, Hospital Cost Reporting Information System Data, Office of Pharmacy Affairs Information System Data, and the American Hospital Association Annual Survey were all used to extract inpatient data from general acute care hospitals from 2008 to 2014 in 15 states. Data was linked on hospital 340B eligibility and participation. The authors did not find discontinuities in inpatient care quality across the Program eligibility threshold for Medicaid and uninsured patients; specifically, on all-cause mortality, 30-day readmission rates, or other measures. Among insured and non-Medicaid patients, they found discontinuities for acute myocardial infarction and postoperative sepsis mortality.
AHRQ-funded; HS026980.
Citation: Smith K, Padmanabhan P, Chen A .
The impacts of the 340B Program on health care quality for low-income patients.
Health Serv Res 2023 Oct; 58(5):1089-97. doi: 10.1111/1475-6773.14204..
Keywords: Low-Income, Hospitals, Vulnerable Populations, Medicaid, Uninsured, Inpatient Care, Quality of Care
Menez S, Coca Moledina, Moledina DG
Evaluation of plasma biomarkers to predict major adverse kidney events in hospitalized patients with COVID-19.
There is an increased risk for major adverse kidney events (MAKE) in patients hospitalized with COVID-19. The purpose of this prospective cohort study was to identify plasma biomarkers predictive of MAKE in patients hospitalized with COVID-19. The study found that in total, 95 patients (16%) experienced MAKE. Each 1 SD increase in soluble tumor necrosis factor receptor 1 (sTNFR1) and sTNFR2 was significantly associated with an increased risk of MAKE. A limitation of the study was a lack of control group of hospitalized patients without COVID-19.
AHRQ-funded; HS027626.
Citation: Menez S, Coca Moledina, Moledina DG .
Evaluation of plasma biomarkers to predict major adverse kidney events in hospitalized patients with COVID-19.
Am J Kidney Dis 2023 Sep; 82(3):322-32.e1. doi: 10.1053/j.ajkd.2023.03.010..
Keywords: COVID-19, Kidney Disease and Health, Inpatient Care
Chen JT, Mehrizi R, Aasman B
Long short-term memory model identifies ARDS and in-hospital mortality in both non-COVID-19 and COVID-19 cohort.
The objective of this study was to identify risk of acute respiratory distress syndrome (ARDS) and in-hospital mortality using a long short-term memory (LSTM) framework in mechanically ventilated (MV) COVID-19 and non-COVID-19 cohorts. The results indicated that the LSTM algorithm accurately identified the risk of ARDS or death in both non-COVID-19 and COVID MV patients. The researchers concluded that a tool that alerts to the risk of ARDS or death can improve the implementation of evidence-based ARDS management and facilitate goals-of-care discussions involving high-risk patients.
AHRQ-funded; HS026188.
Citation: Chen JT, Mehrizi R, Aasman B .
Long short-term memory model identifies ARDS and in-hospital mortality in both non-COVID-19 and COVID-19 cohort.
BMJ Health Care Inform 2023 Sep; 30(1). doi: 10.1136/bmjhci-2023-100782..
Keywords: COVID-19, Mortality, Hospitals, Inpatient Care
Rolfzen ML, Wick A, Mascha EJ
Best Practice Alerts Informed by Inpatient Opioid Intake to Reduce Opioid Prescribing after Surgery (PRIOR): a cluster randomized multiple crossover trial.
This study tested the hypothesis that a decision-support tool embedded in electronic health records (EHRs) leads clinicians to prescribe fewer opioids at discharge after inpatient surgery. Over 21,000 surgical inpatient discharges in a cluster randomized multiple crossover trial in four Colorado hospitals were included. The results indicated that within the context of vigorous opioid education and awareness efforts a decision-support tool incorporated into EHRs did not reduce discharge opioid prescribing for postoperative patients. The authors concluded that opioid prescribing alerts might be valuable in other contexts.
AHRQ-funded; HS027795.
Citation: Rolfzen ML, Wick A, Mascha EJ .
Best Practice Alerts Informed by Inpatient Opioid Intake to Reduce Opioid Prescribing after Surgery (PRIOR): a cluster randomized multiple crossover trial.
Anesthesiology 2023 Aug 1; 139(2):186-96. doi: 10.1097/aln.0000000000004607..
