National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
Data
- Data Infographics
- Data Visualizations
- Data Tools
- Data Innovations
- All-Payer Claims Database
- Healthcare Cost and Utilization Project (HCUP)
- Medical Expenditure Panel Survey (MEPS)
- AHRQ Quality Indicator Tools for Data Analytics
- State Snapshots
- United States Health Information Knowledgebase (USHIK)
- Data Sources Available from AHRQ
Search All Research Studies
AHRQ Research Studies Date
Topics
- Adverse Events (6)
- Ambulatory Care and Surgery (1)
- Antibiotics (1)
- Antimicrobial Stewardship (1)
- Arthritis (4)
- Blood Clots (1)
- Blood Pressure (2)
- Burnout (1)
- Cardiovascular Conditions (3)
- Care Coordination (2)
- Caregiving (2)
- Care Management (2)
- Children/Adolescents (6)
- Chronic Conditions (4)
- Clinical Decision Support (CDS) (2)
- Clinician-Patient Communication (1)
- Communication (2)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (4)
- Critical Care (1)
- Data (1)
- Dementia (2)
- Diabetes (3)
- Diagnostic Safety and Quality (6)
- Education: Patient and Caregiver (2)
- Elderly (2)
- Electronic Health Records (EHRs) (49)
- Emergency Department (2)
- Emergency Medical Services (EMS) (2)
- Evidence-Based Practice (8)
- Healthcare-Associated Infections (HAIs) (4)
- Healthcare Cost and Utilization Project (HCUP) (1)
- Healthcare Delivery (3)
- Healthcare Utilization (1)
- Health Information Exchange (HIE) (3)
- (-) Health Information Technology (HIT) (91)
- Health Literacy (1)
- Health Services Research (HSR) (3)
- Health Systems (2)
- Heart Disease and Health (1)
- Home Healthcare (2)
- Hospitalization (1)
- Hospital Readmissions (2)
- Hospitals (17)
- Imaging (1)
- Implementation (3)
- Injuries and Wounds (2)
- Intensive Care Unit (ICU) (1)
- Learning Health Systems (1)
- Long-Term Care (2)
- Low-Income (1)
- Medicaid (1)
- Medical Errors (3)
- Medication (3)
- Medication: Safety (1)
- Mortality (1)
- Neurological Disorders (3)
- Nursing (2)
- Nursing Homes (2)
- Obesity (1)
- Obesity: Weight Management (1)
- Outcomes (3)
- Patient-Centered Healthcare (3)
- Patient-Centered Outcomes Research (3)
- Patient and Family Engagement (3)
- Patient Experience (4)
- Patient Safety (16)
- Payment (1)
- Practice Patterns (1)
- Pressure Ulcers (1)
- Prevention (1)
- Primary Care (12)
- Primary Care: Models of Care (1)
- Provider (1)
- Provider: Nurse (1)
- Provider Performance (9)
- Quality Improvement (44)
- Quality Indicators (QIs) (8)
- Quality Measures (14)
- (-) Quality of Care (91)
- Racial and Ethnic Minorities (2)
- Registries (2)
- Respiratory Conditions (1)
- Sepsis (2)
- Shared Decision Making (2)
- Simulation (1)
- Stroke (1)
- Surgery (8)
- Telehealth (8)
- Tools & Toolkits (2)
- Trauma (1)
- Urban Health (1)
- Urinary Tract Infection (UTI) (1)
- Vulnerable Populations (1)
- Web-Based (1)
- Workflow (1)
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 91 Research Studies DisplayedYu J, Huckfeldt PJ, Mink PJ
Evaluating the association between expanded coverage of direct-to-consumer telemedicine and downstream utilization and quality of care for urinary tract infections and sinusitis.
