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- Catheter-Associated Urinary Tract Infection (CAUTI) (1)
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- (-) Workflow (15)
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 15 of 15 Research Studies DisplayedRead JM, Weiler DT, Satterly T
Provider preference in exam room layout design and computing.
This study examined the impact of electronic health records (EHRs) on exam room design which would make it easier for providers to promote flexibility, mobility, and body orientation directed towards the patient. Semistructured interviews with 28 providers was conducted and the interviews were audio recorded and transcribed for analysis. Flexibility in sharing the computer screen with patients was an important theme as well as exam room layout, exam room computing and provider workflow.
AHRQ-funded; HS024488.
Citation: Read JM, Weiler DT, Satterly T .
Provider preference in exam room layout design and computing.
Appl Clin Inform 2019 Oct;10(5):972-80. doi: 10.1055/s-0039-3401813..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Workflow, Primary Care, Provider
Manojlovich M, Ameling JM, Forman J
Contextual barriers to communication between physicians and nurses about appropriate catheter use.
This study identified contextual barriers to communication between physicians and nurses that contribute to inappropriate use of catheters and increased risk of health care-associated infections. The researchers conducted individual and small-group semistructured interviewed with physicians and nurses in a progressive care unit of an academic hospital. Common barriers included workflow misalignment between clinicians, issues with electronic medical records and pagers, and strained relationships between clinicians.
AHRQ-funded; HS024385.
Citation: Manojlovich M, Ameling JM, Forman J .
Contextual barriers to communication between physicians and nurses about appropriate catheter use.
Am J Crit Care 2019 Jul;28(4):290-98. doi: 10.4037/ajcc2019372..
Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Communication, Healthcare-Associated Infections (HAIs), Patient Safety, Provider, Provider: Nurse, Provider: Physician, Urinary Tract Infection (UTI), Workflow
Joseph A, Khoshkenar A, Taaffe KM
Minor flow disruptions, traffic-related factors and their effect on major flow disruptions in the operating room.
This study researched the impact of minor flow disruptions (FDs) on operating room (OR) flow and how it contributes to an increase in serious adverse events. The rate of minor FDs increases the rate of major FDs. More major and minor FDs occur in the anesthesia area than in all other OR areas. They concluded that room design and layout issues contribute to those FDs and that is an important consideration in OR design.
AHRQ-funded; HS024380.
Citation: Joseph A, Khoshkenar A, Taaffe KM .
Minor flow disruptions, traffic-related factors and their effect on major flow disruptions in the operating room.
BMJ Qual Saf 2019 Apr;28(4):276-83. doi: 10.1136/bmjqs-2018-007957.
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Keywords: Adverse Events, Healthcare Delivery, Patient Safety, Surgery, Workflow
Batt RJ, Kc DS, Stats BR
The effects of discrete work shifts on a nonterminating service system.
The authors showed that in emergency departments (EDs), the patients’ rate of service completion varies over the course of the physician shift. Furthermore, patients that have experienced a physician handoff have a higher rate of service completion than non-handed-off patients. The authors also demonstrated that patients that have been handed off are more likely to revisit the ED within three days, which suggests that patient handoffs lower clinical quality. Finally, the authors used simulation to demonstrate that shift length and new‐patient cutoff rules can be used to reduce handoffs, but at the expense of system throughput.
AHRQ-funded; HS024558.
Citation: Batt RJ, Kc DS, Stats BR .
The effects of discrete work shifts on a nonterminating service system.
Prod Oper Manag 2019 Jun;28(6):1528-44. doi: 10.1111/poms.12999..
Keywords: Emergency Department, Healthcare Delivery, Quality of Care, Workflow
Hung DY, Harrison MI, Liang SY
AHRQ Author: Harrison MI
Contextual conditions and performance improvement in primary care.
This study examined organizational features of primary care clinics that had gone through Lean redesigns and had experienced the greatest performance improvements. They surveyed 1333 physicians and staff in 43 primary care clinics across a large primary care system. They found that clinics with prior experience with quality improvement had the highest increases in efficiency. Clinics reporting the highest levels of burnout and work stress before the redesign also made efficiency gains. Physician productivity gains was associated with a history of change, staff participation and leadership support. The greatest improvements in patient satisfaction occurred where there was the lowest stress levels with highest levels of teamwork, staff engagement and leadership support.
