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Topics
- Adverse Events (1)
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- Provider: Clinician (1)
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- Teams (4)
- Transitions of Care (3)
- Trauma (1)
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 14 of 14 Research Studies DisplayedVranas KC, Golden SE, Mathews KS
The influence of the COVID-19 pandemic on ICU organization, care processes, and frontline clinician experiences: a qualitative study.
The COVID-19 pandemic resulted in unprecedented adjustments to intensive care unit (ICU) organization and care processes globally. The investigators examined if hospital emergency responses to the COVID-19 pandemic differed depending on hospital setting and explored which strategies worked well to mitigate strain as perceived by intensivists. The investigators concluded that their study demonstrated the importance of trust and transparency between frontline staff and hospital leadership as key components of effective emergency responses during public health crises.
AHRQ-funded; HS028038.
Citation: Vranas KC, Golden SE, Mathews KS .
The influence of the COVID-19 pandemic on ICU organization, care processes, and frontline clinician experiences: a qualitative study.
Chest 2021 Nov;160(5):1714-28. doi: 10.1016/j.chest.2021.05.041..
Keywords: COVID-19, Intensive Care Unit (ICU), Critical Care, Healthcare Delivery, Workforce, Public Health
Anesi GL, Kerlin MP
The impact of resource limitations on care delivery and outcomes: routine variation, the coronavirus disease 2019 pandemic, and persistent shortage.
Researchers discuss the impact of resource limitations on care delivery and outcomes. They conclude that the interaction between resource limitation and care delivery and outcomes is complex and incompletely understood. Further, the COVID-19 pandemic provides a learning opportunity for strain response during both pandemic and non-pandemic times.
AHRQ-funded; HS026372.
Citation: Anesi GL, Kerlin MP .
The impact of resource limitations on care delivery and outcomes: routine variation, the coronavirus disease 2019 pandemic, and persistent shortage.
Curr Opin Crit Care 2021 Oct 1;27(5):513-19. doi: 10.1097/mcc.0000000000000859..
Keywords: COVID-19, Public Health, Healthcare Delivery, Intensive Care Unit (ICU), Outcomes
Anesi GL, Chelluri J, Qasim ZA
Association of an emergency department-embedded critical care unit with hospital outcomes and intensive care unit use.
The purpose of this study was to evaluate the potential impact of an emergency department-embedded critical care unit (CCU) at the Hospital of the University of Pennsylvania among patients with sepsis and acute respiratory failure (ARF) admitted from the emergency department to a medical ward or ICU from January 2016 to December 2017. Findings showed that the emergency department-embedded CCU was not associated with clinical outcomes among patients admitted with sepsis or ARF. Among less sick patients with sepsis, the emergency department-embedded CCU was initially associated with reduced rates of direct ICU admission from the emergency department. Further research was recommended to further evaluate the impact and utility of the emergency department-embedded CCU model.
AHRQ-funded; HS026372.
Citation: Anesi GL, Chelluri J, Qasim ZA .
Association of an emergency department-embedded critical care unit with hospital outcomes and intensive care unit use.
Ann Am Thorac Soc 2020 Dec;17(12):1599-609. doi: 10.1513/AnnalsATS.201912-912OC..
Keywords: Emergency Department, Critical Care, Intensive Care Unit (ICU), Hospitals, Sepsis, Respiratory Conditions, Outcomes, Patient-Centered Outcomes Research, Healthcare Delivery
Anesi GL, Chowdhury M, Small DS GL, Chowdhury M, Small DS
Association of a novel index of hospital capacity strain with admission to intensive care units.
Researchers sought to develop a novel composite strain index and measure its association with intensive care unit (ICU) admission decisions and hospital outcomes.
AHRQ-funded; HS026372.
Citation: Anesi GL, Chowdhury M, Small DS GL, Chowdhury M, Small DS .
Association of a novel index of hospital capacity strain with admission to intensive care units.
Ann Am Thorac Soc 2020 Nov;17(11):1440-47. doi: 10.1513/AnnalsATS.202003-228OC.
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Keywords: Intensive Care Unit (ICU), Hospitals, Healthcare Delivery
Ma AL, Cohen RS, Lee HC
Learning from wildfire disaster experience in California NICUs.
The authors’ objective was to learn how personnel working in neonatal intensive care units (NICUs) of California hospitals handled issues of neonatal transfer during wildfire disasters in recent years; their ultimate goal was to share lessons learned with healthcare teams on disaster preparedness. They found that while describing disaster preparedness, equipment (such as bassinets and backpacks), ambulance access/transport and documentation/charting were noted as important and essential. They concluded that teamwork, willingness to do other tasks that are not part of typical job descriptions, and unconventional strategies contributed to the success of keeping NICU babies safe when California wildfire strikes.
AHRQ-funded; HS023506.
