National Healthcare Quality and Disparities Report
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Topics
- Adverse Events (1)
- Asthma (1)
- Behavioral Health (3)
- Cancer (1)
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- Care Coordination (1)
- Caregiving (2)
- Children/Adolescents (3)
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- Clinician-Patient Communication (3)
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- Education: Patient and Caregiver (2)
- Electronic Health Records (EHRs) (4)
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- Health Services Research (HSR) (1)
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- Outcomes (1)
- Palliative Care (1)
- (-) Patient-Centered Healthcare (15)
- (-) Patient-Centered Outcomes Research (15)
- Patient and Family Engagement (5)
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- Primary Care: Models of Care (2)
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- Provider: Clinician (1)
- Provider: Physician (1)
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- Sickle Cell Disease (1)
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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 15 of 15 Research Studies DisplayedKukulka K, Washington KT, Govindarajan R
Stakeholder perspectives on the biopsychosocial and spiritual realities of living with ALS: implications for palliative care teams.
The purpose of this study was to generate a rich description of the realities of living with amyotrophic lateral sclerosis (ALS), equipping palliative care teams with an in-depth understanding of the experiences and needs of patients with ALS and their family caregivers. Study findings illustrated the intricacies of living with ALS and the importance of eliciting individualized values when caring for patients with ALS and their families. The investigators concluded that the complex biopsychosocial needs experienced by patients and family caregivers suggested numerous opportunities for meaningful palliative care involvement.
AHRQ-funded; HS022140.
Citation: Kukulka K, Washington KT, Govindarajan R .
Stakeholder perspectives on the biopsychosocial and spiritual realities of living with ALS: implications for palliative care teams.
Am J Hosp Palliat Care 2019 Oct;36(10):851-57. doi: 10.1177/1049909119834493..
Keywords: Palliative Care, Patient-Centered Outcomes Research, Neurological Disorders, Patient-Centered Healthcare, Patient and Family Engagement, Caregiving
Timbie JW, Kranz AM, Mahmud A
Federally qualified health center strategies for integrating care with hospitals and their association with measures of communication.
Federally qualified health centers have aligned clinical services and systems with local hospitals, but little is known about the specific care integration strategies health centers use or their impact on care. In this study, a research team examined the use of strategies by health centers to integrate care with hospitals and emergency departments (EDs) and their association with performance on measures of health center-hospital communication.
AHRQ-funded; HS024067.
Citation: Timbie JW, Kranz AM, Mahmud A .
Federally qualified health center strategies for integrating care with hospitals and their association with measures of communication.
Jt Comm J Qual Patient Saf 2019 Sep;45(9):620-28. doi: 10.1016/j.jcjq.2019.06.004..
Keywords: Patient-Centered Healthcare, Patient-Centered Outcomes Research, Hospitals, Communication, Emergency Department, Care Coordination, Healthcare Delivery
Rogers ES, Cuthel AM, Berry CA
Clinician perspectives on the benefits of practice facilitation for small primary care practices.
This study examined the effectiveness of practice facilitation to improve cardiovascular disease in 257 small independent primary care practices (SIPs) enrolled in the AHRQ-funded EvidenceNOW initiative called HealthyHearts. These SIPs were enrolled in HealthyHearts NYC in New York City. Interviews were conducted with SIPs with 3 or fewer office staff and their answers were compared with interviews with practices with more than 3 office staff. Three facilitation benefits were found to the most important, including 1. Creating awareness of quality gaps; 2. Connecting practices to information, resources, and strategies, and; 3. Optimizing the HER for QI goals.
AHRQ-funded; HS023922.
Citation: Rogers ES, Cuthel AM, Berry CA .
Clinician perspectives on the benefits of practice facilitation for small primary care practices.
Ann Fam Med 2019 Aug 12;17(Suppl 1):S17-s23. doi: 10.1370/afm.2427..
