National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Access to Care (1)
- Asthma (1)
- Autism (1)
- Cancer (2)
- Cardiovascular Conditions (1)
- (-) Care Coordination (22)
- Caregiving (2)
- Care Management (2)
- Children/Adolescents (5)
- Chronic Conditions (5)
- Clinician-Patient Communication (2)
- Communication (3)
- Community-Based Practice (1)
- Elderly (1)
- Electronic Health Records (EHRs) (1)
- Healthcare Costs (3)
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- Health Information Technology (HIT) (4)
- Health Insurance (1)
- Health Services Research (HSR) (1)
- Hospital Discharge (1)
- Hospitalization (1)
- Hospitals (2)
- Implementation (1)
- Injuries and Wounds (1)
- Inpatient Care (1)
- Low-Income (1)
- Mortality (1)
- Patient-Centered Healthcare (6)
- Patient and Family Engagement (3)
- Patient Experience (2)
- Patient Safety (1)
- Patient Self-Management (1)
- Primary Care (4)
- Primary Care: Models of Care (1)
- Quality Improvement (2)
- Quality of Care (3)
- Racial and Ethnic Minorities (1)
- Research Methodologies (1)
- Stroke (1)
- Teams (4)
- Tools & Toolkits (1)
- Transitions of Care (3)
- Trauma (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 22 of 22 Research Studies DisplayedParikh K, Richmond M, Lee M
Outcomes from a pilot patient-centered hospital-to-home transition program for children hospitalized with asthma.
The purpose of this study was to evaluate a multi-component hospital-to-home (H2H) transition program for children hospitalized with an asthma exacerbation. A pilot prospective randomized clinical trial of guideline-based asthma care with and without a patient-centered multi-component H2H program was conducted among children enrolled in K-8(th) grade on Medicaid hospitalized for an asthma exacerbation. The investigators concluded that the pilot data suggested that comprehensive care coordination initiated during the inpatient stay was feasible and acceptable.
AHRQ-funded; HS024554.
Citation: Parikh K, Richmond M, Lee M .
Outcomes from a pilot patient-centered hospital-to-home transition program for children hospitalized with asthma.
J Asthma 2021 Oct;58(10):1384-94. doi: 10.1080/02770903.2020.1795877..
Keywords: Children/Adolescents, Patient-Centered Healthcare, Transitions of Care, Asthma, Hospital Discharge, Care Coordination, Chronic Conditions
Hou Y, Bushnell CD, Duncan PW
Hospital to home transition for patients with stroke under bundled payments.
In this paper, the authors describe COMprehensive Post-Acute Stroke Services (COMPASS), a comprehensive transitional care intervention focused on discharge from the acute care setting to home. The COMPASS care model is aligned with the incentive structures and essential components of bundled payments in terms of care coordination, patient assessment, patient and family involvement, and continuity of care. They concluded that ongoing evaluation will inform the design of incorporating COMPASS-like transitional care interventions into a stroke bundle.
AHRQ-funded; R01 HS025723.
Citation: Hou Y, Bushnell CD, Duncan PW .
Hospital to home transition for patients with stroke under bundled payments.
Arch Phys Med Rehabil 2021 Aug;102(8):1658-64. doi: 10.1016/j.apmr.2021.03.010..
Keywords: Transitions of Care, Stroke, Cardiovascular Conditions, Care Coordination
Okado I, Pagano I, Cassel K
Perceptions of care coordination in cancer patient-family caregiver dyads.
The authors examined cancer patients and their family caregivers' perspectives of care coordination (CC) using a dyadic research design. They found that a subgroup of family caregivers reported poorer perception of CC than patients, suggesting that those family caregivers and providers may benefit from intervention. They concluded that further understanding of patient-family caregiver dyads' perspectives of CC can inform development of strategies to integrate family caregivers into the cancer care team, develop effective CC interventions for family caregivers, and contribute to improved quality and value of cancer care.
AHRQ-funded; HS027286.
Citation: Okado I, Pagano I, Cassel K .
Perceptions of care coordination in cancer patient-family caregiver dyads.
Support Care Cancer 2021 May;29(5):2645-52. doi: 10.1007/s00520-020-05764-8..