Keywords: Opioids, Medication, Surgery, Inpatient Care, Clinical Decision Support (CDS), Health Information Technology (HIT)
Volerman A, Balachandran U, Zhu M
Evaluating inhaler education interventions for hospitalized children with asthma: a randomized controlled trial.
The objective of this study was to evaluate whether the technology-based intervention-Virtual Teach-to-Goal (V-TTG) could lead to less inhaler misuse among children hospitalized with asthma. A single-center randomized controlled trial of V-TTG vs brief intervention was conducted with children aged 5-10 with asthma. At baseline, nearly all children misused inhalers; inhaler misuse decreased significantly in both V-TTG and brief intervention. The researchers suggested that future studies evaluate V-TTG intervention across diverse populations and disease severities to identify its greatest impact.
AHRQ-funded; HS027804.
Citation: Volerman A, Balachandran U, Zhu M .
Evaluating inhaler education interventions for hospitalized children with asthma: a randomized controlled trial.
Ann Allergy Asthma Immunol 2023 Aug; 131(2):217-23.e1. doi: 10.1016/j.anai.2023.02.023..
Keywords: Children/Adolescents, Asthma, Respiratory Conditions, Education: Patient and Caregiver, Inpatient Care
Faerber JA, Xiao R, Makeneni S
Sustainment of continuous pulse oximetry deimplementation: analysis of eliminating monitor overuse study data from six hospitals.
The purpose of this longitudinal analysis from the Eliminating Monitor Overuse (EMO) study was to evaluate changes in continuous pulse oximetry cSpO(2) overuse before, during, and after intensive cSpO(2) -deimplementation efforts in six hospitals. The researchers collected monitoring data during three phases of the study: 1) "P1" baseline, 2) "P2" active deimplementation (all sites involved in education and audit and feedback strategies), and 3) "P3" sustainment (a new baseline measured after strategies were withdrawn). 2,053 observations were analyzed. The study found that each hospital experienced reductions during active deimplementation (P2), with overall adjusted cSpO(2) overuse decreasing from 53% to 22%, between P1 and P2. However, following the withdrawal of deimplementation strategies, overuse rebounded in all six sites, with overall adjusted cSpO(2) overuse increasing to 37% in P3.
AHRQ-funded; HS026763.
Citation: Faerber JA, Xiao R, Makeneni S .
Sustainment of continuous pulse oximetry deimplementation: analysis of eliminating monitor overuse study data from six hospitals.
J Hosp Med 2023 Aug; 18(8):724-29. doi: 10.1002/jhm.13154..
Keywords: Hospitals, Inpatient Care
Trenaman L, Harrison M, Hoch JS
Medicare beneficiaries' perspectives on the quality of hospital care and their implications for value-based payment.
The objective of this study was to estimate the relative importance of the 4 quality domains in the Medicare's Hospital Value-Based Purchasing (HVBP) program from the perspective of Medicare beneficiaries and the impact of using beneficiary value weights on incentive payments for hospitals enrolled in FY 2019. A nationally representative sample of 1025 Medicare beneficiaries was recruited through Ipsos KnowledgePanel for an online survey. Hospital performance on clinical outcomes was most highly valued by beneficiaries, followed by safety, patient experience, and efficiency. The authors concluded that current HVBP program value weights do not reflect beneficiary preferences, suggesting that the use of beneficiary value weights may exacerbate disparities by rewarding larger, high-volume hospitals.
AHRQ-funded; HS027853.
Citation: Trenaman L, Harrison M, Hoch JS .
Medicare beneficiaries' perspectives on the quality of hospital care and their implications for value-based payment.
JAMA Netw Open 2023 Jun; 6(6):e2319047. doi: 10.1001/jamanetworkopen.2023.19047..
Keywords: Medicare, Inpatient Care, Hospitals
Auerbach AD, Astik GJ, O'Leary KJ
Prevalence and causes of diagnostic errors in hospitalized patients under investigation for COVID-19.
During the COVID-19 pandemic, clinicians were required to address a disease with continuously changing traits while simultaneously complying with changes in care (e.g., physical distancing) that could contribute to diagnostic errors (DEs). The purpose of this study was to examine the frequency of DEs and their causes in patients hospitalized under investigation (PUI) for COVID-19. The researchers randomly selected up to 8 cases per site per month for evaluation, with each case evaluated by two clinicians to determine whether a DE occurred, and whether any diagnostic process faults took place. The study found that wo hundred and fifty-seven patient charts were evaluated, of which 14% contained a DE. Patients with and without DE were statistically similar in socioeconomic factors, comorbidities, risk factors for COVID-19, and COVID-19 test turnaround time and eventual positivity. The most common diagnostic process issues contributing to DE were problems with clinical assessment, testing choices, history taking, and physical examination. Diagnostic process issues related with COVID-19 policies and procedures were not related with DE risk. 35.9% of patients with errors and 5.4% of patients overall suffered harm or death due to diagnostic error.