The purpose of this study was to compare rates of testing, follow-up health care use, and quality for urinary tract infections (UTIs) and sinusitis between direct-to-consumer (DTC) telemedicine and in-person visits. Primary outcomes included number of laboratory tests, antibiotics filled, office and outpatient visits, emergency department (ED) visits, and standardized spending, based on standardized health service prices. The UTI and sinusitis samples included 215,134 and 624,630 episodes of care, respectively. Following the introduction of coverage for DTC telemedicine, 15.7% of UTI episodes and 8.9% of sinusitis episodes were initiated with DTC telemedicine. When compared to episodes without coverage for DTC telemedicine, UTI episodes with coverage had 0.25 fewer lab tests, lower standardized spending for the first UTI visit, and no change in office and outpatient visits, ED visits, antibiotics filled, or standardized medical spending. Sinusitis episodes with coverage for DTC telemedicine had fewer antibiotics filled and a minor increase in ED visits but no difference in lab tests, office and outpatient visits, or standardized medical spending.
AHRQ-funded; HS026088.
Citation: Yu J, Huckfeldt PJ, Mink PJ .
Evaluating the association between expanded coverage of direct-to-consumer telemedicine and downstream utilization and quality of care for urinary tract infections and sinusitis.
Health Serv Res 2023 Oct; 58(5):976-87. doi: 10.1111/1475-6773.14129..
Keywords: Telehealth, Health Information Technology (HIT), Healthcare Utilization, Quality of Care
Rome D, Sales A, Cornelius T
Impact of telemedicine modality on quality metrics in diverse settings: implementation science-informed retrospective cohort study.
The objective of this study was to assess telemedicine uptake during the COVID-19 pandemic and impact of visit modality on primary care quality metrics in diverse, low socioeconomic status settings. Research was informed by the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework. Researchers found that there were marginally better quality metrics for in-person care versus video and phone visits, and that de-adoption of telemedicine was marked within 2 years in the study population. They concluded that the impact of visit modality on quality outcomes, provider and patient preferences, and technological barriers in historically marginalized settings should be considered.
AHRQ-funded; HS025198.
Citation: Rome D, Sales A, Cornelius T .
Impact of telemedicine modality on quality metrics in diverse settings: implementation science-informed retrospective cohort study.
J Med Internet Res 2023 Jul 26; 25:e47670. doi: 10.2196/47670..
Keywords: Telehealth, Health Information Technology (HIT), Implementation, Quality Measures, Quality of Care
Bradford A, Shofer M, Singh H
AHRQ Author: Shofer M, Singh H
Measure Dx: implementing pathways to discover and learn from diagnostic errors.
This paper discusses Measure Dx, a new AHRQ resource that translates knowledge from diagnostic measurement research into actionable recommendations. This resource guides healthcare organizations to detect, analyze, and learn from diagnostic safety events as part of a continuous learning and feedback cycle. The goal of Measure Dx is to advance new frontiers in reducing preventable diagnostic harm to patients.
AHRQ-authored; AHRQ-funded; 233201500022I; HS027363.
Citation: Bradford A, Shofer M, Singh H .
Measure Dx: implementing pathways to discover and learn from diagnostic errors.
Int J Qual Health Care 2022 Sep 10;34(3). doi: 10.1093/intqhc/mzac068..
Keywords: Diagnostic Safety and Quality, Patient Safety, Quality Improvement, Quality of Care, Electronic Health Records (EHRs), Health Information Technology (HIT), Health Systems, Learning Health Systems
Lieu TA, Warton EM, Levan C
Association of medical assistant-supported virtual rooming with successful video visit connections.
The purpose of this study was to systematically evaluate medical assistant-supported virtual rooming for physician video visits to address the digital divide which exists in physician video visit availability and accessibility for patients who have lower socioeconomic status (SES), low English proficiency, or are African American or Black or Latino. The study found that of the 114,214 video visits with successful connections, 14.2% had low neighborhood SES, 3.6% needed interpreters, 20.1% were Latino, and 7.9% were African American or Black. African American or Black race, Latino ethnicity, needing an interpreter, and living in a low SES neighborhood were associated with a lower likelihood of connecting. The researchers concluded that medical assistant–supported virtual rooming was associated with successful video visit connections in this diverse population. High medical assistant supported rooming rates were associated with larger connection improvements for patients at higher risk of not connecting, including those with lower SES, of Latino ethnicity or African American or Black race, or needing interpreters.
