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
- Adverse Events (1)
- Asthma (1)
- Cardiovascular Conditions (9)
- Caregiving (1)
- Care Management (4)
- Children/Adolescents (1)
- Clinician-Patient Communication (1)
- Communication (2)
- Comparative Effectiveness (2)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (1)
- Decision Making (1)
- Diabetes (1)
- Diagnostic Safety and Quality (1)
- Electronic Health Records (EHRs) (2)
- Emergency Department (1)
- Evidence-Based Practice (11)
- Healthcare Costs (1)
- (-) Healthcare Delivery (51)
- Health Information Technology (HIT) (3)
- Health Services Research (HSR) (2)
- Health Systems (2)
- Heart Disease and Health (5)
- Home Healthcare (1)
- Hospital Discharge (1)
- Hospitalization (1)
- Hospital Readmissions (1)
- Hospitals (3)
- Implementation (8)
- Injuries and Wounds (1)
- Inpatient Care (1)
- Labor and Delivery (1)
- Learning Health Systems (2)
- Maternal Care (1)
- Medical Errors (1)
- Newborns/Infants (1)
- Organizational Change (9)
- Outcomes (2)
- Palliative Care (2)
- Patient-Centered Healthcare (13)
- Patient-Centered Outcomes Research (9)
- Patient and Family Engagement (3)
- Patient Experience (1)
- Patient Safety (6)
- Patient Self-Management (1)
- Payment (1)
- Practice Improvement (7)
- Pregnancy (1)
- Prevention (5)
- Primary Care (20)
- Primary Care: Models of Care (5)
- Provider Performance (2)
- (-) Quality Improvement (51)
- Quality Indicators (QIs) (1)
- Quality Measures (1)
- Quality of Care (40)
- Registries (1)
- Rehabilitation (1)
- Research Methodologies (2)
- Rural/Inner-City Residents (1)
- Surgery (2)
- Teams (5)
- Telehealth (1)
- Urban Health (2)
- Vulnerable Populations (1)
- Women (1)
- Workflow (3)
- Workforce (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 25 of 51 Research Studies DisplayedKuzel AJ, Cuellar A, Nichols L
The EvidenceNOW practice support initiative: the Heart of Virginia Healthcare.
The purpose of this study was for The Heart of Virginia Health care (HVH) collaborative (one of the Agency for Healthcare Research and Quality's (AHRQ) Evidence Now project’s 7 collaboratives) to test different ways to improve performance and outcomes on ABCS clinical quality measures (appropriate Aspirin use, Blood pressure control, Cholesterol control, and Smoking cessation counseling) within small primary care practices. The researchers recruited 264 eligible practices and randomized them to 3 cohorts in a stepped wedge design, with 173, utilizing 16 different EHRs, participated through the entire initiative. Trained coaches delivered the practice support curriculum to improve performance on the ABCS measures. The program included an initial kickoff meeting, 3 months of focused support, 9 months of continued support, and access to online materials and faculty. The intervention phase was shortened due to difficulty in recruiting a sufficient number of practices. The study found that the short HVH intervention had a small but statistically significant positive average effects on appropriate use of aspirin and other anti-thrombotics, small negative effects on blood pressure control, except for those practices which did not attend the kickoff, and small negative effects on smoking cessation counseling. The researchers concluded that the truncation of the intervention contributed to the lack of substantial improvements in the ABCS.
AHRQ-funded; HS023913.
Citation: Kuzel AJ, Cuellar A, Nichols L .
The EvidenceNOW practice support initiative: the Heart of Virginia Healthcare.
J Am Board Fam Med 2022 Oct 18;35(5):979-89. doi: 10.3122/jabfm.2022.05.210021..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Evidence-Based Practice, Primary Care, Patient-Centered Outcomes Research, Quality Improvement, Quality of Care, Healthcare Delivery
Lieu TA, Warton EM, Levan C
Association of medical assistant-supported virtual rooming with successful video visit connections.
The purpose of this study was to systematically evaluate medical assistant-supported virtual rooming for physician video visits to address the digital divide which exists in physician video visit availability and accessibility for patients who have lower socioeconomic status (SES), low English proficiency, or are African American or Black or Latino. The study found that of the 114,214 video visits with successful connections, 14.2% had low neighborhood SES, 3.6% needed interpreters, 20.1% were Latino, and 7.9% were African American or Black. African American or Black race, Latino ethnicity, needing an interpreter, and living in a low SES neighborhood were associated with a lower likelihood of connecting. The researchers concluded that medical assistant–supported virtual rooming was associated with successful video visit connections in this diverse population. High medical assistant supported rooming rates were associated with larger connection improvements for patients at higher risk of not connecting, including those with lower SES, of Latino ethnicity or African American or Black race, or needing interpreters.
