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AHRQ Research Studies Date
Topics
- Cancer (1)
- Care Coordination (2)
- Chronic Conditions (2)
- Clinician-Patient Communication (2)
- Communication (3)
- COVID-19 (1)
- Diabetes (1)
- Diagnostic Safety and Quality (1)
- Disparities (1)
- Education: Patient and Caregiver (2)
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- (-) Healthcare Delivery (23)
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- Human Immunodeficiency Virus (HIV) (1)
- Lifestyle Changes (1)
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- Patient-Centered Healthcare (10)
- Patient-Centered Outcomes Research (3)
- (-) Patient and Family Engagement (23)
- Policy (1)
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- Primary Care: Models of Care (1)
- Quality Improvement (3)
- Quality of Care (1)
- Shared Decision Making (7)
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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 23 of 23 Research Studies DisplayedBell SK, Dong ZJ, Desroches CM
Partnering with patients and families living with chronic conditions to coproduce diagnostic safety through OurDX: a previsit online engagement tool.
Involving patients and their families in the diagnostic process is crucial, but there is a lack of methods for consistent engagement. The implementation of policies providing patients with access to electronic health records offers new possibilities. The researchers evaluated a novel online tool ("OurDX"), co-created with patients and families, to examine the nature and frequency of potential safety issues identified by patients and their families with chronic health conditions and whether these insights were incorporated into visit notes. At two US healthcare facilities, patients and their families were encouraged to participate via an online pre-visit questionnaire, which covered: (1) visit priorities, (2) recent medical history and symptoms, and (3) potential diagnostic concerns. Two physicians assessed patient-reported diagnostic issues to validate and classify diagnostic safety opportunities (DSOs). The researchers performed a chart review to determine if patient inputs were integrated into the visit note. Descriptive statistics were employed to report implementation outcomes, DSO verification, and chart review findings. The study found that OurDX reports were completed in 7075 of 18,129 (39%) eligible pediatric subspecialty visits (site 1) and 460 of 706 (65%) eligible adult primary care visits (site 2). Of the patients expressing diagnostic concerns, 63% were confirmed as probable DSOs. Overall, 7.5% of pediatric and adult patients and their families with chronic health conditions identified probable DSOs. The most frequent DSO types included patients and families feeling unheard; issues or delays in tests or referrals; and complications or delays in clarification or subsequent steps. The chart review revealed that most clinician notes incorporated all or some of the patient or family priorities and patient-reported histories.
AHRQ-funded; HS027367
Citation: Bell SK, Dong ZJ, Desroches CM .
Partnering with patients and families living with chronic conditions to coproduce diagnostic safety through OurDX: a previsit online engagement tool.
J Am Med Inform Assoc 2023 Mar 16;30(4):692-702. doi: 10.1093/jamia/ocad003.
Keywords: Chronic Conditions, Diagnostic Safety and Quality, Health Information Technology (HIT), Patient and Family Engagement, Healthcare Delivery
Schuttner L, Hockett Sherlock S, Simons CE
My goals are not their goals: barriers and facilitators to delivery of patient-centered care for patients with multimorbidity.
This study’s goal was to clarify facilitators and barriers perceived by primary care physicians in the Veterans Health Administration to delivering patient-centered care for high-risk or complex patients with multimorbidity. The authors conducted semi-structured telephone interviews from April to July 2020 with 23 physicians across 20 clinical sites, with most being female (61%). Facilitators included: effective physician-patient communication to individualize care, prioritize among multiple needs, and elicit goals to improve patient engagement; access to care, enabled by interdisciplinary teams, and dictating personalized care planning; effortful but worthwhile care coordination and continuity; meeting complex needs through effective teamwork; and integrating medical and non-medical care aspects in recognition of patients' psychosocial contexts. Barriers included: intra- and interpersonal (e.g., perceived patient reluctance to engage in care); organizational (e.g., limited encounter time); and community or policy impediments (e.g., state decisional capacity laws) to patient-centered care.
AHRQ-funded; HS026369.
Citation: Schuttner L, Hockett Sherlock S, Simons CE .
My goals are not their goals: barriers and facilitators to delivery of patient-centered care for patients with multimorbidity.
J Gen Intern Med 2022 Dec;37(16):4189-96. doi: 10.1007/s11606-022-07533-1..
Keywords: Patient-Centered Healthcare, Healthcare Delivery, Chronic Conditions, Clinician-Patient Communication, Communication, Patient and Family Engagement
Abrams EM, Shaker M, Oppenheimer J
The challenges and opportunities for shared decision making highlighted by COVID-19.
