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AHRQ Research Studies Date
Topics
- Adverse Events (1)
- Burnout (1)
- Cardiovascular Conditions (1)
- Care Coordination (1)
- Care Management (1)
- Case Study (1)
- Chronic Conditions (1)
- Communication (2)
- Community-Based Practice (1)
- Critical Care (2)
- Decision Making (4)
- Diabetes (1)
- Education: Continuing Medical Education (1)
- Electronic Health Records (EHRs) (2)
- Emergency Department (2)
- Falls (1)
- Healthcare Delivery (5)
- Health Systems (1)
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- Intensive Care Unit (ICU) (3)
- Organizational Change (1)
- Patient-Centered Healthcare (3)
- Patient Safety (4)
- Prevention (1)
- Primary Care (6)
- Primary Care: Models of Care (1)
- Provider: Physician (1)
- Quality Improvement (1)
- Quality of Care (1)
- Rural Health (1)
- Simulation (3)
- Surgery (1)
- (-) Teams (16)
- TeamSTEPPS (1)
- Training (1)
- Workflow (1)
- Workforce (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 16 of 16 Research Studies DisplayedRodriguez HP, Friedberg MW, Vargas-Bustamante A
The impact of integrating medical assistants and community health workers on diabetes care management in community health centers.
The purpose of this study was to compare the impact of implementing team-based diabetes care management involving community health workers (CHWs) vs. medical assistants (MA) in community health centers (CHCs) on diabetes care processes, intermediate outcomes, and patients' experiences of chronic care. The investigators found that diabetes care improved in CHCs integrating CHWs and MAs onto primary care teams, but the improvements were no different than improvements observed among matched control group patients.
AHRQ-funded; HS02012001.
Citation: Rodriguez HP, Friedberg MW, Vargas-Bustamante A .
The impact of integrating medical assistants and community health workers on diabetes care management in community health centers.
BMC Health Serv Res 2018 Nov 20;18(1):875. doi: 10.1186/s12913-018-3710-9..
Keywords: Community-Based Practice, Diabetes, Healthcare Delivery, Teams
Misra-Hebert AD, Perzynski A, Rothberg MB
Implementing team-based primary care models: a mixed-methods comparative case study in a large, integrated health care system.
This mixed-methods comparative case study examined the implementation of team-based primary care models in a large integrated health system. Field observations of 9 practices were conducted along with 75 interviews and provider and staff surveys. The 9 practices were categorized into 3 groups: high, partial, and low update of the new models. Ability of the practices to implement the new team-based model depended on their ability to adapt to change and to adapt team roles in workflow.
AHRQ-funded; HS024128.
Citation: Misra-Hebert AD, Perzynski A, Rothberg MB .
Implementing team-based primary care models: a mixed-methods comparative case study in a large, integrated health care system.
J Gen Intern Med 2018 Nov;33(11):1928-36. doi: 10.1007/s11606-018-4611-7..
Keywords: Case Study, Health Systems, Patient-Centered Healthcare, Primary Care, Primary Care: Models of Care, Teams
Murray DJ, Boyle WA, Beyatte MB
Decision-making skills improve with critical care training: using simulation to measure progress.
Health care professionals are expected to acquire decision-making skills during their training, but few methods are available to assess progress in acquiring these essential skills. The purpose of this study was to determine whether a simulation methodology could be used to assess whether decision-making skills improve during critical care training. The investigators indicate that their findings provide evidence to support the validity of a simulation-based method to assess progress in decision-making skills.
AHRQ-funded; HS022265.
Citation: Murray DJ, Boyle WA, Beyatte MB .
Decision-making skills improve with critical care training: using simulation to measure progress.
J Crit Care 2018 Oct;47:133-38. doi: 10.1016/j.jcrc.2018.06.021..
Keywords: Critical Care, Education: Continuing Medical Education, Decision Making, Simulation, Teams, Training
Bordley J, Sakata KK, Bierman J
Use of a novel, electronic health record-centered, interprofessional ICU rounding simulation to understand latent safety issues.
