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Research Studies is a compilation of published research articles funded by ´óÏóÊÓƵor authored by ´óÏóÊÓƵresearchers.

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1 to 25 of 244 Research Studies Displayed
Dalal AK, Plombon S, Konieczny K
Adverse diagnostic events in hospitalised patients: a single-centre, retrospective cohort study.
The purpose of this study was to investigate the prevalence of harmful diagnostic errors during hospital stays. Researchers examined 675 general medicine cases, strategically oversampling high-risk patients including those transferred to intensive care, those who died within 90 days, and those with complex clinical events. Using trained adjudicators and expert panel reviews, they estimated that harmful diagnostic errors occurred in 7.2% of hospitalized patients—approximately one in every 14 patients. Of these errors, 6.1% were deemed preventable and 1.1% caused severe harm. Diagnostic delays represented the most common type of error with severely harmful errors occurring predominantly in high-risk cases. The study identified several process failures significantly associated with harmful diagnostic errors, including problems with assessment, diagnostic testing, subspecialty consultation, patient experience, and history-taking. These findings highlight the need for innovative approaches to monitor and prevent adverse diagnostic events in hospital settings.
AHRQ-funded; HS026613.
Citation: Dalal AK, Plombon S, Konieczny K . Adverse diagnostic events in hospitalised patients: a single-centre, retrospective cohort study. BMJ Qual Saf 2025 May 19; 34(6):377-88. doi: 10.1136/bmjqs-2024-017183..
Keywords: Diagnostic Safety and Quality, Adverse Events, Patient Safety, Inpatient Care, Hospitals
Diaz A, Mead M, Rohde S
Hospitals acquired by private equity firms: increased postoperative mortality for common inpatient surgeries.
The purpose of this study was to evaluate the impact of private equity acquisition on surgical outcomes in acute care hospitals. Using a difference-in-differences approach, researchers compared outcomes for Medicare beneficiaries undergoing four common general surgical operations across 67 private equity-acquired hospitals and 634 control hospitals. Results revealed that private equity acquisition was associated with a 2.7-percentage-point increase in thirty-day postoperative mortality compared to control hospitals. This higher mortality was primarily driven by a 3.9-percentage-point increase in failure to rescue, with no observed change in complication rates. Further analysis showed that mortality increases were particularly pronounced for emergency surgeries, while no significant changes occurred for elective procedures.
AHRQ-funded; HS028606.
Citation: Diaz A, Mead M, Rohde S . Hospitals acquired by private equity firms: increased postoperative mortality for common inpatient surgeries. Health Aff 2025 May; 44(5):554-62. doi: 10.1377/hlthaff.2024.01102.
Keywords: Hospitals, Surgery, Inpatient Care, Mortality, Healthcare Delivery
Lyndon A, Simpson KR, Landstrom GL
Relationship between nurse staffing during labor and cesarean birth rates in U.S. hospitals.
The purpose of this survey of U.S. labor nurses was to examine the relationship between labor/delivery staffing and hospital cesarean and vaginal birth after cesarean (VBAC) rates. Results indicated that better nurse staffing predicted lower cesarean birth rates and higher VBAC rates. The authors concluded that hospitals should be responsible for providing adequate nurse staffing during childbirth.
AHRQ-funded; HS025715.
Citation: Lyndon A, Simpson KR, Landstrom GL . Relationship between nurse staffing during labor and cesarean birth rates in U.S. hospitals. Nurs Outlook 2025 Mar-Apr; 73(2):102346. doi: 10.1016/j.outlook.2024.102346..
Keywords: Maternal Health, Hospitals, Inpatient Care, Provider: Nurse, Workforce
Markham JL, Hall M, Shah SS
Antibiotic Diversity Index: a novel metric to assess antibiotic variation among hospitalized children.
The objectives of this study were to develop a standardized metric to quantify antibiotic prescribing variability within and across children's hospitals, and to examine its association with outcomes. Data on children hospitalized with common pediatric infections were taken from the Pediatric Health Information System database. The authors developed and applied a metric that quantified diversity in antibiotic prescribing; the metric permitted comparisons across hospitals and can be leveraged to identify high-priority areas for local and national stewardship interventions.
AHRQ-funded; HS028845.
