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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 DisplayedColey RY, Duan KI, Hoopes AJ
A call to integrate health equity into learning health system research training.
This paper is a call to integrate health equity into the competency domain for learning health systems (LHS) research training. In 2016, AHRQ recommended seven domains for training and mentoring researchers, but health equity was not included. Scholars in the Consortium for Applied Training to Advance the Learning health system with Scholars/Trainees (CATALyST) K12 program recommend that competency domains be extended to reflect growing demands for evidence on health inequities and interventions to alleviate them. The authors present real-life case studies in an LHS research training program that illustrate facilitators, challenges, and potential solutions at the program, funder, and research community-level to receiving training and mentorship in health equity-focused LHS science. They recommend actions in four areas for LHS research training programs: (a) integrate health equity throughout the current LHS domains; (b) develop training and mentoring in health equity; (c) establish program evaluation standards for consideration of health equity; and (d) bring forth relevant, extant expertise from the areas of health disparities research, community-based participatory research, and community-engaged health services research.
AHRQ-funded; HS026369.
Citation: Coley RY, Duan KI, Hoopes AJ .
A call to integrate health equity into learning health system research training.
Learn Health Syst 2022 Oct;6(4):e10330. doi: 10.1002/lrh2.10330..
Keywords: Learning Health Systems, Health Systems, Health Services Research (HSR), Training, Disparities
Franklin PD, Drane D, Wakschlag L
Development of a learning health system science competency assessment to guide training and proficiency assessment.
This paper describes the development of the learning health systems (LHS) Competency Assessment by the AHRQ-funded ACCELERAT K12 training program. Domain experts and trainees were recruited to define and operationalize items to include in an LHS Competency Assessment to support emerging and existing LHS scientists in prioritizing and monitoring proficiency development. The method used was to conduct sequential interviews with 18 experts who iteratively defined skills and tasks to illustrate stage in proficiency and its progression for each of 42 competencies in the seven LHS expertise domains: systems science; research questions and standards of scientific evidence; research methods; informatics; ethics of research and implementation in health systems; improvement and implementation science; and engagement, leadership, and research management. The LHS Competency Assessment was reviewed, and pilot tested by current trainees and further refinement was completed using their feedback. The LHS Competency Assessment was found to offer consistent, graded criteria across the seven LHS domains.
AHRQ-funded; HS026369.
Citation: Franklin PD, Drane D, Wakschlag L .
Development of a learning health system science competency assessment to guide training and proficiency assessment.
Learn Health Syst 2022 Oct;6(4):e10343. doi: 10.1002/lrh2.10343..
Keywords: Learning Health Systems, Health Systems, Health Services Research (HSR), Training, Education: Curriculum
Lozano PM, Lane-Fall M, Franklin PD
AHRQ Author: Chesley FD
Training the next generation of learning health system scientists.
The purpose of this paper was to describe the approaches developed by 11 Agency for Healthcare Research and Quality (AHRQ)- and Patient-Centered Outcomes Research Institute- funded Centers of Excellence (COEs) to grow the number of learning health systems (LHS) scientists. Program directors for each COE have provided descriptive program data since 2018. The authors found that since the program began, the 11 COEs have partnered with health systems to train 110 scholars. Nine programs partner with a Veterans Affairs health system and 9 partner with safety net providers. Clinically trained scholars include 70 physicians and 17 scholars in other clinical disciplines. Non-clinicians represent diverse fields, with most representing population health sciences. Challenges include guiding scholars through issues that can disrupt or delay projects during already-limited program time, such as delays in accessing data, organizational changes, pandemic impacts and others. The researchers concluded that the program documentation provides evidence of scholars' academic accomplishments and career-trajectory achievements.
AHRQ-authored; AHRQ-funded; HS026369; HS026370; HS026372; HS026379; HS026383; HS026385; HS026390; HS026393; HS026395; HS026396; HS026407
Citation: Lozano PM, Lane-Fall M, Franklin PD .
Training the next generation of learning health system scientists.
Learn Health Syst 2022 Oct;6(4):e10342. doi: 10.1002/lrh2.10342..
Keywords: Learning Health Systems, Health Systems, Patient-Centered Outcomes Research, Evidence-Based Practice, Training, Workforce
Bradford A, Shofer M, Singh H
AHRQ Author: Shofer M, Singh H
Measure Dx: implementing pathways to discover and learn from diagnostic errors.
