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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 122 Research Studies Displayed
Konetzka RT, Davila H, Brauner DJ
The quality measures domain in Nursing Home Compare: is high performance meaningful or misleading?
The Federal Centers for Medicare and Medicaid Services publishes a Nursing Home Compare (NHC) web site that provides information to compare nursing homes across the nation. Since NHC began reporting the percent of nursing home residents suffering adverse outcomes, the negative outcomes decreased dramatically. However, the validity of scores has been questioned for nursing homes that score well on facility-reported measures but scored poorly on inspections. The study purpose was to determine whether nursing homes with these “discordant” scores are better than nursing homes that score poorly across all domains. The researchers analyzed national data from 2012- 2016, conducted in-depth interviews and observations of 12 nursing homes in 2017 to 2018, and studied nursing home performance trajectories over time. Both qualitative and quantitative methods were utilized and interpreted together. The study found that facilities identified as discordant took part in more quality improvement (QI) activities than those identified as poor performers, but those QI activities were lower-resource improvements and not of the type and scope that would impact improvements across other quality domains. It was determined that the poor-performing facilities appeared to lack the leadership and staff continuity required for even low-resource improvements. The study concluded that while high performance on quality measures using facility-reported data is mostly meaningful, and the quality measures domain should continue to be utilized in Nursing Home Compare, facilities identified as discordant still have quality defects.
AHRQ-funded; HS024967.
Citation:
Konetzka RT, Davila H, Brauner DJ .
The quality measures domain in Nursing Home Compare: is high performance meaningful or misleading?
Gerontologist 2022 Feb 9;62(2):293-303. doi: 10.1093/geront/gnab054..
Keywords:
Nursing Homes, Long-Term Care, Provider Performance, Quality Indicators (QIs), Quality Measures, Quality of Care
Schwartz ML, Rahman M, Thomas KS
Consumer selection and home health agency quality and patient experience stars.
The objective of this study was to compare the impact of the introduction of two distinct sets of star ratings, quality of care, and patient experience, on home health agency (HHA) selection. The investigators concluded that the introduction of quality of care and patient experience stars were associated with changes in HHA selection; however, the strength of these relationships was weaker than observed in other health care settings where a single star rating was reported.
AHRQ-funded; HS026440.
Citation:
Schwartz ML, Rahman M, Thomas KS .
Consumer selection and home health agency quality and patient experience stars.
Health Serv Res 2022 Feb;57(1):113-24. doi: 10.1111/1475-6773.13867..
Keywords:
Consumer Assessment of Healthcare Providers and Systems (CAHPS), Home Healthcare, Patient Experience, Quality Measures, Quality of Care, Provider Performance, Quality Indicators (QIs)
Izadi Z, Schmajuk G, Gianfrancesco M
Significant gains in rheumatoid arthritis quality measures among RISE Registry practices.
This study examined performance on rheumatoid arthritis (RA) quality measures and assessed the association between practice characteristics and changes in performance over time among participating practices. The authors analyzed data from practices enrolled in the American College of Rheumatology Rheumatology Informatics System for Effectiveness (RISE) registry from 2015 to 2017. Eight quality measures in the areas of RA disease management, cardiovascular risk reduction, and patient safety were analyzed. Data from 59,986 patients from 54 practices were examined. Cohort characteristics were a mean age of 62 years, 77% female, 69% Caucasian, and most patients (46%) were seen in a single-specialty group practice. Measures related to RA functional status and disease activity assessment improved over time, with single-specialty group practices having the fastest rates of improvement across all measures.
AHRQ-funded; HS025638; HS024412.
Citation:
Izadi Z, Schmajuk G, Gianfrancesco M .
Significant gains in rheumatoid arthritis quality measures among RISE Registry practices.
Arthritis Care Res 2022 Feb;74(2):219-28. doi: 10.1002/acr.24444..
Keywords:
Arthritis, Chronic Conditions, Quality Measures, Quality Indicators (QIs), Registries, Quality of Care
Hysong Hysong, Arredondo K, Hughes AM
An evidence-based, structured, expert approach to selecting essential indicators of primary care quality.
The purpose of this article was to illustrate the application of an evidence-based, structured performance measurement methodology to identify, prioritize, and generate new measures of health care quality, using primary care as a case example. Subject matter experts identified three fundamental objectives: access, patient-health care team partnerships, and technical quality. The authors indicated that their article provides an actionable guide to applying their Productivity Measurement and Enhancement System, which can be adapted to the needs of various industries, including measure selection and modification from existing data sources, and proposing new measures.