This article discusses the challenges and opportunities for shared decision making (SDM) that have been emphasized more recently due to the COVID-19 pandemic. It has changed how clinicians deliver care due to the need for social distancing and health service reallocation. It is causing clinicians to reevaluate common practices and enhance effectiveness of their management strategies.
AHRQ-funded; HS024599.
Citation: Abrams EM, Shaker M, Oppenheimer J .
The challenges and opportunities for shared decision making highlighted by COVID-19.
J Allergy Clin Immunol Pract 2020 Sep;8(8):2474-80.e1. doi: 10.1016/j.jaip.2020.07.003.
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Keywords: Shared Decision Making, COVID-19, Healthcare Delivery, Patient and Family Engagement, Patient-Centered Healthcare
Austin E, LeRouge C, Hartzler AL
Capturing the patient voice: implementing patient-reported outcomes across the health system.
This study reported learnings and practice insights from University of Wisconsin’s (UW’s) efforts to implement patient-reported outcomes (PROs) in a healthcare system. The researchers engaged with UW Medicine clinical and administrative stakeholders experienced with PRO implementation. There were 14 total implementations conducted, and nearly half captured shared clinical domains. They developed three vignettes that illustrate how users interact with PRO, characterize common ways PRO implementations support clinical care across the health system, and elucidate opportunities to enhance efficient PRO implementations.
AHRQ-funded; HS023785.
Citation: Austin E, LeRouge C, Hartzler AL .
Capturing the patient voice: implementing patient-reported outcomes across the health system.
Qual Life Res 2020 Feb;29(2):347-55. doi: 10.1007/s11136-019-02320-8..
Keywords: Patient-Centered Outcomes Research, Patient and Family Engagement, Healthcare Delivery
Dukhanin V, Feeser S, Berkowitz SA
Who represents me? A patient-derived model of patient engagement via patient and family advisory councils (PFACs).
This study examined what expectations would be from patients who are not patient and family advisory council (PFAC) members of PFACs. Patients and caregivers from the Johns Hopkins Medical Alliance for Patients, LLC were recruited in 2014. This Medicare accountable care organization has an established PFAC, the Beneficiary Advisory Council. Five focus groups with 42 patients and caregivers participated. Most participants were not aware of PFACs and wanted to know more about representation, what they could do and expected that patients could communicate with PFACs if desired.
AHRQ-funded; HS023684.
Citation: Dukhanin V, Feeser S, Berkowitz SA .
Who represents me? A patient-derived model of patient engagement via patient and family advisory councils (PFACs).
Health Expect 2020 Feb;23(1):148-58. doi: 10.1111/hex.12983..
Keywords: Patient and Family Engagement, Patient-Centered Outcomes Research, Patient-Centered Healthcare, Healthcare Delivery, Health Systems
DeCamp M, Dukhanin V, Hebert LC
Patients' views about patient engagement and representation in healthcare governance.
Researchers used surveys to assess the importance of patient representation. Their analysis of free-text responses illuminated why patient representatives are important, keys to successful engagement, and reasons behind the skepticism. They conclude that most patients believe representation in health system governance is important, and that realizing its potential requires engagement activities that improve general patients' awareness of, and interaction with, their representatives.
AHRQ-funded; HS023684.
Citation: DeCamp M, Dukhanin V, Hebert LC .
Patients' views about patient engagement and representation in healthcare governance.
J Healthc Manag 2019 Sep-Oct;64(5):332-46. doi: 10.1097/jhm-d-18-00152..
Keywords: Patient and Family Engagement, Health Systems, Healthcare Delivery
Sadasivaiah S, Lyles CR, Kyoi S
Disparities in patient-reported interest in web-based patient portals: survey at an urban academic safety-net hospital.
Offering hospitalized patients' enrollment into a health system's patient portal may improve patient experience and engagement throughout the care continuum, especially across care transitions, but this process is less studied than portal engagement in the ambulatory setting. The objective of this study was to evaluate sociodemographic characteristics associated with interest in a health care system's portal among hospitalized patients and reasons for no interest.
AHRQ-funded; HS022408; HS022561; HS023558.
Citation: Sadasivaiah S, Lyles CR, Kyoi S .
Disparities in patient-reported interest in web-based patient portals: survey at an urban academic safety-net hospital.
J Med Internet Res 2019 Mar 26;21(3):e11421. doi: 10.2196/11421..
Keywords: Disparities, Patient-Centered Healthcare, Electronic Health Records (EHRs), Health Information Technology (HIT), Healthcare Delivery, Hospitals, Patient and Family Engagement, Urban Health
Holmes E, Thompson D, Michell D
An inpatient HIV support nurse to promote engagement in outpatient HIV care.
