National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Blood Pressure (1)
- Cardiovascular Conditions (4)
- Central Line-Associated Bloodstream Infections (CLABSI) (1)
- Children/Adolescents (2)
- Communication (1)
- Elderly (1)
- (-) Evidence-Based Practice (12)
- Guidelines (3)
- Healthcare-Associated Infections (HAIs) (1)
- Healthcare Delivery (1)
- Health Information Technology (HIT) (1)
- Heart Disease and Health (2)
- Implementation (4)
- Intensive Care Unit (ICU) (1)
- Lifestyle Changes (1)
- Nursing (1)
- Nutrition (1)
- Obesity (1)
- Orthopedics (1)
- Outcomes (4)
- Patient-Centered Outcomes Research (4)
- Patient Safety (2)
- Practice Improvement (2)
- Pressure Ulcers (1)
- Prevention (3)
- Primary Care (4)
- Primary Care: Models of Care (1)
- (-) Quality Improvement (12)
- Quality Measures (1)
- Quality of Care (10)
- Risk (1)
- Rural Health (1)
- Sepsis (1)
- Surgery (2)
- Telehealth (1)
- Tobacco Use (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 12 of 12 Research Studies DisplayedFranklin PD, Bond CP, Rothrock NE
Strategies for effective implementation of patient-reported outcome measures in arthroplasty practice.
This study’s goal was to synthesize patient-reported outcome measure (PROM) implementation strategies that are successfully used by hundreds of arthroplasty surgeons and early PROM-adopter clinical systems. The authors developed guidelines to inform clinical care, drive quality-improvement activities, and support reporting for payer-sponsored incentives. They also outlined future research that is needed to define methods for optimal patient engagement, technology infrastructure, and operational systems to seamlessly integrate PROM collection in clinical care.
AHRQ-funded; HS018910.
Citation: Franklin PD, Bond CP, Rothrock NE .
Strategies for effective implementation of patient-reported outcome measures in arthroplasty practice.
J Bone Joint Surg Am 2021 Dec 15;103(24):e97. doi: 10.2106/jbjs.20.02072..
Keywords: Patient-Centered Outcomes Research, Orthopedics, Quality Improvement, Quality of Care, Evidence-Based Practice, Implementation, Outcomes
Bender M, Williams M, Cruz MF
A study protocol to evaluate the implementation and effectiveness of the Clinical Nurse Leader care model in improving quality and safety outcomes.
The authors discuss the Clinical Nurse Leader care model, a Hybrid Type II Implementation-Effectiveness study to evaluate the effect of the care model on standardized quality and safety outcomes and to identify implementation characteristics that are sufficient and necessary to achieve outcomes. Findings are expected to elucidate Registered Nurse's mechanisms of action as organized into frontline models of care and link actions to improved care quality and safety.
AHRQ-funded; HS027181.
Citation: Bender M, Williams M, Cruz MF .
A study protocol to evaluate the implementation and effectiveness of the Clinical Nurse Leader care model in improving quality and safety outcomes.
Nurs Open 2021 Nov;8(6):3688-96. doi: 10.1002/nop2.910..
Keywords: Implementation, Quality Improvement, Quality of Care, Patient Safety, Nursing, Evidence-Based Practice
Delaney LD, Howard R, Palazzolo K
Outcomes of a presurgical optimization program for elective hernia repairs among high-risk patients.
The authors evaluated the feasibility of evidence-based patient optimization before surgery by implementing a low-cost preoperative optimization clinic. They found that a hernia optimization clinic safely improved management of high-risk patients and increased operative yield for the institution. They concluded that their results represented an opportunity to create sustainable and scalable models that provide longitudinal care and optimize patients to improve outcomes of hernia repair.
AHRQ-funded; HS025778.
Citation: Delaney LD, Howard R, Palazzolo K .
Outcomes of a presurgical optimization program for elective hernia repairs among high-risk patients.
JAMA Netw Open 2021 Nov;4(11):e2130016. doi: 10.1001/jamanetworkopen.2021.30016..
Keywords: Surgery, Risk, Evidence-Based Practice, Quality Improvement, Quality of Care, Outcomes
Berry CA, Nguyen AM, Cuthel AM
Measuring implementation strategy fidelity in HealthyHearts NYC: a complex intervention using practice facilitation in primary care.
