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Research Studies is a compilation of published research articles funded by 大象APPor authored by 大象APPresearchers.

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1 to 25 of 236 Research Studies Displayed
Rosenman ED, Grand JA, Fernandez R
Validity evidence of a resuscitation team leadership assessment measure for use in actual trauma resuscitations.
The authors constructed a 12-item behaviorally anchored rating scale (BARS) to measure trauma resuscitation team leadership in clinical settings. The team leadership BARS and a previously studied checklist-based team leadership measure produced convergent assessments of behavior; higher overall ratings on the BARS also correlated with better patient care delivery at the team level.
Citation: Rosenman ED, Grand JA, Fernandez R . Validity evidence of a resuscitation team leadership assessment measure for use in actual trauma resuscitations. AEM Educ Train 2025 Apr; 9(2):e11061. doi: 10.1002/aet2.11061.
Keywords: Trauma, Teams, Quality Measures, Quality of Care
Marsolais E, Anhang Price R, Berdahl CT
The technical expert/clinical user/patient panel (TECUPP): centering patient and family perspectives in patient-reported measure development.
This paper describes a newly developed stakeholder panel model for incorporating patient/caregiver voices in the development of patient-reported measures, the Technical Expert/Clinical User/Patient Panel (TECUPP) model. The authors reported key design features of the TECUPP model and how they used this model to develop survey-based patient experience measures of timeliness of cancer diagnosis. They described benefits and challenges of using the TECUPP model and considerations to guide others who might use it as part of developing patient-centered quality measures, based on their experience convening a TECUPP to inform development of a patient-reported measure on timeliness of cancer diagnosis. Benefits included creating space for significant contributions from patients/caregivers and development of a shared understanding of patient experiences and observability of measure domains between clinicians and patients/caregivers. Challenges included time management and managing conversations outside the project scope.
AHRQ-funded; HS029534.
Citation: Marsolais E, Anhang Price R, Berdahl CT . The technical expert/clinical user/patient panel (TECUPP): centering patient and family perspectives in patient-reported measure development. Res Involv Engagem 2025 Jan 7; 11(1):2. doi: 10.1186/s40900-024-00661-4..
Keywords: Quality of Care, Patient-Centered Healthcare, Patient Experience, Quality Measures, Quality Improvement
Zimolzak SJ, Khan SP, Singh H
Application of a digital quality measure for cancer diagnosis in Epic Cosmos.
This follow-up study aimed to apply a previously validated digital quality measure (dOM) of emergency presentation (EP) of lung cancer in 2 US health systems to a new national electronic health record (EHR) database and examine demographic associations. They applied the dOM to Epic Cosmos, a deidentified database covering 184 million US patients and examined associations with sociodemographic factors. Overall EP rate was 19.6%. EP rate was higher in Black vs White patients (24% vs 19%) and patients with younger age, higher social vulnerability, lower-income ZIP code, and self-reported transport difficulties.
AHRQ-funded.
Citation: Zimolzak SJ, Khan SP, Singh H . Application of a digital quality measure for cancer diagnosis in Epic Cosmos. J Am Med Inform Assoc 2025 Jan; 32(1):227-29. doi: 10.1093/jamia/ocae253.
Keywords: Cancer, Quality Measures, Quality of Care, Health Information Technology (HIT), Electronic Health Records (EHRs), Cancer: Lung Cancer
Tully KP
Birthing parent perspectives on measuring the quality of perinatal care: metrics, timing, and process.
This cross-sectional qualitative research study, conducted at an academic medical center in the southeastern U.S., investigated patient perspectives on measuring quality of perinatal care. Forty birthing parents participated in the study, expressing desire for their perinatal healthcare experiences to be understood. The authors concluded that meaningful quality measurement may be promoted through transparent and multimethod opportunities for patients to share their insights securely.
AHRQ-funded; HS025429.
Citation: Tully KP . Birthing parent perspectives on measuring the quality of perinatal care: metrics, timing, and process. Front Health Serv 2024 Dec 10; 4:1473848. doi: 10.3389/frhs.2024.1473848..
Keywords: Maternal Health, Women, Quality Measures, Quality of Care
Austin Austin, Zhu Y, Sebestyen K
The development and endorsement of a performance measure for stroke misdiagnosis in the emergency department.
