National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (1)
- Ambulatory Care and Surgery (2)
- Antimicrobial Stewardship (1)
- Asthma (1)
- Cancer (1)
- Cardiovascular Conditions (4)
- Caregiving (1)
- Care Management (1)
- Children/Adolescents (2)
- Communication (1)
- Critical Care (3)
- Diagnostic Safety and Quality (2)
- Elderly (1)
- Electronic Health Records (EHRs) (2)
- Emergency Department (7)
- (-) Emergency Medical Services (EMS) (21)
- Falls (1)
- Guidelines (2)
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- Healthcare Costs (2)
- Healthcare Delivery (1)
- Healthcare Utilization (1)
- Health Information Exchange (HIE) (1)
- Health Information Technology (HIT) (6)
- Health Literacy (1)
- Health Services Research (HSR) (1)
- Human Immunodeficiency Virus (HIV) (1)
- Injuries and Wounds (2)
- Medicaid (1)
- Medication (3)
- Opioids (1)
- Pain (1)
- Patient-Centered Outcomes Research (1)
- Patient Safety (2)
- Practice Patterns (1)
- Provider: Health Personnel (2)
- Quality of Care (1)
- Risk (1)
- Sickle Cell Disease (1)
- Social Determinants of Health (1)
- Stroke (3)
- Telehealth (1)
- Transitions of Care (1)
- Trauma (1)
- Urban Health (1)
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 21 of 21 Research Studies DisplayedRogers H, Madathil KC, Joseph A
An exploratory study investigating the barriers, facilitators, and demands affecting caregivers in a telemedicine integrated ambulance-based setting for stroke care.
This study investigates the impact of telemedicine on workload, teamwork, workflow, and communication of geographically distributed caregivers delivering stroke care in ambulance-based telemedicine. Simulated stroke sessions were conducted with selected caregivers, then followed with a survey and interviews. Findings showed that barriers included frustration with equipment, the loss of personal connection of the neurologists with the patients, and physical constraints in the ambulance. Facilitators included live visual communication increasing teamwork and efficiency, the ease of access to neurologist, increased flexibility, and high overall satisfaction and usability.
AHRQ-funded; HS026809.
Citation: Rogers H, Madathil KC, Joseph A .
An exploratory study investigating the barriers, facilitators, and demands affecting caregivers in a telemedicine integrated ambulance-based setting for stroke care.
Appl Ergon 2021 Nov;97:103537. doi: 10.1016/j.apergo.2021.103537..
Keywords: Telehealth, Health Information Technology (HIT), Caregiving, Stroke, Cardiovascular Conditions, Emergency Medical Services (EMS)
Kass-Hout T, Lee J, Tataris K
Prehospital comprehensive stroke center vs primary stroke center triage in patients with suspected large vessel occlusion stroke.
This study’s objective was to evaluate the association of a regional prehospital transport policy that directly triages patients with suspected large vascular occlusion (LVO) stroke to the nearest comprehensive stroke center with rates of endovascular therapy (EVT). This retrospective, multicenter preimplementation-postimplementation study used an interrupted time series analysis to compare treatment rates before and after implementation in patients with acute ischemic stroke (AIS) arriving at 15 primary stroke centers and 8 comprehensive stroke centers in Chicago, Illinois, via emergency medical services (EMS) transport from December 1, 2017, to May 31, 2019. Among 7709 individuals with stroke, 663 with AIS arrived within 6 hours of stroke onset by EMS transport. The EVT rate increased overall among patients with AIS postimplementation and among EMS-transported patients with AIS within 6 hours of onset. There were no differences in EVT rates in patients not arriving by EMS within the 6- to 24-hour window or by interhospital transfer or walk-in.
AHRQ-funded; HS025359.
Citation: Kass-Hout T, Lee J, Tataris K .
Prehospital comprehensive stroke center vs primary stroke center triage in patients with suspected large vessel occlusion stroke.
JAMA Neurol 2021 Oct;78(10):1220-27. doi: 10.1001/jamaneurol.2021.2485..
