National Healthcare Quality and Disparities Report
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Search All Research Studies
Topics
- Ambulatory Care and Surgery (1)
- Cancer (2)
- Cancer: Lung Cancer (1)
- Cardiovascular Conditions (1)
- Care Coordination (3)
- Care Management (2)
- Case Study (2)
- Chronic Conditions (2)
- Communication (1)
- Community-Based Practice (2)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (1)
- Critical Care (1)
- Diabetes (5)
- Evidence-Based Practice (2)
- Healthcare Delivery (7)
- Health Information Technology (HIT) (1)
- Health Systems (1)
- Heart Disease and Health (1)
- Hospitalization (1)
- Hospitals (1)
- Human Immunodeficiency Virus (HIV) (1)
- Implementation (1)
- Inpatient Care (1)
- Intensive Care Unit (ICU) (1)
- Medication (1)
- Nursing (2)
- Opioids (1)
- Organizational Change (2)
- Outcomes (2)
- Pain (1)
- (-) Patient-Centered Healthcare (23)
- Patient-Centered Outcomes Research (2)
- Patient and Family Engagement (2)
- Patient Experience (1)
- Patient Safety (1)
- Practice Improvement (2)
- Practice Patterns (2)
- Primary Care (12)
- Primary Care: Models of Care (4)
- Provider (1)
- Provider: Health Personnel (3)
- Quality Improvement (3)
- Quality of Care (2)
- (-) Teams (23)
- TeamSTEPPS (1)
- Transitions of Care (1)
- Urban Health (1)
- Vulnerable Populations (1)
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 23 of 23 Research Studies DisplayedNijhawan AE, Bhattatiry M, Chansard M
HIV care cascade before and after hospitalization: impact of a multidisciplinary inpatient team in the US South.
Hospitalization represents an opportunity to re-engage out-of-care individuals, improve HIV outcomes, and reduce health disparities. The authors reviewed electronic health records of HIV-positive individuals hospitalized at an urban, public hospital between September 2013 and December 2015. They found that hospitalized patients with HIV had low rates of engagement in care, retention in care, and virologic suppression, though all three outcomes improved after hospitalization. A multidisciplinary transitions team improved care engagement and virologic suppression in those who received the intervention.
AHRQ-funded; HS022418.
Citation: Nijhawan AE, Bhattatiry M, Chansard M .
HIV care cascade before and after hospitalization: impact of a multidisciplinary inpatient team in the US South.
AIDS Care 2020 Nov;32(11):1343-52. doi: 10.1080/09540121.2019.1698704.
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Keywords: Human Immunodeficiency Virus (HIV), Transitions of Care, Inpatient Care, Teams, Hospitalization, Patient and Family Engagement, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice
Halladay JR, Weiner BJ, In Kim J
Practice level factors associated with enhanced engagement with practice facilitators; findings from the Heart Health Now study.
In this analysis, the authors explored the practice and facilitator factors associated with greater team engagement at the mid-point of a 12-month practice facilitation intervention focused on implementing cardiovascular prevention activities in practice. Using data from the EvidenceNow initiative's NC Cooperative, named Heart Health Now, they found that their analysis provided information for practice facilitation stakeholders to consider when determining which practices may be more amendable to embracing facilitation services.
AHRQ-funded; HS023912.
Citation: Halladay JR, Weiner BJ, In Kim J .
Practice level factors associated with enhanced engagement with practice facilitators; findings from the Heart Health Now study.
BMC Health Serv Res 2020 Jul 28;20(1):695. doi: 10.1186/s12913-020-05552-4.
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Keywords: Heart Disease and Health, Cardiovascular Conditions, Primary Care, Primary Care: Models of Care, Patient-Centered Healthcare, Evidence-Based Practice, Teams
McAlearney AS, Gaughan A, MacEwan SR
Improving acceptance of inpatient portals: patients' and care team members' perspectives.
