National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Access to Care (2)
- Adverse Events (2)
- Ambulatory Care and Surgery (2)
- Behavioral Health (2)
- Burnout (2)
- Cancer (3)
- Cancer: Lung Cancer (1)
- Care Coordination (1)
- Catheter-Associated Urinary Tract Infection (CAUTI) (1)
- Central Line-Associated Bloodstream Infections (CLABSI) (1)
- Children/Adolescents (1)
- Communication (3)
- Community-Based Practice (3)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (1)
- Critical Care (2)
- Cultural Competence (1)
- Diagnostic Safety and Quality (1)
- Dialysis (1)
- Elderly (1)
- Electronic Health Records (EHRs) (2)
- Evidence-Based Practice (4)
- Falls (1)
- Genetics (2)
- Guidelines (2)
- Healthcare-Associated Infections (HAIs) (2)
- Healthcare Costs (1)
- Healthcare Delivery (21)
- Health Information Technology (HIT) (2)
- Health Insurance (2)
- Health Services Research (HSR) (7)
- Health Systems (6)
- Hospitals (10)
- Implementation (18)
- Intensive Care Unit (ICU) (1)
- Kidney Disease and Health (1)
- Learning Health Systems (4)
- Long-Term Care (1)
- Medication (3)
- Mortality (1)
- Nursing (1)
- Nursing Homes (2)
- (-) Organizational Change (73)
- Patient-Centered Healthcare (19)
- Patient-Centered Outcomes Research (2)
- Patient Experience (2)
- Patient Safety (11)
- Payment (1)
- Policy (4)
- Practice Improvement (12)
- Pressure Ulcers (1)
- Prevention (3)
- Primary Care (28)
- Primary Care: Models of Care (7)
- Provider (8)
- Provider: Clinician (2)
- Provider: Nurse (1)
- Provider: Physician (3)
- Provider Performance (3)
- Quality Improvement (21)
- Quality Indicators (QIs) (1)
- Quality Measures (1)
- Quality of Care (28)
- Risk (1)
- Rural Health (1)
- Screening (2)
- Social Determinants of Health (1)
- Stress (1)
- Substance Abuse (1)
- Surgery (2)
- Surveys on Patient Safety Culture (3)
- Teams (7)
- TeamSTEPPS (1)
- Urban Health (1)
- Vulnerable Populations (1)
- Workflow (5)
- Workforce (3)
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 73 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
Rafferty M, Stoff L, Smith JD
Promoting evidence-based practice: the influence of novel structural change to accelerate translational rehabilitation.
The objective of this study was to evaluate changes in clinicians' use of evidence-based practice (EBP), openness toward EBP, and acceptance of organizational changes after a rehabilitation hospital transitioned to a new facility designed to accelerate clinician-researcher collaborations. Clinicians participated in three surveys before, 7-9 months, and 2.5 years after transition to the new facility. Results indicated that attitudes toward EBPs were similar over time. Acceptance of the new model of care was lowest during the second survey period. The authors concluded that organizations must be responsive to clinicians' changing concerns to adapt and sustain a collaborative translational medicine model and allow sufficient time for such transitions to occur.
AHRQ-funded; HS025077.
Citation: Rafferty M, Stoff L, Smith JD .
Promoting evidence-based practice: the influence of novel structural change to accelerate translational rehabilitation.
Arch Phys Med Rehabil 2023 Aug; 104(8):1289-99. doi: 10.1016/j.apmr.2023.02.014..
Keywords: Evidence-Based Practice, Organizational Change
Sorra J, Zebrak K, Yount N
Development and pilot testing of survey items to assess the culture of value and efficiency in hospitals and medical offices.
Given rising costs and changing payment models, healthcare organisations are increasingly focused on value and efficiency. The goal of this study was to develop survey items to assess clinician and staff perspectives about the extent to which the organizational culture in hospitals and medical offices supports value and efficiency. The investigators concluded when added to the Agency for Healthcare Research and Quality Surveys on Patient Safety Culture, the item sets they developed extended those surveys by assessing additional dimensions of organizational culture that affect care delivery.
