National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Ambulatory Care and Surgery (1)
- Behavioral Health (2)
- Cancer (4)
- Cancer: Breast Cancer (2)
- Cancer: Lung Cancer (1)
- Cardiovascular Conditions (1)
- Care Coordination (4)
- Caregiving (1)
- Care Management (6)
- Case Study (1)
- Children/Adolescents (7)
- Chronic Conditions (3)
- Clinical Decision Support (CDS) (1)
- Clinician-Patient Communication (1)
- Communication (4)
- Community-Based Practice (1)
- Comparative Effectiveness (1)
- Critical Care (2)
- Cultural Competence (1)
- Data (1)
- Depression (1)
- Diabetes (2)
- Diagnostic Safety and Quality (2)
- Disparities (3)
- Education: Continuing Medical Education (1)
- Electronic Health Records (EHRs) (4)
- Emergency Department (2)
- Emergency Medical Services (EMS) (3)
- Evidence-Based Practice (2)
- Genetics (1)
- Guidelines (2)
- Healthcare Cost and Utilization Project (HCUP) (1)
- Healthcare Costs (2)
- (-) Healthcare Delivery (64)
- Healthcare Utilization (2)
- Health Information Technology (HIT) (8)
- Health Insurance (5)
- Health Services Research (HSR) (1)
- Health Systems (1)
- Hospital Discharge (1)
- Hospitalization (1)
- Hospitals (1)
- Human Immunodeficiency Virus (HIV) (2)
- Implementation (3)
- Injuries and Wounds (1)
- Intensive Care Unit (ICU) (2)
- Kidney Disease and Health (2)
- Lifestyle Changes (1)
- Low-Income (2)
- Medicaid (1)
- Medical Expenditure Panel Survey (MEPS) (1)
- Medicare (1)
- Medication (1)
- Neurological Disorders (2)
- Nursing (1)
- Organizational Change (1)
- Outcomes (2)
- Palliative Care (2)
- Patient-Centered Healthcare (8)
- Patient-Centered Outcomes Research (7)
- Patient Adherence/Compliance (2)
- Patient and Family Engagement (7)
- Patient Experience (3)
- Patient Safety (4)
- Patient Self-Management (1)
- Payment (1)
- Policy (5)
- Primary Care (11)
- Primary Care: Models of Care (3)
- Provider (2)
- Provider Performance (1)
- Public Health (1)
- Quality Improvement (7)
- Quality Measures (2)
- Quality of Care (8)
- Quality of Life (1)
- Racial and Ethnic Minorities (3)
- Research Methodologies (1)
- Risk (1)
- Shared Decision Making (5)
- Social Determinants of Health (2)
- Stroke (1)
- Surgery (2)
- Teams (4)
- Tobacco Use (1)
- Training (2)
- Transitions of Care (1)
- Transplantation (1)
- Treatments (3)
- Urban Health (1)
- Vulnerable Populations (2)
- Workflow (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 25 of 64 Research Studies DisplayedCaliff RM, Robb MA, Bindman AB
AHRQ Author: Bindman AB, Dymek C
Transforming evidence generation to support health and health care decisions.
Collaborations among federal health agencies involved in biomedical research and health care delivery with regard to data sharing, research infrastructure, and computational capabilities require combining expertise and resources and will entail substantial changes to the culture of clinical research, In this article, the authors propose a set of core principles for data collaboration and system organizational design that they believe will further enable research efforts by both the private sector and government agencies.
AHRQ-authored.
Citation: Califf RM, Robb MA, Bindman AB .
Transforming evidence generation to support health and health care decisions.
N Engl J Med 2016 Dec 15;375(24):2395-400. doi: 10.1056/NEJMsb1610128.
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Keywords: Healthcare Delivery, Shared Decision Making, Evidence-Based Practice, Policy
Bierman AS, Tinetti ME
AHRQ Author: Bierman AS
Precision medicine to precision care: managing multimorbidity.
Multimorbidity is the most common condition managed in practice. The authors argue that health-care delivery must be transformed to provide precision care to people with multimorbidity. Accomplishing this transition will require a change in practice, research, and policy from disease-specific to patient-centered models of care delivery.
AHRQ-authored.
Citation: Bierman AS, Tinetti ME .
Precision medicine to precision care: managing multimorbidity.
Lancet 2016 Dec 3;388(10061):2721-23. doi: 10.1016/s0140-6736(16)32232-2.
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Keywords: Healthcare Delivery, Chronic Conditions, Guidelines, Patient-Centered Healthcare, Primary Care, Primary Care: Models of Care
Sherry M, Wolff JL, Ballreich J
Bridging the silos of service delivery for high-need, high-cost individuals.
