National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
Data
- Data Infographics
- Data Visualizations
- Data Tools
- Data Innovations
- All-Payer Claims Database
- Healthcare Cost and Utilization Project (HCUP)
- Medical Expenditure Panel Survey (MEPS)
- AHRQ Quality Indicator Tools for Data Analytics
- State Snapshots
- United States Health Information Knowledgebase (USHIK)
- Data Sources Available from AHRQ
Search All Research Studies
AHRQ Research Studies Date
Topics
- Blood Pressure (1)
- Cardiovascular Conditions (9)
- Care Management (1)
- Children/Adolescents (1)
- Chronic Conditions (1)
- Communication (2)
- Comparative Effectiveness (1)
- Diagnostic Safety and Quality (1)
- Electronic Health Records (EHRs) (3)
- Evidence-Based Practice (9)
- Healthcare Delivery (4)
- Health Information Technology (HIT) (2)
- Health Services Research (HSR) (1)
- Heart Disease and Health (4)
- Implementation (2)
- Medical Errors (1)
- Outcomes (2)
- Patient-Centered Healthcare (5)
- Patient-Centered Outcomes Research (7)
- Payment (1)
- Practice Improvement (1)
- Prevention (5)
- (-) Primary Care (15)
- (-) Quality Improvement (15)
- Quality of Care (9)
- Urban Health (1)
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
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 DisplayedWang A, Pollack T, Kadziel LA
Impact of practice facilitation in primary care on chronic disease care processes and outcomes: a systematic review.
The goal of this systematic review was to evaluate the impact of practice facilitation on chronic disease outcomes in the primary care setting. Researchers extracted and assessed the quality of the data on chronic disease process and clinical outcome measures from U.S. studies that implemented practice facilitation and reported quantifiable care processes and chronic disease outcomes. The results of this evaluation suggest that practice facilitation may improve chronic disease care measures; practices across all studies were aware of practice facilitation. The authors conclude that the results support the potential expansion of practice facilitation in primary care, but that future work will need to investigate potential opportunities to improve chronic disease outcomes in other health care settings.
AHRQ-funded; HS000084.
Citation: Wang A, Pollack T, Kadziel LA .
Impact of practice facilitation in primary care on chronic disease care processes and outcomes: a systematic review.
J Gen Intern Med 2018 Nov;33(11):1968-77. doi: 10.1007/s11606-018-4581-9.
.
.
Keywords: Care Management, Chronic Conditions, Primary Care, Quality of Care, Quality Improvement
Baldwin LM, Fischer MA, Powell J
Virtual educational outreach intervention in primary care based on the principles of academic detailing.
This paper describes the efforts of the Healthy Hearts Northwest (H2N) EvidenceNOW cooperative in providing virtual outreach intervention in primary care based on the principles of academic detailing (AD). EvidenceNOW is AHRQ’s initiative to fund seven regional cooperatives to identify and implement effective strategies to improve the quality of cardiovascular care in communities across the United States. The H2N network covers three states: Oregon, Washington, and Idaho. For this initiative they recruited 259 primary care practices that had 10 full-time or fewer providers and met stage 1 electronic health record meaningful use criteria. The aim was to increase adoption of the four ABCS of heart disease prevention: Aspirin use by high-risk individuals, Blood pressure control, Cholesterol management, and Smoking cessation. Due to the long distances and staffing limitations H2N decided to develop an educational outreach program using virtual visits instead of the traditional AD program structure. The findings and outcomes of this program is described in detail in this paper.
AHRQ-funded; HS023236; HS023908.
Citation: Baldwin LM, Fischer MA, Powell J .
Virtual educational outreach intervention in primary care based on the principles of academic detailing.
J Contin Educ Health Prof 2018 Fall;38(4):269-75. doi: 10.1097/ceh.0000000000000224..
Keywords: Cardiovascular Conditions, Heart Disease and Health, Evidence-Based Practice, Primary Care, Quality Improvement, Quality of Care, Patient-Centered Outcomes Research, Outcomes, Prevention
Ciolino JD, Jackson KL, Liss DT
Design of Healthy Hearts in the Heartland (H3): a practice-randomized, comparative effectiveness study.
