National Healthcare Quality and Disparities Report
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Topics
- Access to Care (1)
- Ambulatory Care and Surgery (3)
- Burnout (2)
- Cancer (1)
- Care Coordination (3)
- Caregiving (1)
- Children/Adolescents (8)
- Chronic Conditions (1)
- Clinician-Patient Communication (5)
- Communication (3)
- Community-Based Practice (2)
- (-) Consumer Assessment of Healthcare Providers and Systems (CAHPS) (63)
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- Health Services Research (HSR) (1)
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- Implementation (1)
- Inpatient Care (4)
- Kidney Disease and Health (1)
- Long-Term Care (1)
- Low-Income (1)
- Medical Expenditure Panel Survey (MEPS) (1)
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- Opioids (1)
- Organizational Change (1)
- Pain (1)
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- (-) Patient Experience (63)
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- Provider: Clinician (1)
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- Provider: Nurse (1)
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- Provider Performance (9)
- Quality Improvement (19)
- Quality Indicators (QIs) (4)
- Quality Measures (15)
- Quality of Care (45)
- Racial and Ethnic Minorities (7)
- Research Methodologies (1)
- Teams (1)
- Training (1)
- Transitions of Care (1)
- Transplantation (1)
- Urban Health (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
26 to 50 of 63 Research Studies DisplayedHargraves JL, Cosenza C, Elliott MN, et al.
The effect of different sampling and recall periods in the CAHPS Clinician & Group (CG-CAHPS) survey.
Researchers examined the effect of changing the sampling and reference periods for the CAHPS((R)) Clinician & Group Survey from 12 to 6 months. They found that shortening the reference reduced the proportion of respondents reporting a blood test, X-ray, or other tests, and the most positive response was selected more often on the 6-month survey for 12 out of 13 questions. They concluded that surveys using a 6-month recall period may yield slightly higher scores than surveys with a 12-month recall period.
AHRQ-funded; HS016978.
Citation: Hargraves JL, Cosenza C, Elliott MN, et al..
The effect of different sampling and recall periods in the CAHPS Clinician & Group (CG-CAHPS) survey.
Health Serv Res 2019 Oct;54(5):1036-44. doi: 10.1111/1475-6773.13173..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient Experience, Quality of Care, Research Methodologies
Beckett MK, Elliott MN, Burkhart Q
The effects of survey version on patient experience scores and plan rankings.
Researchers assessed the effect of changing survey questions on plan-level patient experience measures and ratings. Using CAHPS data, they concluded that their analyses illustrated how to assess the impact of seemingly minor survey modifications for other national surveys considering changes and highlighted the importance of screeners in instrument design.
AHRQ-funded; HS016978.
Citation: Beckett MK, Elliott MN, Burkhart Q .
The effects of survey version on patient experience scores and plan rankings.
Health Serv Res 2019 Oct;54(5):1016-22. doi: 10.1111/1475-6773.13172..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient Experience, Medicare, Quality of Care
Setodji CM, Peipert JD, Hays RD
Differential item functioning of the CAHPS(R) In-Center Hemodialysis Survey.
End-stage renal disease patients' experience of care is an integral part of the assessment of the quality of the care provided at hemodialysis centers and is needed to promote patient choice, quality improvement, and accountability. The purpose of this study was to evaluate the In-Center Hemodialysis Consumer Assessment of Healthcare Providers and Systems (ICH-CAHPS(R)) survey and its equivalence in different age, gender, race, and education subgroups.
AHRQ-funded; HS016980; HS016978.
Citation: Setodji CM, Peipert JD, Hays RD .
Differential item functioning of the CAHPS(R) In-Center Hemodialysis Survey.
Qual Life Res 2019 Jul 26;28(11):3117-35. doi: 10.1007/s11136-019-02250-5.
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Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Kidney Disease and Health, Quality of Care, Patient Experience, Quality Improvement
Ahluwalia SC, Damberg CL, Haas A
How are medical groups identified as high-performing? The effect of different approaches to classification of performance.
The researchers examined how different classification approaches influence which providers are designated as "high-performers.” They found that classification of medical groups as high performing is sensitive to the domains of performance included, the classification approach, and the choice of threshold. They further suggest that the absence of a consistently applied approach to identifying high performers impedes efforts to reliably compare, select and reward high-performing providers.
AHRQ-funded; HS024067.
Citation: Ahluwalia SC, Damberg CL, Haas A .
How are medical groups identified as high-performing? The effect of different approaches to classification of performance.
