National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Cardiovascular Conditions (5)
- Case Study (1)
- Children/Adolescents (4)
- Clinical Decision Support (CDS) (1)
- Communication (3)
- Decision Making (1)
- Disparities (2)
- Emergency Department (1)
- Evidence-Based Practice (19)
- Healthcare Delivery (1)
- Health Information Technology (HIT) (1)
- Health Services Research (HSR) (2)
- Health Systems (1)
- Heart Disease and Health (3)
- (-) Implementation (20)
- Learning Health Systems (3)
- Medication (1)
- Orthopedics (1)
- Outcomes (3)
- Patient-Centered Healthcare (4)
- (-) Patient-Centered Outcomes Research (20)
- Policy (1)
- Practice Improvement (2)
- Prevention (4)
- Primary Care (4)
- Primary Care: Models of Care (1)
- Provider Performance (1)
- Public Health (1)
- Quality Improvement (5)
- Quality Measures (1)
- Quality of Care (5)
- Racial and Ethnic Minorities (1)
- Research Methodologies (2)
- Respiratory Conditions (1)
- Risk (1)
- Sleep Problems (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 20 of 20 Research Studies DisplayedRizk S, Kaelin VC, Sim JGC
Implementing an electronic patient-reported outcome and decision support tool in early intervention.
The study’s aim was to identify and prioritize early intervention (EI) stakeholders' perspectives of supports and barriers to implementing the Young Children's Participation and Environment Measure (YC-PEM), an electronic patient-reported outcome (e-PRO) tool, for scaling its implementation across multiple local and state EI programs. A mixed-methods study was conducted with EI families (n = 6), service coordinators (n = 9), and program leadership (n = 7). Semi-structured interviews and focus groups were conducted and used to share quantitative trial results. All three stakeholder groups identified thematic supports and barriers across multiple constructs within each of four Consolidated Framework for Implementation Research (CFIR) domains: (1) Six themes for "intervention characteristics," (2) Six themes for "process," (3) Three themes for "inner setting," and (4) Four themes for "outer setting." Priorities from stakeholders included prioritized reaching families with diverse linguistic preferences and user navigation needs, further tailoring its interface with automated data capture and exchange processes ("process"); and fostering a positive implementation climate ("inner setting"). Improving EI access (“outer setting”) using YC-PEM e-PRO results was also articulated by service coordinators and program leadership.
AHRQ-funded; HS027583.
Citation: Rizk S, Kaelin VC, Sim JGC .
Implementing an electronic patient-reported outcome and decision support tool in early intervention.
Appl Clin Inform 2023 Jan; 14(1):91-107. doi: 10.1055/s-0042-1760631..
Keywords: Clinical Decision Support (CDS), Health Information Technology (HIT), Children/Adolescents, Evidence-Based Practice, Patient-Centered Outcomes Research, Implementation
Franklin PD, Bond CP, Rothrock NE
Strategies for effective implementation of patient-reported outcome measures in arthroplasty practice.
This study’s goal was to synthesize patient-reported outcome measure (PROM) implementation strategies that are successfully used by hundreds of arthroplasty surgeons and early PROM-adopter clinical systems. The authors developed guidelines to inform clinical care, drive quality-improvement activities, and support reporting for payer-sponsored incentives. They also outlined future research that is needed to define methods for optimal patient engagement, technology infrastructure, and operational systems to seamlessly integrate PROM collection in clinical care.
AHRQ-funded; HS018910.
Citation: Franklin PD, Bond CP, Rothrock NE .
Strategies for effective implementation of patient-reported outcome measures in arthroplasty practice.
J Bone Joint Surg Am 2021 Dec 15;103(24):e97. doi: 10.2106/jbjs.20.02072..
Keywords: Patient-Centered Outcomes Research, Orthopedics, Quality Improvement, Quality of Care, Evidence-Based Practice, Implementation, Outcomes
Berry CA, Nguyen AM, Cuthel AM
Measuring implementation strategy fidelity in HealthyHearts NYC: a complex intervention using practice facilitation in primary care.
This study measured implementation strategy fidelity for the HealthyHearts NYC intervention program, an AHRQ-funded program that uses practice facilitation (PF) to improve adoption of cardiovascular disease evidence-based guidelines in primary care practices. Data from 257 practices measured fidelity using 4 categories: frequency, duration, content, and coverage. Almost all (94.2%) of practices received at least the 13 PF visits with an average 26.3 hours spent at each site by facilitators. Most practices (95.7%) completed all Task List items, and 71.2% were educated on all Chronic Care Models, with the majority (65.8%) receiving full coverage.
