National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Cardiovascular Conditions (4)
- Clinician-Patient Communication (1)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (1)
- Evidence-Based Practice (2)
- Healthcare Delivery (4)
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- Heart Disease and Health (3)
- Implementation (4)
- Organizational Change (2)
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- (-) Practice Improvement (12)
- Prevention (1)
- Primary Care (8)
- Primary Care: Models of Care (2)
- Provider Performance (1)
- Quality Improvement (9)
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- Teams (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 12 of 12 Research Studies DisplayedQuigley DD, Qureshi N, Slaughter ME
Provider and coach perspectives on implementing shadow coaching to improve provider-patient interactions.
Healthcare organizations want to improve patient care experiences. Some use 'shadow coaching' to improve interactions between providers and patients. In this study, the investigators aimed to characterize lessons and barriers to implementing shadow coaching as a mechanism to improve interactions with patients and change organizational culture. The investigators concluded that regular messaging by leadership about the priority and purpose of shadow coaching was essential for both physician engagement and its mature implementation across the organization.
AHRQ-funded; HS025920.
Citation: Quigley DD, Qureshi N, Slaughter ME .
Provider and coach perspectives on implementing shadow coaching to improve provider-patient interactions.
J Eval Clin Pract 2021 Dec;27(6):1381-89. doi: 10.1111/jep.13575..
Keywords: Clinician-Patient Communication, Patient Experience, Practice Improvement
Linzer M, Neprash H, Brown R
Where trust flourishes: perceptions of clinicians who trust their organizations and are trusted by their patients.
Investigators sought to determine perceived characteristics of clinics by clinicians who trust their organizations and whose patients have trust in them. Baseline data was obtained from the Healthy Work Place trial and included 165 clinicians with 1,132 patients. They found that high clinician-high patient trust occurred when clinicians perceived their organizational cultures to have (1) an emphasis on quality, (2) an emphasis on communication and information, (3) cohesiveness among clinicians, and (4) values alignment between clinicians and leaders.
AHRQ-funded; HS018160.
Citation: Linzer M, Neprash H, Brown R .
Where trust flourishes: perceptions of clinicians who trust their organizations and are trusted by their patients.
Ann Fam Med 2021 Nov-Dec;19(6):521-26. doi: 10.1370/afm.2732..
Keywords: Practice Improvement, Quality Improvement, Quality of Care
Khodyakov D, Buttorff C, Xenakis L
Alignment between objective and subjective assessments of health system performance: findings from a mixed-methods study.
This study was a survey of health system executives to examine whether their performance assessments match objective performance assessments and qualitatively explore ways to achieve high performance. Interviews were conducted with 138 C-suite executives of 24 health systems in California, Minnesota, Washington, and Wisconsin between 2017 and 2019. The interviews were focused on executives’ perceptions of their own health system’s performance and factors they perceived generally contributed to high performance. The authors grouped health systems based on objective performance levels used in sampling and compared the ratings to executives’ subjective performance assessments. There was poor agreement between objective and subjective performance assessments. Executives whose views were inconsistent with objective assessments did not cite clinical care quality as their basis for their assessment but focused instead on market competition, financial performance, and high customer satisfaction and loyalty. Executives who cited clinical quality metrics had subjective ratings consistent with objective ratings.
AHRQ-funded; HS024067.
Citation: Khodyakov D, Buttorff C, Xenakis L .
Alignment between objective and subjective assessments of health system performance: findings from a mixed-methods study.
J Healthc Manag 2021 Sep-Oct;66(5):380-94. doi: 10.1097/jhm-d-20-00249..
Keywords: Health Systems, Quality of Care, Practice Improvement, Provider Performance
Ye J, Zhang R, Bannon JE
Identifying practice facilitation delays and barriers in primary care quality improvement.
Practice facilitation is an effective approach to implementing quality improvement (QI) interventions in practice-based research networks (PBRNs). Regular facilitator-practice interactions are necessary for successful facilitation and missed engagements may hinder the process of practice improvement. This study employed a mixed-methods approach to characterize the dynamics of practice facilitation and examine facilitation delays and barriers, as well as their association with the achievement of QI program goals in a PBRN initiative.