The Healthy Hearts in the Heartland (H3) study is part of a nationwide effort, EvidenceNOW, seeking to better understand the ability of small primary care practices to improve "ABCS" clinical quality measures: appropriate Aspirin therapy, Blood pressure control, Cholesterol management, and Smoking cessation. In this paper, the authors describe the design and randomization of the H3 study.
AHRQ-funded; HS023921.
Citation: Ciolino JD, Jackson KL, Liss DT .
Design of Healthy Hearts in the Heartland (H3): a practice-randomized, comparative effectiveness study.
Contemp Clin Trials 2018 Aug;71:47-54. doi: 10.1016/j.cct.2018.06.004..
Keywords: Cardiovascular Conditions, Comparative Effectiveness, Evidence-Based Practice, Heart Disease and Health, Prevention, Primary Care, Quality of Care, Quality Improvement, Outcomes, Patient-Centered Outcomes Research
Chou AF, Homco JB, Nagykaldi Z
Disseminating, implementing, and evaluating patient-centered outcomes to improve cardiovascular care using a stepped-wedge design: healthy hearts for Oklahoma.
The Healthy Hearts for Oklahoma (H2O) Study proposes to build a quality improvement (QI) infrastructure by (1) constructing a sustainable Oklahoma Primary Healthcare Improvement Collaborative (OPHIC) to support dissemination and implementation (D&I) of QI methods; and (2) providing QI support in primary care practices to better manage patients at risk for cardiovascular disease (CVD) events. H2O has 263 small primary care practices across Oklahoma that receive the bundled QI intervention to improve ABCS (aspirin therapy, blood pressure control, cholesterol management, and smoking cessation) performance. The infrastructure established as a result of this funding will help reach medically underserved Oklahomans, particularly among rural and tribal populations.
AHRQ-funded; HS023919.
Citation: Chou AF, Homco JB, Nagykaldi Z .
Disseminating, implementing, and evaluating patient-centered outcomes to improve cardiovascular care using a stepped-wedge design: healthy hearts for Oklahoma.
BMC Health Serv Res 2018 Jun 4;18(1):404. doi: 10.1186/s12913-018-3189-4.
.
.
Keywords: Cardiovascular Conditions, Communication, Heart Disease and Health, Healthcare Delivery, Evidence-Based Practice, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Primary Care, Prevention, Quality of Care, Quality Improvement
Hemler JR, Hall JD, Cholan RA
Practice facilitator strategies for addressing electronic health record data challenges for quality improvement: EvidenceNOW.
In this paper, the authors describe the strategies facilitators use to help practices perform quality improvement (QI) when complete or accurate performance data are not available. The investigators found facilitators faced practice-level EHR data challenges, such as a lack of clinical performance data, partial or incomplete clinical performance data, and inaccurate clinical performance data.
AHRQ-funded; HS023940.
Citation: Hemler JR, Hall JD, Cholan RA .
Practice facilitator strategies for addressing electronic health record data challenges for quality improvement: EvidenceNOW.
J Am Board Fam Med 2018 May-Jun;31(3):398-409. doi: 10.3122/jabfm.2018.03.170274..
Keywords: Electronic Health Records (EHRs), Quality Improvement, Evidence-Based Practice, Health Information Technology (HIT), Primary Care, Quality of Care
Sweeney SM, Hall JD, Ono SS
Recruiting practices for change initiatives is hard: findings from EvidenceNOW.
In this study, the authors describe recruiting primary care recruiting practices. Using grant proposals, online diaries, observational site visits, and interviews with key stakeholders, the authors identified successful practice recruitment strategies in the EvidenceNOW initiative, which aimed to recruit approximately 1500 small- to medium-sized primary care practices.
AHRQ-funded; HS023940.
Citation: Sweeney SM, Hall JD, Ono SS .
Recruiting practices for change initiatives is hard: findings from EvidenceNOW.
Am J Med Qual 2018 May/Jun;33(3):246-52. doi: 10.1177/1062860617728791..