AHRQ-funded; HS025189.
Citation: Lieu TA, Warton EM, Levan C .
Association of medical assistant-supported virtual rooming with successful video visit connections.
JAMA Intern Med 2022 Jun;182(6):680-82. doi: 10.1001/jamainternmed.2022.1032..
Keywords: Quality Improvement, Quality of Care, Telehealth, Health Information Technology (HIT), Clinician-Patient Communication, Communication, Healthcare Delivery
Quigley DD, Slaughter M, Qureshi N
Practices and changes associated with patient-centered medical home transformation.
Knowing which patient-centered medical home (PCMH) care delivery changes and quality improvement (QI) practices further PCMH implementation is essential. In this study, the investigators used the 2008-2017 National Committee of Quality Assurance (NCQA) PCMH directory of 15,188 primary care practices that received Level 1, 2, or 3 NCQA PCMH recognition to: 1.) construct a stratified national sample of 105 practices engaged in PCMH transformation and 2.) examine their QI practices and PCMH changes associated with PCMH transformation.
AHRQ-funded; HS016980; HS025920.
Citation: Quigley DD, Slaughter M, Qureshi N .
Practices and changes associated with patient-centered medical home transformation.
Am J Manag Care 2021 Sep;27(9):386-93. doi: 10.37765/ajmc.2021.88740..
Keywords: Patient-Centered Healthcare, Primary Care, Practice Improvement, Healthcare Delivery, Quality Improvement, Quality of Care
Quigley DD, Qureshi N, AlMasarweh L
Using CAHPS patient experience data for patient-centered medical home transformation.
The purpose of this study was to examine how primary care practices used the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey and its patient-centered medical home (PCMH) items during their PCMH transition. The investigators concluded that CAHPS surveys were considered actionable for PCMH transformation and used in standardizing and coordinating care. The CAHPS PCMH items were considered integral to the continuous QI needed for moving beyond formal PCMH recognition and maximizing transformation.
AHRQ-funded; HS016980; HS025920.
Citation: Quigley DD, Qureshi N, AlMasarweh L .
Using CAHPS patient experience data for patient-centered medical home transformation.
Am J Manag Care 2021 Sep;27(9):e322-e29. doi: 10.37765/ajmc.2021.88745..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient Experience, Patient-Centered Healthcare, Primary Care, Practice Improvement, Healthcare Delivery, Quality Improvement, Quality of Care
Lee YSH, Cleary PD, Nembhard IM
Effects of leader tactics on the creativity, implementation, and evolution of ideas to improve healthcare delivery.
Researchers examined the association between leader tactics and the creativity, implementation outcome, and evolution of quality improvement ideas from clinicians and staff. They found that two identified tactics, brainstorming and reflection, were helpful depending on goals. They suggested that brainstorming may aide leaders seeking disruptive change via more creative, rapidly implemented ideas, while reflection on team process may aide leaders seeking high-engagement ideas that may be implemented slowly. They concluded that both tactics may help leaders cultivate dynamics that increase implementation of ideas that improve healthcare.
AHRQ-funded; HS016978.
Citation: Lee YSH, Cleary PD, Nembhard IM .
Effects of leader tactics on the creativity, implementation, and evolution of ideas to improve healthcare delivery.
J Gen Intern Med 2021 Feb;36(2):341-48. doi: 10.1007/s11606-020-06139-9..
Keywords: Organizational Change, Healthcare Delivery, Quality Improvement, Quality of Care, Implementation
Hung DY, Truong QA, Liang SY
Implementing lean quality improvement in primary care: impact on efficiency in performing common clinical tasks.
Investigators examined 3-year impacts of Lean implementation on the amount of time taken for physicians to complete common clinical tasks. They found that Lean redesigns led to improvements in timely completion of 3 out of 4 common clinical tasks, thus supporting the use of Lean techniques to engage teams in routine aspects of patient care. They recommended more research to understand the mechanisms by which Lean promotes quality improvement and effectiveness of care team workflows.
AHRQ-funded; HS024529.
Citation: Hung DY, Truong QA, Liang SY .
Implementing lean quality improvement in primary care: impact on efficiency in performing common clinical tasks.