AHRQ-funded; HS023921.
Citation: Ye J, Zhang R, Bannon JE .
Identifying practice facilitation delays and barriers in primary care quality improvement.
J Am Board Fam Med 2020 Sep-Oct;33(5):655-64. doi: 10.3122/jabfm.2020.05.200058..
Keywords: Practice Improvement, Primary Care, Quality Improvement, Quality of Care
Quigley DD, Slaughter M, Qureshi N
Practices and changes associated with patient-centered medical home transformation.
Knowing which patient-centered medical home (PCMH) care delivery changes and quality improvement (QI) practices further PCMH implementation is essential. In this study, the investigators used the 2008-2017 National Committee of Quality Assurance (NCQA) PCMH directory of 15,188 primary care practices that received Level 1, 2, or 3 NCQA PCMH recognition to: 1.) construct a stratified national sample of 105 practices engaged in PCMH transformation and 2.) examine their QI practices and PCMH changes associated with PCMH transformation.
AHRQ-funded; HS016980; HS025920.
Citation: Quigley DD, Slaughter M, Qureshi N .
Practices and changes associated with patient-centered medical home transformation.
Am J Manag Care 2021 Sep;27(9):386-93. doi: 10.37765/ajmc.2021.88740..
Keywords: Patient-Centered Healthcare, Primary Care, Practice Improvement, Healthcare Delivery, Quality Improvement, Quality of Care
Quigley DD, Qureshi N, AlMasarweh L
Using CAHPS patient experience data for patient-centered medical home transformation.
The purpose of this study was to examine how primary care practices used the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey and its patient-centered medical home (PCMH) items during their PCMH transition. The investigators concluded that CAHPS surveys were considered actionable for PCMH transformation and used in standardizing and coordinating care. The CAHPS PCMH items were considered integral to the continuous QI needed for moving beyond formal PCMH recognition and maximizing transformation.
AHRQ-funded; HS016980; HS025920.
Citation: Quigley DD, Qureshi N, AlMasarweh L .
Using CAHPS patient experience data for patient-centered medical home transformation.
Am J Manag Care 2021 Sep;27(9):e322-e29. doi: 10.37765/ajmc.2021.88745..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient Experience, Patient-Centered Healthcare, Primary Care, Practice Improvement, Healthcare Delivery, Quality Improvement, Quality of Care
Berry CA, Nguyen AM, Cuthel AM
Measuring implementation strategy fidelity in HealthyHearts NYC: a complex intervention using practice facilitation in primary care.
This study measured implementation strategy fidelity for the HealthyHearts NYC intervention program, an AHRQ-funded program that uses practice facilitation (PF) to improve adoption of cardiovascular disease evidence-based guidelines in primary care practices. Data from 257 practices measured fidelity using 4 categories: frequency, duration, content, and coverage. Almost all (94.2%) of practices received at least the 13 PF visits with an average 26.3 hours spent at each site by facilitators. Most practices (95.7%) completed all Task List items, and 71.2% were educated on all Chronic Care Models, with the majority (65.8%) receiving full coverage.
AHRQ-funded; HS023922.
Citation: Berry CA, Nguyen AM, Cuthel AM .
Measuring implementation strategy fidelity in HealthyHearts NYC: a complex intervention using practice facilitation in primary care.
Am J Med Qual 2021 Jul-Aug;36(4):270-76. doi: 10.1177/1062860620959450..
Keywords: Implementation, Heart Disease and Health, Cardiovascular Conditions, Primary Care, Practice Improvement, Quality Improvement, Quality of Care, Evidence-Based Practice, Patient-Centered Outcomes Research, Primary Care: Models of Care
Fagnan LJ, Ramsey K, Kline T
Place matters: closing the gap on rural primary care quality improvement capacity-the Healthy Hearts Northwest study.