This study measured implementation strategy fidelity for the HealthyHearts NYC intervention program, an AHRQ-funded program that uses practice facilitation (PF) to improve adoption of cardiovascular disease evidence-based guidelines in primary care practices. Data from 257 practices measured fidelity using 4 categories: frequency, duration, content, and coverage. Almost all (94.2%) of practices received at least the 13 PF visits with an average 26.3 hours spent at each site by facilitators. Most practices (95.7%) completed all Task List items, and 71.2% were educated on all Chronic Care Models, with the majority (65.8%) receiving full coverage.
AHRQ-funded; HS023922.
Citation: Berry CA, Nguyen AM, Cuthel AM .
Measuring implementation strategy fidelity in HealthyHearts NYC: a complex intervention using practice facilitation in primary care.
Am J Med Qual 2021 Jul-Aug;36(4):270-76. doi: 10.1177/1062860620959450..
Keywords: Implementation, Heart Disease and Health, Cardiovascular Conditions, Primary Care, Practice Improvement, Quality Improvement, Quality of Care, Evidence-Based Practice, Patient-Centered Outcomes Research, Primary Care: Models of Care
Pham-Singer H, Onakomaiya M, Cuthel A
Using a customer relationship management system to manage a quality improvement intervention.
HealthyHearts New York City (HHNYC), one of 7 cooperatives funded through the Agency for Healthcare Research and Quality's EvidenceNOW initiative, evaluated the impact of practice facilitation on implementation of the Million Hearts guidelines for cardiovascular disease prevention and treatment. Tracking the intervention required a system to facilitate process data collection that was also user-friendly and flexible. Coupled with protocols and training, a strategically planned and customizable customer relationship management system (CRMS) was implemented to support the quality improvement intervention with 257 small independent practices.
AHRQ-funded; HS023922.
Citation: Pham-Singer H, Onakomaiya M, Cuthel A .
Using a customer relationship management system to manage a quality improvement intervention.
Am J Med Qual 2021 Jul-Aug;36(4):247-54. doi: 10.1177/1062860620953214..
Keywords: Quality Improvement, Quality of Care, Implementation, Evidence-Based Practice, Cardiovascular Conditions, Heart Disease and Health, Primary Care
Cohen DJ, Sweeney SM, Miller WL
Improving smoking and blood pressure outcomes: the interplay between operational changes and local context.
This study identified conditions and operational changes linked to improvements in smoking and blood pressure (BP) outcomes in primary care using samples and interviews from a subset of 104 practices participating in EvidenceNOW, a multisite cardiovascular disease prevention initiative. The authors calculated Clinical Quality Measure improvements, with targets of 10-point or greater absolute improvements in the proportion of patients with smoking screening, and if relevant, counseling and the proportion of hypertensive patients with adequately controlled BP. Primary care staff were surveyed and interviewed. In clinician-owned practices, implementing a workflow to routinely screen and counsel patients on smoking cessation resources, or implementing a documentation change or a referral to a resource alone led to an improvement of at least 10 points in the smoking outcome. These improvements did not occur though in health- or hospital system-owned practices or in Federally Qualified Health Centers. BP outcome improved by at least 10 points among solo practices after medical assistants learned how to take an accurate BP. Among larger, clinician-owned practices, BP outcomes improvement took place when staff took a second BP measurement after the first measurement was elevated and when staff learned where to document this information in the electronic health record. For larger and health- and hospital system-owned practices, 50 or more hours of facilitation was needed to improve BP outcomes.
AHRQ-funded; HS023940.
Citation: Cohen DJ, Sweeney SM, Miller WL .
Improving smoking and blood pressure outcomes: the interplay between operational changes and local context.
Ann Fam Med 2021 May-Jun;19(3):240-48. doi: 10.1370/afm.2668..
Keywords: Blood Pressure, Tobacco Use, Primary Care, Quality Improvement, Cardiovascular Conditions, Quality of Care, Evidence-Based Practice, Patient-Centered Outcomes Research, Prevention, Outcomes
Paul R, Niedner M, Brilli R
Metric development for the multicenter Improving Pediatric Sepsis Outcomes (IPSO) Collaborative.
A 56 US hospital collaborative, Improving Pediatric Sepsis Outcomes (IPSO), has developed variables, metrics and a data analysis plan to track quality improvement (QI)-based patient outcomes over time. Improving Pediatric Sepsis Outcomes expands on previous pediatric sepsis QI efforts by improving electronic data capture and uniformity across sites. This paper describes the metric development for the multicenter IPSO Collaborative.
AHRQ-funded; HS025696.
Citation: Paul R, Niedner M, Brilli R .
Metric development for the multicenter Improving Pediatric Sepsis Outcomes (IPSO) Collaborative.
Pediatrics 2021 May;147(5):e2020017889. doi: 10.1542/peds.2020-017889..
