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 25 of 41 Research Studies DisplayedPowell KR, Winkler AE, Liu J
A mixed-methods analysis of telehealth implementation in nursing homes amidst the COVID-19 pandemic.
The objective of this study was to investigate the implementation of telehealth in nursing homes during the COVID-19 pandemic. Researchers conducted a secondary analysis of data from a national survey of nursing home administrative leaders using six survey questions and semi-structured interviews. Their conclusions indicate that training, restructuring teams and tasks, and adaptation of work processes to support communication could improve usability and sustainability of telehealth in nursing homes.
AHRQ-funded; HS02249.
Citation: Powell KR, Winkler AE, Liu J .
A mixed-methods analysis of telehealth implementation in nursing homes amidst the COVID-19 pandemic.
J Am Geriatr Soc 2022 Dec;70(12):3493-502. doi: 10.1111/jgs.18020..
Keywords: COVID-19, Elderly, Telehealth, Health Information Technology (HIT), Nursing Homes, Implementation
Lewis CC, Klasnja P, Lyon AR
The mechanics of implementation strategies and measures: advancing the study of implementation mechanisms.
The purpose of this project is to identify strategy-mechanism linkages, develop causal models for mechanism evaluation, produce measures needed to evaluate such linkages, and make these models, methods, and measures available in a user-friendly website. The study reports that once strategy-mechanism linkages are identified, implementation scientists can utilize the resulting searchable database to create customized implementation strategies and generate stronger evidence about which strategies work best in which situations. Additionally, providers will be able to choose implementation strategies that best address their specific implementation challenges. The researchers concluded that new possibilities in implementation strategy development, optimization, evaluation, and deployment are anticipated to be more achievable as a result of this research, which can lead to improved implementation of evidence-based interventions and related improvements in patient outcomes.
AHRQ-funded; HS025632.
Citation: Lewis CC, Klasnja P, Lyon AR .
The mechanics of implementation strategies and measures: advancing the study of implementation mechanisms.
Implement Sci Commun 2022 Oct 22;3(1):114. doi: 10.1186/s43058-022-00358-3..
Keywords: Implementation
Pestka DL, Paterson NL, Brummel AR
Barriers and facilitators to implementing pharmacist-provided comprehensive medication management in primary care transformation.
The objective of this study was to identify barriers and facilitators when integrating pharmacist-provided comprehensive medication management (CMM) services into a health system's team-based primary care transformation (PCT) using the Consolidated Framework for Implementation Research. Findings showed that identifying and addressing implementation barriers and facilitators early during PCT rollout was critical to the success of team-based services such as CMM and becoming a learning health system. Further, clinical pharmacists providing CMM represented a valuable interdisciplinary care team member who can help to improve healthcare quality and access to primary care.
AHRQ-funded; HS026379.
Citation: Pestka DL, Paterson NL, Brummel AR .
Barriers and facilitators to implementing pharmacist-provided comprehensive medication management in primary care transformation.
Am J Health Syst Pharm 2022 Jul 22;79(15):1255-65. doi: 10.1093/ajhp/zxac104..
Keywords: Medication, Provider: Pharmacist, Primary Care, Implementation, Practice Improvement
Hinson JS, Klein E, Smith A
Multisite implementation of a workflow-integrated machine learning system to optimize COVID-19 hospital admission decisions.
This study’s objective was to develop, implement, and evaluate an electronic health record (EHR) embedded clinical decision support (CDS) system that leveraged machine learning (ML) to estimate short-term risk for clinical deterioration in patients with or under investigation for COVID-19. The system translates model-generated risk for critical care needs within 24 hours and inpatient care needs within 72 hours into rapidly interpretable COVID-19 Deterioration Risk Levels made viewable within ED clinician workflow. A retrospective cohort of 21,452 ED patients who visited one of five ED study sites was used to derive ML models and were prospectively validated in 15,670 ED visits that occurred before (n = 4322) or after (n = 11,348) CDS implementation. Model performance and numerous patient-oriented outcomes including in-hospital mortality were measured across study periods. ML model performance was excellent under all conditions. AUC ranged from 0.85 to 0.91 for prediction of critical care needs and 0.80-0.90 for inpatient care needs. Total mortality was unchanged across study periods but was reduced among high-risk patients after the implementation.