Keywords: Cancer, Caregiving, Care Coordination, Quality of Care
Kuo YF, Agrawal P, Chou LN
Assessing association between team structure and health outcome and cost by social network analysis.
Researchers sought to assess the impact of team structure composition and degree of collaboration among various providers on process and outcomes of primary care. Their findings showed that highly connected primary care practices with high collaborative care and less top-down MD-centered authority have lower odds of hospitalization, fewer emergency room admissions, and lower total spending. They concluded that these findings likely reflect better communication and more coordinated care of older patients.
AHRQ-funded; HS020642.
Citation: Kuo YF, Agrawal P, Chou LN .
Assessing association between team structure and health outcome and cost by social network analysis.
J Am Geriatr Soc 2021 Apr;69(4):946-54. doi: 10.1111/jgs.16962..
Keywords: Elderly, Teams, Healthcare Delivery, Primary Care, Primary Care: Models of Care, Care Coordination
Feinberg E, Kuhn J, Eilenberg JS
Improving family navigation for children with autism: a comparison of two pilot randomized controlled trials.
This study looked at impacts of a modification to a pilot program called Family Navigation to help low-income, minority children needing autism-related diagnostic services receive those services. An advisory group recommended modifications to recruitment criteria and study conditions. 40 parent-child dyad participants were randomized between the two pilots to receive usual care (UC) or modified FN. Participant enrollment, satisfaction with clinical care, and timely completion of the diagnostic assessment were compared. Recruitment improved significantly with the modified protocol (4.8% vs. 19.5%) and no participants were excluded from study enrollment compared to the first pilot (43.6%). Families in the second pilot were more likely to complete diagnostic assessment and report greater satisfaction with clinical care.
AHRQ-funded; HS022155; HS022242.
Citation: Feinberg E, Kuhn J, Eilenberg JS .
Improving family navigation for children with autism: a comparison of two pilot randomized controlled trials.
Acad Pediatr 2021 Mar;21(2):265-71. doi: 10.1016/j.acap.2020.04.007..
Keywords: Children/Adolescents, Autism, Patient-Centered Healthcare, Care Coordination, Racial and Ethnic Minorities, Low-Income, Patient and Family Engagement, Chronic Conditions
Ozkaynak M, Valdez R, Hannah K
Understanding gaps between daily living and clinical settings in chronic disease management: qualitative study.
This study’s objective was to characterize gaps from the patient’s perspective between health-related activities across home-based and clinical settings in the management of chronic conditions. Patients were recruited from an anticoagulation clinic of an urban, western mountain system and primary interviews were conducted with 39 patients and 4 providers. The causes of gaps included clinician recommendations not fitting into patients’ daily routines; recommendations not fitting into a patients’ living contexts; and no information transfer across settings. Consequences of these gaps included increased cognitive and physical workload on the patient, poor patient satisfaction, and compromised adherence to the therapy plan.
AHRQ-funded; HS024092.
Citation: Ozkaynak M, Valdez R, Hannah K .
Understanding gaps between daily living and clinical settings in chronic disease management: qualitative study.
J Med Internet Res 2021 Feb 25;23(2):e17590. doi: 10.2196/17590..
Keywords: Chronic Conditions, Care Management, Care Coordination, Patient Self-Management, Health Information Technology (HIT)
Sather J, Littauer R, Finn E
A multimodal intervention to improve the quality and safety of interhospital care transitions for nontraumatic intracerebral and subarachnoid hemorrhage.
Regionalization of care has increased interhospital transfers (IHTs) of nontraumatic intracerebral hemorrhage (ICH) and subarachnoid hemorrhage (SAH) to specialized centers yet exposes patients to the latent risks inherent to IHT. In this study, the researchers examined how a multimodal quality improvement intervention affected quality and safety measures for patients with ICH or SAH exposed to IHT.
AHRQ-funded; HS023554.
Citation: Sather J, Littauer R, Finn E .
A multimodal intervention to improve the quality and safety of interhospital care transitions for nontraumatic intracerebral and subarachnoid hemorrhage.
Jt Comm J Qual Patient Saf 2021 Feb;47(2):99-106. doi: 10.1016/j.jcjq.2020.10.003..
Keywords: Transitions of Care, Hospitals, Patient Safety, Quality Improvement, Quality of Care, Care Coordination
Wang G, Wignall J, Kinard D
An implementation model for managing cloud-based longitudinal care plans for children with medical complexity.
