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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 24 of 24 Research Studies DisplayedDaniel VT, Ayturk D, Kiefe CI
The current State of the acute care surgery workforce: a boots on the ground perspective.
Acute care surgery (ACS) was proposed to address a general surgery workforce crisis; however, the ACS workforce composition is unknown. A national survey was conducted to determine the differences in the emergency general surgery (EGS) workforce between ACS and non-ACS hospitals. The investigators concluded that ACS and non-ACS hospitals differ in their surgical workforce. It is clear that ACS hospitals have more human capital, which suggests that ACS hospitals may require more dedicated resources compared to non-ACS hospitals.
AHRQ-funded; HS022694.
Citation: Daniel VT, Ayturk D, Kiefe CI .
The current State of the acute care surgery workforce: a boots on the ground perspective.
Am J Surg 2018 Dec;216(6):1076-81. doi: 10.1016/j.amjsurg.2018.08.023..
Keywords: Critical Care, Emergency Department, Hospitals, Workforce
Tabano DC, Anderson ML, Ritzwoller DP
Estimating the impact of diabetes mellitus on worker productivity using self-report, electronic health record and human resource data.
In this study, the investigators assessed the relationship between diabetes mellitus (DM) and measures of worker productivity, direct health care costs, and costs associated with lost productivity (LP) among health care industry workers across two integrated health care systems. They concluded that the impact of DM was reflected in higher rates of LP and higher indirect costs for employers related to LP and higher health care resource use.
AHRQ-funded; HS018913.
Citation: Tabano DC, Anderson ML, Ritzwoller DP .
Estimating the impact of diabetes mellitus on worker productivity using self-report, electronic health record and human resource data.
J Occup Environ Med 2018 Nov;60(11):e569-e74. doi: 10.1097/jom.0000000000001441..
Keywords: Diabetes, Healthcare Costs, Workforce
Brimhall KC, Mor Barak ME
The critical role of workplace inclusion in fostering innovation, job satisfaction, and quality of care in a diverse human service organization.
Using a sample of 213 participants within 21 departmental units in a diverse human service organization, the authors performed multilevel path analysis to examine the critical role of workplace inclusion in fostering innovation, job satisfaction, and quality of care in a diverse human service organization.
AHRQ-funded; HS024650.
Citation: Brimhall KC, Mor Barak ME .
The critical role of workplace inclusion in fostering innovation, job satisfaction, and quality of care in a diverse human service organization.
Hum Serv Organ Manag Leadersh Gov 2018 Nov/Dec;42(5):474-92..
Keywords: Quality of Care, Workforce, Organizational Change
Mor V, Wallace P
Funding the training of future health services researchers.
This article describes the trends in funding for training health service researches in the United States. The government funds some training through grants by NIH and AHRQ through the National Research Service Award (NRSA) mechanism. However, most of the AHRQ grant programs have reduced their funding levels from 2010 to 2015 by almost half, with only the dissertation grants program (R36) experiencing an increase. Other federal mechanisms to fund training come through postdoctoral or post-MD programs with HRSA or the Veterans Administration. Private funding is also available through the Robert Wood Johnson Foundation. Lastly, AcademyHealth started a Delivery System Science Fellowship (DSSF) program to provide a paid post-doctoral learning experience for early-career researchers. Out of 118 applicants, 25 fellows, six trained as physicians have been accepted. Twenty-one researchers have completed the fellowship, and four are current fellows. There has been a wide background in those fellows. The writers believe more stable funding sources need to be established with a close collaboration between HSR researchers and users.
AHRQ-funded; 233201600155P.
Citation: Mor V, Wallace P .
Funding the training of future health services researchers.
Health Serv Res 2018 Oct;53 Suppl 2:3976-84. doi: 10.1111/1475-6773.12844..
Keywords: Health Services Research (HSR), Workforce
Meyers D, LeRoy L, Bailit M
AHRQ Author: Meyers D, Zhan C
Workforce configurations to provide high-quality, comprehensive primary care: a mixed-method exploration of staffing for four types of primary care practices.
The aim of this study was to explore the team configurations and associated costs required to deliver high-quality, comprehensive primary care. The study estimates provided health care decision-makers with needed guideposts for considering primary care staffing and financing and informed broader discussions on primary care innovations and the necessary resources to provide high-quality, comprehensive primary care in the USA.
