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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results1 to 10 of 10 Research Studies Displayed
Nembhard IM, Morrow CT, Bradley EH
Implementing role-changing versus time-changing innovations in health care: differences in helpfulness of staff improvement teams, management, and network for learning.
This paper examined the hypothesis that the degree to which access to groups that can alter organizational learning depends on innovation type. Team representativeness and network membership were positively associated with implementing role-changing practices; while senior management engagement was positively associated with implementing time-changing practices. The authors concluded that these findings advance implementation science by explaining mixed results across past studies, that the nature of change for workers alters potential facilitators' effects on implementation.
Citation: Nembhard IM, Morrow CT, Bradley EH . Implementing role-changing versus time-changing innovations in health care: differences in helpfulness of staff improvement teams, management, and network for learning. Med Care Res Rev 2015 Dec;72(6):707-35. doi: 10.1177/1077558715592315.
Keywords: Healthcare Delivery, Quality Improvement, Organizational Change, Teams, Quality of Care, Learning Health Systems, Implementation
Cutting EM, Overby CL, Banchero M
Using workflow modeling to identify areas to improve genetic test processes in the University of Maryland Translational Pharmacogenomics Project.
The researchers used information gained from focus groups in order to illustrate the current process of delivering genetic test results to clinicians. They proposed a business process model and notation (BPMN) representation of this process for a Translational Pharmacogenomics Project being implemented at the University of Maryland Medical Center. They found that the current process could be improved to reduce input errors, better inform and notify clinicians about the implications of certain genetic tests, and make results more easily understood. They demonstrated theiruse of BPMN to improve this important clinical process for CYP2C19 genetic testing.
Citation: Cutting EM, Overby CL, Banchero M . Using workflow modeling to identify areas to improve genetic test processes in the University of Maryland Translational Pharmacogenomics Project. AMIA Annu Symp Proc 2015 Nov 5;2015:466-74.
Keywords: Genetics, Diagnostic Safety and Quality, Medication, Workflow, Quality Improvement, Quality of Care, Organizational Change
Collins CE, Pringle PL, Santry HP
Innovation or rebranding, acute care surgery diffusion will continue.
The researchers conducted a qualitative study comprising face-to-face interviews with senior surgeons responsible for acute care surgery (ACS) at 18 teaching hospitals chosen to ensure diversity of opinions and practice environment. Their analysis suggests that the implementation of ACS, whether a true health care delivery innovation or an innovative rebranding, fits into the Rogers’ diffusion of innovation theory.
Citation: Collins CE, Pringle PL, Santry HP . Innovation or rebranding, acute care surgery diffusion will continue. J Surg Res 2015 Aug;197(2):354-62. doi: 10.1016/j.jss.2015.03.046..
Keywords: Surgery, Critical Care, Organizational Change, Provider: Physician
Nembhard IM, Labao I, Savage S
Breaking the silence: determinants of voice for quality improvement in hospitals.
The researchers examined the drivers of “voice” for health professionals in hospitals. “Voice” is understood as the discretionary communication of ideas, suggestions, concerns, or opinions about work-related issues with the intent to improve organizational or unit functioning. They found that factors related to individuals (e.g., tenure), work (e.g., work configuration), organizational context (e.g., culture), data (e.g., benchmarking), and the external environment (e.g., attention) influenced health professionals’ voice.
Citation: Nembhard IM, Labao I, Savage S . Breaking the silence: determinants of voice for quality improvement in hospitals. Health Care Manage Rev 2015 Jul-Sep;40(3):225-36. doi: 10.1097/hmr.0000000000000028..
Keywords: Hospitals, Quality Improvement, Quality of Care, Communication, Organizational Change, Health Services Research (HSR)
Fontaine P, Whitebird R, Solberg LI
Minnesota's early experience with medical home implementation: viewpoints from the front lines.
This study aimed to identify the facilitators and barriers encountered by nine diverse primary care practices selected from the first 80 to achieve patient-centered medical home (PCMH) certification in Minnesota. It found that facilitators to achieve PCMH certification included a requirement for patient involvement, which pushed practices to create patient-centered innovations, and new reimbursement models based on quality indicators for a population.
Citation: Fontaine P, Whitebird R, Solberg LI . Minnesota's early experience with medical home implementation: viewpoints from the front lines. J Gen Intern Med 2015 Jul;30(7):899-906. doi: 10.1007/s11606-014-3136-y..