AHRQ-funded; HS026640.
Citation: Hinson JS, Klein E, Smith A .
Multisite implementation of a workflow-integrated machine learning system to optimize COVID-19 hospital admission decisions.
NPJ Digit Med 2022 Jul 16;5(1):94. doi: 10.1038/s41746-022-00646-1..
Keywords: COVID-19, Clinical Decision Support (CDS), Health Information Technology (HIT), Implementation, Electronic Health Records (EHRs), Emergency Department, Shared Decision Making
Wyse JJ, Mackey K, Lovejoy TI
Expanding access to medications for opioid use disorder through locally-initiated implementation.
The purpose of this study was to identify and describe locally- and internally-developed approaches to improve patient access to medication treatment for opioid use disorder (MOUD). The researchers utilized the Consolidated Framework for Implementation Research (CFIR) to guide qualitative interviews and ethnographic observations to examine the planning, design, and implementation of a locally-initiated process to expand access to MOUD. The study found that a self-appointed local team successfully developed and implemented a Primary Care-based Buprenorphine Clinic and E-Consult Service to expand access to MOUD to patients across the health care system, including national and local policy changes, identifying appropriate and widely supported models of care delivery and consultation, and increasing staff investment in the efforts by including them in collaborative planning and problem-solving. The study concluded that a local team can plan, develop and build new processes of care that are customized to meet local needs and contribute to long-term sustainability in the community.
AHRQ-funded; HS026370.
Citation: Wyse JJ, Mackey K, Lovejoy TI .
Expanding access to medications for opioid use disorder through locally-initiated implementation.
Addict Sci Clin Pract 2022 Jun 20;17(1):32. doi: 10.1186/s13722-022-00312-7..
Keywords: Opioids, Substance Abuse, Behavioral Health, Medication, Access to Care, Practice Patterns, Implementation
Petragallo R, Bardach N, Ramirez E
Barriers and facilitators to clinical implementation of radiotherapy treatment planning automation: a survey study of medical dosimetrists.
Researchers examined the barriers and facilitators to adoption of commercially available automated planning tools into the clinical workflow using a survey of medical dosimetrists. Through surveys, three categories of barriers to use of automation were identified. This investigation highlighted several concrete approaches that could potentially increase the translation of automation into the clinic, along with areas of needed research.
AHRQ-funded; HS026486.
Citation: Petragallo R, Bardach N, Ramirez E .
Barriers and facilitators to clinical implementation of radiotherapy treatment planning automation: a survey study of medical dosimetrists.
J Appl Clin Med Phys 2022 May;23(5):e13568. doi: 10.1002/acm2.13568..
Keywords: Treatments, Implementation
Cope EL, Johnson M, Khan M
AHRQ Author: Mistry KB
Contextual factors affecting implementation of pediatric quality improvement programs.
Researchers assessed the role of contextual factors in influencing the efforts of 5 diverse quality improvement projects as part of the Pediatric Quality Measure Program (PQMP) directed by AHRQ. In a mixed methods study, they conducted semistructured interviews, followed by structured worksheets, of 5 PQMP grantees. They found that using a determinant framework, such as the Tailored Implementation for Chronic Diseases, is valuable in facilitating comparisons across heterogeneous projects, allowing identification of key contextual factors influencing the implementation of pediatric quality measures across a diverse range of clinical topics and settings.
AHRQ-authored.
Citation: Cope EL, Johnson M, Khan M .
Contextual factors affecting implementation of pediatric quality improvement programs.
Acad Pediatr 2022 Apr;22(3S):S81-S91. doi: 10.1016/j.acap.2021.08.016..
