National Healthcare Quality and Disparities Report
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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
76 to 100 of 106 Research Studies DisplayedAdams DR, Flores A, Coltri A
A missed opportunity to improve patient satisfaction? Patient perceptions of inpatient communication with their primary care physician.
Patient satisfaction could be driven by patient perception of hospital team communication with their primary care physician (PCP). A retrospective mixed methods approach was used to characterize the relationship between patient satisfaction and patient perception of hospital team-PCP communication.
AHRQ-funded; HS010597l; HS016967.
Citation: Adams DR, Flores A, Coltri A .
A missed opportunity to improve patient satisfaction? Patient perceptions of inpatient communication with their primary care physician.
Am J Med Qual 2016 Nov;31(6):568-76. doi: 10.1177/1062860615593339..
Keywords: Care Coordination, Hospitals, Patient Experience, Primary Care, Quality Improvement
Lee SJ, Clark MA, Cox JV
Achieving coordinated care for patients with complex cases of cancer: a multiteam system approach.
The authors outlined challenges of care coordination in the context of a multiteam system (MTS), through the care experience of a patient in the Dallas County integrated safety-net system. A cancer diagnosis triggered an additional need for augmented coordination between his different provider teams. The authors recommend that further research and practice investigate the relationships of MTS coordination for shared care management, transfer to and from specialty care, treatment compliance, barriers to care, and health outcomes of chronic comorbid conditions, as well as cancer control and surveillance.
AHRQ-funded; HS022418.
Citation: Lee SJ, Clark MA, Cox JV .
Achieving coordinated care for patients with complex cases of cancer: a multiteam system approach.
J Oncol Pract 2016 Nov;12(11):1029-38. doi: 10.1200/jop.2016.013664.
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Keywords: Cancer, Care Coordination, Chronic Conditions, Patient-Centered Healthcare, Teams
Ferrante JM, Friedman A, Shaw EK
Lessons learned designing and using an online discussion forum for care coordinators in primary care.
In this paper, the authors comprehensively describe their experiences, from start to finish, of designing and using an asynchronous online discussion forum for collecting and analyzing information elicited from care coordinators in Patient-Centered Medical Homes across the United States. They conclude that an asynchronous online discussion forum is a feasible, efficient, and effective method to conduct a qualitative study, particularly when subjects are health professionals.
AHRQ-funded; HS020682.
Citation: Ferrante JM, Friedman A, Shaw EK .
Lessons learned designing and using an online discussion forum for care coordinators in primary care.
Qual Health Res 2016 Nov;26(13):1851-61. doi: 10.1177/1049732315609567..
Keywords: Care Coordination, Health Services Research (HSR), Patient-Centered Healthcare, Primary Care, Research Methodologies
Wittmeier KD, Restall G, Mulder K
Central intake to improve access to physiotherapy for children with complex needs: a mixed methods case report.
The researchers evaluated the process and impact of implementing a central intake system, using pediatric physiotherapy as a case example. They found that central intake implementation achieved the intended outcomes of streamlining processes and improving transparency and access to pediatric physiotherapy for families of children with complex needs. They recommended future research to build on this single discipline case study approach.
AHRQ-funded; HS016657.
Citation: Wittmeier KD, Restall G, Mulder K .
Central intake to improve access to physiotherapy for children with complex needs: a mixed methods case report.
BMC Health Serv Res 2016 Aug 31;16:455. doi: 10.1186/s12913-016-1700-3.
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Keywords: Access to Care, Children/Adolescents, Care Coordination, Patient Experience, Children/Adolescents
Feraco AM, Starmer AJ, Sectish TC
Reliability of verbal handoff assessment and handoff quality before and after implementation of a resident handoff bundle.
This study developed validity evidence for the use of the Verbal Handoff Assessment Tool (VHAT),examined the reliability of VHAT scores, and determined whether implementation of a resident handoff bundle was associated with improved verbal patient handoffs among pediatric resident physicians. It found that verbal handoffs improved following implementation of a resident handoff bundle, though gains were variable across the two clinical units.
AHRQ-funded; HS019456.
