National Healthcare Quality and Disparities Report
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Topics
- Access to Care (1)
- Adverse Drug Events (ADE) (1)
- Adverse Events (1)
- Asthma (1)
- Behavioral Health (4)
- Cancer (1)
- Cancer: Colorectal Cancer (1)
- Cardiovascular Conditions (8)
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- Comparative Effectiveness (2)
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- (-) Evidence-Based Practice (42)
- Falls (1)
- Guidelines (5)
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- Health Services Research (HSR) (6)
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- Human Immunodeficiency Virus (HIV) (1)
- Implementation (10)
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- Learning Health Systems (3)
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- Practice Patterns (1)
- Pregnancy (1)
- Prevention (7)
- Primary Care (12)
- Primary Care: Models of Care (2)
- Quality Improvement (11)
- Quality of Care (11)
- Racial and Ethnic Minorities (1)
- Research Methodologies (5)
- Rural Health (1)
- Sepsis (1)
- Teams (1)
- Telehealth (1)
- Women (2)
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 25 of 42 Research Studies DisplayedSaldanha IJ, Adam GP, Kanaan G
Delivery strategies for postpartum care: a systematic review and meta-analysis.
This systematic review examined the effects of postpartum health care-delivery strategies on health care utilization and maternal outcomes. The authors searched medical databases from inception to November 16, 2022. They found 64 eligible studies (50 randomized controlled trials, 14 nonrandomized comparative studies; N=543,480). The review found that for general postpartum care, care location (clinic, at home, by telephone) did not affect depression or anxiety symptoms (low strength of evidence), and care integration (by multiple types of health care professionals) did not affect depression symptoms or substance use (low strength of evidence). Providing contraceptive care earlier (compared with later) was associated with greater implant use at 6 months (moderate strength of evidence). Low strength of evidence was found for location of breastfeeding affecting hospitalization, other unplanned care utilization, or mental health symptoms. Peer support was associated with higher rates of any or exclusive breastfeeding at 1 month and any breastfeeding at 3-6 months but not other breastfeeding measures (all moderate strength of evidence). Care by a lactation consultant was associated with higher breastfeeding rates at 6 months but not exclusive breastfeeding (all moderate strength of evidence). Moderate strength of evidence was found for the association of use and nonuse of information technology for breastfeeding care with comparable rates of breastfeeding. Moderate strength of evidence was found for the association of testing reminders for screening or preventive care and greater adherence to oral glucose tolerance testing but not random glucose or hemoglobin A1c testing.
AHRQ-funded; 75Q80120D00001; 75Q80121F32007.
Citation: Saldanha IJ, Adam GP, Kanaan G .
Delivery strategies for postpartum care: a systematic review and meta-analysis.
Obstet Gynecol 2023 Sep 1; 142(3):529-42. doi: 10.1097/aog.0000000000005293..
Keywords: Maternal Care, Women, Healthcare Delivery, Evidence-Based Practice, Patient-Centered Outcomes Research
Tugwell P, Welch V, Magwood O
AHRQ Author: Chang C
Protocol for the development of guidance for collaborator and partner engagement in health care evidence syntheses.
The objectives of this protocol were to: Identify, map, and synthesize findings related to engagement in evidence syntheses; Explore how engagement in evidence synthesis promotes health equity; Develop equity-oriented guidance on methods for conducting, evaluating, and reporting engagement. The authors intended to use their findings to develop draft guidance checklists and assess agreement with each item through an international survey. The guidance checklists will be co-produced and after being finalized at a consensus meeting, an international team will develop guidance for collaborators and partner engagement. The authors concluded that incorporating partnership values and expectations may result in better uptake, potentially reducing health inequities.
AHRQ-authored.
Citation: Tugwell P, Welch V, Magwood O .
Protocol for the development of guidance for collaborator and partner engagement in health care evidence syntheses.
Syst Rev 2023 Aug 2; 12(1):134. doi: 10.1186/s13643-023-02279-1..
Keywords: Evidence-Based Practice, Health Services Research (HSR), Healthcare Delivery
Jain A, Brooks JR, Alford CC
AHRQ Author: Jain A, Alford CC, Chang CS, Mueller NM, Umscheid CA, Bierman AS
Awareness of racial and ethnic bias and potential solutions to address bias with use of health care algorithms.