The electronic health record is a primary source of information for all professional groups participating in ICU rounds. However, it is unclear how team dynamics impacts identification and verbalization of viewed data. Therefore, the investigators created an ICU rounding simulation to assess how the interprofessional team recognized and reported data and its impact on decision-making.
AHRQ-funded; HS023793.
Citation: Bordley J, Sakata KK, Bierman J .
Use of a novel, electronic health record-centered, interprofessional ICU rounding simulation to understand latent safety issues.
Crit Care Med 2018 Oct;46(10):1570-76. doi: 10.1097/ccm.0000000000003302..
Keywords: Decision Making, Electronic Health Records (EHRs), Intensive Care Unit (ICU), Patient Safety, Teams
Meyers D, LeRoy L, Bailit M
AHRQ Author: Meyers D, Zhan C
Workforce configurations to provide high-quality, comprehensive primary care: a mixed-method exploration of staffing for four types of primary care practices.
The aim of this study was to explore the team configurations and associated costs required to deliver high-quality, comprehensive primary care. The study estimates provided health care decision-makers with needed guideposts for considering primary care staffing and financing and informed broader discussions on primary care innovations and the necessary resources to provide high-quality, comprehensive primary care in the USA.
AHRQ-authored; AHRQ-funded; 290201000004I; 29032009T.
Citation: Meyers D, LeRoy L, Bailit M .
Workforce configurations to provide high-quality, comprehensive primary care: a mixed-method exploration of staffing for four types of primary care practices.
J Gen Intern Med 2018 Oct;33(10):1774-79. doi: 10.1007/s11606-018-4530-7..
Keywords: Healthcare Delivery, Quality of Care, Primary Care, Workforce, Teams
Howard J, Miller WL, Willard-Grace R
Creating and sustaining care teams in primary care: perspectives from innovative patient-centered medical homes.
The purpose of this study was to learn from the experiences of innovative primary care practices that have successfully developed care teams. The authors assert that team-based care is possible and valuable in primary care but that it is difficult to develop and sustain, and requires dedicated time and resources. They suggest that the challenges described by the highly motivated practices, in their paper, raised the question of feasibility for more average practices in the current funding environment.
AHRQ-funded.
Citation: Howard J, Miller WL, Willard-Grace R .
Creating and sustaining care teams in primary care: perspectives from innovative patient-centered medical homes.
Qual Manag Health Care 2018 Jul/Sep;27(3):123-29. doi: 10.1097/qmh.0000000000000176..
Keywords: Primary Care, Patient-Centered Healthcare, Teams, Healthcare Delivery
Baloh J, Zhu X, Ward MM
Implementing team huddles in small rural hospitals: how does the Kotter model of change apply?
The purpose of this study was to examine how the process of change prescribed in Kotter's change model applies in implementing team huddles, and to assess the impact of the execution of early change phases on change success in later phases. The investigators found mixed support for the Kotter model.
AHRQ-funded; HS024112.
Citation: Baloh J, Zhu X, Ward MM .
Implementing team huddles in small rural hospitals: how does the Kotter model of change apply?
J Nurs Manag 2018 Jul;26(5):571-78. doi: 10.1111/jonm.12584..
Keywords: Hospitals, Rural Health, Teams, TeamSTEPPS
Annis AM, Harris M, Kim HM
Trends in primary care encounters across professional roles in PCMH.
Evaluation measures of team-based care models are often reported at a clinic or primary care provider (PCP) level, creating challenges in describing and analyzing the use and impact of non-PCP clinician team members. This study aimed to measure clinician-specific care delivery trends and determine whether trends were responsive to system wide patient centered medical home implementation.
AHRQ-funded;
Citation: Annis AM, Harris M, Kim HM .
Trends in primary care encounters across professional roles in PCMH.
Am J Manag Care 2018 Jul;24(7):e222-e29..