AHRQ-funded; HS025189.
Citation: Lieu TA, Warton EM, Levan C .
Association of medical assistant-supported virtual rooming with successful video visit connections.
JAMA Intern Med 2022 Jun;182(6):680-82. doi: 10.1001/jamainternmed.2022.1032..
Keywords: Quality Improvement, Quality of Care, Telehealth, Health Information Technology (HIT), Clinician-Patient Communication, Communication, Healthcare Delivery
Bardach NS, Stotts JR, Fiore DM
Family Input for Quality and Safety (FIQS): using mobile technology for in-hospital reporting from families and patients.
This study’s goal was to test a real-time mobile-responsive website called Family Input for Quality and Safety (FIQS) for inpatient reporting from families and patients. The tool was piloted from June 2017 to April 2018 on the medical-surgical unit of a children’s hospital. The authors enrolled 253 patients aged 13 and older and patient family members. This resulted in 8.15 safety reports/100 patient-days, most frequently regarding medications (29% of reports) and communication (20% of reports). Fifty-one reports met incident reporting (IR) criteria with only 1 having been reported via the IR system. White participants submitted more observations than Latinx participants.
AHRQ-funded; HS028477; HS024553.
Citation: Bardach NS, Stotts JR, Fiore DM .
Family Input for Quality and Safety (FIQS): using mobile technology for in-hospital reporting from families and patients.
J Hosp Med 2022 Jun;17(6):456-65. doi: 10.1002/jhm.2777..
Keywords: Quality of Care, Patient Safety, Health Information Technology (HIT), Patient and Family Engagement
Huo T, Li Q, Cardel MI
AHRQ Author: Mistry K
Enhancing quality measurement with clinical information: a use case of body mass index change among children taking second generation antipsychotics.
The authors sought to examine the extent to which body mass index (BMI) was available in electronic health records for Florida Medicaid recipients aged 5 to 18 years taking Second-Generation Antipsychotics (SGAP). They concluded that meeting the 2030 CMS goal of digital monitoring of quality of care will require continuing expansion of clinical encounter data capture to provide the data needed for digital quality monitoring. Using linked electronic health records and claims data allows identifying children at higher risk for SGAP-induced weight gain.
AHRQ-authored; AHRQ-funded; HS025298.
Citation: Huo T, Li Q, Cardel MI .
Enhancing quality measurement with clinical information: a use case of body mass index change among children taking second generation antipsychotics.
Acad Pediatr 2022 Apr;22(3S):S140-S49. doi: 10.1016/j.acap.2021.11.012..
Keywords: Children/Adolescents, Electronic Health Records (EHRs), Health Information Technology (HIT), Medication, Obesity, Obesity: Weight Management, Quality Measures, Quality of Care
Richardson JE, Rasmussen LV, Dorr DA
Generating and reporting electronic clinical quality measures from electronic health records: strategies from EvidenceNOW cooperatives.
This study’s goal was to characterize strategies that seven regional cooperatives participating in the EvidenceNOW initiative developed to generate and report electronic health record (EHR)-based electronic clinical quality measures (eCQMs) for quality improvement (QI) in small-to-medium-sized practices. Findings showed that cooperatives ultimately generated and reported eCQMs using hybrid strategies because they determined that neither EHRs alone nor centralized sources alone could operationalize eCQMs for QI. In order to attain this goal, cooperatives needed to devise solutions and utilize resources that often are unavailable to typical small-to-medium-sized practices.
AHRQ-funded; HS023921.
Citation: Richardson JE, Rasmussen LV, Dorr DA .
Generating and reporting electronic clinical quality measures from electronic health records: strategies from EvidenceNOW cooperatives.