Keywords: Children/Adolescents, Quality Measures, Quality Improvement, Quality of Care, Implementation
Mistry KB, Sagatov RDF, Schur C
AHRQ Author: Mistry KB, Sagatov RDF
Design and implementation of the Pediatric Quality Measures Program 2.0.
This AHRQ-authored research discusses the design and implementation of the Pediatric Quality Measures Program (PQMP) 2.0. The PQMP was established in response to the Children’s Health Insurance Program Reauthorization Act of 2009. AHRQ and CMS awarded 6 grants to Centers of Excellence (COEs) and a contract to facilitate collaboration and learning across the COEs. The COEs partnered with stakeholders from multiple levels to field test real-world implementation and refinement of pediatric quality measures and quality improvement initiatives. A PQMP Learning Collaborative (PQMP-LC) consisting of AHRQ, CMS, the 6 COEs, and L&M Policy Research, LLC was created to complete literature reviews, conduct key informant interviews, and collect data to develop reports to address the Research Foci. It also aided with development of measure implementation and quality improvement toolkits; conceptualized an implementation science framework, analysis, and roadmap; and facilitated dissemination of learnings and products. The various products created are intended to support the uptake of PQMP measures and inform future pediatric measurement and improvement work.
AHRQ-authored.
Citation: Mistry KB, Sagatov RDF, Schur C .
Design and implementation of the Pediatric Quality Measures Program 2.0.
Acad Pediatr 2022 Apr;22(3s):S59-S64. doi: 10.1016/j.acap.2021.12.021..
Keywords: Children/Adolescents, Medicaid, Children's Health Insurance Program (CHIP), Quality Measures, Quality Improvement, Quality of Care, Implementation
Schnipper JL, Reyes Nieva H, Mallouk M
Effects of a refined evidence-based toolkit and mentored implementation on medication reconciliation at 18 hospitals: results of the MARQUIS2 study.
This study was a follow-up of the first Multicenter Medication Reconciliation Quality Improvement Study (MARQUIS1) that demonstrated mentored implementation of a medication reconciliation best practices toolkit. The toolkit decreased total unintentional medication discrepancies in five hospitals, but results varied by site. The toolkit has been refined with lessons learned and retooled as MARQUIS2. The tool was implemented at 18 North American hospitals or hospital systems from 2016 to 2018, offering 17 system-level and 6-patient-level interventions. One of eight physicians coached each site remotely via monthly calls and one or two site visits. A total of 4947 patients were sampled, with 1229 preimplementation and 3718 postimplementation. A steady decline in medication discrepancy rates were experienced from 2.85 discrepancies per patient down to 0.98 discrepancies. An interrupted time series analysis of the 17 sites showed the intervention was associated with a 5% relative decrease in discrepancies per month.
AHRQ-funded; HS025486; HS023757.
Citation: Schnipper JL, Reyes Nieva H, Mallouk M .
Effects of a refined evidence-based toolkit and mentored implementation on medication reconciliation at 18 hospitals: results of the MARQUIS2 study.
BMJ Qual Saf 2022 Apr;31(4):278-86. doi: 10.1136/bmjqs-2020-012709..
Keywords: Medication, Evidence-Based Practice, Tools & Toolkits, Implementation, Quality Improvement, Quality of Care, Medication: Safety, Patient Safety
Forrest CB, Simpson L, Mistry KB
AHRQ Author: Mistry KB
PQMP Phase 2: implementation and dissemination.
The authors provide an overview of the articles in this supplement concerning the Children’s Health Insurance Program Reauthorization Act Pediatric Quality Measures Program (PQMP). The articles examine the opportunities and challenges associated with the PQMP 2.0 work of the Centers for Excellence and how findings may advance the science for pediatric quality measurement and improvement, and, ultimately, child health outcomes.
AHRQ-authored.
Citation: Forrest CB, Simpson L, Mistry KB .
PQMP Phase 2: implementation and dissemination.
