National Healthcare Quality and Disparities Report
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Topics
- Access to Care (1)
- Antimicrobial Stewardship (1)
- Burnout (1)
- Cancer (1)
- Care Coordination (1)
- Children/Adolescents (1)
- Clinical Decision Support (CDS) (1)
- Communication (1)
- Community-Based Practice (1)
- Comparative Effectiveness (2)
- COVID-19 (1)
- Critical Care (1)
- Education: Continuing Medical Education (2)
- Electronic Health Records (EHRs) (3)
- Emergency Department (1)
- Emergency Medical Services (EMS) (2)
- Evidence-Based Practice (1)
- Healthcare-Associated Infections (HAIs) (2)
- Healthcare Costs (1)
- Health Information Technology (HIT) (2)
- Health Services Research (HSR) (1)
- Health Systems (1)
- Home Healthcare (1)
- Intensive Care Unit (ICU) (1)
- Medical Errors (1)
- Nursing Homes (1)
- Outcomes (1)
- Patient-Centered Healthcare (1)
- Patient Safety (5)
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- Practice Patterns (1)
- Prevention (3)
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- (-) Provider: Health Personnel (21)
- Provider: Pharmacist (1)
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- Quality of Care (1)
- Respiratory Conditions (1)
- Risk (1)
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- Social Determinants of Health (1)
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- Surgery (2)
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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 21 of 21 Research Studies DisplayedSexton JB, Adair KC, Cu X
Effectiveness of a bite-sized web-based intervention to improve healthcare worker wellbeing: a randomized clinical trial of WISER.
The purpose of this randomized controlled trial was to test the effectiveness of the Web-based Implementation for the Science of Enhancing Resilience (WISER) intervention, a positive psychology program constructed to improve six dimensions of the wellbeing of healthcare workers (HCW). The researchers utilized cohorts comprised of actively employed HCWs across the United States: cohort 1 received WISER web-based intervention in the form of links daily for 10 days exposing them to videos and positive psychology exercises; cohort 2 served as a 14-day waiting list control before receiving the same. The study found that at 1 week, when compared to the control group, WISER significantly improved depressive symptoms, work-life integration, happiness, emotional thriving, and emotional recovery, but not emotional exhaustion. Results of the combined cohort 1, 6, and 12 months revealed that all 6 wellbeing outcomes were significantly improved relative to the baseline. At the 6-month assessment, 87% of partifipants reported favorable impressions of WISER.
AHRQ-funded; HS027837.
Citation: Sexton JB, Adair KC, Cu X .
Effectiveness of a bite-sized web-based intervention to improve healthcare worker wellbeing: a randomized clinical trial of WISER.
Front Public Health 2022 Dec 8; 10:1016407. doi: 10.3389/fpubh.2022.1016407..
Keywords: Provider: Health Personnel, Burnout, Stress
Kostelanetz S, Pettapiece-Phillips M, Weems J
Health care professionals' perspectives on universal screening of social determinants of health: a mixed-methods study.
The purpose of this AHRQ-funded study was to assess health care providers’ perceptions of universal social determinants of health (SDH) screening. Th researchers used mixed methods of electronic surveys and qualitative interviews to assess health care providers (physicians, administrators, advanced practice providers, nurses, pharmacists, social workers, and case managers) on their perceptions of universal SDH screening at an academic medical center. The electronic survey evaluated SDH screening practices, attitudes and barriers to universal screening, priorities for SDH domains, and disciplines to perform screening. There were 193 survey participants, representing a 62.5% response rate, most of which were physicians (31%) or social workers (22%). Ninety-three percent of respondents reported using SDH information in patient care, with 95% reporting that social workers were the most appropriate for providing screening. Barriers to SDH screening which were identified included lacking the: resources to address the needs which were identified (51%); time to ask (45%); staff to ask (33%) and; training in responding to the identified needs (28%). Social worker staff reported barriers less frequently than non- social worker staff. The qualitative interview (n=16) results were utilized to elaborate the electronic survey findings and identify themes. Qualitative interview data supported the survey findings and described barriers such as lack of standardized approaches and professional burnout. The researchers concluded that health care providers support universal social determinants of health screening and recommend that strategies to address barriers to implementation should include improving SDH data access for providers and capitalize on social worker expertise.