In this paper, the investigators describe an inpatient HIV support nurse to promote engagement in outpatient HIV care. It provides two case reports and a discussion. The investigators indicate that their hospital has employed an RN specializing in HIV care coordination for more than a decade on their dedicated HIV unit and has recently created a position to extend this work to PLWH who have been admitted to the 42 other adult units in their hospital.
AHRQ-funded; R01 HS024079.
Citation: Holmes E, Thompson D, Michell D .
An inpatient HIV support nurse to promote engagement in outpatient HIV care.
J Assoc Nurses AIDS Care 2019 Mar-Apr;30(2):245-48. doi: 10.1097/jnc.0000000000000017..
Keywords: Human Immunodeficiency Virus (HIV), Patient and Family Engagement, Care Coordination, Nursing, Healthcare Delivery
Brown SD, Grijalva CS, Ferrara A
Leveraging EHRs for patient engagement: perspectives on tailored program outreach.
Electronic health records (EHRs) present healthcare delivery systems with scalable, cost-effective opportunities to promote lifestyle programs among patients at high risk for type 2 diabetes, yet little consensus exists on strategies to enhance patient engagement. In this study, the investigators explored patient perspectives on program outreach messages containing content tailored to EHR-derived diabetes risk factors--a theory-driven strategy to increase the persuasiveness of health communications.
AHRQ-funded; HS019367.
Citation: Brown SD, Grijalva CS, Ferrara A .
Leveraging EHRs for patient engagement: perspectives on tailored program outreach.
Am J of Manag Care 2017 Jul;23(7):e223-e30..
Keywords: Diabetes, Communication, Education: Patient and Caregiver, Electronic Health Records (EHRs), Health Information Technology (HIT), Healthcare Delivery, Lifestyle Changes, Patient and Family Engagement
Rocque GB, Pisu M, Jackson BE
Resource use and Medicare costs during lay navigation for geriatric patients with cancer.
This study examined the influence of lay navigation on health care spending and resource use among geriatric patients with cancer within The University of Alabama at Birmingham Health System Cancer Community Network. It found that, compared with a matched comparison group, the mean total costs declined by $781.29 more per quarter per navigated patient, for an estimated $19 million decline per year across the network.
AHRQ-funded; HS023009.
Citation: Rocque GB, Pisu M, Jackson BE .
Resource use and Medicare costs during lay navigation for geriatric patients with cancer.
JAMA Oncol 2017 Jun;3(6):817-25. doi: 10.1001/jamaoncol.2016.6307.
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Keywords: Elderly, Cancer, Healthcare Costs, Medicare, Patient and Family Engagement, Patient-Centered Healthcare, Healthcare Delivery
Armstrong MJ, Mullins CD
Value assessment at the point of care: incorporating patient values throughout care delivery and a draft taxonomy of patient values.
In this commentary, the authors propose a taxonomy of values underlying patient decision making and provide examples of how these impact provision of health care. Their draft taxonomy describes four categories of patient values: global, decisional, situational, and external, highlights different values impacting decision making and facilitates a more complete value assessment at the point of care.
AHRQ-funded; HS024159.
Citation: Armstrong MJ, Mullins CD .
Value assessment at the point of care: incorporating patient values throughout care delivery and a draft taxonomy of patient values.
Value Health 2017 Feb;20(2):292-95. doi: 10.1016/j.jval.2016.11.008.
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Keywords: Shared Decision Making, Healthcare Delivery, Patient and Family Engagement
Adler-Milstein J, Embi PJ, Middleton B
Crossing the health IT chasm: considerations and policy recommendations to overcome current challenges and enable value-based care.
There is a chasm between the current health IT ecosystem and the health IT ecosystem. In this paper, the authors identify a set of focal goals and associated near-term achievable actions that are critical to pursue in order to enable the health IT ecosystem to meet the acute needs of modern health care delivery. These ideas emerged from discussions that occurred during the 2015 American Medical Informatics Association Policy Invitational Meeting.
AHRQ-funded; HS023969.
Citation: Adler-Milstein J, Embi PJ, Middleton B .
Crossing the health IT chasm: considerations and policy recommendations to overcome current challenges and enable value-based care.
J Am Med Inform Assoc 2017 Sep 1;24(5):1036-43. doi: 10.1093/jamia/ocx017.
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Keywords: Healthcare Delivery, Health Information Technology (HIT), Patient and Family Engagement, Policy, Health Information Technology (HIT)
Balbale SN, Locatelli SM, LaVela SL
Through their eyes: lessons learned using participatory methods in health care quality improvement projects.