Citation: Markham JL, Hall M, Shah SS . Antibiotic Diversity Index: a novel metric to assess antibiotic variation among hospitalized children. J Hosp Med 2025 Jan; 20(1):8-16. doi: 10.1002/jhm.13470.
Keywords: Antibiotics, Medication, Children/Adolescents, Inpatient Care
Aklilu AM, Menez S, Baker ML
Early, individualized recommendations for hospitalized patients with acute kidney injury: a randomized clinical trial.
This randomized clinical trial evaluated whether personalized recommendations from a kidney action team improved outcomes for hospitalized patients with acute kidney injury (AKI). The study, conducted across seven hospitals in two health systems, involved 4,003 patients. In the intervention group, a team consisting of a physician and pharmacist delivered customized recommendations through electronic health records within one hour of AKI detection. The primary outcome measured was a composite of AKI progression, dialysis need, or mortality within 14 days of randomization. Despite making 14,539 recommendations and achieving higher implementation rates in the intervention group (33.8% vs 24.3% in usual care), the intervention did not significantly reduce the primary outcome.
AHRQ-funded; HS027626.
Citation: Aklilu AM, Menez S, Baker ML . Early, individualized recommendations for hospitalized patients with acute kidney injury: a randomized clinical trial. JAMA 2024 Dec 24; 332(24):2081-90. doi: 10.1001/jama.2024.22718.
Keywords: Inpatient Care, Kidney Disease and Health, Electronic Health Records (EHRs), Health Information Technology (HIT), Teams, Patient-Centered Outcomes Research
Jakubowski A, Singh-Tan S, Torres-Lockhart K
Addiction consult service and inpatient outcomes among patients with OUD.
The purpose of this study was to evaluate how addiction consultation services affect treatment outcomes for hospitalized patients with opioid use disorder. The research compared 100 cases receiving consultation against 100 matched controls, examining medication initiation and post-discharge care. Patients who received consultation showed higher rates of starting medication treatment during hospitalization and maintaining treatment after discharge. The investigation revealed that consulted patients were more likely to receive buprenorphine prescriptions and connect with methadone programs. The findings demonstrated the value of specialized addiction services in promoting evidence-based care.
AHRQ-funded; HS026396.
Citation: Jakubowski A, Singh-Tan S, Torres-Lockhart K . Addiction consult service and inpatient outcomes among patients with OUD. J Gen Intern Med 2024 Nov; 39(15):2961-69. doi: 10.1007/s11606-024-08837-0.
Keywords: Opioids, Substance Abuse, Behavioral Health, Medication, Inpatient Care
Reffat N, Schwei, RJ, Griffin M
A scoping review of bacterial resistance among inpatients amidst the COVID-19 pandemic.
A comprehensive literature review examined antimicrobial resistance patterns in hospital settings before and during the COVID-19 pandemic. The analysis covered 55 studies from multiple databases through June 2023, focusing on clinical bacterial cultures from inpatients. The most studied organisms included Acinetobacter baumannii, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Staphylococcus aureus. Among 464 antimicrobial resistance results analyzed, most showed no significant changes during the pandemic period, while smaller percentages demonstrated increases or decreases in resistance patterns.
AHRQ-funded; HS028669.
Citation: Reffat N, Schwei, RJ, Griffin M . A scoping review of bacterial resistance among inpatients amidst the COVID-19 pandemic. J Glob Antimicrob Resist 2024 Sep; 38:49-65. doi: 10.1016/j.jgar.2024.05.010..
Keywords: COVID-19, Inpatient Care, Antimicrobial Stewardship, Antibiotics, Medication
Byrd TF, Phelan TA, Ingraham NE
Beyond unplanned ICU transfers: linking a revised definition of deterioration to patient outcomes.
The objectives of this retrospective study were to develop an electronic descriptor of clinical deterioration for hospitalized patients that can predict short-term mortality and identify patient deterioration earlier than current standard definitions. Subjects were adult patients within a 12-hospital community-academic health system who had an acute hospital encounter between 2018 and 2022. The results indicated that the revised definition of deterioration established an electronic descriptor of clinical deterioration strongly associated with short-term mortality and length of stay, and identified deterioration over 2.5 hours earlier than ICU transfer. The authors concluded that incorporation of the revised definition of deterioration into training and validation of early warning system algorithms may enhance their timeliness and clinical accuracy.
AHRQ-funded; HS029744.
