National Healthcare Quality and Disparities Report
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Topics
- Access to Care (1)
- Adverse Events (2)
- Care Coordination (1)
- Children/Adolescents (2)
- Clostridium difficile Infections (1)
- COVID-19 (11)
- Critical Care (1)
- Elderly (1)
- Electronic Health Records (EHRs) (1)
- Emergency Preparedness (2)
- Healthcare-Associated Infections (HAIs) (5)
- Healthcare Cost and Utilization Project (HCUP) (1)
- Healthcare Costs (1)
- Healthcare Delivery (3)
- Health Information Technology (HIT) (1)
- Hospital Discharge (1)
- Hospitalization (3)
- Hospital Readmissions (1)
- (-) Hospitals (18)
- Infectious Diseases (6)
- Inpatient Care (2)
- Intensive Care Unit (ICU) (1)
- Long-Term Care (1)
- Mortality (1)
- Nursing Homes (1)
- Palliative Care (1)
- Patient-Centered Outcomes Research (1)
- Patient Safety (4)
- Policy (1)
- Prevention (3)
- Provider: Health Personnel (1)
- (-) Public Health (18)
- Public Reporting (1)
- Respiratory Conditions (1)
- Risk (1)
- Sepsis (1)
- Surgery (2)
- Transitions of Care (1)
AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 18 of 18 Research Studies DisplayedUsher MC, Tignanelli CJ, Hilliard B
Responding to COVID-19 through interhospital resource coordination: a mixed-methods evaluation
Researchers sought to describe a novel hospital system approach to managing the COVID-19 pandemic, including multihospital coordination capability and transfer of COVID-19 patients to a single, dedicated hospital. They found that, with standardized communication, interhospital transfers were a safe and effective method of cohorting COVID-19 patients, were well-received by health care providers, and had the potential to improve care quality.
AHRQ-funded; HS026379; HS026732.
Citation: Usher MC, Tignanelli CJ, Hilliard B .
Responding to COVID-19 through interhospital resource coordination: a mixed-methods evaluation
J Patient Saf 2022 Jun 1;18(4):287-94. doi: 10.1097/pts.0000000000000916..
Keywords: COVID-19, Hospitals, Healthcare Delivery, Public Health, Care Coordination, Transitions of Care
Michelson KA, Rees CA, Sarathy J
Interregional transfers for pandemic surges.
Hospital inpatient and intensive care unit (ICU) bed shortfalls may arise due to regional surges in volume. In this study, the investigators sought to determine how interregional transfers could alleviate bed shortfalls during a pandemic, using estimates of past and projected inpatient and ICU cases of coronavirus disease 2019 (COVID-19) from 4 February 2020 to 1 October 2020.
AHRQ-funded; HS026503.
Citation: Michelson KA, Rees CA, Sarathy J .
Interregional transfers for pandemic surges.
Clin Infect Dis 2021 Dec 6;73(11):e4103-e10. doi: 10.1093/cid/ciaa1549..
Keywords: COVID-19, Hospitals, Public Health, Intensive Care Unit (ICU), Critical Care
Barbash IJ, Kahn JM
Fostering hospital resilience-lessons from COVID-19.
This article describes how hospitals can foster organizational resistance using lessons from the COVID-19 pandemic. They describe what resilience would look like including: 1) resilient hospitals would respond to a surge in COVID-19 cases in ways that ensure the delivery of high-quality care for patients with the disease; 2) resilient hospitals would response to COVID-19 surges in ways that preserve standards of care for patients without COVID-19; 3) resilient hospitals would preserve access to care for the entire community of patients they serve, including continuing elective surgeries and mitigating effects of health disparities; and 4) resilient hospitals would do all of this while protecting the well-being of frontline staff. Protection of front-line staff includes ensuring adequate personal protective equipment as well as through clear communication from leaders. Factors that foster resilience are described including well-developed, scalable clinical protocols, flexible electronic health records, and a supportive, interdisciplinary working environment in which all team members feel safe to raise concerns and share new ideas. Resilience might also be fostered among hospitals through their interactions.
