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Research Studies is a monthly compilation of research articles funded by AHRQ or authored by AHRQ researchers and recently published in journals or newsletters.
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1 to 25 of 903 Research Studies Displayed
Hoffmann JA, Johnson JK, Pergjika A
Development of quality measures for pediatric agitation management in the emergency department.
This study’s objective was to develop quality measures for pediatric emergency department (ED) agitation management informed by multidisciplinary perspectives. A multidisciplinary panel was created to develop quality measures for pediatric ED agitation management through the modified Delphi method. The panelists included 36 physicians, nurses, social workers, security, child life specialists, hospital data analysts, and parents. Measures were ranked by panelists in importance and feasibility on a 9-point scale during 2 survey rounds, with a teleconference discussion between surveys. Consensus was defined at >75% of panelists ranking a quality measure greater or equal to 7 in importance and median feasibility of greater or equal to 4. Consensus was reached on 20 quality measures that incorporated multidisciplinary perspectives.
AHRQ-funded; HS026385.
Citation:
Hoffmann JA, Johnson JK, Pergjika A .
Development of quality measures for pediatric agitation management in the emergency department.
J Healthc Qual 2022 Jul-Aug;44(4):218-29. doi: 10.1097/jhq.0000000000000339..
Keywords:
Children/Adolescents, Quality Measures, Quality Indicators (QIs), Quality of Care, Emergency Department
Bardach NS, Stotts JR, Fiore DM
Family Input for Quality and Safety (FIQS): using mobile technology for in-hospital reporting from families and patients.
This study’s goal was to test a real-time mobile-responsive website called Family Input for Quality and Safety (FIQS) for inpatient reporting from families and patients. The tool was piloted from June 2017 to April 2018 on the medical-surgical unit of a children’s hospital. The authors enrolled 253 patients aged 13 and older and patient family members. This resulted in 8.15 safety reports/100 patient-days, most frequently regarding medications (29% of reports) and communication (20% of reports). Fifty-one reports met incident reporting (IR) criteria with only 1 having been reported via the IR system. White participants submitted more observations than Latinx participants.
AHRQ-funded; HS028477; HS024553.
Citation:
Bardach NS, Stotts JR, Fiore DM .
Family Input for Quality and Safety (FIQS): using mobile technology for in-hospital reporting from families and patients.
J Hosp Med 2022 Jun;17(6):456-65. doi: 10.1002/jhm.2777..
Keywords:
Quality of Care, Patient Safety, Health Information Technology (HIT), Patient and Family Engagement
Zrelak PA, Utter GH, McDonald KM
Incorporating harms into the weighting of the revised Agency for Healthcare Research and Quality Patient Safety for Selected Indicators Composite (Patient Safety Indicator 90).
The purpose of this study was to reweight AHRQ’s Patient Safety for Selected Indicators Composite (Patient Safety Indicator 90) from weights based solely on the frequency of component Patient Safety Indicators (PSIs) to those that incorporate excess harm reflecting patients' preferences for outcome-related health states. Findings showed that including harms in the weighting scheme changed individual component weights from the original frequency-based weighting. In the reweighted composite, PSIs 11, 13, and 12 contributed the greatest harm. The investigators concluded that reformulation of PSI 90 with harm-based weights is feasible and results in satisfactory reliability and discrimination.
AHRQ-authored; AHRQ-funded; 290201200003I.
Citation:
Zrelak PA, Utter GH, McDonald KM .
Incorporating harms into the weighting of the revised Agency for Healthcare Research and Quality Patient Safety for Selected Indicators Composite (Patient Safety Indicator 90).
Health Serv Res 2022 Jun;57(3):654-67. doi: 10.1111/1475-6773.13918..
Keywords:
Healthcare Cost and Utilization Project (HCUP), Patient Safety, Quality Indicators (QIs), Quality Measures, Quality of Care, Adverse Events, Medicare
Milliren CE, Bailey G, Graham DA
Relationships between pediatric safety indicators across a national sample of pediatric hospitals: dispelling the myth of the "safest" hospital.