This study examined 5 innovative community-oriented programs that are successfully coordinating medical and nonmedical services to identify factors that stimulate and sustain community-level collaboration and coordinated care across silos of health care, public health, and social services delivery. The authors constructed a conceptual framework depicting community health systems that highlights 4 foundational factors that facilitate community-oriented collaboration.
AHRQ-funded; HS000029.
Citation: Sherry M, Wolff JL, Ballreich J .
Bridging the silos of service delivery for high-need, high-cost individuals.
Popul Health Manag 2016 Dec;19(6):421-28. doi: 10.1089/pop.2015.0147.
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Keywords: Community-Based Practice, Healthcare Costs, Healthcare Delivery, Care Coordination
O'Malley JP, O'Keeffe-Rosetti M, Lowe RA
Health care utilization rates after Oregon's 2008 Medicaid expansion: within-group and between-group differences over time among new, returning, and continuously insured enrollees.
The authors sought to assess changes in emergency department, primary care, mental and behavioral health care, and specialist care visit rates among individuals gaining Medicaid over 24 months postinsurance gain and also to evaluate the association of previous insurance with utilization. They found that primary care visit rates in both newly and returning insured individuals significantly exceeded those of the continuously insured in months 4 through 12, but were not significantly elevated in the second year. In contrast, emergency department utilization rates were significantly higher in returning insured compared with newly or continuously insured individuals and remained elevated over time. New visits to primary and specialist care were higher among those who gained Medicaid compared with the continuously insured throughout the study period. They concluded that expansion evaluations should allow for rate stabilization.
AHRQ-funded; HS021522.
Citation: O'Malley JP, O'Keeffe-Rosetti M, Lowe RA .
Health care utilization rates after Oregon's 2008 Medicaid expansion: within-group and between-group differences over time among new, returning, and continuously insured enrollees.
Med Care 2016 Nov;54(11):984-91. doi: 10.1097/mlr.0000000000000600.
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Keywords: Medicaid, Healthcare Delivery, Healthcare Utilization, Emergency Department, Emergency Medical Services (EMS)
Fraze T, Lewis VA, Rodriguez HP
Housing, transportation, and food: how ACOs seek to improve population health by addressing nonmedical needs of patients.
The authors examined how accountable care organizations (ACOs) addressed the nonmedical needs of their patients. They found that ACOs most commonly addressed the need for transportation, housing, and food insecurity, which they identified through the primary care visit or care transformation programs. They concluded that their findings offer insights into how health care organizations such as ACOs integrate themselves with nonmedical organizations.
AHRQ-funded; HS024792.
Citation: Fraze T, Lewis VA, Rodriguez HP .
Housing, transportation, and food: how ACOs seek to improve population health by addressing nonmedical needs of patients.
Health Aff 2016 Nov;35(11):2109-15. doi: 10.1377/hlthaff.2016.0727.
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Keywords: Social Determinants of Health, Patient-Centered Healthcare, Health Insurance, Healthcare Delivery, Primary Care, Public Health
Fong A, Hoffman DJ, Zachary Hettinger A
Identifying visual search patterns in eye gaze data; gaining insights into physician visual workflow.
The authors propose an algorithmic approach to identify different visual search patterns. They demonstrate this approach by identifying common physician visual search patterns using a simulated prototype emergency department patient tracking system. They then discuss the benefits and limitations as well as insights from this initial evaluation.
AHRQ-funded; HS020433.
Citation: Fong A, Hoffman DJ, Zachary Hettinger A .
Identifying visual search patterns in eye gaze data; gaining insights into physician visual workflow.
J Am Med Inform Assoc 2016 Nov;23(6):1180-84. doi: 10.1093/jamia/ocv196.
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Keywords: Healthcare Delivery, Electronic Health Records (EHRs), Health Information Technology (HIT), Workflow
Werner NE, Gurses AP, Leff B
Improving care transitions across healthcare settings through a human factors approach.
This article describes how a systems' approach known as Human Factors and Ergonomics can complement and further strengthen efforts to improve care transitions.
AHRQ-funded; HS022916.
Citation: Werner NE, Gurses AP, Leff B .
Improving care transitions across healthcare settings through a human factors approach.
J Healthc Qual 2016 Nov/Dec;38(6):328-43. doi: 10.1097/jhq.0000000000000025.
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Keywords: Healthcare Delivery, Provider, Hospital Discharge, Patient Safety, Transitions of Care
Gerber DE, Reimer T, Williams EL
Resolving rivalries and realigning goals: challenges of clinical and research multiteam systems.