Citation:
Hysong Hysong, Arredondo K, Hughes AM .
An evidence-based, structured, expert approach to selecting essential indicators of primary care quality.
PLoS One 2022 Jan 18;17(1):e0261263. doi: 10.1371/journal.pone.0261263..
Keywords:
Primary Care, Evidence-Based Practice, Quality Improvement, Quality Indicators (QIs), Quality Measures, Quality of Care
Davila H, Shippee TP, Park YS
Inside the black box of improving on nursing home quality measures.
This qualitative study investigated how nursing homes (NHs) interact with quality measures (QMs) used by Nursing Home Compare (NHC) as part of its 5-star rating system. Semistructured interviews were conducted with 110 NH personnel and 23 NH provider association representatives. Observations of organizational processes in 12 NHs in three states were also done. The authors found that most NHs are working to improve the quality of care they provide, not merely to improve their QM scores. They also found limitations with the QMs, suggesting that the QMs on their own may not accurately reflect the quality of care that NHs provide. The findings suggest several changes to improve NHC.
AHRQ-funded; HS024967.
Citation:
Davila H, Shippee TP, Park YS .
Inside the black box of improving on nursing home quality measures.
Med Care Res Rev 2021 Dec;78(6):758-70. doi: 10.1177/1077558720960326..
Keywords:
Nursing Homes, Quality Indicators (QIs), Quality Measures, Quality Improvement, Quality of Care, Provider Performance, Long-Term Care
Holmgren AJ, Kuznetsova M, Classen D
Assessing hospital electronic health record vendor performance across publicly reported quality measures.
The authors measured hospital performance, stratified by electronic health record (EHR) vendor, across 4 quality metrics. They found that no EHR vendor was associated with higher quality across all measures, and the 2 largest vendors were not associated with the highest scores. Only a small fraction of quality variation was explained by EHR vendor choice. They concluded that top performance on quality measures can be achieved with any EHR vendor, as much of quality performance is driven by the hospital and how it uses the EHR.
AHRQ-funded; HS023696.
Citation:
Holmgren AJ, Kuznetsova M, Classen D .
Assessing hospital electronic health record vendor performance across publicly reported quality measures.
J Am Med Inform Assoc 2021 Sep 18;28(10):2101-07. doi: 10.1093/jamia/ocab120..
Keywords:
Electronic Health Records (EHRs), Health Information Technology (HIT), Quality Indicators (QIs), Quality Measures, Hospitals, Quality of Care, Provider Performance
Tedesco D, Moghavem N, Weng Y
Improvement in patient safety may precede policy changes: trends in patient safety indicators in the United States, 2000-2013.
This study’s aim was to assess changes in national patient safety trends that corresponded to U.S. pay-for-performance reforms. The study analyzed 13 patient safety indicators (PSIs) that were developed by AHRQ. PSI trends, Center for Medicaid and Medicare Services payment policy changes, and Inpatient Prospective Payment System regulations and notices between 2000 and 2013 were analyzed. Twelve of the thirteen PSIs had decreasing or stable trends in the last 5 years of the study. Central-line bloodstream infections had the greatest annual decrease (-31.1 annual percent change between 2006 and 2013) whereas postoperative respiratory failure had the smallest annual percent change (-3.5 between 2005 and 2013). Significant decreases in trends preceded federal payment reform initiatives in all but postoperative hip fracture. These findings suggest that intense public discourses targeting patient safety may drive national policy reforms.
AHRQ-funded; HS018558.
Citation:
Tedesco D, Moghavem N, Weng Y .
Improvement in patient safety may precede policy changes: trends in patient safety indicators in the United States, 2000-2013.
J Patient Saf 2021 Jun 1;17(4):e327-e34. doi: 10.1097/pts.0000000000000615..
Keywords:
Patient Safety, Quality Improvement, Quality Indicators (QIs), Quality Measures, Quality of Care, Policy
Palen TE, Peterson L, Palen TE
Clinical quality measure exchange is not easy.
The Trial of Aggregate Data Exchange for Maintenance of Certification and Raising Quality was a randomized controlled trial which first had to test whether quality reporting could be a by-product of clinical care. The investigators reported on the initial descriptive study of the capacity for and quality of exchange of whole-panel, standardized quality measures from health systems. They concluded that the secure transfer of standardized, physician-level quality measures from 4 health systems with mature measure processes proved difficult. There were many errors that required human intervention and manual repair, precluding full automation.
AHRQ-funded; HS022583.
Citation:
Palen TE, Peterson L, Palen TE .
Clinical quality measure exchange is not easy.