Keywords: Children/Adolescents, Sepsis, Quality Improvement, Quality of Care, Outcomes, Patient-Centered Outcomes Research, Evidence-Based Practice
Dworsky JQ, Shenoy R, Childers CP
Older veterans undergoing inpatient surgery: what is the compliance with best practice guidelines?
This study’s objective was to determine the documented compliance with best practice guidelines for optimal perioperative care for the older adult surgical patient that were created by the American College of Surgeons Quality Improvement Program and the American Geriatrics Society. The guidelines include 38 measures. A retrospective chart review was conducted on 86 older adults undergoing elective inpatient coronary artery bypass graft, prostatectomy, or colectomy over a 2-year period at a single Veterans Affairs hospital. Mean reported compliance across measures was 41% ± 4%. Of the 38 analyzed measures, 10 measures were achieved for 0 patients, and only 1 patient for 7 measures. Future work is needed to understand barriers for implementation.
AHRQ-funded; HS000046.
Citation: Dworsky JQ, Shenoy R, Childers CP .
Older veterans undergoing inpatient surgery: what is the compliance with best practice guidelines?
Surgery 2021 Feb;169(2):356-61. doi: 10.1016/j.surg.2020.08.033..
Keywords: Elderly, Surgery, Guidelines, Evidence-Based Practice, Quality Improvement, Quality of Care, Quality Measures
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
Shaikh U, Nettiksimmons J, Joseph JG
Collaborative practice improvement for childhood obesity in rural clinics: the Healthy Eating Active Living Telehealth Community of Practice (HEALTH COP).
The authors assessed the impact of participation in a virtual quality improvement (QI) learning network on adherence to clinical guidelines for childhood obesity prevention in rural clinics. They found that children who received care from clinicians who led the implementation of the intervention at their clinic showed significant improvements in nutrition and physical activity. Virtual QI learning networks in geographically dispersed clinics can significantly increase clinicians' adherence to guidelines for childhood obesity and improve access to recommended care for rural and underserved children.
AHRQ-funded; HS018567.
Citation: Shaikh U, Nettiksimmons J, Joseph JG .
Collaborative practice improvement for childhood obesity in rural clinics: the Healthy Eating Active Living Telehealth Community of Practice (HEALTH COP).
Am J Med Qual 2014 Nov-Dec;29(6):467-75. doi: 10.1177/1062860613506252.
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Keywords: Children/Adolescents, Evidence-Based Practice, Health Information Technology (HIT), Lifestyle Changes, Nutrition, Obesity, Prevention, Quality Improvement, Rural Health, Telehealth
Padula WV, Mishra MK, Makic MB
A framework of quality improvement interventions to implement evidence-based practices for pressure ulcer prevention.
The purpose of this paper is to enhance the learner’s competence with knowledge about a framework of quality improvement (QI) interventions to implement evidence-based practices for pressure ulcer (PrU) prevention. The best-practice framework offers a reference point to initiating a bundle of QI interventions in support of evidence-based practices. Hospitals and clinicians tasked with quality improvement efforts can use this framework to problem-solve PrU prevention and other critical issues.
AHRQ-funded; HS023710.
Citation: Padula WV, Mishra MK, Makic MB .
A framework of quality improvement interventions to implement evidence-based practices for pressure ulcer prevention.
Adv Skin Wound Care 2014 Jun;27(6):280-4; quiz 85-6. doi: 10.1097/01.ASW.0000450703.87099.5b..
Keywords: Quality Improvement, Patient Safety, Evidence-Based Practice, Pressure Ulcers, Guidelines
Rangachari P, Madaio M, Rethemeyer RK
Role of communication content and frequency in enabling evidence-based practices.
The study sought to promote central line bundle (CLB) implementation in a medical ICU and a pediatric ICU through periodic quality improvement (QI) interventions over a 52-week period. It found that proactive communications increased by 68 percent in the MICU and 61 percent in the PICU. During the same timeframe, both units increased CLB adherence to 100 percent. Both units also demonstrated statistically significant declines in catheter days.
AHRQ-funded; HS019785.
Citation: Rangachari P, Madaio M, Rethemeyer RK .
Role of communication content and frequency in enabling evidence-based practices.
Qual Manag Health Care 2014 Jan-Mar;23(1):43-58. doi: 10.1097/qmh.0000000000000017..
Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Communication, Evidence-Based Practice, Guidelines, Healthcare-Associated Infections (HAIs), Intensive Care Unit (ICU), Quality of Care, Quality Improvement