Keywords: Stroke, Cardiovascular Conditions, Critical Care, Emergency Medical Services (EMS)
Mayampurath A, Parnianpour Z, Richards CT
Improving prehospital stroke diagnosis using natural language processing of paramedic reports.
Accurate prehospital diagnosis of stroke by emergency medical services (EMS) can increase treatments rates, mitigate disability, and reduce stroke deaths. IN this study, the investigators aimed to develop a model that utilized natural language processing of EMS reports and machine learning to improve prehospital stroke identification. The investigators conducted a retrospective study of patients transported by the Chicago EMS to 17 regional primary and comprehensive stroke centers.
AHRQ-funded; HS025359; HS027264.
Citation: Mayampurath A, Parnianpour Z, Richards CT .
Improving prehospital stroke diagnosis using natural language processing of paramedic reports.
Stroke 2021 Aug;52(8):2676-79. doi: 10.1161/strokeaha.120.033580..
Keywords: Stroke, Cardiovascular Conditions, Diagnostic Safety and Quality, Health Information Technology (HIT), Emergency Medical Services (EMS)
Newgard CD, Lin A, Caughey AB
The cost of a fall among older adults requiring emergency services.
Researchers evaluated medical expenditures to 1 year among community-dwelling older adults who fell and required ambulance transport, including acute versus post-acute periods, the primary drivers of cost, and comparison to baseline expenditures. They found that older adults who fall and require emergency services have increased healthcare expenditures compared with baseline, particularly during the post-acute period. Comorbidities, noninjury medical conditions, fracture type, and surgical interventions were independently associated with increased costs.
AHRQ-funded; HS023796.
Citation: Newgard CD, Lin A, Caughey AB .
The cost of a fall among older adults requiring emergency services.
J Am Geriatr Soc 2021 Feb;69(2):389-98. doi: 10.1111/jgs.16863..
Keywords: Elderly, Falls, Emergency Department, Healthcare Costs, Emergency Medical Services (EMS)
Goss FR, Plasek JM, Lau JJ
An evaluation of a natural language processing tool for identifying and encoding allergy information in emergency department clinical notes.
This paper presents early experience and preliminary findings in developing an allergy module for a general natural language processing (NLP) system, named Medical Text Extraction, Reasoning, and Mapping System (MTERMS), to extract and encode allergy information from clinical text. The preliminary results demonstrate the feasibility using NLP to extract and encode allergy information from clinical notes.
AHRQ-funded; HS022728.
Citation: Goss FR, Plasek JM, Lau JJ .
An evaluation of a natural language processing tool for identifying and encoding allergy information in emergency department clinical notes.
AMIA Annu Symp Proc 2014 Nov 14;2014:580-8..
Keywords: Health Information Technology (HIT), Electronic Health Records (EHRs), Emergency Medical Services (EMS), Emergency Department
Cummins MR, Crouch BI, Del Fiol G
Information requirements for health information exchange supported communication between emergency departments and poison control centers.
The researchers analyzed audio recordings of current telephone-based communications between emergency departments (EDs) and poison control centers (PCCs) in order to describe the information requirements for health information exchange between PCCs and EDs. Their goal was to identify a focused subset of available health information, most relevant to emergency treatment of poison exposure, in order to support generalizable process re-design.
AHRQ-funded; HS018773.
Citation: Cummins MR, Crouch BI, Del Fiol G .
Information requirements for health information exchange supported communication between emergency departments and poison control centers.
AMIA Annu Symp Proc 2014 Nov 14;2014:449-56..
Keywords: Communication, Emergency Department, Emergency Medical Services (EMS), Health Information Exchange (HIE), Health Information Technology (HIT)
Malhotra K, Baltrus P P, Zhang S
Geographic and racial variation in asthma prevalence and emergency department use among Medicaid-enrolled children in 14 southern states.
Using 2007 Medicaid claims data from 556 counties in 14 southern states, the researchers described the local area variation in 1-year asthma prevalence rates, emergency department visit rates, and racial disparity rate ratios. They found much local area variation in asthma prevalence and asthma ED visit rates among Medicaid-enrolled children. Between black and white children, more counties had higher prevalence of asthma and higher ED visit rates among blacks.
