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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
151 to 175 of 383 Research Studies DisplayedUmberfield E, Ghaferi AA, Krein SL
Using incident reports to assess communication failures and patient outcomes.
Communication failures pose a significant threat to the quality of care and safety of hospitalized patients. Yet little is known about the nature of communication failures. The aims of this study were to identify and describe types of communication failures in which nurses and physicians were involved and determine how different types of communication failures might affect patient outcomes. The investigators found that incident reports could identify specific types of communication failures and patient outcomes.
AHRQ-funded; HS023621; HS024403; HS022305; HS024760.
Citation: Umberfield E, Ghaferi AA, Krein SL .
Using incident reports to assess communication failures and patient outcomes.
Jt Comm J Qual Patient Saf 2019 Jun;45(6):406-13. doi: 10.1016/j.jcjq.2019.02.006..
Keywords: Communication, Medical Errors, Adverse Events, Patient Safety
Patel MR, Friese CR, Mendelsohn-Victor K
Clinician perspectives on electronic health records, communication, and patient safety across diverse medical oncology practices.
This study examined the effects of electronic health records (EHRs) on communication and patient safety in oncology practices. The authors conducted a survey of 297 oncology nurses and prescribers in a statewide collaborative. They found there was an inverse relationship between reliance on EHRs and safety.
AHRQ-funded; HS024914.
Citation: Patel MR, Friese CR, Mendelsohn-Victor K .
Clinician perspectives on electronic health records, communication, and patient safety across diverse medical oncology practices.
J Oncol Pract 2019 Jun;15(6):e529-e36. doi: 10.1200/jop.18.00507..
Keywords: Cancer, Communication, Electronic Health Records (EHRs), Health Information Technology (HIT), Patient Safety, Provider, Provider: Clinician
Patel MR, Smith A, Leo H
Improving patient-provider communication and therapeutic practice through better integration of electronic health records in the exam room: a pilot study.
This study assessed the effectiveness of providing physicians who use electronic health records (EHRs) education for communication strategies and its impact on patient outcomes. The evidence-based Physician Asthma Care Education (PACE) program was extended in a pilot program using 18 providers and 126 adult patients with persistent asthma. Outcomes were assessed at baseline and 3- and 6-month postintervention intervals. Providers who completed the EHR-PACE program felt more confident in communicating with their patients, but there was no significant changes in patient asthma outcomes or their perceptions of their provider’s communication skills.
AHRQ-funded; HS023786.
Citation: Patel MR, Smith A, Leo H .
Improving patient-provider communication and therapeutic practice through better integration of electronic health records in the exam room: a pilot study.
Health Educ Behav 2019 Jun;46(3):484-93. doi: 10.1177/1090198118796879..
Keywords: Asthma, Clinician-Patient Communication, Communication, Electronic Health Records (EHRs), Evidence-Based Practice, Health Information Technology (HIT), Outcomes, Patient-Centered Healthcare, Patient-Centered Outcomes Research
Pavlo AJ, O'Connell M, Olsen S
Missing ingredients in shared decision-making?
This article discusses the practice of shared decision making (SDM) for clinicians when making decisions in health care. This widespread practice is considered the best approach for person-centered care, but for individuals diagnosed with serious mental illness there are still many barriers to effective collaboration. The authors suggest that more emphasis needs to be placed on the doctor-patient relationship itself conducting SDM.
AHRQ-funded; HS023000.
Citation: Pavlo AJ, O'Connell M, Olsen S .
Missing ingredients in shared decision-making?
Psychiatr Q 2019 Jun;90(2):333-38. doi: 10.1007/s11126-019-9624-9..
Keywords: Chronic Conditions, Clinician-Patient Communication, Communication, Decision Making, Behavioral Health, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Patient and Family Engagement
Rodriguez JA, Davis RB, Percac-Lima S
Non-English language availability of community health center websites.
This study examined the availability of the Health Resources and Services Administration (HRSA)-supported community health center (CHC) websites that provide translated home page content. Out of 1400 CHC homepages, 34.3% provided translated information with half using Google Translate. Odds of the homepage being translated increased as the limited English-proficient (LEP) population by county increased, Internet subscription at the state level increased, or if the CHC was in a metropolitan area. Most of the homepages were translated into Spanish in counties with higher Spanish LEP populations, but this was not true for other non-Spanish language LEP populations.