Acad Pediatr 2022 Apr;22(3s):S55-S58. doi: 10.1016/j.acap.2022.01.012..
Keywords: Children/Adolescents, Medicaid, Children's Health Insurance Program (CHIP), Quality Measures, Quality Improvement, Quality of Care, Implementation
Schur C, Johnson M, Doherty J
AHRQ Author: Mistry KB
Real-world considerations for implementing pediatric quality measures: insights from key stakeholders.
This AHRQ-authored paper describes key stakeholder insights focused on measure implementation and increasing the uptake of Pediatric Quality Measures (PQM). The PQMP Learning Collaborative conducted semistructured interviews with 9 key informants (KIs) presenting states, health plans, and other potential end users. The interviews focused on obtaining KIs’ perspectives on 6 research questions focused on assessing the feasibility and usability of PQM and strengthening the connection between measurement and improvement. The KIs uniformly acknowledged the complexity of the issues raised and pinpointed multiple unresolved issues.
AHRQ-authored; AHRQ-funded; 290201400003I.
Citation: Schur C, Johnson M, Doherty J .
Real-world considerations for implementing pediatric quality measures: insights from key stakeholders.
Acad Pediatr 2022 Apr;22(3S):S76-S80. doi: 10.1016/j.acap.2021.04.007..
Keywords: Children/Adolescents, Medicaid, Children's Health Insurance Program (CHIP), Quality Measures, Quality Improvement, Quality of Care, Implementation
Kukhareva PV, Weir C, Del Fiol G
Evaluation in Life Cycle of Information Technology (ELICIT) framework: supporting the innovation life cycle from business case assessment to summative evaluation.
The authors developed an evaluation framework for electronic health record-integrated innovations to support activities at four information technology (IT) life cycle phases: planning, development, implementation, and operation. The resulting Evaluation in Life Cycle of IT (ELICIT) framework covers these four phases and three measure levels: society, user, and IT. The ELICIT framework recommends 12 evaluation steps. The authors concluded that, as health care undergoes a digital transformation, it will be critical for EHR-integrated innovations to be systematically evaluated, and their framework can facilitate such evaluations.
AHRQ-funded; HS026198.
Citation: Kukhareva PV, Weir C, Del Fiol G .
Evaluation in Life Cycle of Information Technology (ELICIT) framework: supporting the innovation life cycle from business case assessment to summative evaluation.
J Biomed Inform 2022 Mar; 127:104014. doi: 10.1016/j.jbi.2022.104014..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Implementation
Reese TJ, Schlechter CR, Kramer H
Implementing lung cancer screening in primary care: needs assessment and implementation strategy design.
This study explored the implementation of lung cancer screening with low-dose computed tomography (CT) in primary care. The study’s two goals included exploring the implementation of lung cancer screening primary care in the context of integrating a decision aid into the electronic health record and a designing of implementation strategies that target hypothesized mechanics of change and context-specific barriers. The two phases included a Qualitative Analysis phase including semi-structured interviews with primary care physicians to elicit key task behaviors, and an Implementation Strategy Design phase consisting of defining implementation strategies and hypothesizing causal pathways to improve screening with a decision aid. Fourteen interviews were conducted and out of that 3 key task behaviors and four behavioral determinants emerged. Strategies included increasing provider self-efficacy toward performing shared decision making and using the decision aid, improving provider performance expectancy, increasing social influence, and addressing key facilitators to using the decision aid.
AHRQ-funded; HS026198.
Citation: Reese TJ, Schlechter CR, Kramer H .
Implementing lung cancer screening in primary care: needs assessment and implementation strategy design.
Transl Behav Med 2022 Feb 16;12(2):187-97. doi: 10.1093/tbm/ibab115..
Keywords: Cancer: Lung Cancer, Cancer, Primary Care, Screening, Implementation, Shared Decision Making
Barnes GD, Sippola E, Ranusch A
Implementing an electronic health record dashboard for safe anticoagulant management: learning from qualitative interviews with existing and potential users to develop an implementation process.
