National Healthcare Quality and Disparities Report
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Search All Research Studies
Topics
- (-) Cardiovascular Conditions (15)
- Communication (1)
- Community-Based Practice (1)
- Disparities (1)
- Education: Patient and Caregiver (1)
- Evidence-Based Practice (12)
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- Heart Disease and Health (7)
- (-) Implementation (15)
- Lifestyle Changes (1)
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- Patient-Centered Outcomes Research (5)
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- Patient Self-Management (2)
- Practice Improvement (4)
- Prevention (5)
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- Quality Improvement (9)
- Quality of Care (9)
- Respiratory Conditions (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 15 of 15 Research Studies DisplayedBerry 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
Pham-Singer H, Onakomaiya M, Cuthel A
Using a customer relationship management system to manage a quality improvement intervention.
HealthyHearts New York City (HHNYC), one of 7 cooperatives funded through the Agency for Healthcare Research and Quality's EvidenceNOW initiative, evaluated the impact of practice facilitation on implementation of the Million Hearts guidelines for cardiovascular disease prevention and treatment. Tracking the intervention required a system to facilitate process data collection that was also user-friendly and flexible. Coupled with protocols and training, a strategically planned and customizable customer relationship management system (CRMS) was implemented to support the quality improvement intervention with 257 small independent practices.
AHRQ-funded; HS023922.
Citation: Pham-Singer H, Onakomaiya M, Cuthel A .
Using a customer relationship management system to manage a quality improvement intervention.
Am J Med Qual 2021 Jul-Aug;36(4):247-54. doi: 10.1177/1062860620953214..
Keywords: Quality Improvement, Quality of Care, Implementation, Evidence-Based Practice, Cardiovascular Conditions, Heart Disease and Health, Primary Care
Walunas TL, Ye J, Bannon J
Does coaching matter? Examining the impact of specific practice facilitation strategies on implementation of quality improvement interventions in the Healthy Hearts in the Heartland study.
Practice facilitation is a multicomponent implementation strategy used to improve the capacity for practices to address care quality and implementation gaps. In this study, the investigators sought to assess whether practice facilitators use of coaching strategies aimed at improving self-sufficiency were associated with improved implementation of quality improvement (QI) interventions in the Healthy Hearts in the Heartland Study.
AHRQ-funded; HS023921.
Citation: Walunas TL, Ye J, Bannon J .
Does coaching matter? Examining the impact of specific practice facilitation strategies on implementation of quality improvement interventions in the Healthy Hearts in the Heartland study.
Implement Sci 2021 Mar 31;16(1):33. doi: 10.1186/s13012-021-01100-8..
Keywords: Practice Improvement, Quality Improvement, Quality of Care, Implementation, Heart Disease and Health, Cardiovascular Conditions
Tuzzio L, O'Meara ES, Holden E
Barriers to implementing cardiovascular risk calculation in primary care: alignment with the consolidated framework for implementation research.
The uptake of cardiovascular disease risk calculators in primary care has been slow despite the recommendation in national cardiovascular disease prevention guidelines. Identifying the barriers to the implementation of cardiovascular disease risk calculators is essential for promoting their adoption. In this study, the authors qualitatively analyzed structured physician educator notes written during an outreach education intervention with 44 small- and medium-sized primary care clinics that participated in the Agency for Healthcare Research and Quality‒funded EvidenceNOW Healthy Hearts Northwest trial.
AHRQ-funded; HS023908.
Citation: Tuzzio L, O'Meara ES, Holden E .
Barriers to implementing cardiovascular risk calculation in primary care: alignment with the consolidated framework for implementation research.
Am J Prev Med 2021 Feb;60(2):250-57. doi: 10.1016/j.amepre.2020.07.027..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Primary Care, Risk, 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
Nguyen AM, Cuthel AM, Rogers ES
Attributes of high-performing small practices in a guideline implementation: a multiple-case study.
This study called HealthyHearts NYC was a stepped wedge randomized control trial that tested the effectiveness of practice facilitation in small primary care practices in adopting cardiovascular disease guidelines. The practice-level benchmark desired was having 70% or greater of hypertensive patients having controlled blood pressure. A mixed methods multiple-case study design was used and implemented at 6 small practices. The investigator’s first key finding was that the high-performing and improved practices in their study looked and acted similarly during the intervention implementation. Three key attributes of these practices were found to be: 1) advanced use of electronic health records; 2) dedicated resources and commitment to quality improvement; and 3) an actively engaged lead clinician and office manager.
AHRQ-funded; HS023922.
Citation: Nguyen AM, Cuthel AM, Rogers ES .
Attributes of high-performing small practices in a guideline implementation: a multiple-case study.
J Prim Care Community Health 2020 Jan-Dec;11. doi: 10.1177/2150132720984411..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Primary Care, Evidence-Based Practice, Guidelines, Implementation
Abramsohn E, DePumpo M, Boyd K
Implementation of community-based resource referrals for cardiovascular disease self-management.
Investigators described primary care practices' implementation of CommunityRx-H3. They found that practice facilitators were increasingly being utilized by primary care practices to support quality improvement interventions and could also play an important role in implementation science. Their study yielded insights to improve implementation of community resource referral solutions to support primary care cardiovascular disease prevention efforts.