AHRQ-funded; HS021495.
Citation: Rodriguez JA, Davis RB, Percac-Lima S .
Non-English language availability of community health center websites.
Med Care 2019 Jun;57 Suppl 6 Suppl 2:S121-s26. doi: 10.1097/mlr.0000000000001027..
Keywords: Communication, Cultural Competence, Education: Patient and Caregiver, Health Information Technology (HIT)
Pack AP, Golin CE, Hill LM
Patient and clinician perspectives on optimizing graphical displays of longitudinal medication adherence data.
This study looked into the value of using graphical display prototypes of hypothetical daily drug concentrations measured in hair for patients to assess their medication adherence. Investigators surveyed 30 HIV-positive patients and 29 clinicians to assess their preferences for three different prototypes. Patients and clinicians generally found the prototypes acceptable, but clinicians largely preferred daily drug concentrations in bar graph display. Patients with lower health literacy had trouble understanding the link between medication-taking and drug concentrations in hair and also preferred pictographs over bar or line graphs.
AHRQ-funded; HS000032.
Citation: Pack AP, Golin CE, Hill LM .
Patient and clinician perspectives on optimizing graphical displays of longitudinal medication adherence data.
Patient Educ Couns 2019 Jun;102(6):1090-97. doi: 10.1016/j.pec.2018.12.029..
Keywords: Clinician-Patient Communication, Communication, Health Literacy, Medication, Patient Adherence/Compliance, Provider, Provider: Clinician
Hoover DS, Pappadis MR, Housten AJ
Preferences for communicating about breast cancer screening among racially/ethnically diverse older women.
The purpose of this study was to examine preferences for communicating about screening mammography among racially/ethnically diverse older women. Through in-depth interviews, findings revealed that older women desire information about the benefits and harms of screening mammography and would prefer to learn this information through discussions with healthcare providers and multiple other formats. Results were consistent regardless of participants' age, race/ethnicity, or education.
AHRQ-funded; HS022134.
Citation: Hoover DS, Pappadis MR, Housten AJ .
Preferences for communicating about breast cancer screening among racially/ethnically diverse older women.
Health Commun 2019 Jun;34(7):702-06. doi: 10.1080/10410236.2018.1431026..
Keywords: Cancer, Cancer: Breast Cancer, Clinician-Patient Communication, Communication, Elderly, Women, Prevention, Racial and Ethnic Minorities, Screening
Links AR, Callon W, Wasserman C
Surgeon use of medical jargon with parents in the outpatient setting.
This study analyzed the use of unexplained medical jargon with parents whose children have sleep-disordered breathing and their consultations with otolaryngologists in a pediatric surgical setting. Participants (64 parents and 8 otolaryngologists) completed questionnaires that evaluated demographics, clinical features and parental role in decision-making. Unexplained medical jargon was commonly used by physicians (mean total utterances per visit = 28.9) while parents used jargon a mean of 4.3 times. Clinicians used more jargon when they felt that parents had greater involvement in decision-making or when parents used more jargon themselves. These results will be incorporated into communication training for clinicians.
AHRQ-funded; HS022932.
Citation: Links AR, Callon W, Wasserman C .
Surgeon use of medical jargon with parents in the outpatient setting.
Patient Educ Couns 2019 Jun;102(6):1111-18. doi: 10.1016/j.pec.2019.02.002..
Keywords: Ambulatory Care and Surgery, Caregiving, Children/Adolescents, Clinician-Patient Communication, Communication, Decision Making, Education: Patient and Caregiver, Provider, Provider: Physician
Chan B, Goldman LE, Sarkar U
High perceived social support and hospital readmissions in an older multi-ethnic, limited English proficiency, safety-net population.