AHRQ-authored; AHRQ-funded; 290201000004I; 29032009T.
Citation: Meyers D, LeRoy L, Bailit M .
Workforce configurations to provide high-quality, comprehensive primary care: a mixed-method exploration of staffing for four types of primary care practices.
J Gen Intern Med 2018 Oct;33(10):1774-79. doi: 10.1007/s11606-018-4530-7..
Keywords: Healthcare Delivery, Quality of Care, Primary Care, Workforce, Teams
Costa DK, Moss M
The cost of caring: emotion, burnout, and psychological distress in critical care clinicians.
This paper comments on emotion, burnout, and psychological distress in critical care clinicians. It stresses that the current management approaches for burnout and other forms of psychological distress are insufficient and discusses possibilities for improvement.
AHRQ-funded; HS024552.
Citation: Costa DK, Moss M .
The cost of caring: emotion, burnout, and psychological distress in critical care clinicians.
Ann Am Thorac Soc 2018 Jul;15(7):787-90. doi: 10.1513/AnnalsATS.201804-269PS..
Keywords: Burnout, Critical Care, Provider, Workforce
Huber MT, Ham SA, Qayyum M
Association between job factors, burnout, and preference for a new job: a nationally representative physician survey.
Investigators used an experimental vignette to test associations between physician demographics, salary, and working with exemplary colleagues on the likelihood of preferring a new job among burned out and non-burned out physicians in various specialties. They found that, among burned out physicians, the opportunity for better salary and colleagues made them more likely to prefer a new job compared to non-burned out physicians, with change in salary associated with the greatest difference. They recommended focusing on improving physician-colleague relationships to improve job retention.
AHRQ-funded; HS000078.
Citation: Huber MT, Ham SA, Qayyum M .
Association between job factors, burnout, and preference for a new job: a nationally representative physician survey.
J Gen Intern Med 2018 Jun;33(6):789-91. doi: 10.1007/s11606-018-4412-z..
Keywords: Burnout, Workforce, Provider: Physician, Provider
Berridge C, Tyler DA, Miller SC
Staff empowerment practices and CNA retention: findings from a nationally representative nursing home culture change survey.
This article examines whether staff empowerment practices common to nursing home culture change are associated with certified nursing assistant (CNA) retention. It concluded that after adjustment for covariates, a greater staff empowerment practice score was positively associated with greater retention. Compared with the low empowerment category, nursing homes with scores in the medium category had a 44 percent greater likelihood of having higher CNA retention.
AHRQ-funded; HS000011.
Citation: Berridge C, Tyler DA, Miller SC .
Staff empowerment practices and CNA retention: findings from a nationally representative nursing home culture change survey.
J Appl Gerontol 2018 Apr;37(4):419-34. doi: 10.1177/0733464816665204.
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Keywords: Long-Term Care, Nursing Homes, Provider, Provider: Health Personnel, Workforce
Snyder CR, Frogner BK, Skillman SM
Facilitating racial and ethnic diversity in the health workforce.
This study explored changes in the racial and ethnic diversity of the health workforce in the United States over the last decade, and evidence on the effectiveness of programs designed to promote racial and ethnic diversity in the U.S. health workforce. Findings suggested that although the health workforce overall is becoming more diverse, people of color are most often represented among the entry-level, lower-skilled health occupations.
AHRQ-funded; HS022982.
Citation: Snyder CR, Frogner BK, Skillman SM .
Facilitating racial and ethnic diversity in the health workforce.
J Allied Health 2018 Spring;47(1):58-65..
Keywords: Provider, Racial and Ethnic Minorities, Workforce
Leyenaar JK, Frintner MP
Graduating pediatric residents entering the hospital medicine workforce, 2006-2015.
This study analyzed the population of graduating pediatric residents entering the new subspecialty – pediatric hospital medicine (PHM). Data was analyzed from the American Academic of Pediatrics Annual Survey of Graduating Residents, 2006-2015. A total of 5969 graduates completed the survey, and 10.3% reported that they were entering PHM and 33.9% were reporting subspecialty fellowships. A multivariable analysis was done of the demographics, and a higher rate of residents entering PHM were female, to have children, to report that family factors limited their job selection, and to have higher levels of student debt than residents entering fellowships.
