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AHRQ Research Studies Date
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- Adverse Events (1)
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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 15 of 15 Research Studies DisplayedSmith ME, Wells EE, Friese CR
Interpersonal and organizational dynamics are key drivers of failure to rescue.
This qualitative study of providers from hospitals with high and low rescue rates identified key factors that providers believe influence the successful rescue of surgical patients. These factors are: teamwork, action taking, psychological safety, recognition of complications, and communication. Providers surveyed agreed on two targets for improvement: delayed recognition of developing complications, and poor interprofessional communication and inability to express clinical concerns. The authors conclude that, to improve perioperative outcomes, hospitals and payers should shift their attention to improving early detection and increasing communication effectiveness when major complications occur.
AHRQ-funded; HS023621; HS024403.
Citation: Smith ME, Wells EE, Friese CR .
Interpersonal and organizational dynamics are key drivers of failure to rescue.
Health Aff 2018 Nov;37(11):1870-76. doi: 10.1377/hlthaff.2018.0704..
Keywords: Adverse Events, Communication, Hospitals, Mortality, Organizational Change, Patient Safety, Surgery
Brimhall KC, Mor Barak ME
The critical role of workplace inclusion in fostering innovation, job satisfaction, and quality of care in a diverse human service organization.
Using a sample of 213 participants within 21 departmental units in a diverse human service organization, the authors performed multilevel path analysis to examine the critical role of workplace inclusion in fostering innovation, job satisfaction, and quality of care in a diverse human service organization.
AHRQ-funded; HS024650.
Citation: Brimhall KC, Mor Barak ME .
The critical role of workplace inclusion in fostering innovation, job satisfaction, and quality of care in a diverse human service organization.
Hum Serv Organ Manag Leadersh Gov 2018 Nov/Dec;42(5):474-92..
Keywords: Quality of Care, Workforce, Organizational Change
Carpenter D, Hassell S, Mardon R
Ambulatory Surgery, Cost-Effectiveness, Health Care Costs, Evidence-based Practice, Organization and Administration
This paper describes the concept of using learning communities to support adoption of health care innovations. The authors assert that the learning community model of group learning can serve as an effective method to support dissemination and implementation of innovations, and to achieve desired outcomes in local settings.
AHRQ-funded; 290201100001C.
Citation: Carpenter D, Hassell S, Mardon R .
Ambulatory Surgery, Cost-Effectiveness, Health Care Costs, Evidence-based Practice, Organization and Administration
Jt Comm J Qual Patient Saf 2018 Oct;44(10):566-73. doi: 10.1016/j.jcjq.2018.03.010..
Keywords: Organizational Change, Patient-Centered Healthcare, Quality Improvement, Quality of Care
Wagner EH, LeRoy L, Schaefer J
AHRQ Author: Zhan C, Meyers D.
How do innovative primary care practices achieve the quadruple aim?
The Patient-Centered Medical Home (PCMH) defines excellent primary care but there is little empiric evidence that helps practices, payers, or policy makers understand how high-performing practices have improved outcomes. This paper reports findings from 38 high-performing practices. The authors describe how these practices execute 8 functions that collectively meet patient needs.
AHRQ-authored.
Citation: Wagner EH, LeRoy L, Schaefer J .
How do innovative primary care practices achieve the quadruple aim?
J Ambul Care Manage 2018 Oct/Dec;41(4):288-97. doi: 10.1097/jac.0000000000000249..
Keywords: Primary Care, Patient-Centered Healthcare, Practice Improvement, Organizational Change, Patient-Centered Outcomes Research
Harrison MI, Grantham S
AHRQ Author: Harrison MI
Learning from implementation setbacks: identifying and responding to contextual challenges.
The authors addressed organizational learning about implementation context during setbacks to primary care redesign in an ambulatory system. They found that redesigned teams were not implemented as widely or rapidly as anticipated and did not deliver hoped-for gains in operational metrics; however, team redesign was leading to improvements in chronic care and prevention and eased provider burden. Redesign and system leaders engaged in more thorough organizational learning. Their responses to challenges helped to strengthen the redesign's prospects, improved the delivery system's position in its labor market, and helped the system prepare to meet emerging requirements for value-based care and population health.
AHRQ-authored; AHRQ-funded; 2902010000341.
