National Healthcare Quality and Disparities Report
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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 16 of 16 Research Studies DisplayedNguyen AM, Cuthel AM, Rogers ES
Attributes of high-performing small practices in a guideline implementation: a multiple-case study.
This study called HealthyHearts NYC was a stepped wedge randomized control trial that tested the effectiveness of practice facilitation in small primary care practices in adopting cardiovascular disease guidelines. The practice-level benchmark desired was having 70% or greater of hypertensive patients having controlled blood pressure. A mixed methods multiple-case study design was used and implemented at 6 small practices. The investigator’s first key finding was that the high-performing and improved practices in their study looked and acted similarly during the intervention implementation. Three key attributes of these practices were found to be: 1) advanced use of electronic health records; 2) dedicated resources and commitment to quality improvement; and 3) an actively engaged lead clinician and office manager.
AHRQ-funded; HS023922.
Citation: Nguyen AM, Cuthel AM, Rogers ES .
Attributes of high-performing small practices in a guideline implementation: a multiple-case study.
J Prim Care Community Health 2020 Jan-Dec;11. doi: 10.1177/2150132720984411..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Primary Care, Evidence-Based Practice, Guidelines, Implementation
Knerr S, West KM, Angelo FA
Organizational readiness to implement population-based screening and genetic service delivery for hereditary cancer prevention and control.
Programs conducting population-based screening and genetic service delivery for hereditary cancer prevention and control are rare in practice. The authors interviewed individuals instrumental in implementing seven unique clinical programs conducting either universal tumor screening for Lynch Syndrome or routine family history screening and provision of genetic services for hereditary breast and ovarian cancer in the United States. Their findings suggest that developing interventions targeting change efficacy and cultivating practice change champions may be two promising ways to increase uptake of population-based hereditary cancer screening and genetic service delivery in clinical practice.
AHRQ-funded; HS022982.
Citation: Knerr S, West KM, Angelo FA .
Organizational readiness to implement population-based screening and genetic service delivery for hereditary cancer prevention and control.
J Genet Couns 2020 Oct;29(5):867-76. doi: 10.1002/jgc4.1216.
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Keywords: Cancer, Screening, Genetics, Prevention, Guidelines, Healthcare Delivery, Organizational Change, Implementation
Kaiser SV, Lam Cabana, MD
Best practices in implementing inpatient pediatric asthma pathways: a qualitative study.
The objective of this study was to identify potential best practices in pathway implementation. Building upon a previous observational study in which the researchers identified higher and lower performing children's hospitals based on hospital-level changes in asthma patient length of stay after implementation of a pathway, they conducted semi-structured interviews with a sample of healthcare providers involved in pathway implementation at these hospitals. They identified several potential best practices to support pathway implementation. They recommended that hospitals implementing pathways consider applying these strategies to ensure success in improving quality of asthma care for children.
AHRQ-funded; HS024592.
Citation: Kaiser SV, Lam Cabana, MD .
Best practices in implementing inpatient pediatric asthma pathways: a qualitative study.
J Asthma 2020 Jul;57(7):744-54. doi: 10.1080/02770903.2019.1606237..
Keywords: Children/Adolescents, Asthma, Respiratory Conditions, Hospitals, Inpatient Care, Guidelines, Evidence-Based Practice, Implementation, Quality Improvement, Quality of Care
Ngo-Metzger Q, Mabry-Hernandez IR
AHRQ Author: Ngo-Metzger Q, Mabry-Hernandez
Implementation of evidence-based recommendations for preventive services in the Veterans Health Administration.
The Veterans Health Administration (VHA) is the largest integrated health care system in the United States. To date, there has been scant research on how VHA adopts clinical preventive services guidelines and how U.S. Preventive Services Task Force recommendations factor into the process. In this study, the investigators conducted semistructured interviews with eight VHA leaders to examine how they adopt, disseminate, and measure adherence to recommendations. They concluded that provision of evidence-based clinical preventive services is an important part of VHA's effort to provide high-quality care for Veterans.