This observational study aimed to explore the covariance of pediatric hospital quality indicators and evaluate the use of a single composite score. Pediatric hospital performance across 13 safety indicators were extracted from the Pediatric Health Information System, a comparative database of children’s hospitals in the U.S. Patients discharged from 36 hospitals from 2016 to 2019 were included. The authors investigated relationships among patient safety measures from AHRQ pediatric quality indicators and Center for Medicare and Medicaid Services hospital-acquired conditions. They identified 5 orthogonal variance components accounting for 68% of variation in pediatric hospital quality indicators. The ranking comparison and summary found greater within-hospital variation compared with between-hospital variation. They observed discordant rankings among commonly used summary measures and concluded that these measures demonstrate at least 2 underlying variance components.
AHRQ-funded; HS026246.
Citation:
Milliren CE, Bailey G, Graham DA .
Relationships between pediatric safety indicators across a national sample of pediatric hospitals: dispelling the myth of the "safest" hospital.
J Patient Saf 2022 Jun 1;18(4):e741-e46. doi: 10.1097/pts.0000000000000938..
Keywords:
Children/Adolescents, Quality Indicators (QIs), Quality Measures, Patient Safety, Hospitals, Quality of Care
Ellsworth BL, Metz AK, Mott MM
Review of cancer-specific quality measures promoting the avoidance of low-value care.
The purpose of this study was to explore cancer quality measures to identify and describe those that encourage the avoidance of caner overtreatment and low-value care. The study also aimed to identify gaps that could direct the future development of cancer-specific quality measures. The researchers collected, reviewed, and identified 313 quality measures encouraging the avoidance of low-value cancer care, from six leading quality measures organizations. Of the 313 quality measures identified, 55 (18%) focused on avoidance of low-value care. Quality measure most likely to focus on low-value care included: 13 end-of-life care measures (50%); 12 breast cancer care measures (18%); 9 lung cancer care measures (31%); 8 colon cancer care measures (20%); 5 prostate cancer care measures (38%); and 4 general cancer care measures (3%). The study concluded that the majority of cancer quality measures are not aimed at avoiding cancer over-treatment and low value care, and existing recommendations have not been incorporated in the field.
AHRQ-funded; HS026030.
Citation:
Ellsworth BL, Metz AK, Mott MM .
Review of cancer-specific quality measures promoting the avoidance of low-value care.
Ann Surg Oncol 2022 Jun;39(6):3750-62. doi: 10.1245/s10434-021-11303-4..
Keywords:
Cancer, Quality Measures, Quality Indicators (QIs), Quality of Care, Value
Olin SS, Freed GL, Scholle SH
Aligning to improve pediatric health care quality.
The authors presented a population health framework for collaboration and coordination across the delivery system to improve care quality, with quality measures as key tools for monitoring and incentivizing collaboration and alignment of efforts across levels, based on each entity's sphere of influence within the Applegate Alignment Framework.
AHRQ-funded; HS025296; HS025292.
Citation:
Olin SS, Freed GL, Scholle SH .
Aligning to improve pediatric health care quality.
Acad Pediatr 2022 Apr;22(3s):S115-s18. doi: 10.1016/j.acap.2021.08.021..
Keywords:
Children/Adolescents, Quality Improvement, Quality Measures, Quality Indicators (QIs), Quality of Care, Medicaid
Cope EL, Johnson M, Khan M
Contextual factors affecting implementation of pediatric quality improvement programs.
Researchers assessed the role of contextual factors in influencing the efforts of 5 diverse quality improvement projects as part of the Pediatric Quality Measure Program (PQMP) directed by AHRQ. In a mixed methods study, they conducted semistructured interviews, followed by structured worksheets, of 5 PQMP grantees. They found that using a determinant framework, such as the Tailored Implementation for Chronic Diseases, is valuable in facilitating comparisons across heterogeneous projects, allowing identification of key contextual factors influencing the implementation of pediatric quality measures across a diverse range of clinical topics and settings.
AHRQ-authored.
Citation:
Cope EL, Johnson M, Khan M .
Contextual factors affecting implementation of pediatric quality improvement programs.
Acad Pediatr 2022 Apr;22(3S):S81-S91. doi: 10.1016/j.acap.2021.08.016..
Keywords:
Children/Adolescents, Quality Measures, Quality Improvement, Quality of Care, Implementation
Mistry KB, Sagatov RDF, Schur C
Design and implementation of the Pediatric Quality Measures Program 2.0.