AHRQ-funded; HS027369.
Citation: Auerbach AD, Astik GJ, O'Leary KJ .
Prevalence and causes of diagnostic errors in hospitalized patients under investigation for COVID-19.
J Gen Intern Med 2023 Jun; 38(8):1902-10. doi: 10.1007/s11606-023-08176-6..
Keywords: COVID-19, Diagnostic Safety and Quality, Hospitals, Inpatient Care, Quality of Care
Kuzma N, Khan A, Rickey L
Effect of Patient and Family Centered I-PASS on adverse event rates in hospitalized children with complex chronic conditions.
This study’s objective was to compare the effect of the intervention Patient and Family Centered (PFC)I-PASS on adverse events (AE) rates in children with and without complex chronic conditions (CCCs). A cohort of 3106 hospitalized children from seven North American pediatric hospitals between December 2014 and January 2017 were included. An effect modification analysis did not show difference in the intervention on children with and without CCCs. There was no statistically significant change in AEs for children with or without CCCs.
AHRQ-funded; HS022986.
Citation: Kuzma N, Khan A, Rickey L .
Effect of Patient and Family Centered I-PASS on adverse event rates in hospitalized children with complex chronic conditions.
J Hosp Med 2023 Apr;18(4):316-20. doi: 10.1002/jhm.13065.
Keywords: Children/Adolescents, Patient-Centered Healthcare, Chronic Conditions, Adverse Events, Inpatient Care, Transitions of Care
Martino SC, Reynolds KA, Grob R
Evaluation of a protocol for eliciting narrative accounts of pediatric inpatient experiences of care.
This study’s objective was to evaluate the measurement properties of a set of six items designed to elicit narrative accounts of pediatric inpatient experience. This cross-sectional survey with follow-up phone interviews used data from 163 participants recruited from a probability-based online panel of US adults. Eligible participants were family members of a child who had an overnight hospital stay in the past 12 months. Participants completed an online (n = 129) or phone (n = 34) survey about their child's hospitalization experience that contained closed-ended items from the Child HCAHPS Survey followed by the six narrative items. About two weeks after completing the survey, 47 participants additionally completed a one-hour, semi-structured phone interview, the results of which served as a "gold standard" for evaluating the fidelity of narrative responses. The average narrative was 248 words, with 79% of narratives mentioning a topic included on the Child HCAHPS survey; 89% mentioning a topic not covered by that survey; 75% including at least one detailed description of an actionable event. Overall, there was a 66% correspondence between narrative and interview responses, with higher correspondence in the phone than in the online condition (75% vs. 59%).
AHRQ-funded; HS025920; HS016978.
Citation: Martino SC, Reynolds KA, Grob R .
Evaluation of a protocol for eliciting narrative accounts of pediatric inpatient experiences of care.
Health Serv Res 2023 Apr;58(2):271-81. doi: 10.1111/1475-6773.14134.
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient Experience, Inpatient Care
Soares WE, Schoenfeld EM, Visintainer P
Safety assessment of a noninvasive respiratory protocol for adults with COVID-19.
As evidence emerged supporting noninvasive strategies for coronavirus disease 2019 (COVID-19)-related respiratory distress, the investigators implemented a noninvasive COVID-19 respiratory protocol (NCRP) that encouraged high-flow nasal cannula (HFNC) and self-proning across our healthcare system. To assess safety, the investigators conducted a retrospective chart review evaluating mortality and other patient safety outcomes after implementation of the NCRP protocol (April 3, 2020, to April 15, 2020) for adult patients hospitalized with COVID-19, compared with preimplementation outcomes (March 15, 2020, to April 2, 2020).
AHRQ-funded; HS025701.
Citation: Soares WE, Schoenfeld EM, Visintainer P .
Safety assessment of a noninvasive respiratory protocol for adults with COVID-19.
J Hosp Med 2020 Dec;15(12):734-38. doi: 10.12788/jhm.3548..