Inpatient portals are gaining interest as a means to increase patient-centered care during hospitalization. However, acceptance of a new technology such as the inpatient portal relies on perceptions of both its usefulness and ease of use. These factors have not been studied in the context of inpatient portal implementation. In this study, the investigators interviewed patients and care team members about their experiences using an inpatient portal that had been implemented across a large, academic medical center.
AHRQ-funded; HS024379; HS024091.
Citation: McAlearney AS, Gaughan A, MacEwan SR .
Improving acceptance of inpatient portals: patients' and care team members' perspectives.
Telemed J E Health 2020 Mar;26(3):310-26. doi: 10.1089/tmj.2019.0026..
Keywords: Health Information Technology (HIT), Patient-Centered Healthcare, Teams
Nembhard IM, Buta E, Lee YSH
A quasi-experiment assessing the six-months effects of a nurse care coordination program on patient care experiences and clinician teamwork in community health centers.
The authors assessed effects of adding care coordination formally to nurses’ roles on care experiences of high-risk patients and clinician teamwork during the first 6 months of use. They conducted a quasi-experimental study in which changes in staff and patient experiences at six community health center practice locations that introduced the added-role approach for high-risk patients were compared to changes in six locations without the program in the same health system. They found that there were some positive effects of adding care coordination to nurses' role within 6 months of implementation, suggesting value in this improvement strategy. They concluded that addressing compatibility between coordination and other job demands is important when implementing this approach to coordination.
AHRQ-funded; HS016978.
Citation: Nembhard IM, Buta E, Lee YSH .
A quasi-experiment assessing the six-months effects of a nurse care coordination program on patient care experiences and clinician teamwork in community health centers.
BMC Health Serv Res 2020 Feb 24;20(1):137. doi: 10.1186/s12913-020-4986-0..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Care Coordination, Nursing, Patient Experience, Community-Based Practice, Patient-Centered Healthcare, Ambulatory Care and Surgery, Teams
Kelly Costa D, Liu H, Boltey EM
The structure of critical care nursing teams and patient outcomes: a network analysis.
This examined the connectiveness of critical nursing teams and patient outcomes. The study measured “coreness” (the degree to which a network is represented by a densely integrated core) and “betweenness” (whether a nurse lies on the path of others not directly connected). The researchers used ICU data from a medical center during 2011 and looked at nurses who worked in surgical ICU (SICU) or neurosurgical ICU (NICU) during that same time period. The sample included 598 adult patients and 281 nurses. The researchers found that the greater the coreness of the team, and the more betweenness there was with ICU nurses the less likely patients were to die.
AHRQ-funded; HS024552.
Citation: Kelly Costa D, Liu H, Boltey EM .
The structure of critical care nursing teams and patient outcomes: a network analysis.
Am J Respir Crit Care Med 2020 Feb 15;201(4):483-85. doi: 10.1164/rccm.201903-0543LE..
Keywords: Intensive Care Unit (ICU), Critical Care, Nursing, Teams, Outcomes, Healthcare Delivery, Patient-Centered Outcomes Research, Patient-Centered Healthcare
Derrett S, Gunter KE, Samaranayaka A
Development and testing of the Provider and Staff Perceptions of Integrated Care (PSPIC) Survey.
The authors developed and tested a 21-item questionnaire titled Provider and Staff Perceptions of Integrated Care Survey. The questionnaire was sent to 2,936 providers and staff at 100 federally qualified health centers and other clinics in Midwestern U.S. States, of which 2,604 were deemed eligible. Four mailings were conducted with a 30% response rate from 97 health centers. Four latent factors were suggested: Teams and Care Continuity, Patient Centeredness, Coordination with External Providers, and Coordination with Community Resources.
AHRQ-funded; HS000084.
Citation: Derrett S, Gunter KE, Samaranayaka A .
Development and testing of the Provider and Staff Perceptions of Integrated Care (PSPIC) Survey.