This paper discusses Measure Dx, a new AHRQ resource that translates knowledge from diagnostic measurement research into actionable recommendations. This resource guides healthcare organizations to detect, analyze, and learn from diagnostic safety events as part of a continuous learning and feedback cycle. The goal of Measure Dx is to advance new frontiers in reducing preventable diagnostic harm to patients.
AHRQ-authored; AHRQ-funded; 233201500022I; HS027363.
Citation: Bradford A, Shofer M, Singh H .
Measure Dx: implementing pathways to discover and learn from diagnostic errors.
Int J Qual Health Care 2022 Sep 10;34(3). doi: 10.1093/intqhc/mzac068..
Keywords: Diagnostic Safety and Quality, Patient Safety, Quality Improvement, Quality of Care, Electronic Health Records (EHRs), Health Information Technology (HIT), Health Systems, Learning Health Systems
Perlin J, Sands K, Meyers D
AHRQ Author: Meyers D
Harnessing COVID-19 data through collaboration-rhe Consortium of HCA Healthcare and Academia for Research Generation.
This article describes the rapid initiation of a COVID-19 research consortium known as CHARGE (Consortium of HCA Healthcare and Academia for Research Generation), a multi-institution research partnership in conjunction AHRQ, and its resulting application of the learning health system model. HCA Healthcare developed a curated registry of data during the care of
121, 000 inpatients with COVID-19 in 2020, and AHRQ, along with other partners, helped guide the development of CHARGE to facilitate external researchers using registry data to expand evidence regarding the best management of COVID-19. While HCA Healthcare retained full control of its registry data sets and their use, consortium members were provided academic freedom to conduct approved studies. Through the process, 10 research projects were approved through March 2022. Topics included therapeutic efficacy, health equity, risk stratification, operation efficiency, and predictive models for COVID-19 outcomes. Operational support for all workgroups, including database management, subject matter expertise, legal and privacy consultation, and other support, was provided by HCA Healthcare. The researchers concluded that the development of CHARGE facilitated the development of research partnerships and data solutions to utilize immense amounts of health care data collected during the care of a large influx of critically ill patients.
121, 000 inpatients with COVID-19 in 2020, and AHRQ, along with other partners, helped guide the development of CHARGE to facilitate external researchers using registry data to expand evidence regarding the best management of COVID-19. While HCA Healthcare retained full control of its registry data sets and their use, consortium members were provided academic freedom to conduct approved studies. Through the process, 10 research projects were approved through March 2022. Topics included therapeutic efficacy, health equity, risk stratification, operation efficiency, and predictive models for COVID-19 outcomes. Operational support for all workgroups, including database management, subject matter expertise, legal and privacy consultation, and other support, was provided by HCA Healthcare. The researchers concluded that the development of CHARGE facilitated the development of research partnerships and data solutions to utilize immense amounts of health care data collected during the care of a large influx of critically ill patients.
AHRQ-authored.
Citation: Perlin J, Sands K, Meyers D .
Harnessing COVID-19 data through collaboration-rhe Consortium of HCA Healthcare and Academia for Research Generation.
JAMA Health Forum 2022 May 6;3(5):e220874. doi: 10.1001/jamahealthforum.2022.0874..
Keywords: COVID-19, Learning Health Systems, Health Systems, Registries
Bierman AS, Tong ST, McNellis RJ
AHRQ Author: Bierman AS, Tong ST, McNellis RJ
Realizing the dream: the future of primary care research.
In this article, the authors discussed the primary care research central to successful primary care transformation and to realizing the vision of a high-performing US health system to serve effectively all Americans and their communities while advancing health equity.
AHRQ-authored.
Citation: Bierman AS, Tong ST, McNellis RJ .
Realizing the dream: the future of primary care research.
Ann Fam Med 2022 Mar-Apr;20(2):170-74. doi: 10.1370/afm.2788..
Keywords: Primary Care, Healthcare Delivery, Evidence-Based Practice, Health Systems, Learning Health Systems, Patient-Centered Healthcare
Pestka DL, White KM, DeRoche KK
'Trying to fly the plane while we were building it'. applying a learning health systems approach to evaluate early-stage barriers and facilitators to implementing primary care transformation: a qualitative study.