This article details the development and endorsement process for the Avoid Hospitalization After Release with a Misdiagnosis (Avoid H.A.R.M.)-ED Stroke/Dizziness quality measure, which addresses a gap in diagnostic error measurement. Utilizing the Symptom-disease Pair Analysis of Diagnostic Error (SPADE) framework, the claims-based measure tracks the number of adult patients treated and subsequently released from the emergency department (ED) with 鈥渂enign dizziness鈥 who were admitted to the hospital within 30 days of their ED visit. Initial concerns about the measure included limited provider training on eye-movement-based diagnosis techniques and questions about the measure's statistical reliability. The team responded to all concerns, including by using the 大象APP鈥檚 Healthcare Cost and Utilization Project (HCUP) data for Florida hospitals for the updated analysis.
AHRQ-funded; HS027614; HS029350.
Citation: Austin Austin, Zhu Y, Sebestyen K . The development and endorsement of a performance measure for stroke misdiagnosis in the emergency department. Qual Manag Health Care 2024 Oct-Dec; 33(4):289-90. doi: 10.1097/qmh.0000000000000492..
Keywords: Stroke, Cardiovascular Conditions, Emergency Department, Diagnostic Safety and Quality, Medical Errors, Adverse Events, Quality Measures, Quality Improvement, Quality of Care
Shetty KD, Basu AR, Nuckols TK
Refining quality measures for electrodiagnostic testing in suspected carpal tunnel syndrome to account for acceptable variations in practice: expert review process.
This study aimed to enhance the applicability and validity of quality measures for electrodiagnostic testing in suspected carpal tunnel syndrome (CTS) by integrating acceptable variations in practices. Thirteen expert specialists refined five quality measures and rated their validity on a scale of 1-9. Three measures received high validity ratings (8-9), while two others were rated valid (8) after revisions. The refined measures establish minimum standards for electrodiagnostic testing and will be assessed for feasibility and reliability in various practices.
AHRQ-funded; HS018982.
Citation: Shetty KD, Basu AR, Nuckols TK . Refining quality measures for electrodiagnostic testing in suspected carpal tunnel syndrome to account for acceptable variations in practice: expert review process. Muscle Nerve 2024 Sep; 70(3):316-24. doi: 10.1002/mus.28176..
Keywords: Quality Measures, Diagnostic Safety and Quality, Quality of Care
Kapadia P, Zimolzak AJ, Upadhyay DK
Development and implementation of a digital quality measure of emergency cancer diagnosis.
This paper examined a new automated measure of quality of cancer diagnosis that was developed and implemented by the authors. They developed and implemented a digital quality measure (dQM) of cancer emergency presentation (EP) using electronic health record databases of two health systems and characterized the measure's association with missed opportunities for diagnosis (MODs) and mortality. They defined EP as a new cancer diagnosis within 30 days after emergency department or inpatient visit. They identified EPs for lung cancer and colorectal cancer (CRC) in the Department of Veterans Affairs (VA) and Geisinger from 2016 to 2020. They validated measure accuracy and identified preceding MODs through standardized chart review of 100 records per cancer per health system. Among 38,565 and 2,914 patients with lung cancer and 14,674 and 1,649 patients with CRCs at VA and Geisinger, respectively, their dQM identified EPs in 20.9% and 9.4% of lung cancers, and 22.4% and 7.5% of CRCs. Chart reviews found high positive predictive values for EPs across sites and cancer types (72%-90%), and a substantial percent represented MODs (48.8%-84.9%). EP was associated with significantly higher odds of 1-year mortality for lung cancer and CRC (adjusted odds ratio, 1.78 and 1.83).
AHRQ-funded; HS027363; HS028595; HS029347.
Citation: Kapadia P, Zimolzak AJ, Upadhyay DK . Development and implementation of a digital quality measure of emergency cancer diagnosis. J Clin Oncol 2024 Jul 20; 42(21):2506-15. doi: 10.1200/jco.23.01523..
Keywords: Emergency Department, Health Information Technology (HIT), Quality Measures, Quality of Care, Cancer, Diagnostic Safety and Quality
Zheng H, Ash AS, Yang W
Strengthening quality measurement to predict success for total knee arthroplasty: results from a nationally representative total knee arthroplasty cohort.