This article describes the care processes for a 64-year-old man with newly diagnosed advanced non-small-cell lung cancer who was enrolled in a first-line clinical trial of a new immunotherapy regimen. Research team and clinical team members have limited knowledge of the roles and work of individuals outside their team. Recommendations to increase trust and collaboration are provided.
AHRQ-funded; HS022418.
Citation: Gerber DE, Reimer T, Williams EL .
Resolving rivalries and realigning goals: challenges of clinical and research multiteam systems.
J Oncol Pract 2016 Nov;12(11):1020-28. doi: 10.1200/jop.2016.013060.
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Keywords: Cancer, Cancer: Lung Cancer, Case Study, Healthcare Delivery, Patient-Centered Healthcare, Teams
Stepanikova I, Oates GR
Dimensions of racial identity and perceived discrimination in health care.
Drawing from the scholarship on multidimensionality of race, this study examined the relationships between perceived discrimination in health care and two dimensions of racial identity: self-identified race/ethnicity and perceived attributed race/ethnicity (respondents' perceptions of how they are racially classified by others). The investigators used Behavioral Risk Factor Surveillance System data collected in 2004-2013 for their analysis.
AHRQ-funded; HS023009.
Citation: Stepanikova I, Oates GR .
Dimensions of racial identity and perceived discrimination in health care.
Ethn Dis 2016 Oct 20;26(4):501-12. doi: 10.18865/ed.26.4.501..
Keywords: Disparities, Healthcare Delivery, Racial and Ethnic Minorities
Cutting E, Banchero M, Beitelshees AL
User-centered design of multi-gene sequencing panel reports for clinicians.
The objective of this study was to develop a high-fidelity prototype for delivering multi-gene sequencing panel (GS) reports to clinicians that simulates the user experience of a final application. Findings illustrated a need to support customized notification approaches, user-specific information, and access to genetics specialists with GS reports. These design principles can be incorporated into software applications that deliver GS reports.
AHRQ-funded; R21 HS023390.
Citation: Cutting E, Banchero M, Beitelshees AL .
User-centered design of multi-gene sequencing panel reports for clinicians.
J Biomed Inform 2016 Oct;63:1-10. doi: 10.1016/j.jbi.2016.07.014.
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Keywords: Genetics, Health Information Technology (HIT), Healthcare Delivery
Carney RM, Freedland KE, Steinmeyer BC
Collaborative care for depression symptoms in an outpatient cardiology setting: a randomized clinical trial.
The purpose of this study was to determine whether collaborative care (CC) for patients who screen positive for depression during an outpatient cardiology visit results in greater improvement in depression symptoms and better medical outcomes than seen in patients who screen positive for depression but receive only usual care (UC). Tthis trial did not show that CC produces better depression outcomes than UC.
AHRQ-funded; HS018335.
Citation: Carney RM, Freedland KE, Steinmeyer BC .
Collaborative care for depression symptoms in an outpatient cardiology setting: a randomized clinical trial.
Int J Cardiol 2016 Sep 15;219:164-71. doi: 10.1016/j.ijcard.2016.06.045.
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Keywords: Care Management, Cardiovascular Conditions, Depression, Healthcare Delivery, Behavioral Health, Outcomes, Ambulatory Care and Surgery, Teams
Dy CJ, Baty J, Saeed MJ
A population-based analysis of time to surgery and travel distances for brachial plexus surgery.
Since the published brachial plexus injuries (BPI) experience is largely from individual centers, the authors used a population-based approach to evaluate the delivery of care for patients with BPI. They found that nearly one third of patients underwent BPI surgery more than 1 year after the injury, with patients initially treated at smaller hospitals at risk for undergoing delayed BPI surgery. These findings can inform efforts to expedite timely referral of patients with BPI to experienced centers.
AHRQ-funded; HS019455.
Citation: Dy CJ, Baty J, Saeed MJ .
A population-based analysis of time to surgery and travel distances for brachial plexus surgery.
J Hand Surg Am 2016 Sep;41(9):903-09.e3. doi: 10.1016/j.jhsa.2016.07.054.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Healthcare Delivery, Surgery, Neurological Disorders
Conlon C, Asch S, Hanson M
Assessing the value of high-quality care for work-associated carpal tunnel syndrome in a large integrated health care system: study design.
The researchers described the design of a study that is assessing quality of care for work-associated carpal tunnel syndrome and associations with clinical outcomes and costs. They found that time off work was generally short and related to surgery. They recommended systematic efforts to evaluate and improve quality of medical care for this condition.
AHRQ-funded; HS018982.
Citation: Conlon C, Asch S, Hanson M .