This study’s objective was to examine the use of a learning health system (LHS) in primary care transformation (PCT) by utilizing the Consolidated Framework for Implementation Research (CFIR) to categorize implementation lessons. A large integrated health delivery system in Minnesota began implementation of a population management PCT in two of its 40 primary care clinics in May 2019. Semistructured qualitative interviews were conducted and observational field notes were taken. Inductive coding of the data was performed, and resultant codes were mapped to the CFIR. Seventeen codes emerged to describe care team members from the two clinics to adopt PCT occurring in each of the five CFIR domains (intervention characteristics, outer setting, inner setting, characteristics of individuals and process), with most codes occurring in the ‘inner setting’ domain.
AHRQ-funded; HS026379.
Citation: Pestka DL, White KM, DeRoche KK .
'Trying to fly the plane while we were building it'. applying a learning health systems approach to evaluate early-stage barriers and facilitators to implementing primary care transformation: a qualitative study.
BMJ Open 2022 Jan 3;12(1):e053209. doi: 10.1136/bmjopen-2021-053209..
Keywords: Learning Health Systems, Health Systems, Primary Care, Practice Improvement
Henriksen K, Rodrick D, Grace EN
AHRQ Author: Henriksen K, Rodrick D, Grace EN, Shofer M, Brady, JP
Pursuing patient safety at the intersection of design, systems engineering, and health care delivery research: an ongoing assessment.
This article describes a grant initiative undertaken by AHRQ that brings design, systems engineering, and health care delivery research together to test new ideas that could make health care safer. Based on feedback received from project teams, lessons learned are emerging that find considerable variation among project teams in deploying the methodology and a longer-than-anticipated amount of time in bringing team members from different disciplines together where they learn to communicate and function as a team. Three narratives are generated in terms of what success might look like.
AHRQ-authored.
Citation: Henriksen K, Rodrick D, Grace EN .
Pursuing patient safety at the intersection of design, systems engineering, and health care delivery research: an ongoing assessment.
J Patient Saf 2021 Dec 1;17(8):e1685-e90. doi: 10.1097/pts.0000000000000577..
Keywords: Patient Safety, Healthcare Delivery, Learning Health Systems, Health Systems
Austin EJ, LeRouge C, Lee JR
A learning health systems approach to integrating electronic patient-reported outcomes across the health care organization.
The authors reported on their effort to develop generalizable learnings that can support the integration of electronic patient-reported outcome measures into clinical practice within a learning health system (LHS) framework. They concluded that the guidelines produced from this work highlighted the complex, multidisciplinary nature of implementing change within LHS contexts, as well as the value of action research approaches to enable rapid, iterative learning that leverages the knowledge and experience of communities of practice.
AHRQ-funded; HS023785.
Citation: Austin EJ, LeRouge C, Lee JR .
A learning health systems approach to integrating electronic patient-reported outcomes across the health care organization.
Learn Health Syst 2021 Oct;5(4):e10263. doi: 10.1002/lrh2.10263..
Keywords: Learning Health Systems, Health Information Technology (HIT), Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice
Atkinson MK, Singer SJ
Managing organizational constraints in innovation teams: a qualitative study across four health systems.
This study examined how interdisciplinary teams are affected by and manage external constraints over the lifecycle of their innovation project. The authors used a multimethod qualitative approach consisting of over 3 years of participant observation data to analyze how four interdisciplinary teams across different health system experienced and managed constraints as they pursued process innovations. Their findings point to several practical implications concerning innovation processes in healthcare: 1) how conditions in the organizational context, or constraints, can impede team progress at different stages of innovation; and 2) the collective efforts, or tactics, teams use to manage or work around those constraints to further progress on their innovations.
AHRQ-funded; HS024453.
Citation: Atkinson MK, Singer SJ .
Managing organizational constraints in innovation teams: a qualitative study across four health systems.
Med Care Res Rev 2021 Oct;78(5):521-36. doi: 10.1177/1077558720925993..
Keywords: Learning Health Systems, Health Systems, Teams
Subash M, Liu LH, DeQuattro K
The Development of the Rheumatology Informatics System for Effectiveness Learning Collaborative for improving patient-reported outcome collection and patient-centered communication in adult rheumatology.
Patient-reported outcomes (PROs) are an integral part of treat-to-target approaches in managing rheumatoid arthritis (RA). In clinical practice, however, routine collection, documentation, and discussion of PROs with patients are highly variable. In this paper, the investigators discussed the Development of the Rheumatology Informatics System for Effectiveness Learning Collaborative for improving patient-reported outcome collection and patient-centered communication in adult rheumatology.
