National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (1)
- Adverse Events (3)
- Anxiety (1)
- Behavioral Health (1)
- Brain Injury (1)
- Children/Adolescents (1)
- Chronic Conditions (1)
- Clinical Decision Support (CDS) (1)
- Decision Making (1)
- Dementia (1)
- Diagnostic Safety and Quality (1)
- Education: Patient and Caregiver (1)
- Elderly (11)
- Electronic Health Records (EHRs) (1)
- Emergency Department (1)
- Evidence-Based Practice (1)
- Eye Disease and Health (1)
- (-) Falls (21)
- Health Information Technology (HIT) (2)
- Hospitalization (2)
- Hospitals (2)
- Imaging (1)
- Injuries and Wounds (7)
- Inpatient Care (1)
- Medical Errors (1)
- Medicare (1)
- Medication (2)
- Medication: Safety (1)
- Neurological Disorders (2)
- Nursing (1)
- Nursing Homes (4)
- Outcomes (1)
- Patient-Centered Healthcare (1)
- Patient-Centered Outcomes Research (1)
- Patient and Family Engagement (2)
- Patient Safety (8)
- Prevention (4)
- Public Reporting (1)
- Quality Indicators (QIs) (2)
- Quality Measures (2)
- Quality of Care (2)
- Research Methodologies (1)
- Risk (6)
- Tools & Toolkits (1)
- Training (1)
- Trauma (1)
- Young Adults (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 DisplayedPatterson BW, Jacobsohn GC, Maru AP
Comparing strategies for identifying falls in older adult emergency department visits using EHR data.
This study compared seven different strategies for identifying falls in older adult emergency department (ED) visits using electronic health record (EHR) data. This retrospective cohort study used randomly selected data from 500 ED visits by patients 65 and older at an academic medical center from December 2016 to April 2017. The seven strategies tested were: Chief complaint (CC), ICD codes, Restrictive ICD codes, Broad ICD codes, Combined approaches, Natural language processing (NLP), and Manual abstraction (gold standard). When compared with manual chart review, NLP was found to be the most accurate fall identification strategy, followed by a combination of a restrictive ICD code-based definition with CC.
AHRQ-funded; HS024558.
Citation: Patterson BW, Jacobsohn GC, Maru AP .
Comparing strategies for identifying falls in older adult emergency department visits using EHR data.
J Am Geriatr Soc 2020 Dec;68(12):2965-67. doi: 10.1111/jgs.16831..
Keywords: Elderly, Falls, Emergency Department, Electronic Health Records (EHRs), Health Information Technology (HIT)
Dykes PC, Burns Z, Adelman J
Evaluation of a patient-centered fall-prevention tool kit to reduce falls and injuries: a nonrandomized controlled trial.
The purpose of this study was to assess whether a fall-prevention tool kit that engages patients and families in the fall-prevention process throughout hospitalization is associated with reduced falls and injurious falls. Findings showed that, in this nonrandomized controlled trial, implementation of a fall-prevention tool kit was associated with a significant reduction in falls and related injuries. A patient-care team partnership appeared to be beneficial for prevention of falls and fall-related injuries.
AHRQ-funded; HS023535.
Citation: Dykes PC, Burns Z, Adelman J .
Evaluation of a patient-centered fall-prevention tool kit to reduce falls and injuries: a nonrandomized controlled trial.
JAMA Netw Open 2020 Nov 2;3(11):e2025889. doi: 10.1001/jamanetworkopen.2020.25889..
Keywords: Falls, Injuries and Wounds, Prevention, Tools & Toolkits, Patient and Family Engagement, Patient-Centered Healthcare, Clinical Decision Support (CDS), Hospitalization, Hospitals
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
Hoffman GJ, Tinetti ME, Ha J
Prehospital and posthospital fall injuries in older US adults.