This AHRQ-authored research discusses the design and implementation of the Pediatric Quality Measures Program (PQMP) 2.0. The PQMP was established in response to the Children’s Health Insurance Program Reauthorization Act of 2009. AHRQ and CMS awarded 6 grants to Centers of Excellence (COEs) and a contract to facilitate collaboration and learning across the COEs. The COEs partnered with stakeholders from multiple levels to field test real-world implementation and refinement of pediatric quality measures and quality improvement initiatives. A PQMP Learning Collaborative (PQMP-LC) consisting of AHRQ, CMS, the 6 COEs, and L&M Policy Research, LLC was created to complete literature reviews, conduct key informant interviews, and collect data to develop reports to address the Research Foci. It also aided with development of measure implementation and quality improvement toolkits; conceptualized an implementation science framework, analysis, and roadmap; and facilitated dissemination of learnings and products. The various products created are intended to support the uptake of PQMP measures and inform future pediatric measurement and improvement work.
AHRQ-authored.
Citation:
Mistry KB, Sagatov RDF, Schur C .
Design and implementation of the Pediatric Quality Measures Program 2.0.
Acad Pediatr 2022 Apr;22(3s):S59-S64. doi: 10.1016/j.acap.2021.12.021..
Keywords:
Children/Adolescents, Medicaid, Children's Health Insurance Program (CHIP), Quality Measures, Quality Improvement, Quality of Care, Implementation
Parast L, Burkhart Q, Bardach NS
Development and testing of an emergency department quality measure for pediatric suicidal ideation and self-harm.
The authors sought to develop and test a new quality measure assessing timeliness of follow-up mental health care for youth presenting to the emergency department (ED) with suicidal ideation or self-harm. Using Medicaid administrative data, they concluded that this new ED quality measure may be useful for monitoring and improving the quality of care for this vulnerable population; however, they recommended future work in order to establish the measure's predictive validity using more prevalent outcomes such as recurrence of suicidal ideation or deliberate self-harm.
AHRQ-funded; HS025291.
Citation:
Parast L, Burkhart Q, Bardach NS .
Development and testing of an emergency department quality measure for pediatric suicidal ideation and self-harm.
Acad Pediatr 2022 Apr;22(3s):S92-s99. doi: 10.1016/j.acap.2021.03.005..
Keywords:
Children/Adolescents, Emergency Department, Behavioral Health, Quality Measures, Quality Indicators (QIs), Quality of Care
McCleskey SG, Shek L, Grein J
Economic evaluation of quality improvement interventions to prevent catheter-associated urinary tract infections in the hospital setting: a systematic review.
This systematic review looked at economic evaluations of quality improvement (QI) interventions to reduce rates of catheter-associated urinary tract infections (CAUTIs). A literature review was conducted for conference abstracts and studies from January 2000 to October 2020. Dual reviewers assessed study design, effectiveness, costs and study quality for eligibility. The reviewers performed a cost-consequence analysis from the hospital perspective, estimating the incidence rate ratio and increment net cost/savings per hospital over 3 years for each eligible study. Fifteen unique economic evaluations were eligible, and 12 studies were amenable to standardization. QI interventions were associated with a 43% decline in infections and wide ranges of net costs relative to usual care.
AHRQ-funded; HS022644.
Citation:
McCleskey SG, Shek L, Grein J .
Economic evaluation of quality improvement interventions to prevent catheter-associated urinary tract infections in the hospital setting: a systematic review.
BMJ Qual Saf 2022 Apr;31(4):308-21. doi: 10.1136/bmjqs-2021-013839..
Keywords:
Quality Improvement, Quality of Care, Urinary Tract Infection (UTI), Healthcare-Associated Infections (HAIs), Hospitals, Healthcare Costs
Schnipper JL, Reyes Nieva H, Mallouk M
Effects of a refined evidence-based toolkit and mentored implementation on medication reconciliation at 18 hospitals: results of the MARQUIS2 study.