Citation: Harrison MI, Grantham S .
Learning from implementation setbacks: identifying and responding to contextual challenges.
Learn Health Syst 2018 Oct;2(4):e10068. doi: 10.1002/lrh2.10068..
Keywords: Organizational Change, Learning Health Systems, Health Systems, Primary Care: Models of Care, Primary Care, Ambulatory Care and Surgery, Implementation
McDonald KM, Rodriguez HP, Shortell SM
Organizational influences on time pressure stressors and potential patient consequences in primary care.
This study examines organizational determinants and patient consequences of time pressure, theorizing two types of time pressure and based on analysis of data from surveys of care team members and their patients. Measures of the two types - encounter-level and practice-level - were not correlated, nor predicted, which supported the hypothesis. Different organizational factors are associated with each type.
AHRQ-funded; HS024075.
Citation: McDonald KM, Rodriguez HP, Shortell SM .
Organizational influences on time pressure stressors and potential patient consequences in primary care.
Med Care 2018 Oct;56(10):822-30. doi: 10.1097/mlr.0000000000000974..
Keywords: Organizational Change, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Primary Care
Skinner D, Franz B, Howard J
The politics of primary care expansion: lessons from cancer survivorship and substance abuse.
The purpose of this study was to understand the perspectives of primary care innovators treating patient populations not traditionally considered to be within the purview of primary care. The authors indicated that their study findings suggested that the politics surrounding entrenched professional identities contributed to barriers faced by conference participants in their efforts to provide innovative care for these nontraditional populations. Specifically, obstacles surfaced in relation to sharing patients across disciplinary boundaries, which resulted in issues of possessiveness, a questioning of provider qualifications, and a lack of interprofessional trust.
AHRQ-funded; HS021287.
Citation: Skinner D, Franz B, Howard J .
The politics of primary care expansion: lessons from cancer survivorship and substance abuse.
J Healthc Manag 2018 Sep-Oct;63(5):323-36. doi: 10.1097/jhm-d-16-00030..
Keywords: Primary Care, Primary Care: Models of Care, Patient-Centered Healthcare, Cancer, Substance Abuse, Policy, Healthcare Delivery, Organizational Change, Quality of Care
Hung DY, Harrison MI , Truong Q
AHRQ Author: Harrison MI
Experiences of primary care physicians and staff following lean workflow redesign.
The researchers examined the work experiences of primary care physicians and staff after implementing Lean-based workflow redesigns. They found that both physicians and nonphysician staff reported higher levels of engagement and teamwork after implementing redesigns. However, the subjects also experienced higher levels of burnout and perceptions of the workplace as stressful.
AHRQ-authored; AHRQ-funded; 290201000022I.
Citation: Hung DY, Harrison MI , Truong Q .
Experiences of primary care physicians and staff following lean workflow redesign.
BMC Health Serv Res 2018 Apr 10;18(1):274. doi: 10.1186/s12913-018-3062-5.
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Keywords: Primary Care, Workflow, Burnout, Organizational Change, Provider: Physician, Teams
Martsolf GR, Ashwood S, Friedberg MW
Linking structural capabilities and workplace climate in community health centers.
This study examined the relationship between workplace climate and structural capabilities. Twenty-five community health centers (CHCs) were surveyed to determine workplace climate. CHC directors and adult primary care clinicians and staff were surveyed. Positive attributes included a manageable workload, staff relationships, a quality improvement orientation, and manager readiness. Lower electronic record functionality did not seem to improve workplace climates.
AHRQ-funded; HS020120.
Citation: Martsolf GR, Ashwood S, Friedberg MW .
Linking structural capabilities and workplace climate in community health centers.
Inquiry 2018 Jan-Dec;55:46958018794542. doi: 10.1177/0046958018794542..
Keywords: Community-Based Practice, Organizational Change, Quality Improvement, Quality of Care
Conway PH, Mostashari F, Clancy CM
AHRQ Author: Clancy CM
The future of quality measurement for improvement and accountability.
The authors describe the characteristics of the quality measurement enterprise of the future, outline a potential roadmap for the transition, and identify a set of opportunities for public- and private-sector collaboration.
AHRQ-authored.
Citation: Conway PH, Mostashari F, Clancy CM .
The future of quality measurement for improvement and accountability.