This study examined the implementation of electronic dashboards and the key barriers that were found. Semi-structured interviews were conducted at the national Veterans Health Affairs (VA) following implementation of a population health tool, and in Michigan for the Michigan Anticoagulation Quality Improvement Initiative (MAQI(2) dashboard tool designed for pharmacist or nurse use to monitor safe outpatient anticoagulant prescribing by physicians and other clinicians. A total of 45 stakeholders were interviewed, 32 at the VA, and 13 at MAQI(2). Five key determinants of implementation success were identified: (1) clinician authority and autonomy, (2) clinician self-identity and job satisfaction, (3) documentation and administrative needs, (4) staffing and work schedule, and (5) integration with existing information systems. Key differences between the two contexts included concerns about IT support and prioritization within MAQI(2) prior to implementation but not VHA after implementation and also concerns about authority and autonomy.
AHRQ-funded; HS026874.
Citation: Barnes GD, Sippola E, Ranusch A .
Implementing an electronic health record dashboard for safe anticoagulant management: learning from qualitative interviews with existing and potential users to develop an implementation process.
Implement Sci Commun 2022 Feb 2;3(1):10. doi: 10.1186/s43058-022-00262-w..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Blood Thinners, Medication, Implementation
Katz MJ, Tamma PD, Cosgrove SE
Implementation of an antibiotic stewardship program in long-term care facilities across the US.
The purpose of this study was to determine if AHRQ’s Safety Program for Improving Antibiotic Use was associated with reductions in antibiotic use in long-term care (LTC) facilities in the US. Findings showed that participation in the AHRQ safety program was associated with the development of antibiotic stewardship programs (ASPs) that actively engaged clinical staff in the decision-making processes around antibiotic prescriptions in participating LTC facilities. The reduction in days of antibiotic therapy and starts, which was more pronounced in more engaged facilities, indicated that implementation of this multifaceted program may support successful ASPs in LTC settings.
AHRQ-funded; 233201500020I.
Citation: Katz MJ, Tamma PD, Cosgrove SE .
Implementation of an antibiotic stewardship program in long-term care facilities across the US.
JAMA Netw Open 2022 Feb;5(2):e220181. doi: 10.1001/jamanetworkopen.2022.0181..
Keywords: Elderly, Antimicrobial Stewardship, Antibiotics, Long-Term Care, Medication, Implementation, Patient Safety
Chyr LC, DeGroot L, Waldfogel JM
Implementation and effectiveness of integrating palliative care into ambulatory care of noncancer serious chronic illness: mixed methods review and meta-analysis.
The purpose of this study was to assess the implementation of models for integrating palliative care into ambulatory care for adults with noncancer serious chronic illness. Between January 2000 to May 2020, the researchers reviewed 3 electronic databases and included qualitative, mixed methods studies, and randomized and nonrandomized controlled trial studies. Quantitative analysis included 14 studies of 2,934 US adult patients. The study found that when compared to usual care the models assessed were not more effective for improving patient health-related quality of life (HRQOL) or for patient depressive symptom scores. Qualitative analysis included 5 studies of 146 patients. There was variance in patient preferences for appropriate timing of palliative care; barriers to implementation included costs, additional visits, and travel. The researchers concluded that models were not more effective than usual care for improving HRQOL or depressive symptom scores and may have little to no effect on decreasing overall symptom burden but were more effective for increasing AD documentation.
AHRQ-funded; 2902015000061
Citation: Chyr LC, DeGroot L, Waldfogel JM .
Implementation and effectiveness of integrating palliative care into ambulatory care of noncancer serious chronic illness: mixed methods review and meta-analysis.
Ann Fam Med 2022 Jan-Feb;20(1):77-83. doi: 10.1370/afm.2754..