Citation: Byrd TF, Phelan TA, Ingraham NE . Beyond unplanned ICU transfers: linking a revised definition of deterioration to patient outcomes. Crit Care Med 2024 Sep; 52(9):e439-e49. doi: 10.1097/ccm.0000000000006333..
Keywords: Intensive Care Unit (ICU), Inpatient Care
Kast KA, Le TDV , Stewart LS
Impact of inpatient addiction psychiatry consultation on opioid use disorder outcomes.
This retrospective cohort study assessed opioid use disorder (OUD) outcomes associated with addiction consultation during hospital admission. The cohort included individuals admitted to an academic medical center between 2018 and 2023. Primary outcomes included initiating medication for OUD (MOUD), hospital length of stay, before-medically-advised (BMA) discharge, and 30- and 90-day postdischarge acute care utilization. Of 26,766 admissions with 10,501 patients with OUD, 2826 addiction consultations were completed. The consultation cohort were more likely to be young, male, and White than the controls. Consultation was associated with greater MOUD initiation (adjusted odds ratio [aOR], 5.07), fewer emergency department visits at 30 (aOR, 0.78) and 90 (aOR, 0.79) days, and fewer hospitalizations at 30 (aOR, 0.656) and 90 (aOR, 0.67) days. Consultation patients were also more likely to have a longer hospital stay and leave BMA.
AHRQ-funded; HS029695.
Citation: Kast KA, Le TDV , Stewart LS . Impact of inpatient addiction psychiatry consultation on opioid use disorder outcomes. Am J Addict 2024 Sep; 33(5):543-50. doi: 10.1111/ajad.13540..
Keywords: Opioids, Inpatient Care, Substance Abuse, Behavioral Health, Outcomes
Darivemula SM, Massengale KE, Montiel C
Postpartum menstrual equity: video and audio analysis of vaginal bleeding counseling during postpartum inpatient care at a southeastern US tertiary hospital.
This observational study’s objective was to evaluate the patterns and content of vaginal bleeding counseling provided to birthing parents while on a postnatal inpatient unit. Data was collected from 15 families at a tertiary hospital in the southeastern US. Video and audio data were coded by a multidisciplinary team from each family from 12 hours before hospital discharge. Parent participants were self-identified Spanish-speaking Hispanic White, non-Hispanic Black, non-Hispanic White, and non-Hispanic multi-race. Different amounts of communication were found: 12 of the 15 birthing parents had communication on these topics between 2 and 5 times, 2 had one exchange, and 1 had no counseling on postpartum bleeding observed. Four of the six Spanish-speaking birthing parents had counseling on these topics that was not in Spanish. The authors concluded there was a lack of adequate access, variation in accurate and respectful care, and a busy clinical environment with differences in information provided.
AHRQ-funded; HS027260.
Citation: Darivemula SM, Massengale KE, Montiel C . Postpartum menstrual equity: video and audio analysis of vaginal bleeding counseling during postpartum inpatient care at a southeastern US tertiary hospital. Womens Health 2024 Jan-Dec; 20:17455057241274897. doi: 10.1177/17455057241274897..
Keywords: Maternal Health, Women, Inpatient Care, Hospitals
Studenmund C, Lyndon A, Stotts JR
What do patients and families observe about pediatric safety?: A thematic analysis of real-time narratives.
The Family Input for Quality and Safety (FIQS) study aimed to capture real-time safety observations from pediatric patients and their families during hospitalization through a mobile health tool. An analysis of 120 narrative reports from 58 participants revealed that 57% met safety event criteria, with only 0.8% corresponding to staff-reported incident reports. Key safety domains identified included patients as safety actors, emotional safety, and system-centered care. The findings suggest that integrating patient and family observations could enhance hospital safety data collection and improve patient safety initiatives.
AHRQ-funded; HS024553; HS028477.
Citation: Studenmund C, Lyndon A, Stotts JR . What do patients and families observe about pediatric safety?: A thematic analysis of real-time narratives. J Hosp Med 2024 Sep; 19(9):765-76. =. doi: 10.1002/jhm.13388..
Keywords: Patient Safety, Quality of Care, Inpatient Care
Banks CA, Blakeslee-Carter J, Nkie V
Occurrence, predictors, and management of late vascular complications following extracorporeal membrane oxygenation.