Citation: Feraco AM, Starmer AJ, Sectish TC .
Reliability of verbal handoff assessment and handoff quality before and after implementation of a resident handoff bundle.
Acad Pediatr 2016 Aug;16(6):524-31. doi: 10.1016/j.acap.2016.04.002.
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Keywords: Care Coordination, Communication, Children/Adolescents
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
Rundall TG, Wu FM, Lewis VA
Contributions of relational coordination to care management in accountable care organizations: views of managerial and clinical leaders.
The researchers identified the extent to which accountable care organization (ACO) leaders are aware of the dimensions of relational coordination and the ways these leaders believe the dimensions influenced care management practices in their organization. They found that ACO leaders mentioned four relational coordination dimensions: shared goals, frequency of communication, timeliness of communication, and problem solving communication. Their analysis identified ways leaders believed the four dimensions contributed to the development of care management, including contributions to standardization of care, patient engagement, coordination of care, and care planning.
AHRQ-funded; HS022241.
Citation: Rundall TG, Wu FM, Lewis VA .
Contributions of relational coordination to care management in accountable care organizations: views of managerial and clinical leaders.
Health Care Manage Rev 2016 Apr-Jun;41(2):88-100. doi: 10.1097/hmr.0000000000000064.
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Keywords: Care Coordination, Health Insurance, Healthcare Delivery, Communication
Cohen GR, Adler-Milstein J
Meaningful use care coordination criteria: perceived barriers and benefits among primary care providers.
This systematic review of studies of laser treatment of infantile hemangioma concluded that the studies primarily addressed different laser modalities compared with observation or other laser modalities. Pulsed dye laser was the most commonly studied laser type, but multiple variations in treatment protocols did not allow for demonstration of superiority of a single method.
AHRQ-funded; HS022674.
Citation: Cohen GR, Adler-Milstein J .
Meaningful use care coordination criteria: perceived barriers and benefits among primary care providers.
J Am Med Inform Assoc 2016 Apr;23(e1):e146-51. doi: 10.1093/jamia/ocv147.
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Keywords: Primary Care, Care Coordination, Electronic Health Records (EHRs), Health Information Technology (HIT)
Miller AD, Mishra SR, Kendall L
Partners in care: Design considerations for caregivers and patients during a hospital stay.
The researchers described how caregivers and patients coordinate and collaborate to manage patients' care and wellbeing during a hospital stay. They defined and described five roles caregivers adopt: companion, assistant, representative, navigator, and planner, and show how patients and caregivers negotiate these roles and responsibilities throughout a hospital stay. Finally, they identified key design considerations for technology to support patients and caregivers during a hospital stay.
AHRQ-funded; HS022894.
Citation: Miller AD, Mishra SR, Kendall L .
Partners in care: Design considerations for caregivers and patients during a hospital stay.
Cscw 2016 Feb-Mar;2016:756-69. doi: 10.1145/2818048.2819983..
Keywords: Care Coordination, Caregiving, Hospitalization, Inpatient Care, Patient and Family Engagement
Newgard CD, Lowe RA
Cost savings in trauma systems: The devil's in the details.
The authors comment on an article in the same issue of Annals by Zocchi et al. They argue that it makes an important contribution to trauma research and health policy by addressing the question: Can we potentially save money in trauma systems without compromising outcomes by redirecting patients with minor to moderate injuries away from major trauma centers?
AHRQ-funded; HS023796.
Citation: Newgard CD, Lowe RA .
Cost savings in trauma systems: The devil's in the details.
Ann Emerg Med 2016 Jan;67(1):68-70. doi: 10.1016/j.annemergmed.2015.06.025..
Keywords: Healthcare Costs, Trauma, Mortality, Care Coordination, Injuries and Wounds
Friedman A, Howard J, Shaw EK
Facilitators and barriers to care coordination in patient-centered medical homes (PCMHs) from coordinators' perspectives.
This is the first study describing experiences of care coordinators across the US from their own perspectives. It concluded that while all the barriers and facilitators were important to performing coordinators' roles, relationship building was key to effective care coordination, whether with clinicians, patients, or outside organizations.