Keywords: Chronic Conditions, Palliative Care, Implementation, Patient-Centered Healthcare, Quality of Life
Zittleman L, Curcija K, Nease DE
Increasing capacity for treatment of opioid use disorder in rural primary care practices.
Evidence supports treatment for opioid use disorder (OUD) with buprenorphine in primary care practices (PCPs). Barriers that slow implementation of this treatment include inadequately trained staff. This study aimed to increase the number of rural PCPs providing OUD treatment with buprenorphine. This evaluation described the impact of a practice team training on the implementation and delivery of OUD treatment with buprenorphine in PCPs of rural Colorado.
AHRQ-funded; HS025065.
Citation: Zittleman L, Curcija K, Nease DE .
Increasing capacity for treatment of opioid use disorder in rural primary care practices.
Ann Fam Med 2022 Jan-Feb;20(1):18-23. doi: 10.1370/afm.2757..
Keywords: Opioids, Rural Health, Primary Care, Substance Abuse, Behavioral Health, Training, Implementation, Medication
Flores EJ, Jue JJ, Giradi G
AHRQ EPC series on Improving translation of evidence: use of a clinical pathway for C. difficile treatment to facilitate the translation of research findings into practice.
In this pilot study, findings from the 2016 AHRQ EPC report on Clostridioides difficile infection were translated into a treatment pathway and disseminated via a cloud-based platform and electronic health record (EHR). Results indicated that pathways can be an approach for disseminating AHRQ EPC report findings within health care systems, with reports including guideline and pathway syntheses. Embedding hyperlinks to pathway content within the EHR may be a viable and low-effort solution for promoting awareness of evidence-based resources.
AHRQ-funded.
Citation: Flores EJ, Jue JJ, Giradi G .
AHRQ EPC series on Improving translation of evidence: use of a clinical pathway for C. difficile treatment to facilitate the translation of research findings into practice.
Jt Comm J Qual Patient Saf 2019 Dec;45(12):822-28. doi: 10.1016/j.jcjq.2019.10.002..
Keywords: Implementation, Evidence-Based Practice, Infectious Diseases, Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Electronic Health Records (EHRs), Health Information Technology (HIT)
Rosa TD, Possin KL, Bernstein A
Variations in costs of a collaborative care model for dementia.
Care coordination programs can improve patient outcomes and decrease healthcare expenditures; however, implementation costs are poorly understood. In this study, the investigators evaluated the direct costs of implementing a collaborative dementia care program. They found that care team navigators caseload was an important driver of service cost. They provide strategies for maximizing caseload without sacrificing quality of care and discuss current barriers to broad implementation that can inform new reimbursement policies.
AHRQ-funded; HS022241.
Citation: Rosa TD, Possin KL, Bernstein A .
Variations in costs of a collaborative care model for dementia.
J Am Geriatr Soc 2019 Dec;67(12):2628-33. doi: 10.1111/jgs.16076.
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Keywords: Dementia, Healthcare Costs, Care Coordination, Elderly, Care Management, Implementation, Teams
Stadnick NA, Sadler E, Sandall J
Comparative case studies in integrated care implementation from across the globe: a quest for action.
There are no formal guidelines for integrated care implementation applicable to diverse healthcare systems. In this paper, the investigators use a multiple case study design to highlight current integrated care implementation efforts through seven international case studies that target a range of healthcare systems, patient populations and implementation strategies and outcomes, and to synthesize the shared and unique challenges and successes across studies using the EPIS framework.
AHRQ-funded; HS024192.
Citation: Stadnick NA, Sadler E, Sandall J .
Comparative case studies in integrated care implementation from across the globe: a quest for action.
BMC Health Serv Res 2019 Nov 27;19(1):899. doi: 10.1186/s12913-019-4661-5..
Keywords: Healthcare Delivery, Health Services Research (HSR), Health Systems, Implementation, Case Study
Barker LT, Bond WF, Vincent AL
A novel in situ simulation framework for introduction of a new technology: the 3-Act-3-Debrief model.
