National Healthcare Quality and Disparities Report
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Topics
- Adverse Drug Events (ADE) (4)
- (-) Adverse Events (76)
- Ambulatory Care and Surgery (2)
- Antimicrobial Stewardship (1)
- Blood Clots (3)
- Blood Pressure (1)
- Brain Injury (1)
- Cancer (3)
- Cancer: Breast Cancer (1)
- Cancer: Colorectal Cancer (1)
- Cancer: Ovarian Cancer (1)
- Cancer: Prostate Cancer (1)
- Cardiovascular Conditions (4)
- Care Management (1)
- Catheter-Associated Urinary Tract Infection (CAUTI) (1)
- Children/Adolescents (9)
- Clinician-Patient Communication (2)
- Colonoscopy (2)
- Communication (7)
- Comparative Effectiveness (5)
- Critical Care (1)
- Diagnostic Safety and Quality (1)
- Dialysis (1)
- Digestive Disease and Health (2)
- Disparities (2)
- Education: Continuing Medical Education (1)
- Education: Patient and Caregiver (2)
- Elderly (8)
- Emergency Department (1)
- Evidence-Based Practice (2)
- Eye Disease and Health (1)
- Guidelines (2)
- Healthcare-Associated Infections (HAIs) (7)
- Healthcare Cost and Utilization Project (HCUP) (5)
- Healthcare Costs (1)
- Health Information Technology (HIT) (2)
- Heart Disease and Health (6)
- Hospitalization (4)
- Hospital Readmissions (5)
- Hospitals (9)
- Imaging (1)
- Injuries and Wounds (5)
- Intensive Care Unit (ICU) (3)
- Kidney Disease and Health (4)
- Labor and Delivery (3)
- Long-Term Care (1)
- Medical Errors (11)
- Medical Liability (7)
- Medicare (2)
- Medication (2)
- Medication: Safety (1)
- Methicillin-Resistant Staphylococcus aureus (MRSA) (1)
- Mortality (10)
- Neurological Disorders (1)
- Newborns/Infants (4)
- Nursing (1)
- Nursing Homes (1)
- Obesity (2)
- Orthopedics (1)
- Outcomes (9)
- Patient-Centered Healthcare (1)
- Patient-Centered Outcomes Research (8)
- Patient Safety (38)
- Pneumonia (1)
- Practice Patterns (3)
- Pregnancy (2)
- Prevention (3)
- Provider Performance (1)
- Public Reporting (1)
- Quality Improvement (3)
- Quality Indicators (QIs) (3)
- Quality Measures (3)
- Quality of Care (5)
- Quality of Life (1)
- Research Methodologies (1)
- Respiratory Conditions (1)
- Risk (17)
- Sepsis (1)
- Sexual Health (1)
- Skin Conditions (1)
- Stress (1)
- Surgery (27)
- Teams (2)
- Tools & Toolkits (1)
- Training (1)
- Transitions of Care (1)
- Transplantation (2)
- Trauma (1)
- Treatments (1)
- Urinary Tract Infection (UTI) (1)
- Women (2)
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 25 of 76 Research Studies DisplayedMello MM, Greenberg Y, Senecal SK
Case outcomes in a communication-and-resolution program in New York hospitals.
The researchers sought to determine case outcomes in a communication-and-resolution program (CRP) implemented to respond to adverse events in general surgery. They concluded that the bulk of CRPs' work is in investigating and communicating about events not caused by substandard care. These CRPs were quite successful in handling such events, but less consistent in offering compensation in cases involving substandard care.
AHRQ-funded; R18 HS019505.
Citation: Mello MM, Greenberg Y, Senecal SK .
Case outcomes in a communication-and-resolution program in New York hospitals.
Health Serv Res 2016 Dec;51 Suppl 3:2583-99. doi: 10.1111/1475-6773.12594.
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Keywords: Adverse Events, Communication, Medical Errors, Medical Liability, Surgery
Helmchen LA, Lambert BL, McDonald TB
Changes in physician practice patterns after implementation of a communication-and-resolution program.
The researchers tested if a 2006 communication-and-resolution program to address unexpected adverse outcomes was associated with changes in cost and use trajectories. They found that the intervention hospital recorded an increase in the number of patients with a principal diagnosis of chest pain. Among admitted patients, quarterly growth rates of clinical laboratory and radiology charges at the intervention hospital declined by 3.8 and 6.9 percentage points.