Keywords: Primary Care, Provider: Clinician, Provider: Physician, Provider, Quality Improvement, Quality of Care, Cardiovascular Conditions, Heart Disease and Health, Evidence-Based Practice, Patient-Centered Healthcare, Patient-Centered Outcomes Research
Sklar M, Hatch MR, Aarons GA
A climate for evidence-based practice implementation in the patient-centred medical home.
This paper discusses variations in climate for evidence-based practice (EBP) implementation in patient-centered medical homes (PCMHs) in the United States. The study compared two Rhode Island PCMHs, one a Family Care Center (FCC), and the other an Internal Medicine Clinic (IMC). The FCC staff had more positive attitudes towards EBP than IMC staff. They also reported greater educational support for EBPs than IMC staff and physicians. The importance of removing barriers to EBP implementation was emphasized.
AHRQ-funded; HS024192.
Citation: Sklar M, Hatch MR, Aarons GA .
A climate for evidence-based practice implementation in the patient-centred medical home.
J Eval Clin Pract 2019 Aug;25(4):637-47. doi: 10.1111/jep.13050..
Keywords: Evidence-Based Practice, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Primary Care, Provider
Yanez B, Bouchard LC, Cella D
Patient-centered engagement and symptom/toxicity monitoring in the new era of tumor next-generation sequencing and immunotherapy: the OncoTool and OncoPRO platforms.
This paper describes the development of the OncoTool and OncoPRO platforms to help patients with late-stage cancer (stages III-IV) and their providers in providing patient-centered education and remote and routine monitoring of symptoms and toxicities after tumor next-generation sequencing testing and treatment. The OncoTool is a web-based educational resource tailored for people with advanced cancer. It aims to provide patients with easy-to-understand treatment options and associated toxicities as well as evidence-based strategies for managing symptoms and improving stress management. It is fully integrated with OncoPRO which provides feedback on patient-reported outcomes (PROs) to clinicians. The data from the platform can be integrated with the patient’s electronic health record (HER) and can provide an alert message. These systems are currently being tested with 4 trials – 1 for OncoTool and the other 3 for OncoPRO.
AHRQ-funded; HS023011.
Citation: Yanez B, Bouchard LC, Cella D .
Patient-centered engagement and symptom/toxicity monitoring in the new era of tumor next-generation sequencing and immunotherapy: the OncoTool and OncoPRO platforms.
Cancer 2019 Jul 15;125(14):2338-44. doi: 10.1002/cncr.32030..
Keywords: Cancer, Education: Patient and Caregiver, Electronic Health Records (EHRs), Evidence-Based Practice, Health Information Technology (HIT), Patient-Centered Healthcare, Patient-Centered Outcomes Research, Patient and Family Engagement
Hall TL, Knierim KE, Nease DE
Primary care practices' implementation of patient-team partnership: findings from EvidenceNOW Southwest.
The authors reported on practice characteristics associated with greater patient-team partnership scores. Using EvidenceNOW Southwest data, they found that practices can improve efforts to partner with patients to assess social needs, gather meaningful input on practice improvement and patient experience, and offer resource connections. These findings supplement recent evidence that patient registries and evidence-based guidelines may effectively prevent and manage cardiovascular disease.
AHRQ-funded; HS023904.
Citation: Hall TL, Knierim KE, Nease DE .
Primary care practices' implementation of patient-team partnership: findings from EvidenceNOW Southwest.
J Am Board Fam Med 2019 Jul-Aug;32(4):490-504. doi: 10.3122/jabfm.2019.04.180361..
Keywords: Cardiovascular Conditions, Clinician-Patient Communication, Evidence-Based Practice, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Patient and Family Engagement, Primary Care, Quality of Care, Quality Improvement
Patel MR, Smith A, Leo H
Improving patient-provider communication and therapeutic practice through better integration of electronic health records in the exam room: a pilot study.