AHRQ-funded; HS023922.
Citation: Berry CA, Nguyen AM, Cuthel AM .
Measuring implementation strategy fidelity in HealthyHearts NYC: a complex intervention using practice facilitation in primary care.
Am J Med Qual 2021 Jul-Aug;36(4):270-76. doi: 10.1177/1062860620959450..
Keywords: Implementation, Heart Disease and Health, Cardiovascular Conditions, Primary Care, Practice Improvement, Quality Improvement, Quality of Care, Evidence-Based Practice, Patient-Centered Outcomes Research, Primary Care: Models of Care
Bishop JR, Huang RS, Brown JT
Pharmacogenomics education, research and clinical implementation in the state of Minnesota.
This article looks at the development and implementation of formal pharmacogenomic (PGx) clinical programs at several healthcare organizations across Minnesota. These programs increase drug safety and effectiveness. The article reviews the state of PGx activities in the state of Minnesota including educational programs, research, national consortia involvement, technology, clinical implementation and utilization and reimbursement, and outlines the challenges and opportunities in equitable implementation of these activities.
AHRQ-funded; HS026379.
Citation: Bishop JR, Huang RS, Brown JT .
Pharmacogenomics education, research and clinical implementation in the state of Minnesota.
Pharmacogenomics 2021 Jul;22(11):681-91. doi: 10.2217/pgs-2021-0058..
Keywords: Medication, Implementation, Learning Health Systems, Evidence-Based Practice, Patient-Centered Outcomes Research
Fournier AK, Wasserman MR, Jones CF
AHRQ Author: Fournier AK, Nourjah P, Bierman AS
Developing AHRQ's feasibility assessment criteria for wide-scale implementation of patient-centered outcomes research findings.
This study’s objective was to develop criteria to assess the feasibility of widely implementing nominated findings from the AHRQ Patient-Centered Outcomes Research (PCOR) Dissemination and Implementation (D&I) Initiative. A literature review was conducted, and thirteen D&I experts were interviewed to identify factors affecting feasibility of implementing PCOR findings. Fourteen technical expert panel (TEP) members discussed the face-validity and relative merits of the themes and additional factors. Seven D&I experts pilot-tested the criteria using sample nominations of findings. Three essential criteria sets were developed for AHRQ to assess feasibility of PCOR findings implementation including 1) acceptability to the implementers; 2) generalizability, adaptability, and ease of implementing with fidelity; and 3) alignment with external policies and incentives. Two supplemental criteria: presence of a plan or toolkit supporting implementation and evidence supporting implementation outside the research setting were also developed.
AHRQ-authored; AHRQ-funded; 233201500021I.
Citation: Fournier AK, Wasserman MR, Jones CF .
Developing AHRQ's feasibility assessment criteria for wide-scale implementation of patient-centered outcomes research findings.
J Gen Intern Med 2021 Feb;36(2):374-82. doi: 10.1007/s11606-020-06247-6..
Keywords: Patient-Centered Outcomes Research, Evidence-Based Practice, Implementation
Cykert S, Keyserling TC, Pignone M
A controlled trial of dissemination and implementation of a cardiovascular risk reduction strategy in small primary care practices.
Researchers assessed the effect of dissemination and implementation of an intervention consisting of practice facilitation and a risk-stratified, population management dashboard on cardiovascular risk reduction for patients at high risk in small, primary care practices. They found that a risk-stratified, population management dashboard combined with practice facilitation led to substantial reductions of 10-year atherosclerotic cardiovascular disease risk for patients at high risk. They recommended utilizing similar approaches to lead to effective dissemination and implementation of other new evidence, especially in rural and other under-resourced practices.
AHRQ-funded; HS023912.
Citation: Cykert S, Keyserling TC, Pignone M .
A controlled trial of dissemination and implementation of a cardiovascular risk reduction strategy in small primary care practices.
Health Serv Res 2020 Dec;55(6):944-53. doi: 10.1111/1475-6773.13571..