AHRQ-funded; HS025455.
Citation: Barbash IJ, Kahn JM .
Fostering hospital resilience-lessons from COVID-19.
JAMA 2021 Aug 24; 326(8):693-94. doi: 10.1001/jama.2021.12484..
Keywords: COVID-19, Hospitals, Healthcare Delivery, Public Health
Santos T, Lee SD, East C
Can collaboration between nonprofit hospitals and local health departments influence population health investments by nonprofit hospitals?
The Patient Protection and Affordable Care Act (ACA) sought to improve population health by requiring nonprofit hospitals (NFPs) to conduct triennial community health needs assessments and address the identified needs. In this context, some states have encouraged collaboration between hospitals and local health department (LHD) to increase the focus of community benefit spending onto population health. The aim of the study was to examine whether a 2012 state law that required NFPs to collaborate with LHDs in local health planning influenced hospital population health improvement spending.
AHRQ-funded; HS024959; HS026116.
Citation: Santos T, Lee SD, East C .
Can collaboration between nonprofit hospitals and local health departments influence population health investments by nonprofit hospitals?
Med Care 2021 Aug;59(8):687-93. doi: 10.1097/mlr.0000000000001561..
Keywords: Hospitals, Public Health
Masonbrink AR, Harris M, Hall M
Safety events in children's hospitals during the COVID-19 pandemic.
The coronavirus disease 2019 (COVID-19) pandemic has impacted hospitals, potentially affecting quality and safety. The objective of this study was to compare pediatric hospitalization safety events during the pandemic versus previous years. The investigators concluded that postoperative sepsis rates increased among children hospitalized during COVID-19. They suggest that efforts are needed to improve safety of postoperative care for hospitalized children.
AHRQ-funded; HS024554; HS024592.
Citation: Masonbrink AR, Harris M, Hall M .
Safety events in children's hospitals during the COVID-19 pandemic.
Hosp Pediatr 2021 Jun;11(6):e95-e100. doi: 10.1542/hpeds.2020-004937..
Keywords: Children/Adolescents, COVID-19, Patient Safety, Sepsis, Adverse Events, Hospitalization, Hospitals, Inpatient Care, Infectious Diseases, Public Health
Ye S, Hiura G, Fleck E
Hospital readmissions after implementation of a discharge care program for patients with COVID-19 illness.
The surge of coronavirus 2019 (COVID-19) hospitalizations in New York City required rapid discharges to maintain hospital capacity. The objective of this study was to determine whether lenient provisional discharge guidelines with remote monitoring after discharge resulted in safe discharges home for patients hospitalized with COVID-19 illness. The investigators found that lenient discharge criteria in conjunction with remote monitoring after discharge were associated with a rate of early readmissions after COVID-related hospitalizations that was comparable to the rate of readmissions after other reasons for hospitalization before the COVID pandemic.
AHRQ-funded; HS024262; HS025198.
Citation: Ye S, Hiura G, Fleck E .
Hospital readmissions after implementation of a discharge care program for patients with COVID-19 illness.
J Gen Intern Med 2021 Mar;36(3):722-29. doi: 10.1007/s11606-020-06340-w..
Keywords: COVID-19, Hospital Discharge, Hospital Readmissions, Hospitals, Public Health, Hospitalization, Risk
Martin BI, Brodke DS, Wilson FA
The impact of halting elective admissions in anticipation of a demand surge due to the coronavirus pandemic (COVID-19).
This study’s objective was to estimate excess demand for hospital beds due to COVID-19 and the net financial impact of eliminating elective admissions to meet demand. An economic simulation was conducted combining epidemiological reports, the US Census, American Hospital Association Annual Survey, and the National Inpatient Sample. The base case used relied on a hospital admission rate reported by the CDC of 137.6 per 100,000, with the highest rates in people aged 65 year and older and 50-64 years. Elective admissions accounted for 20% of total hospital admissions, with an average rate of 30% unoccupied beds across hospitals. Hospitals that restricted elective care due to a COVID surge was only financial favorable if capacity was filled by a high proportion of COVID-19 cases among hospitals with low rates of elective admissions. There is a substantial financial risk to hospitals that restrict elective care.