J Gen Intern Med 2021 Feb;36(2):274-79. doi: 10.1007/s11606-020-06317-9..
Keywords: Primary Care, Quality Improvement, Quality of Care, Primary Care: Models of Care, Primary Care, Implementation, Workflow, Teams, Healthcare Delivery
Solberg LI, Kuzel A, Parchman ML
A taxonomy for external support for practice transformation.
There is no commonly accepted comprehensive framework for describing the practical specifics of external support for practice change. In this study, the researchers’goal was to develop a taxonomy that could be used by both external groups or researchers and health care leaders. The leaders of 8 grants from Agency for Research and Quality for the EvidenceNOW study of improving cardiovascular preventive services in over 1500 primary care practices nationwide worked collaboratively over 18 months to develop descriptions of key domains that might comprehensively characterize any external support intervention.
AHRQ-funded; HS023940.
Citation: Solberg LI, Kuzel A, Parchman ML .
A taxonomy for external support for practice transformation.
J Am Board Fam Med 2021 Jan-Feb;34(1):32-39. doi: 10.3122/jabfm.2021.01.200225..
Keywords: Primary Care, Healthcare Delivery, Cardiovascular Conditions, Evidence-Based Practice, Prevention, Quality Improvement, Practice Improvement, Quality of Care
Qureshi N, Quigley DD, Hays RD
Nationwide qualitative study of practice leader perspectives on what it takes to transform into a patient-centered medical home.
The purpose of this study was to examine reasons practices obtained and maintained patient-centered medical home (PCMH) recognition and what resources were needed. The investigators concluded that PCMH efforts necessitated support and assistance to frontline, on-site practice leaders leading care delivery changes. They suggested that change efforts should include financial incentives (e.g., direct payment or additional reimbursement), leadership direction and support, and internal or external staff with experience with the PCMH application process, implementation changes, and QI expertise in monitoring process and outcome data.
AHRQ-funded; HS016980.
Citation: Qureshi N, Quigley DD, Hays RD .
Nationwide qualitative study of practice leader perspectives on what it takes to transform into a patient-centered medical home.
J Gen Intern Med 2020 Dec;35(12):3501-09. doi: 10.1007/s11606-020-06052-1..
Keywords: Patient-Centered Healthcare, Primary Care: Models of Care, Primary Care, Quality Improvement, Quality of Care, Healthcare Delivery
Aguirre A, Trupin L, Margaretten M
Using process improvement and systems redesign to improve rheumatology care quality in a safety net clinic.
Researchers sought to develop and evaluate interventions to improve quality of care in four priority areas in an urban safety net adult rheumatology clinic serving a racially/ethnically and socioeconomically diverse patient population. Clinical processes were redesigned to achieve pre-specified benchmarks in the following four areas: 13-valent pneumococcal conjugate vaccine (PCV13) administered to immunocompromised patients; Clinical Disease Activity Index (CDAI) disease activity monitoring for patients with rheumatoid arthritis; latent tuberculosis infection (LTBI) screening for new biologic users with rheumatoid arthritis; reproductive health counseling among women receiving potentially teratogenic medications. Through an interprofessional approach, the researchers achieved durable improvements in key rheumatology quality measures largely by enhancing workflow, engaging non-physician providers, and managing practice variation.
AHRQ-funded; HS024412; HS025638.
Citation: Aguirre A, Trupin L, Margaretten M .
Using process improvement and systems redesign to improve rheumatology care quality in a safety net clinic.
J Rheumatol 2020 Nov;47(11):1712-20. doi: 10.3899/jrheum.190472..
Keywords: Urban Health, Rural/Inner-City Residents, Quality Improvement, Quality of Care, Healthcare Delivery
Kaiser SV, Johnson MD, Walls TA
Pathways to improve pediatric asthma care: a multisite, national study of emergency department asthma pathway implementation.
This quality improvement study’s aim was to determine the effects of pediatric asthma pathway implementation in a diverse, national sample of emergency departments (EDs). Desired outcomes included systemic corticosteroid administration within 60 minutes (primary), assessment of severity at ED triage, chest radiograph use, hospital admission or transfer for higher level of care, and ED length of stay. Charts were reviewed each month by EDs for children ages 2-17 years with a primary diagnosis of asthma. A total of 83 EDs were enrolled, with 37 of them children’s hospitals, and 46 community hospitals. Seventy-three percent completed the study (n = 22,963). There was a significant increase in systematic corticosteroid administration within 60 minutes of arrival as well as increased odds of severity assessment at triage and decreased rate of change in odds of hospital admission/transfer. Chest radiograph or ED length of stay was not associated with pathway implementation.