AHRQ-funded; HS020682.
Citation: Friedman A, Howard J, Shaw EK .
Facilitators and barriers to care coordination in patient-centered medical homes (PCMHs) from coordinators' perspectives.
J Am Board Fam Med 2016 Jan-Feb;29(1):90-101. doi: 10.3122/jabfm.2016.01.150175.
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Keywords: Care Coordination, Patient-Centered Healthcare, Healthcare Delivery
Halladay JR, Mottus K, Reiter K
The cost to successfully apply for level 3 medical home recognition.
The National Committee for Quality Assurance patient-centered medical home recognition program provides practices an opportunity to implement medical home activities. Understanding the costs to apply for recognition may enable practices to plan their work. This study found variation in the distribution of costs by activity by practice, but the costs to apply were remarkably similar.
AHRQ-funded; HS022629.
Citation: Halladay JR, Mottus K, Reiter K .
The cost to successfully apply for level 3 medical home recognition.
J Am Board Fam Med 2016 Jan-Feb;29(1):69-77. doi: 10.3122/jabfm.2016.01.150211.
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Keywords: Patient-Centered Healthcare, Healthcare Costs, Care Coordination, Quality of Care
El-Shami K, Oeffinger KC, Erb NL
American Cancer Society colorectal cancer survivorship care guidelines.
Communication and coordination of care between the treating oncologist and the primary care clinician is critical to effectively and efficiently manage the long-term care of colorectal cancer (CRC) survivors. The guidelines in this article are intended to assist primary care clinicians in delivering risk-based health care for CRC survivors who have completed active therapy.
AHRQ-funded; HS020937.
Citation: El-Shami K, Oeffinger KC, Erb NL .
American Cancer Society colorectal cancer survivorship care guidelines.
CA Cancer J Clin 2015 Nov-Dec;65(6):428-55. doi: 10.3322/caac.21286.
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Keywords: Cancer, Cancer: Colorectal Cancer, Care Coordination, Guidelines, Primary Care
Weinger MB, Slagle JM, Kuntz AH
A multimodal intervention improves postanesthesia care unit handovers.
The researchers introduced a multimodal intervention in an adult and a pediatric postanesthesia care unit (PACU) to improve postoperative handovers between anesthesia providers (APs) and PACU registered nurses (RNs). They concluded that a multimodal intervention substantially improved interprofessional PACU handovers, including those by clinicians who had not undergone formal simulation training.
AHRQ-funded; HS016651.
Citation: Weinger MB, Slagle JM, Kuntz AH .
A multimodal intervention improves postanesthesia care unit handovers.
Anesth Analg 2015 Oct;121(4):957-71. doi: 10.1213/ane.0000000000000670..
Keywords: Patient Safety, Care Coordination, Surgery
McElroy LM, Macapagal KR, Collins KM
Clinician perceptions of operating room to intensive care unit handoffs and implications for patient safety: a qualitative study.
The goal of this study is to use qualitative research methods to describe clinician perceptions of OR-to-ICU handoffs, and to elucidate attributes of the handoff process associated with high quality, as well as those with poor quality that can lead to patient harm. The findings suggest that ambiguous roles and conflicting expectations of team members during the OR-to-ICU handoff can increase risk of patient harm.
AHRQ-funded; HS000078.
Citation: McElroy LM, Macapagal KR, Collins KM .
Clinician perceptions of operating room to intensive care unit handoffs and implications for patient safety: a qualitative study.
Am J Surg 2015 Oct;210(4):629-35. doi: 10.1016/j.amjsurg.2015.05.008..
Keywords: Patient Safety, Intensive Care Unit (ICU), Surgery, Adverse Events, Care Coordination
Rosenbluth G, Bale JF, Starmer AJ
Variation in printed handoff documents: results and recommendations from a multicenter needs assessment.
The objective of this study was to determine whether variability exists in the content of printed handoff documents and to identify key data elements that should be uniformly included in these documents. It identified substantial variation in both the structure and content of printed handoff documents. Only 4 of 23 possible data elements (17 percent) were uniformly present in all sites’ handoff documents.