The authors examined participatory methods to demonstrate how these methods can be adopted for quality improvement (QI) projects in health care. They concluded that using participatory methods is a valuable strategy to harness participant engagement and drive improvements that address individual needs.
AHRQ-funded; HS000084.
Citation: Balbale SN, Locatelli SM, LaVela SL .
Through their eyes: lessons learned using participatory methods in health care quality improvement projects.
Qual Health Res 2016 Aug;26(10):1382-92. doi: 10.1177/1049732315618386.
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Keywords: Healthcare Delivery, Quality of Care, Patient and Family Engagement, Quality Improvement
Khan A, Rogers JE, Forster CS
Communication and shared understanding between parents and resident-physicians at night.
The researchers studied communication breakdowns evidenced by lack of shared understanding between parents and night-team residents about the reason for admission and care plan. After conducting a prospective cohort study of 286 parents and 37 night-team senior residents, they found that parents and residents reported that they shared an understanding with one another about care plans in 86.0percent and 73.1 percent of cases, respectively.
AHRQ-funded; HS022986; HS000063.
Citation: Khan A, Rogers JE, Forster CS .
Communication and shared understanding between parents and resident-physicians at night.
Hosp Pediatr 2016 Jun;6(6):319-29. doi: 10.1542/hpeds.2015-0224.
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Keywords: Care Coordination, Healthcare Delivery, Communication, Patient and Family Engagement, Clinician-Patient Communication
Rocque GB, Partridge EE, Pisu M
The Patient Care Connect Program: transforming health care through lay navigation.
In this article, the authors described the Patient Care Connect Program's development, infrastructure, selection and training of lay navigators, and program operations.
AHRQ-funded; HS023009; HS013852.
Citation: Rocque GB, Partridge EE, Pisu M .
The Patient Care Connect Program: transforming health care through lay navigation.
J Oncol Pract 2016 Jun;12(6):e633-42. doi: 10.1200/jop.2015.008896.
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Keywords: Patient and Family Engagement, Patient-Centered Healthcare, Healthcare Delivery
Mazor KM, Smith KM, Fisher KA
Speak up! Addressing the paradox plaguing patient-centered care.
The authors discuss the patient-centered care paradox in which patients' perceptions of care rarely translate into improvements. Instead of placing the burden on patieents to voice their concerns, the authors recommended that health care systems and providers create an environment in which patients and family members feel safe raising concerns. The authors also addressed the issue that health care institutions cannot respond in real time even when patients do express a concern. They concluded by offering suggestions on how to improve this paradox.
AHRQ-funded; HS022757.
Citation: Mazor KM, Smith KM, Fisher KA .
Speak up! Addressing the paradox plaguing patient-centered care.
Ann Intern Med 2016 May 3;164(9):618-9. doi: 10.7326/m15-2416.
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Keywords: Healthcare Delivery, Patient and Family Engagement, Patient-Centered Healthcare, Quality Improvement
Lavallee DC, Chenok KE, Love RM
Incorporating patient-reported outcomes into health care to engage patients and enhance care.
The authors examine the opportunities for using patient-reported outcomes to enhance care delivery and outcomes as health care information needs and technology platforms change. They highlight emerging practices in which patient-reported outcomes provide value to patients and clinicians and improve care delivery. Finally, they examine present and future challenges to maximizing the use of patient-reported outcomes in the clinic.
AHRQ-funded; HS022789.
Citation: Lavallee DC, Chenok KE, Love RM .
Incorporating patient-reported outcomes into health care to engage patients and enhance care.
Health Aff 2016 Apr;35(4):575-82. doi: 10.1377/hlthaff.2015.1362.
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Keywords: Healthcare Delivery, Shared Decision Making, Patient-Centered Outcomes Research, Patient and Family Engagement, Quality Improvement
Stults CD, McCuistion MH, Frosch DL
Shared medical appointments: a promising innovation to improve patient engagement and ease the primary care provider shortage.
The authors examined the patient's perspective on participation in shared medical appointments (SMAs). They conducted five focus groups in the San Francisco Bay Area. They concluded that SMAs improve access, engagement with physicians and other patients, and knowledge of patients' health, as well as also helping to ease the workload for primary care physicians.
AHRQ-funded; HS019167.
Citation: Stults CD, McCuistion MH, Frosch DL .
Shared medical appointments: a promising innovation to improve patient engagement and ease the primary care provider shortage.
Popul Health Manag 2016 Feb;19(1):11-6. doi: 10.1089/pop.2015.0008.
