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Kerm Henriksen, Chris Dymek, Michael I Harrison, P Jeffrey Brady, Sharon B Arnold
BACKGROUND: The Improving Diagnosis in Health Care report from the National Academies of Sciences, Engineering and Medicine (NASEM) provided an opportunity for many groups to reflect on the role they could play in taking actions to improve diagnostic safety. As part of its own process, AHRQ held a research summit in the fall of 2016, inviting members from a diverse collection of organizations, both inside and outside of Government, to share their suggestions regarding what is known about diagnosis and the challenges that need to be addressed...
June 27, 2017: Diagnosis
James F Burgess, Nir Menachemi, Matthew L Maciejewski
OBJECTIVE: To present revised core competencies for doctoral programs in health services research (HSR), modalities to deliver these competencies, and suggested methods for assessing mastery of these competencies. DATA SOURCES AND DATA COLLECTION: Core competencies were originally developed in 2005, updated (but unpublished) in 2008, modestly updated for a 2016 HSR workforce conference, and revised based on feedback from attendees. Additional feedback was obtained from doctoral program directors, employer/workforce experts and attendees of presentation on these competencies at the AcademyHealth's June 2017 Annual Research Meeting...
March 13, 2018: Health Services Research
Chin-Lin Tseng, Orysya Soroka, Leonard M Pogach
AIM: To expand the existing United States Agency for Health Research and Quality (AHRQ) Diabetes composite (AHRQ-DC) to include additional preventable hospitalizations specific or relevant to diabetes. METHODS: A cross-sectional analysis of 834,696 veteran patients with diabetes aged ≥65 years in 2012. An Expanded Diabetes Composite (Expanded-DC) was developed utilizing: (1) the diabetes-specific category: the AHRQ-DC (short-term and long-term complications, uncontrolled diabetes, lower extremity amputations) and two proposed conditions: hypoglycemia and lower extremity ulcers/inflammation/infections (LEU) and (2) the diabetes-relevant category: the AHRQ-Acute Composite (dehydration, pneumonia, urinary tract infections) and one proposed condition, acute kidney injury (AKI)...
February 2, 2018: Journal of Diabetes and its Complications
Emily Leckman-Westin, Molly Finnerty, Sarah Hudson Scholle, Riti Pritam, Deborah Layman, Edith Kealey, Sepheen Byron, Emily Morden, Scott Bilder, Sheree Neese-Todd, Sarah Horwitz, Kimberly Hoagwood, Stephen Crystal
BACKGROUND: Concerns about antipsychotic prescribing for children, particularly those enrolled in Medicaid and with Supplemental Security Income (SSI), continue despite recent calls for selective use within established guidelines. OBJECTIVES: To (a) examine the application of 6 quality measures for antipsychotic medication prescribing in children and adolescents receiving Medicaid and (b) understand distinctive patterns across eligibility categories in order to inform ongoing quality management efforts to support judicious antipsychotic use...
March 2018: Journal of Managed Care & Specialty Pharmacy
Christopher P Childers, Anaar E Siletz, Emily S Singer, Claire Faltermeier, Q Lina Hu, Clifford Y Ko, Gregory J Golladay, Stephen L Kates, Elizabeth C Wick, Melinda Maggard-Gibbons
Background: Use of enhanced recovery pathways (ERPs) can improve patient outcomes, yet national implementation of these pathways remains low. The Agency for Healthcare Research and Quality (AHRQ; funder), the American College of Surgeons, and the Johns Hopkins Medicine Armstrong Institute for Patent Safety and Quality have developed the Safety Program for Improving Surgical Care and Recovery-a national effort to catalyze implementation of practices to improve perioperative care and enhance recovery of surgical patients...
2018: Geriatric Orthopaedic Surgery & Rehabilitation
Huiqian Yu, Huawei Li
Background: Sudden sensorineural hearing loss (SSHL) not only involves cochlear function but might also be accompanied by vestibular disturbances. The assessment of vestibular function could be of great relevance in SSHL. Objective: To investigate the prevalence of vestibulocochlear lesions in SSHL and the correlation of specific vestibular organs with hearing prognosis. Data sources: A complete literature search of eligible studies in the PubMed and EMBASE databases was performed...
2018: Frontiers in Neurology
Marlena H Shin, Peter E Rivard, Michael Shwartz, Ann Borzecki, Enzo Yaksic, Kelly Stolzmann, Lisa Zubkoff, Amy K Rosen
BACKGROUND: Given that patient safety measures are increasingly used for public reporting and pay-for performance, it is important for stakeholders to understand how to use these measures for improvement. The Agency for Healthcare Research and Quality (AHRQ) Patient Safety Indicators (PSIs) are one particularly visible set of measures that are now used primarily for public reporting and pay-for-performance among both private sector and Veterans Health Administration (VA) hospitals. This trend generates a strong need for stakeholders to understand how to interpret and use the PSIs for quality improvement (QI)...