Keywords: Patient Safety, COVID-19, Respiratory Conditions, Inpatient Care, Infectious Diseases
Sosa T, Ferris S, Frese C
Comparing two proximal measures of unrecognized clinical deterioration in children.
Critical deterioration events (CDEs) and emergency transfers (ETs) are two proximal measures to cardiopulmonary arrest, and both aim to evaluate how systems recognize and respond to clinical deterioration in children. This retrospective observational study sought to (1) characterize CDEs and ETs by timing, overlap, and intervention category, and (2) evaluate the performance of the watcher identification system and the pediatric early warning score (PEWS) to identify patients who experience these events.
AHRQ-funded; HS023827.
Citation: Sosa T, Ferris S, Frese C .
Comparing two proximal measures of unrecognized clinical deterioration in children.
J Hosp Med 2020 Nov;15(11):673-76. doi: 10.12788/jhm.3515..
Keywords: Children/Adolescents, Cardiovascular Conditions, Critical Care, Inpatient Care
Nijhawan AE, Bhattatiry M, Chansard M
HIV care cascade before and after hospitalization: impact of a multidisciplinary inpatient team in the US South.
Hospitalization represents an opportunity to re-engage out-of-care individuals, improve HIV outcomes, and reduce health disparities. The authors reviewed electronic health records of HIV-positive individuals hospitalized at an urban, public hospital between September 2013 and December 2015. They found that hospitalized patients with HIV had low rates of engagement in care, retention in care, and virologic suppression, though all three outcomes improved after hospitalization. A multidisciplinary transitions team improved care engagement and virologic suppression in those who received the intervention.
AHRQ-funded; HS022418.
Citation: Nijhawan AE, Bhattatiry M, Chansard M .
HIV care cascade before and after hospitalization: impact of a multidisciplinary inpatient team in the US South.
AIDS Care 2020 Nov;32(11):1343-52. doi: 10.1080/09540121.2019.1698704.
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Keywords: Human Immunodeficiency Virus (HIV), Transitions of Care, Inpatient Care, Teams, Hospitalization, Patient and Family Engagement, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice
Mohr NM, Zebrowski AM, Gaieski DF
Inpatient hospital performance is associated with post-discharge sepsis mortality.
The objective of this study was to test the hypothesis that hospitals with high risk-adjusted inpatient sepsis mortality also have high post-discharge mortality, readmissions, and discharge to nursing homes. Sepsis hospitalization survivors among age-qualifying Medicare beneficiaries were followed for 180 days post-discharge; mortality, readmissions, and new admission to skilled nursing facilities were measured. Findings showed that hospitals with the highest risk-adjusted sepsis inpatient mortality also had higher post-discharge mortality and increased readmissions, suggesting that post-discharge complications were a modifiable risk that may be affected during inpatient care. Recommendations for future work include seeking to elucidate inpatient and healthcare practices that can reduce sepsis post-discharge complications.
AHRQ-funded; HS023614; HS025753.
Citation: Mohr NM, Zebrowski AM, Gaieski DF .
Inpatient hospital performance is associated with post-discharge sepsis mortality.
Crit Care 2020 Oct 27;24(1):626. doi: 10.1186/s13054-020-03341-3..
Keywords: Sepsis, Mortality, Hospital Discharge, Hospitals, Provider Performance, Quality of Care, Inpatient Care, Hospital Readmissions
Thompson HM, Faig W, VanKim NA HM, Faig W, VanKim NA
Differences in length of stay and discharge destination among patients with substance use disorders: The effect of Substance Use Intervention Team (SUIT) consultation service.
Addiction medicine consultation services (ACS) may improve outcomes of hospitalized patients with substance use disorders (SUD). The aim of the study was to examine the difference in length of stay and the hazard ratio for a routine hospital discharge between SUD patients receiving and not receiving ACS. The authors concluded that the Substance Use Intervention Team (SUIT) consultation service was associated with a reduced length of stay and an increased hazard of a routine discharge.
AHRQ-funded; HS026385.
Citation: Thompson HM, Faig W, VanKim NA HM, Faig W, VanKim NA .
Differences in length of stay and discharge destination among patients with substance use disorders: The effect of Substance Use Intervention Team (SUIT) consultation service.
PLoS One 2020 Oct 9;15(10):e0239761. doi: 10.1371/journal.pone.0239761..
