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Search All Research Studies
Topics
- Adverse Events (1)
- Ambulatory Care and Surgery (1)
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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
1 to 17 of 17 Research Studies DisplayedLinks AR, Callon W, Wasserman C
Treatment recommendations to parents during pediatric tonsillectomy consultations: a mixed methods analysis of surgeon language.
A deeper understanding of the dialogue clinicians use to relay treatment recommendations is needed to fully understand their influence on patient decisions about surgery. In this study, the authors characterize how otolaryngologists provide treatment recommendations and suggest a classification framework. The investigators concluded that clinicians provide treatment recommendations in a variety of ways that may introduce more or less certainty and choice to parental treatment decisions.
AHRQ-funded; HS022932.
Citation: Links AR, Callon W, Wasserman C .
Treatment recommendations to parents during pediatric tonsillectomy consultations: a mixed methods analysis of surgeon language.
Patient Educ Couns 2021 Jun;104(6):1371-79. doi: 10.1016/j.pec.2020.11.015..
Keywords: Children/Adolescents, Surgery, Caregiving, Shared Decision Making, Clinician-Patient Communication, Communication, Provider: Physician, Provider
Loo S, Brochier A, Wexler MG
Addressing unmet basic needs for children with sickle cell disease in the United States: clinic and staff perspectives.
The purpose of this study was to assess pediatric hematology clinic staff's perspectives regarding barriers and facilitators in addressing unmet basic needs for children with sickle cell disease. Six focus groups were held at urban pediatric hematology clinics in the Northeastern region of the U.S. Four themes emerged: families of children with SCD have numerous unmet basic needs; clinic staff felt they had a role to play in addressing these needs; staff felt their ability to address these needs depended upon caregivers' capacity to act on staff recommendations; clinic staff's ability to address these needs was limited by organizational and systemic factors beyond their control. These findings have important implications for how best to address adverse social determinants of health for this vulnerable pediatric population so that urban-based pediatric hematology clinics can more equitably support families.
AHRQ-funded; HS022242.
Citation: Loo S, Brochier A, Wexler MG .
Addressing unmet basic needs for children with sickle cell disease in the United States: clinic and staff perspectives.
BMC Health Serv Res 2021 Jan 12;21(1):55. doi: 10.1186/s12913-020-06055-y..
Keywords: Children/Adolescents, Sickle Cell Disease, Chronic Conditions, Social Determinants of Health, Provider: Clinician, Provider: Physician, Provider, Urban Health
Cotter JM, Tyler A, Reese J
Steroid variability in pediatric inpatient asthmatics: survey on provider preferences of dexamethasone versus prednisone.
This study looked at pediatric emergency department (ED) inpatient use of dexamethasone versus prednisone by providers for asthma treatment. A survey was distributed to providers who care for inpatient asthmatics. Ninety-two providers completed the survey. When patients received dexamethasone in the ED, 44% continued dexamethasone, 14% switched to prednisone, 2% stopped steroid use, and 40% said it depended on the circumstances. Hospitalists were significantly more likely to continue dexamethasone than pulmonologists (61% versus 15%). Switching to prednisone included factors such as severity of exacerbation (73%) and asthma history (47%). Just over half of providers (5f1%) felt uncomfortable using dexamethasone because of “minimal data to support [its] use inpatient.”
AHRQ-funded; HS026512.
Citation: Cotter JM, Tyler A, Reese J .
Steroid variability in pediatric inpatient asthmatics: survey on provider preferences of dexamethasone versus prednisone.
J Asthma 2020 Sep;57(9):942-48. doi: 10.1080/02770903.2019.1622713..
Keywords: Children/Adolescents, Asthma, Respiratory Conditions, Medication, Inpatient Care, Care Management, Hospitalization, Emergency Department, Practice Patterns, Provider: Physician, Provider
Tubbs-Cooley HL, Riddle SW, Gold JM
Paediatric clinical and social concerns identified by home visit nurses in the immediate postdischarge period.