This study examined the association between perceived social support and 30-day hospital readmission or death in older adults. The study used the cohort from the Support From Hospital to Home for Elders (SHHE) trial. Participants were English, Chinese and Spanish-speaking adults living in the community who were admitted to wards at an urban safety-net hospital in San Francisco. Overall readmission or death rate was 15%. Participants had a mean age of 66.2 with the majority being Asian (31.9%), then Black (24.8%), Latino (19.3%) and White (18.8%). Researchers found that those with high social support had half the odds of admission or death than those with low social support. The protection however seemed true only among minorities, and seemed to have the opposite effect among whites.
AHRQ-funded; HS022981.
Citation: Chan B, Goldman LE, Sarkar U .
High perceived social support and hospital readmissions in an older multi-ethnic, limited English proficiency, safety-net population.
BMC Health Serv Res 2019 May 24;19(1):334. doi: 10.1186/s12913-019-4162-6..
Keywords: Communication, Cultural Competence, Elderly, Hospital Readmissions, Racial and Ethnic Minorities
Khoong EC, Cherian R, Matta GY
Perspectives of English, Chinese, and Spanish-speaking safety-net patients on clinician computer use: qualitative analysis.
The goal of this study was to understand how safety-net patients, including those with limited English proficiency, view clinician electronic health record (EHR) use. Through focus groups in English, Spanish, and Cantonese, results showed that linguistically diverse patients accepted the value of EHR use during outpatient visits but desired more eye contact, verbal warnings before EHR use, and screen-sharing. Support for clinicians in completing EHR-related tasks during the visit using patient-centered strategies for all patients is recommended.
AHRQ-funded; HS022561; HS023558; HS022408.
Citation: Khoong EC, Cherian R, Matta GY .
Perspectives of English, Chinese, and Spanish-speaking safety-net patients on clinician computer use: qualitative analysis.
J Med Internet Res 2019 May 22;21(5):e13131. doi: 10.2196/13131..
Keywords: Cultural Competence, Racial and Ethnic Minorities, Patient Experience, Electronic Health Records (EHRs), Health Information Technology (HIT), Clinician-Patient Communication, Health Literacy, Communication
Pisu M, Schoenberger YM, Herbey I
Perspectives on conversations about costs of cancer care of breast cancer survivors and cancer center staff: a qualitative study.
Despite recommendations to discuss the cost of care (CoC) with patients with cancer, little formal guidance is available on how to conduct these sensitive conversations in ways that are acceptable to both patients and providers. The objective of this study was to explore the perspectives of patients and medical and nonmedical cancer center staff on CoC conversations.
ARHQ-funded; HS023009.
Citation: Pisu M, Schoenberger YM, Herbey I .
Perspectives on conversations about costs of cancer care of breast cancer survivors and cancer center staff: a qualitative study.
Ann Intern Med 2019 May 7;170(9_Supplement):S54-s61. doi: 10.7326/m18-2117..
Keywords: Cancer: Breast Cancer, Cancer, Healthcare Costs, Clinician-Patient Communication, Communication
Hammer MM, Kapoor N, Desai SP
Adoption of a closed-loop communication tool to establish and execute a collaborative follow-up plan for incidental pulmonary nodules.
The purpose of this study was to assess radiologists' adoption of a closed-loop communication and tracking system, Result Alert and Development of Automated Resolution (RADAR), for incidental pulmonary nodules and to measure its effect on the completeness of radiologists' follow-up recommendations. Results showed that a closed-loop communication system that enables establishing and executing a collaborative follow-up plan for incidental pulmonary nodules can be adopted and improves the quality of radiologists' follow-up recommendations.
AHRQ-funded; HS024722.
Citation: Hammer MM, Kapoor N, Desai SP .
Adoption of a closed-loop communication tool to establish and execute a collaborative follow-up plan for incidental pulmonary nodules.
AJR Am J Roentgenol 2019 May;212(5):1077-81. doi: 10.2214/ajr.18.20692..
Keywords: Diagnostic Safety and Quality, Imaging, Communication
Asan O, Scanlan MC, Crotty B
Parental perceptions of displayed patient data in a PICU: an example of unintentional empowerment.
The objective of this study was to explore the perceptions of parents of pediatric patients in a PICU regarding real-time open electronic health record data displayed in patient rooms. The investigators suggest that a new health information technology system providing continuous access to open electronic health record data may be an effective way to empower and engage parents in the PICU, but also note potential drawbacks.
