National Healthcare Quality and Disparities Report
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Search All Research Studies
Topics
- Community-Based Practice (1)
- Evidence-Based Practice (1)
- Healthcare Delivery (2)
- Implementation (1)
- (-) Organizational Change (6)
- Patient-Centered Healthcare (3)
- (-) Practice Improvement (6)
- Primary Care (5)
- Primary Care: Models of Care (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 6 of 6 Research Studies DisplayedMcHugh M, Heinrich J, Philbin S
Declining participation in primary care quality improvement research: a qualitative study.
This qualitative study’s aim was to identify factors leading primary care practices to decline participation in quality initiative (QI) projects, and strategies to improve the feasibility and attractiveness of QI projects in the future. The authors contacted 109 representatives of practices that had declined participation in 1 of 4 AHRQ-funded EvidenceNOW projects. The representatives were invited to either participate in a 15-minute interview or complete a 5-question questionnaire. Representatives from 31 practices responded. Reasons for declining included staff turnover, staffing shortages, and general time constraints, exacerbated by the pandemic, preventing participation in the QI projects. Secondary reasons included challenges with electronic health records, an expectation of greater financial compensation for participation, and confidence in the practices' current care practices. Tying participation to value-based programs and offering greater compensation were identified as strategies to facilitate recruitment. However, none of the respondents’ recommendations addressed the primary issues of staffing challenges and time constraints.
AHRQ-funded; HS027954.
Citation: McHugh M, Heinrich J, Philbin S .
Declining participation in primary care quality improvement research: a qualitative study.
Ann Fam Med 2023 Sep-Oct; 21(5):388-94. doi: 10.1370/afm.3007..
Keywords: Quality Improvement, Primary Care, Quality of Care, Practice Improvement, Organizational Change, Evidence-Based Practice
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
Friedberg MW, Rodriguez HP, Martsolf GR
Measuring workplace climate in community clinics and health centers.
The authors assessed the psychometric properties of a survey instrument combining items from several existing surveys of workplace climate and generated a shorter instrument for future use. They concluded that survey instruments designed to measure workplace climate have substantial overlap, and the set they identified might help target and tailor clinics' quality improvement efforts.
AHRQ-funded; HS020120.
Citation: Friedberg MW, Rodriguez HP, Martsolf GR .
Measuring workplace climate in community clinics and health centers.
Med Care 2016 Oct;54(10):944-9. doi: 10.1097/mlr.0000000000000585.
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Keywords: Community-Based Practice, Provider, Organizational Change, Quality Improvement, Quality of Care, Practice Improvement
Gray CP, Harrison MI, Hung D
AHRQ Author: Harrison MI
Medical assistants as flow managers in primary care: challenges and recommendations.
Drawing on an empirical study of a large, multispecialty delivery system engaged in reconfiguration of primary care, the authors found that using medical assistants (Mas) as flow managers required overcoming several challenges. These included entrenched social and occupational hierarchies between physicians and MAs, a lack of adequate training and mentorship, and difficulty attracting and retaining talented MAs.
AHRQ-authored; AHRQ-funded; 2902010000221.
Citation: Gray CP, Harrison MI, Hung D .
Medical assistants as flow managers in primary care: challenges and recommendations.
J Healthc Manag 2016 May-Jun;61(3):181-91.
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Keywords: Primary Care, Organizational Change, Practice Improvement, Quality Improvement, Quality of Care, Workflow, Provider
Solberg LI, Stuck LH, Crain AL
Organizational factors and change strategies associated with medical home transformation.
The researchers surveyed leaders of the first 132 primary care practices in Minnesota to achieve medical home certification. The Change Process Capability Questionnaire survey and the Physician Practice Connections survey showed that 80% to 100% of these certified clinics had 15 of the 18 organizational factors important for improving care processes and that 60% to 90% had successfully used 16 improvement strategies.
AHRQ-funded; HS019161.
Citation: Solberg LI, Stuck LH, Crain AL .
Organizational factors and change strategies associated with medical home transformation.
Am J Med Qual 2015 Jul-Aug;30(4):337-44. doi: 10.1177/1062860614532307.
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Keywords: Patient-Centered Healthcare, Primary Care, Practice Improvement, Organizational Change, Quality Improvement, Quality of Care, Healthcare Delivery
Solberg LI, Crain AL, Tillema JO
Challenges of medical home transformation reported by 118 patient-centered medical home (PCMH) leaders.
The authors surveyed newly-certified medical homes in Minnesota to determine the most important organizational factors and strategies for transforming primary clinics into patient-centered medical homes (PCMHs). They found that many items in the survey about transformation seem to have face validity for leaders of certified PCMHs and to be associated with the extent to which their clinics have made systems changes.
AHRQ-funded; HS019161.
Citation: Solberg LI, Crain AL, Tillema JO .
Challenges of medical home transformation reported by 118 patient-centered medical home (PCMH) leaders.
J Am Board Fam Med 2014 Jul-Aug;27(4):449-57. doi: 10.3122/jabfm.2014.04.130303.
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Keywords: Patient-Centered Healthcare, Practice Improvement, Primary Care: Models of Care, Primary Care, Organizational Change, Quality of Care