National Healthcare Quality and Disparities Report
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Search All Research Studies
AHRQ Research Studies Date
Topics
- (-) Cardiovascular Conditions (15)
- Care Management (1)
- Community-Based Practice (1)
- Comparative Effectiveness (1)
- Diagnostic Safety and Quality (1)
- Education: Patient and Caregiver (1)
- Electronic Health Records (EHRs) (1)
- Evidence-Based Practice (12)
- Guidelines (2)
- Healthcare Delivery (2)
- Health Information Technology (HIT) (1)
- Heart Disease and Health (3)
- Imaging (1)
- Implementation (6)
- Lifestyle Changes (1)
- Patient-Centered Healthcare (4)
- Patient-Centered Outcomes Research (7)
- Patient and Family Engagement (1)
- Patient Self-Management (2)
- Practice Improvement (1)
- Prevention (4)
- (-) Primary Care (15)
- Primary Care: Models of Care (4)
- Provider Performance (1)
- Quality Improvement (7)
- Quality Indicators (QIs) (1)
- Quality Measures (2)
- Quality of Care (7)
- Research Methodologies (1)
- Risk (2)
- Shared Decision Making (1)
- Teams (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 15 of 15 Research Studies DisplayedCykert S, Keyserling TC, Pignone M
A controlled trial of dissemination and implementation of a cardiovascular risk reduction strategy in small primary care practices.
Researchers assessed the effect of dissemination and implementation of an intervention consisting of practice facilitation and a risk-stratified, population management dashboard on cardiovascular risk reduction for patients at high risk in small, primary care practices. They found that a risk-stratified, population management dashboard combined with practice facilitation led to substantial reductions of 10-year atherosclerotic cardiovascular disease risk for patients at high risk. They recommended utilizing similar approaches to lead to effective dissemination and implementation of other new evidence, especially in rural and other under-resourced practices.
AHRQ-funded; HS023912.
Citation: Cykert S, Keyserling TC, Pignone M .
A controlled trial of dissemination and implementation of a cardiovascular risk reduction strategy in small primary care practices.
Health Serv Res 2020 Dec;55(6):944-53. doi: 10.1111/1475-6773.13571..
Keywords: Cardiovascular Conditions, Risk, Prevention, Primary Care, Implementation, Evidence-Based Practice, Patient-Centered Healthcare, Patient-Centered Outcomes Research
Nguyen AM, Cuthel AM, Rogers ES
Attributes of high-performing small practices in a guideline implementation: a multiple-case study.
This study called HealthyHearts NYC was a stepped wedge randomized control trial that tested the effectiveness of practice facilitation in small primary care practices in adopting cardiovascular disease guidelines. The practice-level benchmark desired was having 70% or greater of hypertensive patients having controlled blood pressure. A mixed methods multiple-case study design was used and implemented at 6 small practices. The investigator’s first key finding was that the high-performing and improved practices in their study looked and acted similarly during the intervention implementation. Three key attributes of these practices were found to be: 1) advanced use of electronic health records; 2) dedicated resources and commitment to quality improvement; and 3) an actively engaged lead clinician and office manager.
AHRQ-funded; HS023922.
Citation: Nguyen AM, Cuthel AM, Rogers ES .
Attributes of high-performing small practices in a guideline implementation: a multiple-case study.
J Prim Care Community Health 2020 Jan-Dec;11. doi: 10.1177/2150132720984411..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Primary Care, Evidence-Based Practice, Guidelines, Implementation
Fernald DH, Mullen R,, Hall T
Exemplary practices in cardiovascular care: results on clinical quality measures from the EvidenceNOW Southwest Cooperative.
The authors identified practice characteristics associated with high performance on four cardiovascular disease cardiovascular clinical quality measures (CQMs). They found that multiple strategies - registries, prompts and protocols, patient self-management support, and patient-team partnership activities - were associated with delivering high-quality cardiovascular care over time, measured by CQMs.
AHRQ-funded; HS023904.
Citation: Fernald DH, Mullen R,, Hall T .
Exemplary practices in cardiovascular care: results on clinical quality measures from the EvidenceNOW Southwest Cooperative.
J Gen Intern Med 2020 Nov;35(11):3197-204. doi: 10.1007/s11606-020-06094-5..
Keywords: Cardiovascular Conditions, Quality Indicators (QIs), Quality Measures, Quality Improvement, Quality of Care, Evidence-Based Practice, Patient-Centered Outcomes Research, Primary Care
Abramsohn E, DePumpo M, Boyd K
Implementation of community-based resource referrals for cardiovascular disease self-management.
Investigators described primary care practices' implementation of CommunityRx-H3. They found that practice facilitators were increasingly being utilized by primary care practices to support quality improvement interventions and could also play an important role in implementation science. Their study yielded insights to improve implementation of community resource referral solutions to support primary care cardiovascular disease prevention efforts.