AHRQ-funded; HS026122.
Citation: Kostelanetz S, Pettapiece-Phillips M, Weems J .
Health care professionals' perspectives on universal screening of social determinants of health: a mixed-methods study.
Popul Health Manag 2022 Jun;25(3):367-74. doi: 10.1089/pop.2021.0176..
Keywords: Social Determinants of Health, Screening, Provider: Health Personnel
Dube WC, Kellogg JT, Adams C
Quantifying risk for SARS-CoV-2 infection among nursing home workers for the 2020-2021 winter surge of the COVID-19 pandemic in Georgia, USA.
This study’s objective was to estimate incidence of risks for COVID-19 infection among nursing home staff in the state of Georgia during the 2020-2021 Winter surge in the US. Staff at fourteen nursing homes were given a survey and serologic testing at 2 time points with 3-month interval exposure assessment. At the first time point, 203 study eligible contracted or employed staff members from these participating nursing homes were seronegative. At the second time point, 72 (35.5%) had evidence of interval infection. Among unvaccinated staff, infection rates were significantly higher among nurses and certified nursing assistants accounting for race and interval infection incidence in both the community and facility.
AHRQ-funded; HS025987.
Citation: Dube WC, Kellogg JT, Adams C .
Quantifying risk for SARS-CoV-2 infection among nursing home workers for the 2020-2021 winter surge of the COVID-19 pandemic in Georgia, USA.
J Am Med Dir Assoc 2022 Jun;23(6):942-46.e1. doi: 10.1016/j.jamda.2022.02.014..
Keywords: COVID-19, Nursing Homes, Provider: Health Personnel, Risk, Public Health
Sutherland BL, Pecanac K, LaBorde TM
Good working relationships: how healthcare system proximity influences trust between healthcare workers.
The authors interviewed healthcare workers who worked with proximal and distributed colleagues to care for patients with diabetic foot ulcers and analyzed transcripts using content analysis. They found that proximal, compared to distributed, dyads had more options available for interactions which, in turn, facilitated communication and working together to build trust. Further, few effective tools existed at the level of interprofessional collaborations, teams, or broader healthcare systems to support trust between distributed healthcare workers.
AHRQ-funded; HS026279.
Citation: Sutherland BL, Pecanac K, LaBorde TM .
Good working relationships: how healthcare system proximity influences trust between healthcare workers.
J Interprof Care 2022 May-Jun;36(3):331-39. doi: 10.1080/13561820.2021.1920897..
Keywords: Health Systems, Provider, Provider: Health Personnel
Ahern J, Singer S, Bhanja A
Considering dentists within the healthcare team: a cross-sectional, multi-state analysis of primary care provider and staff perspectives.
The authors used novel survey data to examine the extent to which primary care providers, other providers, and staff consider dentists part of the healthcare team, and assessed associated practice and individual characteristics. Their findings indicated that dentists are frequently not considered part of the healthcare team in primary care settings. Further, varied responses within practices suggested that provider and staff perceptions may pose challenges to integrating dentists into primary care. Respondents in practices with more integrated diabetes care management processes were more likely to consider dentists as part of the healthcare team, reflecting dental care recommendations made by the American Diabetes Association.
AHRQ-funded; HS024067.
Citation: Ahern J, Singer S, Bhanja A .
Considering dentists within the healthcare team: a cross-sectional, multi-state analysis of primary care provider and staff perspectives.
J Gen Intern Med 2022 Jan;37(1):246-48. doi: 10.1007/s11606-020-06564-w..
Keywords: Primary Care, Provider: Health Personnel, Patient-Centered Healthcare, Care Coordination
Press A, Khan S, McCullagh L
Avoiding alert fatigue in pulmonary embolism decision support: a new method to examine 'trigger rates.'
The authors developed a new and innovative usability process named 'sensitivity and specificity trigger analysis' (SSTA) as part of a larger project around a pulmonary embolism decision support tool. They explored a unique methodology, SSTA, used to limit inaccurate triggering of a clinical decision support tool prior to integration into the electronic health record. They concluded that their methodology can be applied to other studies aiming to decrease triggering rates and increase adoption rates of previously validated clinical decision support system tools.
AHRQ-funded; HS022061.