AHRQ-funded; HS024592.
Citation: Kaiser SV, Johnson MD, Walls TA .
Pathways to improve pediatric asthma care: a multisite, national study of emergency department asthma pathway implementation.
J Pediatr 2020 Aug;223:100-07.e2. doi: 10.1016/j.jpeds.2020.02.080..
Keywords: Children/Adolescents, Emergency Department, Asthma, Quality Improvement, Quality of Care, Care Management, Healthcare Delivery, Patient-Centered Outcomes Research, Evidence-Based Practice, Outcomes
Rudin RS, Friedberg MW, Shekelle P
Getting value from electronic health records: research needed to improve practice.
Electronic health records (EHRs) are now widely adopted in the United States, but health systems have barely begun using them to deliver high-value care. This article describes 4 potential benefits of EHR-based research: improving clinical decisions, supporting triage decisions, enabling collaboration among the care team (including patients), and increasing productivity via automation of tasks.
AHRQ-funded; HS024067.
Citation: Rudin RS, Friedberg MW, Shekelle P .
Getting value from electronic health records: research needed to improve practice.
Ann Intern Med 2020 Jun 2;172(11 Suppl):S130-s36. doi: 10.7326/m19-0878..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Quality Improvement, Quality of Care, Healthcare Delivery
Herrick HM, Lorch S, Hsu JY
Impact of flow disruptions in the delivery room.
The goal of this study was to identify the impact of flow disruptions during neonatal resuscitation and to determine their association with key process and outcome measures. Delivery-room resuscitations of neonates less 32 weeks gestational age were video recorded for observation. Results showed that flow disruptions occurred frequently during neonatal resuscitation and recommendations included measuring flow disruptions as a feasible method to assess the impact of human factors in the delivery room and to identify modifiable factors and practices to improve patient care.
AHRQ-funded; HS023538; HS026491; HS026625; HS023806.
Citation: Herrick HM, Lorch S, Hsu JY .
Impact of flow disruptions in the delivery room.
Resuscitation 2020 May;150:29-35. doi: 10.1016/j.resuscitation.2020.02.037.
.
.
Keywords: Workflow, Labor and Delivery, Newborns/Infants, Patient Safety, Healthcare Delivery, Quality Improvement, Quality of Care
Persell SD, Liss DT, Walunas TL
Effects of 2 forms of practice facilitation on cardiovascular prevention in primary care: a practice-randomized, comparative effectiveness trial.
Effective quality improvement (QI) strategies are needed for small practices. The objective of this study was to compare practice facilitation implementing point-of-care (POC) QI strategies alone versus facilitation implementing point-of-care plus population management (POC+PM) strategies on preventive cardiovascular care. The investigators concluded that facilitator-led QI promoting population management approaches plus POC improvement strategies was not clearly superior to POC strategies alone.
AHRQ-funded; HS023921.
Citation: Persell SD, Liss DT, Walunas TL .
Effects of 2 forms of practice facilitation on cardiovascular prevention in primary care: a practice-randomized, comparative effectiveness trial.
.
Keywords: Cardiovascular Conditions, Prevention, Primary Care: Models of Care, Primary Care, Comparative Effectiveness, Patient-Centered Outcomes Research, Evidence-Based Practice, Quality Improvement, Quality of Care, Care Management, Healthcare Delivery
Sweeney SM, Hemler JR, Baron AN
Dedicated workforce required to support large-scale practice improvement.
Facilitation is an effective approach for helping practices implement sustainable evidence-based practice improvements. Few studies examine the facilitation infrastructure and support needed for large-scale dissemination and implementation initiatives. In this paper, the authors discuss a project by the Agency for Health care Research and Quality in which it funded 7 Cooperatives, each of which worked with over 200 primary care practices to rapidly disseminate and implement improvements in cardiovascular preventive care.
AHRQ-funded; HS023940.
Citation: Sweeney SM, Hemler JR, Baron AN .
Dedicated workforce required to support large-scale practice improvement.
J Am Board Fam Med 2020 Mar-Apr;33(2):230-39. doi: 10.3122/jabfm.2020.02.190261..