AHRQ-funded; HS025638.
Citation: Subash M, Liu LH, DeQuattro K .
The Development of the Rheumatology Informatics System for Effectiveness Learning Collaborative for improving patient-reported outcome collection and patient-centered communication in adult rheumatology.
ACR Open Rheumatol 2021 Oct;3(10):690-98. doi: 10.1002/acr2.11310..
Keywords: Arthritis, Patient-Centered Outcomes Research, Learning Health Systems, Health Information Technology (HIT)
Siddique SM, Tipton K, Leas B
Interventions to reduce hospital length of stay in high-risk populations: a systematic review.
Many strategies to reduce hospital length of stay (LOS) have been implemented, but few studies have evaluated hospital-led interventions focused on high-risk populations. The Agency for Healthcare Research and Quality (AHRQ) Learning Health System panel commissioned this study to further evaluate system-level interventions for LOS reduction. The objective of this study was to identify and synthesize evidence regarding potential systems-level strategies to reduce LOS for patients at high risk for prolonged LOS.
AHRQ-funded; 75Q80120D00002.
Citation: Siddique SM, Tipton K, Leas B .
Interventions to reduce hospital length of stay in high-risk populations: a systematic review.
JAMA Netw Open 2021 Sep;4(9):e2125846. doi: 10.1001/jamanetworkopen.2021.25846..
Keywords: Learning Health Systems, Health Systems, Evidence-Based Practice, Hospital Discharge, Risk, Inpatient Care, Care Management
Bishop JR, Huang RS, Brown JT
Pharmacogenomics education, research and clinical implementation in the state of Minnesota.
This article looks at the development and implementation of formal pharmacogenomic (PGx) clinical programs at several healthcare organizations across Minnesota. These programs increase drug safety and effectiveness. The article reviews the state of PGx activities in the state of Minnesota including educational programs, research, national consortia involvement, technology, clinical implementation and utilization and reimbursement, and outlines the challenges and opportunities in equitable implementation of these activities.
AHRQ-funded; HS026379.
Citation: Bishop JR, Huang RS, Brown JT .
Pharmacogenomics education, research and clinical implementation in the state of Minnesota.
Pharmacogenomics 2021 Jul;22(11):681-91. doi: 10.2217/pgs-2021-0058..
Keywords: Medication, Implementation, Learning Health Systems, Evidence-Based Practice, Patient-Centered Outcomes Research
Yano EM, Resnick A, Gluck M
AHRQ Author: Kwon H, Mistry KB
Accelerating learning healthcare system development through embedded research: career trajectories, training needs, and strategies for managing and supporting embedded researchers.
Health systems and organizations seeking to achieve learning healthcare system principles are increasingly relying on embedded research teams to optimize delivery of evidence-based, high-quality care that improves patient and staff experience alike. In February 2018, 115 attendees from multiple agencies, institutions and professional societies participated in a conference to accelerate development of learning healthcare systems through embedded research. This paper describes the process.
AHRQ-authored.
Citation: Yano EM, Resnick A, Gluck M .
Accelerating learning healthcare system development through embedded research: career trajectories, training needs, and strategies for managing and supporting embedded researchers.
Healthc 2021 Jun;8(Suppl 1):100479. doi: 10.1016/j.hjdsi.2020.100479..
Keywords: Learning Health Systems, Health Systems, Health Services Research (HSR)
Harrison MI, Shortell SM
AHRQ Author: Harrison MI
Multi-level analysis of the learning health system: Integrating contributions from research on organizations and implementation.
The authors have developed a comprehensive, multilevel framework to inform learning health systems (LHSs) research and practice in order to enhance both research on LHSs and practical steps toward their development. Drawing on the Consolidated Framework for Implementation Research, the social-ecological framework, and the organizational change framework, their new framework can help investigators and practitioners broadly scan and then investigate forces influencing improvement and learning and may point to otherwise unnoticed interactions among influential factors.
AHRQ-authored.
Citation: Harrison MI, Shortell SM .
Multi-level analysis of the learning health system: Integrating contributions from research on organizations and implementation.
Learn Health Syst 2021 Apr;5(2):e10226. doi: 10.1002/lrh2.10226..
Keywords: Learning Health Systems, Health Systems, Implementation, Organizational Change