Citation: Press A, Khan S, McCullagh L .
Avoiding alert fatigue in pulmonary embolism decision support: a new method to examine 'trigger rates.'
Evid Based Med 2016 Dec;21(6):203-07. doi: 10.1136/ebmed-2016-110440.
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Keywords: Clinical Decision Support (CDS), Respiratory Conditions, Electronic Health Records (EHRs), Provider: Health Personnel, Patient Safety
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
Thomas KS, Allen SM
Interagency partnership to deliver veteran-directed home and community-based services: interviews with Aging and Disability Network agency personnel regarding their experience with partner Department of Veterans Affairs medical centers.
The objective of this article is to describe the Aging and Disability Network agency (ADNA) personnel's perceptions of the implementation of the VD-HCBS program with partner Department of Veterans Affairs medical centers (VAMCs). Results suggest that the majority of ADNA personnel interviewed perceive the collaboration experience to be positive. Interviewees reported several key mechanisms for facilitating a successful partnership.
AHRQ-funded; HS000011.
Citation: Thomas KS, Allen SM .
Interagency partnership to deliver veteran-directed home and community-based services: interviews with Aging and Disability Network agency personnel regarding their experience with partner Department of Veterans Affairs medical centers.
J Rehabil Res Dev 2016;53(5):611-18. doi: 10.1682/jrrd.2015.02.0019.
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Keywords: Community-Based Practice, Provider: Health Personnel, Home Healthcare, Training
Mueller LR, Donnelly JP, Jacobson KE
National characteristics of emergency medical services in frontier and remote areas.
This study sought to describe the national characteristics and outcomes of EMS care provided in frontier and remote (FAR) areas in the continental United States (US). It found that FAR responses were more likely to be of American Indian or Alaska Native race. Age, ethnicity, location type, and clinical impressions were similar between FAR and non-FAR responses. On-scene death was more likely in FAR than non-FAR responses.
AHRQ-funded; HS013852.
Citation: Mueller LR, Donnelly JP, Jacobson KE .
National characteristics of emergency medical services in frontier and remote areas.
Prehosp Emerg Care 2016;20(2):191-9. doi: 10.3109/10903127.2015.1086846.
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Keywords: Emergency Medical Services (EMS), Rural Health, Provider: Health Personnel, Health Services Research (HSR), Outcomes
Nathan H, Dimick JB
Opportunities for surgical leadership in managing population health costs.
The concept of population health management—long a mainstay in primary care and chronic disease management—is taking root in surgery. The 2010 Affordable Care Act (ACA) ushered in the implementation of several innovative payment models that shift accountability for population costs to health systems and providers. The authors discuss the implications of th trends for the surgical profession.
AHRQ-funded; HS024763.
Citation: Nathan H, Dimick JB .
Opportunities for surgical leadership in managing population health costs.
Ann Surg 2016 Dec;264(6):909-10. doi: 10.1097/sla.0000000000001759.
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Keywords: Healthcare Costs, Payment, Provider: Health Personnel, Surgery
Sakata KK, Stephenson LS, Mulanax A
Professional and interprofessional differences in electronic health records use and recognition of safety issues in critically ill patients.
The authors conducted this study to determine how each professional group - physicians, nurses, and pharmacists - reviews electronic health records (EHR) data in preparation for rounds and their ability to identify patient safety issues. They found significant and non-overlapping differences in individual profession recognition of patient safety issues in the EHR which may be attributed to differences in EHR use.
AHRQ-funded; HS023793; HS021637.
Citation: Sakata KK, Stephenson LS, Mulanax A .
Professional and interprofessional differences in electronic health records use and recognition of safety issues in critically ill patients.
J Interprof Care 2016 Sep;30(5):636-42. doi: 10.1080/13561820.2016.1193479.
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Keywords: Critical Care, Electronic Health Records (EHRs), Provider: Health Personnel, Intensive Care Unit (ICU), Patient Safety
Ray KN, Kahn JM, Miller E
Use of adult-trained medical subspecialists by children seeking medical subspecialty care.
The objectives of this study are to quantify the use of adult-trained medical subspecialists by children and to determine the association between geographic access to pediatric subspecialty care and the use of adult-trained subspecialists. Among medical subspecialty fields with pediatric and adult-trained subspecialists, the authors found that adult-trained subspecialists provided 10% of care to children overall and 18% of care to children living more than 90 minutes from pediatric referral centers.