In this study, the investigators aimed to iteratively refine an implementation model for managing cloud-based longitudinal care plans (LCPs) for children with medical complexity (CMC). They conducted iterative 1-on-1 design sessions with CMC caregivers (ie, parents/legal guardians) and providers between August 2017 and March 2019. The investigators concluded that utilizing the management strategies, described in the article, when implementing cloud-based LCPs had the potential to improve team-based care across settings.
AHRQ-funded; HS024299.
Citation: Wang G, Wignall J, Kinard D .
An implementation model for managing cloud-based longitudinal care plans for children with medical complexity.
J Am Med Inform Assoc 2021 Jan 15;28(1):23-32. doi: 10.1093/jamia/ocaa207..
Keywords: Children/Adolescents, Implementation, Chronic Conditions, Care Management, Care Coordination, Health Information Exchange (HIE), Health Information Technology (HIT), Teams
Abraham J, Kannampallil TG, Patel VL
Impact of structured rounding tools on time allocation during multidisciplinary rounds: an observational study.
The aim of this study was to investigate whether disproportionate time allocation effects during multidisciplinary rounds (MDRs) persist with the use of structured rounding tools. It concluded that the use of structured rounding tools potentially mitigates disproportionate time allocation and communication breakdowns during rounds with the more structured system-based Handoff Intervention Tool (HAND-IT), almost completely eliminating such effects.
AHRQ-funded; HS017586.
Citation: Abraham J, Kannampallil TG, Patel VL .
Impact of structured rounding tools on time allocation during multidisciplinary rounds: an observational study.
JMIR Hum Factors 2016 Dec 09;3(2):e29. doi: 10.2196/humanfactors.6642.
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Keywords: Tools & Toolkits, Clinician-Patient Communication, Teams, Health Information Technology (HIT), Care Coordination
Sherry M, Wolff JL, Ballreich J
Bridging the silos of service delivery for high-need, high-cost individuals.
This study examined 5 innovative community-oriented programs that are successfully coordinating medical and nonmedical services to identify factors that stimulate and sustain community-level collaboration and coordinated care across silos of health care, public health, and social services delivery. The authors constructed a conceptual framework depicting community health systems that highlights 4 foundational factors that facilitate community-oriented collaboration.
AHRQ-funded; HS000029.
Citation: Sherry M, Wolff JL, Ballreich J .
Bridging the silos of service delivery for high-need, high-cost individuals.
Popul Health Manag 2016 Dec;19(6):421-28. doi: 10.1089/pop.2015.0147.
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Keywords: Community-Based Practice, Healthcare Costs, Healthcare Delivery, Care Coordination
Adams DR, Flores A, Coltri A
A missed opportunity to improve patient satisfaction? Patient perceptions of inpatient communication with their primary care physician.
Patient satisfaction could be driven by patient perception of hospital team communication with their primary care physician (PCP). A retrospective mixed methods approach was used to characterize the relationship between patient satisfaction and patient perception of hospital team-PCP communication.
AHRQ-funded; HS010597l; HS016967.
Citation: Adams DR, Flores A, Coltri A .
A missed opportunity to improve patient satisfaction? Patient perceptions of inpatient communication with their primary care physician.
Am J Med Qual 2016 Nov;31(6):568-76. doi: 10.1177/1062860615593339..
Keywords: Care Coordination, Hospitals, Patient Experience, Primary Care, Quality Improvement
Lee SJ, Clark MA, Cox JV
Achieving coordinated care for patients with complex cases of cancer: a multiteam system approach.
The authors outlined challenges of care coordination in the context of a multiteam system (MTS), through the care experience of a patient in the Dallas County integrated safety-net system. A cancer diagnosis triggered an additional need for augmented coordination between his different provider teams. The authors recommend that further research and practice investigate the relationships of MTS coordination for shared care management, transfer to and from specialty care, treatment compliance, barriers to care, and health outcomes of chronic comorbid conditions, as well as cancer control and surveillance.
AHRQ-funded; HS022418.
Citation: Lee SJ, Clark MA, Cox JV .
Achieving coordinated care for patients with complex cases of cancer: a multiteam system approach.
