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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
176 to 200 of 299 Research Studies DisplayedVergis A, Hardy K, Stogryn S
Fellow and attending surgeon operative notes are deficient in reporting established quality indicators for Roux-en-y gastric bypass: a preliminary retrospective analysis of operative dictation.
This retrospective analysis investigated the completeness of reporting documentation for Roux-en-Y Gastric Bypass (RYGB) surgery. A total of 40 bariatric fellow and 40 attending RYGB narrative reports were analyzed. Fellows had a mean completion rate of 66.4% compared to 61.5% for attendings. Fellows also did a better job of completing subsections, with the exception of closure details. This information is important to communicating operative events and can make an impact on patient safety and quality.
AHRQ-funded; HS018546.
Citation: Vergis A, Hardy K, Stogryn S .
Fellow and attending surgeon operative notes are deficient in reporting established quality indicators for Roux-en-y gastric bypass: a preliminary retrospective analysis of operative dictation.
Cureus 2019 Apr 24;11(4):e4535. doi: 10.7759/cureus.4535..
Keywords: Obesity, Quality of Care, Quality Indicators (QIs), Patient Safety, Provider, Provider: Physician, Surgery
Monestime JP, Biener AI, Wolford M
AHRQ Author: Wolford M
Characteristics of office-based providers associated with secure electronic messaging use: achieving meaningful use.
The purpose of this study was to identify characteristics of office-based provider used as a usual source of care (USC) associated with secure electronic messaging (SM) use. The investigators concluded that patients were more likely to have visited a USC that exchanged SMs if that practice also used other electronic health records functionalities. The authors indicated that findings suggested that while patients' USC practices were likely to exchange secure messages, there is a disparity in SM use between physician-owned practices, and hospital-owned practices.
AHRQ-authored.
Citation: Monestime JP, Biener AI, Wolford M .
Characteristics of office-based providers associated with secure electronic messaging use: achieving meaningful use.
Int J Med Inform 2019 Apr 4;129:43-48. doi: 10.1016/j.ijmedinf.2019.04.002..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Medical Expenditure Panel Survey (MEPS), Patient-Centered Healthcare, Provider
Hurley VB, Rodriguez HP, Shortell SM
The role of accountable care organization affiliation and ownership in promoting physician practice participation in quality improvement collaboratives.
The goal of this study was to examine organizational influences on physician practices' propensity to participate in quality improvement collaboratives (QICs). Using data from the third wave of the National Study of Physician Organizations, findings showed that 13.6% of practices surveyed participated in a QIC. ACO affiliation, CHC ownership, larger practice size, and health information technology functionality were positively associated with QIC participation. Practice use of QI methods partially mediated the association of ACO affiliation with QIC participation.
AHRQ-funded; HS022241.
Citation: Hurley VB, Rodriguez HP, Shortell SM .
The role of accountable care organization affiliation and ownership in promoting physician practice participation in quality improvement collaboratives.
Health Care Manage Rev 2019 Apr/Jun;44(2):174-82. doi: 10.1097/hmr.0000000000000148.
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Keywords: Quality Improvement, Quality of Care, Provider: Physician, Provider, Community-Based Practice
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
P Dellsperger, KC Fallaw, D
AHRQ Author: Rangachari
A mixed-method study of practitioners' perspectives on issues related to EHR medication reconciliation at a health system.
This study sought to identify issues related to electronic health record (EHR) medication reconciliation (MedRec) from the perspective of practitioners directly involved in the EHR MedRec process, with the goal of reducing medication discrepancies during transitions of care and improving the accuracy of patient medication lists. The study was conducted in two rounds: individual interviews, then a survey of physicians, nurses, and pharmacists based in the outpatient and inpatient medicine service at AU Health. The survey elicited practitioner ratings of the importance of issues identified during the interviews. Issues that were rated as important by more than 70 percent of respondents include care coordination, patient education, ownership and accountability, processes-of-care, IT-related issues, and workforce training. From these issues, the authors conclude that there is an absence of shared understanding among practitioners regarding the value of EHR MedRec in promoting patient safety, which contributes to work-arounds and the suboptimal use of the EHR MedRec system, and there is also a sociotechnical dimension to many of these issues which creates an additional layer of complexity.
AHRQ-funded; HS024335.
Citation: P Dellsperger, KC Fallaw, D .
A mixed-method study of practitioners' perspectives on issues related to EHR medication reconciliation at a health system.