AHRQ-funded; HS023921.
Citation: Abramsohn E, DePumpo M, Boyd K .
Implementation of community-based resource referrals for cardiovascular disease self-management.
Ann Fam Med 2020 Nov;18(6):486-95. doi: 10.1370/afm.2583..
Keywords: Cardiovascular Conditions, Patient Self-Management, Primary Care, Quality Improvement, Quality of Care, Implementation
Makelarski JA, DePumpo M, Boyd K
Implementation of systematic community resource referrals at small primary care practices to promote cardiovascular disease self-management.
The purpose of this study was to describe outcomes from implementation of a community resource referral system into small clinical practices to reduce cardiovascular disease risk. HealtheRx-H3, a printed list of resources for patients, was created. It was feasible to create practice-specific HealtheRx-H3s; however, systematic distribution of HealtheRx-H3s using digital electronic health record integration was found to be infeasible. Successful implementation of quality improvement strategies to systematize community resource referral solutions was feasible at small practices, but more research was recommended in order to understand what motivates small practices to participate in implementation of these solutions.
AHRQ-funded; HS023921.
Citation: Makelarski JA, DePumpo M, Boyd K .
Implementation of systematic community resource referrals at small primary care practices to promote cardiovascular disease self-management.
J Healthc Qual 2020 Sep/Oct;42(5):278-86. doi: 10.1097/jhq.0000000000000234..
Keywords: Cardiovascular Conditions, Risk, Community-Based Practice, Patient Self-Management, Education: Patient and Caregiver, Primary Care, Implementation, Lifestyle Changes
Dickinson WP, Nease DE, Rhyne RL
Practice transformation support and patient engagement to improve cardiovascular care: from EvidenceNOW Southwest (ENSW).
The purpose of this study was to improve cardiovascular care through supporting primary care practices' adoption of evidence-based guidelines; a cluster randomized trial compared standard practice support--practice facilitation, practice assessment with feedback, health information technology assistance, and collaborative learning sessions--and standard support plus patient engagement support. Findings showed that practice transformation support can assist practices with improving quality of care. Patient engagement in practice transformation can further enhance practices' implementation of aspects of new models of care.
AHRQ-funded; HS023904.
Citation: Dickinson WP, Nease DE, Rhyne RL .
Practice transformation support and patient engagement to improve cardiovascular care: from EvidenceNOW Southwest (ENSW).
J Am Board Fam Med 2020 Sep-Oct;33(5):675-86. doi: 10.3122/jabfm.2020.05.190395..
Keywords: Cardiovascular Conditions, Primary Care: Models of Care, Primary Care, Patient and Family Engagement, Evidence-Based Practice, Implementation, Quality Improvement, Quality of Care
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
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
Goetz Goldberg D, Haghighat S, Kavalloor S S
A qualitative analysis of implementing EvidenceNOW to improve cardiovascular care.
This study’s objective was to perform a quantitative analysis of the implementation of an EvidenceNOW initiative to assist primary care practices in implementing evidence-based cardiovascular care and building capacity for quality improvement. The Heart of Virginia Health care (HVH) regional cooperative was surveyed to understand HVH team member viewpoints on the initiative’s challenges, strengths, and lessons learned in each phase of the project. The researchers interviewed 22 HVH team members in depth. Positives aspects included diverse team member skills and areas of expertise, a well-received kick-off event, and a comprehensive set of practice improvement resources. Challenges included recruiting primary practices, varying types and capabilities of electronic health records, working with practices at different transformation stages and different objectives for participating and involvement in other government initiatives.
AHRQ-funded; HS023913.
Citation: Goetz Goldberg D, Haghighat S, Kavalloor S S .
A qualitative analysis of implementing EvidenceNOW to improve cardiovascular care.
J Am Board Fam Med 2019 Sep-Oct;32(5):705-14. doi: 10.3122/jabfm.2019.05.190084..
Keywords: Cardiovascular Conditions, Primary Care, Quality Improvement, Quality of Care, Evidence-Based Practice, Implementation
Perry CK, Damschroder LJ, Hemler JR
Specifying and comparing implementation strategies across seven large implementation interventions: a practical application of theory.
This study used empirical data to test how the Expert Recommendations for Implementing Change (ERIC) taxonomy applies to a large dissemination and implementation initiative aimed at taking cardiac prevention to scale in primary care practice. The ERIC taxonomy was applied to the seven cooperatives funded by AHRQ’s EvidenceNOW initiative. The cooperatives' implementation strategies were identified using ERIC; a matrix of the specified ERIC strategies across the cooperatives was then mapped and compiled, and implementation strategies grouped according to outcomes and justifications. The findings suggest revisions to be made to the ERIC implementation strategies to reflect their utilization in real-work dissemination and implementation efforts.
AHRQ-funded; HS023940.
Citation: Perry CK, Damschroder LJ, Hemler JR .
Specifying and comparing implementation strategies across seven large implementation interventions: a practical application of theory.
Implement Sci 2019 Mar 21;14(1):32. doi: 10.1186/s13012-019-0876-4..
Keywords: Cardiovascular Conditions, Evidence-Based Practice, Prevention, Primary Care, 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