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AHRQ Research Studies Date
Topics
- Access to Care (1)
- Ambulatory Care and Surgery (2)
- Antibiotics (1)
- Behavioral Health (2)
- Cancer (1)
- Cardiovascular Conditions (1)
- Care Management (1)
- Case Study (1)
- Children/Adolescents (3)
- Chronic Conditions (1)
- Clinical Decision Support (CDS) (1)
- Depression (1)
- Education: Patient and Caregiver (1)
- Emergency Department (1)
- Healthcare Delivery (5)
- Health Information Technology (HIT) (2)
- Health Literacy (1)
- Health Systems (2)
- Heart Disease and Health (1)
- Implementation (2)
- Learning Health Systems (1)
- Medical Expenditure Panel Survey (MEPS) (1)
- Organizational Change (4)
- Patient-Centered Healthcare (8)
- Patient and Family Engagement (1)
- Patient Experience (1)
- Patient Safety (1)
- Policy (1)
- Primary Care (11)
- (-) Primary Care: Models of Care (16)
- Quality Improvement (3)
- Quality of Care (4)
- Screening (1)
- Shared Decision Making (2)
- Substance Abuse (1)
- System Design (1)
- Teams (1)
- Workflow (1)
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 16 of 16 Research Studies DisplayedDodd JH, Hall TA, Guilliams K
Optimizing neurocritical care follow-up through the integration of neuropsychology.
The authors proposed that integration of neuropsychology into neurocritical care follow-up provides incremental benefit to the identification and treatment of persisting complications and reduction in co-morbidities. Studying sixteen patients over six months, they found that integration of neuropsychology into follow-up care resulted in recommendations being made for services or concerns not already addressed. Parents reported high satisfaction, indicating that neuropsychological consultation improved their understanding and communication with their child, aiding them in knowing what to expect from their child during post-acute recovery. The authors conclude that these results indicate that integration of neuropsychology into neurocritical care follow-up programs contributes not only to parent satisfaction, but may provide incremental benefits to patient care.
AHRQ-funded; HS022981.
Citation: Dodd JH, Hall TA, Guilliams K .
Optimizing neurocritical care follow-up through the integration of neuropsychology.
Pediatr Neurol 2018 Dec;89:58-62. doi: 10.1016/j.pediatrneurol.2018.09.007..
Keywords: Children/Adolescents, Chronic Conditions, Patient-Centered Healthcare, Primary Care: Models of Care
Misra-Hebert AD, Perzynski A, Rothberg MB
Implementing team-based primary care models: a mixed-methods comparative case study in a large, integrated health care system.
This mixed-methods comparative case study examined the implementation of team-based primary care models in a large integrated health system. Field observations of 9 practices were conducted along with 75 interviews and provider and staff surveys. The 9 practices were categorized into 3 groups: high, partial, and low update of the new models. Ability of the practices to implement the new team-based model depended on their ability to adapt to change and to adapt team roles in workflow.
AHRQ-funded; HS024128.
Citation: Misra-Hebert AD, Perzynski A, Rothberg MB .
Implementing team-based primary care models: a mixed-methods comparative case study in a large, integrated health care system.
J Gen Intern Med 2018 Nov;33(11):1928-36. doi: 10.1007/s11606-018-4611-7..
Keywords: Case Study, Health Systems, Patient-Centered Healthcare, Primary Care, Primary Care: Models of Care, Teams
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
Fraze TK, Fisher ES, Tomaino MR
Comparison of populations served in hospital service areas with and without comprehensive primary care plus medical homes.
The purpose of this comparative cross sectional study was to describe practices that joined the Comprehensive Primary Care Plus (CPC+) model and compare hospital service areas with and without CPC+ practices. The authors concluded that according to this study, although a diverse set of practices joined the CPC+ program, practices in areas characterized by patient populations with greater advantage were more likely to join, which may affect access to advanced primary care medical home models such as CPC+, by vulnerable populations.
AHRQ-funded; HS024075.
Citation: Fraze TK, Fisher ES, Tomaino MR .
Comparison of populations served in hospital service areas with and without comprehensive primary care plus medical homes.
JAMA Netw Open 2018 Sep 7;1(5):e182169. doi: 10.1001/jamanetworkopen.2018.2169..
Keywords: Primary Care, Patient-Centered Healthcare, Primary Care: Models of Care, Healthcare Delivery, Access to 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
Yonek JC, Jordan N, Dunlop D
Patient-centered medical home care for adolescents in need of mental health treatment.
The patient-centered medical home (PCMH) has emerged as an optimal primary care model for all youth; however, little is known about the extent to which adolescents in need of mental health (MH) treatment receive care consistent with the PCMH. This study assessed (1) 10-year trends in PCMH care among U.S. adolescents according to MH need and (2) variations in PCMH care and its subcomponents among adolescents with MH need, by individual and family characteristics.
AHRQ-funded; HS024183.
Citation: Yonek JC, Jordan N, Dunlop D .
Patient-centered medical home care for adolescents in need of mental health treatment.
J Adolesc Health 2018 Aug;63(2):172-80. doi: 10.1016/j.jadohealth.2018.02.006..
Keywords: Medical Expenditure Panel Survey (MEPS), Children/Adolescents, Behavioral Health, Patient-Centered Healthcare, Primary Care: Models of Care, Primary Care
Reed JE, Kaplan HC, Ismail SA
A new typology for understanding context: qualitative exploration of the model for understanding success in quality (MUSIQ).
The objective of this study was to advance understanding of the complex and dynamic interaction between context, intervention, and implementation strategies. Using the Model for Understanding Success in Quality (MUSIQ), the authors aimed to better understand the roles of, and inter-relationships between, contextual factors within quality improvement and implementation initiatives.