Qual Manag Health Care 2019 Apr/Jun;28(2):84-95. doi: 10.1097/qmh.0000000000000208..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Medication, Medication: Safety, Patient Safety, Provider, Provider: Clinician
Patel EY, Petemann V, Mark BA
Does state-level nurse practitioner scope-of-practice policy affect access to care?
This study attempts to fill a critical gap between policy reform that grants state-level nurse practitioners (NPs) scope of practice (SOP) and a useful synthesis of empirical studies that assesses the relationship of NP SOP policy to its impact on access to care. Researchers applied Aday and Andersen's Access Framework to operationalize access to care and to map components of access to care that might relate to NP SOP through concepts identified in their review. Their findings suggest that full state-level NP SOP policy is associated with increases in various components of access to care, but that additional work will be required to evaluate causality and underlying mechanisms behind the policy's effect on access.
AHRQ-funded; HS000032.
Citation: Patel EY, Petemann V, Mark BA .
Does state-level nurse practitioner scope-of-practice policy affect access to care?
West J Nurs Res 2019 Apr;41(4):488-518. doi: 10.1177/0193945918795168..
Keywords: Access to Care, Policy, Provider, Provider: Clinician
Mark BA, Patel E
Nurse practitioner scope of practice: what do we know and where do we go?
This article discusses how state-level nurse practitioner (NP) scope of practice (SOP) policies effect access to primary care. In states where SOP policies became less restrictive, patients reported better access to healthcare including increased availability of appointments, greater checkup utilization, decreased emergency visits for ambulatory care, and decreased administrative burden for physicians. There have been a number of studies in states that have restrictive NP SOP policies, and they do not improve quality of care. It was found that states that still had restrictive policies tended to have more political pressure by physician groups than those states and repealed it.
AHRQ-funded; HS000032.
Citation: Mark BA, Patel E .
Nurse practitioner scope of practice: what do we know and where do we go?
West J Nurs Res 2019 Apr;41(4):483-87. doi: 10.1177/0193945918820338..
Keywords: Policy, Primary Care, Provider: Nurse, Provider: Clinician, Provider
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
Azari DP, Fraiser LL, Quamme SRP
Modeling surgical technical skill using expert assessment for automated computer rating.
The authors used computer vision to predict expert performance ratings from surgeon hand motions for tying and suturing tasks. Open surgeries were video recorded, and surgeon hands tracked without using sensors or markers. The authors found that the computer algorithm consistently predicted the panel ratings of individual tasks, and were more objective and reliable than individual assessment by surgical experts.
AHRQ-funded; F32 HS022403.
Citation: Azari DP, Fraiser LL, Quamme SRP .
Modeling surgical technical skill using expert assessment for automated computer rating.
Ann Surg 2019 Mar;269(3):574-81. doi: 10.1097/sla.0000000000002478..
Keywords: Surgery, Provider Performance, Provider: Physician, Provider
Tong BC, Kim S, Kosinski A
Penetration, completeness, and representativeness of the Society of Thoracic Surgeons General Thoracic Surgery Database for lobectomy.
Not all surgeons performing lobectomy in the United States report outcomes to The Society of Thoracic Surgeons General Thoracic Surgery Database (STS GTSD). In this study, the investigators examined penetration, completeness, and representativeness of the STS GTSD for lobectomy in the Centers for Medicare and Medicaid Services (CMS) patient population. The investigators concluded that participation in the STS GTSD increased over time, but penetration lagged behind that of the other STS National Databases.
AHRQ-funded; HS022279.
Citation: Tong BC, Kim S, Kosinski A .
Penetration, completeness, and representativeness of the Society of Thoracic Surgeons General Thoracic Surgery Database for lobectomy.
Ann Thorac Surg 2019 Mar;107(3):897-902. doi: 10.1016/j.athoracsur.2018.07.059..
Keywords: Surgery, Cancer: Lung Cancer, Cancer, Data, Provider: Physician, Provider
Werzen A, Thom KA, Robinson GL
Comparing brief, covert, directly observed hand hygiene compliance monitoring to standard methods: a multicenter cohort study.
The purpose of this study was to examine and compare the effect of covert observers versus brief observation periods on hand hygiene compliance. The authors conclude that compliance rates were greater when reported by infection prevention programs than when reported by covert observers over brief observation periods.
AHRQ-funded; HS024108.
Citation: Werzen A, Thom KA, Robinson GL .