AHRQ-funded; HS024714.
Citation: Martin BI, Brodke DS, Wilson FA .
The impact of halting elective admissions in anticipation of a demand surge due to the coronavirus pandemic (COVID-19).
Med Care 2021 Mar;59(3):213-19. doi: 10.1097/mlr.0000000000001496..
Keywords: Healthcare Cost and Utilization Project (HCUP), COVID-19, Hospitals, Healthcare Costs, Access to Care, Public Health
Montoya A, Jenq G, Mills JP
Partnering with local hospitals and public health to manage COVID-19 outbreaks in nursing homes.
In this study, the authors described, among short-term and long-term residents at three nursing homes (NHs) in Michigan, the outbreak identification process, universal testing, point prevalence of COVID-19, and subsequent containment efforts, outcomes, and challenges. They found that proactive and coordinated steps between NH medical directors and administrators, referral hospitals including their laboratories, and local public health officials were necessary to respond rapidly to an outbreak and to limit the transmission of COVID-19. They suggested that this coordinated public health approach may save lives, minimize the burden to the healthcare system, and reduce healthcare costs.
AHRQ-funded; HS025451.
Citation: Montoya A, Jenq G, Mills JP .
Partnering with local hospitals and public health to manage COVID-19 outbreaks in nursing homes.
J Am Geriatr Soc 2021 Jan;69(1):30-36. doi: 10.1111/jgs.16869..
Keywords: Hospitals, Nursing Homes, Long-Term Care, Public Health, COVID-19, Elderly, Infectious Diseases
Rhee C, Baker M, Vaidya V
Incidence of nosocomial COVID-19 in patients hospitalized at a large US academic medical center.
Some patients are avoiding essential care for fear of contracting coronavirus disease 2019 (COVID-19) in hospitals. The purpose of this study was to assess the incidence of COVID-19 among patients hospitalized at a large US academic medical center in the 12 weeks after the first inpatient case was identified. The investigators concluded that in this cohort study of patients in a large academic medical center with rigorous infection control measures, nosocomial COVID-19 was rare during the height of the pandemic in the region.
AHRQ-funded; K08 HS025008.
Citation: Rhee C, Baker M, Vaidya V .
Incidence of nosocomial COVID-19 in patients hospitalized at a large US academic medical center.
JAMA Netw Open 2020 Sep;3(9):e2020498. doi: 10.1001/jamanetworkopen.2020.20498..
Keywords: COVID-19, Hospitalization, Hospitals, Public Health
Auerbach A, O'Leary KJ, Greysen SR
Hospital ward adaptation during the COVID-19 pandemic: a national survey of academic medical centers.
The authors sought to characterize inpatient adaptations to care for non-ICU COVID-19 patients. They found that the COVID-19 pandemic has required medical wards to rapidly adapt with expanding use of respiratory isolation units and use of technology emerging as critical approaches. Reports of unrecognized or delayed diagnoses highlight how such adaptations may produce potential adverse effects on care.
AHRQ-funded; HS026383; HS026215; HS027369.
Citation: Auerbach A, O'Leary KJ, Greysen SR .
Hospital ward adaptation during the COVID-19 pandemic: a national survey of academic medical centers.
J Hosp Med 2020 Aug;15(8):483-88. doi: 10.12788/jhm.3476..
Keywords: COVID-19, Emergency Preparedness, Hospitals, Public Health, Healthcare Delivery, Inpatient Care
Cho HJ, Feldman LS, Keller S
Choosing Wisely in the COVID-19 era: preventing harm to healthcare workers.