This AHRQ-authored study examined the increased use of health care algorithms in health decision tools, and whether including a patient's race or ethnicity among their inputs can lead clinicians and decision-makers to make choices that vary by race and potentially affect inequities. This qualitative survey included 42 organization representatives (e.g., clinical professional societies, universities, government agencies, payers, and health technology organizations) and individuals. The respondents identified 18 algorithms currently in use with the potential for bias. Seven qualitative themes with 31 subthemes were identified including: (1) algorithms are in widespread use and have significant repercussions, (2) bias can result from algorithms whether or not they explicitly include race, (3) clinicians and patients are often unaware of the use of algorithms and potential for bias, (4) race is a social construct used as a proxy for clinical variables, (5) there is a lack of standardization in how race and social determinants of health are collected and defined, (6) bias can be introduced at all stages of algorithm development, and (7) algorithms should be discussed as part of shared decision-making between the patient and clinician.
AHRQ-authored.
Citation: Jain A, Brooks JR, Alford CC .
Awareness of racial and ethnic bias and potential solutions to address bias with use of health care algorithms.
JAMA Health Forum 2023 Jun 2; 4(6):e231197. doi: 10.1001/jamahealthforum.2023.1197..
Keywords: Racial and Ethnic Minorities, Disparities, Healthcare Delivery, Evidence-Based Practice
Dykes PC, Curtin-Bowen M, Lipsitz S
Cost of inpatient falls and cost-benefit analysis of implementation of an evidence-based fall prevention program.
The financial implications of patient falls within healthcare settings, a primary cause of nonreimbursable negative incidents, have not been thoroughly investigated. The aim of this study was to determine the expenses related to inpatient falls and the potential cost savings achieved through the adoption of a proven fall prevention program. This economic assessment employed a matched case-control approach, utilizing results from an interrupted time series analysis that evaluated the alterations in fall rates after the introduction of an evidence-based fall prevention program to estimate inpatient fall expenses. Subsequently, an economic analysis was conducted to evaluate the cost advantages of implementing the program across two American healthcare systems from June 1, 2013, to August 31, 2019, in New York, New York, and Boston, Massachusetts. All adult patients admitted to the participating units were included in the analysis. Data analysis took place between October 2021 and November 2022. The fall prevention program, based on evidence, was introduced in 33 medical and surgical departments across eight hospitals. The primary outcome was the expense related to inpatient falls. Secondary outcomes included costs and savings linked to the evidence-based fall prevention program. The study found that the case-control study and economic analysis included 10,176 patients who experienced a fall event (with or without injury) and 29,161 matched controls without a fall event (51.9% aged 65-74 years, 67.1% White, and 53.6% male). Prior to the intervention, there were 2,503 falls and 900 injuries; following the intervention, there were 2,078 falls and 758 injuries. Based on a 19% decrease in falls and a 20% decrease in injury-causing falls from the beginning to the end of the post-intervention period, the economic analysis revealed that noninjurious and injurious falls led to cost increases of $35,365 and $36,776, respectively. The introduction of the evidence-based fall prevention program resulted in $14,600 in net avoided expenses for every 1000 patient-days.
AHRQ-funded; HS027557; HS025128
Citation: Dykes PC, Curtin-Bowen M, Lipsitz S .
Cost of inpatient falls and cost-benefit analysis of implementation of an evidence-based fall prevention program.
JAMA Health Forum 2023 Jan 6;4(1):e225125. doi: 10.1001/jamahealthforum.2022.5125.
Keywords: Falls, Healthcare Delivery, Evidence-Based Practice, Prevention
Kuzel 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
Bergman ZR, Usher M, Olson A
Comparison of outcomes and process of care for patients treated at hospitals dedicated for COVID-19 care vs other hospitals.
The purpose of this study was to analyze the mortality rate and complications associated with treatment at the COVID-19-dedicated hospitals. Findings showed that, in this cohort study, COVID-19-dedicated hospitals in Minnesota had multiple benefits, including providing high-volume repetitive treatment and isolating patients with the infection. This experience suggests improved in-hospital mortality for patients treated at dedicated hospitals.
AHRQ-funded; HS026732; HS026379.
Citation: Bergman ZR, Usher M, Olson A .
Comparison of outcomes and process of care for patients treated at hospitals dedicated for COVID-19 care vs other hospitals.