Med Care Res Rev 2019 Dec;76(6):807-29. doi: 10.1177/1077558717745936..
Keywords: Provider, Care Coordination, Patient-Centered Healthcare, Teams
Kim LY, Giannitrapani KF, Huynh AK
What makes team communication effective: a qualitative analysis of interprofessional primary care team members' perspectives.
This paper describes the elements of effective communication as perceived by members of interprofessional patient-centered medical home primary care teams and identified elements of effective communication that have persisted over time. Nine elements of effective communication emerged: shared knowledge, situation/goal awareness, problem-solving, mutual respect, transparency, timeliness, frequency, consistency, and parsimony. Recommendations included comprehensive quality improvement efforts incorporating a variety of strategies to facilitate communication of pertinent patient information in a brief and concise manner.
AHRQ-funded; HS000046.
Citation: Kim LY, Giannitrapani KF, Huynh AK .
What makes team communication effective: a qualitative analysis of interprofessional primary care team members' perspectives.
J Interprof Care 2019 Nov-Dec;33(6):836-38. doi: 10.1080/13561820.2019.1577809..
Keywords: Teams, Communication, Primary Care: Models of Care, Primary Care, Patient-Centered Healthcare
Parchman ML, Penfold RB, Ike B
Team-based clinic redesign of opioid medication management in primary care: effect on opioid prescribing.
This study examined the effect of using an opioid medication management program called Six Building Blocks in primary care practices to help reduce the rate of opioid prescriptions. Six rural-serving organizations with 20 clinic locations received support for 15 months to help them implement the Six Building Blocks. This case-control study compared monthly trends in patients undergoing long-term opioid therapy (LtOT) for patients enrolled in the intervention clinics with those enrolled in a regional health plan who did not receive care at the study sites but resided in the same areas. There was a significant rate of decrease of patients on LtOT at intervention clinics compared with the control group.
AHRQ-funded; HS023750.
Citation: Parchman ML, Penfold RB, Ike B .
Team-based clinic redesign of opioid medication management in primary care: effect on opioid prescribing.
Ann Fam Med 2019 Jul;17(4):319-25. doi: 10.1370/afm.2390..
Keywords: Opioids, Primary Care: Models of Care, Primary Care, Teams, Medication, Pain, Chronic Conditions, Practice Patterns, Patient-Centered Healthcare
Misra-Hebert AD, Perzynski A, Rothberg MB
Implementing team-based primary care models: a mixed-methods comparative case study in a large, integrated health care system.
This mixed-methods comparative case study examined the implementation of team-based primary care models in a large integrated health system. Field observations of 9 practices were conducted along with 75 interviews and provider and staff surveys. The 9 practices were categorized into 3 groups: high, partial, and low update of the new models. Ability of the practices to implement the new team-based model depended on their ability to adapt to change and to adapt team roles in workflow.
AHRQ-funded; HS024128.
Citation: Misra-Hebert AD, Perzynski A, Rothberg MB .
Implementing team-based primary care models: a mixed-methods comparative case study in a large, integrated health care system.
J Gen Intern Med 2018 Nov;33(11):1928-36. doi: 10.1007/s11606-018-4611-7..
Keywords: Case Study, Health Systems, Patient-Centered Healthcare, Primary Care, Primary Care: Models of Care, Teams
Howard J, Miller WL, Willard-Grace R
Creating and sustaining care teams in primary care: perspectives from innovative patient-centered medical homes.
The purpose of this study was to learn from the experiences of innovative primary care practices that have successfully developed care teams. The authors assert that team-based care is possible and valuable in primary care but that it is difficult to develop and sustain, and requires dedicated time and resources. They suggest that the challenges described by the highly motivated practices, in their paper, raised the question of feasibility for more average practices in the current funding environment.
AHRQ-funded.
Citation: Howard J, Miller WL, Willard-Grace R .