JAMA 2013 Jun 5;309(21):2215-6. doi: 10.1001/jama.2013.4929.
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Keywords: Healthcare Delivery, Policy, Organizational Change, Quality Indicators (QIs), Quality Measures, Quality of Care
McNellis RJ, Genevro JL, Meyers DS
AHRQ Author: McNellis RJ, Genevro JL, Meyers DS
Lessons learned from the study of primary care transformation.
This article discusses the patient-centered medical home (PCMH) model. The authors conclude that the transformation of primary care is essential to achieving the triple aim of better outcomes, better value, and better experience of care, and that the PCMH may be the most viable solution in the current health care environment.
AHRQ-authored.
Citation: McNellis RJ, Genevro JL, Meyers DS .
Lessons learned from the study of primary care transformation.
Ann Fam Med 2013 May-Jun;11 Suppl 1:S1-5. doi: 10.1370/afm.1548.
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Keywords: Patient-Centered Healthcare, Primary Care: Models of Care, Primary Care, Healthcare Delivery, Organizational Change, Quality Improvement, Quality of Care
Sokas R, Braun B, Chenven L
AHRQ Author: Hogan E
Frontline hospital workers and the worker safety/patient safety nexus.
This article reported on panels and small-group discussions from a day-long workshop held in Washington, D.C., on October 25, 2012, to explore whether and how hospital-based frontline health care workers (HCWs) affect patient safety and how they experience safety in their work settings. Conference sponsors included AHRQ, and workshop sessions focused on the intersection of worker safety and patient safety and on specific steps that health care institutions have used to implement a culture of safety in the workplace.
AHRQ-authored.
Citation: Sokas R, Braun B, Chenven L .
Frontline hospital workers and the worker safety/patient safety nexus.
Jt Comm J Qual Patient Saf 2013 Apr;39(4):185-92.
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Keywords: Provider, Organizational Change, Patient Safety, Hospitals
Lee SY, Weiner BJ, Harrison MI
AHRQ Author: Harrison MI
Organizational transformation: a systematic review of empirical research in health care and other industries.
The investigators reported findings from a systematic review of empirical research on transformational change in the health care and non-health care literature, with a focus on the antecedents, processes, and outcomes of transformational change. They found that available research documents the multiplicity of factors affecting change and the complexity of their interactions, but less information is available about the processes of transformational change than about its antecedents and consequences. They discussed research and practice implications.
AHRQ-authored.
Citation: Lee SY, Weiner BJ, Harrison MI .
Organizational transformation: a systematic review of empirical research in health care and other industries.
Med Care Res Rev 2013 Apr;70(2):115-42. doi: 10.1177/1077558712458539.
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Keywords: Healthcare Delivery, Health Services Research (HSR), Organizational Change
Kleinman LC, Dougherty D
AHRQ Author: Dougherty D
Assessing quality improvement in health care: theory for practice.
The authors reviewed the role of theory as a means to enhance the practice of quality improvement (QI) research and to propose a novel conceptual model focused on the operations of health care. They concluded that such a theory can promote opportunities for moving the field forward and organizing the planning and interpretation of comparable studies.
AHRQ-authored.
Citation: Kleinman LC, Dougherty D .
Assessing quality improvement in health care: theory for practice.
Pediatrics 2013 Mar;131 Suppl 1:S110-9. doi: 10.1542/peds.2012-1427n.
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Keywords: Quality Improvement, Healthcare Delivery, Organizational Change, Quality of Care, Health Services Research (HSR)
Taylor EF, Machta RM, Meyers DS
AHRQ Author: Meyers DS, Genevro J
Enhancing the primary care team to provide redesigned care: the roles of practice facilitators and care managers.
This article discusses how practice facilitators and care managers can play important but distinct roles in redesigning and improving care delivery in order to deliver coordinated, accessible, comprehensive, and patient-centered care.
AHRQ-authored.
Citation: Taylor EF, Machta RM, Meyers DS .
Enhancing the primary care team to provide redesigned care: the roles of practice facilitators and care managers.
Ann Fam Med 2013 Jan-Feb;11(1):80-3. doi: 10.1370/afm.1462.
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Keywords: Patient-Centered Healthcare, Primary Care: Models of Care, Primary Care, Healthcare Delivery, Organizational Change, Quality Improvement, Quality of Care