AHRQ-funded; 290201000025I.
Citation: Sorra J, Zebrak K, Yount N .
Development and pilot testing of survey items to assess the culture of value and efficiency in hospitals and medical offices.
BMJ Qual Saf 2022 Jul;31(7):493-502. doi: 10.1136/bmjqs-2020-012407..
Keywords: Surveys on Patient Safety Culture, Organizational Change
Zebrak K, Yount N, Sorra J
Development, pilot study, and psychometric analysis of the AHRQ Surveys on Patient Safety Culture™ (SOPS(®)) workplace safety supplemental items for hospitals.
The purpose of this AHRQ-funded study was to develop and test survey items that can be utilized together with the Agency for Healthcare Research and Quality (AHRQ) Surveys on Patient Safety Culture™ (SOPS(®)) Hospital Survey to evaluate how hospitals’ organizational cultures support workplace safety for both providers and staff. Based on a literature review and qualitative interviews with experts in workplace safety, the researchers identified prime areas of workplace safety culture (workplace hazards, moving patients, workplace aggression, management support for workplace safety, workplace safety reporting, and work stress or burnout) and drafted survey items to evaluate these areas. The survey items were then pilot tested on providers and staff in 28 U.S. hospitals using the SOPS Hospital Survey 2.0. Data from 6,684 respondents was analyzed and demonstrated conceptual convergence among the survey measures. The researchers concluded that both researchers and hospitals can utilize the Workplace Safety Supplemental items to evaluate the dimensions of organizational culture that support provider and staff safety and to pinpoint organizational strengths and areas for improvement.
AHRQ-funded; 233201500026I.
Citation: Zebrak K, Yount N, Sorra J .
Development, pilot study, and psychometric analysis of the AHRQ Surveys on Patient Safety Culture™ (SOPS(®)) workplace safety supplemental items for hospitals.
Int J Environ Res Public Health 2022 Jun 2;19(11). doi: 10.3390/ijerph19116815..
Keywords: Surveys on Patient Safety Culture, Patient Safety, Hospitals, Organizational Change
Spalluto LB, Lewis JA, Stolldorf D
Organizational readiness for lung cancer screening: a cross-sectional evaluation at a Veterans Affairs medical center.
Lung cancer has the highest cancer-related mortality in the United States and among Veterans. Screening of high-risk individuals with low-dose CT (LDCT) can improve survival through detection of early-stage lung cancer. Organizational factors that aid or impede implementation of this evidence-based practice in diverse populations are not well described. In this study, the investigators evaluated organizational readiness for change and change valence (belief that change is beneficial and valuable) for implementation of LDCT screening.
AHRQ-funded; HS026395.
Citation: Spalluto LB, Lewis JA, Stolldorf D .
Organizational readiness for lung cancer screening: a cross-sectional evaluation at a Veterans Affairs medical center.
J Am Coll Radiol 2021 Jun;18(6):809-19. doi: 10.1016/j.jacr.2020.12.010..
Keywords: Cancer: Lung Cancer, Cancer, Screening, Implementation, Organizational Change
Harrison MI, Shortell SM
AHRQ Author: Harrison MI
Multi-level analysis of the learning health system: Integrating contributions from research on organizations and implementation.
The authors have developed a comprehensive, multilevel framework to inform learning health systems (LHSs) research and practice in order to enhance both research on LHSs and practical steps toward their development. Drawing on the Consolidated Framework for Implementation Research, the social-ecological framework, and the organizational change framework, their new framework can help investigators and practitioners broadly scan and then investigate forces influencing improvement and learning and may point to otherwise unnoticed interactions among influential factors.
AHRQ-authored.
Citation: Harrison MI, Shortell SM .
Multi-level analysis of the learning health system: Integrating contributions from research on organizations and implementation.
Learn Health Syst 2021 Apr;5(2):e10226. doi: 10.1002/lrh2.10226..
Keywords: Learning Health Systems, Health Systems, Implementation, Organizational Change
Baloh J, Zhu X, Ward MM
What influences sustainment and nonsustainment of facilitation activities in implementation? Analysis of organizational factors in hospitals implementing TeamSTEPPS.