AHRQ-funded; HS023626.
Citation: Asan O, Scanlan MC, Crotty B .
Parental perceptions of displayed patient data in a PICU: an example of unintentional empowerment.
Pediatr Crit Care Med 2019 May;20(5):435-41. doi: 10.1097/pcc.0000000000001895..
Keywords: Caregiving, Children/Adolescents, Communication, Electronic Health Records (EHRs), Health Information Technology (HIT), Hospitals, Intensive Care Unit (ICU), Patient and Family Engagement
Armstrong MJ, Rastgardani T, Gagliardi AR
Barriers and facilitators of communication about off periods in Parkinson's disease: qualitative analysis of patient, carepartner, and physician Interviews.
This article discusses barriers and facilitators of communication with Parkinson’s disease patients, care partners, and their physicians specifically during off periods. Twenty persons with Parkinson’s and their care partners, and 20 physicians participated in interviews using a semi-structured questionnaire. Communication barrier levels were identified as patient-level, caregiver-level, and physician-level. For patients cognitive impairment and reluctance to discuss symptoms was the largest barrier. Caregiver absence was also a barrier. For physicians barriers were distraction by technology and lack of appreciation of off period burdens. Various tools such as home diaries, questionnaires and mobile phone videos can be used to aid communication regarding off periods. Patients and their caregivers stressed the need for more formal educational materials and improved educational tools.
AHRQ-funded; HS024159.
Citation: Armstrong MJ, Rastgardani T, Gagliardi AR .
Barriers and facilitators of communication about off periods in Parkinson's disease: qualitative analysis of patient, carepartner, and physician Interviews.
PLoS One 2019 Apr 18;14(4):e0215384. doi: 10.1371/journal.pone.0215384..
Keywords: Communication, Clinician-Patient Communication, Neurological Disorders, Caregiving, Education: Patient and Caregiver, Health Literacy, Patient and Family Engagement
Roche SD, Reichheld AM, Demosthenes N
Measuring the quality of inpatient specialist consultation in the intensive care unit: Nursing and family experiences of communication.
The purpose of this study was to document the receipt of communication by nurses and family members regarding consultations performed on their patient or loved one, and to quantify how this impacted their overall perceptions of the quality of specialty care. The investigators found that most ICU families and nurses had no interaction with specialist providers. They concluded that nurses' frequent exclusion from conversations about specialty care may pose safety risks and increase the likelihood of mixed messages for patients and families, most of whom desire some interaction with specialists.
AHRQ-funded; K08 HS024288.
Citation: Roche SD, Reichheld AM, Demosthenes N .
Measuring the quality of inpatient specialist consultation in the intensive care unit: Nursing and family experiences of communication.
PLoS One 2019 Apr 11;14(4):e0214918. doi: 10.1371/journal.pone.0214918..
Keywords: Clinician-Patient Communication, Communication, Quality of Care, Intensive Care Unit (ICU), Patient Experience, Inpatient Care
Grob R, Darien G, Meyers D
AHRQ Author: Meyers D
Why physicians should trust in patients.
This viewpoint article explores shifting the patient-physician relationship from simply emphasizing patients’ adherence to cultivating patients’ ability to contribute to the development of care plans that reflect their own values and preferences.
AHRQ-authored.
Citation: Grob R, Darien G, Meyers D .
Why physicians should trust in patients.
JAMA 2019 Apr 9;321(14):1347-48. doi: 10.1001/jama.2019.1500..
Keywords: Clinician-Patient Communication, Patient and Family Engagement, Communication
Law AC, Roche S, Reichheld A
Failures in the respectful care of critically ill patients.
The emotional toll of critical illness on patients and their families can be profound and is emerging as an important target for value improvement. One source of emotional harm to patients and families may be care perceived as inadequately respectful. The prevalence and risk factors for types of emotional harms is under-studied. This prospective cohort study was conducted in nine ICUs at a tertiary care academic medical center in the United States.
AHRQ-funded; HS024288.
Citation: Law AC, Roche S, Reichheld A .
Failures in the respectful care of critically ill patients.
Jt Comm J Qual Patient Saf 2019 Apr;45(4):276-84. doi: 10.1016/j.jcjq.2018.05.008..