This study was a follow-up of the first Multicenter Medication Reconciliation Quality Improvement Study (MARQUIS1) that demonstrated mentored implementation of a medication reconciliation best practices toolkit. The toolkit decreased total unintentional medication discrepancies in five hospitals, but results varied by site. The toolkit has been refined with lessons learned and retooled as MARQUIS2. The tool was implemented at 18 North American hospitals or hospital systems from 2016 to 2018, offering 17 system-level and 6-patient-level interventions. One of eight physicians coached each site remotely via monthly calls and one or two site visits. A total of 4947 patients were sampled, with 1229 preimplementation and 3718 postimplementation. A steady decline in medication discrepancy rates were experienced from 2.85 discrepancies per patient down to 0.98 discrepancies. An interrupted time series analysis of the 17 sites showed the intervention was associated with a 5% relative decrease in discrepancies per month.
AHRQ-funded; HS025486; HS023757.
Citation:
Schnipper JL, Reyes Nieva H, Mallouk M .
Effects of a refined evidence-based toolkit and mentored implementation on medication reconciliation at 18 hospitals: results of the MARQUIS2 study.
BMJ Qual Saf 2022 Apr;31(4):278-86. doi: 10.1136/bmjqs-2020-012709..
Keywords:
Medication, Evidence-Based Practice, Tools & Toolkits, Implementation, Quality Improvement, Quality of Care, Medication: Safety, Patient Safety
Jin B, Nembhard IM
Effects of affiliation network membership on hospital quality and financial performance.
This study examined the effects of hospital membership in affiliation networks-franchise-like networks sponsored by high-quality health systems in which affiliate hospitals pay an annual fee for access to sponsor's operational and clinical resources-on clinical quality, patient experience ratings, and financial performance of affiliates and their competitors. The authors used network membership data from press releases and websites of four sponsors (Mayo Clinic, Cleveland Clinic, MD Anderson, Memorial Sloan Kettering), American Hospital Association's Annual Survey, Centers for Medicare & Medicaid Services' Hospital Compare, and Healthcare Cost Report Information System, all for 2005-2016. The authors looked at 199 network affiliates. The affiliates experienced insignificant clinical quality changes but increased their net income and operating margin more than non-affiliates. There were no changes in measures for multispecialty affiliates.
AHRQ-funded; HS017589.
Citation:
Jin B, Nembhard IM .
Effects of affiliation network membership on hospital quality and financial performance.
Health Serv Res 2022 Apr;57(2):248-58. doi: 10.1111/1475-6773.13876..
Keywords:
Hospitals, Quality of Care
Huo T, Li Q, Cardel MI
Enhancing quality measurement with clinical information: a use case of body mass index change among children taking second generation antipsychotics.
The authors sought to examine the extent to which body mass index (BMI) was available in electronic health records for Florida Medicaid recipients aged 5 to 18 years taking Second-Generation Antipsychotics (SGAP). They concluded that meeting the 2030 CMS goal of digital monitoring of quality of care will require continuing expansion of clinical encounter data capture to provide the data needed for digital quality monitoring. Using linked electronic health records and claims data allows identifying children at higher risk for SGAP-induced weight gain.
AHRQ-authored; AHRQ-funded; HS025298.
Citation:
Huo T, Li Q, Cardel MI .
Enhancing quality measurement with clinical information: a use case of body mass index change among children taking second generation antipsychotics.
Acad Pediatr 2022 Apr;22(3S):S140-S49. doi: 10.1016/j.acap.2021.11.012..
Keywords:
Children/Adolescents, Electronic Health Records (EHRs), Health Information Technology (HIT), Medication, Obesity, Obesity: Weight Management, Quality Measures, Quality of Care
Leyenaar JK, Esporas M, Mangione-Smith R
How does pediatric quality measure development reflect the real world needs of hospitalized children?
This study examined to what extent do the Pediatric Quality Measures Program (PQMP) reflect the real world needs of hospitalized children. The authors discussed recent advances in pediatric quality measurement in the context of the current epidemiology of pediatric hospitalization in the US. The history of PQMP is discussed, including AHRQ’s role from 2011 to 2016 as the manager of cooperative agreement grants to seven academic medical centers to develop the initial set of evidence-based quality measures designed to improve children’s quality of care. During the second phase (2016 to 2020), 6 institutions were funded to implement and disseminate these quality measures, with a goal of determining their feasibility and usability. The majority of these measures were developed at large children’s hospitals. However, 20% of children live in rural areas not near a children’s hospital. Among all general hospitals that admit children, 80% have pediatric volumes of less than 375 hospitalizations per year. Unique strategies will be needed to evaluate healthcare quality at these hospitals. The role of interhospital transfer to larger children’s hospitals is also discussed and how it impacts quality of care.