The purpose of this study was to describe paediatric postdischarge concerns manifesting in the first 96 hr after hospital discharge. The investigators analysed home visit records of 651 children (age <18) hospitalized at a large Midwestern children's hospital in 2015 and 2016 who were enrolled in the trial. Registered nurses documented concerns in structured fields and free-text notes in visit records. Descriptive statistics were used to summarize visit documentation. Free-text visit notes were reviewed and exemplars illustrative of quantitative findings were selected.
AHRQ-funded; HS024735.
Citation: Tubbs-Cooley HL, Riddle SW, Gold JM .
Paediatric clinical and social concerns identified by home visit nurses in the immediate postdischarge period.
J Adv Nurs 2020 Jun;76(6):1394-403. doi: 10.1111/jan.14341..
Keywords: Children/Adolescents, Home Healthcare, Hospital Discharge, Provider: Nurse, Provider
Michelson KA, Nigrovic LE, Nagler J
Research interest in pediatric emergency medicine fellows.
The authors sought to determine the prevalence and determinants of interest in research careers among pediatric emergency medicine (PEM) fellows. They performed an electronically distributed national survey of current PEM fellows, assessing demographics, barriers to successful research, and beliefs about research using 4-point ordinal scales. The authors found that most fellows expect to devote a minority of their career to clinical research. Enthusiasm about research was strongly correlated with career research interest.
AHRQ-funded; HS000063.
Citation: Michelson KA, Nigrovic LE, Nagler J .
Research interest in pediatric emergency medicine fellows.
Pediatr Emerg Care 2020 Feb;36(2):e38-e42. doi: 10.1097/pec.0000000000001085..
Keywords: Emergency Department, Children/Adolescents, Health Services Research (HSR), Provider: Physician, Provider, Education: Continuing Medical Education
Brunsberg KA, Landrigan CP, Garcia BM
Association of pediatric resident physician depression and burnout with harmful medical errors on inpatient services.
The objective of this paper was to determine whether higher rates of medical errors were associated with positive screenings for depression or burnout among resident physicians. Results of this prospective cohort study showed that resident physicians with a positive depression screen were three times more likely than those who screened negative to make harmful errors, indicating the importance of determining what interventions might mitigate the patient safety risk.
AHRQ-funded; HS019456.
Citation: Brunsberg KA, Landrigan CP, Garcia BM .
Association of pediatric resident physician depression and burnout with harmful medical errors on inpatient services.
Acad Med 2019 Aug;94(8):1150-56. doi: 10.1097/acm.0000000000002778..
Keywords: Children/Adolescents, Provider: Physician, Provider, Medical Errors, Adverse Events, Burnout, Patient Safety, Depression, Behavioral Health
Hoonakker PLT, Wooldridge AR, Hose BZ
Information flow during pediatric trauma care transitions: things falling through the cracks.
In order to investigate information flow during pediatric trauma care transitions, researchers interviewed 18 clinicians about communication and coordination between the emergency department, operating room, and pediatric intensive care unit, then surveyed the clinicians about patient safety during these transitions. They found that, despite the fact that the many services and units involved in pediatric trauma cooperate well together during trauma cases, important patient care information is often lost when transitioning patients between units. To manage the transition of this fragile and complex population better, they recommend finding ways to manage the information flow during these transitions better by, for instance, providing technological support to ensure shared mental models.
AHRQ-funded; HS023837.
Citation: Hoonakker PLT, Wooldridge AR, Hose BZ .
Information flow during pediatric trauma care transitions: things falling through the cracks.
Intern Emerg Med 2019 Aug;14(5):797-805. doi: 10.1007/s11739-019-02110-7..
Keywords: Children/Adolescents, Communication, Emergency Department, Healthcare Delivery, Intensive Care Unit (ICU), Patient Safety, Provider, Provider: Clinician, Surgery, Transitions of Care, Trauma
Ranganathan K, Kochkodan JM, Baker MK
Variation in the desire for cleft revision surgery among children, caregivers, and surgeons.