JAMA Netw Open 2022 Mar;5(3):e220873. doi: 10.1001/jamanetworkopen.2022.0873..
Keywords: COVID-19, Patient-Centered Outcomes Research, Evidence-Based Practice, Outcomes, Healthcare Delivery, Hospitals
Brajcich BC, Benson AB, Gantt G
Management of colorectal cancer during the COVID-19 pandemic: recommendations from a statewide multidisciplinary cancer collaborative.
J Surg Oncol 2022 Mar;125(4):560-63. doi: 10.1002/jso.26758.
AHRQ-funded; HS026385.
Citation: Brajcich BC, Benson AB, Gantt G .
Management of colorectal cancer during the COVID-19 pandemic: recommendations from a statewide multidisciplinary cancer collaborative.
J Surg Oncol 2022 Mar;125(4):560-63. doi: 10.1002/jso.26758..
Keywords: COVID-19, Cancer: Colorectal Cancer, Cancer, Guidelines, Evidence-Based Practice, Healthcare Delivery
Bierman AS, Tong ST, McNellis RJ
AHRQ Author: Bierman AS, Tong ST, McNellis RJ
Realizing the dream: the future of primary care research.
In this article, the authors discussed the primary care research central to successful primary care transformation and to realizing the vision of a high-performing US health system to serve effectively all Americans and their communities while advancing health equity.
AHRQ-authored.
Citation: Bierman AS, Tong ST, McNellis RJ .
Realizing the dream: the future of primary care research.
Ann Fam Med 2022 Mar-Apr;20(2):170-74. doi: 10.1370/afm.2788..
Keywords: Primary Care, Healthcare Delivery, Evidence-Based Practice, Health Systems, Learning Health Systems, Patient-Centered Healthcare
Samal L, Fu HN, Camara DS
AHRQ Author: Camara DS, Wang J, Bierman AS
Health information technology to improve care for people with multiple chronic conditions.
The objective of this study was to review evidence regarding the use of Health Information Technology (health IT) interventions aimed at improving care for people living with multiple chronic conditions (PLWMCC) in order to identify critical knowledge gaps. The investigators concluded that the body of literature included in this review provides critical information on the state of the science as well as the many gaps that need to be filled for digital health to fulfill its promise in supporting care delivery that meets the needs of PLWMCC.
AHRQ-authored; AHRQ-funded; HS026849; 290201600001B.
Citation: Samal L, Fu HN, Camara DS .
Health information technology to improve care for people with multiple chronic conditions.
Health Serv Res 2021 Oct;56(Suppl 1):1006-36. doi: 10.1111/1475-6773.13860..
Keywords: Chronic Conditions, Health Information Technology (HIT), Evidence-Based Practice, Decision Making, Healthcare Delivery
Bierman AS, Wang J, O'Malley PG
AHRQ Author: Bierman AS, Wang J, O'Malley PG, Moss DK
Transforming care for people with multiple chronic conditions: Agency for Healthcare Research and Quality's research agenda.
This article describes issues addressing the needs of those with multiple chronic conditions and discusses the AHRQ research agenda.
AHRQ-authored.
Citation: Bierman AS, Wang J, O'Malley PG .
Transforming care for people with multiple chronic conditions: Agency for Healthcare Research and Quality's research agenda.
Health Serv Res 2021 Oct;56(Suppl 1):973-79. doi: 10.1111/1475-6773.13863..
Keywords: Chronic Conditions, Health Services Research (HSR), Healthcare Delivery, Quality of Care, Primary Care, Guidelines, Evidence-Based Practice
Mohr NM, Harland KK, Okoro UE
TELEmedicine as an Intervention for Sepsis in Emergency Departments: a multicenter, comparative effectiveness study (TELEvISED Study).
Sepsis is a life-threatening infection that affects over 1.7 million Americans annually. Low-volume rural hospitals have worse sepsis outcomes, and emergency department (ED)-based telemedicine (tele-ED) has been one promising strategy for improving rural sepsis care. The objective of this study was to evaluate the impact of tele-ED consultation on sepsis care and outcomes in rural ED patients.
AHRQ-funded; HS025753.
Citation: Mohr NM, Harland KK, Okoro UE .