Creating and sustaining care teams in primary care: perspectives from innovative patient-centered medical homes.
Qual Manag Health Care 2018 Jul/Sep;27(3):123-29. doi: 10.1097/qmh.0000000000000176..
Keywords: Primary Care, Patient-Centered Healthcare, Teams, Healthcare Delivery
Annis AM, Harris M, Kim HM
Trends in primary care encounters across professional roles in PCMH.
Evaluation measures of team-based care models are often reported at a clinic or primary care provider (PCP) level, creating challenges in describing and analyzing the use and impact of non-PCP clinician team members. This study aimed to measure clinician-specific care delivery trends and determine whether trends were responsive to system wide patient centered medical home implementation.
AHRQ-funded;
Citation: Annis AM, Harris M, Kim HM .
Trends in primary care encounters across professional roles in PCMH.
Am J Manag Care 2018 Jul;24(7):e222-e29..
Keywords: Healthcare Delivery, Patient-Centered Healthcare, Primary Care, Teams
Quigley DD, Predmore ZS, Chen AY
Implementation and sequencing of practice transformation in urban practices with underserved patients.
Researchers conducted interviews at 14 primary care practices undergoing patient-centered medical home (PCMH) transformation in a large urban federally qualified health center in California and used grounded theory to identify common themes and patterns. They concluded that full PCMH transformation took time and effort and relied on a sequential approach, with an early focus on foundational changes that included use of a robust quality improvement strategy.
AHRQ-funded; HS000029.
Citation: Quigley DD, Predmore ZS, Chen AY .
Implementation and sequencing of practice transformation in urban practices with underserved patients.
Qual Manag Health Care 2017 Jan/Mar;26(1):7-14. doi: 10.1097/qmh.0000000000000118.
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Keywords: Patient-Centered Healthcare, Urban Health, Vulnerable Populations, Practice Improvement, Organizational Change, Quality Improvement, Quality of Care, Primary Care, Healthcare Delivery, Implementation, Teams
Lee SJ, Clark MA, Cox JV
Achieving coordinated care for patients with complex cases of cancer: a multiteam system approach.
The authors outlined challenges of care coordination in the context of a multiteam system (MTS), through the care experience of a patient in the Dallas County integrated safety-net system. A cancer diagnosis triggered an additional need for augmented coordination between his different provider teams. The authors recommend that further research and practice investigate the relationships of MTS coordination for shared care management, transfer to and from specialty care, treatment compliance, barriers to care, and health outcomes of chronic comorbid conditions, as well as cancer control and surveillance.
AHRQ-funded; HS022418.
Citation: Lee SJ, Clark MA, Cox JV .
Achieving coordinated care for patients with complex cases of cancer: a multiteam system approach.
J Oncol Pract 2016 Nov;12(11):1029-38. doi: 10.1200/jop.2016.013664.
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Keywords: Cancer, Care Coordination, Chronic Conditions, Patient-Centered Healthcare, Teams
Gerber DE, Reimer T, Williams EL
Resolving rivalries and realigning goals: challenges of clinical and research multiteam systems.
This article describes the care processes for a 64-year-old man with newly diagnosed advanced non-small-cell lung cancer who was enrolled in a first-line clinical trial of a new immunotherapy regimen. Research team and clinical team members have limited knowledge of the roles and work of individuals outside their team. Recommendations to increase trust and collaboration are provided.
AHRQ-funded; HS022418.
Citation: Gerber DE, Reimer T, Williams EL .
Resolving rivalries and realigning goals: challenges of clinical and research multiteam systems.
J Oncol Pract 2016 Nov;12(11):1020-28. doi: 10.1200/jop.2016.013060.
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Keywords: Cancer, Cancer: Lung Cancer, Case Study, Healthcare Delivery, Patient-Centered Healthcare, Teams
Rodriguez HP, Chen X, Martinez AE
Availability of primary care team members can improve teamwork and readiness for change.
