National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Ambulatory Care and Surgery (1)
- Cancer (1)
- Cardiovascular Conditions (1)
- Children/Adolescents (1)
- Diagnostic Safety and Quality (4)
- Elderly (2)
- Emergency Department (2)
- Evidence-Based Practice (2)
- Falls (2)
- Healthcare Delivery (1)
- Health Systems (1)
- Hospitals (4)
- Imaging (1)
- Injuries and Wounds (2)
- Inpatient Care (1)
- Intensive Care Unit (ICU) (1)
- Medicare (1)
- Neonatal Intensive Care Unit (NICU) (1)
- Neurological Disorders (1)
- Newborns/Infants (1)
- Nursing (3)
- Nursing Homes (1)
- Outcomes (1)
- Patient-Centered Outcomes Research (2)
- Patient Experience (1)
- Practice Patterns (1)
- Pressure Ulcers (1)
- Prevention (1)
- Primary Care (1)
- Provider (1)
- Provider: Nurse (1)
- Provider Performance (3)
- Public Reporting (1)
- Quality Improvement (3)
- (-) Quality Indicators (QIs) (13)
- Quality Measures (10)
- (-) Quality of Care (13)
- Respiratory Conditions (1)
- Skin Conditions (1)
- Social Determinants of Health (1)
- Stroke (1)
- Surgery (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 13 of 13 Research Studies DisplayedAgniel D, Haviland A, Shekelle P
Distinguishing high-performing health systems using a composite of publicly reported measures of ambulatory care.
The purpose of this study was to develop and evaluate a measure that ranks health care systems by ambulatory care quality. The authors concluded that their measure, using publicly reported data to produce valid, reliable, and stable ranks of ambulatory care quality for health care systems in Minnesota and California, could also be used in other applications.
AHRQ-funded; HS024067.
Citation: Agniel D, Haviland A, Shekelle P .
Distinguishing high-performing health systems using a composite of publicly reported measures of ambulatory care.
Ann Intern Med 2020 Nov 17;173(10):791-98. doi: 10.7326/m20-0718..
Keywords: Health Systems, Ambulatory Care and Surgery, Quality Indicators (QIs), Quality Measures, Quality of Care, Provider Performance, Healthcare Delivery
Bryan MA, Tyler A, Zhou C
Associations between quality measures and outcomes for children hospitalized with bronchiolitis.
The authors used adherence to the Pediatric Respiratory Illness Measurement System (PRIMES) indicators to evaluate the strength of associations for individual indicators with length of stay (LOS) and cost for bronchiolitis. They found that three indicators were significantly associated with shorter LOS and lower cost, while two underuse indicators were associated with higher cost. They concluded that a subset of PRIMES quality indicators for bronchiolitis were strongly associated with improved outcomes and can serve as important measures for future quality improvement efforts.
AHRQ-funded; HS026512.
Citation: Bryan MA, Tyler A, Zhou C .
Associations between quality measures and outcomes for children hospitalized with bronchiolitis.
Hosp Pediatr 2020 Nov;10(11):932-40. doi: 10.1542/hpeds.2020-0175..
Keywords: Children/Adolescents, Respiratory Conditions, Hospitals, Quality Indicators (QIs), Quality Measures, Quality of Care
Fernald DH, Mullen R,, Hall T
Exemplary practices in cardiovascular care: results on clinical quality measures from the EvidenceNOW Southwest Cooperative.
The authors identified practice characteristics associated with high performance on four cardiovascular disease cardiovascular clinical quality measures (CQMs). They found that multiple strategies - registries, prompts and protocols, patient self-management support, and patient-team partnership activities - were associated with delivering high-quality cardiovascular care over time, measured by CQMs.
AHRQ-funded; HS023904.
Citation: Fernald DH, Mullen R,, Hall T .
Exemplary practices in cardiovascular care: results on clinical quality measures from the EvidenceNOW Southwest Cooperative.
J Gen Intern Med 2020 Nov;35(11):3197-204. doi: 10.1007/s11606-020-06094-5..
Keywords: Cardiovascular Conditions, Quality Indicators (QIs), Quality Measures, Quality Improvement, Quality of Care, Evidence-Based Practice, Patient-Centered Outcomes Research, Primary Care
Jin B, Nembhard IM
Voluntary hospital reporting of performance in cancer care: does volume make a difference?
The authors hypothesized that patient volume is positively associated with both reporting and performance in cancer care. Studying 72 Pennsylvania hospitals accredited by the Commission on Cancer, they found that hospitals that publicly reported their performance had higher patient volumes than hospitals that did not release performance. Among reporting hospitals, no association was found between patient volume and performance on process of care metrics, suggesting that volume is not a predictor of performance for reporting hospitals. They recommended further research to identify other factors that differentiate performance within and across reporting and nonreporting hospitals.
AHRQ-funded; HS017589.
Citation: Jin B, Nembhard IM .
Voluntary hospital reporting of performance in cancer care: does volume make a difference?
J Healthc Qual 2020 Nov/Dec;42(6):e75-e82. doi: 10.1097/jhq.0000000000000225..
