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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 12 of 12 Research Studies DisplayedColey RY, Duan KI, Hoopes AJ
A call to integrate health equity into learning health system research training.
This paper is a call to integrate health equity into the competency domain for learning health systems (LHS) research training. In 2016, AHRQ recommended seven domains for training and mentoring researchers, but health equity was not included. Scholars in the Consortium for Applied Training to Advance the Learning health system with Scholars/Trainees (CATALyST) K12 program recommend that competency domains be extended to reflect growing demands for evidence on health inequities and interventions to alleviate them. The authors present real-life case studies in an LHS research training program that illustrate facilitators, challenges, and potential solutions at the program, funder, and research community-level to receiving training and mentorship in health equity-focused LHS science. They recommend actions in four areas for LHS research training programs: (a) integrate health equity throughout the current LHS domains; (b) develop training and mentoring in health equity; (c) establish program evaluation standards for consideration of health equity; and (d) bring forth relevant, extant expertise from the areas of health disparities research, community-based participatory research, and community-engaged health services research.
AHRQ-funded; HS026369.
Citation: Coley RY, Duan KI, Hoopes AJ .
A call to integrate health equity into learning health system research training.
Learn Health Syst 2022 Oct;6(4):e10330. doi: 10.1002/lrh2.10330..
Keywords: Learning Health Systems, Health Systems, Health Services Research (HSR), Training, Disparities
Franklin PD, Drane D, Wakschlag L
Development of a learning health system science competency assessment to guide training and proficiency assessment.
This paper describes the development of the learning health systems (LHS) Competency Assessment by the AHRQ-funded ACCELERAT K12 training program. Domain experts and trainees were recruited to define and operationalize items to include in an LHS Competency Assessment to support emerging and existing LHS scientists in prioritizing and monitoring proficiency development. The method used was to conduct sequential interviews with 18 experts who iteratively defined skills and tasks to illustrate stage in proficiency and its progression for each of 42 competencies in the seven LHS expertise domains: systems science; research questions and standards of scientific evidence; research methods; informatics; ethics of research and implementation in health systems; improvement and implementation science; and engagement, leadership, and research management. The LHS Competency Assessment was reviewed, and pilot tested by current trainees and further refinement was completed using their feedback. The LHS Competency Assessment was found to offer consistent, graded criteria across the seven LHS domains.
AHRQ-funded; HS026369.
Citation: Franklin PD, Drane D, Wakschlag L .
Development of a learning health system science competency assessment to guide training and proficiency assessment.
Learn Health Syst 2022 Oct;6(4):e10343. doi: 10.1002/lrh2.10343..
Keywords: Learning Health Systems, Health Systems, Health Services Research (HSR), Training, Education: Curriculum
Lozano PM, Lane-Fall M, Franklin PD
AHRQ Author: Chesley FD
Training the next generation of learning health system scientists.
The purpose of this paper was to describe the approaches developed by 11 Agency for Healthcare Research and Quality (AHRQ)- and Patient-Centered Outcomes Research Institute- funded Centers of Excellence (COEs) to grow the number of learning health systems (LHS) scientists. Program directors for each COE have provided descriptive program data since 2018. The authors found that since the program began, the 11 COEs have partnered with health systems to train 110 scholars. Nine programs partner with a Veterans Affairs health system and 9 partner with safety net providers. Clinically trained scholars include 70 physicians and 17 scholars in other clinical disciplines. Non-clinicians represent diverse fields, with most representing population health sciences. Challenges include guiding scholars through issues that can disrupt or delay projects during already-limited program time, such as delays in accessing data, organizational changes, pandemic impacts and others. The researchers concluded that the program documentation provides evidence of scholars' academic accomplishments and career-trajectory achievements.
AHRQ-authored; AHRQ-funded; HS026369; HS026370; HS026372; HS026379; HS026383; HS026385; HS026390; HS026393; HS026395; HS026396; HS026407
Citation: Lozano PM, Lane-Fall M, Franklin PD .