February 14, 2018: BMC Health Services Research
Tom Basson, Alfred Montoya, Julia Neily, Lisa Harmon, Bradley V Watts
OBJECTIVE: The aim of the study was to improve the safety culture at a Veterans Administration hospital using evidence-based approaches. METHODS: We implemented a patient safety summit with follow-up actions. We measured safety climate before and after the summit using the Agency for Healthcare Research and Quality (AHRQ) Hospital Survey of Patient Safety Culture with modifications and the Safety Attitudes Questionnaire (SAQ). The summit brought hospital leaders together to discuss patient safety topics and relate them to our hospital...
February 9, 2018: Journal of Patient Safety
Rebekah Wagner, Folashade B Agusto
BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) is a bacterial pathogen resistance to antibiotics including methicillin. The resistance first emerged in 1960 in a healthcare setting only after two years of using methicillin as a viable treatment for methicillin-susceptible Staphylococcus aureus. MRSA leads to infections in different parts of the body including the skin, bloodstream, lungs, or the urinary tract. METHODS: A deterministic model for methicillin-resistant Staphylococcus aureus (MRSA) with injection drug users is designed...
February 7, 2018: BMC Infectious Diseases
Roger Chou, William L Baker, Lionel L Bañez, Suchitra Iyer, Evan R Myers, Sydne Newberry, Laura Pincock, Karen A Robinson, Lyndzie Sardenga, Nila Sathe, Stacey Springs, Timothy J Wilt
OBJECTIVES: Systematic reviews should provide balanced assessments of benefits and harms, while focusing on the most important outcomes. Selection of harms to be reviewed can be a challenge due to the potential for large numbers of diverse harms. STUDY DESIGN AND SETTING: A workgroup of methodologists from Evidence-based Practice Centers (EPCs) developed consensus-based guidance on selection and prioritization of harms in systematic reviews. Recommendations were informed by a literature scan, review of Evidence-based Practice Center reports, and interviews with experts in conducting reviews or assessing harms and persons representing organizations that commission or use systematic reviews...
February 2, 2018: Journal of Clinical Epidemiology
Michael P Cary, Victoria Goode, Nancy Crego, Deirdre Thornlow, Cathleen Colón-Emeric, Helen M Hoenig, Kayla Baba, Scarlet Fellingham, Elizabeth I Merwin
OBJECTIVE: To document changes in 30-day hospital readmission rates and causes for returning to the hospital for care among THR patients in US hospitals in 2009 and 2014. DESIGN: Cross-sectional, retrospective descriptive. We used data from the Nationwide Readmissions Database (NRD) which is drawn from the Healthcare Cost and Utilization Project (HCUP) net - sponsored by the Agency for Healthcare Research and Quality (AHRQ). SETTING: The AHRQ database, known as NRD, is based on a 20% sample of all hospital discharges in the nation...
January 30, 2018: Archives of Physical Medicine and Rehabilitation
Mary Nix, Peggy McNamara, Janice Genevro, Natalia Vargas, Kamila Mistry, Alaina Fournier, Margie Shofer, Edwin Lomotan, Therese Miller, Richard Ricciardi, Arlene S Bierman
Learning collaboratives are increasingly used as mechanisms to support and hasten the diffusion and implementation of innovation, clinical evidence, and effective models of care. Factors contributing to the collaboratives' success or failure are poorly understood. The Agency for Healthcare Research and Quality (AHRQ) has sponsored collaboratives for nearly two decades to support improvements in health care quality and value by accelerating the diffusion and implementation of innovation. We examined AHRQ's experience with these collaboratives to characterize their attributes, identify factors that might contribute to their success or failure, and assess the challenges they encountered...
February 2018: Health Affairs
Jeffrey G Jarvik, Laura S Gold, Katherine Tan, Janna L Friedly, Srdjan S Nedeljkovic, Bryan A Comstock, Richard A Deyo, Judith A Turner, Brian W Bresnahan, Sean D Rundell, Kathryn T James, David R Nerenz, Andrew L Avins, Zoya Bauer, Larry Kessler, Patrick J Heagerty
BACKGROUND CONTEXT: Although back pain is common among older adults, there is relatively little research on the course of back pain in this age group. PURPOSE: Our primary goals were to report 2-year outcomes of older adults initiating primary care for back pain and to examine the relative importance of patient factors vs. medical interventions in predicting 2-year disability and pain. STUDY DESIGN/SETTING: Predictive model using data from a prospective, observational cohort from a primary care setting...