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Keywords: Patient and Family Engagement, Primary Care, Healthcare Delivery
DeCamp M, Sugarman J, Berkowitz SA
Meaningfully engaging patients in ACO decision making.
In this article, the authors describe how ACOs can achieve meaningful system-level patient engagement. They specify a three-step engagement framework: identifying beneficiary representatives, cultivating relationships, and evaluating engagement. They conclude that their proposed three-step framework can help accountable care organizations (ACOs) conceptualize a plan for meaningfully engaging patients in ACO governance.
AHRQ-funded; HS023684.
Citation: DeCamp M, Sugarman J, Berkowitz SA .
Meaningfully engaging patients in ACO decision making.
Am J Accountable Care 2015 Jun;3(2):30-33.
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Keywords: Patient and Family Engagement, Shared Decision Making, Health Insurance, Healthcare Delivery
Xie A, Carayon P, Cox ED
Application of participatory ergonomics to the redesign of the family-centred rounds process.
This study applied a participatory ergonomics (PE) approach to redesigning the family-centred rounds (FCR) process to improve family engagement. Human factors and ergonomics (HFE) principles were integrated in both the content and process of FCR redesign. The authors described activities of the PE process and presented data on PE process evaluation. They concluded that to demonstrate the value of PE-based FCR redesign, future research should document its impact on FCR process measures and patient outcome measures.
AHRQ-funded; HS018680.
Citation: Xie A, Carayon P, Cox ED .
Application of participatory ergonomics to the redesign of the family-centred rounds process.
Ergonomics 2015;58(10):1726-44. doi: 10.1080/00140139.2015.1029534.
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Keywords: Healthcare Delivery, Hospitals, Patient and Family Engagement, Patient-Centered Healthcare, Teams
Brach C
AHRQ Author: Brach C
A daughter's frustration with the dearth of patient- and family-centered care.
This article is a first-person account of a hospitalization that describes the lack of patient and family inclusion in decision-making, failure to use plain language and other health literacy strategies, and disregard for patient and family preferences. The author concludes that if the health care system is going to shift from paternalistic to patient- and family-centered, providers must be trained in how to communicate and partner with patients and families. The author references resources to help hospitals make systematic changes to hard wire health literate and patient- and family-centered care.
AHRQ-authored.
Citation: Brach C .
A daughter's frustration with the dearth of patient- and family-centered care.
Patient Exp J 2014 Apr 1;1(1):43-47.
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Keywords: Healthcare Delivery, Shared Decision Making, Health Literacy, Patient and Family Engagement, Patient-Centered Healthcare
Brach C, Dreyer BP, Schillinger D
AHRQ Author: Brach C
Physicians' roles in creating health literate organizations: a call to action.
Physicians are being called on to deliver patient-centered care, reduce medical errors, and generally increase health care quality and health outcomes, all while containing costs. Fully engaging patients in prevention, decision-making and self-management activities is critical to achieving these aims. The authors of this paper concluded that being health literate must be a new way of delivering care rather than an add-on. For national health literacy goals to be met, health care organizations must ingrain health literacy into their routines.
AHRQ-authored.
Citation: Brach C, Dreyer BP, Schillinger D .
Physicians' roles in creating health literate organizations: a call to action.
J Gen Intern Med 2014 Feb;29(2):273-5. doi: 10.1007/s11606-013-2619-6.
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Keywords: Healthcare Delivery, Shared Decision Making, Health Literacy, Patient and Family Engagement, Patient-Centered Healthcare
Koh HK, Brach C, Harris LM
AHRQ Author: Brach C
A proposed 'health literate care model' would constitute a systems approach to improving patients' engagement in care.
The researchers proposed a Health Literate Care Model that would weave health literacy strategies into the widely adopted Care Model (formerly known as the Chronic Care Model). Their new model calls for approaching all patients with the assumption that they are at risk of not understanding their health conditions or how to deal with them, and then confirming and ensuring patients' understanding. They suggested that health literacy would then become an organizational value infused into all aspects of planning and operations. They also proposed a measurement framework to track the impact of the new Health Literate Care Model on patient outcomes and quality of care.
AHRQ-authored.
Citation: Koh HK, Brach C, Harris LM .
A proposed 'health literate care model' would constitute a systems approach to improving patients' engagement in care.
Health Aff 2013 Feb;32(2):357-67. doi: 10.1377/hlthaff.2012.1205.
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Keywords: Healthcare Delivery, Shared Decision Making, Education: Patient and Caregiver, Health Literacy, Primary Care: Models of Care, Patient and Family Engagement