This study looked at the influences on sustainment of internal facilitation activities. For two years the authors followed 10 small rural hospitals implementing TeamSTEPPS, a patient safety program. Factors the authors examined were the influence of senior management support (SMS), middle management support (MMS), facilitator team time availability (TIME), and team continuity (CONTINUITY). Five hospitals sustained facilitation activities and they found that the combination of SMS, MMS, and CONTINUITY was a sufficient condition for sustainment. The five other hospitals that did not sustain facilitation activities either lacked MMS or lacked both TIME and CONTINUITY. They also discussed the implications for research and practice.
AHRQ-funded; HS024112; HS018396.
Citation: Baloh J, Zhu X, Ward MM .
What influences sustainment and nonsustainment of facilitation activities in implementation? Analysis of organizational factors in hospitals implementing TeamSTEPPS.
Med Care Res Rev 2021 Apr;78(2):146-56. doi: 10.1177/1077558719848267..
Keywords: TeamSTEPPS, Teams, Implementation, Hospitals, Patient Safety, Rural Health, Organizational Change
Lee YSH, Cleary PD, Nembhard IM
Effects of leader tactics on the creativity, implementation, and evolution of ideas to improve healthcare delivery.
Researchers examined the association between leader tactics and the creativity, implementation outcome, and evolution of quality improvement ideas from clinicians and staff. They found that two identified tactics, brainstorming and reflection, were helpful depending on goals. They suggested that brainstorming may aide leaders seeking disruptive change via more creative, rapidly implemented ideas, while reflection on team process may aide leaders seeking high-engagement ideas that may be implemented slowly. They concluded that both tactics may help leaders cultivate dynamics that increase implementation of ideas that improve healthcare.
AHRQ-funded; HS016978.
Citation: Lee YSH, Cleary PD, Nembhard IM .
Effects of leader tactics on the creativity, implementation, and evolution of ideas to improve healthcare delivery.
J Gen Intern Med 2021 Feb;36(2):341-48. doi: 10.1007/s11606-020-06139-9..
Keywords: Organizational Change, Healthcare Delivery, Quality Improvement, Quality of Care, Implementation
Yuce TK, Yang AD, Johnson JK
Association between implementing comprehensive learning collaborative strategies in a statewide collaborative and changes in hospital safety culture.
Hospital safety culture remains a critical consideration when seeking to reduce medical errors and improve quality of care. Little is known regarding whether participation in a comprehensive, multicomponent, statewide quality collaborative is associated with changes in hospital safety culture. The purpose of this study was to examine whether implementation of a comprehensive, multicomponent, statewide surgical quality improvement collaborative was associated with changes in hospital safety culture.
AHRQ-funded; HS024516.
Citation: Yuce TK, Yang AD, Johnson JK .
Association between implementing comprehensive learning collaborative strategies in a statewide collaborative and changes in hospital safety culture.
JAMA Surg 2020 Oct;155(10):934-40. doi: 10.1001/jamasurg.2020.2842..
Keywords: Hospitals, Patient Safety, Organizational Change, Quality Improvement, Quality of Care, Implementation
Knerr S, West KM, Angelo FA
Organizational readiness to implement population-based screening and genetic service delivery for hereditary cancer prevention and control.
Programs conducting population-based screening and genetic service delivery for hereditary cancer prevention and control are rare in practice. The authors interviewed individuals instrumental in implementing seven unique clinical programs conducting either universal tumor screening for Lynch Syndrome or routine family history screening and provision of genetic services for hereditary breast and ovarian cancer in the United States. Their findings suggest that developing interventions targeting change efficacy and cultivating practice change champions may be two promising ways to increase uptake of population-based hereditary cancer screening and genetic service delivery in clinical practice.
AHRQ-funded; HS022982.
Citation: Knerr S, West KM, Angelo FA .
Organizational readiness to implement population-based screening and genetic service delivery for hereditary cancer prevention and control.