AHRQ-funded; HS019565.
Citation: Helmchen LA, Lambert BL, McDonald TB .
Changes in physician practice patterns after implementation of a communication-and-resolution program.
Health Serv Res 2016 Dec;51 Suppl 3:2516-36. doi: 10.1111/1475-6773.12610.
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Keywords: Adverse Events, Communication, Medical Errors, Medical Liability, Practice Patterns
Burstein PD, Zalenski DM, Edwards JL
Changing labor and delivery practice: focus on achieving practice and documentation standardization with the goal of improving neonatal outcomes.
The researchers established a multifactorial shoulder dystocia response and management protocol to promote sustainable practice change. In the first year, there was a threefold increase in shoulder dystocia reporting, which continued in years 2 and 3. In the first year, 96 percent of clinicians completed all training elements. Overall teams reached a 99 percent adoption rate of the shoulder dystocia protocol.
AHRQ-funded; HS019608.
Citation: Burstein PD, Zalenski DM, Edwards JL .
Changing labor and delivery practice: focus on achieving practice and documentation standardization with the goal of improving neonatal outcomes.
Health Serv Res 2016 Dec;51 Suppl 3:2472-86. doi: 10.1111/1475-6773.12589.
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Keywords: Labor and Delivery, Newborns/Infants, Adverse Events, Quality Improvement, Quality of Care, Patient Safety, Patient-Centered Outcomes Research, Outcomes, Guidelines, Evidence-Based Practice, Pregnancy, Teams
Gallagher TH, Farrell ML, Karson H
Collaboration with regulators to support quality and accountability following medical errors: The Communication and Resolution Program Certification Pilot.
The Medical Quality Assurance Commission (MQAC, board of medicine) in Washington State has collaborated with the Foundation for Health Care Quality (FHCQ) on the CRP Certification pilot. A panel of physicians, risk managers, and patient advocates at FHCQ will review cases for use of the CRP key elements. After describing the process, the authors concluded that the CRP Certification program is a promising example of collaboration among institutions, insurers, and regulators to promote patient-centered accountability and learning following adverse events.
AHRQ-funded; HS019531.
Citation: Gallagher TH, Farrell ML, Karson H .
Collaboration with regulators to support quality and accountability following medical errors: The Communication and Resolution Program Certification Pilot.
Health Serv Res 2016 Dec;51 Suppl 3:2569-82. doi: 10.1111/1475-6773.12557.
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Keywords: Adverse Events, Communication, Medical Errors, Medical Liability, Patient Safety, Quality of Care
Brown JR, Rezaee ME, Marshall EJ
Hospital mortality in the United States following acute kidney injury.
This review discusses the epidemiology of acute kidney injury (AKI) and its association with in-hospital mortality in the United States. Also discussed is the importance of the 71 percent reduction in AKI-related mortality among hospitalized patients in the United States and whether or not this is a phenomenon of hospital billing (coding) or improvements to the management of AKI.
AHRQ-funded; HS018443.
Citation: Brown JR, Rezaee ME, Marshall EJ .
Hospital mortality in the United States following acute kidney injury.
Biomed Res Int 2016;2016:4278579. doi: 10.1155/2016/4278579.
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Keywords: Mortality, Hospitalization, Adverse Events, Patient Safety
Gallagher TH, Etchegaray JM, Bergstedt B
Improving communication and resolution following adverse events using a patient-created simulation exercise.
The HealthPact Patient and Family Advisory Council (PFAC) created and led a five-stage simulation exercise to help stakeholders understand what patients experience following an adverse event. Take-homes from these exercises included the fact that the response to adverse events can be complex, siloed, and uncoordinated. Participating in this simulation exercise led stakeholders and patient advocates to express interest in continued collaboration.
AHRQ-funded; HS019531.
Citation: Gallagher TH, Etchegaray JM, Bergstedt B .
Improving communication and resolution following adverse events using a patient-created simulation exercise.
Health Serv Res 2016 Dec;51 Suppl 3:2537-49. doi: 10.1111/1475-6773.12601.