Researchers conducted a survey of adult primary care providers and staff in California safety net practices to assess primary care team structure (team size, team member availability, and access to interdisciplinary expertise), teamwork, and readiness for change. Greater team member availability was associated with greater readiness for change, but the relationship was stronger for staff than for primary care providers.
AHRQ-funded; HS020120.
Citation: Rodriguez HP, Chen X, Martinez AE .
Availability of primary care team members can improve teamwork and readiness for change.
Health Care Manage Rev 2016 Oct-Dec;41(4):286-95. doi: 10.1097/hmr.0000000000000082.
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Keywords: Primary Care, Teams, Patient-Centered Healthcare, Organizational Change, Practice Improvement
Howard HA, Malouin R, Callow-Rucker M
Care managers and knowledge shift in primary care patient-centered medical home transformation.
Based on a health insurance company-sponsored primary care transformation project, this study explores the perceptions of care management from the perspective of providers and practice staff to examine shifts in knowledge and their broader implications for primary care. It demonstrates how the diffusion of clinical power and knowledge production redefine primary care relationships to patients, as traditional hierarchies shift to team-based care.
AHRQ-funded; HS020046; HS01795.
Citation: Howard HA, Malouin R, Callow-Rucker M .
Care managers and knowledge shift in primary care patient-centered medical home transformation.
Hum Organ 2016 Spring;75(1):10-20..
Keywords: Care Management, Patient-Centered Healthcare, Primary Care, Practice Patterns, Teams
Xie A, Carayon P, Cox ED
Application of participatory ergonomics to the redesign of the family-centred rounds process.
This study applied a participatory ergonomics (PE) approach to redesigning the family-centred rounds (FCR) process to improve family engagement. Human factors and ergonomics (HFE) principles were integrated in both the content and process of FCR redesign. The authors described activities of the PE process and presented data on PE process evaluation. They concluded that to demonstrate the value of PE-based FCR redesign, future research should document its impact on FCR process measures and patient outcome measures.
AHRQ-funded; HS018680.
Citation: Xie A, Carayon P, Cox ED .
Application of participatory ergonomics to the redesign of the family-centred rounds process.
Ergonomics 2015;58(10):1726-44. doi: 10.1080/00140139.2015.1029534.
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Keywords: Healthcare Delivery, Hospitals, Patient and Family Engagement, Patient-Centered Healthcare, Teams
Brady PJ, Battles JB, Ricciardi R
AHRQ Author: Brady PJ, Battles JB, Ricciardi R
Teamwork: what health care has learned from the military.
Health care depends on clear instructions and relies not just on individuals but also on strong teams. The authors point out that well-functioning teams make fewer mistakes than do individuals. They describe how military principles can be applied to healthcare, including the elements of structure, accountability, and patient-centeredness.
AHRQ-authored.
Citation: Brady PJ, Battles JB, Ricciardi R .
Teamwork: what health care has learned from the military.
J Nurs Care Qual 2015 Jan-Mar;30(1):3-6. doi: 10.1097/ncq.0000000000000094.
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Keywords: TeamSTEPPS, Teams, Patient-Centered Healthcare, Patient Safety, Quality of Care
Van der Wees PJ, Friedberg MW, Guzman EA
Comparing the implementation of team approaches for improving diabetes care in community health centers.
The researchers sought to clarify implementation processes and experiences of integrating office-based medical assistant (MA) panel management and community health worker (CHW) community-based management into routine care for diabetic patients. They found that CHW and MA responsibilities converged over time to focus on health coaching of diabetic patients, with the MA health coaches experiencing difficulty in allocating dedicated time due to other responsibilities. Time constraints also limited the personal introduction of patients to health coaches by clinicians. Participants highlighted the importance of a supportive team climate and proactive leadership as important enablers for MAs and CHWs to implement their health coaching responsibilities. This study suggests that a flexible approach to implementing health coaching is more important than fidelity to rigid models that do not allow for variable allocation of responsibilities across team members.