AHRQ-funded; HS022444; HS019470
Citation: Malhotra K, Baltrus P P, Zhang S .
Geographic and racial variation in asthma prevalence and emergency department use among Medicaid-enrolled children in 14 southern states.
J Asthma. 2014 Nov;51(9):913-21. doi: 10.3109/02770903.2014.930479..
Keywords: Asthma, Medicaid, Social Determinants of Health, Emergency Department, Emergency Medical Services (EMS)
Kilaru AS, Gadsden SM, Perrone J
How do physicians adopt and apply opioid prescription guidelines in the emergency department? A qualitative study.
This qualitative study of emergency physicians attempted to gain insight into the adoption, use, and perceived relevance of opioid-prescribing guidelines. Most of the 61 participants interviewed in a convenience sample had a positive perspective on the intent and role of such guidelines and used them most commonly as communication tools with patients.
AHRQ-funded; HS021956.
Citation: Kilaru AS, Gadsden SM, Perrone J .
How do physicians adopt and apply opioid prescription guidelines in the emergency department? A qualitative study.
Ann Emerg Med 2014 Nov;64(5):482-89.e1. doi: 10.1016/j.annemergmed.2014.03.015.
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Keywords: Emergency Medical Services (EMS), Opioids, Pain, Guidelines, Practice Patterns
Peterson SM, Gurses AP, Regan L
Resident to resident handoffs in the emergency department: an observational study.
This study aimed to identify hazards to patient safety and barriers to efficiency related to resident handoffs in the ED. It found that residents were interrupted, on average, every 8.5 min. The most common deficit in relaying the plan of care strategy was failing to relay medications administered (32 percent). In addition, there were ambiguities related to medication administration.
AHRQ-funded; HS018762.
Citation: Peterson SM, Gurses AP, Regan L .
Resident to resident handoffs in the emergency department: an observational study.
J Emerg Med 2014 Nov;47(5):573-9. doi: 10.1016/j.jemermed.2014.06.027..
Keywords: Emergency Department, Emergency Medical Services (EMS), Patient Safety, Electronic Health Records (EHRs), Medication
Mutter R, Stocks C
AHRQ Author: Stocks C
Using Healthcare Cost and Utilization Project (HCUP) data for emergency medicine research.
This article mentions Kocher et al., elsewhere in this issue, who use the HCUP Nationwide Inpatient Sample to examine the association between the volume of ED encounters that result in admission and inpatient mortality. It further discusses HCUP strengths, weaknesses, and future.
AHRQ-authored.
Citation: Mutter R, Stocks C .
Using Healthcare Cost and Utilization Project (HCUP) data for emergency medicine research.
Ann Emerg Med 2014 Nov;64(5):458-60. doi: 10.1016/j.annemergmed.2014.09.014.
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Keywords: Emergency Medical Services (EMS), Healthcare Costs, Healthcare Delivery, Health Services Research (HSR), Healthcare Cost and Utilization Project (HCUP)
Griffey RT, Kennedy SK, D'Agostino McGowan L, Good RT, Kennedy SK, D'Agostino McGowan L
Is low health literacy associated with increased emergency department utilization and recidivism?
The study objective was to determine whether patients with low health literacy have higher emergency department (ED) use and higher ED recidivism than patients with adequate health literacy. It found that patients with inadequate health literacy had higher ED use compared to those with adequate health literacy.
AHRQ-funded; HS020309
Citation: Griffey RT, Kennedy SK, D'Agostino McGowan L, Good RT, Kennedy SK, D'Agostino McGowan L .
Is low health literacy associated with increased emergency department utilization and recidivism?
Acad Emerg Med. 2014 Oct;21(10):1109-15. doi: 10.1111/acem..
Keywords: Health Literacy, Emergency Department, Emergency Medical Services (EMS), Healthcare Utilization
Friermuth CE, Haywood C, Jr., Silva S
Attitudes toward patients with sickle cell disease in a multicenter sample of emergency department providers.