Keywords: Cardiovascular Conditions, Risk, Prevention, Primary Care, Implementation, Evidence-Based Practice, Patient-Centered Healthcare, Patient-Centered Outcomes Research
Borsky AE, Savitz LA, Bindman AB
AHRQ Author: Borsky AE
AHRQ series on improving translation of evidence: perceived value of translational products by the AHRQ EPC Learning Health Systems Panel.
This paper discusses the outcomes of an evaluation of translational products for clinicians and healthcare providers by an EPC (Evidence-based Practice Center) Learning Health Systems Panel convened by AHRQ. The panel, led by two national leaders and composed of key stakeholders evaluated different translational products for learning health systems and also discussed challenges in adopting evidence-based practices. They evaluated a number of different products, and decided that the one- and three-page summaries, the MAGICapp and Tableau for interactive data visualization, and clinical encounter and health system decision aids were the most useful products. As a result of their findings, the EPC Program is further developing the one- and three-page summaries and MAGICapp and Tableau data visualization products.
AHRQ-authored; AHRQ-funded; 233201500014I.
Citation: Borsky AE, Savitz LA, Bindman AB .
AHRQ series on improving translation of evidence: perceived value of translational products by the AHRQ EPC Learning Health Systems Panel.
Jt Comm J Qual Patient Saf 2019 Nov;45(11):772-78. doi: 10.1016/j.jcjq.2019.08.002..
Keywords: Implementation, Evidence-Based Practice, Patient-Centered Outcomes Research, Learning Health Systems
White CM, Coleman CI, Jackman K
AHRQ series on improving translation of evidence: linking evidence reports and performance measures to help learning health systems use new information for improvement.
This paper analyzed ways to enhance usability of AHRQ’s Evidence-based Practice Center (EPC) reports. The reports are often lengthy and difficult for users to navigate. A quality measure index was created to allow health systems to more efficiently access relevant information. A test was created where two tables were embedded in an EPC report. The first identified quality measures covered by the report descriptively. The second contained page numbers in the executive summary which hyperlinked to those pages with the quality measures. An exercise with two health system-targeted scenarios was then created. The participants were timed how long it took to find answers to scenario questions and gave feedback. It was found that it took 63.4% less time to find quality measure information with the hyperlinked indexing tables than without. The participants felt that the tables were easy to use and more user friendly to health systems.
Jt Comm J Qual Patient Saf 2019 Oct;45(10):706-10. doi: 10.1016/j.jcjq.2019.05.002.
Citation: White CM, Coleman CI, Jackman K .
AHRQ series on improving translation of evidence: linking evidence reports and performance measures to help learning health systems use new information for improvement.
Jt Comm J Qual Patient Saf 2019 Oct;45(10):706-10. doi: 10.1016/j.jcjq.2019.05.002..
Keywords: Implementation, Evidence-Based Practice, Health Systems, Learning Health Systems, Patient-Centered Outcomes Research, Provider Performance, Quality Measures, Quality Improvement, Quality of Care
Springs S, Rofeberg V, Brown S
Community-engaged evidence synthesis to inform public health policy and clinical practice: a case study.
This case study documents the work of the Rhode Island Arts and Health Advisory Group, which convened in 2016 to develop a set of policy, clinical practice, and research recommendations for implementation by the Rhode Island Department of Health, The Rhode Island State Council on the Arts, and partners. Comprised of artists, clinicians, community members, and patients, the group partnered with researchers to complete an evidence synthesis project of arts-based health care interventions.
AHRQ-funded; HS023299; HS022998.
Citation: Springs S, Rofeberg V, Brown S .
Community-engaged evidence synthesis to inform public health policy and clinical practice: a case study.
Med Care 2019 Oct;57 Suppl 10 Suppl 3:S253-s58. doi: 10.1097/mlr.0000000000001180..
Keywords: Public Health, Policy, Case Study, Evidence-Based Practice, Implementation, Patient-Centered Outcomes Research
Sterling MR, Echeverria SE, Commodore-Mensah Y
Health equity and implementation science in heart, lung, blood, and sleep-related research: emerging themes from the 2018 Saunders-Watkins Leadership Workshop.
This article discusses the key themes from a 2-day workshop that was held at the National Institutes of Health in May 2018 to promote health equity and implementation science in heart, lung, and sleep-related research. This inaugural workshop was named the Saunders-Watkins Leadership Workshop. Recommendations are offered for the future direction of this research.