AHRQ-authored.
Citation: Ngo-Metzger Q, Mabry-Hernandez IR .
Implementation of evidence-based recommendations for preventive services in the Veterans Health Administration.
J Healthc Qual 2020 May/Jun;42(3):148-56. doi: 10.1097/jhq.0000000000000217..
Keywords: U.S. Preventive Services Task Force (USPSTF), Prevention, Evidence-Based Practice, Guidelines, Implementation
Jiang V, Brooks EM, Tong ST
Factors influencing uptake of changes to clinical preventive guidelines.
Despite widespread recognition that adherence to clinical preventive guidelines improves patient outcomes, clinicians struggle to implement guideline changes in a timely manner. Multiple factors influence guideline adoption and effective implementation. However, few studies evaluate their collective and inter-related effects. This qualitative study provided a comprehensive picture of the interplay between multiple factors on uptake of new or changed preventive guidelines.
AHRQ-funded; HS025032.
Citation: Jiang V, Brooks EM, Tong ST .
Factors influencing uptake of changes to clinical preventive guidelines.
J Am Board Fam Med 2020 Mar-Apr;33(2):271-78. doi: 10.3122/jabfm.2020.02.190146..
Keywords: Guidelines, Evidence-Based Practice, Implementation, Prevention
Petkovic J, Riddle A, Akl EA
AHRQ Author: Chang SM
Protocol for the development of guidance for stakeholder engagement in health and healthcare guideline development and implementation.
Stakeholder engagement has become widely accepted as a necessary component of guideline development and implementation. While frameworks for developing guidelines express the need for those potentially affected by guideline recommendations to be involved in their development, there is a lack of consensus on how this should be done in practice. In this study, the investigators aimed to develop guidance for the meaningful and equitable engagement of multiple stakeholders in guideline development and implementation.
AHRQ-authored.
Citation: Petkovic J, Riddle A, Akl EA .
Protocol for the development of guidance for stakeholder engagement in health and healthcare guideline development and implementation.
Syst Rev 2020 Feb 1;9(1):21. doi: 10.1186/s13643-020-1272-5..
Keywords: Guidelines, Implementation, Evidence-Based Practice
Jue JJ, Cunningham S, Lohr K
AHRQ Author: Nix M
Developing and testing the Agency for Healthcare Research and Quality's National Guideline Clearinghouse Extent of Adherence to Trustworthy Standards (NEATS) Instrument.
In 2011, the Institute of Medicine (IOM) (now the National Academy of Medicine) published standards for trustworthy guidelines and recommended that the National Guideline Clearinghouse (NGC) of the Agency for Healthcare Research and Quality clearly indicate the extent to which guidelines adhere to these standards. To accomplish this, the authors developed and tested the NGC Extent of Adherence to Trustworthy Standards (NEATS) instrument which they discuss in this paper.
AHRQ-authored; AHRQ-funded; 290-2013-00006C.
Citation: Jue JJ, Cunningham S, Lohr K .
Developing and testing the Agency for Healthcare Research and Quality's National Guideline Clearinghouse Extent of Adherence to Trustworthy Standards (NEATS) Instrument.
Ann Intern Med 2019 Apr 2. doi: 10.7326/m18-2950..
Keywords: Implementation, Evidence-Based Practice, Guidelines
Armstrong MJ, Gronseth GS
Approach to assessing and using clinical practice guidelines.
Knowing when to use guidelines in clinical practice requires neurologists to assess the rigor of published guidelines. This review briefly describes guideline definitions and the American Academy of Neurology process for guideline development, outlines key elements for assessing guideline quality, and details a practical approach for incorporating guideline recommendations when partnering with patients in shared decision-making.
AHRQ-funded; HS024159.
Citation: Armstrong MJ, Gronseth GS .
Approach to assessing and using clinical practice guidelines.