Researchers studied a simulation-based introduction to new technologies in order to address specific factors that influence adoption. They found that a novel 3-stage simulation-debriefing structure positively targeted factors influencing the adoption of new healthcare technologies.
AHRQ-funded; HS024027.
Citation: Barker LT, Bond WF, Vincent AL .
A novel in situ simulation framework for introduction of a new technology: the 3-Act-3-Debrief model.
Adv Simul 2020 Sep 25;5:25. doi: 10.1186/s41077-020-00145-x..
Keywords: Telehealth, Health Information Technology (HIT), Implementation, Simulation
Schuttner L, Wong ES, Rosland AM
Association of the patient-centered medical home implementation with chronic disease quality in patients with multimorbidity.
The purpose of this retrospective cohort study was to examine the association of Patient-Aligned Care Team (PACT) implementation, the Veterans Health Administration (VA) PCMH model, and care quality for multimorbid patients enrolled in VA primary care from 2012 to 2014. The investigators found that for one-third of metrics (5/15), greater implementation of PACT in 2012 was associated with higher predicted probability of meeting the quality metric in 2013-2014. This association persisted for only two metrics among patients with > 5 chronic diseases.
AHRQ-funded; HS026369.
Citation: Schuttner L, Wong ES, Rosland AM .
Association of the patient-centered medical home implementation with chronic disease quality in patients with multimorbidity.
J Gen Intern Med 2020 Oct;35(10):2932-38. doi: 10.1007/s11606-020-06076-7..
Keywords: Patient-Centered Healthcare, Implementation, Chronic Conditions, Primary Care: Models of Care, Primary Care, Quality Improvement, Quality of Care
Davis MM, Gunn R, Kenzie E
Integration of improvement and implementation science in practice-based research networks: a longitudinal, comparative case study.
This study’s goal was to systematically examine implementation science (IS), quality improvement (QI), and IS/QI projects conducted within a practice-based research network (PBRN) over time to identify similarities, differences, and synergies. Documents were reviewed and staff interviews were conducted in the Oregon Rural Practice-based Research Network (ORPRN) from January 2007 to January 2019. Almost 30% of ORPRN’s projects (26/99) included IS or QI elements, and 54% were classified as IS/QI. All 26 projects used an evidence-based intervention and shared many similarities in relation to objective and settings. Randomized designs and theoretical frameworks were used by over half of the IS and IS/QI projects, while no QI projects did. Projects used a similar number of practice change strategies.
AHRQ-funded; HS027080.
Citation: Davis MM, Gunn R, Kenzie E .
Integration of improvement and implementation science in practice-based research networks: a longitudinal, comparative case study.
J Gen Intern Med 2021 Jun;36(6):1503-13. doi: 10.1007/s11606-021-06610-1..
Keywords: Implementation, Quality Improvement, Quality of Care
Stolldorf DP, Schnipper JL, Mixon AS
Organisational context of hospitals that participated in a multi-site mentored medication reconciliation quality improvement project (MARQUIS2): a cross-sectional observational study.
Medication reconciliation (MedRec) is an important patient safety strategy and is widespread in US hospitals and globally. Nevertheless, high quality MedRec has been difficult to implement. As part of a larger study investigating MedRec interventions, the investigators evaluated and compared organisational contextual factors and team cohesion by hospital characteristics and implementation team members' profession to better understand the environmental context and its correlates during a multi-site quality improvement (QI) initiative.
AHRQ-funded; HS025486.
Citation: Stolldorf DP, Schnipper JL, Mixon AS .
Organisational context of hospitals that participated in a multi-site mentored medication reconciliation quality improvement project (MARQUIS2): a cross-sectional observational study.
BMJ Open 2019 Nov 2;9(11):e030834. doi: 10.1136/bmjopen-2019-030834.
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Keywords: Medication, Quality Improvement, Hospitals, Medication: Safety, Patient Safety, Adverse Drug Events (ADE), Adverse Events, Medical Errors, Implementation
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