BMC Health Serv Res 2019 Jul 18;19(1):500. doi: 10.1186/s12913-019-4293-9..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient Experience, Provider Performance, Quality of Care, Quality Measures
Sheetz KH, Nathan H, Dimick JB
Patients' perceptions of hospitals affiliated with America's highest-rated medical centers.
Using the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey to measure how patients perceive a hospital’s overall quality and reputation, the investigators sought to determine whether HCAHPS scores increased for those affiliating with the prominent medical centers named to the U.S. News and World Report Honor Roll.
AHRQ-funded; HS023597.
Citation: Sheetz KH, Nathan H, Dimick JB .
Patients' perceptions of hospitals affiliated with America's highest-rated medical centers.
J Gen Intern Med 2019 Jun;34(6):787-88. doi: 10.1007/s11606-018-4822-y..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient Experience, Hospitals, Quality Measures, Quality of Care
Tieu L, Hobbs A, Sarkar U
Adapting patient experience data collection processes for lower literacy patient populations using tablets at the point of care.
This study compared the acceptability of low-literacy tablet-based and traditional paper-based patient experience surveys in English and Spanish. The Consumer Assessment of Healthcare Providers & Systems Clinician & Group Survey (CG-CAHPS) was adapted for a pilot survey using low-literacy questions in Spanish and English. The majority of interview participants preferred the tablet version over the traditional paper-based survey. This was especially true for the younger and Latino respondents.
AHRQ-funded; HS022408.
Citation: Tieu L, Hobbs A, Sarkar U .
Adapting patient experience data collection processes for lower literacy patient populations using tablets at the point of care.
Med Care 2019 Jun;57 Suppl 6 Suppl 2:S140-s48. doi: 10.1097/mlr.0000000000001030..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Health Information Technology (HIT), Health Literacy, Patient Experience, Primary Care, Quality of Care, Quality Improvement, Racial and Ethnic Minorities, Urban Health
Fowler FJ, Cosenza C, Cripps LA
The effect of administration mode on CAHPS survey response rates and results: a comparison of mail and web-based approaches.
The researchers compared response rates, respondents' characteristics, and substantive results for CAHPS surveys administered using web and mail protocols. They found that response rates to surveys administered using the Internet protocols were lower than for the surveys administered by mail, but characteristics of respondents and survey answers were very similar across protocols. Respondents without email addresses tended to be older, less educated, and more likely to be male than those with email addresses, and there were a few differences in their responses.
AHRQ-funded; HS016978.
Citation: Fowler FJ, Cosenza C, Cripps LA .
The effect of administration mode on CAHPS survey response rates and results: a comparison of mail and web-based approaches.
Health Serv Res 2019 Jun;54(3):714-21. doi: 10.1111/1475-6773.13109..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Health Information Technology (HIT), Patient Experience, Primary Care, Quality of Care, Quality Improvement
Hanson C, Herring B, Trish E
Do health insurance and hospital market concentration influence hospital patients' experience of care?
Researchers examined the effects of insurance and hospital market concentration on hospital patients' experience of care. They found that changes in patient satisfaction are positively associated with increases in insurance concentration and negatively associated with increases in hospital concentration. They concluded that their findings add to the evidence on the harms of hospital consolidation but suggest that insurer consolidation may improve patient experience.
AHRQ-funded; HS026333.
Citation: Hanson C, Herring B, Trish E .
Do health insurance and hospital market concentration influence hospital patients' experience of care?
Health Serv Res 2019 May 16;54(4):805-15. doi: 10.1111/1475-6773.13168..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Health Insurance, Hospitals, Patient Experience, Quality of Care, Quality Improvement
Toomey SL, Elliott MN, Zaslavsky AM
Improving response rates and representation of hard-to-reach groups in family experience surveys.
This study examined the use of an audio-enabled tablet to survey parents of children discharged from 4 units of a children’s hospital. Normal mail survey response rates are very low, especially for black, Latino, and low-income respondents. This survey was done day of discharge at the hospital and there was a response rate of 71.1% via tablet versus 16.3% for mail only. The Child Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey was used. Tablet response rates were highest with fathers, those more likely to have a high school education or less, less likely to be white, and more likely to be publicly insured. The results are promising for future surveys using tablet administration.
AHRQ-funded; HS020513; HS025299.
Citation: Toomey SL, Elliott MN, Zaslavsky AM .
Improving response rates and representation of hard-to-reach groups in family experience surveys.
Acad Pediatr 2019 May - Jun;19(4):446-53. doi: 10.1016/j.acap.2018.07.007..