AHRQ-funded; HS022989.
Citation: Ray KN, Kahn JM, Miller E .
Use of adult-trained medical subspecialists by children seeking medical subspecialty care.
J Pediatr 2016 Sep;176:173-81.e1. doi: 10.1016/j.jpeds.2016.05.073.
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Keywords: Access to Care, Children/Adolescents, Provider: Health Personnel, Children/Adolescents
Pradarelli JC, Jaffe GA, Lemak CH
A leadership development program for surgeons: first-year participant evaluation.
The researchers evaluated a Leadership Development Program for practicing surgeons by exploring how the program's strengths and weaknesses affected the surgeons' development as physician-leaders. They found that surgeon-participants reported positive impacts of the program on their day-to-day work activities and general career perspective as well as on their long-term career development plans. The participants also recommended areas where the program could be improved. The authors concluded that a curriculum designed specifically for surgeons may enable future programs to equip surgeons better for important leadership roles in a complex health care environment.
AHRQ-funded; HS023597.
Citation: Pradarelli JC, Jaffe GA, Lemak CH .
A leadership development program for surgeons: first-year participant evaluation.
Surgery 2016 Aug;160(2):255-63. doi: 10.1016/j.surg.2016.03.011.
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Keywords: Education: Continuing Medical Education, Provider: Health Personnel, Surgery
Augustine J, Warholak TL, Hines LE
Ability and use of comparative effectiveness research by P&T committee members and support staff: a 1-year follow-up.
The study’s objective was to provide a follow-up assessment of the use of comparative effectiveness research (CER) in the pharmacy and therapeutics (P&T) committee decision-making process, using information collected from participants 1 year after attending a live continuing education program. It concluded that health professionals attending a continuing education CER program reported higher use of CER materials compared with nonattendees.
AHRQ-funded; HS019220.
Citation: Augustine J, Warholak TL, Hines LE .
Ability and use of comparative effectiveness research by P&T committee members and support staff: a 1-year follow-up.
J Manag Care Spec Pharm 2016 Jun;22(6):618-25. doi: 10.18553/jmcp.2016.22.6.618.
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Keywords: Comparative Effectiveness, Education: Continuing Medical Education, Provider: Health Personnel, Provider: Pharmacist
Rizvi RF, Harder KA, Hultman GM
A comparative observational study of inpatient clinical note-entry and reading/retrieval styles adopted by physicians.
The researchers sought to understand physicians' usage of inpatient notes in two Electronic Health Record (EHR) systems. They found that the highest variability was observed with progress notes and the least variability was within discharge summaries, while note-writing styles were most consistent for history and physical notes. Physician preference for adopting a certain reading/retrieval order appeared to be a function of what best fits their workflow while fulfilling the stimulus demands. They also found that time spent entering history and physical, discharge summaries, and progress notes were similar in both EHRs.
AHRQ-funded; HS022085.
Citation: Rizvi RF, Harder KA, Hultman GM .
A comparative observational study of inpatient clinical note-entry and reading/retrieval styles adopted by physicians.
Int J Med Inform 2016 Jun;90:1-11. doi: 10.1016/j.ijmedinf.2016.02.011.
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Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Provider: Health Personnel, Practice Patterns
Dimou FM, Eckelbarger D, Riall TS
Surgeon burnout: a systematic review.
The authors sought to provide a concise review and identify studies reporting on identification, prevention, or intervention for surgeons suffering from burnout. They concluded that systematic evaluation of the structure, effectiveness, and resources required for existing programs needs to be done to better understand what does and does not work, with feedback from participants providing significant information.
AHRQ-funded; HS022134.
Citation: Dimou FM, Eckelbarger D, Riall TS .
Surgeon burnout: a systematic review.
J Am Coll Surg 2016 Jun;222(6):1230-39. doi: 10.1016/j.jamcollsurg.2016.03.022.
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Keywords: Comparative Effectiveness, Evidence-Based Practice, Provider: Health Personnel
Musuuza JS, Barker A, Ngam C
Assessment of fidelity in interventions to improve hand hygiene of healthcare workers: a systematic review.