Citation: Ma AL, Cohen RS, Lee HC .
Learning from wildfire disaster experience in California NICUs.
Children 2020 Oct;7(10):E155. doi: 10.3390/children7100155..
Keywords: Newborns/Infants, Neonatal Intensive Care Unit (NICU), Intensive Care Unit (ICU), Transitions of Care, Emergency Preparedness, Teams, Healthcare Delivery
Vakayil V, Ingraham NE, Robbins AJ
Epidemiological trends of surgical admissions to the intensive care unit in the United States.
Epidemiologic assessment of surgical admissions into intensive care units (ICUs) provides a framework to evaluate health care system efficiency and project future health care needs. The investigators performed a 9-year (2008-2016), retrospective, cohort analysis of all adult admissions to 88 surgical ICUs. They concluded that temporal analysis demonstrated a significant change in the type of surgical patients admitted to the ICU over the last decade, with decreasing mortality and LOS in selected cohorts, but an increasing rate of FS deterioration.
AHRQ-funded; HS026379.
Citation: Vakayil V, Ingraham NE, Robbins AJ .
Epidemiological trends of surgical admissions to the intensive care unit in the United States.
J Trauma Acute Care Surg 2020 Aug;89(2):279-88. doi: 10.1097/ta.0000000000002768..
Keywords: Intensive Care Unit (ICU), Surgery, Healthcare Delivery
Kelly Costa D, Liu H, Boltey EM
The structure of critical care nursing teams and patient outcomes: a network analysis.
This examined the connectiveness of critical nursing teams and patient outcomes. The study measured “coreness” (the degree to which a network is represented by a densely integrated core) and “betweenness” (whether a nurse lies on the path of others not directly connected). The researchers used ICU data from a medical center during 2011 and looked at nurses who worked in surgical ICU (SICU) or neurosurgical ICU (NICU) during that same time period. The sample included 598 adult patients and 281 nurses. The researchers found that the greater the coreness of the team, and the more betweenness there was with ICU nurses the less likely patients were to die.
AHRQ-funded; HS024552.
Citation: Kelly Costa D, Liu H, Boltey EM .
The structure of critical care nursing teams and patient outcomes: a network analysis.
Am J Respir Crit Care Med 2020 Feb 15;201(4):483-85. doi: 10.1164/rccm.201903-0543LE..
Keywords: Intensive Care Unit (ICU), Critical Care, Nursing, Teams, Outcomes, Healthcare Delivery, Patient-Centered Outcomes Research, Patient-Centered Healthcare
Hussain FS, Sosa T, Ambroggio L
Emergency transfers: an important predictor of adverse outcomes in hospitalized children.
This case-control study aimed to determine the predictive validity of an emergency transfer (ET) for outcomes in a free-standing children's hospital. Controls were matched in terms of age, hospital unit, and time of year. Patients who experienced an ET had a significantly higher likelihood of in-hospital mortality (22% vs 9%), longer ICU length of stay (4.9 vs 2.2 days), and longer posttransfer length of stay (26.4 vs 14.7 days) compared with controls (P < .03 for each).
AHRQ-funded; HS023827.
Citation: Hussain FS, Sosa T, Ambroggio L .
Emergency transfers: an important predictor of adverse outcomes in hospitalized children.
J Hosp Med 2019 Aug;14(8):482-85. doi: 10.12788/jhm.3219..
Keywords: Transitions of Care, Children/Adolescents, Critical Care, Intensive Care Unit (ICU), Adverse Events, Outcomes, Patient-Centered Outcomes Research, Inpatient Care, Hospitalization, Hospitals, Healthcare Delivery
Hoonakker PLT, Wooldridge AR, Hose BZ
Information flow during pediatric trauma care transitions: things falling through the cracks.
In order to investigate information flow during pediatric trauma care transitions, researchers interviewed 18 clinicians about communication and coordination between the emergency department, operating room, and pediatric intensive care unit, then surveyed the clinicians about patient safety during these transitions. They found that, despite the fact that the many services and units involved in pediatric trauma cooperate well together during trauma cases, important patient care information is often lost when transitioning patients between units. To manage the transition of this fragile and complex population better, they recommend finding ways to manage the information flow during these transitions better by, for instance, providing technological support to ensure shared mental models.
AHRQ-funded; HS023837.
Citation: Hoonakker PLT, Wooldridge AR, Hose BZ .
Information flow during pediatric trauma care transitions: things falling through the cracks.
Intern Emerg Med 2019 Aug;14(5):797-805. doi: 10.1007/s11739-019-02110-7..
Keywords: Children/Adolescents, Communication, Emergency Department, Healthcare Delivery, Intensive Care Unit (ICU), Patient Safety, Provider, Provider: Clinician, Surgery, Transitions of Care, Trauma
Barbash IJ, Wallace DJ, Kahn JM
Effects of changes in ICU bed supply on ICU utilization.
