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Search All Research Studies
Topics
- Cardiovascular Conditions (5)
- Care Management (1)
- Communication (1)
- Comparative Effectiveness (1)
- (-) Evidence-Based Practice (7)
- Falls (1)
- Guidelines (1)
- (-) Healthcare Delivery (7)
- Heart Disease and Health (1)
- Implementation (3)
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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 7 of 7 Research Studies DisplayedDykes PC, Curtin-Bowen M, Lipsitz S
Cost of inpatient falls and cost-benefit analysis of implementation of an evidence-based fall prevention program.
The financial implications of patient falls within healthcare settings, a primary cause of nonreimbursable negative incidents, have not been thoroughly investigated. The aim of this study was to determine the expenses related to inpatient falls and the potential cost savings achieved through the adoption of a proven fall prevention program. This economic assessment employed a matched case-control approach, utilizing results from an interrupted time series analysis that evaluated the alterations in fall rates after the introduction of an evidence-based fall prevention program to estimate inpatient fall expenses. Subsequently, an economic analysis was conducted to evaluate the cost advantages of implementing the program across two American healthcare systems from June 1, 2013, to August 31, 2019, in New York, New York, and Boston, Massachusetts. All adult patients admitted to the participating units were included in the analysis. Data analysis took place between October 2021 and November 2022. The fall prevention program, based on evidence, was introduced in 33 medical and surgical departments across eight hospitals. The primary outcome was the expense related to inpatient falls. Secondary outcomes included costs and savings linked to the evidence-based fall prevention program. The study found that the case-control study and economic analysis included 10,176 patients who experienced a fall event (with or without injury) and 29,161 matched controls without a fall event (51.9% aged 65-74 years, 67.1% White, and 53.6% male). Prior to the intervention, there were 2,503 falls and 900 injuries; following the intervention, there were 2,078 falls and 758 injuries. Based on a 19% decrease in falls and a 20% decrease in injury-causing falls from the beginning to the end of the post-intervention period, the economic analysis revealed that noninjurious and injurious falls led to cost increases of $35,365 and $36,776, respectively. The introduction of the evidence-based fall prevention program resulted in $14,600 in net avoided expenses for every 1000 patient-days.
AHRQ-funded; HS027557; HS025128
Citation: Dykes PC, Curtin-Bowen M, Lipsitz S .
Cost of inpatient falls and cost-benefit analysis of implementation of an evidence-based fall prevention program.
JAMA Health Forum 2023 Jan 6;4(1):e225125. doi: 10.1001/jamahealthforum.2022.5125.
Keywords: Falls, Healthcare Delivery, Evidence-Based Practice, Prevention
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
Persell SD, Liss DT, Walunas TL
Effects of 2 forms of practice facilitation on cardiovascular prevention in primary care: a practice-randomized, comparative effectiveness trial.
Effective quality improvement (QI) strategies are needed for small practices. The objective of this study was to compare practice facilitation implementing point-of-care (POC) QI strategies alone versus facilitation implementing point-of-care plus population management (POC+PM) strategies on preventive cardiovascular care. The investigators concluded that facilitator-led QI promoting population management approaches plus POC improvement strategies was not clearly superior to POC strategies alone.
AHRQ-funded; HS023921.
Citation: Persell SD, Liss DT, Walunas TL .
Effects of 2 forms of practice facilitation on cardiovascular prevention in primary care: a practice-randomized, comparative effectiveness trial.
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Keywords: Cardiovascular Conditions, Prevention, Primary Care: Models of Care, Primary Care, Comparative Effectiveness, Patient-Centered Outcomes Research, Evidence-Based Practice, Quality Improvement, Quality of Care, Care Management, Healthcare Delivery
Sweeney SM, Hemler JR, Baron AN
Dedicated workforce required to support large-scale practice improvement.