AHRQ-funded; HS019456.
Citation: Rosenbluth G, Bale JF, Starmer AJ .
Variation in printed handoff documents: results and recommendations from a multicenter needs assessment.
J Hosp Med 2015 Aug;10(8):517-24. doi: 10.1002/jhm.2380..
Keywords: Patient Safety, Medical Errors, Communication, Comparative Effectiveness, Care Coordination
Van Cleave J, Boudreau AA, McAllister J
Care coordination over time in medical homes for children with special health care needs.
This study explored how care coordination changes conceptually and practically in primary care practices when implementing the medical home and to identify reasons for different types of changes. They found that in high-performing medical homes, care coordination activities changed from being mostly reactive to patients’ episodic needs to being more systematically proactive and comprehensive.
AHRQ-funded; HS019157.
Citation: Van Cleave J, Boudreau AA, McAllister J .
Care coordination over time in medical homes for children with special health care needs.
Pediatrics 2015 Jun;135(6):1018-26. doi: 10.1542/peds.2014-1067..
Keywords: Care Coordination, Care Management, Patient-Centered Healthcare, Primary Care
Jones CD, Vu MB, O'Donnell CM
A failure to communicate: a qualitative exploration of care coordination between hospitalists and primary care providers around patient hospitalizations.
The purpose of this study was to understand the challenges in coordination of care, as well as potential solutions, from the perspective of hospitalists and PCPs in North Carolina. Hospitalists and PCPs were found to encounter similar care coordination challenges, including (1) lack of time, (2) difficulty reaching other clinicians, and (3) lack of personal relationships with other clinicians.
AHRQ-funded; HS020940.
Citation: Jones CD, Vu MB, O'Donnell CM .
A failure to communicate: a qualitative exploration of care coordination between hospitalists and primary care providers around patient hospitalizations.
J Gen Intern Med 2015 Apr;30(4):417-24. doi: 10.1007/s11606-014-3056-x..
Keywords: Care Coordination, Communication, Hospital Discharge, Hospitalization, Primary Care
Brennan PF, Valdez R, Alexander G
Patient-centered care, collaboration, communication, and coordination: a report from AMIA's 2013 Policy Meeting.
AMIA’s 2013 Health Policy Invitational was focused on examining existing challenges surrounding full engagement of the patient and crafting a research agenda and policy framework encouraging the use of informatics solutions to achieve this goal. This paper summarizes the meeting as well as the research agenda and policy recommendations prioritized among the invited experts and stakeholders.
AHRQ-funded; HS021825.
Citation: Brennan PF, Valdez R, Alexander G .
Patient-centered care, collaboration, communication, and coordination: a report from AMIA's 2013 Policy Meeting.
J Am Med Inform Assoc 2015 Apr;22(e1):e2-6. doi: 10.1136/amiajnl-2014-003176..
Keywords: Care Coordination, Communication, Electronic Health Records (EHRs), Health Information Technology (HIT), Patient-Centered Healthcare, Policy
Hilligoss B, Vogus TJ
Navigating care transitions: a process model of how doctors overcome organizational barriers and create awareness.
Using interviews and observations of doctors, the researchers examined transitions from an emergency department to inpatient units through a 2-year study of an academic medical center. They describe and document 3 challenges to between-unit transitions of care and identify the adaptive workarounds that doctors employ to resolve these challenges, thus addressing a significant gap in the literature on high-reliability healthcare organizations.
AHRQ-funded; HS018758
Citation: Hilligoss B, Vogus TJ .
Navigating care transitions: a process model of how doctors overcome organizational barriers and create awareness.
Med Care Res Rev. 2015 Feb;72(1):25-48. doi: 10.1177/1077558714563170..
Keywords: Transitions of Care, Emergency Department, Hospitalization, Care Coordination
Hsiao CJ, King J, Hing E
AHRQ Author: Hsiao CJ
The role of health information technology in care coordination in the United States.
This study used 2012 national data to explore the extent to which office-based physicians in the United States receive patient health information (electronically or non-electronically) needed to coordinate care with providers outside their practice, as well as with hospitals. It found that a higher percentage of physicians using health information technology (HIT) received patient information necessary for care coordination than those who did not use HIT.