Keywords: Healthcare Delivery, Patient-Centered Healthcare, Primary Care, Teams
Reiter-Palmon R, Kennel V, Allen J
Good catch! Using interdisciplinary teams and team reflexivity to improve patient safety.
This article considers the role of reflexivity in team innovation implementation and its association with inpatient fall rates. The study it describes examined 16 small rural hospitals in which interdisciplinary teams intended to decrease fall risk were implemented, supported, and evaluated. Team reflexivity was assessed at the start and at the end of the 2-year intervention, and innovation implementation assessed at the end of the intervention. The hospitals reported objective fall event data and patient days throughout the project. Both the theoretical and practical applications of the results are discussed.
AHRQ-funded; HS021429; HS024630.
Citation: Reiter-Palmon R, Kennel V, Allen J .
Good catch! Using interdisciplinary teams and team reflexivity to improve patient safety.
Group & Organization Management 2018 Jun;43(3):414-39. doi: 10.1177/1059601118768163..
Keywords: Teams, Patient Safety, Falls, Prevention, Hospitals, Adverse Events
Bordley J, Sakata KK, Bierman J
Medication history versus point-of-care platelet activity testing in patients with intracerebral hemorrhage.
This study evaluated whether reduced platelet activity detected by point-of-care (POC) testing was a better predictor of hematoma expansion and poor functional outcomes in patients with intracerebral hemorrhage (ICH) than a history of antiplatelet medication exposure. A history of antiplatelet medication use better identified patients at risk for hematoma growth and poor functional outcomes than POC measures of platelet activity after spontaneous ICH.
AHRQ-funded; HS023793.
Citation: Bordley J, Sakata KK, Bierman J .
Medication history versus point-of-care platelet activity testing in patients with intracerebral hemorrhage.
Crit Care Med 2018 Oct;46(10):1570-76. doi: 10.1097/ccm.0000000000003302..
Keywords: Decision Making, Electronic Health Records (EHRs), Intensive Care Unit (ICU), Patient Safety, Teams
Holtrop JS, Ruland S, Diaz S
Using social network analysis to examine the effect of care management structure on chronic disease management communication within primary care.
The investigators examined the communication regarding chronic disease care within 24 primary care practices in Michigan and Colorado. They sought to answer the following questions: Do care managers play a key role in chronic disease management in the practice? Does the prominence of the care manager's connectivity within the practice's communication network vary by the type of care management structure implemented? Using surveys, they found that social network analysis provided a useful means of examining chronic disease communication in practice, and highlighted the central role of care managers in this communication when their role structure supported such communication. They concluded that structuring care managers as embedded team members within the practice has important implications for their role in chronic disease communication within primary care.
AHRQ-funded; HS022690.
Citation: Holtrop JS, Ruland S, Diaz S .
Using social network analysis to examine the effect of care management structure on chronic disease management communication within primary care.
J Gen Intern Med 2018 May;33(5):612-20. doi: 10.1007/s11606-017-4247-z.
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Keywords: Care Management, Chronic Conditions, Communication, Primary Care, Teams
Hung DY, Harrison MI , Truong Q
AHRQ Author: Harrison MI
Experiences of primary care physicians and staff following lean workflow redesign.
The researchers examined the work experiences of primary care physicians and staff after implementing Lean-based workflow redesigns. They found that both physicians and nonphysician staff reported higher levels of engagement and teamwork after implementing redesigns. However, the subjects also experienced higher levels of burnout and perceptions of the workplace as stressful.
AHRQ-authored; AHRQ-funded; 290201000022I.
Citation: Hung DY, Harrison MI , Truong Q .
Experiences of primary care physicians and staff following lean workflow redesign.
BMC Health Serv Res 2018 Apr 10;18(1):274. doi: 10.1186/s12913-018-3062-5.