Assessing the value of high-quality care for work-associated carpal tunnel syndrome in a large integrated health care system: study design.
Perm J 2016 Fall;20(4):87-95. doi: 10.7812/tpp/15-220.
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Keywords: Healthcare Delivery, Quality of Care, Injuries and Wounds, Neurological Disorders, Patient-Centered Outcomes Research
Adler-Milstein J, Embi PJ, Middleton B
Crossing the health IT chasm: considerations and policy recommendations to overcome current challenges and enable value-based care.
There is a chasm between the current health IT ecosystem and the health IT ecosystem. In this paper, the authors identify a set of focal goals and associated near-term achievable actions that are critical to pursue in order to enable the health IT ecosystem to meet the acute needs of modern health care delivery. These ideas emerged from discussions that occurred during the 2015 American Medical Informatics Association Policy Invitational Meeting.
AHRQ-funded; HS023969.
Citation: Adler-Milstein J, Embi PJ, Middleton B .
Crossing the health IT chasm: considerations and policy recommendations to overcome current challenges and enable value-based care.
J Am Med Inform Assoc 2017 Sep 1;24(5):1036-43. doi: 10.1093/jamia/ocx017.
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Keywords: Healthcare Delivery, Health Information Technology (HIT), Patient and Family Engagement, Policy, Health Information Technology (HIT)
Rudin RS, Schneider EC, Predmore Z
Knowledge gaps inhibit health IT development for coordinating complex patients' care.
The authors sought to determine the leading edge of health information technology (IT) tools for care coordination of complex patients. They found barriers to developing technical capabilities for improving care coordination, including lack of knowledge of users' needs; lack of standardized roles, responsibilities, and protocols; required changes in providers' work activities to achieve coordination; and an unclear value proposition.
AHRQ-funded; HS000029.
Citation: Rudin RS, Schneider EC, Predmore Z .
Knowledge gaps inhibit health IT development for coordinating complex patients' care.
Am J Manag Care 2016 Sep;22(9):e317-22.
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Keywords: Healthcare Delivery, Health Information Technology (HIT), Health Information Technology (HIT)
Brand SR, Pickard L, Mack JW
What adult cancer care can learn from pediatrics.
However, pediatric cancer centers follow three core principles that enhance their patients’ overall care experience. This article discusses those principles, with the aim of helping adult cancer centers learn from what pediatric centers do well.
AHRQ-funded; HS000063.
Citation: Brand SR, Pickard L, Mack JW .
What adult cancer care can learn from pediatrics.
J Oncol Pract 2016 Sep;12(9):765-7. doi: 10.1200/jop.2016.015057..
Keywords: Cancer, Children/Adolescents, Health Services Research (HSR), Healthcare Delivery, Patient Experience, Children/Adolescents
Holtrop JS, Potworowski G, Fitzpatrick L
Effect of care management program structure on implementation: a normalization process theory analysis.
This study used normalization process theory (NPT) to understand how care management structure affected how well care management became routine in practice. It concluded that, although care management can introduce many new changes into delivery of clinical practice, implementing it successfully as a new complex intervention is possible. NPT can be helpful in explaining differences in implementing a new care management program.
AHRQ-funded; HS020108.
Citation: Holtrop JS, Potworowski G, Fitzpatrick L .
Effect of care management program structure on implementation: a normalization process theory analysis.
BMC Health Serv Res 2016 Aug 15;16(a):386. doi: 10.1186/s12913-016-1613-1.
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Keywords: Care Management, Chronic Conditions, Primary Care, Healthcare Delivery
Colla CH, Lewis VA, Bergquist SL
Accountability across the continuum: the participation of postacute care providers in accountable care organizations.
The authors examined the extent to which accountable care organizations (ACOs) formally incorporate postacute care providers. They found that ACOs with a relationship with a postacute care provider are more likely to have advanced transition management, end of life planning, readmission prevention, and care management capabilities. However, many ACOs have not formally engaged postacute care.
AHRQ-funded; HS024075.
Citation: Colla CH, Lewis VA, Bergquist SL .
Accountability across the continuum: the participation of postacute care providers in accountable care organizations.
Health Serv Res 2016 Aug;51(4):1595-611. doi: 10.1111/1475-6773.12442.
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Keywords: Policy, Healthcare Delivery, Health Insurance
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
Balbale SN, Locatelli SM, LaVela SL
Through their eyes: lessons learned using participatory methods in health care quality improvement projects.
The authors examined participatory methods to demonstrate how these methods can be adopted for quality improvement (QI) projects in health care. They concluded that using participatory methods is a valuable strategy to harness participant engagement and drive improvements that address individual needs.