AHRQ-funded; HS024133.
Citation: Leyenaar JK, Frintner MP .
Graduating pediatric residents entering the hospital medicine workforce, 2006-2015.
Acad Pediatr 2018 Mar;18(2):200-07. doi: 10.1016/j.acap.2017.05.001..
Keywords: Education: Continuing Medical Education, Provider, Provider: Clinician, Provider: Physician, Workforce
Kim LY, Rose DE, Soban LM
Primary care tasks associated with provider burnout: findings from a Veterans Health Administration survey.
The purpose of this study was to investigate (1) the extent to which primary care providers (PCPs) share responsibility for 14 discrete primary care tasks with other team members, and (2) which, if any, of the primary care tasks performed by the PCPs (without reliance on team members) are associated with PCP burnout.
AHRQ-funded; HS000046.
Citation: Kim LY, Rose DE, Soban LM .
Primary care tasks associated with provider burnout: findings from a Veterans Health Administration survey.
J Gen Intern Med 2018 Jan;33(1):50-56. doi: 10.1007/s11606-017-4188-6..
Keywords: Healthcare Delivery, Health Services Research (HSR), Patient-Centered Healthcare, Primary Care, Provider, Workforce
Biener A, Cawley J, Meyerhoefer C
AHRQ Author: Biener A
The impact of obesity on medical care costs and labor market outcomes in the US.
The economic consequences of obesity are not well understood. Researchers analyzed data for 2001-2015 and estimated the percentage of healthcare costs that were associated with adult obesity. They found that a substantial and rising percentage of healthcare costs are associated with obesity. This is true for the US, for individual states, for each category of expenditure, and for each type of payer.
AHRQ-authored.
Citation: Biener A, Cawley J, Meyerhoefer C .
The impact of obesity on medical care costs and labor market outcomes in the US.
Clin Chem 2018 Jan;64(1):108-17. doi: 10.1373/clinchem.2017.272450.
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Keywords: Healthcare Costs, Medical Expenditure Panel Survey (MEPS), Obesity, Workforce
Larson EL, Cohen B, Liu J
Assessing intensity of nursing care needs using electronically available data.
The aim of this project was to develop and test a Nursing Intensity of Care Index using electronically available data from 152,072 patient discharges from three hospitals. In preliminary testing, data for the Nursing Intensity of Care Index, which accurately reflect nursing care intensity, can be obtained electronically in real time. The next steps will be a discrete-event simulation model and large-scale field trials.
AHRQ-funded; HS024915.
Citation: Larson EL, Cohen B, Liu J .
Assessing intensity of nursing care needs using electronically available data.
Comput Inform Nurs 2017 Dec;35(12):617-23. doi: 10.1097/cin.0000000000000375.
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Keywords: Electronic Health Records (EHRs), Nursing, Workforce
Dyrbye LN, Shanafelt TD, Sinsky CA
AHRQ Author: Meyers D
https://nam.edu/burnout-among-health-care-professionals-a-call-to-explore-and-address-this-underrecognized-threat-to-safe-high-quality-care
Burnout among health care professionals: a call to explore and address this underrecognized threat to safe, high-quality care.
The high prevalence of burnout among health care professionals is cause for concern because it appears to be affecting quality, safety, and health care system performance. Efforts are needed to address this growing problem. Progress will require methodologically sound studies, adequate funding, and collaborative efforts. The authors hope that research sponsors, institutions, clinician organizations, researchers, clinicians, and patients join in supporting enhanced research efforts focused on these topics.
AHRQ-authored.
Citation: Dyrbye LN, Shanafelt TD, Sinsky CA .
Burnout among health care professionals: a call to explore and address this underrecognized threat to safe, high-quality care.
NAM Perspectives 2017 Jul 5.
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Keywords: Quality of Care, Provider: Health Personnel, Patient Safety, Workforce
Loresto FL, Jr., Jupiter D, Kuo YF
Examining differences in characteristics between patients receiving primary care from nurse practitioners or physicians using Medicare Current Beneficiary Survey data and Medicare claims data.