This study investigated late vascular complications following extracorporeal membrane oxygenation (ECMO) after hospital discharge. Among 116 ECMO survivors, 7.8% developed late complications, primarily infections and limb-threatening ischemia. Most cases occurred in patients who had peripheral veno-arterial ECMO and previous vascular complications during hospitalization. Surgical interventions were frequently required, with arterial revascularization being the most common procedure. Patients requiring ECMO during cardiopulmonary resuscitation faced higher risks of late complications.
AHRQ-funded; HS013852.
Citation: Banks CA, Blakeslee-Carter J, Nkie V . Occurrence, predictors, and management of late vascular complications following extracorporeal membrane oxygenation. J Vasc Surg 2024 Sep; 80(3):864-72.e1. doi: 10.1016/j.jvs.2024.04.041.
Keywords: Cardiovascular Conditions, Adverse Events, Inpatient Care
Schondelmeyer AC, Sauers-Ford H, Touzinsky SM
Clinician perspectives on continuous monitor use in a children's hospital: a qualitative study.
This qualitative study explored how clinical providers at a children's hospital make decisions regarding continuous cardiopulmonary monitor (cCPM) use. Interviews with 24 clinicians revealed that cCPM initiation often occurs by default upon admission, viewed as a low-risk intervention to manage uncertainty. However, there is no structured process for discontinuation, indicating a need for targeted interventions to address these practices and reduce unnecessary monitor use.
AHRQ-funded; HS026763.
Citation: Schondelmeyer AC, Sauers-Ford H, Touzinsky SM . Clinician perspectives on continuous monitor use in a children's hospital: a qualitative study. Hosp Pediatr 2024 Aug; 14(8):649-57. doi: 10.1542/hpeds.2023-007638..
Keywords: Children/Adolescents, Provider: Clinician, Inpatient Care, Hospitals
Crook H, Horta M, Michelson KA
Performance of health care service area definitions for capturing variation in inpatient care and social determinants of health.
The objective of this study was to quantify the degree to which health care service area (HCSA) definitions captured hospitalizations and heterogeneity in social determinants of health (SDOH). The authors used geospatial data from the Centers for Medicare and Medicaid Services, the Census Bureau, and the Dartmouth Institute, Fee-For-Service Medicare data from 48 states, drive-time isochrones from MapBox. And 2017 inpatient discharge data from HCUP State Inpatient Databases for Arizona, Florida, Iowa, Maryland, Nebraska, New Jersey, New York, and Wisconsin. The principal findings showed that HCSA definitions captured a wide range of inpatient discharges. The proportion of hospital discharges captured by each HCSA varied; Metropolitan Statistical Areas (MSAs) captured the highest proportion of discharges and Public Use Microdata Areas (PUMAs) captured the lowest. The authors noted that researchers face a trade-off between capture rate and population homogeneity when deciding which HCSA to use.
AHRQ-funded; HS025976.
Citation: Crook H, Horta M, Michelson KA . Performance of health care service area definitions for capturing variation in inpatient care and social determinants of health. Health Serv Res 2024 Aug; 59(4):e14312. doi: 10.1111/1475-6773.14312..
Keywords: Healthcare Cost and Utilization Project (HCUP), Social Determinants of Health, Inpatient Care
Pecanac KE, Jaeb M, Larson M
Clinicians navigating moral accountability when discussing parental behaviors in the care of the child in the hospital.
The purpose of this study was to explore the navigation of moral accountability when clinicians talk about parental behaviors to support the health of hospitalized children. Researchers conducted a secondary data analysis of video recorded conversations during daily rounds in one children's hospital. Two phenomena were apparent: physicians avoided or delayed parental agency in references to parent behaviors; parents demonstrated, and clinicians reassured, parental competence in caring for children. The researchers concluded that physicians appeared oriented toward the potential moral implications of asking about parental behavior. Avoiding attributions of agency and moral accountability as well as providing reassurance for the parents' competence may be useful for clinicians to maintain a good relationship with the parents of children in the hospital setting.
AHRQ-funded; HS018680.
Citation: Pecanac KE, Jaeb M, Larson M . Clinicians navigating moral accountability when discussing parental behaviors in the care of the child in the hospital. Patient Educ Couns 2024 Aug; 125:108317. doi: 10.1016/j.pec.2024.108317..