Facilitation is an effective approach for helping practices implement sustainable evidence-based practice improvements. Few studies examine the facilitation infrastructure and support needed for large-scale dissemination and implementation initiatives. In this paper, the authors discuss a project by the Agency for Health care Research and Quality in which it funded 7 Cooperatives, each of which worked with over 200 primary care practices to rapidly disseminate and implement improvements in cardiovascular preventive care.
AHRQ-funded; HS023940.
Citation: Sweeney SM, Hemler JR, Baron AN .
Dedicated workforce required to support large-scale practice improvement.
J Am Board Fam Med 2020 Mar-Apr;33(2):230-39. doi: 10.3122/jabfm.2020.02.190261..
Keywords: Practice Improvement, Primary Care, Cardiovascular Conditions, Healthcare Delivery, Quality Improvement, Quality of Care, Prevention, Implementation, Evidence-Based Practice
Chou AF, Homco JB, Nagykaldi Z
Disseminating, implementing, and evaluating patient-centered outcomes to improve cardiovascular care using a stepped-wedge design: healthy hearts for Oklahoma.
The Healthy Hearts for Oklahoma (H2O) Study proposes to build a quality improvement (QI) infrastructure by (1) constructing a sustainable Oklahoma Primary Healthcare Improvement Collaborative (OPHIC) to support dissemination and implementation (D&I) of QI methods; and (2) providing QI support in primary care practices to better manage patients at risk for cardiovascular disease (CVD) events. H2O has 263 small primary care practices across Oklahoma that receive the bundled QI intervention to improve ABCS (aspirin therapy, blood pressure control, cholesterol management, and smoking cessation) performance. The infrastructure established as a result of this funding will help reach medically underserved Oklahomans, particularly among rural and tribal populations.
AHRQ-funded; HS023919.
Citation: Chou AF, Homco JB, Nagykaldi Z .
Disseminating, implementing, and evaluating patient-centered outcomes to improve cardiovascular care using a stepped-wedge design: healthy hearts for Oklahoma.
BMC Health Serv Res 2018 Jun 4;18(1):404. doi: 10.1186/s12913-018-3189-4.
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Keywords: Cardiovascular Conditions, Communication, Heart Disease and Health, Healthcare Delivery, Evidence-Based Practice, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Primary Care, Prevention, Quality of Care, Quality Improvement
Ono SS, Crabtree BF, Hemler JR
Taking innovation to scale in primary care practices: the functions of health care extension.
Health care extension is an approach to providing external support to primary care practices with the aim of diffusing innovation. EvidenceNOW was launched to rapidly disseminate and implement evidence-based guidelines for cardiovascular preventive care in the primary care setting. This article describes how cooperatives varied in their approaches to extension and provides early empirical evidence that health care extension is a feasible and potentially useful approach for providing quality improvement.
AHRQ-funded; HS023940.
Citation: Ono SS, Crabtree BF, Hemler JR .
Taking innovation to scale in primary care practices: the functions of health care extension.
Health Aff 2018 Feb;37(2):222-30. doi: 10.1377/hlthaff.2017.1100.
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Keywords: Primary Care, Implementation, Cardiovascular Conditions, Evidence-Based Practice, Healthcare Delivery, Practice Improvement, Quality Improvement, Quality of Care, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Prevention
Doherty JA, Crelia SJ, Smith MW
AHRQ Author: Mabry-Hernandez IR, Ngo-Metzger Q
Large health systems' prevention guideline implementation: a qualitative study.
In 2015, researchers conducted and analyzed interviews with quality leaders from eight hospital-based systems and one physician organization who explained organizational processes to adapt, adopt, disseminate, and incentivize adherence to preventive services guidelines. Nearly all have a formal process for reviewing and refining guidelines, developing clinician support, and disseminating the approved guidelines.
AHRQ-authored.
Citation: Doherty JA, Crelia SJ, Smith MW .
Large health systems' prevention guideline implementation: a qualitative study.
Am J Prev Med 2018 Jan;54(1s1):S88-s94. doi: 10.1016/j.amepre.2017.07.025.
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Keywords: Primary Care, Guidelines, Evidence-Based Practice, Prevention, Implementation, Healthcare Delivery