There is a perception that nurse practitioners (NPs), as compared with primary care medical doctors (PCMDs), tend to provide care to healthier patients. In this study, patients utilizing NP-only or PCMD-only models for primary care were characterized and compared in terms of functional, cognitive, and psychological factors. The results were contrary to the initial perception. In terms of health status, NP-only patients were similar to PCMD-only patients.
AHRQ-funded; HS020642.
Citation: Loresto FL, Jr., Jupiter D, Kuo YF .
Examining differences in characteristics between patients receiving primary care from nurse practitioners or physicians using Medicare Current Beneficiary Survey data and Medicare claims data.
J Am Assoc Nurse Pract 2017 Jun;29(6):340-47. doi: 10.1002/2327-6924.12465.
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Keywords: Provider: Health Personnel, Medicare, Primary Care, Workforce
Washington DM, Paasche-Orlow MK, Liebschutz JM
Promoting progress or propagating problems: strategic plans and the advancement of academic faculty diversity in U.S. medical schools.
The aim of this study was to investigate whether academic institutions that have engaged in strategic planning for faculty diversity, as exhibited by plan presence on their websites, had a higher rate of underrepresented minorities in medicine (URM) faculty growth than institutions who do not have evidence of such planning.
AHRQ-funded; HS022242.
Citation: Washington DM, Paasche-Orlow MK, Liebschutz JM .
Promoting progress or propagating problems: strategic plans and the advancement of academic faculty diversity in U.S. medical schools.
J Natl Med Assoc 2017 Summer;109(2):72-78. doi: 10.1016/j.jnma.2016.10.001..
Keywords: Education: Curriculum, Racial and Ethnic Minorities, Workforce
Kavalieratos D, Siconolfi DE, Steinhauser KE
"It is like heart failure. It is chronic ... and it will kill you": a qualitative analysis of burnout among hospice and palliative care clinicians.
This study explored burnout among palliative care clinicians, specifically their experiences with burnout, their perceived sources of burnout, and potential individual, interpersonal, organizational, and policy-level solutions to address burnout. Common sources of burnout included increasing workload, tensions between nonspecialists and palliative care specialists, and regulatory issues. Participants proposed antiburnout solutions, including promoting the provision of generalist palliative care, frequent rotations on-and-off service, and organizational support for self-care.
AHRQ-funded; HS023681; HS022989.
Citation: Kavalieratos D, Siconolfi DE, Steinhauser KE .
"It is like heart failure. It is chronic ... and it will kill you": a qualitative analysis of burnout among hospice and palliative care clinicians.
J Pain Symptom Manage 2017 May;53(5):901-10.e1. doi: 10.1016/j.jpainsymman.2016.12.337.
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Keywords: Provider: Health Personnel, Palliative Care, Workforce
Poghosyan L, Liu J, Shang J
Practice environments and job satisfaction and turnover intentions of nurse practitioners: implications for primary care workforce capacity.
Researchers examined nurse practitioner (NP) practice environments in primary care organizations and the extent to which they were associated with NP retention measures. NPs rated the relationship between NPs and physicians favorably, contrary to the relationship between NPs and administrators. With every unit increase in each standardized subscale score, the odds of job satisfaction increased about 20 percent whereas the odds of intention of turnover decreased about 20 percent.
AHRQ-funded; HS020999.
Citation: Poghosyan L, Liu J, Shang J .
Practice environments and job satisfaction and turnover intentions of nurse practitioners: implications for primary care workforce capacity.
Health Care Manage Rev 2017 Apr/Jun;42(2):162-71. doi: 10.1097/hmr.0000000000000094.
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Keywords: Primary Care, Provider: Nurse, Provider: Clinician, Provider, Workforce
Scott KW, Orav EJ, Cutler DM
Changes in hospital-physician affiliations in U.S. hospitals and their effect on quality of care.
This study examined changes in U.S. acute care hospitals that reported employment relationships with their physicians and to determine whether quality of care improved after the hospitals switched to this integration model. It concluded that during the past decade, hospitals have increasingly become employers of physicians. The study's findings suggest that physician employment alone probably is not a sufficient tool for improving hospital care.
AHRQ-funded; HS000055.
Citation: Scott KW, Orav EJ, Cutler DM .
Changes in hospital-physician affiliations in U.S. hospitals and their effect on quality of care.