This study assessed the effectiveness of providing physicians who use electronic health records (EHRs) education for communication strategies and its impact on patient outcomes. The evidence-based Physician Asthma Care Education (PACE) program was extended in a pilot program using 18 providers and 126 adult patients with persistent asthma. Outcomes were assessed at baseline and 3- and 6-month postintervention intervals. Providers who completed the EHR-PACE program felt more confident in communicating with their patients, but there was no significant changes in patient asthma outcomes or their perceptions of their provider’s communication skills.
AHRQ-funded; HS023786.
Citation: Patel MR, Smith A, Leo H .
Improving patient-provider communication and therapeutic practice through better integration of electronic health records in the exam room: a pilot study.
Health Educ Behav 2019 Jun;46(3):484-93. doi: 10.1177/1090198118796879..
Keywords: Asthma, Clinician-Patient Communication, Communication, Electronic Health Records (EHRs), Evidence-Based Practice, Health Information Technology (HIT), Outcomes, Patient-Centered Healthcare, Patient-Centered Outcomes Research
Pavlo AJ, O'Connell M, Olsen S
Missing ingredients in shared decision-making?
This article discusses the practice of shared decision making (SDM) for clinicians when making decisions in health care. This widespread practice is considered the best approach for person-centered care, but for individuals diagnosed with serious mental illness there are still many barriers to effective collaboration. The authors suggest that more emphasis needs to be placed on the doctor-patient relationship itself conducting SDM.
AHRQ-funded; HS023000.
Citation: Pavlo AJ, O'Connell M, Olsen S .
Missing ingredients in shared decision-making?
Psychiatr Q 2019 Jun;90(2):333-38. doi: 10.1007/s11126-019-9624-9..
Keywords: Chronic Conditions, Clinician-Patient Communication, Communication, Decision Making, Behavioral Health, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Patient and Family Engagement
Riley AR, Paternostro JK, Walker BL
The impact of behavioral health consultations on medical encounter duration in pediatric primary care: a retrospective match-controlled study.
This retrospective match-controlled study examined the impact of behavioral health consultations on medical visit duration in pediatric primary care. Patient encounters involving behavioral health consultants were significantly longer (11 plus minutes) than matched controls, and had less time allowed for medical care. The authors of the study recommend that behavioral health consultants work with the clinician to improve time efficiency.
AHRQ-funded; HS022981.
Citation: Riley AR, Paternostro JK, Walker BL .
The impact of behavioral health consultations on medical encounter duration in pediatric primary care: a retrospective match-controlled study.
Fam Syst Health 2019 Jun;37(2):162-66. doi: 10.1037/fsh0000406..
Keywords: Behavioral Health, Children/Adolescents, Healthcare Delivery, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Primary Care, Primary Care: Models of Care
Lyles CR, Gupta R, Tieu L
After-visit summaries in primary care: mixed methods results from a literature review and stakeholder interviews.
This literature review examined the perception of the value of after visit summaries (AVS) in primary care practices to both patients and providers. Seventeen studies were identified, and overall patients reported a higher perceived value of AVS than providers. Even so, key informants found that AVS included incorrect information and that they weren’t being used to their potential to help educate patients.
AHRQ-funded; HS022408.
Citation: Lyles CR, Gupta R, Tieu L .
After-visit summaries in primary care: mixed methods results from a literature review and stakeholder interviews.
Fam Pract 2019 Mar 20;36(2):206-13. doi: 10.1093/fampra/cmy045..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Patient-Centered Healthcare, Patient-Centered Outcomes Research, Primary Care
Lyles CR, Tieu L, Sarkar U
A randomized trial to train vulnerable primary care patients to use a patient portal.
This study examined the use of patient care portals in primary care practices with vulnerable patients such as those with lower socioeconomic status or limited health literacy (LHL). A randomized control trial was created with 93 English-speaking patients with 1+ chronic diseases. The patients were provided with either an 1) in-person tutorial with a research assistant, or 2) a link to view the videos on their own. A third arm of the trial were control patients with just normal access to get to the portal. There was a higher rate of access (21%) after the trial was over with the two intervention groups as compared with 9% for the usual care patients.
AHRQ-funded; HS022408; HS022561; HS023558.