Keywords: Children/Adolescents, Communication, Inpatient Care
Chrouser K, Fowler KE, Mann JD
Urinary retention evaluation and catheterization algorithm for adult inpatients.
The objective of this mixed-methods study was to develop an algorithm for screening and management of urinary retention (UR) among adult inpatients. Using the RAND/UCLA Appropriateness Method and qualitative interviews, a multidisciplinary expert panel of nurses and physicians from across the U.S. rated clinical scenarios involving diagnosis and management of adult UR in postoperative and medical inpatients; panel ratings informed the first algorithm draft. The draft algorithm was iteratively refined based on stakeholder feedback. The UR algorithm including the following: bladder scanners preferred over catheterization for UR diagnosis in symptomatic patients; bladder scanner volumes appropriate to prompt catheterization in symptomatic patients and asymptomatic patients; intermittent preferred to indwelling catheterization for managing lower bladder volumes. The authors concluded that the algorithm addresses the need for practical guidance to manage UR among adult inpatients.
AHRQ-funded; 2902010000025I; HS026912.
Citation: Chrouser K, Fowler KE, Mann JD . Urinary retention evaluation and catheterization algorithm for adult inpatients. JAMA Netw Open 2024 Jul; 7(7):e2422281. doi: 10.1001/jamanetworkopen.2024.22281..
Keywords: Inpatient Care
Bogojevic M, Bansal V, Pattan V
Association of hypothyroidism with outcomes in hospitalized adults with COVID-19: results from the International SCCM Discovery Viral Infection and Respiratory Illness Universal Study (VIRUS): COVID-19 Registry.
The objectives of this observational cohort study were to identify frequency of hypothyroidism in hospitalized patients with COVID-19 as well as to describe differences in outcomes between patients with and without pre-existing hypothyroidism. Participants were patients 18 years or older with laboratory-confirmed severe acute respiratory syndrome coronavirus-2 infection; pre-existing hypothyroidism was identified in 7.9%. The results indicated that pre-existing hypothyroidism in hospitalized COVID-19 patients was not associated with higher disease severity or increased risk of mortality. The researchers noted that further research will be needed on the possible effects of COVID-19 on the thyroid gland and its function.
AHRQ-funded; HS026609; HS026485.
Citation: Bogojevic M, Bansal V, Pattan V . Association of hypothyroidism with outcomes in hospitalized adults with COVID-19: results from the International SCCM Discovery Viral Infection and Respiratory Illness Universal Study (VIRUS): COVID-19 Registry. Clin Endocrinol 2024 Jul; 101(1):85-93. doi: 10.1111/cen.14699.
Keywords: COVID-19, Inpatient Care, Outcomes
Sun C, Fu C, Cato K
Characterizing nursing time with patients using computer vision.
This study aimed to characterize nurses' interactions with patients at the bedside using innovative continuous surveillance technology over a one-year period. The research employed a device called AUGi, which combines obfuscated computer vision with Bluetooth beacons on nurses' identification badges to track their activities. The study was conducted in two medical/surgical units of a major urban hospital, covering 37 patient beds and involving 49 nurses. Data collection took place from April 15, 2019, to March 15, 2020. The study analyzed 408,588 interactions across 670 shifts, revealing more frequent interactions during day shifts compared to night shifts, although night shift interactions were slightly longer on average. Each nurse averaged 7.86 interactions per bed per shift, with a mean total interaction time of 9.39 minutes per bed. Nurses typically covered about 7.43 beds per shift, with a slight difference between day and night shifts. The study also examined specific nursing activities, finding that hourly rounding averaged 69.5 seconds and bedside shift reports averaged 50.1 seconds. Notably, bedside shift reports were only completed 20.7% of the time, while hourly rounding occurred 52.9% of the time.
AHRQ-funded; HS027006.
Citation: Sun C, Fu C, Cato K . Characterizing nursing time with patients using computer vision. J Nurs Scholarsh 2024 Jul; 56(4):599-605. doi: 10.1111/jnu.12971.
Keywords: Provider: Nurse, Nursing, Inpatient Care
Popov V, Tan Y, Manojlovich M
Applying ordered network analysis to video-recorded physician-nurse interactions to examine communication patterns associated with shared understanding in inpatient oncology care settings.
