National Healthcare Quality and Disparities Report
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 4 of 4 Research Studies DisplayedCifra CL, Custer JW, Singh H
Diagnostic errors in pediatric critical care: a systematic review.
This study is a systematic review on the prevalence, impact, and contributing factors related to diagnostic errors in the PICU. A database search was done for literature up through December 2019. Using specific criteria, 396 abstracts were screened, and 17 studies were included. Fifteen of 17 studies had an observational research design. Autopsy studies showed a 10-23% rate of missed major diagnosis with 5-16% of the errors having a potential adverse impact on survival and would have changed care management. Retrospective record review studies reported varying rates of diagnostic error from 8% in a general PICU population to 12% among unexpected critical admissions. About a quarter of those patients were discussed at PICU morbidity and mortality conferences. Most misdiagnosed conditions were cardiovascular, infectious, congenital, or neurologic. System, cognitive, and both system and cognitive factors were associated with diagnostic error but there is limited information on the impact of misdiagnosis.
AHRQ-funded; HS026965.
Citation: Cifra CL, Custer JW, Singh H .
Diagnostic errors in pediatric critical care: a systematic review.
Pediatr Crit Care Med 2021 Aug;22(8):701-12. doi: 10.1097/pcc.0000000000002735..
Keywords: Children/Adolescents, Diagnostic Safety and Quality, Medical Errors, Adverse Events, Patient Safety, Intensive Care Unit (ICU), Critical Care
Harrison AM, Gajic O, Pickering BW
Development and implementation of sepsis alert systems.
Development and implementation of sepsis alert systems is challenging, particularly outside the monitored intensive care unit (ICU) setting. Current evidence does not support routine use of sepsis alert systems in clinical practice. Continuous improvement in the afferent and efferent aspects will help translate theoretic advantages into measurable patient benefit.
AHRQ-funded; HS022799.
Citation: Harrison AM, Gajic O, Pickering BW .
Development and implementation of sepsis alert systems.
Clin Chest Med 2016 Jun;37(2):219-29. doi: 10.1016/j.ccm.2016.01.004..
Keywords: Intensive Care Unit (ICU), Sepsis, Outcomes, Adverse Events
McElroy LM, Khorzad R, Nannicelli AP
Failure mode and effects analysis: a comparison of two common risk prioritisation methods.
The investigators compared a simplified scoring method with the traditional scoring method to determine the degree of congruence in identifying high-risk failures. They found that the simplified method did not result in the same degree of discrimination in the ranking of failures offered by the traditional method.
AHRQ-funded; HS000078.
Citation: McElroy LM, Khorzad R, Nannicelli AP .
Failure mode and effects analysis: a comparison of two common risk prioritisation methods.
BMJ Qual Saf 2016 May;25(5):329-36. doi: 10.1136/bmjqs-2015-004130.
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Keywords: Adverse Events, Intensive Care Unit (ICU), Outcomes, Patient Safety, Risk
Li S, Rehder KJ, Giuliano JS, Jr.
Development of a quality improvement bundle to reduce tracheal intubation-associated events in pediatric ICUs.
This paper described a methodology to develop a bundle to improve quality and safety of tracheal intubations in the pediatric intensive care unit. The Airway Bundle Checklist consists of four parts: a risk factor assessment, a plan generation, a preprocedure time-out, and a postprocedure huddle to identify improvement opportunities.
AHRQ-funded; HS021583.
Citation: Li S, Rehder KJ, Giuliano JS, Jr. .
Development of a quality improvement bundle to reduce tracheal intubation-associated events in pediatric ICUs.
Am J Med Qual 2016 Jan-Feb;31(1):47-55. doi: 10.1177/1062860614547259.
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Keywords: Adverse Events, Intensive Care Unit (ICU), Quality Improvement, Patient Safety, Children/Adolescents