Training the next generation of learning health system scientists.
Learn Health Syst 2022 Oct;6(4):e10342. doi: 10.1002/lrh2.10342..
Keywords: Learning Health Systems, Health Systems, Patient-Centered Outcomes Research, Evidence-Based Practice, Training, Workforce
Bradford A, Shofer M, Singh H
AHRQ Author: Shofer M, Singh H
Measure Dx: implementing pathways to discover and learn from diagnostic errors.
This paper discusses Measure Dx, a new AHRQ resource that translates knowledge from diagnostic measurement research into actionable recommendations. This resource guides healthcare organizations to detect, analyze, and learn from diagnostic safety events as part of a continuous learning and feedback cycle. The goal of Measure Dx is to advance new frontiers in reducing preventable diagnostic harm to patients.
AHRQ-authored; AHRQ-funded; 233201500022I; HS027363.
Citation: Bradford A, Shofer M, Singh H .
Measure Dx: implementing pathways to discover and learn from diagnostic errors.
Int J Qual Health Care 2022 Sep 10;34(3). doi: 10.1093/intqhc/mzac068..
Keywords: Diagnostic Safety and Quality, Patient Safety, Quality Improvement, Quality of Care, Electronic Health Records (EHRs), Health Information Technology (HIT), Health Systems, Learning Health Systems
Perlin J, Sands K, Meyers D
AHRQ Author: Meyers D
Harnessing COVID-19 data through collaboration-rhe Consortium of HCA Healthcare and Academia for Research Generation.
This article describes the rapid initiation of a COVID-19 research consortium known as CHARGE (Consortium of HCA Healthcare and Academia for Research Generation), a multi-institution research partnership in conjunction AHRQ, and its resulting application of the learning health system model. HCA Healthcare developed a curated registry of data during the care of
121, 000 inpatients with COVID-19 in 2020, and AHRQ, along with other partners, helped guide the development of CHARGE to facilitate external researchers using registry data to expand evidence regarding the best management of COVID-19. While HCA Healthcare retained full control of its registry data sets and their use, consortium members were provided academic freedom to conduct approved studies. Through the process, 10 research projects were approved through March 2022. Topics included therapeutic efficacy, health equity, risk stratification, operation efficiency, and predictive models for COVID-19 outcomes. Operational support for all workgroups, including database management, subject matter expertise, legal and privacy consultation, and other support, was provided by HCA Healthcare. The researchers concluded that the development of CHARGE facilitated the development of research partnerships and data solutions to utilize immense amounts of health care data collected during the care of a large influx of critically ill patients.
121, 000 inpatients with COVID-19 in 2020, and AHRQ, along with other partners, helped guide the development of CHARGE to facilitate external researchers using registry data to expand evidence regarding the best management of COVID-19. While HCA Healthcare retained full control of its registry data sets and their use, consortium members were provided academic freedom to conduct approved studies. Through the process, 10 research projects were approved through March 2022. Topics included therapeutic efficacy, health equity, risk stratification, operation efficiency, and predictive models for COVID-19 outcomes. Operational support for all workgroups, including database management, subject matter expertise, legal and privacy consultation, and other support, was provided by HCA Healthcare. The researchers concluded that the development of CHARGE facilitated the development of research partnerships and data solutions to utilize immense amounts of health care data collected during the care of a large influx of critically ill patients.
AHRQ-authored.
Citation: Perlin J, Sands K, Meyers D .
Harnessing COVID-19 data through collaboration-rhe Consortium of HCA Healthcare and Academia for Research Generation.
JAMA Health Forum 2022 May 6;3(5):e220874. doi: 10.1001/jamahealthforum.2022.0874..
Keywords: COVID-19, Learning Health Systems, Health Systems, Registries
Bierman AS, Tong ST, McNellis RJ
AHRQ Author: Bierman AS, Tong ST, McNellis RJ
Realizing the dream: the future of primary care research.