AHRQ-authored; AHRQ-funded; 2902010000221.
Citation: Hung DY, Harrison MI, Liang SY .
Contextual conditions and performance improvement in primary care.
Qual Manag Health Care 2019 Apr/Jun;28(2):70-77. doi: 10.1097/qmh.0000000000000198..
Keywords: Organizational Change, Healthcare Delivery, Primary Care, Provider Performance, Quality Improvement, Quality of Care, Workflow
McGrath SP, Perreard IM, Garland MD
Improving patient safety and clinician workflow in the general care setting with enhanced surveillance monitoring.
This researched analyzed the impact of implementing an improved clinical monitoring system with enhanced surveillance. This enhanced monitoring system was shown to improve patient safety and clinical workflow in inpatient hospital settings. After implementation higher staff satisfaction was shown and reduced average vital signs data collection time by 28%. It improved the availability and accuracy of patient information. However, there was little or no impact on clinical alarms.
AHRQ-funded; HS024403.
Citation: McGrath SP, Perreard IM, Garland MD .
Improving patient safety and clinician workflow in the general care setting with enhanced surveillance monitoring.
IEEE J Biomed Health Inform 2019 Mar;23(2):857-66. doi: 10.1109/jbhi.2018.2834863..
Keywords: Hospitals, Inpatient Care, Patient Safety, Provider: Clinician, Quality Improvement, Workflow
Fiori K, Patel M, Sanderson D
From policy statement to practice: integrating social needs screening and referral assistance with community health workers in an urban academic health center.
The authors described their experience implementing a novel social needs screening program at an academic pediatric clinic. They found that, on average, 76% of providers had their patients screened on more than half of eligible well-child visits. Their experience suggested that screening for social needs at well-child visits is feasible as part of routine primary care. They recommended that success would best be achieved by leveraging resources, obtaining provider buy-in, and defining program components to sustain activities.
AHRQ-funded; HS026396.
Citation: Fiori K, Patel M, Sanderson D .
From policy statement to practice: integrating social needs screening and referral assistance with community health workers in an urban academic health center.
J Prim Care Community Health 2019 Jan-Dec;10:2150132719899207. doi: 10.1177/2150132719899207..
Keywords: Children/Adolescents, Community-Based Practice, Healthcare Delivery, Implementation, Screening, Social Determinants of Health, Urban Health, Workflow, Primary Care
Hung DY, Gray CP, Truong QA
AHRQ Author: Harrison MI
Sustainment of lean redesigns for primary care teams.
This mixed-methods study examined the sustainment of Lean workflow redesigns for primary care teams several years after being implemented in a large, ambulatory care delivery system. Results showed that staff participation in Lean redesign is a key to facilitating buy-in and adherence to changes. Change ownership and continued availability of time for improvement activities are also critical to the long-term success of Lean implementation in primary care.
AHRQ-authored; AHRQ-funded; 2902010000221.
Citation: Hung DY, Gray CP, Truong QA .
Sustainment of lean redesigns for primary care teams.
Qual Manag Health Care 2019 Jan/Mar;28(1):15-24. doi: 10.1097/qmh.0000000000000200..
Keywords: Primary Care, Workflow, Teams, Organizational Change, Quality Improvement, Quality of Care
Fong A, Hoffman DJ, Zachary Hettinger A
Identifying visual search patterns in eye gaze data; gaining insights into physician visual workflow.
The authors propose an algorithmic approach to identify different visual search patterns. They demonstrate this approach by identifying common physician visual search patterns using a simulated prototype emergency department patient tracking system. They then discuss the benefits and limitations as well as insights from this initial evaluation.
AHRQ-funded; HS020433.
Citation: Fong A, Hoffman DJ, Zachary Hettinger A .
Identifying visual search patterns in eye gaze data; gaining insights into physician visual workflow.
J Am Med Inform Assoc 2016 Nov;23(6):1180-84. doi: 10.1093/jamia/ocv196.
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Keywords: Healthcare Delivery, Electronic Health Records (EHRs), Health Information Technology (HIT), Workflow
Valdez RS, Holden RJ
Health care human factors/ergonomics fieldwork in home and community settings.
The researchers offered several strategies that human factors and ergonomics professionals can use before, during, and after home and community site visits to optimize fieldwork and mitigate challenges in these settings.