This paper highlights the 5 top recommendations developed for hospitals in the COVID-19 era as part of the Choosing Wisely® campaign. This top 5 list of overuse practices in hospital medicine can lead to harm of both patients and healthcare workers. The recommendations include: 1) Do not obtain nonurgent labs in separate blood draws if they can be batched together; 2) Do not use bronchodilators unless there is active obstructive airway disease; 3) Do not use posteroanterior and lateral chest X-ray (CXR) as initial imaging, use a portable CXR instead; 4) Avoid in-person evaluations in favor of virtual communication unless necessary; and 5) Do not delay goals of care conversations for hospitalized patients who are unlikely to benefit from life-sustaining treatments.
AHRQ-funded; HS025782.
Citation: Cho HJ, Feldman LS, Keller S .
Choosing Wisely in the COVID-19 era: preventing harm to healthcare workers.
J Hosp Med 2020 Jun;15(6):360-62. doi: 10.12788/jhm.3457..
Keywords: COVID-19, Infectious Diseases, Hospitals, Prevention, Public Health, Provider: Health Personnel
Baker AW, Nehls N, Ilies I
Use of optimised dual statistical process control charts for early detection of surgical site infection outbreaks.
This study analyzed the use of optimized dual statistical process control (SPC) charts to predict surgical site infection (SSI) outbreaks. The researchers retrospectively applied an optimized pair of moving average (MA) SPC charts to all 30 SSI outbreaks previously identified and investigated from 2007 to 2015 in the Duke Infection Control Outreach Network (DICON), which is a network of more than 50 community hospitals. The dual MA SPC chart approach detected all 30 outbreaks at a median of 16 months prior to traditional surveillance detection.
AHRQ-funded; HS23821.
Citation: Baker AW, Nehls N, Ilies I .
Use of optimised dual statistical process control charts for early detection of surgical site infection outbreaks.
BMJ Qual Saf 2020 Jun;29(6):517-20. doi: 10.1136/bmjqs-2019-010586..
Keywords: Healthcare-Associated Infections (HAIs), Surgery, Patient Safety, Hospitals, Public Health, Infectious Diseases
Steuart R, Huang FS, Schaffzin JK
Finding the value in personal protective equipment for hospitalized patients during a pandemic and beyond.
Innovative protocols have been conceptualized and used to conserve PPE in hospitals. Conservation protocols often fail to identify missed opportunities to improve the value of personal protective equipment (PPE) that already exist in hospital care. By defining the value of inpatient PPE, hospitals can identify opportunities for value improvement. Changes implemented now will maximize PPE value and preserve supply during this pandemic and beyond. In this article, the authors discuss the value in PPE for hospitalized patients during a pandemic and beyond.
AHRQ-funded; HS025138.
Citation: Steuart R, Huang FS, Schaffzin JK .
Finding the value in personal protective equipment for hospitalized patients during a pandemic and beyond.
J Hosp Med 2020 May;15(5):295-98. doi: 10.12788/jhm.3429..
Keywords: COVID-19, Emergency Preparedness, Public Health, Hospitals, Patient Safety
McHaney-Lindstrom M, Hebert C, Miller H
Network analysis of intra-hospital transfers and hospital onset Clostridium difficile infection.
This paper explores how social network analysis (SNA) software can be used to analyze intra-hospital networks of individuals with a healthcare associated infection (HAI) for further analysis in a GIS environment. The SNA analysis compared cases to controls which highlighted significant differences in the overall structure of the networks.
AHRQ-funded; HS024379.
Citation: McHaney-Lindstrom M, Hebert C, Miller H .
Network analysis of intra-hospital transfers and hospital onset Clostridium difficile infection.
Health Info Libr J 2020 Mar;37(1):26-34. doi: 10.1111/hir.12274..
Keywords: Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Infectious Diseases, Hospitals, Public Health
Ji W, McKenna C, Ochoa A
Development and assessment of objective surveillance definitions for nonventilator hospital-acquired pneumonia.