In this article, the authors discussed the primary care research central to successful primary care transformation and to realizing the vision of a high-performing US health system to serve effectively all Americans and their communities while advancing health equity.
AHRQ-authored.
Citation: Bierman AS, Tong ST, McNellis RJ .
Realizing the dream: the future of primary care research.
Ann Fam Med 2022 Mar-Apr;20(2):170-74. doi: 10.1370/afm.2788..
Keywords: Primary Care, Healthcare Delivery, Evidence-Based Practice, Health Systems, Learning Health Systems, Patient-Centered Healthcare
Pestka DL, White KM, DeRoche KK
'Trying to fly the plane while we were building it'. applying a learning health systems approach to evaluate early-stage barriers and facilitators to implementing primary care transformation: a qualitative study.
This study’s objective was to examine the use of a learning health system (LHS) in primary care transformation (PCT) by utilizing the Consolidated Framework for Implementation Research (CFIR) to categorize implementation lessons. A large integrated health delivery system in Minnesota began implementation of a population management PCT in two of its 40 primary care clinics in May 2019. Semistructured qualitative interviews were conducted and observational field notes were taken. Inductive coding of the data was performed, and resultant codes were mapped to the CFIR. Seventeen codes emerged to describe care team members from the two clinics to adopt PCT occurring in each of the five CFIR domains (intervention characteristics, outer setting, inner setting, characteristics of individuals and process), with most codes occurring in the ‘inner setting’ domain.
AHRQ-funded; HS026379.
Citation: Pestka DL, White KM, DeRoche KK .
'Trying to fly the plane while we were building it'. applying a learning health systems approach to evaluate early-stage barriers and facilitators to implementing primary care transformation: a qualitative study.
BMJ Open 2022 Jan 3;12(1):e053209. doi: 10.1136/bmjopen-2021-053209..
Keywords: Learning Health Systems, Health Systems, Primary Care, Practice Improvement
Borsky AE, Savitz LA, Bindman AB
AHRQ Author: Borsky AE
AHRQ series on improving translation of evidence: perceived value of translational products by the AHRQ EPC Learning Health Systems Panel.
This paper discusses the outcomes of an evaluation of translational products for clinicians and healthcare providers by an EPC (Evidence-based Practice Center) Learning Health Systems Panel convened by AHRQ. The panel, led by two national leaders and composed of key stakeholders evaluated different translational products for learning health systems and also discussed challenges in adopting evidence-based practices. They evaluated a number of different products, and decided that the one- and three-page summaries, the MAGICapp and Tableau for interactive data visualization, and clinical encounter and health system decision aids were the most useful products. As a result of their findings, the EPC Program is further developing the one- and three-page summaries and MAGICapp and Tableau data visualization products.
AHRQ-authored; AHRQ-funded; 233201500014I.
Citation: Borsky AE, Savitz LA, Bindman AB .
AHRQ series on improving translation of evidence: perceived value of translational products by the AHRQ EPC Learning Health Systems Panel.
Jt Comm J Qual Patient Saf 2019 Nov;45(11):772-78. doi: 10.1016/j.jcjq.2019.08.002..
Keywords: Implementation, Evidence-Based Practice, Patient-Centered Outcomes Research, Learning Health Systems
White CM, Coleman CI, Jackman K
AHRQ series on improving translation of evidence: linking evidence reports and performance measures to help learning health systems use new information for improvement.
This paper analyzed ways to enhance usability of AHRQ’s Evidence-based Practice Center (EPC) reports. The reports are often lengthy and difficult for users to navigate. A quality measure index was created to allow health systems to more efficiently access relevant information. A test was created where two tables were embedded in an EPC report. The first identified quality measures covered by the report descriptively. The second contained page numbers in the executive summary which hyperlinked to those pages with the quality measures. An exercise with two health system-targeted scenarios was then created. The participants were timed how long it took to find answers to scenario questions and gave feedback. It was found that it took 63.4% less time to find quality measure information with the hyperlinked indexing tables than without. The participants felt that the tables were easy to use and more user friendly to health systems.