Investigators estimated the risk of older adult fall injury within and across discrete periods during a 12-month care episode anchored by an acute hospitalization using national data from 2006 to 2014. Participants in this cohort study included Medicare fee-for-service beneficiaries aged 65 and older from the Health and Retirement Study. The investigators found that an episode-based assessment of fall injury illustrated substantial variability in period-specific risks over an extended period including an anchor hospitalization. Risk transitions between periods included sizable increases just before hospitalization that do not fully subside after hospital discharge. Financial incentives to coordinate hospital and posthospital care for patients at risk for fall injury are needed.
AHRQ-funded; HS025838.
Citation: Hoffman GJ, Tinetti ME, Ha J .
Prehospital and posthospital fall injuries in older US adults.
JAMA Netw Open 2020 Aug 3;3(8):e2013243. doi: 10.1001/jamanetworkopen.2020.13243..
Keywords: Elderly, Falls, Injuries and Wounds, Risk, Hospitalization, Medicare
Lurie JD, Zagaria AB, Ellis L
Surface perturbation training to prevent falls in older adults: a highly pragmatic, randomized controlled trial.
This study’s objective was to determine if adding a component of surface-perturbation training to usual gait/balance training was more effective than gait/balance training alone for reducing falls and fall-related injuries in high-risk older adults referred to physical therapy. This multi-center trial took place at 8 outpatient physical therapy clinics. The cohort included 506 patients aged 65 and older at high fall risk. The group was randomized between treatment with and without surface-perturbation treadmill training. The results were that the training did not significantly reduce risk of any fall but did significantly reduce chance of a fall-related injury after the first 3 months.
AHRQ-funded; HS018459.
Citation: Lurie JD, Zagaria AB, Ellis L .
Surface perturbation training to prevent falls in older adults: a highly pragmatic, randomized controlled trial.
Phys Ther 2020 Jul 19;100(7):1153-62. doi: 10.1093/ptj/pzaa023..
Keywords: Elderly, Falls, Prevention, Training
Bushnell GA, Gerhard T, Crystal S
Benzodiazepine treatment and fracture risk in young persons with anxiety disorders.
This study examined whether benzodiazepine treatment increases fall and fracture risk in young persons as it has been shown to do in older adults. They examined whether children (6-17 years) and young adults (18-24) recently diagnosed with anxiety disorder had an increased fracture risk. A cohort of commercially insured children and young adults who had initiated use of benzodiazepine or SSRIs were followed for 3 months, or until fracture, treatment discontinuation or switching or disenrollment occurred. The cohort consisted of 120,715 children and 179,768 young adults. There was an increased fracture rate found in children, but not young adults.
AHRQ-funded; HS026001.
Citation: Bushnell GA, Gerhard T, Crystal S .
Benzodiazepine treatment and fracture risk in young persons with anxiety disorders.
Pediatrics 2020 Jul;146(1):e20193478. doi: 10.1542/peds.2019-3478..
Keywords: Children/Adolescents, Young Adults, Medication, Falls, Injuries and Wounds, Risk, Anxiety, Behavioral Health
Sanghavi P, Pan S, Caudry D
Assessment of nursing home reporting of major injury falls for quality measurement on Nursing Home Compare.
The purpose of this study was to assess the accuracy of nursing home self-report of major injury falls on the Minimum Data Set (MDS). They linked inpatient claims for major injury falls with MDS assessments. The investigators concluded that the nursing home-reported data used for the Nursing Home Compare (NHC) falls measure may be highly inaccurate.
AHRQ-funded; HS026957.
Citation: Sanghavi P, Pan S, Caudry D .
Assessment of nursing home reporting of major injury falls for quality measurement on Nursing Home Compare.
Health Serv Res 2020 Apr;55(2):201-10. doi: 10.1111/1475-6773.13247..
Keywords: Falls, Nursing Homes, Quality Measures, Quality Indicators (QIs), Quality of Care, Elderly, Public Reporting, Injuries and Wounds
Christiansen TL, Lipsitz S, Scanlan M
Patient activation related to fall prevention: a multisite study.