Keywords: Caregiving, Children/Adolescents, Consumer Assessment of Healthcare Providers and Systems (CAHPS), Health Information Technology (HIT), Hospitals, Low-Income, Patient Experience, Quality of Care, Quality Improvement, Racial and Ethnic Minorities
Cefalu MS, Elliott MN, Setodji CM
Hospital quality indicators are not unidimensional: a reanalysis of Lieberthal and Comer.
The objective of this study was to evaluate the dimensionality of hospital quality indicators treated as unidimensional in a prior publication. The investigators found that there were four underlying dimensions of hospital quality: patient experience, mortality, and two clinical process dimensions. They concluded that hospital quality should be measured using a variety of indicators reflecting different dimensions of quality.
AHRQ-funded; HS016980; HS016978.
Citation: Cefalu MS, Elliott MN, Setodji CM .
Hospital quality indicators are not unidimensional: a reanalysis of Lieberthal and Comer.
Health Serv Res 2019 Apr;54(2):502-08. doi: 10.1111/1475-6773.13056..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Hospitals, Patient Experience, Provider Performance, Quality of Care, Quality Indicators (QIs), Quality Measures
Quigley DD, Elliott MN, Setodji CM
Quantifying magnitude of group-level differences in patient experiences with health care.
The purpose of this paper is to review approaches for assessing magnitude of differences in patient experience scores between different providers. The authors suggest routine estimation of magnitude in patient experience research. More work is needed documenting magnitude of differences between providers to make patient experience data more interpretable and usable.
AHRQ-funded; HS016980.
Citation: Quigley DD, Elliott MN, Setodji CM .
Quantifying magnitude of group-level differences in patient experiences with health care.
Health Serv Res 2018 Aug;53 Suppl 1:3027-51. doi: 10.1111/1475-6773.12828..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Health Services Research (HSR), Patient Experience, Patient Experience, Quality Measures
Parast L, Burkhart Q, Gidengil C
Validation of new care coordination quality measures for children with medical complexity.
The purpose of this paper was to validate new caregiver-reported quality measures assessing care coordination services for children with medical complexity (CMC). Results showed that 19 newly-developed Family Experiences with Coordination of Care quality measures demonstrated convergent validity with previously-validated CAHPS measures. These new measures are valid for assessing the quality of care coordination services provided to CMC and may be useful for evaluating new models of care focused on improving these services.
AHRQ-funded; HS020506.
Citation: Parast L, Burkhart Q, Gidengil C .
Validation of new care coordination quality measures for children with medical complexity.
Acad Pediatr 2018 Jul;18(5):581-88. doi: 10.1016/j.acap.2018.03.006..
Keywords: Care Coordination, Children/Adolescents, Chronic Conditions, Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient Experience, Quality Indicators (QIs), Quality Measures, Quality Improvement, Quality of Care
Al Danaf J, Chang BH, Shaear M
Surfacing and addressing hospitalized patients' needs: proactive nurse rounding as a tool.
This paper reported on rounding interventions employed at high performing hospitals, and provided three case studies on how proactive nurse rounding was successfully implemented to improve patient-centredness. The investigators concluded that proactive rounding interventions are a feasible approach to help surface and address hospitalized patients' needs in a timely manner.
AHRQ-funded; HS021921.
Citation: Al Danaf J, Chang BH, Shaear M .
Surfacing and addressing hospitalized patients' needs: proactive nurse rounding as a tool.
J Nurs Manag 2018 Jul;26(5):540-47. doi: 10.1111/jonm.12580..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Hospitalization, Hospitals, Inpatient Care, Nursing, Patient-Centered Healthcare, Patient Experience, Quality Improvement
Hatfield LA, Zaslavsky AM
Separable covariance models for health care quality measures across years and topics.
Public quality reports for Medicare Advantage health plans include 11 measures of patient experiences reported in the annual Consumer Assessment of Healthcare Providers and Systems surveys. To summarize associations among measures and years, the authors model the variance-covariance matrix governing the plan-level vectors of yearly quality measures as a Kronecker product of an across-measure matrix and an across-year matrix, or a sum of such Kronecker products.
AHRQ-funded; HS016978.
Citation: Hatfield LA, Zaslavsky AM .
Separable covariance models for health care quality measures across years and topics.
Stat Med 2018 May 30;37(12):2053-66. doi: 10.1002/sim.7656..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Quality Measures, Quality of Care, Patient Experience, Medicare
Yang L, Liu C, Huang C
Patients' perceptions of interactions with hospital staff are associated with hospital readmissions: a national survey of 4535 hospitals.