This study examined the differences in perception between children, caregivers, and their surgeons for the need for cleft revision surgery. A sample of 100 children with cleft lip and/or cleft palate and their caregivers (n=100) were surveyed on satisfaction with appearance using the Cleft Evaluation Profile. Ten surgeons and ten control observers then rated photographs of these children using questions analogous to the Profile. The children generally reported greater satisfaction in appearance across all domains compared with surgeons. Children and caregivers had similar degrees of satisfaction in appearance of the lip and maxilla. The authors concluded that more care must be given to children’s perception before moving forward with further revision surgery.
AHRQ-funded; HS023313.
Citation: Ranganathan K, Kochkodan JM, Baker MK .
Variation in the desire for cleft revision surgery among children, caregivers, and surgeons.
Plast Reconstr Surg 2019 Jul;144(1):171-78. doi: 10.1097/prs.0000000000005722..
Keywords: Caregiving, Children/Adolescents, Surgery, Provider, Provider: Physician
Links AR, Callon W, Wasserman C
Surgeon use of medical jargon with parents in the outpatient setting.
This study analyzed the use of unexplained medical jargon with parents whose children have sleep-disordered breathing and their consultations with otolaryngologists in a pediatric surgical setting. Participants (64 parents and 8 otolaryngologists) completed questionnaires that evaluated demographics, clinical features and parental role in decision-making. Unexplained medical jargon was commonly used by physicians (mean total utterances per visit = 28.9) while parents used jargon a mean of 4.3 times. Clinicians used more jargon when they felt that parents had greater involvement in decision-making or when parents used more jargon themselves. These results will be incorporated into communication training for clinicians.
AHRQ-funded; HS022932.
Citation: Links AR, Callon W, Wasserman C .
Surgeon use of medical jargon with parents in the outpatient setting.
Patient Educ Couns 2019 Jun;102(6):1111-18. doi: 10.1016/j.pec.2019.02.002..
Keywords: Ambulatory Care and Surgery, Caregiving, Children/Adolescents, Clinician-Patient Communication, Communication, Shared Decision Making, Education: Patient and Caregiver, Provider, Provider: Physician
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
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
Auger KA, Shah SS, Tubbs-Cooley HL
Effects of a 1-time nurse-led telephone call after pediatric discharge: the H2O II randomized clinical trial.
The purpose of this study was to determine whether a single nurse-led telephone call after pediatric discharge decreased the 30-day reutilization rate for urgent care services and enhanced overall transition success. The investigators concluded that although postdischarge nurse contact did not decrease the reutilization rate of postdischarge urgent health care services, the method showed promise to bolster postdischarge education.
AHRQ-funded; HS024735.
Citation: Auger KA, Shah SS, Tubbs-Cooley HL .
Effects of a 1-time nurse-led telephone call after pediatric discharge: the H2O II randomized clinical trial.
JAMA Pediatr 2018 Sep;172(9):e181482. doi: 10.1001/jamapediatrics.2018.1482..
Keywords: Care Coordination, Children/Adolescents, Health Information Technology (HIT), Health Services Research (HSR), Healthcare Delivery, Healthcare Utilization, Hospital Discharge, Outcomes, Provider, Provider: Nurse, Telehealth, Transitions of Care
Shah PD, Calo WA, Marciniak MW
Support for pharmacist-provided HPV vaccination: national surveys of U.S. physicians and parents.
Cancer Epidemiol Biomarkers Prev 2018 Aug;27(8):970-78. doi: 10.1158/1055-9965.Epi-18-0380.
State laws about pharmacists providing human papillomavirus (HPV) vaccines vary considerably, limiting many pharmacists' ability to provide this important cancer prevention service. In this study, the investigators characterized physician and parent support for pharmacist-provided HPV vaccination for adolescents who are past due for vaccination. The authors concluded that to increase support for HPV vaccination services, pharmacists should raise awareness about their immunization training and standardize vaccination protocols that ensure coordination with primary care.
State laws about pharmacists providing human papillomavirus (HPV) vaccines vary considerably, limiting many pharmacists' ability to provide this important cancer prevention service. In this study, the investigators characterized physician and parent support for pharmacist-provided HPV vaccination for adolescents who are past due for vaccination. The authors concluded that to increase support for HPV vaccination services, pharmacists should raise awareness about their immunization training and standardize vaccination protocols that ensure coordination with primary care.