Ann Fam Med 2021 May-Jun;19(3):207-11. doi: 10.1370/afm.2649..
Keywords:
Quality Measures, Quality Indicators (QIs), Quality of Care, Health Information Exchange (HIE), Health Information Technology (HIT)
Anderson KE, Alexander GC, Niles L
Quality of preventive and chronic illness care for insured adults with opioid use disorder.
Investigators sought to measure quality of non-opioid use disorder (OUD) preventive and chronic illness care and care coordination for individuals with OUD compared with individuals without OUD. They used deidentified data on outpatients throughout the United States from claims for commercially insured and Medicare Advantage enrollees aged 18 years or older with diagnosis codes for OUD. They found that individuals with OUD have moderately lower quality of care across preventive and chronic illness care and care coordination for non-OUD care compared with individuals without OUD. They recommended more attention to measurement and improvement of non-OUD care for these individuals.
AHRQ-funded; HS000029.
Citation:
Anderson KE, Alexander GC, Niles L .
Quality of preventive and chronic illness care for insured adults with opioid use disorder.
JAMA Netw Open 2021 Apr;4(4):e214925. doi: 10.1001/jamanetworkopen.2021.4925..
Keywords:
Opioids, Medication, Substance Abuse, Quality Indicators (QIs), Quality of Care, Behavioral Health, Chronic Conditions, Prevention
Elysee G, Yu H, Herrin J
Association between 30-day readmission rates and health information technology capabilities in US hospitals.
A study was conducted to determine if there is an association of health information technology (HIT) adoption and a decrease in 30-day hospital readmission rates. Data was used from the 2013 American Hospital Association IT survey which included non-federal U.S. acute care hospitals with self-reported capabilities. A 54-indicator 7-factor structure of hospital health IT capabilities was identified by exploratory factor analysis. A one-point increase in the hospital adoption of patient engagement capability latent scores generally leads to a 0.086% decrease in risk-standardized readmission rates (RSRRs). However, computerized hospital discharge and information exchange among clinicians did not seem as beneficial.
AHRQ-funded; HS022882.
Citation:
Elysee G, Yu H, Herrin J .
Association between 30-day readmission rates and health information technology capabilities in US hospitals.
Medicine 2021 Feb 26;100(8):e24755. doi: 10.1097/md.0000000000024755..
Keywords:
Electronic Health Records (EHRs), Health Information Technology (HIT), Hospital Readmissions, Hospitals, Quality Indicators (QIs), Quality of Care
Agniel 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:
Healthcare 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
Classen DC, Holmgren AJ, Co Z
National trends in the safety performance of electronic health record systems from 2009 to 2018.
This study examined trends in the safety performance of electronic health records (EHRs) in hospitals from 2009 to 2018. The Leapfrog Health IT Safety Measure test was administered by the Leapfrog Group from July 2018 to December 1, 2019. Overall mean performance scores increased from 53.9% in 2009 to 65.6% in 2018. Mean hospital scores for categories representing basic clinical decision support increased from 69.8% in 2009 to 85.6% in 2018. Advanced decision clinical support also increased from 29.5% in 2009 to 46.1%. These results showed great improvement, but there is still substantial safety risk in current hospital EHR systems.
AHRQ-funded; HS023696.
Citation:
Classen DC, Holmgren AJ, Co Z .
National trends in the safety performance of electronic health record systems from 2009 to 2018.
JAMA Netw Open 2020 May;3(5):e205547. doi: 10.1001/jamanetworkopen.2020.5547..
Keywords:
Electronic Health Records (EHRs), Health Information Technology (HIT), Hospitals, Patient Safety, Quality Measures, Clinical Decision Support (CDS), Quality Indicators (QIs)
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
Sheetz KH, Dimick JB, Nathan H
Centralization of high-risk cancer surgery within existing hospital systems.
Centralization is often proposed as a strategy to improve the quality of certain high-risk health care services. In this study, the investigators evaluated the extent to which existing hospital systems centralize high-risk cancer surgery and whether centralization is associated with short-term clinical outcomes. The investigators concluded that greater centralization of complex cancer surgery within existing hospital systems was associated with better outcomes.
AHRQ-funded; HS023597.
Citation:
Sheetz KH, Dimick JB, Nathan H .
Centralization of high-risk cancer surgery within existing hospital systems.
J Clin Oncol 2019 Dec 1;37(34):3234-42. doi: 10.1200/jco.18.02035..
Keywords:
Surgery, Cancer, Risk, Hospitals, Healthcare Systems, Quality Improvement, Quality Indicators (QIs), Quality of Care, Outcomes