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Keywords: Primary Care, Workflow, Burnout, Organizational Change, Provider: Physician, Teams
Costa DK, Valley TS, Miller MA
AHRQ Author: Miller MA
ICU team composition and its association with ABCDE implementation in a quality collaborative.
Awakening, Breathing Coordination, Delirium, and Early Mobility bundle (ABCDE) should involve an interprofessional team, yet no studies describe what team composition supports implementation. This study found that ABCDE implementation was associated with frequent involvement of team members, suggesting a need for role articulation and coordination.
AHRQ-authored; AHRQ-funded; HS024552.
Citation: Costa DK, Valley TS, Miller MA .
ICU team composition and its association with ABCDE implementation in a quality collaborative.
J Crit Care 2018 Apr;44:1-6. doi: 10.1016/j.jcrc.2017.09.180.
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Keywords: Critical Care, Intensive Care Unit (ICU), Patient Safety, Quality Improvement, Teams
Everson J, Funk RJ, Kaufman SR
Repeated, close physician coronary artery bypass grafting teams associated with greater teamwork.
This study sought to determine whether observed patterns of physician interaction around shared patients are associated with higher levels of teamwork as perceived by physicians. It found that in hospitals where physicians repeatedly cared for patients with the same colleagues, physicians perceived better teamwork. When physicians who worked together also had other colleagues in common, the reported teamwork was stronger.
AHRQ-funded; HS024525; HS024728.
Citation: Everson J, Funk RJ, Kaufman SR .
Repeated, close physician coronary artery bypass grafting teams associated with greater teamwork.
Health Serv Res 2018 Apr;53(2):1025-41. doi: 10.1111/1475-6773.12703.
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Keywords: Cardiovascular Conditions, Care Coordination, Communication, Surgery, Teams
Rosenman ED, Dixon AJ, Webb JM
A simulation-based approach to measuring team situational awareness in emergency medicine: a multicenter, observational study.
This study’s goal was to develop and evaluate a novel approach to the measurement of team situational awareness (TSA) in interprofessional emergency medicine (EM) teams. EM teams, consisting of resident physicians, nurses, and medical students, were recruited from the University of Washington and Wayne State University; each team completed a simulated emergency resuscitation scenario, then completed three measures: a TSA measure, a team perception of shared understanding measure, and a team leader effectiveness measure. The simulations were recorded and coded independently for team performance by using a previously validated measure. Relationships between the TSA measure and other variables were explored. The authors conclude that simulations can provide a platform for TSA research and that their study provides a feasible method for simulation-based assessment of TSA.
AHRQ-funded; HS020295; HS022458.
Citation: Rosenman ED, Dixon AJ, Webb JM .
A simulation-based approach to measuring team situational awareness in emergency medicine: a multicenter, observational study.
Acad Emerg Med 2018 Feb;25(2):196-204. doi: 10.1111/acem.13257..
Keywords: Decision Making, Emergency Department, Simulation, Teams
Rosenman ED, Fernandez R, Wong AH
Changing systems through effective teams: a role for simulation.
The objectives of this research were to explore the antecedents and processes that support team effectiveness, to summarize the role of simulation in the development and understanding team effectiveness, and to identify research targets that further the improvement of team-based training and assessment; the ultimate goal was the improvement of healthcare systems. The authors explore the foundations of team effectiveness, with a focus on team affect and team cognition. They also discuss advanced team processes that build on these foundations. The role of simulation‐based training in targeting these constructs and identifying resources from the team science literature is highlighted. The collaboration between educators and researchers from emergency medicine and the team sciences is emphasized, as is the importance of using a translational science approach to evaluate simulation‐based team training and elucidate the relationship between training and systems‐level outcomes.
AHRQ-funded; HS024820.
Citation: Rosenman ED, Fernandez R, Wong AH .
Changing systems through effective teams: a role for simulation.
Acad Emerg Med 2018 Feb;25(2):128-43. doi: 10.1111/acem.13260.
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Keywords: Emergency Department, Healthcare Delivery, Simulation, Teams