Ann Intern Med 2017 Jan 3;166(1):1-8. doi: 10.7326/m16-0125.
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Keywords: Hospitals, Quality of Care, Critical Care, Workforce
de Cordova PB
Staffing and nurse-perceived quality of care.
This article comments on a study by Cho and colleagues, the purpose of which was to explore the associations between nurse staffing and overtime with nurse-perceived patient safety and care left undone. Cho and colleagues found that as patients per nurse and nurse work hours increase, so does the perception of reduced patient safety. The author argues that the study reinforces the view that educating nurses, administrators and policymakers about the importance of nurse staffing on quality care should continue.
AHRQ-funded; HS024339.
Citation: de Cordova PB .
Staffing and nurse-perceived quality of care.
Evid Based Nurs 2017 Jan;20(1):19. doi: 10.1136/eb-2016-102478.
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Keywords: Quality of Care, Provider, Nursing, Workforce
Laccetti AL, Chen B, Cai J
Increase in cancer center staff effort related to electronic patient portal use.
The authors examined patterns of use of electronic portals by clinic staff at a National Cancer Institute-designated comprehensive cancer center. They found that from 2011 to 2014, staff portal activity increased approximately 10-fold, and sixteen percent of all actions occurred outside clinic hours. They concluded that cancer center employee use of an electronic patient portal has increased markedly over time, particularly among nursing staff.
AHRQ-funded; HS022418.
Citation: Laccetti AL, Chen B, Cai J .
Increase in cancer center staff effort related to electronic patient portal use.
J Oncol Pract 2016 Dec;12(12):e981-e90. doi: 10.1200/jop.2016.011817.
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Keywords: Cancer, Health Information Technology (HIT), Provider: Health Personnel, Web-Based, Workforce
Klerman EB, Beckett SA, Landrigan CP
Applying mathematical models to predict resident physician performance and alertness on traditional and novel work schedules.
Using a mathematical model of the effects of circadian rhythms and length of time awake on objective performance and subjective alertness, the researchers compared predictions for traditional intern schedules to those that limit work to </= 16 consecutive hours. Their model predicted fewer hours with poor performance and alertness, especially during night-time work hours, for all three novel schedules than for either of the two traditional schedules.
AHRQ-funded; HS017357.
Citation: Klerman EB, Beckett SA, Landrigan CP .
Applying mathematical models to predict resident physician performance and alertness on traditional and novel work schedules.
BMC Med Educ 2016 Sep 13;16(1):239. doi: 10.1186/s12909-016-0751-9.
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Keywords: Education: Continuing Medical Education, Patient Safety, Provider Performance, Workforce
Silber JH, Rosenbaum PR, McHugh MD
Comparison of the value of nursing work environments in hospitals across different levels of patient risk.
This study tested whether hospitals with better nursing work environments displayed better value than those with worse nursing. It found that hospitals with better nursing environments and above-average staffing levels were associated with better value (lower mortality with similar costs) compared with hospitals without nursing environment recognition and with below-average staffing, especially for higher-risk patients.
AHRQ-funded; HS018338.
Citation: Silber JH, Rosenbaum PR, McHugh MD .
Comparison of the value of nursing work environments in hospitals across different levels of patient risk.
JAMA Surg 2016 Jun;151(6):527-36. doi: 10.1001/jamasurg.2015.4908.
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Keywords: Healthcare Costs, Quality of Care, Nursing, Workforce
Morris AM, Ricci KA, Griffin AR
AHRQ Author: Heslin KC
Personal and professional challenges confronted by hospital staff following hurricane sandy: a qualitative assessment of management perspectives.
This qualitative study assessed the personal and professional challenges that affected staff decisions to report to work following a natural disaster and examined the role of management in addressing staff needs and concerns. Results indicated that staff encountered several barriers in the initial post-Sandy period including transportation problems, personal property damage, and communication issues.
AHRQ-authored.
Citation: Morris AM, Ricci KA, Griffin AR .
Personal and professional challenges confronted by hospital staff following hurricane sandy: a qualitative assessment of management perspectives.
BMC Emerg Med 2016 May 5;16(1):18. doi: 10.1186/s12873-016-0082-5.
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Keywords: Communication, Emergency Preparedness, Workforce