The purpose of this study was to determine the relationship between intensive care unit (ICU) bed supply and ICU admission in US hospitals. Using a difference-in-differences approach, researchers compared the risk-adjusted probability of ICU admission at hospitals that increased their ICU bed supply over time with matched hospitals that did not. Subjects were three patient groups with a low likelihood of benefiting from ICU admission: low-severity patients with acute myocardial infarction and pulmonary embolism, and high-severity patients with metastatic cancer at the end of life. Results showed that increases in ICU bed supply were associated with inconsistent changes in the probability of ICU admission that varied across patient subgroups.
AHRQ-funded; HS025455.
Citation: Barbash IJ, Wallace DJ, Kahn JM .
Effects of changes in ICU bed supply on ICU utilization.
Med Care 2019 Jul;57(7):544-50. doi: 10.1097/mlr.0000000000001137..
Keywords: Intensive Care Unit (ICU), Critical Care, Healthcare Utilization, Hospitalization, Healthcare Delivery, Hospitals
Boltey EM, Iwashyna TJ, Hyzy RC
Ability to predict team members' behaviors in ICU teams is associated with routine ABCDE implementation.
In order to support coordination among ICU team members, researchers developed a shared mental model (SMM). After administering a survey at the 2016 MHA Keystone Center ICU workshop, different components of SMMs were measured using five items from a validated survey, each on a 5-point Likert scale. Self-reported routine ABCDE implementation was measured using a single item 4-point Likert scale, and the relationship between SMMs and routine ABCDE implementation measured using logistic regression. The majority of survey respondents reported using the ABCDE bundle routinely. Odds of reporting routine ABCDE implementation significantly decreased when clinicians agreed it was difficult to predict team members' behaviors. The researchers conclude that increased awareness of team members' behaviors may be a mechanism to improve the implementation of complex care bundles such as ABCDE.
AHRQ-funded; HS024552.
Citation: Boltey EM, Iwashyna TJ, Hyzy RC .
Ability to predict team members' behaviors in ICU teams is associated with routine ABCDE implementation.
J Crit Care 2019 Jun;51:192-97. doi: 10.1016/j.jcrc.2019.02.028..
Keywords: Care Management, Critical Care, Hospitals, Intensive Care Unit (ICU), Healthcare Delivery, Teams
Costa DK, Dammeyer J, White M
Interprofessional team interactions about complex care in the ICU: pilot development of an observational rating tool.
The purpose of this study was to examine the reliability of an observational rating tool to assess team interactions about the awakening and breathing coordination, delirium, and early mobility (ABCDE) bundle in one ICU. It provided pilot evidence of reliability of an observational rating tool to assess interprofessional team interactions about ABCDE.
AHRQ-funded; HS024552.
Citation: Costa DK, Dammeyer J, White M .
Interprofessional team interactions about complex care in the ICU: pilot development of an observational rating tool.
BMC Res Notes 2016 Aug 18;9:408. doi: 10.1186/s13104-016-2213-1.
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Keywords: Healthcare Delivery, Communication, Critical Care, Intensive Care Unit (ICU), Teams
Baird J, Rehm RS, Hinds PS
Do you know my child? Continuity of nursing care in the pediatric intensive care unit.
The objective of this analysis was to explore the delivery of continuity of nursing care in the pediatric intensive care unit (PICU), from the perspective of both parents and nurses. Parents repeatedly endorsed a desire for continuity of nursing care, wanting to ensure that the bedside nurse valued their child as an individual and understood the complexities of the child's care regimen.
AHRQ-funded; HS000063.
Citation: Baird J, Rehm RS, Hinds PS .
Do you know my child? Continuity of nursing care in the pediatric intensive care unit.
Nurs Res 2016 Mar-Apr;65(2):142-50. doi: 10.1097/nnr.0000000000000135.
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Keywords: Care Management, Children/Adolescents, Critical Care, Healthcare Delivery, Intensive Care Unit (ICU), Nursing
Admon AJ, Seymour CW, Gershengorn HB
Hospital-level variation in ICU admission and critical care procedures for patients hospitalized for pulmonary embolism.
The researchers examined the relationship between intensive care unit (ICU) use for patients with pulmonary embolism (PE) and cost, mortality, readmission, and procedure use in 263 hospitals. They found wide variations in ICU admission rates for acute PE without a detectable impact on mortality, cost, or readmission.
AHRQ-funded; HS020672
Citation: Admon AJ, Seymour CW, Gershengorn HB .
Hospital-level variation in ICU admission and critical care procedures for patients hospitalized for pulmonary embolism.
Chest. 2014 Dec;146(6):1452-61. doi: 10.1378/chest.14-0059..
Keywords: Blood Clots, Care Management, Critical Care, Healthcare Delivery, Intensive Care Unit (ICU)