J Oncol Pract 2016 Nov;12(11):1029-38. doi: 10.1200/jop.2016.013664.
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Keywords: Cancer, Care Coordination, Chronic Conditions, Patient-Centered Healthcare, Teams
Ferrante JM, Friedman A, Shaw EK
Lessons learned designing and using an online discussion forum for care coordinators in primary care.
In this paper, the authors comprehensively describe their experiences, from start to finish, of designing and using an asynchronous online discussion forum for collecting and analyzing information elicited from care coordinators in Patient-Centered Medical Homes across the United States. They conclude that an asynchronous online discussion forum is a feasible, efficient, and effective method to conduct a qualitative study, particularly when subjects are health professionals.
AHRQ-funded; HS020682.
Citation: Ferrante JM, Friedman A, Shaw EK .
Lessons learned designing and using an online discussion forum for care coordinators in primary care.
Qual Health Res 2016 Nov;26(13):1851-61. doi: 10.1177/1049732315609567..
Keywords: Care Coordination, Health Services Research (HSR), Patient-Centered Healthcare, Primary Care, Research Methodologies
Wittmeier KD, Restall G, Mulder K
Central intake to improve access to physiotherapy for children with complex needs: a mixed methods case report.
The researchers evaluated the process and impact of implementing a central intake system, using pediatric physiotherapy as a case example. They found that central intake implementation achieved the intended outcomes of streamlining processes and improving transparency and access to pediatric physiotherapy for families of children with complex needs. They recommended future research to build on this single discipline case study approach.
AHRQ-funded; HS016657.
Citation: Wittmeier KD, Restall G, Mulder K .
Central intake to improve access to physiotherapy for children with complex needs: a mixed methods case report.
BMC Health Serv Res 2016 Aug 31;16:455. doi: 10.1186/s12913-016-1700-3.
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Keywords: Access to Care, Children/Adolescents, Care Coordination, Patient Experience, Children/Adolescents
Feraco AM, Starmer AJ, Sectish TC
Reliability of verbal handoff assessment and handoff quality before and after implementation of a resident handoff bundle.
This study developed validity evidence for the use of the Verbal Handoff Assessment Tool (VHAT),examined the reliability of VHAT scores, and determined whether implementation of a resident handoff bundle was associated with improved verbal patient handoffs among pediatric resident physicians. It found that verbal handoffs improved following implementation of a resident handoff bundle, though gains were variable across the two clinical units.
AHRQ-funded; HS019456.
Citation: Feraco AM, Starmer AJ, Sectish TC .
Reliability of verbal handoff assessment and handoff quality before and after implementation of a resident handoff bundle.
Acad Pediatr 2016 Aug;16(6):524-31. doi: 10.1016/j.acap.2016.04.002.
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Keywords: Care Coordination, Communication, Children/Adolescents
Khan A, Rogers JE, Forster CS
Communication and shared understanding between parents and resident-physicians at night.
The researchers studied communication breakdowns evidenced by lack of shared understanding between parents and night-team residents about the reason for admission and care plan. After conducting a prospective cohort study of 286 parents and 37 night-team senior residents, they found that parents and residents reported that they shared an understanding with one another about care plans in 86.0percent and 73.1 percent of cases, respectively.
AHRQ-funded; HS022986; HS000063.
Citation: Khan A, Rogers JE, Forster CS .
Communication and shared understanding between parents and resident-physicians at night.
Hosp Pediatr 2016 Jun;6(6):319-29. doi: 10.1542/hpeds.2015-0224.
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Keywords: Care Coordination, Healthcare Delivery, Communication, Patient and Family Engagement, Clinician-Patient Communication
Rundall TG, Wu FM, Lewis VA
Contributions of relational coordination to care management in accountable care organizations: views of managerial and clinical leaders.
The researchers identified the extent to which accountable care organization (ACO) leaders are aware of the dimensions of relational coordination and the ways these leaders believe the dimensions influenced care management practices in their organization. They found that ACO leaders mentioned four relational coordination dimensions: shared goals, frequency of communication, timeliness of communication, and problem solving communication. Their analysis identified ways leaders believed the four dimensions contributed to the development of care management, including contributions to standardization of care, patient engagement, coordination of care, and care planning.
AHRQ-funded; HS022241.
Citation: Rundall TG, Wu FM, Lewis VA .