In 2027, the Centers for Medicare & Medicaid Services (CMS) will begin mandating Patient-reported outcome measures (PROMs) to assess the quality of total knee arthroplasty (TKA). Using data from a national cohort of primary unilateral TKA patients, the authors developed, tested, and enhanced a model closely following a CMS-proposed measure to predict substantial clinical benefit. Only the enhanced model predicted success accurately across the spectrum of baseline scores. Findings were virtually identical when analyses were replicated on patients over 65. The authors concluded that adding a baseline knee-specific PROM score to a quality measurement model in a nationally representative cohort dramatically improved its predictive power.
AHRQ-funded; HS018910.
Citation: Zheng H, Ash AS, Yang W . Strengthening quality measurement to predict success for total knee arthroplasty: results from a nationally representative total knee arthroplasty cohort. J Bone Joint Surg Am 2024 Apr 17; 106(8):708-15. doi: 10.2106/jbjs.23.00602..
Keywords: Quality Measures, Quality of Care, Orthopedics, Surgery, Outcomes, Evidence-Based Practice, Patient-Centered Outcomes Research
Bingham CA, Harris JG, Qui T
Pediatric Rheumatology Care and Outcomes Improvement Network's quality measure set to improve care of children with juvenile idiopathic arthritis.
The objective of this study was to describe the selection, development, and implementation of quality measures for juvenile idiopathic arthritis (JIA) by the Pediatric Rheumatology Care and Outcomes Improvement Network (PR-COIN), a multihospital learning health network. Clinicians in PR-COIN and parents of children with JIA collaboratively selected outcome quality measures and a committee of rheumatologists and data analysts developed operational definitions. Initial measures were clinical inactive disease, low pain score, and optimal physical functioning; the revised set included additional measures of disease activity, data quality, and a balancing measure. The authors concluded that PR-COIN's set of JIA quality measures is the first comprehensive set used at the point-of-care for a large cohort of JIA patients in a variety of pediatric rheumatology practice settings.
AHRQ-funded; HS021114.
Citation: Bingham CA, Harris JG, Qui T . Pediatric Rheumatology Care and Outcomes Improvement Network's quality measure set to improve care of children with juvenile idiopathic arthritis. Arthritis Care Res 2023 Dec; 75(12):2442-52. doi: 10.1002/acr.25168.
Keywords: Children/Adolescents, Arthritis, Quality Measures, Quality Improvement, Quality of Care, Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice
Agniel D, Cabreros I, Damberg CL
A formal framework for incorporating equity into health care quality measurement.
This paper examines how tying incentives on the basis of stratification or disparities in quality measurement may have unintended consequences or limited effects. Addressing one aspect of equity may be in competition with addressing others. The authors proposed equity weighting, a new measurement framework to advance equity on multiple fronts that addresses the shortcomings of existing approaches and explicitly calibrates incentives to align with equity goals. They used colorectal cancer screening data derived from 2017 Medicare claims to illustrate how equity weighting fixes unintended consequences in other methods and how it can be adapted to policy goals.
AHRQ-funded; HS024067.
Citation: Agniel D, Cabreros I, Damberg CL . A formal framework for incorporating equity into health care quality measurement. Health Aff 2023 Oct; 42(10):1383-91. doi: 10.1377/hlthaff.2022.01483..
Keywords: Quality Measures, Quality Improvement, Quality of Care, Disparities
Murphy DR, Zimolzak AJ, Upadhyay DK
Developing electronic clinical quality measures to assess the cancer diagnostic process.
Electronic clinical quality measures (eCQMs) to evaluate quality of cancer diagnosis could facilitate quantification and improvement of diagnostic performance. The purpose of this study was to developed 2 eCQMs to evaluate diagnostic assessment of red-flag clinical findings for colorectal cancer (CRC) and lung cancer. At each site the researchers assessed 100 positive and 20 negative randomly chosen records for each eCQM at each site to validate accuracy and categorized missed opportunities associated with system, provider, or patient factors. The researchers applied the CRC eCQM at both sites, while the lung cancer eCQM was only applied at the VA due to an absence of structured data indicating level of cancer suspicion on most chest imaging results at Geisinger. The study found that for the CRC eCQM, the appropriate follow-up took place in 26,鈥746 out of 74,鈥314 patients (36.0%) in the VA after removing clinical exclusions and in 1,009 out of 2,461 patients (41.1%) at Geisinger. The appropriate assessment for lung cancer in the VA took place in 25,鈥166 out of 40,鈥924 patients (61.5). Provider factors were cited by reviewers the primary source of missed opportunities at both sites.
AHRQ-funded; HS022087.
