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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 16 of 16 Research Studies DisplayedYang AD, Quinn CM, Hewitt DB
National evaluation of needlestick events and reporting among surgical residents.
Needlestick injuries pose significant health hazards; however, the nationwide frequency of needlesticks and reporting practices among surgical residents are unknown. The objectives of this study were to examine the rate and circumstances of self-reported needlestick events in US surgery residents, assess factors associated with needlestick injuries, evaluate reporting practices, and identify reporting barriers.
AHRQ-funded; HS000078.
Citation: Yang AD, Quinn CM, Hewitt DB .
National evaluation of needlestick events and reporting among surgical residents.
J Am Coll Surg 2019 Dec;229(6):609-20. doi: 10.1016/j.jamcollsurg.2019.09.001..
Keywords: Education: Continuing Medical Education, Surgery, Injuries and Wounds, Provider
DiBrito SR, Bowring MG, Holscher CM
Acute care surgery for transplant recipients: a national survey of surgeon perspectives and practices.
This study is a survey of acute care surgeons (ACS) and transplant surgeons on their attitudes as to who would feel comfortable operating on transplant patients for nontransplant-related issues. The researchers conducted a national survey of ACS and transplant surgeons and obtained 230 ACS responses and 240 from transplant surgeons. While both ACS and transplant surgeons felt care is better at transplant centers and if the patient requires acute surgery they should be transferred to a transplant center, the ACS still felt comfortable operating and performing laparoscopy on transplant recipients.
Citation: DiBrito SR, Bowring MG, Holscher CM .
Acute care surgery for transplant recipients: a national survey of surgeon perspectives and practices.
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Keywords: Transplantation, Surgery, Provider: Physician, Provider, Practice Patterns
Vitous CA, Shubeck S, Kanters A
Reflections on a leadership development program: Impacts on culture in a surgical environment.
Although a growing body of literature has focused on the impacts leadership development programs have had on the individual surgeon, little effort has been focused on understanding the impacts these programs have had on surgical culture. The purpose of this study was to explore the impacts of implementing a leadership development program on the culture of the Department of Surgery at University of Michigan, Ann Arbor.
AHRQ-funded; HS000053.
Citation: Vitous CA, Shubeck S, Kanters A .
Reflections on a leadership development program: Impacts on culture in a surgical environment.
Surgery 2019 Nov;166(5):721-25. doi: 10.1016/j.surg.2019.05.015..
Keywords: Surgery, Provider: Physician, Provider
Hu YY, Ellis RJ, Hewitt DB
Discrimination, Abuse, Harassment, and Burnout in Surgical Residency Training.
A cross-sectional national survey of general surgery residents, administered with the 2018 American Board of Surgery In-Training Examination, assessed mistreatment, burnout, and suicidal thoughts during the past year. The authors assessed the association of mistreatment with burnout and suicidal thoughts; they found that mistreatment occurs frequently among general surgery residents, especially women, and is associated with burnout and suicidal thoughts.
AHRQ-funded; HS000078.
Citation: Hu YY, Ellis RJ, Hewitt DB .
Discrimination, Abuse, Harassment, and Burnout in Surgical Residency Training.
N Engl J Med 2019 Oct 31;381(18):1741-52. doi: 10.1056/NEJMsa1903759..
Keywords: Education: Continuing Medical Education, Burnout, Stress, Surgery, Provider: Physician, Provider, Training
Childers CP, Hofer IS, Cheng DS
Evaluating surgeons on intraoperative disposable supply costs: details matter.
Cost report cards have demonstrated variation in intraoperative supply costs and may allow comparisons between surgeons. However, cost data are complex and, if not properly vetted, may be inaccurate. In this study, a retrospective assessment of intraoperative supply costs for consecutive laparoscopic cholecystectomies (2013-2017) at a 4-facility academic center was performed. The investigators concluded that evaluating surgeons based on intraoperative supply costs was sensitive to analytic methods.
AHRQ-funded; HS025079.
Citation: Childers CP, Hofer IS, Cheng DS .
Evaluating surgeons on intraoperative disposable supply costs: details matter.
J Gastrointest Surg 2019 Oct;23(10):2054-62. doi: 10.1007/s11605-018-3889-4..
Keywords: Healthcare Costs, Provider, Provider: Physician, Surgery
Vemulakonda VM, Hamer MK, Kempe A
Surgical decision-making in infants with suspected UPJ obstruction: stakeholder perspectives.
Although there are significant demographic and clinical variations in treatment decisions for infants with high-grade hydronephrosis concerning for ureteropelvic junction obstruction (UPJO), there has been little research on the roles of parents and surgeons in the surgical decision-making (DM) process. The purpose of this study was to understand parents' and surgeons' perceived roles in the surgical DM process for infants with high-grade hydronephrosis.
AHRQ-funded; HS024597.
Citation: Vemulakonda VM, Hamer MK, Kempe A .
Surgical decision-making in infants with suspected UPJ obstruction: stakeholder perspectives.
J Pediatr Urol 2019 Oct;15(5):469.e1-69.e9. doi: 10.1016/j.jpurol.2019.05.027..