J Genet Couns 2020 Oct;29(5):867-76. doi: 10.1002/jgc4.1216.
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Keywords: Cancer, Screening, Genetics, Prevention, Guidelines, Healthcare Delivery, Organizational Change, Implementation
Poghosyan L, Ghaffari A, Liu J
Organizational support for nurse practitioners in primary care and workforce outcomes.
Lack of organizational support in healthcare settings has been linked to high levels of clinician stress, burnout, and job dissatisfaction. Little research exists on organizational support for nurse practitioners. In this study, the researchers investigated the relationship between organizational support and nurse practitioner outcomes, including job satisfaction, intent to leave, and quality of care. The investigators concluded that nurse practitioners from primary care practices with higher levels of organizational support were more likely to be satisfied with their jobs, have less intent to leave their jobs, and report better quality of care.
AHRQ-funded; HS024758.
Citation: Poghosyan L, Ghaffari A, Liu J .
Organizational support for nurse practitioners in primary care and workforce outcomes.
Nurs Res 2020 Jul/Aug;69(4):280-88. doi: 10.1097/nnr.0000000000000425..
Keywords: Provider: Clinician, Provider, Primary Care, Burnout, Stress, Workforce, Organizational Change
Smith JD, Rafferty MR, Heinemann AW
Pragmatic adaptation of implementation research measures for a novel context and multiple professional roles: a factor analysis study.
In this study, the investigators examined the internal consistency, factor structure, and structural invariance of four well-validated measures of inner setting factors across four groups of respondents. The items in these measures were adapted as part of an evaluation of a large-scale organizational change in a rehabilitation hospital, which involved transitioning to a new building and a new model of patient care, facilitated by a significant redesign of patient care and research spaces.
AHRQ-funded; HS025077.
Citation: Smith JD, Rafferty MR, Heinemann AW .
Pragmatic adaptation of implementation research measures for a novel context and multiple professional roles: a factor analysis study.
BMC Health Serv Res 2020 Mar 30;20(1):257. doi: 10.1186/s12913-020-05118-4..
Keywords: Implementation, Health Services Research (HSR), Organizational Change
Heeringa J, Mutti A, Furukawa MF
AHRQ Author: Furukawa MF
Horizontal and vertical integration of health care providers: a framework for understanding various provider organizational structures.
The authors conducted a narrative review of 10 years of literature to identify definitional components of key organizational structures in the United States. They found that U.S. policymakers seek to promote provider integration and coordination. They conclude that emerging evidence suggested that organizational structures, composition, and other characteristics influence cost and quality performance. They recommend future research to examine systematically the role of organizational structure in cost and quality outcomes.
AHRQ-authored; AHRQ-funded.
Citation: Heeringa J, Mutti A, Furukawa MF .
Horizontal and vertical integration of health care providers: a framework for understanding various provider organizational structures.
Int J Integr Care 2020 Jan 20;20(1):2. doi: 10.5334/ijic.4635.
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Keywords: Health Systems, Healthcare Delivery, Patient-Centered Healthcare, Care Coordination, Organizational Change, Policy
Israel N, McMillen JC, Adams DR
Development of quality management capacity in child-serving nonprofit agencies.
In this study, the authors explored quality management capabilities and their development at nine different child serving agencies. Respondents described four emergent core quality management capabilities, although none of the nine agencies excelled at all four. The researchers discussed quality management capability and implications for research, policy, and practice.
AHRQ-funded; HS000084.
Citation: Israel N, McMillen JC, Adams DR .
Development of quality management capacity in child-serving nonprofit agencies.
Adm Policy Ment Health 2020 Jan;47(1):94-106. doi: 10.1007/s10488-019-00971-w..
Keywords: Children/Adolescents, Behavioral Health, Organizational Change, Quality Improvement, Quality of Care
Allen JA, Reiter-Palmon R, Kennel V, et al.
Group and organizational safety norms set the stage for good post-fall huddles.
In this study, the investigators explored group and organizational safety norms as antecedents to meeting leader behaviors and achievement of desired outcomes in a special after-action review case-a post-fall huddle. Findings indicated that organizational and group safety norms related to perceived huddle meeting effectiveness through appropriate huddle leader behavior in a partial mediated framework.