Keywords: Practice Improvement, Primary Care, Cardiovascular Conditions, Healthcare Delivery, Quality Improvement, Quality of Care, Prevention, Implementation, Evidence-Based Practice
Amin AP, Spertus JA, Kulkarni H
Improving care pathways for acute coronary syndrome: patients undergoing percutaneous coronary intervention.
This study examined ways to improve care pathways for acute coronary syndrome (ACS) patients who are low-risk with no complications. They looked at 434,172 low-risk uncomplicated ACS patients eligible for early discharge from the Premier database and identified ACS care pathways. They compared percutaneous coronary intervention (PCI) types (trans-radial intervention [TRI] vs. transfemoral intervention (TFI) and by length of stay (LOS). Associations with costs and outcomes were tested using hierarchical, mixed-effects regression and projections of cost savings were obtained using modeling. More cost-savings were associated with TRI versus TFI. There was not an increased risk of adverse outcomes with a shorter LOS.
AHRQ-funded; HS022481.
Citation: Amin AP, Spertus JA, Kulkarni H .
Improving care pathways for acute coronary syndrome: patients undergoing percutaneous coronary intervention.
Am J Cardiol 2020 Feb;125(3):354-61. doi: 10.1016/j.amjcard.2019.10.019..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Quality Improvement, Quality of Care, Healthcare Delivery, Registries, Healthcare Costs
Singh H, Graber ML, Hofer TP
Measures to improve diagnostic safety in clinical practice.
In this paper, the investigators discuss how the need to develop measures to improve diagnostic performance could move forward at a time when the scientific foundation needed to inform measurement is still evolving. They highlight challenges and opportunities for developing potential measures of "diagnostic safety" related to clinical diagnostic errors and associated preventable diagnostic harm. In doing so, they propose a starter set of measurement concepts for initial consideration that seem reasonably related to diagnostic safety and call for these to be studied and further refined.
AHRQ-funded; HS022087.
Citation: Singh H, Graber ML, Hofer TP .
Measures to improve diagnostic safety in clinical practice.
J Patient Saf 2019 Dec;15(4):311-16. doi: 10.1097/pts.0000000000000338.
.
.
Keywords: Patient Safety, Diagnostic Safety and Quality, Healthcare Delivery, Quality Improvement, Quality of Care, Medical Errors, Adverse Events
Keller SC, Cosgrove SE, Arbaje AI
Roles and role ambiguity in patient- and caregiver-performed outpatient parenteral antimicrobial therapy.
This study examined roles and role ambiguity in patient- and caregiver-performed outpatient parenteral antimicrobial therapy (OPAT). A qualitative study of patients and caregivers was conducted using 40 semistructured telephone interviews and 20 contextual inquiries for patients and caregivers. The participants had been discharged from two academic medical centers and put on OPAT. Four main roles were identified: communicator, advocate, learner-trainer, and lay health care worker. There was ambiguity shown among health care workers as well as patients and caregivers. Clearer delineation of roles as to who performs which tasks was indicated in the study.
AHRQ-funded; HS025782.
Citation: Keller SC, Cosgrove SE, Arbaje AI .
Roles and role ambiguity in patient- and caregiver-performed outpatient parenteral antimicrobial therapy.
Jt Comm J Qual Patient Saf 2019 Nov;45(11):763-71. doi: 10.1016/j.jcjq.2019.07.003..
Keywords: Patient-Centered Healthcare, Quality Improvement, Healthcare Delivery, Patient Self-Management, Care Management, Caregiving, Quality of Care, Patient Safety
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
O'Leary KJ, Johnson JK, Manojlovich M
Redesigning systems to improve teamwork and quality for hospitalized patients (RESET): study protocol evaluating the effect of mentored implementation to redesign clinical microsystems.
The goal of this study was to implement the Advanced and Integrated MicroSystems (AIMS) set of evidence-based complementary interventions across a range of clinical microsystems, to identify factors and strategies associated with successful implementation, and to evaluate impact on quality. The AIMS interventions are Unit-based Physician Teams; Unit Nurse-Physician Co-leadership; Enhanced Interprofessional Rounds; Unit-level Performance Reports; Patient Engagement Activities. Four hospital sites, each with a local leadership team, received guidance and resources to implement the AIMS interventions. A multi-method approach was used to collect and triangulate qualitative data during three visits to the sites. Outcomes included teamwork climate and adverse events.
AHRQ-funded; HS025649.
Citation: O'Leary KJ, Johnson JK, Manojlovich M .
Redesigning systems to improve teamwork and quality for hospitalized patients (RESET): study protocol evaluating the effect of mentored implementation to redesign clinical microsystems.