January 29, 2018: Spine Journal: Official Journal of the North American Spine Society
Katherine J Baxter, Hannah T M H Nguyen, Mark L Wulkan, Mehul V Raval
Importance: The pediatric perforated appendix rate is a quality metric measured by the Agency for Healthcare Research and Quality (AHRQ) that reflects access to care. The association of health care utilization prior to presentation with appendicitis is unknown. Objective: To determine whether increased health care utilization prior to presentation with appendicitis is associated with lower perforated appendicitis rates in children. Design, Setting, and Participants: Retrospective cohort study of privately insured children drawn from large employer and insurance company administrative data found in the Truven MarketScan national insurance claims database...
January 31, 2018: JAMA Surgery
John K Peel, Christopher M Schlachta, Nawar A Alkhamesi
BACKGROUND: Interest in surgical careers among medical students has declined over the past decade. Multiple explanations have been offered for why top students are deterred or rejected from surgical programs, though no consensus has emerged. METHODS: We conducted a review of the literature to better characterize what factors affect the pursuit of a surgical career. We searched PubMed and EMBASE and performed additional reference checks. Agency for Healthcare Research and Quality (AHRQ) and Newcastle-Ottawa Education scores were used to evaluate the included data...
February 2018: Canadian Journal of Surgery. Journal Canadien de Chirurgie
Juan José Yepes-Nuñez, Rebecca L Morgan, Lawrence Mbuagbaw, Alonso Carrasco-Labra, Stephanie Chang, Susanne Hempel, Paul Shekelle, Mark Helfand, Tejan Baldeh, Holger J Schünemann
OBJECTIVE: Summary of findings (SoF) tables present results of systematic reviews in a concise and explicit format. Adopted by many review groups including the Cochrane Collaboration and the Agency for Healthcare Research and Quality (AHRQ), optimal understanding of SoF table may be influenced by the type of information being conveyed and objectives or preferences of the end user. This study aims to compare three SoF table formats in terms of understanding, accessibility, satisfaction and preference with systematic review users...
January 23, 2018: BMJ Open
Apeksha Chaturvedi, Abhishek Chaturvedi, A Luana Stanescu, Johan G Blickman, Steven P Meyers
Mechanical birth-related injuries to the neonate are declining in incidence with advances in prenatal diagnosis and care. These injuries, however, continue to represent an important source of morbidity and mortality in the affected patient population. In the United States, these injuries are estimated to occur among 2.6% of births. Although more usual in context of existing feto-maternal risk factors, their occurrence can be unpredictable. While often superficial and temporary, functional and cosmetic sequelae, disability or even death can result as a consequence of birth-related injuries...
January 22, 2018: Insights Into Imaging
Steven W Howard, Zidong Zhang, Paula Buchanan, Stephanie L Bernell, Christine Williams, Lindsey Pearson, Michael Huetsch, Jeff Gill, Jose A Pineda
BACKGROUND: Inpatient care for children with severe traumatic brain injury (sTBI) is expensive, with inpatient charges averaging over $70,000 per case (Hospital Inpatient, Children Only, National Statistics. Diagnoses- clinical classification software (CCS) principal diagnosis category 85 coma, stupor, and brain damage, and 233 intracranial injury. Diagnoses by Aggregate charges [ ]). This ranks sTBI in the top quartile of pediatric conditions with the greatest inpatient costs (Hospital Inpatient, Children Only, National Statistics...
January 12, 2018: BMC Health Services Research
Jill McArdle, Asta Sorensen, Christina I Fowler, Samantha Sommerness, Katrina Burson, Leila Kahwati
OBJECTIVE: To assess implementation of safety strategies to improve management of births complicated by shoulder dystocia in labor and delivery units. DESIGN: Mixed-methods implementation evaluation. SETTING/LOCAL PROBLEM: Labor and delivery units (N = 18) in 10 states participating in the Safety Program for Perinatal Care (SPPC). Shoulder dystocia is unpredictable, requiring rapid and coordinated action. PARTICIPANTS: Key informants were labor and delivery unit staff who implemented SPPC safety strategies...
January 2, 2018: Journal of Obstetric, Gynecologic, and Neonatal Nursing: JOGNN
Joanne Campione, Theresa Famolaro
BACKGROUND: Patient safety culture has a positive influence on the effectiveness of patient safety and quality improvement interventions. A study was conducted to gain knowledge about promising best practices used by hospitals to improve patient safety culture hospitalwide. METHODS: Agency for Healthcare Research and Quality (AHRQ) Surveys on Patient Safety Culture™ (SOPS) Hospital Survey longitudinal results from 536 hospitals that submitted data to the Hospital SOPS database from 2007 to 2014 were analyzed...
January 2018: Joint Commission Journal on Quality and Patient Safety
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