AHRQ-funded; HS025291.
Citation:
Leyenaar JK, Esporas M, Mangione-Smith R .
How does pediatric quality measure development reflect the real world needs of hospitalized children?
Acad Pediatr 2022 Apr;22(3s):S70-s72. doi: 10.1016/j.acap.2021.01.019..
Keywords:
Children/Adolescents, Quality Measures, Quality Improvement, Quality of Care, Quality Indicators (QIs), Hospitals
Thorp K, Van CM, Olin SS
Integrating youth voice in health plan quality improvement.
This article describes lessons learned from working with health plans to incorporate youth voice in quality improvement (QI) approaches to improve adolescent depression care. Findings showed that plan approaches to youth engagement varied and evolved over time as plans learned how to employ deliberate approaches to engage youth perspectives. Further, plans learned that building genuine relationships with youth and family takes an investment of time and trust that can provide rich and useful information for QI.
AHRQ-funded; HS025296.
Citation:
Thorp K, Van CM, Olin SS .
Integrating youth voice in health plan quality improvement.
Acad Pediatr 2022 Apr;22(3s):S68-s69. doi: 10.1016/j.acap.2021.03.006..
Keywords:
Children/Adolescents, Patient and Family Engagement, Quality Improvement, Quality of Care
Cabana MD, Robinson K, Plavin J
Partnering to improve pediatric asthma quality.
The purpose of this article was to explore the need for partnering between emergency departments (Eds) and primary care physicians (PCPs) to improve asthma quality measures, practice level improvements for both PCPs and EDs, and ultimately improve outcomes for children with asthma. Proper and timely management of asthma is thought to prevent ED visits, and the responsibility for addressing improvements in PCP performance should be shared by the PCP practices and health care payors and plans. The ability to measure the drivers of asthma-related visits to the ED may be outside of what a PCP practice can address, and so practices must be able to partner with health plans to successfully measure and develop system-wide interventions for quality and outcomes improvement. Although a child’s asthma may be managed in their PCP office, treatment of asthma issues often takes place in an ED setting or urgent care clinic that may be completely isolated from the patient’s PCP provider and system. Health plans can fill in the missing pieces to provide feedback on performance which can reduce ED visits, improve medication adherence and management, and provide actionable and timely data about hospital visits and discharge to PCP practices for quality improvements. Social determinants and comorbidities play a role in addressing ED visits for asthma. Health plan, public health systems, and provider coordination, integration, and partnerships are required to effectively address those issues and improve outcomes. The authors conclude that a systems approach and thoughtful partnerships across disciplines will be required beyond the PCP practice level to improve the outcomes of children with asthma.
AHRQ-funded; HS025297.
Citation:
Cabana MD, Robinson K, Plavin J .
Partnering to improve pediatric asthma quality.
Acad Pediatr 2022 Apr;22(3S):S73-S75. doi: 10.1016/j.acap.2021.06.013..
Keywords:
Children/Adolescents, Asthma, Chronic Conditions, Emergency Department, Quality Measures, Quality Improvement, Quality of Care
Forrest CB, Simpson L, Mistry KB
PQMP Phase 2: implementation and dissemination.
The authors provide an overview of the articles in this supplement concerning the Children’s Health Insurance Program Reauthorization Act Pediatric Quality Measures Program (PQMP). The articles examine the opportunities and challenges associated with the PQMP 2.0 work of the Centers for Excellence and how findings may advance the science for pediatric quality measurement and improvement, and, ultimately, child health outcomes.
AHRQ-authored.
Citation:
Forrest CB, Simpson L, Mistry KB .
PQMP Phase 2: implementation and dissemination.
Acad Pediatr 2022 Apr;22(3s):S55-S58. doi: 10.1016/j.acap.2022.01.012..
Keywords:
Children/Adolescents, Medicaid, Children's Health Insurance Program (CHIP), Quality Measures, Quality Improvement, Quality of Care, Implementation
Murphy PB, Oslock WM, Ingraham AM
Quality of care for gallstone pancreatitis-the impact of the acute care surgery model and hospital-level operative resources.