Keywords: Critical Care, Intensive Care Unit (ICU), Patient Experience, Clinician-Patient Communication, Communication
Jones CD, Jones J, Bowles KH
Quality of hospital communication and patient preparation for home health care: results from a statewide survey of home health care nurses and staff.
The purpose of this study was to evaluate the quality of communication between hospitals and home health care (HHC) clinicians and patient preparedness to receive HHC in a statewide sample of HHC nurses and staff. The authors concluded that communication between hospitals and HHC was suboptimal, and patients were often not prepared to receive HHC. They suggest that providing EHR access for HHC clinicians is a promising solution to improve the quality of communication.
AHRQ-funded; HS024569.
Citation: Jones CD, Jones J, Bowles KH .
Quality of hospital communication and patient preparation for home health care: results from a statewide survey of home health care nurses and staff.
J Am Med Dir Assoc 2019 Apr;20(4):487-91. doi: 10.1016/j.jamda.2019.01.004..
Keywords: Transitions of Care, Home Healthcare, Hospital Discharge, Hospitals, Communication
Xie A, Woods-Hill CZ, Berenholtz SM
Use of human factors and ergonomics to disseminate health care quality improvement programs.
Human factors and ergonomics (HFE) is recognized as a key systems engineering approach to improve health care quality and safety. In this article, the authors suggest that HFE can play an important role in the dissemination of quality improvement programs across diverse health care settings. They suggest that to achieve this, health care organizations need to build capacity by leveraging HFE expertise and develop tools that guide local adaptation of interventions developed for large-scale quality initiatives.
AHRQ-funded; HS025642; HS025238.
Citation: Xie A, Woods-Hill CZ, Berenholtz SM .
Use of human factors and ergonomics to disseminate health care quality improvement programs.
Qual Manag Health Care 2019 Apr/Jun;28(2):117-18. doi: 10.1097/qmh.0000000000000211..
Keywords: Quality Improvement, Quality of Care, Communication, Provider
Kahwati LC, Sorensen AV, Teixeira-Poit S
AHRQ Author: Mistry KB
Impact of the Agency for Healthcare Research and Quality's Safety Program for Perinatal Care.
The purpose of this study was to describe the Safety Program for Perinatal Care (SPPC) implementation experience and evaluate the short-term impact on labor and delivery (L&D) unit patient safety culture, processes, and adverse events. SPPC implementation by L&D units were supported sing a program toolkit, trainings, and technical assistance. Researchers then evaluated the program using a pre-post, mixed-methods design. Changes in safety and quality were measured using the Modified Adverse Outcome Index (MAOI) and other perinatal care indicators. Findings showed that SPPC had a favorable impact on unit patient safety culture and processes, but mixed short-term impact on maternal and neonatal adverse events.
AHRQ-authored; AHRQ-funded; 2902010000241.
Citation: Kahwati LC, Sorensen AV, Teixeira-Poit S .
Impact of the Agency for Healthcare Research and Quality's Safety Program for Perinatal Care.
Jt Comm J Qual Patient Saf 2019 Apr;45(4):231-40. doi: 10.1016/j.jcjq.2018.11.002..
Keywords: Adverse Events, Communication, Comprehensive Unit-based Safety Program (CUSP), Labor and Delivery, Maternal Care, Newborns/Infants, Outcomes, Patient Safety, Pregnancy, Simulation, Surveys on Patient Safety Culture, Teams, TeamSTEPPS, Training, Women
Frasier LL, Pavuluri Quamme SR, Ma Y
Familiarity and communication in the operating room.
Researchers sought to evaluate the relationship between familiarity, communication rates, and communication ineffectiveness of health care providers in the operating room. They found that team members do not compensate for unfamiliarity by increasing their verbal communication, and dyad familiarity is not protective against ineffective communication. Cross-disciplinary communication remains vulnerable in the operating room, suggesting poor crosstalk across disciplines in the operative setting. They recommended further investigation to explore these relationships and identify effective interventions, ensuring that all team members have the necessary information to optimize their performance.
AHRQ-funded; HS022403.
Citation: Frasier LL, Pavuluri Quamme SR, Ma Y .