AHRQ-funded; HS000066.
Citation: Sterling MR, Echeverria SE, Commodore-Mensah Y .
Health equity and implementation science in heart, lung, blood, and sleep-related research: emerging themes from the 2018 Saunders-Watkins Leadership Workshop.
Circ Cardiovasc Qual Outcomes 2019 Oct;12(10):e005586. doi: 10.1161/circoutcomes.119.005586..
Keywords: Implementation, Evidence-Based Practice, Disparities, Patient-Centered Outcomes Research, Cardiovascular Conditions, Heart Disease and Health, Respiratory Conditions, Sleep Problems
Huppert JS, Fournier AK, Bihm JL
AHRQ Author: Hupper JS, Fournier AK, Bihm JL, Chang CS, Miller TL, Nourjah P, Chang SM Bierman AS
Prioritizing evidence-based interventions for dissemination and implementation investments: AHRQ's Model and Experience.
The Agency for Healthcare Research and Quality (AHRQ) is mandated to implement patient-centered outcomes research (PCOR) to promote safer, higher quality care. With this goal, the authors developed a process to identify which evidence-based PCOR interventions merited investment in implementation. They present their process and experience to date. The investigators identified 2 evidence-based practice interventions to improve care with sufficient evidence, impact, and feasibility to justify an AHRQ investment to scale up practice.
AHRQ-authored.
Citation: Huppert JS, Fournier AK, Bihm JL .
Prioritizing evidence-based interventions for dissemination and implementation investments: AHRQ's Model and Experience.
Med Care 2019 Oct;57(10 Suppl 3):S272-s77. doi: 10.1097/mlr.0000000000001176..
Keywords: Implementation, Evidence-Based Practice, Patient-Centered Outcomes Research
Adam GP, Balk EM, Jap J
AHRQ EPC series on improving translation of evidence: web-based interactive presentation of systematic review reports.
In this study, an open-source Web-based interactive report presentation of a systematic review was developed to allow users to generate their own "reports" from the information produced by the review. Data from a broad-scope systematic review were used with network meta-analysis conducted on nonsurgical treatments of urinary incontinence (UI) in women. Stakeholders informed and piloted the tool and assessed its usefulness.
AHRQ-funded; 290201500002I.
Citation: Adam GP, Balk EM, Jap J .
AHRQ EPC series on improving translation of evidence: web-based interactive presentation of systematic review reports.
Jt Comm J Qual Patient Saf 2019 Sep;45(9):629-38. doi: 10.1016/j.jcjq.2019.05.001..
Keywords: Evidence-Based Practice, Patient-Centered Outcomes Research, Implementation
Ishimine P, Adelgais K, Barata I
Executive summary: the 2018 Academic Emergency Medicine Consensus Conference: Aligning the Pediatric Emergency Medicine Research Agenda to Reduce Health Outcome Gaps.
Emergency care providers share a compelling interest in developing an effective patient-centered, outcomes-based research agenda that can decrease variability in pediatric outcomes. The 2018 Academic Emergency Medicine Consensus Conference "Aligning the Pediatric Emergency Medicine Research Agenda to Reduce Health Outcome Gaps (AEMCC)" aimed to fulfill this role. This paper discusses the conference which convened major thought leaders and stakeholders to introduce a research, scholarship, and innovation agenda for pediatric emergency care specifically to reduce health outcome gaps.
AHRQ-funded; HS026101.
Citation: Ishimine P, Adelgais K, Barata I .
Executive summary: the 2018 Academic Emergency Medicine Consensus Conference: Aligning the Pediatric Emergency Medicine Research Agenda to Reduce Health Outcome Gaps.
Acad Emerg Med 2018 Dec;25(12):1317-26. doi: 10.1111/acem.13667..
Keywords: Implementation, Evidence-Based Practice, Patient-Centered Outcomes Research, Children/Adolescents, Emergency Department, Outcomes, Research Methodologies
Morrow AS, Whiteside SP, Sim LA
Developing tools to enhance the use of systematic reviews for clinical care in health systems.