This study aimed to determine the influence of structure and process related to operating room access on achieving index cholecystectomy for gallstone pancreatitis. In 2015, 2811 US hospitals on acute care surgery practices were surveyed, including infrastructure for operative access, with 1690 hospitals (60%) responding. The authors identified patients ≥ 18 years who were admitted with gallstone pancreatitis. Over the study period, 5656 patients were admitted with gallstone pancreatitis, and 70% had an index cholecystectomy. High-performing hospitals had an index cholecystectomy rate of 84.1%, compared to 58.5% at low-performing hospitals. High-performing hospitals were associated with teaching, and access to dedicated daytime operative resources.
AHRQ-funded; HS022694.
Citation:
Murphy PB, Oslock WM, Ingraham AM .
Quality of care for gallstone pancreatitis-the impact of the acute care surgery model and hospital-level operative resources.
J Gastrointest Surg 2022 Apr;26(4):849-60. doi: 10.1007/s11605-021-05145-4..
Keywords:
Healthcare Cost and Utilization Project (HCUP), Surgery, Quality of Care
Schur C, Johnson M, Doherty J
Real-world considerations for implementing pediatric quality measures: insights from key stakeholders.
This AHRQ-authored paper describes key stakeholder insights focused on measure implementation and increasing the uptake of Pediatric Quality Measures (PQM). The PQMP Learning Collaborative conducted semistructured interviews with 9 key informants (KIs) presenting states, health plans, and other potential end users. The interviews focused on obtaining KIs’ perspectives on 6 research questions focused on assessing the feasibility and usability of PQM and strengthening the connection between measurement and improvement. The KIs uniformly acknowledged the complexity of the issues raised and pinpointed multiple unresolved issues.
AHRQ-authored; AHRQ-funded; 290201400003I.
Citation:
Schur C, Johnson M, Doherty J .
Real-world considerations for implementing pediatric quality measures: insights from key stakeholders.
Acad Pediatr 2022 Apr;22(3S):S76-S80. doi: 10.1016/j.acap.2021.04.007..
Keywords:
Children/Adolescents, Medicaid, Children's Health Insurance Program (CHIP), Quality Measures, Quality Improvement, Quality of Care, Implementation
Shenkman E, Mistry KB, Davis D
Stakeholder engagement: bridging research and policy to improve measurement and dental care for children in Medicaid.
The University of Florida Child Health Quality (CHeQ) initiative, funded by the Agency for Health Care Research and Quality (AHRQ)/Centers for Medicare and Medicaid Services (CMS) Pediatric Quality Measurement Program, examined measures that states use to evaluate quality of oral health care for children in Medicaid and the Children’s Health Insurance Program (CHIP). This paper discusses stakeholder engagement in bridging research and policy to improve measurement and dental care for children in Medicaid.
AHRQ-authored; AHRQ-funded; HS025298.
Citation:
Shenkman E, Mistry KB, Davis D .
Stakeholder engagement: bridging research and policy to improve measurement and dental care for children in Medicaid.
Acad Pediatr 2022 Apr;22(3S):S65-S67. doi: 10.1016/j.acap.2021.08.012..
Keywords:
Children/Adolescents, Dental and Oral Health, Medicaid, Children's Health Insurance Program (CHIP), Quality Measures, Quality Improvement, Quality of Care
Yang P, Diaz A, Chhabra KR
Surgical quality assurance at expanding health networks: a qualitative study.
This study used qualitative methods to understand the nuances that affect the variation in network-level surgical quality assurance and provided strategies that surgical leaders can use to improve surgical quality at expanding health networks. Through semi-structured interviews, three themes emerged. Participants wanted standardized tools for quality measurement, an organizational structure that provides clear oversight over quality, and a culture shift toward quality improvement.
AHRQ-funded; HS024763.
Citation:
Yang P, Diaz A, Chhabra KR .
Surgical quality assurance at expanding health networks: a qualitative study.
Surgery 2022 Apr;171(4):966-72. doi: 10.1016/j.surg.2021.09.023..
Keywords:
Surgery, Quality Improvement, Quality of Care
Herrin J, Yu H, Venkatesh AK
Identifying high-value care for Medicare beneficiaries: a cross-sectional study of acute care hospitals in the USA.