AHRQ-funded; HS024630; HS021429.
Citation: Allen JA, Reiter-Palmon R, Kennel V, et al..
Group and organizational safety norms set the stage for good post-fall huddles.
J Leadersh Organ Stud 2019 Nov;26(4):465-75. doi: 10.1177/1548051818781820..
Keywords: Adverse Events, Falls, Organizational Change, Patient Safety
Wood SJ, Albertson EM, Conrad DA
Accountable care program implementation and effects on participating health care systems in Washington state: a conceptual model.
This study used key informant interviews with health care executives representing 5 large health systems contracted with the Washington State Health Care Authority to provide accountable care network services under the State Innovation Model initiative. Two rounds of semistructured interviews were conducted, and results indicated the need to present a modified conceptual model aligned better with accountable care program (ACP) implementation.
AHRQ-funded; HS013853.
Citation: Wood SJ, Albertson EM, Conrad DA .
Accountable care program implementation and effects on participating health care systems in Washington state: a conceptual model.
J Ambul Care Manage 2019 Oct/Dec;42(4):321-36. doi: 10.1097/jac.0000000000000302..
Keywords: Health Systems, Provider Performance, Organizational Change, Health Services Research (HSR), Payment, Health Insurance, Implementation
Brimhall KC
Inclusion and commitment as key pathways between leadership and nonprofit performance.
This study used longitudinal multilevel path analyses to examine whether transformational leadership influenced work group performance through creating a climate for including and increasing employee commitment in a diverse nonprofit health care organization. The results indicated that transformational leaders do help increase perceptions of inclusion, which improves employee performance and commitment to the organization.
AHRQ-funded; HS024650.
Citation: Brimhall KC .
Inclusion and commitment as key pathways between leadership and nonprofit performance.
Nonprofit Manag Leadersh 2019 Fall;30(1):31-49. doi: 10.1002/nml.21368..
Keywords: Workforce, Organizational Change
Lasater KB, Jarrin OF, Aiken LH
A methodology for studying organizational performance: a multistate survey of front-line providers.
The objective of this study was to describe a novel approach to obtaining a representative sample of organizations using individuals nested within organizations, and demonstrate how resurveying nonrespondents could allay concerns about bias from low response rates at the individual-level. The investigators concluded that surveying organizations via random sampling of front-line providers could avoid the self-selection issues caused by directly sampling organizations.
AHRQ-funded; HS022406.
Citation: Lasater KB, Jarrin OF, Aiken LH .
A methodology for studying organizational performance: a multistate survey of front-line providers.
Med Care 2019 Sep;57(9):742-49. doi: 10.1097/mlr.0000000000001167..
Keywords: Provider Performance, Organizational Change
Kaufman A, Dickinson WP, Fagnan LJ
The role of health extension in practice transformation and community health improvement: lessons from 5 case studies.
The states of New Mexico, Oklahoma, Oregon, Colorado, and Washington stand out in stretching the boundaries of health extension; their stories reveal lessons learned regarding the successes and challenges. All states saw the need for long-term, sustained fundraising beyond grants in an environment expecting a short-term return on investment, and they were challenged operating in a shifting health system landscape where the creativity and personal relationships built with small primary care practices was hindered when these practices were purchased by larger health delivery systems.
AHRQ-funded; HS020890; HS020972; HS23904; HS023908.
Citation: Kaufman A, Dickinson WP, Fagnan LJ .
The role of health extension in practice transformation and community health improvement: lessons from 5 case studies.
Ann Fam Med 2019 Aug 12;17(Suppl 1):S67-s72. doi: 10.1370/afm.2409..
Keywords: Community-Based Practice, Health Services Research (HSR), Healthcare Delivery, Organizational Change, Primary Care, Social Determinants of Health, Practice Improvement
Hung DY, Harrison MI, Liang SY
AHRQ Author: Harrison MI
Contextual conditions and performance improvement in primary care.