Comparing brief, covert, directly observed hand hygiene compliance monitoring to standard methods: a multicenter cohort study.
Am J Infect Control 2019 Mar;47(3):346-48. doi: 10.1016/j.ajic.2018.08.015..
Keywords: Patient Safety, Prevention, Provider
Anton NE, Mizota T, Timsina LR
Attentional selectivity, automaticity, and self-efficacy predict simulator-acquired skill transfer to the clinical environment.
The objective of this study was to identify trainee characteristics that predict the transfer of simulator-acquired skill to the operating room. The investigators concluded that promoting automaticity, self-efficacy, and attention selectivity may help improve the transfer of simulator-acquired skill. They indicated that mental skills training and training to automaticity may therefore be valuable interventions to achieve this goal.
AHRQ-funded; HS022080.
Citation: Anton NE, Mizota T, Timsina LR .
Attentional selectivity, automaticity, and self-efficacy predict simulator-acquired skill transfer to the clinical environment.
Am J Surg 2019 Feb;217(2):266-71. doi: 10.1016/j.amjsurg.2018.11.028..
Keywords: Education: Continuing Medical Education, Patient Safety, Provider, Provider: Physician, Simulation, Surgery, Training
Jones CD, Jones J, Bowles KH
Patient, caregiver, and clinician perspectives on expectations for home healthcare after discharge: a qualitative case study.
The objective of this study was to evaluate and compare expectations for skilled home health care (HHC) from the patient, caregiver, and HHC perspectives after hospital discharge. Results showed that unclear expectations occurred when the patient and/or caregiver expectations were uncertain or misaligned with the services received; in most such cases, the patient and caregiver did not have prior experience with HHC. Recommendations to improve HHC transitions included actively engaging both patients and caregivers in the hospital and HHC settings to provide education about HHC services and assess and address additional care needs.
AHRQ-funded; HS024569.
Citation: Jones CD, Jones J, Bowles KH .
Patient, caregiver, and clinician perspectives on expectations for home healthcare after discharge: a qualitative case study.
J Hosp Med 2019 Feb;14(2):90-95. doi: 10.12788/jhm.3140..
Keywords: Caregiving, Health Services Research (HSR), Home Healthcare, Patient Experience, Provider, Provider: Clinician, Transitions of Care
Schiff GD, Klinger E, Salazar A
Screening for adverse drug events: a randomized trial of automated calls coupled with phone-based pharmacist counseling.
In this study, the investigators evaluated an automated telephone surveillance system coupled with transfer to a live pharmacist- to screen potentially drug-related symptoms after newly starting medications for four common primary care conditions: hypertension, diabetes, depression, and insomnia. Systematic automated telephone outreach monitoring coupled with real-time phone referral to a pharmacist identified a substantial number of previously unidentified potentially drug-related symptoms, many of which were validated as probably or possibly related to the drug by the pharmacist or their physicians.
AHRQ-funded; HS021094.
Citation: Schiff GD, Klinger E, Salazar A .
Screening for adverse drug events: a randomized trial of automated calls coupled with phone-based pharmacist counseling.
J Gen Intern Med 2019 Feb;34(2):285-92. doi: 10.1007/s11606-018-4672-7..
Keywords: Adverse Drug Events (ADE), Adverse Events, Medication, Medication: Safety, Health Information Technology (HIT), Provider: Pharmacist, Provider, Patient Safety
Jarrin OF, Pouladi FA, Madigan EA
International priorities for home care education, research, practice, and management: qualitative content analysis.
The purpose of this study was to articulate an international vision for the future of home care education, research, practice, and management shared by experienced home care nurses working in leadership roles. Four major themes emerged, in this qualitative study, reflecting international priorities for the future of home care education, research, practice, and management: 1) Build the evidence base for home care; 2) Design better systems of care; 3) Develop leaders at all levels; and 4) Address payment and policy issues.
AHRQ-funded; HS022406.
Citation: Jarrin OF, Pouladi FA, Madigan EA .
International priorities for home care education, research, practice, and management: qualitative content analysis.
Nurse Educ Today 2019 Feb;73:83-87. doi: 10.1016/j.nedt.2018.11.020..
Keywords: Education: Continuing Medical Education, Healthcare Delivery, Home Healthcare, Nursing, Provider
Dykes PC, Bogaisky M, Carter EJ
Development and validation of a fall prevention knowledge test.
