National Healthcare Quality and Disparities Report
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- Community-Based Practice (1)
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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 14 of 14 Research Studies DisplayedZimmerman S, Carder P, Schwartz L
The imperative to reimagine assisted living.
Assisted living (AL) has existed in the United States for decades, evolving in response to older adults' need for supportive care and distaste for nursing homes and older models of congregate care. AL is state-regulated, provides at least 2 meals a day, around-the-clock supervision, and help with personal care, but is not licensed as a nursing home. This article presents the background regarding those tensions, as well as potential solutions that have been borne out, paving the path to a better future of assisted living.
AHRQ-funded; HS026893.
Citation: Zimmerman S, Carder P, Schwartz L .
The imperative to reimagine assisted living.
J Am Med Dir Assoc 2022 Feb;23(2):225-34. doi: 10.1016/j.jamda.2021.12.004..
Keywords: Elderly, Long-Term Care, Healthcare Delivery, Workforce, Quality of Care, Quality of Life, Healthcare Costs
Hemler JR, Edwards ST, Valenzuela S
The effects of major disruptions on practice participation in facilitation during a primary care quality improvement initiative.
This study explored the relationship between disruptions in primary care practices and practice participation in facilitated quality improvement (QI). Using data from EvidenceNOW, findings showed that disruptions are prevalent in primary care, but practices can continue participating in QI interventions, particularly when supported by a facilitator.
AHRQ-funded; HS023940.
Citation: Hemler JR, Edwards ST, Valenzuela S .
The effects of major disruptions on practice participation in facilitation during a primary care quality improvement initiative.
J Am Board Fam Med 2022 Jan-Feb;35(1):124-39. doi: 10.3122/jabfm.2022.01.210205..
Keywords: Primary Care, Practice Improvement, Quality Improvement, Quality of Care, Workforce
Luo Q, Dor A, Pittman P
Optimal staffing in community health centers to improve quality of care.
The authors explored optimal workforce configurations in the production of care quality in community health centers (CHCs), accounting for interactions among occupational categories, as well as contributions to the volume of services. By linking the Uniform Data System with Internal Revenue Service nonprofit tax return data, they found that primary care physicians and advanced practice clinicians achieved similar quality outcomes. They recommended that CHCs optimize their workforce configuration to improve quality with further hiring of advanced practice clinicians as a cost-effective investment for CHCs.
AHRQ-funded; HS026816.
Citation: Luo Q, Dor A, Pittman P .
Optimal staffing in community health centers to improve quality of care.
Health Serv Res 2021 Feb;56(1):112-22. doi: 10.1111/1475-6773.13566..
Keywords: Community-Based Practice, Workforce, Quality of Care
Wilson BL, Butler RJ
Identifying optimal labor and delivery nurse staffing: the case of cesarean births and nursing hours.
Numerous studies have identified a relationship between nurse staffing and adverse patient outcomes in medical / surgical patient populations. However, little is known about the impact of labor and delivery (L&D) nurse staffing and adverse birth outcomes, such as unintended cesarean delivery, in low-risk term-gestation women. In this study the investigators examined nurse staffing patterns on the likelihood of cesarean sections (C-sections) among low- risk, full gestation births and provided a testing framework to distinguish optimal from ineffective levels of nurse staffing.
AHRQ-funded; HS024607.
Citation: Wilson BL, Butler RJ .
Identifying optimal labor and delivery nurse staffing: the case of cesarean births and nursing hours.
Nurs Outlook 2021 Jan-Feb;69(1):84-95. doi: 10.1016/j.outlook.2020.07.003..
Keywords: Provider: Nurse, Provider, Workforce, Labor and Delivery, Pregnancy, Quality of Care, Risk, Women
Poghosyan L, Ghaffari A, Liu J
Physician-nurse practitioner teamwork in primary care practices in New York: a cross-sectional survey.
Primary care practices increasingly rely on the growing workforce of nurse practitioners (NPs) to meet primary care demand. Understanding teamwork between NPs and physicians in primary care practices is critically important. In this study, the investigators assessed teamwork between NPs and physicians practicing within the same primary care practice and determined how teamwork affected their job satisfaction, intent to leave their current job, and quality of care.
AHRQ-funded; HS024758.
Citation: Poghosyan L, Ghaffari A, Liu J .
Physician-nurse practitioner teamwork in primary care practices in New York: a cross-sectional survey.
J Gen Intern Med 2020 Apr;35(4):1021-28. doi: 10.1007/s11606-019-05509-2..
Keywords: Primary Care: Models of Care, Primary Care, Provider: Clinician, Provider: Physician, Provider, Workforce, Quality of Care
Than C, Chuang E, Washington DL
Understanding gender sensitivity of the health care workforce at the Veterans Health Administration.
Gender sensitivity of providers and staff has assumed increasing importance in closing historical gender disparities in health care quality and outcomes. The Department of Veterans Affairs (VA) has implemented several initiatives intended to improve gender sensitivity of its health care workforce. The current study examined practice- and individual-level characteristics associated with gender sensitivity of primary care providers (PCPs) and staff.
AHRQ-funded; HS000046.
Citation: Than C, Chuang E, Washington DL .
Understanding gender sensitivity of the health care workforce at the Veterans Health Administration.
Womens Health Issues 2020 Mar-Apr;30(2):120-27. doi: 10.1016/j.whi.2020.01.001..
Keywords: Workforce, Provider, Primary Care, Disparities, Quality of Care
Baron AN, Hemler JR, Sweeney SM
Effects of practice turnover on primary care quality improvement implementation.