Keywords: Cancer, Provider Performance, Hospitals, Quality Indicators (QIs), Quality Measures, Quality of Care
Lake ET, Staiger DO, Cramer E
Association of patient acuity and missed nursing care in U.S. neonatal intensive care units.
The health outcomes of infants in neonatal intensive care units (NICUs) may be jeopardized when required nursing care is missed. The authors conducted a correlational study of using 2016 NICU registered nurse survey responses from the National Database of Nursing Quality Indicators. They found that 36% of nurses missed one or more care activities on their past shift. The most common activities missed involved patient comfort and counseling and parent education. They recommended that nurses' assignments account for patient acuity. NICU nurse staffing and work environments warrant attention to reduce missed care and promote optimal infant and family outcomes.
AHRQ-funded; HS024918.
Citation: Lake ET, Staiger DO, Cramer E .
Association of patient acuity and missed nursing care in U.S. neonatal intensive care units.
Med Care Res Rev 2020 Oct;77(5):451-60. doi: 10.1177/1077558718806743..
Keywords: Newborns/Infants, Neonatal Intensive Care Unit (NICU), Intensive Care Unit (ICU), Nursing, Quality Indicators (QIs), Quality of Care
Burns Z, Khasnabish S, Hurley AC
Classification of injurious fall severity in hospitalized adults.
The purpose of this project was to refine the National Database of Nursing Quality Indicators Major injury classification to derive a valid and reliable categorization of the types and severities of Major inpatient fall-related injuries. Three subcategories were created: A - injuries that caused temporary functional impairment, major facial injury without internal injury, or disruption of a surgical wound; B - injuries that caused long-term functional impairment or had the potential risk of increased mortality; and C - injuries that had a well-established risk of mortality. These subcategories enhanced the National Database of Nursing Quality Indicators categorization. Using this project’s administration manual, trained personnel can classify injurious fall severity with excellent reliability.
AHRQ-funded; HS025128.
Citation: Burns Z, Khasnabish S, Hurley AC .
Classification of injurious fall severity in hospitalized adults.
J Gerontol A Biol Sci Med Sci 2020 Sep 25;75(10):e138-e44. doi: 10.1093/gerona/glaa004..
Keywords: Elderly, Falls, Injuries and Wounds, Nursing, Quality Measures, Quality Indicators (QIs), Quality of Care, Inpatient Care
Aragaki D, Basu A, Conlon C
Quality of electrodiagnostic testing for carpal tunnel syndrome: adherence to quality measures.
This study examined the quality of electrodiagnostic testing for carpal tunnel syndrome (CTS). The authors prospectively recruited 477 adults with workers’ compensation claims for CTS from 30 occupational health clinics and evaluated whether electrodiagnostic testing adhered to five process-oriented quality measures. Among the patients who had CTS surgery, nearly all had the recommended preoperative electrodiagnostic testing. Most (77.8%) included essential components but few documented skin temperature and criteria were seldom met for interpreting test findings as consistent with CTS or severe CTS.
AHRQ-funded; HS018982.
Citation: Aragaki D, Basu A, Conlon C .
Quality of electrodiagnostic testing for carpal tunnel syndrome: adherence to quality measures.
Muscle Nerve 2020 Jul;62(1):50-59. doi: 10.1002/mus.26858.
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Keywords: Diagnostic Safety and Quality, Quality Indicators (QIs), Quality Measures, Quality of Care
Shetty KD, Robbins M, Aragaki D
The quality of electrodiagnostic tests for carpal tunnel syndrome: Implications for surgery, outcomes, and expenditures.
The quality of electrodiagnostic tests may influence treatment decisions, particularly regarding surgery, affecting health outcomes and health-care expenditures. In this study, the investigators evaluated test quality among 338 adults with workers' compensation claims for carpal tunnel syndrome. The investigators found that in simulations, suboptimal quality tests rendered surgery inappropriate for 99 of 309 patients (+32 percentage points). They also found that test quality was not associated with overall health, actual receipt of surgery, or expenditures.
AHRQ-funded; HS018982.
Citation: Shetty KD, Robbins M, Aragaki D .
The quality of electrodiagnostic tests for carpal tunnel syndrome: Implications for surgery, outcomes, and expenditures.
Muscle Nerve 2020 Jul;62(1):60-69. doi: 10.1002/mus.26874..
Keywords: Diagnostic Safety and Quality, Neurological Disorders, Surgery, Quality Indicators (QIs), Quality Measures, Quality of Care
Baernholdt M, Yan G, Hinton ID
Effect of preventive care interventions on pressure ulcer rates in a national sample of rural and urban nursing units: Longitudinal associations over 4 years.
This study looked at the effects of nursing care interventions aimed at preventing pressure ulcers in rural and urban hospitals over a 4-year period. This longitudinal study used unit-level data from the National Database of Nursing Quality Indicators 2010-2013. The authors analyzed 5761 units (332 rural and 5429 urban) in 772 hospitals (89 rural and 683 urban) that reported ulcer rates in two or more quarters. Outcomes from use of a three-care intervention combination was measured with decreases in pressure ulcers shown from any of those interventions (patients receiving skin assessment on admission, receiving risk assessment on admission, and receiving any risk assessment before the pressure ulcer). An increase in RN skill mix and two nurse outcomes (increase in job satisfaction and intent-to-stay) also led to decreases in ulcer rates.