AHRQ-funded; HS023921.
Citation: Abramsohn E, DePumpo M, Boyd K .
Implementation of community-based resource referrals for cardiovascular disease self-management.
Ann Fam Med 2020 Nov;18(6):486-95. doi: 10.1370/afm.2583..
Keywords: Cardiovascular Conditions, Patient Self-Management, Primary Care, Quality Improvement, Quality of Care, Implementation
Makelarski JA, DePumpo M, Boyd K
Implementation of systematic community resource referrals at small primary care practices to promote cardiovascular disease self-management.
The purpose of this study was to describe outcomes from implementation of a community resource referral system into small clinical practices to reduce cardiovascular disease risk. HealtheRx-H3, a printed list of resources for patients, was created. It was feasible to create practice-specific HealtheRx-H3s; however, systematic distribution of HealtheRx-H3s using digital electronic health record integration was found to be infeasible. Successful implementation of quality improvement strategies to systematize community resource referral solutions was feasible at small practices, but more research was recommended in order to understand what motivates small practices to participate in implementation of these solutions.
AHRQ-funded; HS023921.
Citation: Makelarski JA, DePumpo M, Boyd K .
Implementation of systematic community resource referrals at small primary care practices to promote cardiovascular disease self-management.
J Healthc Qual 2020 Sep/Oct;42(5):278-86. doi: 10.1097/jhq.0000000000000234..
Keywords: Cardiovascular Conditions, Risk, Community-Based Practice, Patient Self-Management, Education: Patient and Caregiver, Primary Care, Implementation, Lifestyle Changes
Dickinson WP, Nease DE, Rhyne RL
Practice transformation support and patient engagement to improve cardiovascular care: from EvidenceNOW Southwest (ENSW).
The purpose of this study was to improve cardiovascular care through supporting primary care practices' adoption of evidence-based guidelines; a cluster randomized trial compared standard practice support--practice facilitation, practice assessment with feedback, health information technology assistance, and collaborative learning sessions--and standard support plus patient engagement support. Findings showed that practice transformation support can assist practices with improving quality of care. Patient engagement in practice transformation can further enhance practices' implementation of aspects of new models of care.
AHRQ-funded; HS023904.
Citation: Dickinson WP, Nease DE, Rhyne RL .
Practice transformation support and patient engagement to improve cardiovascular care: from EvidenceNOW Southwest (ENSW).
J Am Board Fam Med 2020 Sep-Oct;33(5):675-86. doi: 10.3122/jabfm.2020.05.190395..
Keywords: Cardiovascular Conditions, Primary Care: Models of Care, Primary Care, Patient and Family Engagement, Evidence-Based Practice, Implementation, Quality Improvement, Quality of Care
Halladay JR, Weiner BJ, In Kim J
Practice level factors associated with enhanced engagement with practice facilitators; findings from the Heart Health Now study.
In this analysis, the authors explored the practice and facilitator factors associated with greater team engagement at the mid-point of a 12-month practice facilitation intervention focused on implementing cardiovascular prevention activities in practice. Using data from the EvidenceNow initiative's NC Cooperative, named Heart Health Now, they found that their analysis provided information for practice facilitation stakeholders to consider when determining which practices may be more amendable to embracing facilitation services.
AHRQ-funded; HS023912.
Citation: Halladay JR, Weiner BJ, In Kim J .
Practice level factors associated with enhanced engagement with practice facilitators; findings from the Heart Health Now study.
BMC Health Serv Res 2020 Jul 28;20(1):695. doi: 10.1186/s12913-020-05552-4.
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Keywords: Heart Disease and Health, Cardiovascular Conditions, Primary Care, Primary Care: Models of Care, Patient-Centered Healthcare, Evidence-Based Practice, Teams
Homco J, Carabin H, Nagykaldi Z
Validity of medical record abstraction and electronic health record-generated reports to assess performance on cardiovascular quality measures in primary care.
The purpose of this study was to compare observed performance scores measured using 2 imperfect reference standard data sources with misclassification-adjusted performance scores obtained using bayesian latent class analysis. Using aspirin, blood pressure, and smoking performance data from the Healthy Hearts for Oklahoma Project, researchers found that extracting information for the same individuals using different data sources generated different performance score estimates. Recommendations included further research to identify the sources of these differences.
AHRQ-funded; HS023919.
Citation: Homco J, Carabin H, Nagykaldi Z .
Validity of medical record abstraction and electronic health record-generated reports to assess performance on cardiovascular quality measures in primary care.
JAMA Netw Open 2020 Jul;3(7):e209411. doi: 10.1001/jamanetworkopen.2020.9411..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Cardiovascular Conditions, Quality Measures, Quality of Care, Primary Care, Provider Performance, Evidence-Based Practice
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
Nguyen AM, Cuthel A, Padgett DK
How practice facilitation strategies differ by practice context.