The researchers examined fidelity reporting in interventions to improve hand hygiene compliance and assessed 5 measures of intervention fidelity. They found that participant responsiveness and adherence to the intervention were the most frequently unreported fidelity measures, while quality of the delivery was the most frequently reported measure. To facilitate replication and effective implementation, the authors recommended that reporting fidelity should be standard practice when describing results of complex behavioral interventions such as hand hygiene.
AHRQ-funded; HS024039.
Citation: Musuuza JS, Barker A, Ngam C .
Assessment of fidelity in interventions to improve hand hygiene of healthcare workers: a systematic review.
Infect Control Hosp Epidemiol 2016 May;37(5):567-75. doi: 10.1017/ice.2015.341.
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Keywords: Healthcare-Associated Infections (HAIs), Provider: Health Personnel, Patient Safety, Prevention
Heath B, Bernhardt J, Michalski TJ
Results of a Veterans Affairs employee education program on antimicrobial stewardship for older adults.
The authors described a course in the Veterans Affairs (VA) Employee Education System designed to engage nursing staff working in VA long-term care facilities as partners in antimicrobial stewardship. They found that the course addressed an important knowledge gap and recommended engaging nursing staff in advancing antimicrobial stewardship, particularly in the long-term care setting.
AHRQ-funded; HS023866.
Citation: Heath B, Bernhardt J, Michalski TJ .
Results of a Veterans Affairs employee education program on antimicrobial stewardship for older adults.
Am J Infect Control 2016 Mar;44(3):349-51. doi: 10.1016/j.ajic.2015.09.026.
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Keywords: Antimicrobial Stewardship, Provider: Health Personnel, Prevention, Training
Johnson TJ, Hickey RW, Switzer GE
The impact of cognitive stressors in the emergency department on physician implicit racial bias.
The researchers sought to determine if physicians have different levels of implicit racial bias post-ED shift versus preshift and to examine associations between demographics and cognitive stressors (e.g., fatigue, stress, time pressure, and complex decision-making) with bias. They concluded that resident implicit bias remained stable overall preshift to postshift, cognitive stressors (overcrowding and patient load) were associated with increased implicit bias.
AHRQ-funded; HS017587.
Citation: Johnson TJ, Hickey RW, Switzer GE .
The impact of cognitive stressors in the emergency department on physician implicit racial bias.
Acad Emerg Med 2016 Mar;23(3):297-305. doi: 10.1111/acem.12901.
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Keywords: Emergency Medical Services (EMS), Emergency Department, Stress, Provider: Health Personnel
Szymczak JE
Infections and interaction rituals in the organisation: clinician accounts of speaking up or remaining silent in the face of threats to patient safety.
The author examined how clinicians talk about speaking up or not in the face of breaches in infection prevention technique. Mutual focus of attention, interactional path dependence, and the presence of an audience are reasons found that influence the decision to speak up in a clinical setting. This decision is dynamic, highly context-dependent, embedded in the interaction rituals that suffuse everyday work, and constrained by organizational dynamics.
AHRQ-funded; HS020760.
Citation: Szymczak JE .
Infections and interaction rituals in the organisation: clinician accounts of speaking up or remaining silent in the face of threats to patient safety.
Sociol Health Illn 2016 Feb;38(2):325-39. doi: 10.1111/1467-9566.12371.
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Keywords: Communication, Provider: Health Personnel, Healthcare-Associated Infections (HAIs), Patient Safety, Prevention
Rabatin J, Williams E, Baier Manwell L
Predictors and outcomes of burnout in primary care physicians.
This study assessed relationships between primary care work conditions, physician burnout, quality of care, and medical errors. It found that burnout is highly associated with adverse work conditions and a greater intention to leave the practice, but not with adverse patient outcomes. Care quality thus appears to be preserved at great personal cost to primary care physicians.
AHRQ-funded; HS011955.
Citation: Rabatin J, Williams E, Baier Manwell L .
Predictors and outcomes of burnout in primary care physicians.
J Prim Care Community Health 2016 Jan;7(1):41-3. doi: 10.1177/2150131915607799.
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Keywords: Provider: Health Personnel, Primary Care, Medical Errors, Patient Safety, Quality of Care