AHRQ-funded; HS022930; HS018809.
Citation: Valdez RS, Holden RJ .
Health care human factors/ergonomics fieldwork in home and community settings.
Ergon Des 2016 Oct;24(4):4-9. doi: 10.1177/1064804615622111.
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Keywords: Caregiving, Community-Based Practice, Home Healthcare, Workflow
Menon S, Murphy DR, SIngh H
Workarounds and test results follow-up in electronic health record-based primary care.
This study sought to understand why primary care practitioners use workarounds to manage test results by analyzing data from a previously conducted national cross-sectional survey on test result management. It concluded that workarounds to manage EHR-based test results are common, and their use results from unmet provider information management needs.
AHRQ-funded; HS022901; HS022087.
Citation: Menon S, Murphy DR, SIngh H .
Workarounds and test results follow-up in electronic health record-based primary care.
Appl Clin Inform 2016 Jun 22;7(2):543-59. doi: 10.4338/aci-2015-10-ra-0135.
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Keywords: Communication, Electronic Health Records (EHRs), Primary Care, Workflow
Gray CP, Harrison MI, Hung D
AHRQ Author: Harrison MI
Medical assistants as flow managers in primary care: challenges and recommendations.
Drawing on an empirical study of a large, multispecialty delivery system engaged in reconfiguration of primary care, the authors found that using medical assistants (Mas) as flow managers required overcoming several challenges. These included entrenched social and occupational hierarchies between physicians and MAs, a lack of adequate training and mentorship, and difficulty attracting and retaining talented MAs.
AHRQ-authored; AHRQ-funded; 2902010000221.
Citation: Gray CP, Harrison MI, Hung D .
Medical assistants as flow managers in primary care: challenges and recommendations.
J Healthc Manag 2016 May-Jun;61(3):181-91.
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Keywords: Primary Care, Organizational Change, Practice Improvement, Quality Improvement, Quality of Care, Workflow, Provider
Abraham J, Kannampallil T, Brenner C
Characterizing the structure and content of nurse handoffs: a Sequential Conversational Analysis approach.
This paper describes Sequential Conversational Analysis (SCA) - a mixed-method approach integrating qualitative conversational analysis with quantitative sequential pattern analysis. This approach allows characterization of the nature of nurse handoff communication, highlighting the relationships underlying verbal content. The authors also discuss how SCA can help in understanding the dynamics of communication in other settings.
AHRQ-funded; HS017586.
Citation: Abraham J, Kannampallil T, Brenner C .
Characterizing the structure and content of nurse handoffs: a Sequential Conversational Analysis approach.
J Biomed Inform 2016 Feb;59:76-88. doi: 10.1016/j.jbi.2015.11.009.
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Keywords: Communication, Quality of Care, Intensive Care Unit (ICU), Nursing, Workflow
Acharya S, Fischer-Valuck BW, Kashani R
Online magnetic resonance image guided adaptive radiation therapy: first clinical applications.
The authors demonstrated the feasibility of online adaptive magnetic resonance (MR) image guided radiation therapy (MR-IGRT) with five patients with abdominopelvic malignancies. They successfully implemented online adaptive MR-IGRT with planning and quality assurance workflow suitable for routine clinical application. Clinical trials are in development to formally evaluate adaptive treatments for a variety of disease sites.
AHRQ-funded; HS022888.
Citation: Acharya S, Fischer-Valuck BW, Kashani R .
Online magnetic resonance image guided adaptive radiation therapy: first clinical applications.
Int J Radiat Oncol Biol Phys 2016 Feb;94(2):394-403. doi: 10.1016/j.ijrobp.2015.10.015.
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Keywords: Cancer, Cancer: Colorectal Cancer, Imaging, Workflow
Holman GT, Beasley JW, Karsh BT
The myth of standardized workflow in primary care.
This analysis evaluates workflow variation in terms of the sequence of tasks performed during patient visits. It concluded that the prevalence of specific tasks shifts significantly as primary care visits progress to their conclusion but, notably, PCPs collect patient information throughout the visit.
AHRQ-funded; HS017115; HS017014.
Citation: Holman GT, Beasley JW, Karsh BT .
The myth of standardized workflow in primary care.
J Am Med Inform Assoc 2016 Jan;23(1):29-37. doi: 10.1093/jamia/ocv107.
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Keywords: Primary Care, Workflow