Neurol Clin Pract 2018 Feb;8(1):58-61. doi: 10.1212/cpj.0000000000000417.
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Keywords: Shared Decision Making, Evidence-Based Practice, Guidelines, Patient and Family Engagement, Implementation
Doherty JA, Crelia SJ, Smith MW
AHRQ Author: Mabry-Hernandez IR, Ngo-Metzger Q
Large health systems' prevention guideline implementation: a qualitative study.
In 2015, researchers conducted and analyzed interviews with quality leaders from eight hospital-based systems and one physician organization who explained organizational processes to adapt, adopt, disseminate, and incentivize adherence to preventive services guidelines. Nearly all have a formal process for reviewing and refining guidelines, developing clinician support, and disseminating the approved guidelines.
AHRQ-authored.
Citation: Doherty JA, Crelia SJ, Smith MW .
Large health systems' prevention guideline implementation: a qualitative study.
Am J Prev Med 2018 Jan;54(1s1):S88-s94. doi: 10.1016/j.amepre.2017.07.025.
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Keywords: Primary Care, Guidelines, Evidence-Based Practice, Prevention, Implementation, Healthcare Delivery
Probst MA, Dayan PS, Raja AS
Knowledge translation and barriers to imaging optimization in the emergency department: a research agenda.
This article outlines a research agenda to promote the dissemination and implementation (also known as knowledge translation) of evidence-based interventions for emergency department (ED) imaging, i.e., clinical pathways, clinical decision instruments, and clinical practice guidelines. A multidisciplinary group of stakeholders held online and telephone discussions over a 6-month period culminating at the 2015 Academic Emergency Medicine consensus conference. They were able to identify four overarching research questions.
AHRQ-funded; HS023498.
Citation: Probst MA, Dayan PS, Raja AS .
Knowledge translation and barriers to imaging optimization in the emergency department: a research agenda.
Acad Emerg Med 2015 Dec;22(12):1455-64. doi: 10.1111/acem.12830.
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Keywords: Emergency Department, Evidence-Based Practice, Health Services Research (HSR), Guidelines, Imaging, Implementation
Dolor RJ, Campbell-Voytal K, Daly J
Practice-based Research Network Research Good Practices (PRGPs): summary of recommendations.
The authors summarized recommendations for improving research processes within practice-based research networks (PBRNs) to ensure research integrity. The result, the PBRN Research Good Practices (PRGPs) document, is organized into four chapters: (1) Building PBRN Infrastructure; (2) Study Development and Implementation; (3) Data Management, and (4) Dissemination Policies.
AHRQ-funded; HS021641; HS021644; HS016713; HS019601.
Citation: Dolor RJ, Campbell-Voytal K, Daly J .
Practice-based Research Network Research Good Practices (PRGPs): summary of recommendations.
Clin Transl Sci 2015 Dec;8(6):638-46. doi: 10.1111/cts.12317.
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Keywords: Guidelines, Practice-Based Research Network (PBRN), Research Methodologies, Implementation
Narayanaswami P, Gronseth G, Dubinsky R
The impact of social media on dissemination and implementation of clinical practice guidelines: a longitudinal observational study.
The researchers’ aim was to develop and evaluate an innovative dissemination strategy by adding social media-based dissemination methods to traditional methods for the clinical practice guidelines (CPGs) “Complementary and alternative medicine in multiple sclerosis.” They found that social media-based dissemination methods did not confer additional benefit over print-, email-, and Internet-based methods in increasing CPG awareness and changing intent in physicians or patients.
AHRQ-funded; HS022004.
Citation: Narayanaswami P, Gronseth G, Dubinsky R .
The impact of social media on dissemination and implementation of clinical practice guidelines: a longitudinal observational study.
J Med Internet Res 2015 Aug 13;17(8):e193. doi: 10.2196/jmir.4414..
Keywords: Communication, Complementary and Alternative Medicine, Evidence-Based Practice, Guidelines, Social Media, Implementation
Morrato EH, Rabin B, Proctor J
Bringing it home: expanding the local reach of dissemination and implementation training via a university-based workshop.