The authors aimed to validate a survey that measures attitudes toward sickle cell disease (SCD) patients among emergency department (ED) providers and to compare differences in attitude scores between provider types. They found that, among ED providers, this scale identified a dimension not observed in research with the original instrument among internal medicine providers. They concluded that provider attitudes influence patient-provider interactions and quality of care.
AHRQ-funded; HS019646.
Citation: Friermuth CE, Haywood C, Jr., Silva S .
Attitudes toward patients with sickle cell disease in a multicenter sample of emergency department providers.
Adv Emerg Nurs J 2014 Oct-Dec;36(4):335-47. doi: 10.1097/tme.0000000000000036.
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Keywords: Emergency Department, Emergency Medical Services (EMS), Provider: Health Personnel, Sickle Cell Disease
Berner ES, Ray MN, Panjamapirom A
Exploration of an automated approach for receiving patient feedback after outpatient acute care visits.
The authors' objective was to provide post-visit feedback to physicians on patient outcomes following acute care visits. They found that many patients who do not improve as expected do not take action to further address unresolved problems. They suggested that systematic follow-up/feedback mechanisms can potentially identify and connect such patients to needed care.
AHRQ-funded; HS017060.
Citation: Berner ES, Ray MN, Panjamapirom A .
Exploration of an automated approach for receiving patient feedback after outpatient acute care visits.
J Gen Intern Med 2014 Aug;29(8):1105-12. doi: 10.1007/s11606-014-2783-3.
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Keywords: Critical Care, Emergency Medical Services (EMS), Health Information Technology (HIT), Ambulatory Care and Surgery, Cancer
Singh H, Sittig DF
Were my diagnosis and treatment correct? No news is not necessarily good news.
The authors discussed Berner et al., elsewhere in the same issue, which explored the use of an automated interactive voice response system to reach patients after acute care visits. They suggested that providers evaluate the rigor and outcomes of follow-up practices within their own clinical settings.
AHRQ-funded; HS022087.
Citation: Singh H, Sittig DF .
Were my diagnosis and treatment correct? No news is not necessarily good news.
J Gen Intern Med 2014 Aug;29(8):1087-9. doi: 10.1007/s11606-014-2890-1.
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Keywords: Emergency Medical Services (EMS), Health Information Technology (HIT), Ambulatory Care and Surgery
Macht M, Mull AC, McVaney KE
Comparison of droperidol and haloperidol for use by paramedics: assessment of safety and effectiveness.
The goal of this study was to compare QTc prolongation (a measure of cardiac function), adverse events, and effectiveness of droperidol and haloperidol among a cohort of agitated patients in the prehospital setting. There was no significant difference found in QTc prolongation, adverse events, or need for repeat sedation between haloperidol and droperidol.
AHRQ-funded; HS01726.
Citation: Macht M, Mull AC, McVaney KE .
Comparison of droperidol and haloperidol for use by paramedics: assessment of safety and effectiveness.
Prehosp Emerg Care 2014 Jul-Sep;18(3):375-80. doi: 10.3109/10903127.2013.864353..
Keywords: Medication, Adverse Drug Events (ADE), Emergency Medical Services (EMS)
Foster NA, Elfenbein DM, Kelley W, Jr.
Comparison of helicopter versus ground transport for the interfacility transport of isolated spinal injury.
The investigators aimed to determine whether ground transport (GT) for interfacility transfer of patients with spinal injury resulted in less favorable clinical outcomes compared with helicopter aeromedical transport systems (HEMS). They found that GT for interfacility transfer of patients with spinal injury appears to be safe and suitable for patients who lack other compelling reasons for HEMS.
AHRQ-funded; HS000032.
Citation: Foster NA, Elfenbein DM, Kelley W, Jr. .
Comparison of helicopter versus ground transport for the interfacility transport of isolated spinal injury.
Spine J 2014 Jul;14(7):1147-54. doi: 10.1016/j.spinee.2013.07.478.
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Keywords: Emergency Medical Services (EMS), Transitions of Care, Injuries and Wounds
Johnson MA, Grahan BJ, Haukoos JS
Demographics, bystander CPR, and AED use in out-of-hospital pediatric arrests.