Appl Clin Inform 2022 Mar;13(2):485-94. doi: 10.1055/s-0042-1748145..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Quality Indicators (QIs), Quality Measures, Quality of Care, Evidence-Based Practice, Primary Care
Ferucci ED, Day GM, Choromanski TL
Outcomes and quality of care in rheumatoid arthritis with or without video telemedicine follow-up visits.
This study’s objective was to evaluate outcomes and quality of care for rheumatoid arthritis (RA) in patients seen by video telemedicine compared to in-person only. Individuals in the Alaska Tribal Health System who were diagnosed with RA were recruited when seeing a rheumatologist either in person or by video telemedicine. Participants completed a Routine Assessment of Patient Index Data 3 (RAPID3) questionnaire and a telephone medicine perception survey at the start of the survey. They also agreed to medical record review. The authors repeated the surveys by telephone and at 6 and 12 months, and medical record abstraction was performed at 12 months for quality measures. By the end of the 12-month period, about half of the 122 RA participants (52%) had ever used telemedicine for RA. Higher RAPID3 score and functional status were associated with the telemedicine group, with no statistically significant change over the 12-month period. The only quality measure that differed between the two groups at 12 months was the proportion of visits in which disease activity was documented, but it was not significantly after multivariate analysis.
AHRQ-funded; HS024540.
Citation: Ferucci ED, Day GM, Choromanski TL .
Outcomes and quality of care in rheumatoid arthritis with or without video telemedicine follow-up visits.
Arthritis Care Res 2022 Mar;74(3):484-92. doi: 10.1002/acr.24485..
Keywords: Arthritis, Chronic Conditions, Telehealth, Health Information Technology (HIT), Quality of Care, Outcomes
Gustafson DH, Kornfield R, Mares ML
Effect of an eHealth intervention on older adults' quality of life and health-related outcomes: a randomized clinical trial.
The authors sought to assess effects of an eHealth intervention for older adults in three Wisconsin communities (urban, suburban, and rural) on quality of life, independence, and related outcomes. They found that interventions like ElderTree may help improve quality of life and socio-emotional outcomes among older adults with more illness burden.
AHRQ-funded; HS019917.
Citation: Gustafson DH, Kornfield R, Mares ML .
Effect of an eHealth intervention on older adults' quality of life and health-related outcomes: a randomized clinical trial.
J Gen Intern Med 2022 Feb;37(3):521-30. doi: 10.1007/s11606-021-06888-1..
Keywords: Elderly, Quality of Care, Telehealth, Health Information Technology (HIT)
Fowler FJ, Brenner PS, Hargraves JL
Comparing web and mail protocols for administering Hospital Consumer Assessment of Healthcare Providers and Systems surveys.
This study’s objective was to compare results of using web-based and mail HCAHPS data collection protocols. The cohort included patients who were hospitalized in a New England Hospital. Patients who provided email addresses were randomized to 1 of 3 data collection protocols: web-only, web with postal mail follow-up, and postal mail only. Those who did not provide email addresses were surveyed by postal mail only. The study lasted 8 weeks. Measures looked at included response rates, characteristics of respondents, 6 composite measures of their patient experiences, and two ratings of the hospital. Web-only response rates were significantly lower than for mail or combined protocols, and those who had not provided email addresses also had lower response rates. Older adults over age 65 were more likely to respond to all protocols, especially for mail-only respondents. Respondents without email addresses were older, less educated, and reported worse health than those who had email addresses.
AHRQ-funded; HS016978.
Citation: Fowler FJ, Brenner PS, Hargraves JL .
Comparing web and mail protocols for administering Hospital Consumer Assessment of Healthcare Providers and Systems surveys.
Med Care 2021 Oct;59(10):907-12. doi: 10.1097/mlr.0000000000001627..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Hospitals, Health Information Technology (HIT), Quality Measures, Provider Performance, Quality of Care
Shi J, Hurdle JF, Johnson SA
Natural language processing for the surveillance of postoperative venous thromboembolism.