The researchers’ goal was to develop tools to facilitate the uptake of evidence as summarized in systematic reviews by clinical decisionmakers in health systems. After they conducted a systematic review on the management of anxiety in children, the researchers interviewed health system representatives, clinicians and patients to gain additional information about decisionmaking. Two decision-aid tools - one for the health system and the other for the clinical encounter - were then developed using stakeholders' feedback and literature searches. The health system decision aid provided information on patients who were candidates for treatment, values and preferences, costs and resources, acceptability, impact on health equity, feasibility, drug dosing, alternative therapies, remission rates, and prognosis. The encounter decision aid was produced as a set of cards that contained information on the issues that drive treatment decisions. Health system stakeholders found the first decision aid useful, and patients, parents, and clinicians found the second to be helpful.
AHRQ-funded; 290201500013I; 29032001T.
Citation: Morrow AS, Whiteside SP, Sim LA .
Developing tools to enhance the use of systematic reviews for clinical care in health systems.
BMJ Evid Based Med 2018 Dec;23(6):206-09. doi: 10.1136/bmjebm-2018-110995..
Keywords: Children/Adolescents, Decision Making, Evidence-Based Practice, Patient-Centered Outcomes Research, Implementation
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.
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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
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.
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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
Castro FG, Yasui M
Advances in EBI development for diverse populations: towards a science of intervention adaptation.
This introduction examines major issues and challenges as presented in this special issue of Prevention Science, "Challenges to the Dissemination and Implementation of Evidence Based Prevention Interventions for Diverse Populations." The authors describe the Fidelity-Adaptation Dilemma that generated controversies and debates and new perspectives on the dissemination and implementation of evidence-based interventions (EBIs) within diverse populations. The five articles in this special issue address many of these controversies and challenges.
AHRQ-funded; HS023007.
Citation: Castro FG, Yasui M .
Advances in EBI development for diverse populations: towards a science of intervention adaptation.
Prev Sci 2017 Aug;18(6):623-29. doi: 10.1007/s11121-017-0809-x.
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Keywords: Communication, Disparities, Evidence-Based Practice, Patient-Centered Outcomes Research, Prevention, Racial and Ethnic Minorities, Implementation
Borden WB, Chiang YP, Kronick R
AHRQ Author: Kronick, R
Bringing patient-centered outcomes research to life.
Achieving better health outcomes requires both the generation of new patient-centered outcomes research (PCOR) knowledge and the appropriate and timely dissemination of that knowledge into practice. This article highlights the work AHRQ has done, is doing, and will do to improve the uptake of PCOR findings.
AHRQ-authored
Citation: Borden WB, Chiang YP, Kronick R .
Bringing patient-centered outcomes research to life.
Value Health. 2015 Jun;18(4):355-7. doi: 10.1016/j.jval.2015.01.010..
Keywords: Communication, Evidence-Based Practice, Outcomes, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Implementation
Holzer JK, Ellis L, Merritt MW
Why we need community engagement in medical research.
The aim of this article was to illustrate how community engagement can help to remedy shortfalls of community trust, participant enrollment, and uptake of research findings. After briefly describing these shortfalls, the authors considered 3 case examples that demonstrate the potential of community engagement to address each. They also discussed the ethical importance and implications of demonstrating respect for the community.
AHRQ-funded; HS017589.
Citation: Holzer JK, Ellis L, Merritt MW .
Why we need community engagement in medical research.
J Investig Med 2014 Aug;62(6):851-5. doi: 10.1097/jim.0000000000000097..
Keywords: Health Services Research (HSR), Patient-Centered Outcomes Research, Research Methodologies, Implementation
Clancy CM, Margolis PA, Miller M
AHRQ Author: Clancy CM
Collaborative networks for both improvement and research.
The authors discuss collaborative improvement networks, which can serve as large-scale, health system laboratories to engage clinicians, researchers, patients, and parents in testing approaches to translate research into practice. Creation of total population registries in collaborative network sites provides large, representative study samples with high-quality data which can be used to generate evidence and to inform clinical decision-making. Collaborative networks for improvement and research offer the opportunity not only to make improvements but also to study improvements to determine which interventions and combination of strategies work best in which settings.
AHRQ-authored; AHRQ-funded; HS021114.
Citation: Clancy CM, Margolis PA, Miller M .
Collaborative networks for both improvement and research.
Pediatrics 2013 Jun;131 Suppl 4:S210-4. doi: 10.1542/peds.2012-3786H.
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Keywords: Evidence-Based Practice, Health Services Research (HSR), Patient-Centered Outcomes Research, Children/Adolescents, Implementation