The authors sought to propose and assess potentially objective, efficient, and reproducible surveillance definitions for non-ventilator hospital-acquired pneumonia (NV-HAP) using routine clinical data stored in electronic health record systems. They found that objective surveillance for NV-HAP using electronically computable definitions that incorporate common clinical criteria is feasible and generates incidence, mortality, and adjusted odds ratios for hospital mortality similar to estimates from manual surveillance. They concluded that these definitions have the potential to facilitate widespread, automated surveillance for NV-HAP and thus inform the development and evaluation of prevention programs.
AHRQ-funded; HS025008.
Citation: Ji W, McKenna C, Ochoa A .
Development and assessment of objective surveillance definitions for nonventilator hospital-acquired pneumonia.
JAMA Netw Open 2019 Oct 2;2(10):e1913674. doi: 10.1001/jamanetworkopen.2019.13674..
Keywords: Healthcare-Associated Infections (HAIs), Hospitals, Respiratory Conditions, Public Health, Electronic Health Records (EHRs), Health Information Technology (HIT)
Pogorzelska-Maziarz M, de Cordova PB, Herzig M, de Cordova PB, Herzig CTA
Perceived impact of state-mandated reporting on infection prevention and control departments.
Currently, most US states have adopted legislation requiring hospitals to submit health care-associated infection (HAI) data. In this study, the authors evaluated the perceived impact of state HAI laws on infection prevention and control (IPC) departments. They concluded that respondents in states with laws reported negative effects on their IPC department, beyond what was required by federal mandates.
AHRQ-funded; HS024339.
Citation: Pogorzelska-Maziarz M, de Cordova PB, Herzig M, de Cordova PB, Herzig CTA .
Perceived impact of state-mandated reporting on infection prevention and control departments.
Am J Infect Control 2019 Feb;47(2):118-22. doi: 10.1016/j.ajic.2018.08.012..
Keywords: Public Reporting, Policy, Public Health, Healthcare-Associated Infections (HAIs), Infectious Diseases, Prevention, Hospitals
Leyenaar JK, Bogetz JF
Child mortality in the United States: bridging palliative care and public health perspectives.
This commentary discusses the findings of the article by Trowbridge et al in this same issue of Pediatrics, which examines modes of death rather than causes of death at a freestanding children’s hospital. Five distinct categories were created: withdrawal of life-sustaining technology; non-escalation of care; failed resuscitation; code then withdrawal; death by neurological criteria. More than 60% of the deaths were infants. The authors of this commentary note that conceptualizing the findings of this study from a public health perspective raises important questions about how causes of death are associated with end-of-life care in hospitals.
AHRQ-funded; HS024133.
Citation: Leyenaar JK, Bogetz JF .
Child mortality in the United States: bridging palliative care and public health perspectives.
Pediatrics 2018 Oct;142(4). doi: 10.1542/peds.2018-1927..
Keywords: Children/Adolescents, Hospitals, Mortality, Palliative Care, Patient-Centered Outcomes Research, Public Health
Baker AW, Haridy S, Salem J
Performance of statistical process control methods for regional surgical site infection surveillance: a 10-year multicentre pilot study.
The authors performed a pilot study within a large network of community hospitals to evaluate performance of statistical process control (SPC) methods for detecting surgical site infections (SSI) outbreaks. Their findings illustrated the potential usefulness and feasibility of real-time SPC surveillance of SSI to rapidly identify outbreaks and improve patient safety. Further study is needed to optimize SPC chart selection and calculation, statistical outbreak detection rules and the process for reacting to signals of potential outbreaks.
AHRQ-funded; HS023821.
Citation: Baker AW, Haridy S, Salem J .
Performance of statistical process control methods for regional surgical site infection surveillance: a 10-year multicentre pilot study.
BMJ Qual Saf 2018 Aug;27(8):600-10. doi: 10.1136/bmjqs-2017-006474..
Keywords: Healthcare-Associated Infections (HAIs), Patient Safety, Surgery, Hospitals, Public Health, Prevention, Adverse Events