The objective of the study was to develop a portal natural language processing approach to aid in the identification of postoperative venous thromboembolism events from free-text clinical notes. The investigators concluded that accurate surveillance of postoperative venous thromboembolism may be achieved using natural language processing on clinical notes in 2 independent health care systems. They indicated that these findings suggest natural language processing may augment manual chart abstraction for large registries such as National Surgical Quality Improvement Program.
AHRQ-funded; HS025776.
Citation: Shi J, Hurdle JF, Johnson SA .
Natural language processing for the surveillance of postoperative venous thromboembolism.
Surgery 2021 Oct;170(4):1175-82. doi: 10.1016/j.surg.2021.04.027..
Keywords: Blood Clots, Health Information Technology (HIT), Quality Improvement, Quality of Care, Surgery, Adverse Events
Holmgren AJ, Kuznetsova M, Classen D
Assessing hospital electronic health record vendor performance across publicly reported quality measures.
The authors measured hospital performance, stratified by electronic health record (EHR) vendor, across 4 quality metrics. They found that no EHR vendor was associated with higher quality across all measures, and the 2 largest vendors were not associated with the highest scores. Only a small fraction of quality variation was explained by EHR vendor choice. They concluded that top performance on quality measures can be achieved with any EHR vendor, as much of quality performance is driven by the hospital and how it uses the EHR.
AHRQ-funded; HS023696.
Citation: Holmgren AJ, Kuznetsova M, Classen D .
Assessing hospital electronic health record vendor performance across publicly reported quality measures.
J Am Med Inform Assoc 2021 Sep 18;28(10):2101-07. doi: 10.1093/jamia/ocab120..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Quality Indicators (QIs), Quality Measures, Hospitals, Quality of Care, Provider Performance
Cifra CL, Sittig DF, Singh H
Bridging the feedback gap: a sociotechnical approach to informing clinicians of patients' subsequent clinical course and outcomes.
This paper discusses challenges to the development of systems for effective patient outcome feedback to improve diagnosis and proposes the application of a sociotechnical approach using health information technology (HIT) to support the implementation of such systems. It discusses current barriers to effective clinician feedback, reasons for them, and features of potential IT solutions. Evaluation and implementation of the feedback process within a sociotechnical health system are then discussed. The authors use an eight-dimension sociotechnical model for studying health IT by authors Sittig and Singh. The eight dimensions are hardware and software; clinical content; human–computer interface; people; workflow and communication; organisational policies and procedures; external rules, regulations and pressures; and system measurement and monitoring. A table is included that shows the potential considerations for each dimension.
AHRQ-funded; 33201500022I; HS027363.
Citation: Cifra CL, Sittig DF, Singh H .
Bridging the feedback gap: a sociotechnical approach to informing clinicians of patients' subsequent clinical course and outcomes.
BMJ Qual Saf 2021 Jul;30(7):591-97. doi: 10.1136/bmjqs-2020-012464..
Keywords: Health Information Technology (HIT), Diagnostic Safety and Quality, Patient Safety, Quality Improvement, Quality of Care
Zhu Y, Simon GJ, Wick EC
Applying machine learning across sites: external validation of a surgical site infection detection algorithm.
Surgical complications have tremendous consequences and costs. Complication detection is important for quality improvement, but traditional manual chart review is burdensome. Automated mechanisms are needed to make this more efficient. The purpose of the study was to understand the generalizability of a machine learning algorithm between sites; automated surgical site infection (SSI) detection algorithms developed at one center were tested at another distinct center.
AHRQ-funded; HS024532.
Citation: Zhu Y, Simon GJ, Wick EC .
Applying machine learning across sites: external validation of a surgical site infection detection algorithm.
J Am Coll Surg 2021 Jun;232(6):963-71.e1. doi: 10.1016/j.jamcollsurg.2021.03.026..