The purpose of this study was to identify contextual factors that drive facilitators' strategies to meet practice improvement goals, and how these strategies are tailored to practice context. This study was conducted as part of a larger study, HealthyHearts New York City, which evaluated the impact of practice facilitation on adoption of cardiovascular disease prevention and treatment guidelines.
AHRQ-funded; HS023922.
Citation: Nguyen AM, Cuthel A, Padgett DK .
How practice facilitation strategies differ by practice context.
J Gen Intern Med 2020 Mar;35(3):824-31. doi: 10.1007/s11606-019-05350-7..
Keywords: Quality Improvement, Evidence-Based Practice, Heart Disease and Health, Cardiovascular Conditions, Primary Care, Quality of Care, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Primary Care: Models of Care
Parchman ML, Fagnan LJ, Dorr DA
Study protocol for "Healthy Hearts Northwest": a 2 x 2 randomized factorial trial to build quality improvement capacity in primary care.
The researchers describe the protocol of the "Healthy Hearts Northwest" (H2N) study, a randomized trial designed to address to quality improvement (QI) capacity within smaller primary care practices while improving risk factors for cardiovascular disease. The study is utilizing a two-by-two factorial design to assess four different combinations of practice support: practice facilitation (PF) alone, PF with educational outreach, PF with shared learning opportunities, or PF with both.
AHRQ-funded; HS023908.
Citation: Parchman ML, Fagnan LJ, Dorr DA .
Study protocol for "Healthy Hearts Northwest": a 2 x 2 randomized factorial trial to build quality improvement capacity in primary care.
Implement Sci 2016 Oct 13;11(1):138.
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Keywords: Primary Care, Evidence-Based Practice, Quality Improvement, Patient-Centered Outcomes Research, Cardiovascular Conditions
Shelley DR, Ogedegbe G, Anane S
Testing the use of practice facilitation in a cluster randomized stepped-wedge design trial to improve adherence to cardiovascular disease prevention guidelines: HealthyHearts NYC.
The long-term goal of the HealthyHearts NYC trial is to create a robust infrastructure for implementing and disseminating evidence-based practice guidelines in primary care practices. The authors hypothesized that practice facilitation will result in superior clinical outcomes compared to usual care and that the effects of practice facilitation will be mediated by greater adoption of system changes in accord with patient-centered medical homes and the chronic care model.
AHRQ-funded; HS023922.
Citation: Shelley DR, Ogedegbe G, Anane S .
Testing the use of practice facilitation in a cluster randomized stepped-wedge design trial to improve adherence to cardiovascular disease prevention guidelines: HealthyHearts NYC.
Implement Sci 2016 Jul 4;11(1):88. doi: 10.1186/s13012-016-0450-2.
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Keywords: Cardiovascular Conditions, Evidence-Based Practice, Guidelines, Patient-Centered Outcomes Research, Primary Care
Cohen DJ, Balasubramanian BA, Gordon L
A national evaluation of a dissemination and implementation initiative to enhance primary care practice capacity and improve cardiovascular disease care: the ESCALATES study protocol.
This paper describes the study protocol for the EvidenceNOW national evaluation, which is called Evaluating System Change to Advance Learning and Take Evidence to Scale (ESCALATES). Quantitative, qualitative, and mixed methods analyses will be conducted to examine how Cooperatives organize to provide external support to practices, to compare effectiveness of the dissemination and implementation approaches they implement, and to examine how regional variations and other organization and contextual factors influence implementation and effectiveness.
AHRQ-funded; HS022981; HS023940.
Citation: Cohen DJ, Balasubramanian BA, Gordon L .
A national evaluation of a dissemination and implementation initiative to enhance primary care practice capacity and improve cardiovascular disease care: the ESCALATES study protocol.
Implement Sci 2016 Jun 29;11(1):86. doi: 10.1186/s13012-016-0449-8.
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Keywords: Cardiovascular Conditions, Evidence-Based Practice, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Prevention, Primary Care, Research Methodologies
Ladapo JA, Blecker S, Douglas PS
Appropriateness of cardiac stress test use among primary care physicians and cardiologists in the United States.
In this study, the researchers used nationally-representative data to examine differences in appropriate use of cardiac stress testing between cardiologists and primary care physicians (PCPs) in the US. Using permissive criteria to determine appropriateness, they found that primary care physicians are more likely to order or perform a rarely appropriate cardiac stress test than cardiologists.
AHRQ-funded; HS023683.
Citation: Ladapo JA, Blecker S, Douglas PS .
Appropriateness of cardiac stress test use among primary care physicians and cardiologists in the United States.
Int J Cardiol 2016 Jan 15;203:584-6. doi: 10.1016/j.ijcard.2015.10.238.
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Keywords: Cardiovascular Conditions, Diagnostic Safety and Quality, Imaging, Primary Care, Shared Decision Making