The authors developed and evaluated a fall prevention knowledge test (FPKT). The 11-item FPKT scale producing statistically significant differences confirmed validity. They recommended that a robust way to assess nurses' knowledge of fall prevention is needed to inform effective educational programs. They concluded that addressing gaps in validated FPKTs provides an opportunity to inform and evaluate effective fall prevention programs.
AHRQ-funded; HS025128; HS023535.
Citation: Dykes PC, Bogaisky M, Carter EJ .
Development and validation of a fall prevention knowledge test.
J Am Geriatr Soc 2019 Jan;67(1):133-38. doi: 10.1111/jgs.15563..
Keywords: Falls, Prevention, Provider: Nurse, Provider, Education: Continuing Medical Education
Herrera CN, Brochier A, Pellicer M
Implementing social determinants of health screening at community health centers: clinician and staff perspectives.
Screening for social determinants of health (SDOH) during primary care office visits is recommended by pediatric and internal medicine professional guidelines. Less is known about how SDOH screening and service referral can be successfully integrated into clinical practice. SDOH screening and referral care models can help support the mission of community health centers by identifying unmet material needs. Additional support for SDOH models might include piloting the SDOH screening model workflow and formalizing the workflow before implementation, including the specific roles for clinicians, staff, and patient navigators.
AHRQ-funded; HS022242.
Citation: Herrera CN, Brochier A, Pellicer M .
Implementing social determinants of health screening at community health centers: clinician and staff perspectives.
J Prim Care Community Health 2019 Jan-Dec;10:2150132719887260. doi: 10.1177/2150132719887260..
Keywords: Social Determinants of Health, Screening, Community-Based Practice, Primary Care, Provider: Clinician, Provider
Hose BZ, Hoonakker PLT, Wooldrige AR
Physician perceptions of the electronic problem list in pediatric trauma care.
Researchers described physician perceptions of the potential goals, characteristics, and content of the electronic problem list (PL) in pediatric trauma. They identified five goals of the PL, seven characteristics, and 22 patient-related information elements. They found that physicians involved in pediatric trauma care described the electronic PL as ideally more than a list of a patient's medical diagnoses and injuries. They recommend future work to evaluate the optimal design of the PL so that users with emergent cases have access to key information related to the patient's immediate problems.
AHRQ-funded; HS023837.
Citation: Hose BZ, Hoonakker PLT, Wooldrige AR .
Physician perceptions of the electronic problem list in pediatric trauma care.
Appl Clin Inform 2019 Jan;10(1):113-22. doi: 10.1055/s-0039-1677737..
Keywords: Children/Adolescents, Electronic Health Records (EHRs), Health Information Technology (HIT), Trauma, Provider: Physician, Provider
Knight LMJ, Onsomu EO, Bosworth HB
Exploring emergency department provider experiences with and perceptions of weight-based versus individualized vaso-occlusive treatment protocols in sickle cell disease.
This study compared perceptions of nurses and physicians on protocols to treat sickle cell disease vaso-occlusive episodes (VOEs) in emergency rooms (ERs). Two different protocols were used for VOEs: weight –based and individualized vaso-occlusive. Nurses were less satisfied with clarity of the protocols than physicians. Pain management protocol perceptions differed widely between physicians, residents, physician assistants, nurse practitioners and nurses.
AHRQ-funded; HS024501.
Citation: Knight LMJ, Onsomu EO, Bosworth HB .
Exploring emergency department provider experiences with and perceptions of weight-based versus individualized vaso-occlusive treatment protocols in sickle cell disease.
Adv Emerg Nurs J 2019 Jan/Mar;41(1):86-97. doi: 10.1097/tme.0000000000000232..
Keywords: Emergency Department, Medication, Opioids, Pain, Provider, Sickle Cell Disease
Frazier SE, Parker SH
Measurement of physiological responses to acute stress in multiple occupations: a systematic review and implications for front line healthcare providers.
The purpose of this review was to examine and synthesize empirical literature to identify studies assessing physiological responses to acute stress, determine common methods for measuring acute stress in near real-time, and identify common research designs employed across industries. The authors suggest that their review demonstrated that acute stress was primarily assessed retrospectively, and that there was a pragmatic gap in methodological approach, with many data collection methods inappropriate for the healthcare environment.
AHRQ-funded; HS023465.
Citation: Frazier SE, Parker SH .
Measurement of physiological responses to acute stress in multiple occupations: a systematic review and implications for front line healthcare providers.