Contributions of relational coordination to care management in accountable care organizations: views of managerial and clinical leaders.
Health Care Manage Rev 2016 Apr-Jun;41(2):88-100. doi: 10.1097/hmr.0000000000000064.
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Keywords: Care Coordination, Health Insurance, Healthcare Delivery, Communication
Cohen GR, Adler-Milstein J
Meaningful use care coordination criteria: perceived barriers and benefits among primary care providers.
This systematic review of studies of laser treatment of infantile hemangioma concluded that the studies primarily addressed different laser modalities compared with observation or other laser modalities. Pulsed dye laser was the most commonly studied laser type, but multiple variations in treatment protocols did not allow for demonstration of superiority of a single method.
AHRQ-funded; HS022674.
Citation: Cohen GR, Adler-Milstein J .
Meaningful use care coordination criteria: perceived barriers and benefits among primary care providers.
J Am Med Inform Assoc 2016 Apr;23(e1):e146-51. doi: 10.1093/jamia/ocv147.
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Keywords: Primary Care, Care Coordination, Electronic Health Records (EHRs), Health Information Technology (HIT)
Miller AD, Mishra SR, Kendall L
Partners in care: Design considerations for caregivers and patients during a hospital stay.
The researchers described how caregivers and patients coordinate and collaborate to manage patients' care and wellbeing during a hospital stay. They defined and described five roles caregivers adopt: companion, assistant, representative, navigator, and planner, and show how patients and caregivers negotiate these roles and responsibilities throughout a hospital stay. Finally, they identified key design considerations for technology to support patients and caregivers during a hospital stay.
AHRQ-funded; HS022894.
Citation: Miller AD, Mishra SR, Kendall L .
Partners in care: Design considerations for caregivers and patients during a hospital stay.
Cscw 2016 Feb-Mar;2016:756-69. doi: 10.1145/2818048.2819983..
Keywords: Care Coordination, Caregiving, Hospitalization, Inpatient Care, Patient and Family Engagement
Newgard CD, Lowe RA
Cost savings in trauma systems: The devil's in the details.
The authors comment on an article in the same issue of Annals by Zocchi et al. They argue that it makes an important contribution to trauma research and health policy by addressing the question: Can we potentially save money in trauma systems without compromising outcomes by redirecting patients with minor to moderate injuries away from major trauma centers?
AHRQ-funded; HS023796.
Citation: Newgard CD, Lowe RA .
Cost savings in trauma systems: The devil's in the details.
Ann Emerg Med 2016 Jan;67(1):68-70. doi: 10.1016/j.annemergmed.2015.06.025..
Keywords: Healthcare Costs, Trauma, Mortality, Care Coordination, Injuries and Wounds
Friedman A, Howard J, Shaw EK
Facilitators and barriers to care coordination in patient-centered medical homes (PCMHs) from coordinators' perspectives.
This is the first study describing experiences of care coordinators across the US from their own perspectives. It concluded that while all the barriers and facilitators were important to performing coordinators' roles, relationship building was key to effective care coordination, whether with clinicians, patients, or outside organizations.
AHRQ-funded; HS020682.
Citation: Friedman A, Howard J, Shaw EK .
Facilitators and barriers to care coordination in patient-centered medical homes (PCMHs) from coordinators' perspectives.
J Am Board Fam Med 2016 Jan-Feb;29(1):90-101. doi: 10.3122/jabfm.2016.01.150175.
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Keywords: Care Coordination, Patient-Centered Healthcare, Healthcare Delivery
Halladay JR, Mottus K, Reiter K
The cost to successfully apply for level 3 medical home recognition.
The National Committee for Quality Assurance patient-centered medical home recognition program provides practices an opportunity to implement medical home activities. Understanding the costs to apply for recognition may enable practices to plan their work. This study found variation in the distribution of costs by activity by practice, but the costs to apply were remarkably similar.
AHRQ-funded; HS022629.
Citation: Halladay JR, Mottus K, Reiter K .
The cost to successfully apply for level 3 medical home recognition.
J Am Board Fam Med 2016 Jan-Feb;29(1):69-77. doi: 10.3122/jabfm.2016.01.150211.
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Keywords: Patient-Centered Healthcare, Healthcare Costs, Care Coordination, Quality of Care