Citation: Murphy DR, Zimolzak AJ, Upadhyay DK . Developing electronic clinical quality measures to assess the cancer diagnostic process. J Am Med Inform Assoc 2023 Aug 18; 30(9):1526-31. doi: 10.1093/jamia/ocad089..
Keywords: Cancer: Lung Cancer, Cancer, Quality Measures, Diagnostic Safety and Quality, 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
Smith DC, Phillippi JC, Tilden EL
Comparing cesarean birth utilization between US hospitals: a demonstration of the robson ten-group classification system for use in quality improvement and benchmarking.
The objective of this study was to describe the application and utility of the World Health Organization-endorsed Robson Ten-Group Classification System (TGCS) to compare hospital-level cesarean births rates for use in quality improvement and benchmarking. The authors conducted a descriptive, secondary data analysis of the Consortium on Safe Labor dataset using data from births from 2002-08 at 12 sites across the US. Results showed a variation in use of cesarean birth, labor induction, and trial of labor after cesarean (TOLAC) across the 12 sites. The authors concluded that TGCS provides a method for between-hospital comparisons and adoption of TGCS in the US would provide an effective benchmarking tool to assist in reducing the use of cesarean birth and increasing the support of TOLAC.
AHRQ-funded; HS024733.
Citation: Smith DC, Phillippi JC, Tilden EL . Comparing cesarean birth utilization between US hospitals: a demonstration of the robson ten-group classification system for use in quality improvement and benchmarking. J Perinat Neonatal Nurs 2023 Jul-Sep; 37(3):214-22. doi: 10.1097/jpn.0000000000000670..
Keywords: Hospitals, Healthcare Utilization, Maternal Health, Women, Quality Improvement, Quality Measures, Quality of Care
Teixeira da Silva D, Makeneni S, Wall H
Measuring quality STI care among adolescent female primary care patients in Philadelphia.
The purpose of this study was to develop and apply a cross-setting, sexually transmitted infection (STI) Care Continuum to improve STI care quality, to assess adherence to guideline-recommended care, and to standardize progress measurement toward National Strategic goals. Review of the CDC STI treatment guidelines identified seven distinct steps of care for gonorrhea, chlamydia, and syphilis; researchers used Youth Risk Behavior Surveillance Survey data to estimate step 1, and electronic health record data for steps 2, 3, 4, 6 and 7. The researchers concluded that local application of an STI Care Continuum identified STI testing, retesting, and HIV testing as areas for improvement. Similar methods may be applied to target resources, standardize data collection and reporting, and improve STI care quality.
AHRQ-funded; HS026116.
Citation: Teixeira da Silva D, Makeneni S, Wall H . Measuring quality STI care among adolescent female primary care patients in Philadelphia. Sex Transm Infect 2023 Jun; 99(4):272-75. doi: 10.1136/sextrans-2022-055623..
Keywords: Children/Adolescents, Sexual Health, Infectious Diseases, Primary Care, Women, Human Immunodeficiency Virus (HIV), Quality Measures, Quality of Care
Sanghavi P, Chen Z
Underreporting of quality measures and associated facility characteristics and racial disparities in US nursing home ratings.
The purpose of this study was to evaluate the relationship between nursing home characteristics and reporting of 2 of 3 specific clinical outcomes reported by the Nursing Home Care Compare (NHCC) website: major injury falls and pressure ulcers. The researchers of this quality improvement study utilized hospitalization data for all Medicare fee-for-service beneficiaries between January 1, 2011, and December 31, 2017. Hospital admission claims for major injury falls and pressure ulcers were linked with facility-reported evaluations at the nursing home resident level. For each linked hospital claim, it was determined whether the nursing home had reported the event and rates of reporting were computed. To evaluate whether nursing homes reported similarly on both measures, the researchers estimated the relationship between reporting of major injury falls and pressure ulcers within a nursing home, and explored racial and ethnic disparities that could otherwise explain the associations. The study sample included 13,179 nursing homes where 131,000 residents experienced major injury fall or pressure ulcer hospitalizations. Of the 98,669 major injury fall hospitalizations, 60.0% were reported, and of the 39,894 stage 3 or 4 pressure ulcer hospitalizations, 67.7% were reported. Underreporting for both conditions was pervasive, with 69.9% and 71.7% of nursing homes having reporting rates less than 80% for major injury fall and pressure ulcer hospitalizations, respectively. Lower reporting rates had few correlations with facility characteristics other than racial and ethnic composition. Facilities with high vs low fall reporting rates had significantly more White residents (86.9% vs 73.3%), and facilities with high vs low pressure ulcer reporting rates had significantly fewer White residents (69.7% vs 74.9%).