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Keywords: Adverse Events, Clinician-Patient Communication, Medical Errors, Medical Liability, Patient-Centered Healthcare, Patient Safety
Sentell T, Chang A, Ahn HJ
Maternal language and adverse birth outcomes in a statewide analysis.
The study goal was to consider the relationship of maternal language to birth outcomes using Hawaii’s hospitalization data. It found that non-English speakers had approximately two times higher risk of having an obstetric trauma during a vaginal birth when other factors, including race/ethnicity, were controlled. Non-English speakers also had higher rates of potentially high-risk deliveries.
AHRQ-funded; HS019990; HS021903.
Citation: Sentell T, Chang A, Ahn HJ .
Maternal language and adverse birth outcomes in a statewide analysis.
Women Health 2016;56(3):257-80. doi: 10.1080/03630242.2015.1088114.
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Keywords: Adverse Events, Communication, Labor and Delivery, Outcomes
Battles JB, Reback KA, Azam I
AHRQ Author: Battles JB, Reback KA, Azam I
Paving the way for progress: the Agency for Healthcare Research and Quality Patient Safety and Medical Liability Demonstration Initiative.
AHRQ launched the Patient Safety and Medical Liability (PSML) initiative in 2009. The papers in this issue cover a breadth of topics related to the PSML initiative. Members of the individual Demonstration project teams have authored the majority of the papers. Seven of these papers report outcomes associated with the individual Demonstrations and another four describe tools generated as a part of the interventions.
AHRQ-funded; 233201500029P.
Citation: Battles JB, Reback KA, Azam I .
Paving the way for progress: the Agency for Healthcare Research and Quality Patient Safety and Medical Liability Demonstration Initiative.
Health Serv Res 2016 Dec;51 Suppl 3:2401-13. doi: 10.1111/1475-6773.12632.
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Keywords: Adverse Events, Medical Errors, Medical Liability, Patient Safety, Prevention
Ridgely MS, Greenberg MD, Pillen MB
Progress at the intersection of patient safety and medical liability: insights from the AHRQ Patient Safety and Medical Liability Demonstration Program.
This article identifies lessons learned from the experience of AHRQ’s Patient Safety and Medical Liability (PSML) Demonstration Program. The demonstration lends credence to the idea that targeted interventions that improve some aspect of patient safety or malpractice performance may also contribute more broadly to institutional culture and the alignment of all parties around reducing risk and preventing harm.
AHRQ-funded; 290200710073T.
Citation: Ridgely MS, Greenberg MD, Pillen MB .
Progress at the intersection of patient safety and medical liability: insights from the AHRQ Patient Safety and Medical Liability Demonstration Program.
Health Serv Res 2016 Dec;51 Suppl 3:2414-30. doi: 10.1111/1475-6773.12625.
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Keywords: Patient Safety, Medical Liability, Adverse Events, Medical Errors
Brown JR, Rezaee ME, Hisey WM
Reduced mortality associated with acute kidney injury requiring dialysis in the United States.
The researchers describe the epidemiology of dialysis-requiring acute kidney injury (AKI-D) as well as associated in-hospital mortality in the US. They found that the incidence rate of AKI-D has increased considerably in the US since 2001. However, in-hospital mortality associated with AKI-D hospital admissions has decreased significantly. AHRQ-funded; HS018443.
AHRQ-funded; HS018443.
Citation: Brown JR, Rezaee ME, Hisey WM .
Reduced mortality associated with acute kidney injury requiring dialysis in the United States.
Am J Nephrol 2016;43(4):261-70. doi: 10.1159/000445846.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Adverse Events, Mortality, Patient Safety, Kidney Disease and Health
Beckman MG, Abe K, Barnes K
AHRQ Author: Brady PJ
Strategies and partnerships toward prevention of healthcare-associated venous thromboembolism.
This issue of the Journal of Hospital Medicine showcases the initiatives of several of the CDC’s healthcare-associated venous thromboembolism (HA-VTE) prevention champions. The CDC and AHRQ are partnering to disseminate and promote these best practices. In addition to this challenge, the CDC, AHRQ and the Joint Commission Center for Transforming Healthcare are working on activities and programs dedicated to improving prevention of HA-VTE. They are summarized in the article.
AHRQ-authored.