Keywords: Substance Abuse, Hospitalization, Inpatient Care, Hospital Discharge, Hospitals
Yen PY, Lehmann LS, Snyder J
Development and validation of WeCares, a survey instrument to assess hospitalized patients' and family members' "Willingness to engage in your care and safety."
Patient engagement is recognized as a method to improve care quality and safety. A research team developed WeCares (Willingness to Engage in Your Care and Safety), a survey instrument assessing patients' and families' engagement in the safety of their care during their hospital stay. The objective of this study was to establish the preliminary construct validity and internal consistency of WeCares.
AHRQ-funded; HS0235335.
Citation: Yen PY, Lehmann LS, Snyder J .
Development and validation of WeCares, a survey instrument to assess hospitalized patients' and family members' "Willingness to engage in your care and safety."
Jt Comm J Qual Patient Saf 2020 Oct;46(10):565-72. doi: 10.1016/j.jcjq.2020.07.002..
Keywords: Patient and Family Engagement, Patient Safety, Inpatient Care, Hospitalization
Mouch CA, Baskin AS, Yearling R CA, Baskin AS, Yearling R
Sleep patterns and quality among inpatients recovering from elective surgery: a mixed-method study.
This study examined sleep quality and barriers to sleep among adult hospital inpatients recovering from elective surgery. A quantitative survey was used followed by a qualitative phone interview with a subsample of participants. Of 113 eligible patients, 102 (90%) completed the survey. Less than half reported sleeping well the night prior to surgery and 93% reported less sleep in the hospital compared to home. A median of 5 (4-7) interruptions were reported each night. Patients with more than three interruptions were likely to report poor sleep compared with those who had three or less. Barriers to sleep included staff interruptions and roommate noise but not pain. Patients interviewed suggested improved timing and knowledge of interruptions or use of noise-reduction aids that would facilitate sleep.
AHRQ-funded; HS026030.
Citation: Mouch CA, Baskin AS, Yearling R CA, Baskin AS, Yearling R .
Sleep patterns and quality among inpatients recovering from elective surgery: a mixed-method study.
J Surg Res 2020 Oct;254:268-74. doi: 10.1016/j.jss.2020.04.032..
Keywords: Sleep Problems, Surgery, Quality Improvement, Quality of Care, Inpatient Care, Hospitals, Patient Experience
Soberano BT, Brady P, Yunger T
The effects of care team roles on situation awareness in the pediatric intensive care unit: a prospective cross-sectional study.
Improved situation awareness (SA) decreases rates of clinical deterioration in the pediatric inpatient setting. The investigators used a prospective, cross-sectional, observational study to measure interprofessional care team SA for a pediatric intensive care unit (PICU) patients. The resident, bedside nurse, and respiratory therapist for each patient were surveyed regarding high clinical deterioration risk status as defined by clinical criteria identified by the PICU fellow or attending and mitigation plan.
AHRQ-funded; HS026975.
Citation: Soberano BT, Brady P, Yunger T .
The effects of care team roles on situation awareness in the pediatric intensive care unit: a prospective cross-sectional study.
J Hosp Med 2020 Oct;15(10):594-97. doi: 10.12788/jhm.3449..
Keywords: Children/Adolescents, Intensive Care Unit (ICU), Teams, Inpatient Care
Burns Z, Khasnabish S, Hurley AC
Classification of injurious fall severity in hospitalized adults.
The purpose of this project was to refine the National Database of Nursing Quality Indicators Major injury classification to derive a valid and reliable categorization of the types and severities of Major inpatient fall-related injuries. Three subcategories were created: A - injuries that caused temporary functional impairment, major facial injury without internal injury, or disruption of a surgical wound; B - injuries that caused long-term functional impairment or had the potential risk of increased mortality; and C - injuries that had a well-established risk of mortality. These subcategories enhanced the National Database of Nursing Quality Indicators categorization. Using this project’s administration manual, trained personnel can classify injurious fall severity with excellent reliability.
AHRQ-funded; HS025128.
Citation: Burns Z, Khasnabish S, Hurley AC .
Classification of injurious fall severity in hospitalized adults.
J Gerontol A Biol Sci Med Sci 2020 Sep 25;75(10):e138-e44. doi: 10.1093/gerona/glaa004..
Keywords: Elderly, Falls, Injuries and Wounds, Nursing, Quality Measures, Quality Indicators (QIs), Quality of Care, Inpatient Care