BMC Health Serv Res 2019 May 8;19(1):293. doi: 10.1186/s12913-019-4116-z..
Keywords: Evidence-Based Practice, Healthcare Delivery, Hospitalization, Inpatient Care, Quality of Care, Quality Improvement, Teams
Lindner S, Solberg LI, Miller WL
Does ownership make a difference in primary care practice?
This study looked into whether ownership of a primary care practice makes a difference in structural characteristics, quality improvement practices, and cardiovascular preventive care. This analysis was done was part of an evaluation of the EvidenceNOW: Advancing Heart Health in Primary Care Initiative by AHRQ. Physician-owned practices, health system or medical group practices, and Federally Qualified Health Centers (FQHCs) were compared using 15 survey-based measures, and 4 electronic health record-based cardiovascular disease (CVD) prevention quality measures known as ABCS (aspirin prevention, blood pressure control, cholesterol management, and smoking cessation support). Physician-owned practices were solo 45% of the time as opposed to 8.1% for health system practices and 12.8% for FQHCs. FQHCs were more likely to use quality improvement practices followed by health system practices. ABCS use was similar across ownership types with the exception of smoking cessation support.
AHRQ-funded; HS023940.
Citation: Lindner S, Solberg LI, Miller WL .
Does ownership make a difference in primary care practice?
J Am Board Fam Med 2019 May-Jun;32(3):398-407. doi: 10.3122/jabfm.2019.03.180271..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Primary Care, Evidence-Based Practice, Quality Improvement, Quality of Care, Healthcare Delivery
Hung DY, Harrison MI, Liang SY
AHRQ Author: Harrison MI
Contextual conditions and performance improvement in primary care.
This study examined organizational features of primary care clinics that had gone through Lean redesigns and had experienced the greatest performance improvements. They surveyed 1333 physicians and staff in 43 primary care clinics across a large primary care system. They found that clinics with prior experience with quality improvement had the highest increases in efficiency. Clinics reporting the highest levels of burnout and work stress before the redesign also made efficiency gains. Physician productivity gains was associated with a history of change, staff participation and leadership support. The greatest improvements in patient satisfaction occurred where there was the lowest stress levels with highest levels of teamwork, staff engagement and leadership support.
AHRQ-authored; AHRQ-funded; 2902010000221.
Citation: Hung DY, Harrison MI, Liang SY .
Contextual conditions and performance improvement in primary care.
Qual Manag Health Care 2019 Apr/Jun;28(2):70-77. doi: 10.1097/qmh.0000000000000198..
Keywords: Organizational Change, Healthcare Delivery, Primary Care, Provider Performance, Quality Improvement, Quality of Care, Workflow
Dowding DW, Russell D, Onorato N
Technology solutions to support care continuity in home care: a focus group study.
The purpose of this study was to explore perceptions among home care clinicians of the barriers they face and the information they need to improve care continuity for patients with heart failure. The study highlighted areas of improvement for health information technology solutions that could support care delivery for patients with heart failure in a home care setting.
AHRQ-funded; HS023855.
Citation: Dowding DW, Russell D, Onorato N .
Technology solutions to support care continuity in home care: a focus group study.
J Healthc Qual 2018 Jul/Aug;40(4):236-46. doi: 10.1097/jhq.0000000000000104..
Keywords: Healthcare Delivery, Health Information Technology (HIT), Heart Disease and Health, Home Healthcare, Quality Improvement
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
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
Shoemaker SJ, McNellis RJ, DeWalt DA
AHRQ Author: McNellis RJ
The capacity of primary care for improving evidence-based care: early findings from AHRQ's EvidenceNOW.
This article introduces a supplement consisting of 8 original research articles representing all 7 regional cooperatives and the national evaluation team. The articles report early findings that represent a range of topics and empirical approaches. The supplement also includes an overview and rationale from AHRQ and 2 commentaries from nationally recognized experts in the field of primary care research and practice transformation.
AHRQ-authored; AHRQ-funded; 290201200019I.
Citation: Shoemaker SJ, McNellis RJ, DeWalt DA .
The capacity of primary care for improving evidence-based care: early findings from AHRQ's EvidenceNOW.
Ann Fam Med 2018 Apr;16(Suppl 1):S2-s4. doi: 10.1370/afm.2227.
.
.
Keywords: Evidence-Based Practice, Cardiovascular Conditions, Healthcare Delivery, Patient-Centered Outcomes Research, Quality Improvement