The researchers examined the extent to which patients' experience with hospital care is related to hospital readmission. Their finding suggests that hospitals with better staff responsiveness were significantly more likely to have lower 30-day readmissions for all conditions. The effect size depended on the baseline readmission rates, with the largest effect on hospitals in the upper 75th quartile.
AHRQ-funded; HS021844.
Citation: Yang L, Liu C, Huang C .
Patients' perceptions of interactions with hospital staff are associated with hospital readmissions: a national survey of 4535 hospitals.
BMC Health Serv Res 2018 Jan 29;18(1):50. doi: 10.1186/s12913-018-2848-9.
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Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Hospitals, Patient Experience, Patient Experience, Hospital Readmissions
Ndumele CD, Cohen MS, Cleary PD
Association of state access standards with accessibility to specialists for Medicaid managed care enrollees.
The researchers compared ratings of access to specialists for adult Medicaid and commercial enrollees before and after the implementation of specialty access standards. Overall, there was no significant improvement in timely access to specialty services for Medicaid managed care enrollees in the period following implementation of standard(s) nor was there any impact of access standards on insurance-based disparities in access.
AHRQ-funded; HS016978; HS017589.
Citation: Ndumele CD, Cohen MS, Cleary PD .
Association of state access standards with accessibility to specialists for Medicaid managed care enrollees.
JAMA Intern Med 2017 Oct;177(10):1445-51. doi: 10.1001/jamainternmed.2017.3766.
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Keywords: Access to Care, Consumer Assessment of Healthcare Providers and Systems (CAHPS), Quality of Care, Health Insurance, Patient Experience
Hatfield LA, Zaslavsky AM
Implications of variation in the relationships between beneficiary characteristics and Medicare Advantage CAHPS measures.
The researchers studied how differences in quality score adjustments across Medicare Advantage contracts change comparisons for individuals and contracts. They found that, for average consumers, standard adjustment is sufficient to represent variation in contract quality standardized to a common population. For people with characteristics far from average, personalized reporting using their characteristics and contract-specific coefficients can substantially change the expected quality measures across contracts.
AHRQ-funded; HS016978.
Citation: Hatfield LA, Zaslavsky AM .
Implications of variation in the relationships between beneficiary characteristics and Medicare Advantage CAHPS measures.
Health Serv Res 2017 Aug;52(4):1310-29. doi: 10.1111/1475-6773.12544.
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Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Medicare, Health Status, Patient Experience, Quality of Care, Quality Improvement, Quality Measures
Khatri N, Gupta V, Varma A
The relationship between HR capabilities and quality of patient care: the mediating role of proactive work behaviors.
The researchers developed a multidimensional construct of human resource (HR) capabilities and tested its relationship with quality of patient care using a national sample of U.S. hospitals. Their analyses using structural equation modeling suggest that the positive relationship of HR capabilities with quality of patient care is mediated by proactive behaviors of health care workers. Implications of the study findings for research and practice are discussed.
AHRQ-funded; HS017549.
Citation: Khatri N, Gupta V, Varma A .
The relationship between HR capabilities and quality of patient care: the mediating role of proactive work behaviors.
Hum Resour Manage 2017 Jul-Aug;56(4):673-91. doi: 10.1002/hrm.21794.
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Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Hospitals, Quality of Care, Patient Experience, Patient Experience
Lee JS, Hu HM, Brummett CM
Postoperative opioid prescribing and the pain scores on Hospital Consumer Assessment of Healthcare Providers and Systems Survey.
The researchers sought to evaluate the association between the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) pain measures and postoperative opioid prescribing in surgical patients, which accounts for nearly 40 percent of surgical prescriptions. They found that postoperative opioid prescribing was not correlated with HCAHPS pain measures.
AHRQ-funded; HS023313.
Citation: Lee JS, Hu HM, Brummett CM .
Postoperative opioid prescribing and the pain scores on Hospital Consumer Assessment of Healthcare Providers and Systems Survey.
JAMA 2017 May 16;317(19):2013-15. doi: 10.1001/jama.2017.2827.
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Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Hospitals, Opioids, Pain, Patient Experience
Toomey SL, Elliott MN, Zaslavsky AM
Variation in family experience of pediatric inpatient care as measured by child HCAHPS.
Making national comparisons of family experience of inpatient pediatric care has been limited by the lack of a publicly available survey. A new survey developed by AHRQ and the Centers for Medicare & Medicaid Services makes use of 18 measures. It found that family experience of pediatric inpatient care shows substantial room for improvement and varies considerably across hospitals and measures.