The purpose of this study was to examine the impact of the Fall TIPS (Tailoring Interventions for Patient Safety) program on patient activation related to fall prevention. Researchers used the short form Patient Activation Measure (PAM-13) adapted for fall prevention. Their findings showed that patient activation improved from preintervention to postintervention at all three studied sites. Patients with access to the Fall TIPS program are more activated and engaged in their fall prevention plan. Recommendations include engaging patients in the fall prevention plan to increase their knowledge, skill, and confidence.
AHRQ-funded; HS023535.
Citation: Christiansen TL, Lipsitz S, Scanlan M .
Patient activation related to fall prevention: a multisite study.
Jt Comm J Qual Patient Saf 2020 Mar;46(3):129-35. doi: 10.1016/j.jcjq.2019.11.010..
Keywords: Falls, Prevention, Patient Safety, Patient and Family Engagement, Education: Patient and Caregiver
Khasnabish S, Burns Z, Couch M
Best practices for data visualization: creating and evaluating a report for an evidence-based fall prevention program.
This case report applied principles from the data visualization literature and feedback from nurses to develop an effective report to display adherence with an evidence-based fall prevention program. The literature emphasized that the ideal display maximizes the information communicated, minimizes the cognitive efforts involved with interpretation, and selects the correct type of display. Lessons learned from this study can inform report development for clinicians in implementation science.
AHRQ-funded; HS025128.
Citation: Khasnabish S, Burns Z, Couch M .
Best practices for data visualization: creating and evaluating a report for an evidence-based fall prevention program.
J Am Med Inform Assoc 2020 Feb;27(2):308-14. doi: 10.1093/jamia/ocz190..
Keywords: Falls, Prevention, Evidence-Based Practice
Rhodes W, Olsho LE, Ward AS
AHRQ Author: Spector WD
https://link.springer.com/article/10.1007/s10742-015-0138-0
Use of Monte Carlo simulation to inform design decisions for pairwise cluster randomization.
This paper demonstrates the utility of the Monte Carlo approach in the context of a planned evaluation of an intervention to reduce falls among nursing home residents and provides recommendations for researchers on key design questions, including the choice between cluster randomization and pairwise cluster randomization, and selection of parametric or nonparametric estimators.
AHRQ-authored; AHRQ-funded; 290201000031I.
Citation: Rhodes W, Olsho LE, Ward AS .
Use of Monte Carlo simulation to inform design decisions for pairwise cluster randomization.
Health Serv Outcomes Res Method (2015) 15: 182-203. https://doi.org/10.1007/s10742-015-0138-0..
Keywords: Nursing Homes, Research Methodologies, Falls
Easter JS, Haukoos JS, Meehan WP
Will neuroimaging reveal a severe intracranial injury in this adult with minor head trauma?: The rational clinical examination systematic review.
The study objective was to assess systematically the accuracy of symptoms and signs in adults with minor head trauma in order to identify those with severe intracranial injuries. It found that combinations of history and physical examination features in clinical decision rules can identify patients with minor head trauma at low risk of severe intracranial injuries.
AHRQ-funded; HS017526.
Citation: Easter JS, Haukoos JS, Meehan WP .
Will neuroimaging reveal a severe intracranial injury in this adult with minor head trauma?: The rational clinical examination systematic review.
JAMA 2015 Dec 22-29;314(24):2672-81. doi: 10.1001/jama.2015.16316..
Keywords: Falls, Brain Injury, Imaging, Trauma, Diagnostic Safety and Quality
Hignett S, Wolf L, Taylor E
Firefighting to innovation: using human factors and ergonomics to tackle slip, trip, and fall risks in hospitals.
The aim of this study was to use a theoretical model (bench) for human factors and ergonomics (HFE) and a comparison with occupational slips, trips, and falls (STFs) risk management to discuss patient STF interventions (bedside). : Three case studies are used to discuss how HFE has been, or could be, applied to STF risk management.
