National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Cancer (1)
- Digestive Disease and Health (1)
- Education: Continuing Medical Education (1)
- Evidence-Based Practice (2)
- Healthcare Costs (2)
- Health Services Research (HSR) (1)
- Hospital Discharge (1)
- Hospitals (1)
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- (-) Quality of Care (9)
- Rehabilitation (1)
- (-) Surgery (9)
- Transitions of Care (1)
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 9 of 9 Research Studies DisplayedHornor MA, Liu JY, Hu QL
Surgical technical evidence review for acute appendectomy conducted for the Agency for Healthcare Research and Quality Safety Program for Improving Surgical Care and Recovery.
This evidence review uses enhanced recovery pathways (ERPs) protocols developed for the AHRQ-funded Safety Program for Improving Surgical Care and Recovery (ISCR Program) to develop ERPs for acute appendectomy surgery. The authors classified appendicitis into uncomplicated (nonperforated) and complicated (perforated or gangrenous) to help with risk stratification. They identified 13 components for appendectomy for review. The processes are organized by perioperative phase, and each phase includes the rationale, evidence review, summary of guidelines, and a recommendation summary of the evidence for or against inclusion in the ERP. Preoperative management components included: education and counseling; preoperative antibiotics; initial nonsurgical management for perforated appendicitis with abscess or phlegmon, venous thromboembolism prophylaxis, delay for operation for 12-24 hours for uncomplicated appendicitis. Intraoperative management components include: laparoscopic surgical technique, peritoneal drain placement, urinary catheter placement, and prophylactic nasogastric tube insertion. Postoperative management components include same-day surgery discharge for uncomplicated appendicitis, antibiotics, early oral alimentation, and early mobilization. Of the ERPs reviewed: there was no evidence to support the routine use of abdominal drainage in patients undergoing appendectomies, urinary catheter insertion for laparoscopic surgery, use of prophylactic nasogastric tube placement, postoperative antibiotic use for uncomplicated appendicitis, and early oral alimentation for uncomplicated appendicitis.
AHRQ-funded.
Citation: Hornor MA, Liu JY, Hu QL .
Surgical technical evidence review for acute appendectomy conducted for the Agency for Healthcare Research and Quality Safety Program for Improving Surgical Care and Recovery.
J Am Coll Surg 2018 Dec;227(6):605-17.e2. doi: 10.1016/j.jamcollsurg.2018.09.024..
Keywords: Surgery, Quality Improvement, Quality of Care, Patient Safety, Evidence-Based Practice, Patient-Centered Outcomes Research, Outcomes
Balentine CJ, Kenzik K, Chu DI
Planning post-discharge destination for gastrointestinal surgery patients: room for improvement?
Investigators compared short-term recovery for patients discharged to inpatient rehabilitation versus skilled nursing facilities after gastrointestinal surgery. They found that there was no difference in 30-day readmission rates, but post-discharge mortality was higher for patients discharged to skilled nursing facilities compared to inpatient rehabilitation.
AHRQ-funded; HS023009.
Citation: Balentine CJ, Kenzik K, Chu DI .
Planning post-discharge destination for gastrointestinal surgery patients: room for improvement?
Am J Surg 2018 Nov;216(5):912-18. doi: 10.1016/j.amjsurg.2018.05.004..
Keywords: Hospital Discharge, Surgery, Digestive Disease and Health, Rehabilitation, Nursing Homes, Quality Improvement, Quality of Care, Transitions of Care
Likosky DS, Harrington SD, Cabrera L
Collaborative quality improvement reduces postoperative pneumonia after isolated coronary artery bypass grafting surgery.
This study examined post cardiac surgery pneumonia rates associated with participation in a statewide, quality improvement collaborative relative to a national physician reporting program. The investigators concluded that participation in a physician-led collaborative was associated with significant reductions in pneumonia relative to a national quality reporting program. They suggest that interventions including collaborative learning may yield superior outcomes relative to solely using physician feedback reporting.
AHRQ-funded; HS022535.
Citation: Likosky DS, Harrington SD, Cabrera L .
Collaborative quality improvement reduces postoperative pneumonia after isolated coronary artery bypass grafting surgery.
Circ Cardiovasc Qual Outcomes 2018 Nov;11(11):e004756. doi: 10.1161/circoutcomes.118.004756..
Keywords: Outcomes, Patient Safety, Pneumonia, Quality of Care, Quality Improvement, Surgery
Quinn CM, Bilimoria KY, Chung JW
Creating individual surgeon performance assessments in a statewide hospital surgical quality improvement collaborative.
In this study, the investigators sought to create surgeon-level comparative assessments within the Illinois Surgical Quality Improvement Collaborative. The investigators found that few individual surgeon performance outliers could be detected in NSQIP clinical registry data for a statewide hospital collaborative over a 30-month period using postoperative patient outcomes. The authors suggest that low surgeon-specific case volumes and minimal variance between surgeons may limit the utility of American College of Surgeons NSQIP outcomes measures for individual profiling.
AHRQ-funded; HS024516.