AHRQ-funded; HS026957.
Citation: Sanghavi P, Chen Z . Underreporting of quality measures and associated facility characteristics and racial disparities in US nursing home ratings. JAMA Netw Open 2023 May; 6(5):e2314822. doi: 10.1001/jamanetworkopen.2023.14822..
Keywords: Quality Measures, Quality of Care, Elderly, Disparities, Racial and Ethnic Minorities, Nursing Homes, Pressure Ulcers, Healthcare-Associated Infections (HAIs), Quality Indicators (QIs), Long-Term Care
JE Wallis, CJD Huang, LC
大象APPAuthor: Tallman
Association between adherence to radiation therapy quality metrics and patient reported outcomes in prostate cancer.
Researchers evaluated the impact of compliance with nationally recognized radiation therapy quality measures on patient-reported health-related quality of life outcomes in the Comparative Effectiveness Analysis of Surgery and Radiation (CEASAR) population-based, prospective cohort study of men with localized prostate cancer. Eight quality measures were identified based on national guidelines. In multivariable analyses, no clinically significant associations were discovered between compliance with evaluated radiation therapy quality measures and patient-reported outcomes such as urinary irritation, urinary incontinence, bowel, sexual or hormonal function. The researchers concluded that further work would be needed to identify patient-centered quality measures of prostate cancer care.
AHRQ-funded; HS019356.
Citation: JE Wallis, CJD Huang, LC . Association between adherence to radiation therapy quality metrics and patient reported outcomes in prostate cancer. Prostate Cancer Prostatic Dis 2023 Mar;26(1):80-87. doi: 10.1038/s41391-022-00518-5.
Keywords: Cancer: Prostate Cancer, Cancer, Patient-Centered Outcomes Research, Evidence-Based Practice, Quality Measures
Beaulieu ND, Chernew ME, McWilliams JM
Organization and performance of US health systems.
The objectives of this evidence review were to identify and describe health systems in the US, to assess differences between physicians and hospitals in and outside of health systems, and to compare quality and cost of care delivered by physicians and hospitals in and outside of health systems. A total of 580 health systems in a great variety of sizes were identified; prices for physician, hospital services, and total spending were assessed in 2018 commercial claims data. Health system physicians and hospitals were shown to deliver a large portion of medical services. Clinical quality performance and patient experience measures were slightly better in systems; however, spending and prices were significantly higher, especially in small practices. The authors concluded that slight quality differentials in combination with large price differentials suggested that health systems have not realized their potential for better care at equal or lower cost.
AHRQ-funded; HS024072.
Citation: Beaulieu ND, Chernew ME, McWilliams JM . Organization and performance of US health systems. JAMA 2023 Jan 24; 329(4):325-35. doi: 10.1001/jama.2022.24032..
Keywords: Health Systems, Healthcare Delivery, Provider Performance, Quality Measures, Quality of Care, Hospitals
Chen Z, Gleason LJ, Sanghavi P
Accuracy of pressure ulcer events in US nursing home ratings.
This study investigated the accuracy of the government website Nursing Home Compare (NHC) pressure ulcer measures, which are chief indicators of nursing home patient safety. The authors identified hospital admissions for pressure ulcers and linked them to the nursing home-reported data at the patient level using Medicare fee-for-service beneficiaries who were nursing home residents between 2011 and 2017. Percentages of pressure ulcers that were appropriately reported by stage, long-stay versus short-stay status, and race was calculated. Reporting rates were low for both short-stay (70.2%) and long-stay (59.7%) for stage 2-4 pressure ulcer hospitalizations. Black residents experienced more severe pressure ulcers than White residents. Correlations between claims-based measures and NHC ratings were found to be poor.
AHRQ-funded; HS026957.
Citation: Chen Z, Gleason LJ, Sanghavi P . Accuracy of pressure ulcer events in US nursing home ratings. Med Care 2022 Oct;60(10):775-83. doi: 10.1097/mlr.0000000000001763.
AHRQ-funded; HS026957..
Keywords: Elderly, Nursing Homes, Long-Term Care, Pressure Ulcers, Quality Measures, Quality of Care, Patient Safety
Waters TM, Burns N, Kaplan CM
Combined impact of medicare's hospital pay for performance programs on quality and safety outcomes is mixed.