Keywords: Cardiovascular Conditions, Evidence-Based Practice, Health Services Research (HSR), Primary Care, Quality Improvement
Meyers D, Miller T, Genevro J
AHRQ Author: Meyers D, Miller T, Genevro J, Zhan C, De La Mare J, Fournier A, Bennett H, McNellis RJ
EvidenceNOW: Balancing primary care implementation and implementation research.
In 2015, AHRQ invested in the largest primary care research project in its history. EvidenceNOW is a $112 million effort to disseminate and implement patient-centered outcomes research evidence in more than 1,500 primary care practices and to study how quality-improvement support can build the capacity of primary care practices to understand and apply evidence. EvidenceNOW comprises 7 implementation research grants, each funded to provide external quality-improvement support to primary care practices to implement evidence-based cardiovascular care and to conduct rigorous internal evaluations of their work.
AHRQ-authored.
Citation: Meyers D, Miller T, Genevro J .
EvidenceNOW: Balancing primary care implementation and implementation research.
Ann Fam Med 2018 Apr;16(Suppl 1):S5-s11. doi: 10.1370/afm.2196.
.
.
Keywords: Cardiovascular Conditions, Communication, Evidence-Based Practice, Heart Disease and Health, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Prevention, Primary Care, Quality of Care, Quality Improvement, Implementation
Henderson KH, DeWalt DA, Halladay J
Organizational leadership and adaptive reserve in blood pressure control: the Heart Health NOW study.
The purpose of this study was to assess whether a practice's adaptive reserve and high leadership capability in quality improvement are associated with population blood pressure control. Its findings showed that adaptive reserve and leadership capability in quality improvement implementation are not statistically associated with achieving top quartile practice-level hypertension control at baseline in the Heart Health NOW project.
AHRQ-funded; HS023912.
Citation: Henderson KH, DeWalt DA, Halladay J .
Organizational leadership and adaptive reserve in blood pressure control: the Heart Health NOW study.
Ann Fam Med 2018 Apr;16(Suppl 1):S29-s34. doi: 10.1370/afm.2210.
.
.
Keywords: Blood Pressure, Cardiovascular Conditions, Patient-Centered Outcomes Research, Primary Care, Quality Improvement
Cohen DJ, Dorr DA, Knierim K
Primary care practices' abilities and challenges in using electronic health record data for quality improvement.
Federal value-based payment programs require primary care practices to conduct quality improvement activities, informed by the electronic reports on clinical quality measures that their electronic health records (EHRs) generate. This study concluded that the current state of EHR measurement functionality may be insufficient to support federal initiatives that tie payment to clinical quality measures.
AHRQ-funded; HS023940.
Citation: Cohen DJ, Dorr DA, Knierim K .
Primary care practices' abilities and challenges in using electronic health record data for quality improvement.
Health Aff 2018 Apr;37(4):635-43. doi: 10.1377/hlthaff.2017.1254.
.
.
Keywords: Electronic Health Records (EHRs), Primary Care, Quality Improvement, Quality of Care, Health Information Technology (HIT), Payment
Shelley D, Blechter B, Siman N
Quality of cardiovascular disease care in small urban practices.
This study described small, independent primary care practices' performance in meeting the Million Hearts ABCSs (aspirin use, blood pressure control, cholesterol management, and smoking screening and counseling). It concluded that achieving targets for ABCS measures varied considerably across practices; however, small practices were meeting or exceeding Million Hearts goals (i.e., 70 percent or greater).
AHRQ-funded; HS023922.
Citation: Shelley D, Blechter B, Siman N .
Quality of cardiovascular disease care in small urban practices.
Ann Fam Med 2018 Apr;16(Suppl 1):S21-s28. doi: 10.1370/afm.2174.
.
.
Keywords: Cardiovascular Conditions, Quality of Care, Primary Care, Quality Improvement, Urban Health
Casalino LP
Technical assistance for primary care practice transformation: free help to perform unpaid labor?
This issue of the Annals of Family Medicine includes articles reporting early information from the implementation of AHRQ’s initiative EvidenceNOW: Advancing Heart Health in Primary care. EvidenceNOW raises many important questions — the author focuses on three. Why should anyone care about small primary care practices? Why should small primary care practices transform the ways they provide care? What might it take for small primary care practice to transform?