Keywords: Healthcare-Associated Infections (HAIs), Surgery, Adverse Events, Diagnostic Safety and Quality, Electronic Health Records (EHRs), Health Information Technology (HIT), Quality Improvement, Quality of Care
Palen TE, Peterson L, Palen TE
Clinical quality measure exchange is not easy.
The Trial of Aggregate Data Exchange for Maintenance of Certification and Raising Quality was a randomized controlled trial which first had to test whether quality reporting could be a by-product of clinical care. The investigators reported on the initial descriptive study of the capacity for and quality of exchange of whole-panel, standardized quality measures from health systems. They concluded that the secure transfer of standardized, physician-level quality measures from 4 health systems with mature measure processes proved difficult. There were many errors that required human intervention and manual repair, precluding full automation.
AHRQ-funded; HS022583.
Citation: Palen TE, Peterson L, Palen TE .
Clinical quality measure exchange is not easy.
Ann Fam Med 2021 May-Jun;19(3):207-11. doi: 10.1370/afm.2649..
Keywords: Quality Measures, Quality Indicators (QIs), Quality of Care, Health Information Exchange (HIE), Health Information Technology (HIT)
Shekelle PG, Pane JD, Agniel D
Assessment of variation in electronic health record capabilities and reported clinical quality performance in ambulatory care clinics, 2014-2017.
This study’s objective was to assess the association between electronic health records (EHRs) with different degrees of capabilities and publicly reported ambulatory quality measures in at least 3 clinical domains of care. This cross-sectional and longitudinal study was conducted using survey responses from 1141 ambulatory clinics in Minnesota, Washington, and Wisconsin affiliated with a health system and reported performance measures in 2014 to 2017. A composite measure of EHR capability that considered 50 EHR capabilities was created using 7 functional domains: no functional EHR, EHR underuser, EHR, neither underuser nor superuser, and EHR superuser; as well as a standardized composite of ambulatory clinical measures that included a median of 13 individual measures (3 to 25). The proportion of clinics that were EHR superusers increased from 51% in 2014 to 61% in 2017. In all survey years EHR superusers had better clinical quality performance than other clinics. This difference in scores translated into an approximately 9% difference in a clinic’s rank order in clinical quality.
AHRQ-funded; HS024067.
Citation: Shekelle PG, Pane JD, Agniel D .
Assessment of variation in electronic health record capabilities and reported clinical quality performance in ambulatory care clinics, 2014-2017.
JAMA Netw Open 2021 Apr;4(4):e217476. doi: 10.1001/jamanetworkopen.2021.7476..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Ambulatory Care and Surgery, Provider Performance, Quality of Care
Elysee G, Yu H, Herrin J
Association between 30-day readmission rates and health information technology capabilities in US hospitals.
A study was conducted to determine if there is an association of health information technology (HIT) adoption and a decrease in 30-day hospital readmission rates. Data was used from the 2013 American Hospital Association IT survey which included non-federal U.S. acute care hospitals with self-reported capabilities. A 54-indicator 7-factor structure of hospital health IT capabilities was identified by exploratory factor analysis. A one-point increase in the hospital adoption of patient engagement capability latent scores generally leads to a 0.086% decrease in risk-standardized readmission rates (RSRRs). However, computerized hospital discharge and information exchange among clinicians did not seem as beneficial.
AHRQ-funded; HS022882.
Citation: Elysee G, Yu H, Herrin J .
Association between 30-day readmission rates and health information technology capabilities in US hospitals.
Medicine 2021 Feb 26;100(8):e24755. doi: 10.1097/md.0000000000024755..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Hospital Readmissions, Hospitals, Quality Indicators (QIs), Quality of Care
Covele BM, Puri KS, Kallis K
ORBIT-RT: a real-time, open platform for knowledge-based quality control of radiotherapy treatment planning.