Citation: Beckman MG, Abe K, Barnes K .
Strategies and partnerships toward prevention of healthcare-associated venous thromboembolism.
J Hosp Med 2016 Dec;11 Suppl 2:S5-s7. doi: 10.1002/jhm.2659.
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Keywords: Prevention, Blood Clots, Quality Improvement, Guidelines, Adverse Events
Rosenberg AS, Ruthazer R, Paulus JK
Survival analyses and prognosis of plasma-cell myeloma and plasmacytoma-like posttransplantation lymphoproliferative disorders.
Multiple myeloma/plasmacytoma-like posttransplantation lymphoproliferative disorder (PTLD-MM) is a rare complication of solid organ transplantation. Case series have shown variable outcomes, and survival data in the modern era are lacking. This study found that age at diagnosis, elevated creatinine, and white race were associated with inferior survival in patients with PTLD-MM.
AHRQ-funded; HS000060.
Citation: Rosenberg AS, Ruthazer R, Paulus JK .
Survival analyses and prognosis of plasma-cell myeloma and plasmacytoma-like posttransplantation lymphoproliferative disorders.
Clin Lymphoma Myeloma Leuk 2016 Dec;16(12):684-92.e3. doi: 10.1016/j.clml.2016.09.002.
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Keywords: Adverse Events, Cancer, Mortality, Transplantation, Outcomes
Lambert BL, Centomani NM, Smith KM
The "Seven Pillars" response to patient safety incidents: effects on medical liability processes and outcomes.
This study's objective was to determine whether a communication and resolution approach to patient harm is associated with changes in medical liability processes and outcomes. It found that the intervention nearly doubled the number of incident reports, halved the number of claims, and reduced legal fees and costs as well as total costs per claim, settlement amounts, and self-insurance costs. The study found that a communication and optimal resolution (CANDOR) approach to adverse events was associated with long-lasting, clinically and financially significant changes in a large set of core medical liability process and outcome measures.
AHRQ-funded; HS019565.
Citation: Lambert BL, Centomani NM, Smith KM .
The "Seven Pillars" response to patient safety incidents: effects on medical liability processes and outcomes.
Health Serv Res 2016 Dec;51 Suppl 3:2491-515. doi: 10.1111/1475-6773.12548.
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Keywords: Adverse Events, Medical Liability, Medical Errors, Communication, Patient Safety
Humble SS, Wilson LD, McKenna JW
Tracheostomy risk factors and outcomes after severe traumatic brain injury.
The researchers sought to determine risk factors associated with tracheostomy placement after severe traumatic brain injury (TBI) and subsequent outcomes among those who did and did not receive a tracheostomy. They concluded that age and insurance status are independently associated with tracheostomy placement, but not with mortality after severe TBI. Tracheostomy placement is associated with increased survival after severe TBI.
AHRQ-funded; HS013833.
Citation: Humble SS, Wilson LD, McKenna JW .
Tracheostomy risk factors and outcomes after severe traumatic brain injury.
Brain Inj 2016;30(13-14):1642-47. doi: 10.1080/02699052.2016.1199915.
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Keywords: Adverse Events, Brain Injury, Outcomes, Risk, Trauma
Pershing S, Morrison DE, Hernandez-Boussard T
Cataract surgery complications and revisit rates among three states.
The authors studied cataract procedures from California, Florida, and New York, to characterize population-based 30-day procedure-related readmissions following surgery. Their results highlight the importance of age as a risk factor for cataract surgery readmissions, and suggest a relationship between black or Hispanic race, Medicaid insurance, and diabetes associated with higher risk for cataract surgery complications.
AHRQ-funded; HS018558.
Citation: Pershing S, Morrison DE, Hernandez-Boussard T .
Cataract surgery complications and revisit rates among three states.
Am J Ophthalmol 2016 Nov;171:130-38. doi: 10.1016/j.ajo.2016.08.036.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Eye Disease and Health, Surgery, Hospital Readmissions, Adverse Events
Kesselheim AS, Bykov K, Gagne JJ
Switching generic antiepileptic drug manufacturer not linked to seizures: a case-crossover study.