AHRQ-funded; HS000084.
Citation: Balbale SN, Locatelli SM, LaVela SL .
Through their eyes: lessons learned using participatory methods in health care quality improvement projects.
Qual Health Res 2016 Aug;26(10):1382-92. doi: 10.1177/1049732315618386.
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Keywords: Healthcare Delivery, Quality of Care, Patient and Family Engagement, Quality Improvement
Luo Z, Chen Q, Annis AM
A comparison of health plan- and provider-delivered chronic care management models on patient clinical outcomes.
Two contrasting strategies of chronic care management include provider-delivered care management (PDCM) and health plan-delivered care management (HPDCM). The researchers aimed to compare the effectiveness of PDCM vs. HPDCM on improving clinical outcomes for patients with chronic diseases. They found that in a commercially insured population, neither PDCM nor HPDCM resulted in substantial improvement in patients' clinical indicators in the first year.
AHRQ-funded; HS020108.
Citation: Luo Z, Chen Q, Annis AM .
A comparison of health plan- and provider-delivered chronic care management models on patient clinical outcomes.
J Gen Intern Med 2016 Jul;31(7):762-70. doi: 10.1007/s11606-016-3617-2.
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Keywords: Chronic Conditions, Care Management, Primary Care: Models of Care, Primary Care, Healthcare Delivery, Comparative Effectiveness, Patient-Centered Outcomes Research, Health Insurance
Shoemaker SJ, Parchman ML, Fuda KK
AHRQ Author: Ricciardi
A review of instruments to measure interprofessional team-based primary care.
The study’s aims were to develop a conceptual framework of high-functioning primary care teams to identify and review instruments that measure the constructs identified in the framework. The majority of instruments were surveys, and the remainder were observational checklists. They addressed multiple constructs, most commonly communication, heedful interrelating , respectful interactions, and shared explicit goals.
AHRQ-authored.
Citation: Shoemaker SJ, Parchman ML, Fuda KK .
A review of instruments to measure interprofessional team-based primary care.
J Interprof Care 2016 Jul;30(4):423-32. doi: 10.3109/13561820.2016.1154023..
Keywords: Communication, Healthcare Delivery, Primary Care, Teams
Hung D, Gray C, Martinez M
AHRQ Author: Harrison MI
Acceptance of Lean redesigns in primary care: a contextual analysis.
The aim of this study was to identify contextual factors most critical to implementing and scaling Lean redesigns across all primary care clinics in a large, ambulatory care delivery system. It found that acceptance was influenced by time and intensity of exposure to changes, "top-down" versus "bottom-up" implementation styles, and degrees of employee engagement in developing new workflows.
AHRQ-authored; AHRQ-funded; 2902010000221.
Citation: Hung D, Gray C, Martinez M .
Acceptance of Lean redesigns in primary care: a contextual analysis.
Health Care Manage Rev 2016 Jul/Sep;42(3):203-12. doi: 10.1097/hmr.0000000000000106.
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Keywords: Healthcare Delivery, Primary Care, Quality Improvement
Dugas AF, Kirsch TD, Toerper M
An electronic emergency triage system to improve patient distribution by critical outcomes.
This study derives and validates a computer-based electronic triage system (ETS) to improve patient acuity distribution based on serious patient outcomes. The authors found improved differentiation of patients compared to the current standard Emergency Severity Index.
AHRQ-funded; HS023641.
Citation: Dugas AF, Kirsch TD, Toerper M .
An electronic emergency triage system to improve patient distribution by critical outcomes.
J Emerg Med 2016 Jun;50(6):910-8. doi: 10.1016/j.jemermed.2016.02.026.
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Keywords: Care Management, Electronic Health Records (EHRs), Emergency Department, Health Information Technology (HIT), Healthcare Delivery
Khan A, Rogers JE, Forster CS
Communication and shared understanding between parents and resident-physicians at night.
The researchers studied communication breakdowns evidenced by lack of shared understanding between parents and night-team residents about the reason for admission and care plan. After conducting a prospective cohort study of 286 parents and 37 night-team senior residents, they found that parents and residents reported that they shared an understanding with one another about care plans in 86.0percent and 73.1 percent of cases, respectively.
AHRQ-funded; HS022986; HS000063.
Citation: Khan A, Rogers JE, Forster CS .
Communication and shared understanding between parents and resident-physicians at night.
Hosp Pediatr 2016 Jun;6(6):319-29. doi: 10.1542/hpeds.2015-0224.
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Keywords: Care Coordination, Healthcare Delivery, Communication, Patient and Family Engagement, Clinician-Patient Communication