This study examined organizational features of primary care clinics that had gone through Lean redesigns and had experienced the greatest performance improvements. They surveyed 1333 physicians and staff in 43 primary care clinics across a large primary care system. They found that clinics with prior experience with quality improvement had the highest increases in efficiency. Clinics reporting the highest levels of burnout and work stress before the redesign also made efficiency gains. Physician productivity gains was associated with a history of change, staff participation and leadership support. The greatest improvements in patient satisfaction occurred where there was the lowest stress levels with highest levels of teamwork, staff engagement and leadership support.
AHRQ-authored; AHRQ-funded; 2902010000221.
Citation: Hung DY, Harrison MI, Liang SY .
Contextual conditions and performance improvement in primary care.
Qual Manag Health Care 2019 Apr/Jun;28(2):70-77. doi: 10.1097/qmh.0000000000000198..
Keywords: Organizational Change, Healthcare Delivery, Primary Care, Provider Performance, Quality Improvement, Quality of Care, Workflow
Adler-Milstein J, Nong P, Friedman CP
AHRQ Author: Adler-Milstein J
Preparing healthcare delivery organizations for managing computable knowledge.
This article describes results of an AHRQ-funded conference where a group of experts from a range of fields examined the current state of knowledge management in healthcare delivery organizations. Conference presentations and discussions were recorded and analyzed by the authors in order to identify foundational concepts. The concepts identified are: the current state of knowledge management in healthcare delivery organizations is reliant upon an outdated biomedical library model, and only a small number of organizations have developed management approaches to push knowledge in computable form to frontline decisions; Learning Health Systems create a need for scalable computable knowledge management approaches; the ability to represent data science discoveries in computable form that are findable, accessible, interoperable, and reusable is fundamental to spreading knowledge at scale.
AHRQ-funded; HS025316.
Citation: Adler-Milstein J, Nong P, Friedman CP .
Preparing healthcare delivery organizations for managing computable knowledge.
Learn Health Syst 2019 Apr;3(2):e10070. doi: 10.1002/lrh2.10070..
Keywords: Healthcare Delivery, Learning Health Systems, Organizational Change, Health Systems
Hung DY, Gray CP, Truong QA
AHRQ Author: Harrison MI
Sustainment of lean redesigns for primary care teams.
This mixed-methods study examined the sustainment of Lean workflow redesigns for primary care teams several years after being implemented in a large, ambulatory care delivery system. Results showed that staff participation in Lean redesign is a key to facilitating buy-in and adherence to changes. Change ownership and continued availability of time for improvement activities are also critical to the long-term success of Lean implementation in primary care.
AHRQ-authored; AHRQ-funded; 2902010000221.
Citation: Hung DY, Gray CP, Truong QA .
Sustainment of lean redesigns for primary care teams.
Qual Manag Health Care 2019 Jan/Mar;28(1):15-24. doi: 10.1097/qmh.0000000000000200..
Keywords: Primary Care, Workflow, Teams, Organizational Change, Quality Improvement, Quality of Care
Montori VM, Hargraves I, McNellis RJ
AHRQ Author: Montori VM, McNellis RJ, Ganiats TG, Genevro J, Miller T, Ricciardi R
The Care and Learn Model: a practice and research model for improving healthcare quality and outcomes.
The Agency for Healthcare Research and Quality conducted internal work to formulate a model that could be used to analyze the Agency's research portfolio, identify gaps, develop and prioritize its research agenda, and evaluate its performance. In this study, the researchers produced a model caring and learning. The Agency and the health services research and improvement communities can use this Care and Learn Model to frame an evidence-based understanding of vexing clinical, healthcare delivery, and population health problems and to identify targets for investment, innovation, and investigation.
AHRQ-authored.
Citation: Montori VM, Hargraves I, McNellis RJ .
The Care and Learn Model: a practice and research model for improving healthcare quality and outcomes.
J Gen Intern Med 2019 Jan;34(1):154-58. doi: 10.1007/s11606-018-4737-7..
Keywords: Quality of Care, Healthcare Delivery, Evidence-Based Practice, Organizational Change
Smith 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