Transl Behav Med 2019 Jan;9(1):158-66. doi: 10.1093/tbm/iby019..
Keywords: Provider, Stress
Clowse MEB, Eudy AM, Revels J
Provider perceptions on the management of lupus during pregnancy: barriers to improved care.
This paper discusses a focus group that was created of women with lupus who either were pregnant or were planning to get pregnant. Outcomes in women with lupus is bad for more than half of pregnancies for the mother or the fetus. The focus group’s objective was to discuss issues about pregnancy planning and management. Problems include ill-timed pregnancies, and medication non-adherence. Communication gaps between the rheumatologist and the obstetrician/gynecologist can result in confusion for the patient with optimal treatment plans.
AHRQ-funded; HS023443.
Citation: Clowse MEB, Eudy AM, Revels J .
Provider perceptions on the management of lupus during pregnancy: barriers to improved care.
Lupus 2019 Jan;28(1):86-93. doi: 10.1177/0961203318815594..
Keywords: Care Management, Chronic Conditions, Maternal Care, Pregnancy, Provider, Women
Dowding D, Merrill JA, Barron Y
Usability evaluation of a dashboard for home care nurses.
Usability tests were conducted on a creation of a dashboard prototype for home care nurses for their patients’ electronic health records (EHRs). The prototype was created by first observing and interviewing several nurses; getting feedback on paper versions of the dashboard; and then a usability evaluation of the electronic prototype. The dashboard was positively evaluated.
AHRQ-funded; HS023855.
Citation: Dowding D, Merrill JA, Barron Y .
Usability evaluation of a dashboard for home care nurses.
Comput Inform Nurs 2019 Jan;37(1):11-19. doi: 10.1097/cin.0000000000000484..
Keywords: Health Information Technology (HIT), Home Healthcare, Nursing, Provider
Grossman LV, Masterson Creber RM, Ryan B
Providers' perspectives on sharing health information through acute care patient portals.
Engaging healthcare providers in acute care patient portal implementation is critical to ensure productive use. However, few studies have assessed provider's perceptions of an acute care portal after implementation. In this study, the investigators surveyed 63 nurses, physicians, and physician assistants following a 3-year randomized trial of an acute care portal. The survey assessed providers' perceptions of the portal and its impact on care delivery.
AHRQ-funded; HS021816.
Citation: Grossman LV, Masterson Creber RM, Ryan B .
Providers' perspectives on sharing health information through acute care patient portals.
AMIA Annu Symp Proc 2018 Dec 5;2018:1273-81..
Keywords: Health Information Technology (HIT), Provider
Edwards ST, Marino M, Balasubramanian BA
Burnout among physicians, advanced practice clinicians and staff in smaller primary care practices.
The purpose of this study was to examine the association between physician-, advanced practice clinician- and staff-reported burnout and specific structural, organizational, and contextual characteristics of smaller primary care practices. Results showed that burnout is prevalent among physicians, advanced practice clinicians, and staff in smaller primary care practices. Members of solo practices less commonly report burnout, while members of health system-owned practices and Federally Qualified Health Centers more commonly report burnout, suggesting that practice level autonomy may be a critical determinant.
AHRQ-funded; HS023940.
Citation: Edwards ST, Marino M, Balasubramanian BA .
Burnout among physicians, advanced practice clinicians and staff in smaller primary care practices.
J Gen Intern Med 2018 Dec;33(12):2138-46. doi: 10.1007/s11606-018-4679-0..
Keywords: Burnout, Primary Care, Provider: Physician, Provider: Clinician, Provider
Goldman MP, Wong AH, Bhatnagar A
Providers' perceptions of caring for pediatric patients in community hospital emergency departments: a mixed-methods analysis.
Approximately 90% of pediatric emergency care is provided in community emergency departments (CEDs) that care for both adults and children. Paradoxically, the majority of pediatric emergency medicine knowledge generation, quality improvement work, and clinical training occurs in children's hospitals. There is a paucity of information of perceptions on pediatric care from CED providers. The objective of this study was to explore interprofessional CED providers' perceptions of caring for pediatric patients.
AHRQ-funded; HS020286.
Citation: Goldman MP, Wong AH, Bhatnagar A .
Providers' perceptions of caring for pediatric patients in community hospital emergency departments: a mixed-methods analysis.
Acad Emerg Med 2018 Dec;25(12):1385-95. doi: 10.1111/acem.13509..
Keywords: Children/Adolescents, Emergency Department, Hospitals, Provider