Keywords: Patient-Centered Healthcare, Primary Care, Implementation, Organizational Change, Healthcare Delivery, Practice Improvement, Health Services Research (HSR)
Solberg LI, Stuck LH, Crain AL
Organizational factors and change strategies associated with medical home transformation.
The researchers surveyed leaders of the first 132 primary care practices in Minnesota to achieve medical home certification. The Change Process Capability Questionnaire survey and the Physician Practice Connections survey showed that 80% to 100% of these certified clinics had 15 of the 18 organizational factors important for improving care processes and that 60% to 90% had successfully used 16 improvement strategies.
Citation: Solberg LI, Stuck LH, Crain AL . Organizational factors and change strategies associated with medical home transformation. Am J Med Qual 2015 Jul-Aug;30(4):337-44. doi: 10.1177/1062860614532307.
Keywords: Patient-Centered Healthcare, Primary Care, Practice Improvement, Organizational Change, Quality Improvement, Quality of Care, Healthcare Delivery
Birken SA, Lee SY, Weiner BJ
From strategy to action: how top managers' support increases middle managers' commitment to innovation implementation in health care organizations.
The researchers surveyed and interviewed middle managers implementing an innovation intended to reduce health disparities in 120 U.S. health centers to assess whether top managers’ support directly influences middle managers’ commitment. Their results suggest that top managers increase middle managers’ commitment by directly conveying to middle managers that innovation implementation is an organizational priority, as well as by several other means.
AHRQ-funded; HS019107; HS013635.
Citation: Birken SA, Lee SY, Weiner BJ . From strategy to action: how top managers' support increases middle managers' commitment to innovation implementation in health care organizations. Health Care Manage Rev 2015 Apr-Jun;40(2):159-68. doi: 10.1097/hmr.0000000000000018..
Keywords: Healthcare Delivery, Implementation, Organizational Change
Nembhard IM, Yuan CT, Shabanova V
The relationship between voice climate and patients' experience of timely care in primary care clinics.
The aims of this study were to assess the relationship between organizational climate and patients’ reports of timely care in primary care clinics and to broadly examine the link between staff’s work environment and patient care experiences. It found that clinical and administrative staff (e.g., nurses and office assistants) reported clinics’ climates to be significantly less supportive of voice than did clinical leaders (e.g., physicians).
AHRQ-funded; HS018987; HS016978.
Citation: Nembhard IM, Yuan CT, Shabanova V . The relationship between voice climate and patients' experience of timely care in primary care clinics. Health Care Manage Rev 2015 Apr-Jun;40(2):104-15. doi: 10.1097/hmr.0000000000000017..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient Experience, Primary Care, Quality of Care, Organizational Change, Provider
James KA, Ross SE, Vance B
AHRQ Author: Harrison MI
Inefficiency in primary care: common causes and potential solutions.
The researchers undertook a project to better understand the sources of and remedies for inefficiency in primary care. With the data they collected, they created a website (http:// cufamilymedicine.org/efficiency) that busy primary care practices can use to learn about common sources of inefficiency in primary care and real-world suggestions on how to improve.
Citation: James KA, Ross SE, Vance B . Inefficiency in primary care: common causes and potential solutions. Fam Pract Manag 2015 Mar-Apr;22(2):18-22..
Keywords: Primary Care, Organizational Change
Rangachari P, Madaio M, Rethemeyer RK
The evolution of knowledge exchanges enabling successful practice change in two intensive care units.
There are gaps in understanding the mechanisms by which top-down communications enable practice change. The authors sought to address these gaps in order to help identify evidence-based management strategies for successful practice change at the unit level. They found that both intensive care units studied experienced substantially improved outcomes and indicated a statistically significant increase in proactive communications. Early in the study, champions emerged within each unit to initiate process improvements. The authors concluded that the study helped to identify evidence-based management strategies for successful practice change at the unit level.
Citation: Rangachari P, Madaio M, Rethemeyer RK . The evolution of knowledge exchanges enabling successful practice change in two intensive care units. Health Care Manage Rev 2015 Jan-Mar;40(1):65-78. doi: 10.1097/hmr.0000000000000001.
Keywords: Intensive Care Unit (ICU), Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Critical Care, Communication, Evidence-Based Practice, Organizational Change, Prevention, Patient Safety