Keywords: Newborns/Infants, Decision Making, Surgery, Kidney Disease and Health, Caregiving, Provider: Physician, Provider, Patient and Family Engagement
Oslock WM, Paredes AZ, Baselice HE
Women surgeons and the emergence of acute care surgery programs.
The authors sought to examine predictors of women surgeons in emergency general surgery (EGS) generally, and in acute care surgery (ACS) particularly. They found that 50.4% of hospitals studied had zero women surgeons. Women were more likely to be among EGS surgeons at hospitals with ACS models. They concluded that their study highlighted the dearth of women representation within EGS hospitals nationally and illuminated some of the underlying characteristics of ACS that may draw women: urban, academic, and staffed by more recently trained surgeons.
AHRQ-funded; HS022694.
Citation: Oslock WM, Paredes AZ, Baselice HE .
Women surgeons and the emergence of acute care surgery programs.
Am J Surg 2019 Oct;218(4):803-08. doi: 10.1016/j.amjsurg.2019.07.008..
Keywords: Surgery, Provider: Physician, Provider, Emergency Department
Hoonakker PLT, Wooldridge AR, Hose BZ
Information flow during pediatric trauma care transitions: things falling through the cracks.
In order to investigate information flow during pediatric trauma care transitions, researchers interviewed 18 clinicians about communication and coordination between the emergency department, operating room, and pediatric intensive care unit, then surveyed the clinicians about patient safety during these transitions. They found that, despite the fact that the many services and units involved in pediatric trauma cooperate well together during trauma cases, important patient care information is often lost when transitioning patients between units. To manage the transition of this fragile and complex population better, they recommend finding ways to manage the information flow during these transitions better by, for instance, providing technological support to ensure shared mental models.
AHRQ-funded; HS023837.
Citation: Hoonakker PLT, Wooldridge AR, Hose BZ .
Information flow during pediatric trauma care transitions: things falling through the cracks.
Intern Emerg Med 2019 Aug;14(5):797-805. doi: 10.1007/s11739-019-02110-7..
Keywords: Children/Adolescents, Communication, Emergency Department, Healthcare Delivery, Intensive Care Unit (ICU), Patient Safety, Provider, Provider: Clinician, Surgery, Transitions of Care, Trauma
Ranganathan K, Kochkodan JM, Baker MK
Variation in the desire for cleft revision surgery among children, caregivers, and surgeons.
This study examined the differences in perception between children, caregivers, and their surgeons for the need for cleft revision surgery. A sample of 100 children with cleft lip and/or cleft palate and their caregivers (n=100) were surveyed on satisfaction with appearance using the Cleft Evaluation Profile. Ten surgeons and ten control observers then rated photographs of these children using questions analogous to the Profile. The children generally reported greater satisfaction in appearance across all domains compared with surgeons. Children and caregivers had similar degrees of satisfaction in appearance of the lip and maxilla. The authors concluded that more care must be given to children’s perception before moving forward with further revision surgery.
AHRQ-funded; HS023313.
Citation: Ranganathan K, Kochkodan JM, Baker MK .
Variation in the desire for cleft revision surgery among children, caregivers, and surgeons.
Plast Reconstr Surg 2019 Jul;144(1):171-78. doi: 10.1097/prs.0000000000005722..
Keywords: Caregiving, Children/Adolescents, Surgery, Provider, Provider: Physician
Anton NE, Mizota T, Whiteside JA
Mental skills training limits the decay in operative technical skill under stressful conditions: results of a multisite, randomized controlled study.
The authors hypothesize that surgery residents trained on mental skills would outperform controls under increased stress conditions in the simulated operating room. They find that their comprehensive mental skills curriculum implemented with surgery residents at two institutions was effective at minimizing the deterioration of resident technical performance under stressful conditions compared with controls. They conclude that their results provide further evidence for the effectiveness of mental skills training to optimize surgery trainees' technical performance during challenging clinical situations.
AHRQ-funded; R18 HS022080.
Citation: Anton NE, Mizota T, Whiteside JA .
Mental skills training limits the decay in operative technical skill under stressful conditions: results of a multisite, randomized controlled study.
Surgery 2019 Jun;165(6):1059-64. doi: 10.1016/j.surg.2019.01.011..
Keywords: Surgery, Education: Continuing Medical Education, Stress, Provider Performance, Training, Provider: Physician, Provider
Martin JR, Anton N, Timsina L
Performance variability during training on simulators is associated with skill transfer.
Researchers looked at performance variability during training on simulators for performing laparoscopic surgery. Their hypothesis was that participants (surgery residents and medical students) who had consistent scores were most likely to have the most expertise and be capable of training others. The trainees first used the Fundamentals of Laparoscopic Surgery (FLS) simulator to learn laparoscopic suturing and then were transfer tested on a live, anesthetized porcine model. Their hypothesis was proven true and those with decreased practice variability was associated with greater scores in posttests and transfer tests.
AHRQ-funded; R18 HS022080.
Citation: Martin JR, Anton N, Timsina L .