The researchers sought to determine if the 2005 American Heart Association guidelines for routine use of automated external defibrillators during pediatric out-of-hospital arrest are used during resuscitations. They found that young children suffering from presumed out-of-hospital cardiac arrests are less likely to have a shockable rhythm when compared to adults, and are less likely to have an AED used during resuscitation.
AHRQ-funded; HS017526.
Citation: Johnson MA, Grahan BJ, Haukoos JS .
Demographics, bystander CPR, and AED use in out-of-hospital pediatric arrests.
Resuscitation 2014 Jul;85(7):920-6. doi: 10.1016/j.resuscitation.2014.03.044.
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Keywords: Cardiovascular Conditions, Children/Adolescents, Emergency Medical Services (EMS), Guidelines, Patient-Centered Outcomes Research
Cleveland N, Colwell C, Douglass E
Motor vehicle crash severity estimations by physicians and prehospital personnel.
The purpose of this study was to determine whether emergency physicians (EPs) and EMS personnel differ in their assessment of motor vehicle collision severity and the potential for serious injury when viewing crash scene photographs. They found excellent crash and injury agreement at both ends of the severity spectrum but only modest agreement, and therefore greater variability, in the middle of the severity spectrum.
AHRQ-funded; HS017526
Citation: Cleveland N, Colwell C, Douglass E .
Motor vehicle crash severity estimations by physicians and prehospital personnel.
Prehosp Emerg Care. 2014 Jul-Sep;18(3):402-7. doi: 10.3109/10903127.2014.891065..
Keywords: Emergency Medical Services (EMS), Trauma, Injuries and Wounds, Provider: Health Personnel, Diagnostic Safety and Quality
Cottrell EK, O'Brien K, Curry M
Understanding safety in prehospital emergency medical services for children.
This paper adds to the qualitative understanding of the nature of and contributors to safety events in the prehospital emergency care of children. The findings of this study suggest that factors at the systems, team, child/family, and individual provider level system contribute to errors in prehospital emergency care. These factors may be modifiable through interventions and systems improvements.
AHRQ-funded; HS019456.
Citation: Cottrell EK, O'Brien K, Curry M .
Understanding safety in prehospital emergency medical services for children.
Prehosp Emerg Care 2014 Jul-Sep;18(3):350-8. doi: 10.3109/10903127.2013.869640.
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Keywords: Care Management, Children/Adolescents, Emergency Medical Services (EMS), Quality of Care, Patient Safety
Hsieh YH, Haukoos JS, Rothman RE
Validation of an abbreviated version of the Denver HIV Risk Score for prediction of HIV infection in an urban ED.
The researchers sought to evaluate the performance of a short version of the Denver HIV Risk Score in 2 urban emergency departments. They found that external validation resulted in good discrimination. The study cohort included 15,184 patients with newly diagnosed HIV infection.
AHRQ-funded; HS017526
Citation: Hsieh YH, Haukoos JS, Rothman RE .
Validation of an abbreviated version of the Denver HIV Risk Score for prediction of HIV infection in an urban ED.
Am J Emerg Med. 2014 Jul;32(7):775-9. doi: 10.1016/j.ajem.2014.02.043..
Keywords: Emergency Medical Services (EMS), Human Immunodeficiency Virus (HIV), Risk, Urban Health
Donnelly JP, Baddley JW, Wang HE
Antibiotic utilization for acute respiratory tract infections in U.S. emergency departments.
Using national surveillance data for acute respiratory tract infections (ARTIs), this study characterized patterns of antibiotic usage in U.S. emergency departments between 2001 and 2010. It found significant progress toward reductions on inappropriate antibiotic use among children; however, adults with ARTI continued to receive inappropriately high amounts of antibiotics.
AHRQ-funded; HS013852
Citation: Donnelly JP, Baddley JW, Wang HE .
Antibiotic utilization for acute respiratory tract infections in U.S. emergency departments.
Antimicrob Agents Chemother. 2014 Mar;58(3):1451-7. doi: 10.1128/AAC.02039-13..
Keywords: Antimicrobial Stewardship, Emergency Medical Services (EMS), Medication, Critical Care