AHRQ-funded; HS020513.
Citation: Toomey SL, Elliott MN, Zaslavsky AM .
Variation in family experience of pediatric inpatient care as measured by child HCAHPS.
Pediatrics 2017 Apr;139(4):e20163372. doi: 10.1542/peds.2016-3372.
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Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Children/Adolescents, Patient Experience, Patient Experience, Quality of Care
Martino SC, Shaller D, Schlesinger M
CAHPS and comments: how closed-ended survey questions and narrative accounts interact in the assessment of patient experience.
The authors investigated whether content from patient narratives explains variation in patients' primary care provider (PCP) ratings beyond information from the closed-ended questions of CAHPS Clinician and Group Survey and whether the relative placement of closed- and open-ended survey questions affects either the content of narratives or the CAHPS composite scores. They found that incorporating a protocol for eliciting narratives into a patient experience survey resulted in minimal distortion of patient feedback, and narratives from sicker patients helped explain variation in provider ratings.
AHRQ-funded; HS016980; HS016978; HS021858.
Citation: Martino SC, Shaller D, Schlesinger M .
CAHPS and comments: how closed-ended survey questions and narrative accounts interact in the assessment of patient experience.
J Patient Exp 2017 Mar;4(1):37-45. doi: 10.1177/2374373516685940.
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Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient Experience, Primary Care, Quality of Care, Quality Measures
Oladeru OA, Hamadu M, Cleary PD
House staff communication training and patient experience scores.
The purpose of this study was to assess whether communication training for housestaff via role-playing exercises (1) was well-received and (2) improved patient experience scores in housestaff clinics. Forty-four of a possible 45 housestaff (97.8%) participated, with 31 (70.5%) indicating that the role-playing exercise increased their perception of the 5-step strategy the study emphasized.
AHRQ-funded; HS016978.
Citation: Oladeru OA, Hamadu M, Cleary PD .
House staff communication training and patient experience scores.
J Patient Exp 2017 Mar 1;4(1):28-36. doi: 10.1177/2374373517694533..
Keywords: Communication, Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient Experience, Patient Experience, Training
Martsolf GR, Gibson TB, Benevent R
AHRQ Author: Jiang HJ, Stocks C
An examination of hospital nurse staffing and patient experience with care: Differences between cross-sectional and longitudinal estimates.
The researchers studied the association between hospital nurse staffing and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores. After controlling for unobserved hospital characteristics, they found that the positive influences of increased nurse staffing levels and skill mix were relatively small in size and limited to a few measures of patients' inpatient experience.
AHRQ-authored.
Citation: Martsolf GR, Gibson TB, Benevent R .
An examination of hospital nurse staffing and patient experience with care: Differences between cross-sectional and longitudinal estimates.
Health Serv Res 2016 Dec;51(6):2221-41. doi: 10.1111/1475-6773.12462.
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Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Nursing, Patient Experience, Patient Experience, Healthcare Cost and Utilization Project (HCUP)
Melnick ER, Powsner SM
Empathy in the time of burnout.
The authors argue that before adding empathy measurements to the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey, it would be wise to consider that measurement fatigue contributes to burnout. Adding empathy measurements might reduce empathy: a perverse Hawthorne effect. A health care system hoping for more substantial physician-patient relationships must invest more in the well-being of its caregivers.
AHRQ-funded; HS021271.
Citation: Melnick ER, Powsner SM .
Empathy in the time of burnout.
Mayo Clin Proc 2016 Dec;91(12):1678-79. doi: 10.1016/j.mayocp.2016.09.003.
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Keywords: Burnout, Consumer Assessment of Healthcare Providers and Systems (CAHPS), Hospitals, Patient Experience
Rajaram R, Saddat L, Chung J
Impact of the 2011 ACGME resident duty hour reform on hospital patient experience and processes-of-care.
The investigators evaluated the association between resident duty hour reform and measures of processes-of-care and patient experience. They concluded that the 2011 Accreditation Council for Graduate Medical Education duty hour reform was not associated with improvements in process-of-care and patient experience measures.
AHRQ-funded; HS000078.
Citation: Rajaram R, Saddat L, Chung J .
Impact of the 2011 ACGME resident duty hour reform on hospital patient experience and processes-of-care.
BMJ Qual Saf 2016 Dec;25(12):962-70. doi: 10.1136/bmjqs-2015-004794.
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Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Education: Continuing Medical Education, Quality of Care, Patient Experience, Patient Safety