This paper describes the Online Real-time Benchmarking Information Technology for RadioTherapy (ORBIT-RT) platform, a free, web-based platform for knowledge-based dose estimation that can be used by clinicians worldwide to benchmark the quality of their radiotherapy plans. It was developed to satisfy four primary design criteria: web-based access, treatment planning systems independence, Health Insurance Portability and Accountability Act compliance, and autonomous operation. The ORBIT-RT system can be used for real-time quality control feedback that provides users with objective comparisons for final plan dose-volume histograms.
AHRQ-funded; HS025440.
Citation: Covele BM, Puri KS, Kallis K .
ORBIT-RT: a real-time, open platform for knowledge-based quality control of radiotherapy treatment planning.
JCO Clin Cancer Inform 2021 Jan;5:134-42. doi: 10.1200/cci.20.00093..
Keywords: Health Information Technology (HIT), Quality of Care
Griffey RT, Schneider RM, Todorov AA
The emergency department trigger tool: validation and testing to optimize yield.
Researchers validated the emergency department trigger tool (EDTT) in an independent sample and compared record selection approaches to optimize yield for quality improvement. In this single-site study of the EDTT, they observed high levels of validity in trigger selection, yield, and representativeness of adverse events, with yields that are superior to estimates for traditional approaches to adverse event detection. Record selection using weighted triggers outperformed a trigger count threshold approach and far outperformed random sampling from records with at least one trigger. They concluded that the EDTT is a promising efficient and high-yield approach for detecting all-cause harm to guide quality improvement efforts in the emergency department.
AHRQ-funded; HS025052.
Citation: Griffey RT, Schneider RM, Todorov AA .
The emergency department trigger tool: validation and testing to optimize yield.
Acad Emerg Med 2020 Dec;27(12):1279-90. doi: 10.1111/acem.14101..
Keywords: Emergency Department, Electronic Health Records (EHRs), Health Information Technology (HIT), Medical Errors, Adverse Events, Patient Safety, Quality Improvement, Quality of Care
Luo B, McLoone M, Rasooly IR
Analysis: protocol for a new method to measure physiologic monitor alarm responsiveness.
A team of researchers including biomedical engineers, human factors engineers, information technology specialists, nurses, physicians, facilitators from a hospital’s simulation center, clinical informaticians, and hospital administrative leadership worked with three units at a pediatric hospital to design and conduct simulations on newly implemented monitoring technology that will be used for patient critical alarms. The system was tested using a simulation with existing hospital technology to transmit an unambiguously critical alarm that appeared to originate from an actual patient to the nurse’s mobile device, with discreet observers measuring responses.
AHRQ-funded; HS026620.
Citation: Luo B, McLoone M, Rasooly IR .
Analysis: protocol for a new method to measure physiologic monitor alarm responsiveness.
Biomed Instrum Technol 2020 Nov/Dec;54(6):389-96. doi: 10.2345/0899-8205-54.6.389..
Keywords: Children/Adolescents, Hospitals, Simulation, Quality Improvement, Quality of Care, Patient Safety, Health Information Technology (HIT)
Scott HF, Brilli RJ, Paul R
Evaluating pediatric sepsis definitions designed for electronic health record extraction and multicenter quality improvement.
The purpose of this study was to describe the Children's Hospital Association's Improving Pediatric Sepsis Outcomes sepsis definitions and to evaluate the definition using a published framework. The investigators concluded that the Improving Pediatric Sepsis Outcomes Sepsis definitions demonstrated feasibility for large-scale data abstraction. When operationalized, these definitions enabled multicenter identification and data aggregation, indicating practical utility for quality improvement.
AHRQ-funded; HS025696.
Citation: Scott HF, Brilli RJ, Paul R .
Evaluating pediatric sepsis definitions designed for electronic health record extraction and multicenter quality improvement.
Crit Care Med 2020 Oct;48(10):e916-e26. doi: 10.1097/ccm.0000000000004505..
Keywords: Children/Adolescents, Electronic Health Records (EHRs), Health Information Technology (HIT), Sepsis, Quality Improvement, Quality of Care
Bucher BT, Shi J, Ferraro JP
Portable automated surveillance of surgical site infections using natural language processing: development and validation.