Performance variability during training on simulators is associated with skill transfer.
Surgery 2019 Jun;165(6):1065-68. doi: 10.1016/j.surg.2019.01.013..
Keywords: Simulation, Training, Surgery, Education: Continuing Medical Education, Provider Performance, Provider: Physician, Provider
Vergis A, Hardy K, Stogryn S
Fellow and attending surgeon operative notes are deficient in reporting established quality indicators for Roux-en-y gastric bypass: a preliminary retrospective analysis of operative dictation.
This retrospective analysis investigated the completeness of reporting documentation for Roux-en-Y Gastric Bypass (RYGB) surgery. A total of 40 bariatric fellow and 40 attending RYGB narrative reports were analyzed. Fellows had a mean completion rate of 66.4% compared to 61.5% for attendings. Fellows also did a better job of completing subsections, with the exception of closure details. This information is important to communicating operative events and can make an impact on patient safety and quality.
AHRQ-funded; HS018546.
Citation: Vergis A, Hardy K, Stogryn S .
Fellow and attending surgeon operative notes are deficient in reporting established quality indicators for Roux-en-y gastric bypass: a preliminary retrospective analysis of operative dictation.
Cureus 2019 Apr 24;11(4):e4535. doi: 10.7759/cureus.4535..
Keywords: Obesity, Quality of Care, Quality Indicators (QIs), Patient Safety, Provider, Provider: Physician, Surgery
Frasier LL, Pavuluri Quamme SR, Ma Y
Familiarity and communication in the operating room.
Researchers sought to evaluate the relationship between familiarity, communication rates, and communication ineffectiveness of health care providers in the operating room. They found that team members do not compensate for unfamiliarity by increasing their verbal communication, and dyad familiarity is not protective against ineffective communication. Cross-disciplinary communication remains vulnerable in the operating room, suggesting poor crosstalk across disciplines in the operative setting. They recommended further investigation to explore these relationships and identify effective interventions, ensuring that all team members have the necessary information to optimize their performance.
AHRQ-funded; HS022403.
Citation: Frasier LL, Pavuluri Quamme SR, Ma Y .
Familiarity and communication in the operating room.
J Surg Res 2019 Mar;235:395-403. doi: 10.1016/j.jss.2018.09.079..
Keywords: Communication, Patient Safety, Surgery, Teams, Provider: Physician, Provider
Azari DP, Fraiser LL, Quamme SRP
Modeling surgical technical skill using expert assessment for automated computer rating.
The authors used computer vision to predict expert performance ratings from surgeon hand motions for tying and suturing tasks. Open surgeries were video recorded, and surgeon hands tracked without using sensors or markers. The authors found that the computer algorithm consistently predicted the panel ratings of individual tasks, and were more objective and reliable than individual assessment by surgical experts.
AHRQ-funded; F32 HS022403.
Citation: Azari DP, Fraiser LL, Quamme SRP .
Modeling surgical technical skill using expert assessment for automated computer rating.
Ann Surg 2019 Mar;269(3):574-81. doi: 10.1097/sla.0000000000002478..
Keywords: Surgery, Provider Performance, Provider: Physician, Provider
Tong BC, Kim S, Kosinski A
Penetration, completeness, and representativeness of the Society of Thoracic Surgeons General Thoracic Surgery Database for lobectomy.
Not all surgeons performing lobectomy in the United States report outcomes to The Society of Thoracic Surgeons General Thoracic Surgery Database (STS GTSD). In this study, the investigators examined penetration, completeness, and representativeness of the STS GTSD for lobectomy in the Centers for Medicare and Medicaid Services (CMS) patient population. The investigators concluded that participation in the STS GTSD increased over time, but penetration lagged behind that of the other STS National Databases.
AHRQ-funded; HS022279.
Citation: Tong BC, Kim S, Kosinski A .
Penetration, completeness, and representativeness of the Society of Thoracic Surgeons General Thoracic Surgery Database for lobectomy.
Ann Thorac Surg 2019 Mar;107(3):897-902. doi: 10.1016/j.athoracsur.2018.07.059..
Keywords: Surgery, Cancer: Lung Cancer, Cancer, Data, Provider: Physician, Provider
Anton NE, Mizota T, Timsina LR
Attentional selectivity, automaticity, and self-efficacy predict simulator-acquired skill transfer to the clinical environment.
The objective of this study was to identify trainee characteristics that predict the transfer of simulator-acquired skill to the operating room. The investigators concluded that promoting automaticity, self-efficacy, and attention selectivity may help improve the transfer of simulator-acquired skill. They indicated that mental skills training and training to automaticity may therefore be valuable interventions to achieve this goal.
AHRQ-funded; HS022080.
Citation: Anton NE, Mizota T, Timsina LR .
Attentional selectivity, automaticity, and self-efficacy predict simulator-acquired skill transfer to the clinical environment.
Am J Surg 2019 Feb;217(2):266-71. doi: 10.1016/j.amjsurg.2018.11.028..
Keywords: Education: Continuing Medical Education, Patient Safety, Provider, Provider: Physician, Simulation, Surgery, Training