This study compared rural independent and health system primary care practices with urban practices to external practice facilitation support in terms of recruitment, readiness, engagement, retention, and change in quality improvement (QI) capacity and quality metric performing. The Healthy Hearts Northwest quality improvement initiative consisting of 135 small or medium-sized primary care practices were used. The practices were stratified by geography, rural or urban, and by ownership. Changes in 3 clinical quality measures (CQMs): appropriate aspirin use, blood pressure (BP) control, and tobacco use screening, were measured at baseline in 2015 and follow-up in 2017. Rural practices were more likely to enroll than urban practices. Rural independent practices had the lowest QI capacity at baseline, making the largest gain in establishing a regular QI process. They made the greatest improvement in meeting the BP control CQM and the smoking cessation metric, from 72.3% to 86.7%.
AHRQ-funded; HS023908; HS023921.
Citation: Fagnan LJ, Ramsey K, Kline T .
Place matters: closing the gap on rural primary care quality improvement capacity-the Healthy Hearts Northwest study.
J Am Board Fam Med 2021 Jul-Aug;34(4):753-61. doi: 10.3122/jabfm.2021.04.210011..
Keywords: Rural Health, Primary Care, Primary Care: Models of Care, Practice Improvement, Quality Improvement, Quality of Care, Heart Disease and Health, Cardiovascular Conditions
Walunas TL, Ye J, Bannon J
Does coaching matter? Examining the impact of specific practice facilitation strategies on implementation of quality improvement interventions in the Healthy Hearts in the Heartland study.
Practice facilitation is a multicomponent implementation strategy used to improve the capacity for practices to address care quality and implementation gaps. In this study, the investigators sought to assess whether practice facilitators use of coaching strategies aimed at improving self-sufficiency were associated with improved implementation of quality improvement (QI) interventions in the Healthy Hearts in the Heartland Study.
AHRQ-funded; HS023921.
Citation: Walunas TL, Ye J, Bannon J .
Does coaching matter? Examining the impact of specific practice facilitation strategies on implementation of quality improvement interventions in the Healthy Hearts in the Heartland study.
Implement Sci 2021 Mar 31;16(1):33. doi: 10.1186/s13012-021-01100-8..
Keywords: Practice Improvement, Quality Improvement, Quality of Care, Implementation, Heart Disease and Health, Cardiovascular Conditions
Solberg LI, Kuzel A, Parchman ML
A taxonomy for external support for practice transformation.
There is no commonly accepted comprehensive framework for describing the practical specifics of external support for practice change. In this study, the researchers’goal was to develop a taxonomy that could be used by both external groups or researchers and health care leaders. The leaders of 8 grants from Agency for Research and Quality for the EvidenceNOW study of improving cardiovascular preventive services in over 1500 primary care practices nationwide worked collaboratively over 18 months to develop descriptions of key domains that might comprehensively characterize any external support intervention.
AHRQ-funded; HS023940.
Citation: Solberg LI, Kuzel A, Parchman ML .
A taxonomy for external support for practice transformation.
J Am Board Fam Med 2021 Jan-Feb;34(1):32-39. doi: 10.3122/jabfm.2021.01.200225..
Keywords: Primary Care, Healthcare Delivery, Cardiovascular Conditions, Evidence-Based Practice, Prevention, Quality Improvement, Practice Improvement, Quality of Care
Hoff T, Scott S
The strategic nature of individual change behavior: how physicians and their staff implement medical home care.
The purpose of this study was to gain insight into patient-centered medical home (PCMH) implementation at the workplace level by understanding better how primary care physicians and staff perceive, experience, and use certain types of PCMH work for adapting to new demands. The investigators indicated that the findings showed that particular forms of PCMH work not only advanced patient care in favorable ways but also enhanced individual and organizational capacity for adapting to this innovative model and its demands.
AHRQ-funded; HS020931.
Citation: Hoff T, Scott S .
The strategic nature of individual change behavior: how physicians and their staff implement medical home care.
Health Care Manage Rev 2017 Jul/Sep;42(3):226-36. doi: 10.1097/hmr.0000000000000109..
Keywords: Patient-Centered Healthcare, Primary Care, Organizational Change, Practice Improvement, Implementation
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