AHRQ-funded; 290201200019I.
Citation: Casalino LP .
Technical assistance for primary care practice transformation: free help to perform unpaid labor?
Ann Fam Med 2018 Apr;16(Suppl 1):S12-s15. doi: 10.1370/afm.2226.
.
.
Keywords: Cardiovascular Conditions, Evidence-Based Practice, Patient-Centered Healthcare, Primary Care, Quality Improvement
Mold JW, Walsh M, Chou AF
The alarming rate of major disruptive events in primary care practices in Oklahoma.
This study documented the rates of major disruptive events in a cohort of primary care practices in Oklahoma. During the first year of the project, 89 major disruptive events occurred in 67 (32 percent) practices, with 20 practices experiencing multiple events. The major disruptive events reported most often during both periods were loss of personnel and implementation of electronic health records and billing systems.
AHRQ-funded; HS023919.
Citation: Mold JW, Walsh M, Chou AF .
The alarming rate of major disruptive events in primary care practices in Oklahoma.
Ann Fam Med 2018 Apr;16(Suppl 1):S52-s57. doi: 10.1370/afm.2201.
.
.
Keywords: Electronic Health Records (EHRs), Healthcare Delivery, Patient-Centered Healthcare, Primary Care, Quality Improvement
Balasubramanian BA, Marino M, Cohen DJ
Use of quality improvement strategies among small to medium-size us primary care practices.
This study examined variations in use of QI strategies among 1,181 small to medium-size primary care practices engaged in a national initiative spanning 12 US States to improve quality of care for heart health and assessed factors associated with those variations. It concluded that there is substantial variation in the use of QI strategies among small to medium-size primary care practices across 12 US States.
AHRQ-funded; HS023940.
Citation: Balasubramanian BA, Marino M, Cohen DJ .
Use of quality improvement strategies among small to medium-size us primary care practices.
Ann Fam Med 2018 Apr;16(Suppl 1):S35-s43. doi: 10.1370/afm.2172.
.
.
Keywords: Healthcare Delivery, Evidence-Based Practice, Patient-Centered Outcomes Research, Primary Care, Quality Improvement
Rinke ML, Singh H, Heo M
Diagnostic errors in primary care pediatrics: Project RedDE.
The objective of this study was to investigate the frequency of two high-frequency/subacute diagnostic errors (DEs), and one missed opportunity for diagnosis (MOD) in primary care pediatrics. DE or MOD rates in pediatric primary care were found to be 54 percent for patients with elevated BP, 11 percent for patients with abnormal laboratory values, and 62 percent for adolescents with an opportunity to evaluate for depression.
AHRQ-funded; HS022087; HS023608; HS023602.
Citation: Rinke ML, Singh H, Heo M .
Diagnostic errors in primary care pediatrics: Project RedDE.
Acad Pediatr 2018 Mar;18(2):220-27. doi: 10.1016/j.acap.2017.08.005.
.
.
Keywords: Children/Adolescents, Diagnostic Safety and Quality, Medical Errors, Primary Care, Quality Improvement
Ono SS, Crabtree BF, Hemler JR
Taking innovation to scale in primary care practices: the functions of health care extension.
Health care extension is an approach to providing external support to primary care practices with the aim of diffusing innovation. EvidenceNOW was launched to rapidly disseminate and implement evidence-based guidelines for cardiovascular preventive care in the primary care setting. This article describes how cooperatives varied in their approaches to extension and provides early empirical evidence that health care extension is a feasible and potentially useful approach for providing quality improvement.
AHRQ-funded; HS023940.
Citation: Ono SS, Crabtree BF, Hemler JR .
Taking innovation to scale in primary care practices: the functions of health care extension.
Health Aff 2018 Feb;37(2):222-30. doi: 10.1377/hlthaff.2017.1100.
.
.
Keywords: Primary Care, Implementation, Cardiovascular Conditions, Evidence-Based Practice, Healthcare Delivery, Practice Improvement, Quality Improvement, Quality of Care, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Prevention