AHRQ-funded; HS020120.
Citation: Van der Wees PJ, Friedberg MW, Guzman EA .
Comparing the implementation of team approaches for improving diabetes care in community health centers.
BMC Health Serv Res 2014 Dec 3;14:608. doi: 10.1186/s12913-014-0608-z.
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Keywords: Community-Based Practice, Diabetes, Patient-Centered Healthcare, Quality Improvement, Teams
Everett CM, Thorpe CT, Palta M
The roles of primary care PAs and NPs caring for older adults with diabetes.
The investigators proposed a multidimensional characterization of PA and NP roles on panels of primary care patients with diabetes. They found that PAs and NPs in primary care perform a variety of roles and frequently perform multiple roles within a clinic.
AHRQ-funded; HS017646; HS018368; HS000083.
Citation: Everett CM, Thorpe CT, Palta M .
The roles of primary care PAs and NPs caring for older adults with diabetes.
Jaapa 2014 Apr;27(4):45-9. doi: 10.1097/01.jaa.0000444736.16669.76.
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Keywords: Diabetes, Provider: Health Personnel, Patient-Centered Healthcare, Primary Care, Teams
Taliani CA, Bricker PL, Adelman AM
Implementing effective care management in the patient-centered medical home.
The investigators explored how a disparate group of patient-centered medical homes (PCMHs) embedded care management in their team care environment to identify best practices. They concluded that PCMHs may want to ensure that care managers are available to meet with patients during visits, support patient self-management, fully leverage the electronic medical record for team messaging and patient tracking, and ensure integration into the care team with office huddles and ongoing communication.
AHRQ-funded; HS019150.
Citation: Taliani CA, Bricker PL, Adelman AM .
Implementing effective care management in the patient-centered medical home.
Am J Manag Care 2013 Dec;19(12):957-64.
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Keywords: Care Management, Diabetes, Healthcare Delivery, Patient-Centered Healthcare, Quality Improvement, Teams
Everett C, Thorpe C, Palta M
Physician assistants and nurse practitioners perform effective roles on teams caring for Medicare patients with diabetes.
The investigators compared outcomes for two groups of adult Medicare patients with diabetes whose conditions were at various levels of complexity: those whose care teams included PAs or NPs in various roles, and those who received care from physicians only. They found that outcomes were generally equivalent in thirteen comparisons but mixed in seven others, so that no role was best for all outcomes. They concluded that patient characteristics, as well as patients' and organizations' goals, should be considered when determining when and how to deploy PAs and NPs on primary care teams.
AHRQ-funded; HS017646; HS018368; HS000083.
Citation: Everett C, Thorpe C, Palta M .
Physician assistants and nurse practitioners perform effective roles on teams caring for Medicare patients with diabetes.
Health Aff 2013 Nov;32(11):1942-8. doi: 10.1377/hlthaff.2013.0506.
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Keywords: Diabetes, Provider: Health Personnel, Patient-Centered Healthcare, Primary Care, Teams
Everett CM, Thorpe CT, Palta M
Division of primary care services between physicians, physician assistants, and nurse practitioners for older patients with diabetes.
The investigators described the division of patients and services between primary care providers for older diabetes patients on panels with varying levels of PA/NP involvement. They concluded that understanding how patients and services are divided between PA/NPs and physicians will assist in defining provider roles on primary care teams.
AHRQ-funded; HS017646; HS018368; HS000083.
Citation: Everett CM, Thorpe CT, Palta M .
Division of primary care services between physicians, physician assistants, and nurse practitioners for older patients with diabetes.
Med Care Res Rev 2013 Oct;70(5):531-41. doi: 10.1177/1077558713495453.
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Keywords: Diabetes, Provider: Health Personnel, Patient-Centered Healthcare, Primary Care, Teams