Jt Comm J Qual Patient Saf 2019 Oct;45(10):706-10. doi: 10.1016/j.jcjq.2019.05.002.
Citation: White CM, Coleman CI, Jackman K .
AHRQ series on improving translation of evidence: linking evidence reports and performance measures to help learning health systems use new information for improvement.
Jt Comm J Qual Patient Saf 2019 Oct;45(10):706-10. doi: 10.1016/j.jcjq.2019.05.002..
Keywords: Implementation, Evidence-Based Practice, Health Systems, Learning Health Systems, Patient-Centered Outcomes Research, Provider Performance, Quality Measures, Quality Improvement, Quality of Care
Fiordalisi C, Borsky A, Chang S
AHRQ EPC series on improving translation of evidence into practice for the learning health system: introduction.
This article introduces a special series of articles summarizing the AHRQ EPC program’s work to improve translation of high-quality evidence into practice. The authors summarize each of the nine EPC pilot projects and characterize the chosen approach to improve uptake of EPC review findings. They anticipate that the articles in this series will inform health systems about how others have tried to improve the translation of evidence into practice and use this information to inform their own efforts to bridge the evidence-to-practice gap going forward.
AHRQ-authored; AHRQ-funded; 290201700003C.
Citation: Fiordalisi C, Borsky A, Chang S .
AHRQ EPC series on improving translation of evidence into practice for the learning health system: introduction.
Jt Comm J Qual Patient Saf 2019 Aug;45(8):558-65. doi: 10.1016/j.jcjq.2019.05.006..
Keywords: Evidence-Based Practice, Learning Health Systems, Implementation, Quality Improvement, Quality of Care
Borsky AE, Flores EJ, Berliner E
AHRQ Author: Borsky AE, Berliner E, Chang C, Chang SM
Next steps in improving healthcare value: AHRQ Evidence-based Practice Center Program-applying the knowledge to practice to data cycle to strengthen the value of patient care.
This paper discusses AHRQ’s Evidence-based Practice Center (EPC) Program which has been in existence for over 20 years. The EPC program and its objectives are described. The three phases of the Learning Healthcare System cycle is described. A sample topic (hospital medicine Clostridium difficile colitis prevention and treatment) is used to describe the process and results of the effectiveness of the EPC program.
AHRQ-authored.
Citation: Borsky AE, Flores EJ, Berliner E .
Next steps in improving healthcare value: AHRQ Evidence-based Practice Center Program-applying the knowledge to practice to data cycle to strengthen the value of patient care.
J Hosp Med 2019 May;14(5):311-14. doi: 10.12788/jhm.3157..
Keywords: Evidence-Based Practice, Learning Health Systems, Implementation
Adler-Milstein J, Nong P, Friedman CP
AHRQ Author: Adler-Milstein J
Preparing healthcare delivery organizations for managing computable knowledge.
This article describes results of an AHRQ-funded conference where a group of experts from a range of fields examined the current state of knowledge management in healthcare delivery organizations. Conference presentations and discussions were recorded and analyzed by the authors in order to identify foundational concepts. The concepts identified are: the current state of knowledge management in healthcare delivery organizations is reliant upon an outdated biomedical library model, and only a small number of organizations have developed management approaches to push knowledge in computable form to frontline decisions; Learning Health Systems create a need for scalable computable knowledge management approaches; the ability to represent data science discoveries in computable form that are findable, accessible, interoperable, and reusable is fundamental to spreading knowledge at scale.
AHRQ-funded; HS025316.
Citation: Adler-Milstein J, Nong P, Friedman CP .
Preparing healthcare delivery organizations for managing computable knowledge.
Learn Health Syst 2019 Apr;3(2):e10070. doi: 10.1002/lrh2.10070..
Keywords: Healthcare Delivery, Learning Health Systems, Organizational Change, Health Systems