AHRQ-funded; HS021114.
Citation: Reed JE, Kaplan HC, Ismail SA .
A new typology for understanding context: qualitative exploration of the model for understanding success in quality (MUSIQ).
BMC Health Serv Res 2018 Jul 25;18(1):584. doi: 10.1186/s12913-018-3348-7..
Keywords: Quality of Care, Quality Improvement, Primary Care: Models of Care
Aysola J, Schapira MM, Huo H
Organizational processes and patient experiences in the patient-centered medical home.
The objective of this study was to examine associations between organizational processes that practices adopt to become patient-centered medical home (PCMH) and patient experiences with care. The researchers concluded that although some organizational processes related to patients' experiences with care irrespective of the background of the patient, further efforts are needed to align practice efforts with patient experience.
AHRQ-funded; HS021706.
Citation: Aysola J, Schapira MM, Huo H .
Organizational processes and patient experiences in the patient-centered medical home.
Med Care 2018 Jun;56(6):497-504. doi: 10.1097/mlr.0000000000000910.
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Keywords: Patient-Centered Healthcare, Patient Experience, Primary Care: Models of Care, Primary Care
Keller SC, Tamma PD, Cosgrove SE
AHRQ Author: Miller MA
Ambulatory antibiotic stewardship through a human factors engineering approach: a systematic review.
The authors conducted a systematic review to identify controlled interventions and qualitative studies of ambulatory antibiotic stewardship (AS) interventions and determine whether and how they incorporated principles from a human factors engineering model, the Systems Engineering Initiative for Patient Safety 2.0 model. They concluded that studies have not focused on clinic-wide approaches to AS.
AHRQ-authored; AHRQ-funded; 233201500020I.
Citation: Keller SC, Tamma PD, Cosgrove SE .
Ambulatory antibiotic stewardship through a human factors engineering approach: a systematic review.
J Am Board Fam Med 2018 May-Jun;31(3):417-30. doi: 10.3122/jabfm.2018.03.170225.
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Keywords: Antibiotics, Clinical Decision Support (CDS), Primary Care: Models of Care, Ambulatory Care and Surgery, Patient Safety
Vankipuram A, Traub S, Patel VL
A method for the analysis and visualization of clinical workflow in dynamic environments.
The authors present a cohesive framework that combines a set of analytic techniques that can potentially complement traditional human observations to derive a deeper understanding of clinical workflow. Their framework is divided into three modules: (i) transformation, (ii) analysis, and (iii) visualization. They describe the methods used in each of these modules, and provide a series of visualizations developed using location-tracking data collected at the Mayo Clinic ED.
AHRQ-funded; HS022670.
Citation: Vankipuram A, Traub S, Patel VL .
A method for the analysis and visualization of clinical workflow in dynamic environments.
J Biomed Inform 2018 Mar;79:20-31. doi: 10.1016/j.jbi.2018.01.007.
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Keywords: Emergency Department, Health Information Technology (HIT), Health Information Technology (HIT), Primary Care: Models of Care, Workflow
Aalsma MC, Zerr AM, Etter DJ
Physician intervention to positive depression screens among adolescents in primary care.
The objective of this study was to determine the effectiveness of computer-based screening and physician feedback to guide adolescent depression management within primary care. The investigators found that when a computer-based decision support system algorithm focused on adolescent depression and was implemented in two primary care clinics, a majority of physicians utilized screening results to guide clinical care.
AHRQ-funded; HS022681.
Citation: Aalsma MC, Zerr AM, Etter DJ .
Physician intervention to positive depression screens among adolescents in primary care.
J Adolesc Health 2018 Feb;62(2):212-18. doi: 10.1016/j.jadohealth.2017.08.023..
Keywords: Care Management, Children/Adolescents, Shared Decision Making, Depression, Health Information Technology (HIT), Behavioral Health, Primary Care, Primary Care: Models of Care, Screening
Ashok M, Hung D, Rojas-Smith L
AHRQ Author: Harrison M
Framework for research on implementation of process redesigns.
Complex system interventions benefit from close attention to factors affecting implementation and resultant outcomes. This article describes a framework for examining these factors in process redesign (PR) and for assessing PR outcomes. The authors concluded that their PR framework helped guide the qualitative study and aided researchers in informing their leadership about critical issues affecting PR implementation.
AHRQ-authored; AHRQ-funded; 290200710056I; 2902010000221.
Citation: Ashok M, Hung D, Rojas-Smith L .
Framework for research on implementation of process redesigns.
Qual Manag Health Care 2018 Jan/Mar;27(1):17-23. doi: 10.1097/qmh.0000000000000158.
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Keywords: Implementation, Primary Care: Models of Care, Primary Care, System Design
Kuo YF, Adhikari D, Eke CG
Processes and outcomes of congestive heart failure care by different types of primary care models.
This study compared treatment of congestive heart failure (CHF) with primary care physicians (PCPs), nurse practitioners (NPs), or shared with PCPs and NPs. The rate of emergency room (ER) visits and hospitalizations along with Medicare spending was tracked although most patients (73%) were treated by PCPs. Patients under the shared care model had a higher rate of ER visits and hospitalizations than the PCP model.
AHRQ-funded; HS020642; HS022134.
Citation: Kuo YF, Adhikari D, Eke CG .
Processes and outcomes of congestive heart failure care by different types of primary care models.
J Card Fail 2018 Jan;24(1):9-18. doi: 10.1016/j.cardfail.2017.08.459..
Keywords: Cardiovascular Conditions, Heart Disease and Health, Primary Care, Primary Care: Models 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
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
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