TELEmedicine as an Intervention for Sepsis in Emergency Departments: a multicenter, comparative effectiveness study (TELEvISED Study).
J Comp Eff Res 2021 Feb;10(2):77-91. doi: 10.2217/cer-2020-0141..
Keywords: Sepsis, Telehealth, Health Information Technology (HIT), Emergency Department, Comparative Effectiveness, Evidence-Based Practice, Rural Health, 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
Fraze TK, Beidler LB, Briggs ADM
Translating evidence into practice: ACOs' use of care plans for patients with complex health needs.
Researchers sought to understand how Medicare accountable care organizations (ACOs) use care plans to manage patients with complex clinical needs. After conducting semi-structured interviews with Medicare ACOs, they found that ACOs were using care plans for patients with complex needs, but their use of care plans did not always meet the best practices; ACOs were adapting use of care plans to better fit the needs of patients and providers.
AHRQ-funded; HS024075.
Citation: Fraze TK, Beidler LB, Briggs ADM .
Translating evidence into practice: ACOs' use of care plans for patients with complex health needs.
J Gen Intern Med 2021 Jan;36(1):147-53. doi: 10.1007/s11606-020-06122-4..
Keywords: Implementation, Evidence-Based Practice, Medicare, Health Insurance, Healthcare Delivery
Callejo-Black A, Wagner DV, Ramanujam K
A systematic review of external validity in pediatric integrated primary care trials.
This study used the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework to conduct a systematic review of external validity reporting in integrated primary care (IPC) interventions for mental health concerns. A literature search was conducted to identify relevant literature from 1998 to 2018 reporting on open, randomized or quasi-randomized trials of IPC interventions that targeted child (ages 0-18 years) psychological symptoms. The authors included 39 publications describing 25 studies in the review. Publications rarely reported indicators of external validity, including the representatives of participants (12%), rate of adoption clinics or providers (16%), cost of implementation (8%), or evidence of maintenance (16%). Few studies also included key pragmatic factors such as cost or organizational change processes related to implementation and maintenance.
AHRQ-funded; HS022981.
Citation: Callejo-Black A, Wagner DV, Ramanujam K .
A systematic review of external validity in pediatric integrated primary care trials.
J Pediatr Psychol 2020 Oct 1;45(9):1039-52. doi: 10.1093/jpepsy/jsaa068..
Keywords: Children/Adolescents, Primary Care, Behavioral Health, Healthcare Delivery, Evidence-Based Practice, Health Services Research (HSR), Research Methodologies
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
Friedman Peahl A, Heisler M, Essenmacher LK
A comparison of international prenatal care guidelines for low-risk women to inform high-value care.
The authors compared U.S. to international prenatal care consensus guidelines for low-risk women to inform care delivery reforms. They found that U.S. and peer-country guidelines recommended similar prenatal education and psychosocial services for low-risk women; however, peer countries generally recommended fewer visits, longer intervals between visits, and less reliance on obstetrician-gynecologists for routine, low-risk prenatal care. They recommended that further investigation evaluate associations between recommended care and actual practice, as well as the effects of different components of prenatal care and delivery models on maternal-infant outcomes, patient-centeredness, and health care expenditures in the U.S.
AHRQ-funded; HS025465.
Citation: Friedman Peahl A, Heisler M, Essenmacher LK .
A comparison of international prenatal care guidelines for low-risk women to inform high-value care.
Am J Obstet Gynecol 2020 May;222(5):505-07. doi: 10.1016/j.ajog.2020.01.021..
Keywords: Maternal Care, Pregnancy, Women, Guidelines, Evidence-Based Practice, Healthcare Delivery
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.
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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
Guise JM, Reid E, Fiordalisi CV
AHRQ Author: Borsky A, Chang S
AHRQ series on improving translation of evidence: progress and promise in supporting learning health systems.
The authors discuss the articles in the AHRQ EPC series published in this journal over the past six months. They state that satisfaction, care, and costs would all improve if health care delivery were as efficient and effective as possible given current knowledge. They conclude that millions of health decisions must be made by clinicians, patients, and health care systems, and they believe better decisions will be made with evidence.
AHRQ-authored; AHRQ-funded; 290201700003C.
Citation: Guise JM, Reid E, Fiordalisi CV .
AHRQ series on improving translation of evidence: progress and promise in supporting learning health systems.