The authors examined the combined impact of Medicare's pay for performance (P4P) programs on clinical areas and populations targeted by the programs, as well as those outside their focus. Using HCUP data, and consistent with previous studies for individual programs, they detected minimal, if any, effect of Medicare's hospital P4P programs on quality and safety. They recommended a redesigning of the P4P programs before continuing to expand them.
AHRQ-funded; HS025148.
Citation: Waters TM, Burns N, Kaplan CM . Combined impact of medicare's hospital pay for performance programs on quality and safety outcomes is mixed. BMC Health Serv Res 2022 Jul 28;22(1):958. doi: 10.1186/s12913-022-08348-w..
Keywords: Healthcare Cost and Utilization Project (HCUP), Medicare, Payment, Provider Performance, Hospitals, Quality Indicators (QIs), Quality Measures, Quality Improvement, Quality of Care, Patient Safety
Hoffmann JA, Johnson JK, Pergjika A
Development of quality measures for pediatric agitation management in the emergency department.
This study鈥檚 objective was to develop quality measures for pediatric emergency department (ED) agitation management informed by multidisciplinary perspectives. A multidisciplinary panel was created to develop quality measures for pediatric ED agitation management through the modified Delphi method. The panelists included 36 physicians, nurses, social workers, security, child life specialists, hospital data analysts, and parents. Measures were ranked by panelists in importance and feasibility on a 9-point scale during 2 survey rounds, with a teleconference discussion between surveys. Consensus was defined at >75% of panelists ranking a quality measure greater or equal to 7 in importance and median feasibility of greater or equal to 4. Consensus was reached on 20 quality measures that incorporated multidisciplinary perspectives.
AHRQ-funded; HS026385.
Citation: Hoffmann JA, Johnson JK, Pergjika A . Development of quality measures for pediatric agitation management in the emergency department. J Healthc Qual 2022 Jul-Aug;44(4):218-29. doi: 10.1097/jhq.0000000000000339..
Keywords: Children/Adolescents, Quality Measures, Quality Indicators (QIs), Quality of Care, Emergency Department
Probst MA, Janke AT, Haimovich AD
Development of a novel emergency department quality measure to reduce very low-risk syncope hospitalizations.
The purpose of this study was to develop a new quality measure to apply with very low risk adult emergency department patients under 50 years of age and with no history of heart disease presenting with syncope. The study found that of the 3,292 patients meeting the study criteria, .46% suffered serious adverse events within 30 days after discharge. When the criteria were applied to the 2019 Nationwide Emergency Department Sample (NEDS) to assess its potential effect (assessing for hospital-level factors associated with hospitalization variation), of the 566,031 patients meeting the criteria, 2.7% were hospitalized. The researchers identified factors associated with increased hospitalization rates, which included a yearly ED volume of more than 80,000 and metropolitan teaching status. The study concluded that the novel syncope quality measure developed by the researchers can evaluate variation in low-value hospitalizations for unexplained syncope.
AHRQ-funded; HS022882.
Citation: Probst MA, Janke AT, Haimovich AD . Development of a novel emergency department quality measure to reduce very low-risk syncope hospitalizations. Ann Emerg Med 2022 Jun;79(6):509-17. doi: 10.1016/j.annemergmed.2022.03.008..
Keywords: Emergency Department, Quality Measures, Hospitalization, Quality Indicators (QIs), Quality of Care
Zrelak PA, Utter GH, McDonald KM
Incorporating harms into the weighting of the revised 大象APP Patient Safety for Selected Indicators Composite (Patient Safety Indicator 90).
The purpose of this study was to reweight AHRQ鈥檚 Patient Safety for Selected Indicators Composite (Patient Safety Indicator 90) from weights based solely on the frequency of component Patient Safety Indicators (PSIs) to those that incorporate excess harm reflecting patients' preferences for outcome-related health states. Findings showed that including harms in the weighting scheme changed individual component weights from the original frequency-based weighting. In the reweighted composite, PSIs 11, 13, and 12 contributed the greatest harm. The investigators concluded that reformulation of PSI 90 with harm-based weights is feasible and results in satisfactory reliability and discrimination.
AHRQ-authored; AHRQ-funded; 290201200003I.
Citation: Zrelak PA, Utter GH, McDonald KM . Incorporating harms into the weighting of the revised 大象APP Patient Safety for Selected Indicators Composite (Patient Safety Indicator 90). Health Serv Res 2022 Jun;57(3):654-67. doi: 10.1111/1475-6773.13918..