The authors presented the development and validation of a portable natural language processing (NLP) approach for automated surveillance of surgical site infections (SSIs). Patient clinical text notes from EHRs following surgical procedures from two independent healthcare systems were abstracted. The authors found that automated surveillance of SSIs can be achieved using NLP of clinical notes with high sensitivity and specificity.
AHRQ-funded; HS025776.
Citation: Bucher BT, Shi J, Ferraro JP .
Portable automated surveillance of surgical site infections using natural language processing: development and validation.
Ann Surg 2020 Oct;272(4):629-36. doi: 10.1097/sla.0000000000004133..
Keywords: Surgery, Healthcare-Associated Infections (HAIs), Electronic Health Records (EHRs), Health Information Technology (HIT), Quality Improvement, Quality of Care
Alexander GL, Madsen R, Deroche CB
Ternary trends in nursing home information technology and quality measures in the United States.
This survey investigated whether improvements in nursing home information technology (NH IT) increases quality measures. Nursing home administrators were surveyed from 2014 to 2017. Nine dimensions/domains and total IT sophistication were measured. A total of 815 Year 1 surveys were completed. It was found that for every 10 units increase in administrative activity of IT use, a decrease of 1.3% occurred in the percentage of low-risk long-stay residents with bowel or bladder incontinence.
AHRQ-funded; HS022497.
Citation: Alexander GL, Madsen R, Deroche CB .
Ternary trends in nursing home information technology and quality measures in the United States.
J Appl Gerontol 2020 Oct;39(10):1134-43. doi: 10.1177/0733464819862928..
Keywords: Nursing Homes, Health Information Technology (HIT), Quality Measures, Quality Improvement, Long-Term Care, Quality of Care
Co Z, Holmgren AJ, Classen DC
The tradeoffs between safety and alert fatigue: data from a national evaluation of hospital medication-related clinical decision support.
This study evaluated the overall performance of hospitals that used the Computerized Physician Order Entry Evaluation Tool in 2017 and 2018 and compared performances for fatal orders and nuisance orders each year. The authors evaluated 1599 hospitals that took the test by using their overall percentage scores along with the percentage of fatal orders appropriately alerted on and the percentage of nuisance orders incorrectly alerted on. Overall hospital scores improved from 58.1% in 2017 to 66.2% in 2018. Fatal order performance improved slightly from 78.8% to 83.0%, but there no very little change in nuisance order performance (89.0% to 89.7%). Conclusions were that perhaps hospitals are not targeting the deadliest orders first and some hospitals may be achieving higher scores by over-alerting. This has the potential to cause clinician burnout and even worsen patient safety.
AHRQ-funded; HS023696.
Citation: Co Z, Holmgren AJ, Classen DC .
The tradeoffs between safety and alert fatigue: data from a national evaluation of hospital medication-related clinical decision support.
J Am Med Inform Assoc 2020 Aug;27(8):1252-58. doi: 10.1093/jamia/ocaa098..
Keywords: Medication: Safety, Medication, Patient Safety, Clinical Decision Support (CDS), Shared Decision Making, Burnout, Hospitals, Health Information Technology (HIT), Quality of Care
Bronsert M, Singh AB, Henderson WG
Identification of postoperative complications using electronic health record data and machine learning.
Investigators developed a machine learning algorithm for identifying patients with one or more complications using data from the electronic health record (EHR). They concluded that using machine learning on EHR postoperative data linked to American College of Surgeons National Surgical Quality Improvement Program outcomes data, a model with 163 predictors from the EHR identified complications well at their institution.
AHRQ-funded; HS026019.
Citation: Bronsert M, Singh AB, Henderson WG .
Identification of postoperative complications using electronic health record data and machine learning.
Am J Surg 2020 Jul;220(1):114-19. doi: 10.1016/j.amjsurg.2019.10.009..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Surgery, Quality Improvement, Quality of Care, Diagnostic Safety and Quality