Jt Comm J Qual Patient Saf 2020 Jan;46(1):51-52. doi: 10.1016/j.jcjq.2019.10.008..
Keywords: Implementation, Evidence-Based Practice, Learning Health Systems, Health Systems, Healthcare Delivery, Decision Making
Broder-Fingert S, Kuhn J, Sheldrick RC
Using the Multiphase Optimization Strategy (MOST) framework to test intervention delivery strategies: a study protocol.
Researchers describe a study protocol for a large randomized controlled trial using the Multiphase Optimization Strategy (MOST), a novel framework developed to optimize interventions. They apply this framework to delivery of Family Navigation (FN), an evidence-based care management strategy designed to reduce disparities and improve access to behavioral health services, and test four components related to its implementation. In this paper, they describe how the MOST framework can be used to improve intervention delivery. These methods will be useful for future studies testing intervention delivery strategies and their impact on implementation.
AHRQ-funded; HS022242.
Citation: Broder-Fingert S, Kuhn J, Sheldrick RC .
Using the Multiphase Optimization Strategy (MOST) framework to test intervention delivery strategies: a study protocol.
Trials 2019 Dec 16;20(1):728. doi: 10.1186/s13063-019-3853-y..
Keywords: Research Methodologies, Health Services Research (HSR), Healthcare Delivery, Behavioral Health, Evidence-Based Practice, Access to Care
Mixon AS, Kripalani S, Stein J
An on-treatment analysis of the MARQUIS study: interventions to improve inpatient medication reconciliation.
This paper examined evidence-based interventions implemented in five US hospitals to improve inpatient medication reconciliation. The sites implemented one to seven interventions in 791 patients during a 25-month implementation period. Three interventions were associated with significant decreases in potentially harmful reconciliation rates while two interventions were associated with significant increases. The positive interventions included: defining clinical roles and responsibilities, training, and hiring staff to perform discharge medication reconciliation. The negative interventions were training staff to take medication histories and implementing a new electronic health record (EHR) system.
AHRQ-funded; HS019598.
Citation: Mixon AS, Kripalani S, Stein J .
An on-treatment analysis of the MARQUIS study: interventions to improve inpatient medication reconciliation.
J Hosp Med 2019 Oct;14(10):614-17. doi: 10.12788/jhm.3308..
Keywords: Medication, Evidence-Based Practice, Adverse Drug Events (ADE), Adverse Events, Medical Errors, Patient Safety, Hospitals, Healthcare Delivery, Inpatient Care
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
Montori VM, Hargraves I, McNellis RJ
AHRQ Author: Montori VM, McNellis RJ, Ganiats TG, Genevro J, Miller T, Ricciardi R
The Care and Learn Model: a practice and research model for improving healthcare quality and outcomes.
The Agency for Healthcare Research and Quality conducted internal work to formulate a model that could be used to analyze the Agency's research portfolio, identify gaps, develop and prioritize its research agenda, and evaluate its performance. In this study, the researchers produced a model caring and learning. The Agency and the health services research and improvement communities can use this Care and Learn Model to frame an evidence-based understanding of vexing clinical, healthcare delivery, and population health problems and to identify targets for investment, innovation, and investigation.
AHRQ-authored.
Citation: Montori VM, Hargraves I, McNellis RJ .
The Care and Learn Model: a practice and research model for improving healthcare quality and outcomes.
J Gen Intern Med 2019 Jan;34(1):154-58. doi: 10.1007/s11606-018-4737-7..
Keywords: Quality of Care, Healthcare Delivery, Evidence-Based Practice, Organizational Change
Guise JM, Savitz LA, Friedman CP
Mind the gap: putting evidence into practice in the era of learning health systems.
This paper discusses two main mechanisms to close the evidence-to-practice gap: (1) integrating Learning Health System (LHS) results with existing systematic review evidence and (2) providing this combined evidence in a standardized, computable data format.
AHRQ-funded; 29020120004C.
Citation: Guise JM, Savitz LA, Friedman CP .
Mind the gap: putting evidence into practice in the era of learning health systems.
J Gen Intern Med 2018 Dec;33(12):2237-39. doi: 10.1007/s11606-018-4633-1..
Keywords: Evidence-Based Practice, Healthcare Delivery, Learning Health Systems, Implementation