This study examined the effect primary care practice turnover has on quality improvement (QI) implementation. It often stops momentum in the improvement process, especially if key members leave. Key member turnover causes loss of institutional memory about QI purpose, processes, and long-term vision.
AHRQ-funded; HS023940.
Citation: Baron AN, Hemler JR, Sweeney SM .
Effects of practice turnover on primary care quality improvement implementation.
Am J Med Qual 2020 Jan/Feb;35(1):16-22. doi: 10.1177/1062860619844001..
Keywords: Primary Care, Quality Improvement, Quality of Care, Workforce, Implementation
Ward ST, Dimick JB, Zhang W
Association between hospital staffing models and failure to rescue.
The purpose of this study was to identify hospital staffing models associated with failure to rescue (FTR) rates at low- and high-performing hospitals. The investigators concluded that low FTR hospitals had significantly more staffing resources than high FTR hospitals. They indicated that although hiring additional staff may be beneficial, there remain significant financial limitations for many hospitals to implement robust staffing models.
AHRQ-funded; HS023621; HS024403.
Citation: Ward ST, Dimick JB, Zhang W .
Association between hospital staffing models and failure to rescue.
Ann Surg 2019 Jul;270(1):91-94. doi: 10.1097/sla.0000000000002744..
Keywords: Patient Safety, Hospitals, Workforce, Quality Indicators (QIs), Quality Improvement, Quality of Care, Healthcare Delivery
Brimhall KC, Mor Barak ME
The critical role of workplace inclusion in fostering innovation, job satisfaction, and quality of care in a diverse human service organization.
Using a sample of 213 participants within 21 departmental units in a diverse human service organization, the authors performed multilevel path analysis to examine the critical role of workplace inclusion in fostering innovation, job satisfaction, and quality of care in a diverse human service organization.
AHRQ-funded; HS024650.
Citation: Brimhall KC, Mor Barak ME .
The critical role of workplace inclusion in fostering innovation, job satisfaction, and quality of care in a diverse human service organization.
Hum Serv Organ Manag Leadersh Gov 2018 Nov/Dec;42(5):474-92..
Keywords: Quality of Care, Workforce, Organizational Change
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
Dyrbye LN, Shanafelt TD, Sinsky CA
AHRQ Author: Meyers D
https://nam.edu/burnout-among-health-care-professionals-a-call-to-explore-and-address-this-underrecognized-threat-to-safe-high-quality-care
Burnout among health care professionals: a call to explore and address this underrecognized threat to safe, high-quality care.
The high prevalence of burnout among health care professionals is cause for concern because it appears to be affecting quality, safety, and health care system performance. Efforts are needed to address this growing problem. Progress will require methodologically sound studies, adequate funding, and collaborative efforts. The authors hope that research sponsors, institutions, clinician organizations, researchers, clinicians, and patients join in supporting enhanced research efforts focused on these topics.
AHRQ-authored.
Citation: Dyrbye LN, Shanafelt TD, Sinsky CA .
Burnout among health care professionals: a call to explore and address this underrecognized threat to safe, high-quality care.
NAM Perspectives 2017 Jul 5.
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Keywords: Quality of Care, Provider: Health Personnel, Patient Safety, Workforce
Scott KW, Orav EJ, Cutler DM
Changes in hospital-physician affiliations in U.S. hospitals and their effect on quality of care.
This study examined changes in U.S. acute care hospitals that reported employment relationships with their physicians and to determine whether quality of care improved after the hospitals switched to this integration model. It concluded that during the past decade, hospitals have increasingly become employers of physicians. The study's findings suggest that physician employment alone probably is not a sufficient tool for improving hospital care.
AHRQ-funded; HS000055.
Citation: Scott KW, Orav EJ, Cutler DM .
Changes in hospital-physician affiliations in U.S. hospitals and their effect on quality of care.
Ann Intern Med 2017 Jan 3;166(1):1-8. doi: 10.7326/m16-0125.
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Keywords: Hospitals, Quality of Care, Critical Care, Workforce
de Cordova PB
Staffing and nurse-perceived quality of care.
This article comments on a study by Cho and colleagues, the purpose of which was to explore the associations between nurse staffing and overtime with nurse-perceived patient safety and care left undone. Cho and colleagues found that as patients per nurse and nurse work hours increase, so does the perception of reduced patient safety. The author argues that the study reinforces the view that educating nurses, administrators and policymakers about the importance of nurse staffing on quality care should continue.
AHRQ-funded; HS024339.
Citation: de Cordova PB .
Staffing and nurse-perceived quality of care.
Evid Based Nurs 2017 Jan;20(1):19. doi: 10.1136/eb-2016-102478.
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Keywords: Quality of Care, Provider, Nursing, Workforce
Silber JH, Rosenbaum PR, McHugh MD
Comparison of the value of nursing work environments in hospitals across different levels of patient risk.
This study tested whether hospitals with better nursing work environments displayed better value than those with worse nursing. It found that hospitals with better nursing environments and above-average staffing levels were associated with better value (lower mortality with similar costs) compared with hospitals without nursing environment recognition and with below-average staffing, especially for higher-risk patients.
AHRQ-funded; HS018338.
Citation: Silber JH, Rosenbaum PR, McHugh MD .
Comparison of the value of nursing work environments in hospitals across different levels of patient risk.
JAMA Surg 2016 Jun;151(6):527-36. doi: 10.1001/jamasurg.2015.4908.
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Keywords: Healthcare Costs, Quality of Care, Nursing, Workforce