Citation: Quinn CM, Bilimoria KY, Chung JW .
Creating individual surgeon performance assessments in a statewide hospital surgical quality improvement collaborative.
J Am Coll Surg 2018 Sep;227(3):303-12.e3. doi: 10.1016/j.jamcollsurg.2018.06.002..
Keywords: Quality of Care, Provider Performance, Quality Improvement, Surgery
Greenberg CC, Ghousseini HN, Pavuluri Quamme SR
A statewide surgical coaching program provides opportunity for continuous professional development.
Researchers sought to develop and evaluate a video-based coaching program for board-eligible/certified surgeons. They found that, overall, participants were satisfied with their experience and found the coaching program valuable. Future research to evaluate the impact of coaching on practice change and patient outcomes is recommended.
AHRQ-funded; HS022403.
Citation: Greenberg CC, Ghousseini HN, Pavuluri Quamme SR .
A statewide surgical coaching program provides opportunity for continuous professional development.
Ann Surg 2018 May;267(5):868-73. doi: 10.1097/sla.0000000000002341..
Keywords: Education: Continuing Medical Education, Health Services Research (HSR), Patient Safety, Provider, Provider: Physician, Quality of Care, Surgery
Chen LM, Ryan AM, Shih T
Medicare's acute care episode demonstration: effects of bundled payments on costs and quality of surgical care.
This study evaluated whether participation in Medicare's Acute Care Episode (ACE) Demonstration Program-an early, small, voluntary episode-based payment program-was associated with a change in expenditures or quality of care. Participation in Medicare's ACE Demonstration Program was not associated with a change in 30-day episode-based Medicare payments or 30-day mortality for cardiac or orthopedic surgery, but it was associated with lower total 30-day post-acute care payments.
AHRQ-funded; HS018546; HS024698; HS020671.
Citation: Chen LM, Ryan AM, Shih T .
Medicare's acute care episode demonstration: effects of bundled payments on costs and quality of surgical care.
Health Serv Res 2018 Apr;53(2):632-48. doi: 10.1111/1475-6773.12681.
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Keywords: Healthcare Costs, Payment, Quality of Care, Surgery
Sawyer JM, Anton NE, Korndorffer JR
Time crunch: increasing the efficiency of assessment of technical surgical skill via brief video clips.
Video review for assessment of surgical performance is gaining popularity but is time consuming for busy expert reviewers, making review delays inevitable. The study authors hypothesized that a shorter duration video clip would not affect the quality of expert ratings compared with full-length review. Their hypothesis was rejected as shorter video durations for surgical performance assessment led to inflated reviewer ratings both for expert and novice reviewers. They concluded that shortening duration of the video could not be recommended for accurate performance assessment.
AHRQ-funded; HS022080.
Citation: Sawyer JM, Anton NE, Korndorffer JR .
Time crunch: increasing the efficiency of assessment of technical surgical skill via brief video clips.
Surgery 2018 Apr;163(4):933-37. doi: 10.1016/j.surg.2017.11.011..
Keywords: Surgery, Quality of Care, Provider Performance, Quality Measures
Shubeck SP, Thumma JR, Dimick JB
Hospital quality, patient risk, and Medicare expenditures for cancer surgery.
The authors evaluated the potential interactive effect of hospital quality and patient risk on expenditures for cancer resections. They found that the total episode expenditures for cancer resections were lower when care was delivered at low-complication, high-quality hospitals. Expenditure differences were particularly large for high-risk patients, suggesting that the selective referral of high-risk patients to high-quality centers may be an effective strategy for optimizing value in cancer surgery.
AHRQ-funded; HS024763.
Citation: Shubeck SP, Thumma JR, Dimick JB .
Hospital quality, patient risk, and Medicare expenditures for cancer surgery.
Cancer 2018 Feb 15;124(4):826-32. doi: 10.1002/cncr.31120.
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Keywords: Cancer, Healthcare Costs, Quality of Care, Hospitals, Surgery
Childers CP, Siletz AE, Singer ES
Surgical technical evidence review for elective total joint replacement conducted for the AHRQ Safety Program for Improving Surgical Care and Recovery.
AHRQ, the American College of Surgeons, and the Johns Hopkins Medicine Armstrong Institute for Patent Safety and Quality have developed the Safety Program for Improving Surgical Care and Recovery - a national effort to catalyze implementation of practices to improve perioperative care and enhance recovery of surgical patients. This review synthesizes evidence that can be used to develop a protocol for elective total knee arthroplasty and total hip arthroplasty.
AHRQ-funded; 233201500020I.
Citation: Childers CP, Siletz AE, Singer ES .
Surgical technical evidence review for elective total joint replacement conducted for the AHRQ Safety Program for Improving Surgical Care and Recovery.
Geriatr Orthop Surg Rehabil 2018 Feb 12;9:2151458518754451. doi: 10.1177/2151458518754451.
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Keywords: Evidence-Based Practice, Orthopedics, Patient Safety, Surgery, Quality Improvement, Quality of Care, Patient-Centered Outcomes Research