Investigators sought to define hospital value and identify the characteristics of hospitals which provide high-value care. Participants were Medicare beneficiaries with claims included in CMS Overall Star Ratings or in publicly available Medicare spending per beneficiary data. The researchers found that there are high quality hospitals that are not high value, and a number of factors are strongly associated with being low or high value. They suggested that their findings can inform efforts of policymakers and hospitals to increase the value of care.
AHRQ-funded; HS022882; HS026980.
Citation:
Herrin J, Yu H, Venkatesh AK .
Identifying high-value care for Medicare beneficiaries: a cross-sectional study of acute care hospitals in the USA.
BMJ Open 2022 Mar 31;12(3):e053629. doi: 10.1136/bmjopen-2021-053629..
Keywords:
Medicare, Quality of Care, Hospitals
Raman DL, Bixby EC, Wang K
A Comprehensive Unit-based Safety Program to improve perioperative efficiency in adolescent idiopathic scoliosis.
In this study, the Comprehensive Unit-based Safety Program (CUSP) methodology was utilized to improve perioperative efficiency in pediatric spine surgery, and pre-implementation and post-implementation efficiency were compared. Findings showed that CUSP was effective in enhancing perioperative efficiency, demonstrating strong improvement in on-time starts over 5 years. These results indicated that process improvement in operating rooms requires consistent attention to sustain gains over time. Recommendations included engaging frontline staff in quality improvement in order to foster collaboration and provide employee buy-in to promoting a culture of safety and improving value in patient care.
AHRQ-funded; HS022198.
Citation:
Raman DL, Bixby EC, Wang K .
A Comprehensive Unit-based Safety Program to improve perioperative efficiency in adolescent idiopathic scoliosis.
J Pediatr Orthop 2022 Mar;42(3):123-30. doi: 10.1097/bpo.0000000000001992..
Keywords:
Children/Adolescents, Patient Safety, Quality Improvement, Quality of Care
Richardson JE, Rasmussen LV, Dorr DA
Generating and reporting electronic clinical quality measures from electronic health records: strategies from EvidenceNOW cooperatives.
This study’s goal was to characterize strategies that seven regional cooperatives participating in the EvidenceNOW initiative developed to generate and report electronic health record (EHR)-based electronic clinical quality measures (eCQMs) for quality improvement (QI) in small-to-medium-sized practices. Findings showed that cooperatives ultimately generated and reported eCQMs using hybrid strategies because they determined that neither EHRs alone nor centralized sources alone could operationalize eCQMs for QI. In order to attain this goal, cooperatives needed to devise solutions and utilize resources that often are unavailable to typical small-to-medium-sized practices.
AHRQ-funded; HS023921.
Citation:
Richardson JE, Rasmussen LV, Dorr DA .
Generating and reporting electronic clinical quality measures from electronic health records: strategies from EvidenceNOW cooperatives.
Appl Clin Inform 2022 Mar;13(2):485-94. doi: 10.1055/s-0042-1748145..
Keywords:
Electronic Health Records (EHRs), Health Information Technology (HIT), Quality Indicators (QIs), Quality Measures, Quality of Care, Evidence-Based Practice, Primary Care
Perry CK, Linder S, Hall J
How type of practice ownership affects participation with quality improvement external facilitation: findings from EvidenceNOW.
This study examined how practice ownership influences participation in external facilitation using data from EvidenceNOW. The authors collected data from practices on practice characteristics and ownership type via surveys and from facilitators on the number of hours, encounters, and months each practice had with a facilitator via facilitation logs. Semi-structured interviewers with EvidenceNOW leadership (n = 12) and facilitators (n = 51) were conducted, and facilitators (n = 64) were observed for patterns of facilitation. In the fully adjusted model, differences by ownership were non-significant. Federally Qualified Health Centers (FQHCs) however, had significantly less participation in facilitation than clinician-owned practices for the measures number of encounters and number of months with encounters.
AHRQ-funded; HS023940.
Citation:
Perry CK, Linder S, Hall J .
How type of practice ownership affects participation with quality improvement external facilitation: findings from EvidenceNOW.
J Gen Intern Med 2022 Mar;37(4):793-801. doi: 10.1007/s11606-021-07204-7..
Keywords:
Quality Improvement, Quality of Care, Primary Care, Practice Improvement