Citation: Lyles CR, Tieu L, Sarkar U .
A randomized trial to train vulnerable primary care patients to use a patient portal.
J Am Board Fam Med 2019 Mar-Apr;32(2):248-58. doi: 10.3122/jabfm.2019.02.180263..
Keywords: Electronic Health Records (EHRs), Health Information Exchange (HIE), Health Literacy, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Primary Care, Vulnerable Populations
Riley AR, Freeman KA
Impacting pediatric primary care: opportunities and challenges for behavioral research in a shifting healthcare landscape.
This commentary discusses the role that behavioral analysts can have in partnership with pediatric medicine. There have been advances, but there has been limited impact for the daily practice of pediatrics. The authors discuss why behavioral pediatrics has failed to gain traction in primary care, describe possible opportunities for an expanded portfolio of research, and identify several examplars from the behavior analytic literature that has influenced pediatric primary care, and make further recommendations for producing influential data.
AHRQ-funded; HS022981.
Citation: Riley AR, Freeman KA .
Impacting pediatric primary care: opportunities and challenges for behavioral research in a shifting healthcare landscape.
Behav Anal 2019 Feb;19(1):23-38. doi: 10.1037/bar0000114..
Keywords: Behavioral Health, Children/Adolescents, Health Services Research (HSR), Healthcare Delivery, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Primary Care, Primary Care: Models of Care, Research Methodologies
Crosby LE, Walton A, Shook LM
Development of a hydroxyurea decision aid for parents of children with sickle cell anemia.
This study developed a decision aid for use of hydroxyurea for parents of children with sickle cell anemia. There are national evidence-based guidelines, but they do not offer strategies for implementation. A multicomponent decision aid was developed via a needs assessment, clinic observations and iterative feedback. The decision aid was considered useful by the 75 parents and 28 clinicians who participated in all phases of the study.
AHRQ-funded; HS021114.
Citation: Crosby LE, Walton A, Shook LM .
Development of a hydroxyurea decision aid for parents of children with sickle cell anemia.
J Pediatr Hematol Oncol 2019 Jan;41(1):56-63. doi: 10.1097/mph.0000000000001257..
Keywords: Caregiving, Children/Adolescents, Chronic Conditions, Decision Making, Education: Patient and Caregiver, Medication, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Sickle Cell Disease
Sanger P, Hartzler A, Lober WB
Design considerations for post-acute care mHealth: patient perspectives.
The authors are developing an mHealth platform to engage patients in wound tracking to identify and manage surgical site infections (SSI) after hospital discharge. Their key design qualities include: meeting basic accessibility, usability and security needs; encouraging patient-centeredness; facilitating better, more predictable communication; and supporting personalized management by providers. In this article, they illustrated their application of these guiding design considerations and proposed a new framework for mHealth design based on illness duration and intensity.
AHRQ-funded; HS019482.
Citation: Sanger P, Hartzler A, Lober WB .
Design considerations for post-acute care mHealth: patient perspectives.
AMIA Annu Symp Proc 2014 Nov 14;2014:1920-9.
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Keywords: Telehealth, Patient Self-Management, Surgery, Injuries and Wounds, Healthcare-Associated Infections (HAIs), Hospital Discharge, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Adverse Events
Lavallee DC, Wicks P, Alfonso Cristancho R
Stakeholder engagement in patient-centered outcomes research: high-touch or high-tech?
In this article, the authors compared and contrasted high-tech and high-touch approaches to engaging stakeholders and suggested hybrid processes.
AHRQ-funded; HS022135; HS022959.
Citation: Lavallee DC, Wicks P, Alfonso Cristancho R .
Stakeholder engagement in patient-centered outcomes research: high-touch or high-tech?
Expert Rev Pharmacoecon Outcomes Res 2014 Jun;14(3):335-44. doi: 10.1586/14737167.2014.901890.
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Keywords: Patient-Centered Outcomes Research, Evidence-Based Practice, Patient-Centered Healthcare, Patient and Family Engagement