The Colorado Research in Implementation Science Program (CRISP) developed and delivered an introductory D&I workshop adapted from national programs to extend training reach and foster a local learning community for D&I. This paper describes the context of the local training environment, findings from a pre-workshop needs assessment survey, training design and structure, and post-workshop evaluation. Lessons learned may inform others intending to develop local D&I training workshop.
AHRQ-funded; HS021138.
Citation: Morrato EH, Rabin B, Proctor J .
Bringing it home: expanding the local reach of dissemination and implementation training via a university-based workshop.
Implement Sci 2015 Jul 4;10:94. doi: 10.1186/s13012-015-0281-6..
Keywords: Communication, Education: Continuing Medical Education, Evidence-Based Practice, Guidelines, Quality of Care, Quality Improvement, Training, Implementation
Tjia J, Field T, Mazor K
Dissemination of evidence-based antipsychotic prescribing guidelines to nursing homes: a cluster randomized trial.
This study evaluated the effectiveness of efforts to translate and disseminate evidence-based guidelines about atypical antipsychotic use to nursing homes (NHs). It found that RE-AIM indicators suggest some success in disseminating the toolkit and differences in reach, adoption, and implementation according to dissemination strategy but no measurable effect on antipsychotic prescribing trends.
AHRQ-funded; HS019351.
Citation: Tjia J, Field T, Mazor K .
Dissemination of evidence-based antipsychotic prescribing guidelines to nursing homes: a cluster randomized trial.
J Am Geriatr Soc 2015 Jul;63(7):1289-98. doi: 10.1111/jgs.13488..
Keywords: Communication, Evidence-Based Practice, Guidelines, Long-Term Care, Medication, Nursing Homes, Practice Patterns, Tools & Toolkits, Implementation
Mold JW, Aspy CB, Smith PD
Leveraging practice-based research networks to accelerate implementation and diffusion of chronic kidney disease guidelines in primary care practices: a prospective cohort study.
This study was conducted to determine whether practice-based research networks (PBRNs) could increase dissemination, implementation, and diffusion of evidence-based treatment guidelines for chronic kidney disease by leveraging early adopter practices. After the intervention, the initial four PBRNs increased the use of ACEIs/ARBs, discontinuation of NSAIDs, testing for anemia, and testing and/or treatment for vitamin D deficiency. Most were able to recruit two additional practices, which also increased their use of ACEIs/ARBs and testing and/or treatment of vitamin D deficiency. The researchers concluded that, with some assistance, early adopter practices can facilitate the diffusion of evidence-based approaches to other practices.
AHRQ-funded; HS019945.
Citation: Mold JW, Aspy CB, Smith PD .
Leveraging practice-based research networks to accelerate implementation and diffusion of chronic kidney disease guidelines in primary care practices: a prospective cohort study.
Implement Sci 2014 Nov 23;9:169. doi: 10.1186/s13012-014-0169-x.
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Keywords: Practice-Based Research Network (PBRN), Primary Care, Kidney Disease and Health, Chronic Conditions, Guidelines, Implementation
Weng C, Payne PR, Velez M
Towards symbiosis in knowledge representation and natural language processing for structuring clinical practice guidelines.
This vision paper discusses the value and feasibility of supporting symbiosis in text-based knowledge acquisition (KA) and knowledge representation (KR). It concludes that KA for KR should be made explicit, scalable, elastic, iterative, and “just expressive enough” to allow NLP-assisted knowledge engineering and increase the facility by which clinical practice guidelines are translated from research into practice.
AHRQ-funded; HS022961.
Citation: Weng C, Payne PR, Velez M .
Towards symbiosis in knowledge representation and natural language processing for structuring clinical practice guidelines.
Stud Health Technol Inform 2014;201:461-9..
Keywords: Evidence-Based Practice, Guidelines, Implementation, Health Information Technology (HIT)