This study’s main objective was to demonstrate how ordered network analysis of video-recorded interactions combined with verbal response mode (VRM) coding (eg, edification, disclosure, reflection and interpretation) can uncover specific communication patterns that contribute to the development of shared understanding between physicians and nurses. This study was conducted on two oncology units at a large Midwestern academic health care system with a total of 33 unique physician-nurse dyadic interactions included in the analysis. Primary outcome measure was the development of shared understanding between physicians and nurses, as determined by prior qualitative analysis, and secondary measures were the frequencies, orders, and co-occurrences of VRM codes in the interactions. A Mann-Whitney U test showed that dyads that reached shared understanding (N=6) were statistically significantly different from dyads that did not reach shared understanding (N=25) in terms of the sequential relationships between edification and disclosure, edification and advisement, as well as edification and questioning. More edification followed by disclosure was a characteristic of dyads that reached shared understanding.
AHRQ-funded; HS022305; HS024914; HS024760.
Citation: Popov V, Tan Y, Manojlovich M . Applying ordered network analysis to video-recorded physician-nurse interactions to examine communication patterns associated with shared understanding in inpatient oncology care settings. BMJ Open 2024 Jun 17; 14(6):e084653. doi: 10.1136/bmjopen-2024-084653.
Keywords: Communication, Inpatient Care, Provider: Physician, Provider: Nurse
Quigley DD, Elliott MN, Slaughter ME
Narrative comments about pediatric inpatient experiences yield substantial information beyond answers to closed-ended CAHPS survey questions.
The authors investigated if narrative comments on the CAHPS® survey of inpatient pediatric care (Child HCAHPS) accounted for global perceptions of hospitals beyond those explained by reports about specific aspects of care. They analyzed 545 comments from 927 Child HCAHPS surveys completed by parents and guardians of hospitalized children. The narrative comment data provided significant additional information about what was important to parents and guardians during inpatient pediatric care. The authors concluded that quality improvement efforts should include a review of narrative comments alongside closed-ended responses to identify ways to improve inpatient care experiences. Comments should also be encouraged for racial-and-ethnic minority patients and those with lower educational attainment to promote health equity.
AHRQ-funded; HS025920; HS029321.
Citation: Quigley DD, Elliott MN, Slaughter ME . Narrative comments about pediatric inpatient experiences yield substantial information beyond answers to closed-ended CAHPS survey questions. J Pediatr Nurs 2024 May-Jun; 76:e126-e31. doi: 10.1016/j.pedn.2024.02.016..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Provider, Children/Adolescents, Inpatient Care, Hospitals, Patient Experience
Collins ME, Hall M, Shah SS
Phlebotomy-free days in children hospitalized with common infections and their association with clinical outcomes.
This study looked at the association of clinical outcomes of phlebotomy-free days (PFDs) in children hospitalized with common infections. The authors performed a cross-sectional study of children hospitalized 2018-2019 with common infections at 38 hospitals using the Pediatric Health Information System database. They included infectious All Patients Refined Diagnosis Related Groups with a median length of stay (LOS) >2 days. They defined PFDs as hospital days (midnight to midnight) without laboratory blood testing and measured the proportion of PFDs divided by total hospital LOS (PFD ratio) for each condition and hospital. The higher the PDF ratio, the more days without phlebotomy. They identified 126,135 encounters with bronchiolitis (0.78) and pneumonia (0.54) having the highest PDF ratios, while osteoarticular infections (0.28) and gastroenteritis (0.30) having the lowest PDF ratios. There were no differences in adjusted clinical outcomes across the ratio groups. No association with clinical outcomes were found.
AHRQ-funded; HS028845.
Citation: Collins ME, Hall M, Shah SS . Phlebotomy-free days in children hospitalized with common infections and their association with clinical outcomes. J Hosp Med 2024 Apr; 19(4):251-58. doi: 10.1002/jhm.13282..
Keywords: Children/Adolescents, Inpatient Care, Pneumonia, Respiratory Conditions
Bradford W, Akselrod H, Bassler J
Hospitalization is a missed opportunity for HIV screening, pre-exposure prophylaxis, and treatment.