Familiarity and communication in the operating room.
J Surg Res 2019 Mar;235:395-403. doi: 10.1016/j.jss.2018.09.079..
Keywords: Communication, Patient Safety, Surgery, Teams, Provider: Physician, Provider
Henderson ML, Adler JT, Van Pilsum Rasmussen SE
How should social media be used in transplantation? A survey of the American Society of Transplant Surgeons.
The authors investigated how social media-driven communication is perceived by providers in the field of transplantation. 299 members of the American Society of Transplant Surgeons were surveyed regarding their use of, attitudes toward, and perceptions of social media; the authors analyzed relationships between their responses and participant characteristics. The authors found that individual characteristics influence opinions about the role and clinical usefulness of social media. They concluded that increasing use of social media among transplant professionals may provide an opportunity to deliver high-quality information to patients.
AHRQ-funded; HS024600.
Citation: Henderson ML, Adler JT, Van Pilsum Rasmussen SE .
How should social media be used in transplantation? A survey of the American Society of Transplant Surgeons.
Transplantation 2019 Mar;103(3):573-80. doi: 10.1097/tp.0000000000002243..
Keywords: Transplantation, Social Media, Clinician-Patient Communication, Communication, Provider: Physician
Chung CF, Wang Q, Schroeder J
Identifying and planning for individualized change: patient-provider collaboration using lightweight food diaries in healthy eating and irritable bowel syndrome.
This study examined if the use of a photo-based food diary app will help patients with irritable bowel syndrome (IBS) help gather food and symptom data to help their doctors with disease management. The investigators designed and developed Foodprint which includes a mobile and web app and pre-visit note to go to experts which communicate an individual’s expectations and questions. A control group and a group with IBS were used to determine the effectiveness of Foodprint.
AHRQ-funded; HS023654.
Citation: Chung CF, Wang Q, Schroeder J .
Identifying and planning for individualized change: patient-provider collaboration using lightweight food diaries in healthy eating and irritable bowel syndrome.
Proc ACM Interact Mob Wearable Ubiquitous Technol 2019 Mar;3(1). doi: 10.1145/3314394..
Keywords: Chronic Conditions, Clinician-Patient Communication, Communication, Digestive Disease and Health, Health Information Technology (HIT), Lifestyle Changes, Nutrition, Patient Self-Management
Lin W-T, Mayer C, Lee B-O
Validity and reliability of the Teamwork Evaluation of Non-Technical Skills tool.
This study evaluated the use of the assessment tool TENTS (Teamwork Evaluation of Non-Technical Skills) to measure effectiveness of different clinician teams. The tool measures communication, leadership, and crossmonitoring. Researchers used to tool to observe five different events: new admissions, transfers to and from other units, rapid response team events, morning rounds, and medical procedures.
AHRQ-funded; 290200600001I.
Citation: Lin W-T, Mayer C, Lee B-O .
Validity and reliability of the Teamwork Evaluation of Non-Technical Skills tool.
Aust J Adv Nurs 2019 Mar-May;36(3):29-38..
Keywords: Communication, Teams, TeamSTEPPS
Lion KC, Kieran K, Desai A
Audio-recorded discharge instructions for limited English proficient parents: a pilot study.
Parents with limited English proficiency (LEP) demonstrate lower comprehension of discharge instructions. This study was conducted to (1) determine the feasibility of providing a greeting card with language-specific, audio-recorded discharge instructions to LEP parents; (2) describe use of and satisfaction with the cards; and (3) evaluate card effect on instruction comfort with home care and comprehension. The authors concluded that providing language-concordant, audio-recorded discharge instructions was feasible, and parents reported high satisfaction with and frequent use of the cards with multiple caregivers.
AHRQ-funded; HS024299.
Citation: Lion KC, Kieran K, Desai A .
Audio-recorded discharge instructions for limited English proficient parents: a pilot study.
Jt Comm J Qual Patient Saf 2019 Feb;45(2):98-107. doi: 10.1016/j.jcjq.2018.06.001..
Keywords: Hospital Discharge, Cultural Competence, Clinician-Patient Communication, Communication, Education: Patient and Caregiver