Keywords: Healthcare Cost and Utilization Project (HCUP), Patient Safety, Quality Indicators (QIs), Quality Measures, Quality of Care, Adverse Events, Medicare
Milliren CE, Bailey G, Graham DA
Relationships between pediatric safety indicators across a national sample of pediatric hospitals: dispelling the myth of the "safest" hospital.
This observational study aimed to explore the covariance of pediatric hospital quality indicators and evaluate the use of a single composite score. Pediatric hospital performance across 13 safety indicators were extracted from the Pediatric Health Information System, a comparative database of children鈥檚 hospitals in the U.S. Patients discharged from 36 hospitals from 2016 to 2019 were included. The authors investigated relationships among patient safety measures from 大象APPpediatric quality indicators and Center for Medicare and Medicaid Services hospital-acquired conditions. They identified 5 orthogonal variance components accounting for 68% of variation in pediatric hospital quality indicators. The ranking comparison and summary found greater within-hospital variation compared with between-hospital variation. They observed discordant rankings among commonly used summary measures and concluded that these measures demonstrate at least 2 underlying variance components.
AHRQ-funded; HS026246.
Citation: Milliren CE, Bailey G, Graham DA . Relationships between pediatric safety indicators across a national sample of pediatric hospitals: dispelling the myth of the "safest" hospital. J Patient Saf 2022 Jun 1;18(4):e741-e46. doi: 10.1097/pts.0000000000000938..
Keywords: Children/Adolescents, Quality Indicators (QIs), Quality Measures, Patient Safety, Hospitals, Quality of Care
Ellsworth BL, Metz AK, Mott MM
Review of cancer-specific quality measures promoting the avoidance of low-value care.
The purpose of this study was to explore cancer quality measures to identify and describe those that encourage the avoidance of caner overtreatment and low-value care. The study also aimed to identify gaps that could direct the future development of cancer-specific quality measures. The researchers collected, reviewed, and identified 313 quality measures encouraging the avoidance of low-value cancer care, from six leading quality measures organizations. Of the 313 quality measures identified, 55 (18%) focused on avoidance of low-value care. Quality measure most likely to focus on low-value care included: 13 end-of-life care measures (50%); 12 breast cancer care measures (18%); 9 lung cancer care measures (31%); 8 colon cancer care measures (20%); 5 prostate cancer care measures (38%); and 4 general cancer care measures (3%). The study concluded that the majority of cancer quality measures are not aimed at avoiding cancer over-treatment and low value care, and existing recommendations have not been incorporated in the field.
AHRQ-funded; HS026030.
Citation: Ellsworth BL, Metz AK, Mott MM . Review of cancer-specific quality measures promoting the avoidance of low-value care. Ann Surg Oncol 2022 Jun;39(6):3750-62. doi: 10.1245/s10434-021-11303-4..
Keywords: Cancer, Quality Measures, Quality Indicators (QIs), Quality of Care
Bucholz EM, Toomey SL, McCulloch CE EM, Toomey SL, McCulloch CE
Adjusting for social risk factors in pediatric quality measures: adding to the evidence base.
The purpose of this study was to evaluate a method for incorporating social risk variables into a pediatric measure of utilization from the Pediatric Quality Measures Program (PQMP). The researchers utilized data from California Medicaid claims (2015-16) and Massachusetts All Payer Claims Database (2014-2015) to assess health plan performance using the Pediatric Asthma Emergency Department Use measure. The study found that of 133 health plans serving 404,649 pediatric patients with asthma, 7% to 13% changed performance categories after social risk adjustment. Health plans that shifted to higher performance categories cared for lower socioeconomic status (SES) patients, while those that shifted to lower performance categories cared for higher SES patients. The study concluded that adjustment for social risk factors shifted performance rankings on the PQMP Pediatric Asthma Emergency Department Use measure for a large number of health plans.
AHRQ-funded; HS025297; HS025299.
Citation: Bucholz EM, Toomey SL, McCulloch CE EM, Toomey SL, McCulloch CE . Adjusting for social risk factors in pediatric quality measures: adding to the evidence base. Acad Pediatr 2022 Apr;22(3s):S108-s14. doi: 10.1016/j.acap.2021.09.023..
Keywords: Children/Adolescents, Quality Measures, Quality of Care, Risk, Social Determinants of Health

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