This multisite, retrospective cohort study of hospitalized patients with opioid use disorder with infectious complications of injection drug use looked at rates of HIV screening, pre-exposure prophylaxis, and treatment among these patients. The authors included 322 patients, with most (300) now known to have HIV. Of those, only 2 had a documented discussion of PrEP, while only 1 was prescribed PrEP on discharge. Among the 22 people with HIV (PWH), only 13 had a viral load collected during admission of whom all were viremic and 10 were successfully linked to care post-discharge. Both groups had high rates of readmission, Medicaid or uninsured status, and unstable housing.
AHRQ-funded; HS013852.
Citation: Bradford W, Akselrod H, Bassler J . Hospitalization is a missed opportunity for HIV screening, pre-exposure prophylaxis, and treatment. Addict Sci Clin Pract 2024 Mar 26; 19(1):22. doi: 10.1186/s13722-024-00451-z..
Keywords: Human Immunodeficiency Virus (HIV), Screening, Prevention, Inpatient Care
Auerbach AD, Lee TM, Hubbard CC
Diagnostic errors in hospitalized adults who died or were transferred to intensive care.
The objective of this retrospective cohort study was to determine the prevalence, underlying causes, and harms of diagnostic errors in hospitalized adults who were transferred to an intensive care unit or who died. Data was taken from 29 academic medical centers in the U.S. in a random sample of adults hospitalized with general medical conditions. Errors were found to have contributed to temporary harm, permanent harm, or death in nearly 18% of patients; among patients who died, diagnostic error was judged to have contributed to death in 6.6% of cases. The researchers noted that problems with choosing and interpreting tests and the processes involved with clinician assessment were a high priority for improvement efforts.
AHRQ-funded; HS027369.
Citation: Auerbach AD, Lee TM, Hubbard CC . Diagnostic errors in hospitalized adults who died or were transferred to intensive care. JAMA Intern Med 2024 Feb; 184(2):164-73. doi: 10.1001/jamainternmed.2023.7347..
Keywords: Diagnostic Safety and Quality, Medical Errors, Hospitals, Inpatient Care, Quality of Care, Patient Safety, Adverse Events
Wolf RM, Hall M, Williams DJ
Disparities in pharmacologic restraint for children hospitalized in mental health crisis.
This retrospective cohort study examined associations between pharmacologic restraint use and race and ethnicity among children (aged 5-≤18 years) admitted for mental health conditions to acute care nonpsychiatric children's hospitals. Study period was 2018 to 2022 and was conducted at 41 US children’s hospitals and included a cohort of 61,503 hospitalizations. Compared with non-Hispanic Black children, children of non-Hispanic White (adjusted odds ratio [aOR], 0.81), Asian (aOR, 0.82), or other race and ethnicity (aOR, 0.68) were less likely to receive pharmacologic restraint, with no significant difference with Hispanic children. When stratified by sex, racial/ethnic differences were magnified in males, except for Hispanic males, and not found in females. Sensitivity analysis revealed amplified disparities for all racial/ethnic groups, including Hispanic youth.
AHRQ-funded; HS026122.
Citation: Wolf RM, Hall M, Williams DJ . Disparities in pharmacologic restraint for children hospitalized in mental health crisis. Pediatrics 2024 Jan; 153(1). doi: 10.1542/peds.2023-061353..
Keywords: Disparities, Children/Adolescents, Behavioral Health, Inpatient Care, Hospitals, Medication
Quinn M, Horowitz JK, Krein SL
The role of hospital-based vascular access teams and implications for patient safety: a multi-methods study.
The purpose of this study was to examine the roles, functions, and composition of vascular access teams (VATs) related to the use and management of PICC and midline catheters. The researchers administered an online survey of 62 hospitals participating in a quality improvement consortium and qualitative interviews with 74 hospital-based clinicians in 10 sites. The study found that more than 77% of hospitals had an on-site VAT. The average team size was seven nurses; their main function was device insertion. Findings from the interviews revealed variations in team characteristics and functions. Interviewees characterized the broad role that teams play in device insertion, care, and removal, and in educating/training hospital staff. The researchers found that teams' role in decision making, especially related to appropriate device selection, was limited an was met with physician resistance in some cases.
AHRQ-funded; HS025891.
Citation: Quinn M, Horowitz JK, Krein SL . The role of hospital-based vascular access teams and implications for patient safety: a multi-methods study. J Hosp Med 2024 Jan; 19(1):13-23. doi: 10.1002/jhm.13253..
Keywords: Patient Safety, Inpatient Care, Cardiovascular Conditions

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