AHRQ-funded; HS000032.
Citation: Shah PD, Calo WA, Marciniak MW .
Support for pharmacist-provided HPV vaccination: national surveys of U.S. physicians and parents.
Cancer Epidemiol Biomarkers Prev 2018 Aug;27(8):970-78. doi: 10.1158/1055-9965.Epi-18-0380..
Keywords: Caregiving, Children/Adolescents, Infectious Diseases, Provider, Provider: Pharmacist, Provider: Physician, Vaccination
Riley AR, Grennan A, Menousek K
Pediatric primary care psychologists' reported level of integration, billing practices, and reimbursement frequency.
The aim of this study was to investigate the relationships between psychologists' reported billing practices, reimbursement rates, and model of integration in pediatric primary care. Survey results showed a clear pattern of higher integration being associated with greater utilization of health & behavior codes and better reimbursement for consultation activities.
AHRQ-funded; HS022981.
Citation: Riley AR, Grennan A, Menousek K .
Pediatric primary care psychologists' reported level of integration, billing practices, and reimbursement frequency.
Fam Syst Health 2018 Mar;36(1):108-12. doi: 10.1037/fsh0000306..
Keywords: Behavioral Health, Children/Adolescents, Payment, Primary Care, Provider
Gawel M, Emerson B, Giuliano JS, Jr.,
A qualitative study of multidisciplinary providers' experiences with the transfer process for injured children and ideas for improvement.
The purpose of this study was 1) to explore multidisciplinary providers' experiences with the process of transferring injured children and 2) to describe proposed ideas for process improvement. The authors concluded that efforts to improve the transfer process for injured children should be guided by the experiences of and input from multidisciplinary frontline emergency providers.
AHRQ-funded; HS023554.
Citation: Gawel M, Emerson B, Giuliano JS, Jr., .
A qualitative study of multidisciplinary providers' experiences with the transfer process for injured children and ideas for improvement.
Pediatr Emerg Care 2018 Feb;34(2):125-31. doi: 10.1097/pec.0000000000001405..
Keywords: Children/Adolescents, Patient Safety, Provider, Quality Improvement, Injuries and Wounds
Feuille E, Menon NR, Huang F
Knowledge of food protein-induced enterocolitis syndrome among general pediatricians.
In this study, investigators examined knowledge of food protein-induced enterocolitis syndrome among general pediatricians. They created a 32-question survey, collecting information regarding participants’ experience with FPIES and knowledge of FPIES diagnosis and management. Investigators found that many pediatricians had a basic but incomplete understanding of FPIES diagnosis and initial management.
AHRQ-funded; HS024599.
Citation: Feuille E, Menon NR, Huang F .
Knowledge of food protein-induced enterocolitis syndrome among general pediatricians.
Ann Allergy Asthma Immunol 2017 Sep;119(3):291-92.e3. doi: 10.1016/j.anai.2017.07.001..
Keywords: Children/Adolescents, Digestive Disease and Health, Diagnostic Safety and Quality, Nutrition, Provider, Provider: Clinician, Provider: Physician
Starmer AJ, Destino L, Yoon CS
Intern and resident workflow patterns on pediatric inpatient units: a multicenter time-motion study.
The researchers sought to quantify the proportion of time spent by residents in direct care, indirect care activities, and education across 9 pediatric institutions. They found that across all sites and levels of training, trainees spent more time in interprofessional communication (34.7 percent), and at the computer (20.5 percent), and less time in contact with patients and families (12.0 percent) and in educational activities (4.7 percent).
AHRQ-funded; HS019456.
Citation: Starmer AJ, Destino L, Yoon CS .
Intern and resident workflow patterns on pediatric inpatient units: a multicenter time-motion study.
JAMA Pediatr 2015 Dec;169(12):1175-7. doi: 10.1001/jamapediatrics.2015.2471..
Keywords: Children/Adolescents, Education: Continuing Medical Education, Inpatient Care, Provider, Training, Workflow