The researchers estimated the risk of seizure-related events associated with refilling antiepileptic drugs (AED) with generic AEDs and the effect of switching between different manufacturers of the same generic drug. They found that among patients on a generic AED, refilling the same AED was associated with an elevated risk of seizure-related event; however, there was no additional risk from switching during that refill to a different manufacturer.
AHRQ-funded; HS022193.
Citation: Kesselheim AS, Bykov K, Gagne JJ .
Switching generic antiepileptic drug manufacturer not linked to seizures: a case-crossover study.
Neurology 2016 Oct 25;87(17):1796-801. doi: 10.1212/wnl.0000000000003259.
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Keywords: Adverse Drug Events (ADE), Adverse Events, Medication, Medication: Safety, Neurological Disorders, Patient Safety, Risk
Pradarelli JC, Healy MA, Osborne NH
Variation in Medicare expenditures for treating perioperative complications: the cost of rescue.
The researchers evaluated differences across hospitals in the costs of care for patients surviving perioperative complications after major inpatient surgery. After 4 selected inpatient operations, substantial variation was observed across hospitals regarding Medicare episode payments for patients rescued from perioperative complications. Notably, higher Medicare payments were not associated with improved clinical performance.
AHRQ-funded; HS017765.
Citation: Pradarelli JC, Healy MA, Osborne NH .
Variation in Medicare expenditures for treating perioperative complications: the cost of rescue.
JAMA Surg 2016 Oct 5:e163340. doi: 10.1001/jamasurg.2016.3340.
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Keywords: Medicare, Adverse Events, Surgery, Healthcare Costs, Patient Safety
Strobel RJ, Liang Q, Zhang M
A preoperative risk model for postoperative pneumonia after coronary artery bypass grafting.
The authors developed a preoperative prediction model for postoperative pneumonia after coronary artery bypass grafting (CABG). In this article, they describe and discuss their model, which may be used to provide individualized risk estimation and to identify opportunities to reduce a patient's preoperative risk of pneumonia through prehabilitation.
AHRQ-funded; HS022535.
Citation: Strobel RJ, Liang Q, Zhang M .
A preoperative risk model for postoperative pneumonia after coronary artery bypass grafting.
Ann Thorac Surg 2016 Oct;102(4):1213-9. doi: 10.1016/j.athoracsur.2016.03.074.
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Keywords: Cardiovascular Conditions, Pneumonia, Adverse Events, Risk, Patient Safety
Waljee JF, Ghaferi A, Cassidy R
Are patient-reported outcomes correlated with clinical outcomes after surgery? A population-based study.
The researchers evaluated the extent to which patient-reported outcomes (eg, health-related quality of life) are distinct from clinical outcomes following bariatric surgery. They concluded that patient-reported outcomes are not correlated with early perioperative events, but are correlated with measures of clinical effectiveness after bariatric surgery.
AHRQ-funded; HS023313.
Citation: Waljee JF, Ghaferi A, Cassidy R .
Are patient-reported outcomes correlated with clinical outcomes after surgery? A population-based study.
Ann Surg 2016 Oct;264(4):682-9. doi: 10.1097/sla.0000000000001852.
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Keywords: Surgery, Obesity, Adverse Events, Patient-Centered Outcomes Research, Patient Safety
Ban KA, Cohen ME, Ko CY
Evaluation of the ProPublica surgeon scorecard "Adjusted Complication Rate" measure specifications.
The authors sought to (1) determine the proportion of cases excluded by ProPublica's specifications, (2) assess the proportion of inpatient complications excluded from ProPublica's measure, and (3) examine the validity of ProPublica's outcome measure by comparing performance on the measure to well-established postoperative outcome measures. They found that ProPublica's outcome measure specifications exclude 82% of cases, miss 84% of postoperative complications, and correlate poorly with well-established postoperative outcomes.
AHRQ-funded; HS021857.
Citation: Ban KA, Cohen ME, Ko CY .
Evaluation of the ProPublica surgeon scorecard "Adjusted Complication Rate" measure specifications.
Ann Surg 2016 Oct;264(4):566-74. doi: 10.1097/sla.0000000000001858.
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Keywords: Adverse Events, Outcomes, Public Reporting, Quality Measures, Surgery
Krouss M, Croft L, Morgan DJ
Physician understanding and ability to communicate harms and benefits of common medical treatments.