AHRQ-funded; HS023147.
Citation: Baernholdt M, Yan G, Hinton ID .
Effect of preventive care interventions on pressure ulcer rates in a national sample of rural and urban nursing units: Longitudinal associations over 4 years.
Int J Nurs Stud 2020 May;105:103455. doi: 10.1016/j.ijnurstu.2019.103455..
Keywords: Pressure Ulcers, Prevention, Skin Conditions, Nursing, Practice Patterns, Provider: Nurse, Provider, Quality Indicators (QIs), Quality Measures, Quality of Care
Sanghavi P, Pan S, Caudry D
Assessment of nursing home reporting of major injury falls for quality measurement on Nursing Home Compare.
The purpose of this study was to assess the accuracy of nursing home self-report of major injury falls on the Minimum Data Set (MDS). They linked inpatient claims for major injury falls with MDS assessments. The investigators concluded that the nursing home-reported data used for the Nursing Home Compare (NHC) falls measure may be highly inaccurate.
AHRQ-funded; HS026957.
Citation: Sanghavi P, Pan S, Caudry D .
Assessment of nursing home reporting of major injury falls for quality measurement on Nursing Home Compare.
Health Serv Res 2020 Apr;55(2):201-10. doi: 10.1111/1475-6773.13247..
Keywords: Falls, Nursing Homes, Quality Measures, Quality Indicators (QIs), Quality of Care, Elderly, Public Reporting, Injuries and Wounds
Fahrenbach J, Chin MH, Huang ES
Neighborhood disadvantage and hospital quality ratings in the Medicare Hospital Compare Program.
This study examined the relationship between neighborhood social risk factors (SRFs) and hospital ratings in Medicare's Hospital Compare Program. Results showed that lower hospital summary scores were associated with caring for neighborhoods with higher social risk. Associations between neighborhood SRFs and hospital ratings were largest in the timeliness of care, patient experience, and hospital readmission groups and smallest in the safety, efficiency, and effectiveness of care groups. Failing to account for neighborhood social risk in hospital rating systems may reinforce hidden disincentives to care for medically underserved areas in the United States.
AHRQ-funded; HS023007.
Citation: Fahrenbach J, Chin MH, Huang ES .
Neighborhood disadvantage and hospital quality ratings in the Medicare Hospital Compare Program.
Med Care 2020 Apr;58(4):376-83. doi: 10.1097/mlr.0000000000001283..
Keywords: Quality of Care, Hospitals, Medicare, Quality Indicators (QIs), Patient Experience, Social Determinants of Health
Kocher KE, Arora R, Bassin BS
Baseline performance of real-world clinical practice within a statewide emergency medicine quality network: the Michigan Emergency Department Improvement Collaborative (MEDIC).
The Michigan Emergency Department Improvement Collaborative (MEDIC) has baseline performance data to identify practice variation across 15 diverse emergency departments on key emergency care quality indicators. The authors assessed MEDIC quality measures and found that performance varied greatly, with demonstrated opportunity for improvement. They conclude that MEDIC provides a robust platform for emergency physician engagement across emergency department practice settings to improve care and is a model for other states.
AHRQ-funded; HS024160.
Citation: Kocher KE, Arora R, Bassin BS .
Baseline performance of real-world clinical practice within a statewide emergency medicine quality network: the Michigan Emergency Department Improvement Collaborative (MEDIC).
Ann Emerg Med 2020 Feb;75(2):192-205. doi: 10.1016/j.annemergmed.2019.04.033..
Keywords: Emergency Department, Quality Improvement, Quality Indicators (QIs), Quality Measures, Quality of Care, Imaging, Diagnostic Safety and Quality
Colton K, Richards CT, Pruitt PB
Early stroke recognition and time-based emergency care performance metrics for intracerebral hemorrhage.
This study compared time for early stroke recognition for intracerebral hemorrhage for hospitals with and without stroke teams. An observational cohort study was conducted at an urban comprehensive stroke center from 2009 to 2017 with 204 cases included. Stroke team activation resulted in faster emergency care compared to no activation. This process resulted in shorter onset-to-arrival times, higher NIH Stroke Scale scores, and higher Glasgow Coma Scale scores.
AHRQ-funded; HS023437.
Citation: Colton K, Richards CT, Pruitt PB .
Early stroke recognition and time-based emergency care performance metrics for intracerebral hemorrhage.
J Stroke Cerebrovasc Dis 2020 Feb;29(2):104552. doi: 10.1016/j.jstrokecerebrovasdis.2019.104552..
Keywords: Stroke, Emergency Department, Provider Performance, Diagnostic Safety and Quality, Quality Improvement, Quality Indicators (QIs), Patient-Centered Outcomes Research, Outcomes, Quality of Care, Evidence-Based Practice, Hospitals