AHRQ-funded; HS021824.
Citation: Hignett S, Wolf L, Taylor E .
Firefighting to innovation: using human factors and ergonomics to tackle slip, trip, and fall risks in hospitals.
Hum Factors 2015 Nov;57(7):1195-207. doi: 10.1177/0018720815593642.
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Keywords: Patient Safety, Risk, Falls, Hospitals
Leland NE, Gozalo P, Bynum J
What happens to patients when they fracture their hip during a skilled nursing facility stay?
This study characterized outcomes of patients experiencing a fall and subsequent hip fracture while in a nursing home receiving skilled nursing facility (SNF) services. In the first 90 days following hospitalization for surgical repair of the hip fracture, 24.1 percent of patients died, 7.3 percent were discharged to the community but remained fewer than 30 days, and 14.0 percent achieved successful community discharge.
AHRQ-funded; HS000011.
Citation: Leland NE, Gozalo P, Bynum J .
What happens to patients when they fracture their hip during a skilled nursing facility stay?
J Am Med Dir Assoc 2015 Sep;16(9):767-74. doi: 10.1016/j.jamda.2015.03.026..
Keywords: Nursing Homes, Falls, Injuries and Wounds, Outcomes
Callaghan B, Kerber K, Langa KM
Longitudinal patient-oriented outcomes in neuropathy: importance of early detection and falls.
This study evaluated longitudinal patient-oriented outcomes in peripheral neuropathy over a 14-year time period including time before and after diagnosis. It concluded that, in older persons, differences in falls, pain, and self-rated health can be detected 3–5 years prior to peripheral neuropathy diagnosis, but only falls deteriorate more rapidly over time in neuropathy cases compared to controls.
AHRQ-funded; HS017690; HS022258.
Citation: Callaghan B, Kerber K, Langa KM .
Longitudinal patient-oriented outcomes in neuropathy: importance of early detection and falls.
Neurology 2015 Jul 7;85(1):71-9. doi: 10.1212/wnl.0000000000001714..
Keywords: Patient-Centered Outcomes Research, Neurological Disorders, Falls, Elderly, Patient Safety
Reiter-Palmon R, Kennel V, Allen JA
Naturalistic decision making in after-action review meetings: the implementation of and learning from post-fall huddles.
In this study, the authors added to our understanding of Naturalistic Decision Making (NDM) in healthcare and how After Action Reviews (AARs) can be utilized as a learning tool to reduce errors. They found that the use of self-guided post-fall huddles increased over the time of the project, the types of errors identified as contributing to the patient fall changed, and the proportion of falls with less adverse effects increased during the project time period. They concluded that , over time, self-guided AARs can be useful for some aspects of learning from errors.
AHRQ-funded; HS021429.
Citation: Reiter-Palmon R, Kennel V, Allen JA .
Naturalistic decision making in after-action review meetings: the implementation of and learning from post-fall huddles.
J Occup Organ Psychol 2015 Jun;88(2):322-40. doi: 10.1111/joop.12084.
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Keywords: Adverse Events, Falls, Decision Making, Medical Errors, Patient Safety
Su BY, Ho KC, Rantz MJ
Doppler radar fall activity detection using the wavelet transform.
The authors propose the use of Wavelet transform (WT) to detect human falls using a ceiling mounted Doppler range control radar. Evaluations based on the data collected in the lab, in the bathrooms, and in the senior residence apartment validate the promising and robust performance of the proposed WT fall activity detector.
AHRQ-funded; HS018477.
Citation: Su BY, Ho KC, Rantz MJ .
Doppler radar fall activity detection using the wavelet transform.
IEEE Trans Biomed Eng 2015 Mar;62(3):865-75. doi: 10.1109/tbme.2014.2367038..
Keywords: Falls, Patient Safety, Adverse Events
Steinman BA, Allen SM, Chen J
Functional limitations as potential mediators of the effects of self-reported vision status on fall risk of older adults.