The researchers evaluated physician understanding of harms and benefits of common tests and therapies. They found that most clinicians overestimate harms and benefits for most treatments. Likewise, most of the clinicians in our study reported rarely or never using statistical terms to explain treatment options to patients. However, they were interested in resources to improve understanding of treatment effect size.
AHRQ-funded; HS018111.
Citation: Krouss M, Croft L, Morgan DJ .
Physician understanding and ability to communicate harms and benefits of common medical treatments.
JAMA Intern Med 2016 Oct;176(10):1565-67. doi: 10.1001/jamainternmed.2016.5027.
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Keywords: Adverse Events, Communication, Education: Patient and Caregiver, Patient Safety, Clinician-Patient Communication
Morris MS, Graham LA, Richman JS
Postoperative 30-day readmission: time to focus on what happens outside the hospital.
The authors of this study aimed to understand the relative contribution of preoperative patient factors, operative characteristics, and postoperative hospital course on 30-day postoperative readmissions. They found that although postoperative readmissions are difficult to predict at the time of discharge, preoperative factors are the most important.
AHRQ-funded; HS013852.
Citation: Morris MS, Graham LA, Richman JS .
Postoperative 30-day readmission: time to focus on what happens outside the hospital.
Ann Surg 2016 Oct;264(4):621-31. doi: 10.1097/sla.0000000000001855.
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Keywords: Hospital Readmissions, Surgery, Adverse Events, Risk, Risk
Tedesco D, Hernandez-Boussard T, Carretta E
Evaluating patient safety indicators in orthopedic surgery between Italy and the USA.
The authors compared patient safety in major orthopedic procedures between an orthopedic hospital in Italy and 26 Florida hospitals of similar size. AHRQ Patient Safety Indicators (PSIs) were used to identify inpatient adverse events (AEs). They found that US patients had lower adjusted odds of developing a PSI compared to Italy for pressure ulcers, hemorrhage or hematoma, and physiologic and metabolic derangement. while Italian patients had lower odds of pulmonary embolism/deep vein thrombosis compared to US patients.
AHRQ-funded; HS018558.
Citation: Tedesco D, Hernandez-Boussard T, Carretta E .
Evaluating patient safety indicators in orthopedic surgery between Italy and the USA.
Int J Qual Health Care 2016 Sep;28(4):486-91. doi: 10.1093/intqhc/mzw053.
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Keywords: Adverse Events, Orthopedics, Patient Safety, Quality Indicators (QIs), Surgery
Mueller SK, Schnipper JL, Giannelli K
Impact of regionalized care on concordance of plan and preventable adverse events on general medicine services.
This study regionalized 3 inpatient general medical teams to nursing units and examined the association with communication and preventable adverse events (AEs). It found that regionalization of care teams improved recognition of care team members, discussion of daily care plan, and agreement on estimated discharge date, but did not significantly improve nurse and physician concordance of the care plan or reduce the odds of preventable AEs.
AHRQ-funded; HS023331.
Citation: Mueller SK, Schnipper JL, Giannelli K .
Impact of regionalized care on concordance of plan and preventable adverse events on general medicine services.
J Hosp Med 2016 Sep;11(9):620-7. doi: 10.1002/jhm.2566.
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Keywords: Adverse Events, Communication, Hospitals, Patient Safety, Teams
Dimou FM, Adhikari D, Mehta HB
Incidence of hepaticojejunostomy stricture after hepaticojejunostomy.
The authors aimed to determine the timing, incidence, and management of stricture after biliary-enteric anastomosis. They found that younger age was associated with a decreased likelihood of stricture formation and that the presence of an endostent predicted stricture formation. They concluded that biliary-enteric anastomotic strictures occur with significant frequency after a biliary-enteric anastomosis, and that while many patients are managed nonoperatively, stricture diagnosis remains burdensome.
AHRQ-funded; HS022134.
Citation: Dimou FM, Adhikari D, Mehta HB .
Incidence of hepaticojejunostomy stricture after hepaticojejunostomy.
Surgery 2016 Sep;160(3):691-8. doi: 10.1016/j.surg.2016.05.021.
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Keywords: Surgery, Adverse Events, Digestive Disease and Health, Elderly, Patient-Centered Outcomes Research