AHRQ-authored.
Citation: Hsiao CJ, King J, Hing E .
The role of health information technology in care coordination in the United States.
Med Care. 2015 Feb;53(2):184-90. doi: 10.1097/mlr.0000000000000276..
Keywords: Health Information Technology (HIT), Care Coordination, Primary Care, Hospitals
Dy SM, Ashok M, Wines RC
A framework to guide implementation research for care transitions interventions.
The authors described a framework for evaluating implementation of hospital to ambulatory care transitions interventions and application to a case study. They adapted the general Consolidated Framework for Implementation Research, adding elements relevant to other complex interventions, such as conceptualization around organizations and around patient- and caregiver-centeredness.
AHRQ-funded; 290200710056I.
Citation: Dy SM, Ashok M, Wines RC .
A framework to guide implementation research for care transitions interventions.
J Healthc Qual 2015 Jan-Feb;37(1):41-54. doi: 10.1097/01.JHQ.0000460121.06309.f9.
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Keywords: Care Coordination, Case Study, Hospital Discharge, Patient-Centered Outcomes Research, Transitions of Care
Nasarwanji N, Werner NE, Carl K
Identifying challenges associated with the care transition workflow from hospital to skilled home health care: perspectives of home health care agency providers.
The authors studied the workflow for transitioning older adults from the hospital to skilled home health care (SHHC). They found three overarching challenges to optimal care transitions: information access, coordination, and communication/teamwork. They recommended that future investigations test whether redesigning the transition from hospital to SHHC improves workflow and care quality.
AHRQ-funded; HS022916.
Citation: Nasarwanji N, Werner NE, Carl K .
Identifying challenges associated with the care transition workflow from hospital to skilled home health care: perspectives of home health care agency providers.
Home Health Care Serv Q 2015;34(3-4):185-203. doi: 10.1080/01621424.2015.1092908.
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Keywords: Care Coordination, Elderly, Home Healthcare, Hospital Discharge, Transitions of Care
Hwang D, Teno JM, Clark M
Family perceptions of quality of hospice care in the nursing home.
The investigators examined bereaved family members' perceptions of nursing home-hospice collaborations in terms of what family members believe went well or could have been improved. The focus group participants identified three major aspects of collaboration as important to care delivery: knowing who (nursing home or hospice) is responsible for which aspects of patient care, concern about information coordination between the nursing home and hospice, and the need for hospice to advocate for high-quality care rather than their having to directly do so on behalf of their family members. These concerns have been incorporated into the revised Family Evaluation of Hospice Care, a post-death survey used to evaluate quality of hospice care.
AHRQ-funded; HS019675.
Citation: Hwang D, Teno JM, Clark M .
Family perceptions of quality of hospice care in the nursing home.
J Pain Symptom Manage 2014 Dec;48(6):1100-7. doi: 10.1016/j.jpainsymman.2014.04.003.
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Keywords: Care Coordination, Nursing Homes, Palliative Care, Quality of Care
Garfield CF, Lee Y, Kim HN
Paternal and maternal concerns for their very low-birth-weight infants transitioning from the NICU to home.
The authors examined the concerns and coping mechanisms of fathers and mothers of very low-birth-weight neonatal intensive care unit (NICU) infants as they transition to home from the NICU. They found that overriding concerns included pervasive uncertainty, lingering medical concerns, and partner-related adjustment concerns that differed by gender. They concluded that many parental concerns can be addressed with improved discharge information exchanges and anticipatory guidance.
AHRQ-funded; HS020316.
Citation: Garfield CF, Lee Y, Kim HN .
Paternal and maternal concerns for their very low-birth-weight infants transitioning from the NICU to home.
J Perinat Neonatal Nurs 2014 Oct-Dec;28(4):305-12. doi: 10.1097/jpn.0000000000000021.
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Keywords: Care Coordination, Hospital Discharge, Neonatal Intensive Care Unit (NICU), Newborns/Infants, Transitions of Care