The purpose of this study was to examine mediating effects of two indices of physical functioning (mobility and large-muscle functioning) on self-reported vision status, as it relates to falls in older adults. Limited evidence was found for a mediating effect among women; however, large-muscle groups were implicated as partially mediating risk factors for falls among men with fair self-reported vision status.
AHRQ-funded; HS000011.
Citation: Steinman BA, Allen SM, Chen J .
Functional limitations as potential mediators of the effects of self-reported vision status on fall risk of older adults.
J Aging Health 2015 Feb;27(1):158-76. doi: 10.1177/0898264314543473..
Keywords: Elderly, Falls, Eye Disease and Health, Risk
Stone E, Skubic M, Rantz M
Average in-home gait speed: investigation of a new metric for mobility and fall risk assessment of elders.
This study assessed how a new metric, average in-home gait speed (AIGS), measured using a low-cost, continuous, environmentally mounted monitoring system, compares to a set of traditional physical performance instruments used for mobility and fall risk assessment of elderly adults. It found that, using the ability of an instrument to predict how an individual would score on all the instruments as a metric, AIGS performs best, having better predictive ability than the traditional instruments.
AHRQ-funded; HS018477.
Citation: Stone E, Skubic M, Rantz M .
Average in-home gait speed: investigation of a new metric for mobility and fall risk assessment of elders.
Gait Posture 2015 Jan;41(1):57-62. doi: 10.1016/j.gaitpost.2014.08.019..
Keywords: Patient Safety, Falls, Elderly, Risk
Aspinall SL, Zhao X, Semia TP
Epidemiology of drug-disease interactions in older veteran nursing home residents.
The objective of this study was to assess the prevalence of and factors associated with potentially inappropriate drug– disease combinations according to the AGS 2012 Beers criteria that are clinically important in elderly adults residing in Veterans Affairs Community Living Centers. It found that drug-disease interactions were common in older residents with dementia or cognitive impairment or a history of falls or hip fracture.
AHRQ-funded; HS018721.
Citation: Aspinall SL, Zhao X, Semia TP .
Epidemiology of drug-disease interactions in older veteran nursing home residents.
J Am Geriatr Soc 2015 Jan;63(1):77-84. doi: 10.1111/jgs.13197..
Keywords: Adverse Drug Events (ADE), Adverse Events, Dementia, Elderly, Falls, Injuries and Wounds, Medication, Medication: Safety, Neurological Disorders, Nursing Homes, Patient Safety
Stone EE, Skubic M
Fall detection in homes of older adults using the Microsoft Kinect.
The researchers present a method for detecting falls in the homes of older adults using the Microsoft Kinect and a two-stage fall detection system. The method is compared against five state-of-the-art fall detection algorithms and significantly better results are achieved.
AHRQ-funded; HS018477.
Citation: Stone EE, Skubic M .
Fall detection in homes of older adults using the Microsoft Kinect.
IEEE J Biomed Health Inform 2015 Jan;19(1):290-301. doi: 10.1109/jbhi.2014.2312180..
Keywords: Patient Safety, Falls, Elderly, Health Information Technology (HIT)
Nilsagard Y, Gunn H, Freeman J
Falls in people with MS--an individual data meta-analysis from studies from Australia, Sweden, United Kingdom and the United States.
The objectives of this paper are to compile fall rates across a broad range of ages and disease severity and to definitively assess the extent to which multiple sclerosis (MS)-associated and demographic factors influence fall rates. It found that persons with MS are at high risk of falls and there are important associations between falls and MS-associated disability, gender and age.
AHRQ-funded; HS017582.
Citation: Nilsagard Y, Gunn H, Freeman J .
Falls in people with MS--an individual data meta-analysis from studies from Australia, Sweden, United Kingdom and the United States.
Mult Scler 2015 Jan;21(1):92-100. doi: 10.1177/1352458514538884..
Keywords: Falls, Risk, Elderly, Chronic Conditions