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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 3 of 3 Research Studies DisplayedHarvey JB, Vanderbrink J, Mahmud Y
Understanding how health systems facilitate primary care redesign.
The objectives of this study were to understand how health systems are facilitating primary care redesign (PCR), examine the PCR initiatives taking place within systems, and identify barriers to this work. A sample of 24 health systems in 4 states was used to identify how system leaders define and implement initiatives to redesign primary care delivery and identify challenges. Codes based on the theoretical PCR literature was used and researchers also created new codes. Semi-structured telephone interviews with 162 system executives and physician organization leaders from 24 systems were conducted. Initiatives to redesign the delivery of primary care were described by leaders, but many were still in the early stages. Motivating factors for team-based care included improvement efficiency and enhancing clinician job satisfaction. Changes in payment and risk assumption as well as community needs were commonly cited as motivators for population health management and care coordination. Challenges health systems face in redesigning primary included return on investment and slower than anticipated rate in moving from fee-for-service to value-based payment.
AHRQ-funded; HS024067.
Citation: Harvey JB, Vanderbrink J, Mahmud Y .
Understanding how health systems facilitate primary care redesign.
Health Serv Res 2020 Dec;55(Suppl 3):1144-54. doi: 10.1111/1475-6773.13576..
Keywords: Health Systems, Primary Care: Models of Care, Primary Care, Healthcare Delivery
Misra-Hebert AD, Perzynski A, Rothberg MB
Implementing team-based primary care models: a mixed-methods comparative case study in a large, integrated health care system.
This mixed-methods comparative case study examined the implementation of team-based primary care models in a large integrated health system. Field observations of 9 practices were conducted along with 75 interviews and provider and staff surveys. The 9 practices were categorized into 3 groups: high, partial, and low update of the new models. Ability of the practices to implement the new team-based model depended on their ability to adapt to change and to adapt team roles in workflow.
AHRQ-funded; HS024128.
Citation: Misra-Hebert AD, Perzynski A, Rothberg MB .
Implementing team-based primary care models: a mixed-methods comparative case study in a large, integrated health care system.
J Gen Intern Med 2018 Nov;33(11):1928-36. doi: 10.1007/s11606-018-4611-7..
Keywords: Case Study, Health Systems, Patient-Centered Healthcare, Primary Care, Primary Care: Models of Care, Teams
Harrison MI, Grantham S
AHRQ Author: Harrison MI
Learning from implementation setbacks: identifying and responding to contextual challenges.
The authors addressed organizational learning about implementation context during setbacks to primary care redesign in an ambulatory system. They found that redesigned teams were not implemented as widely or rapidly as anticipated and did not deliver hoped-for gains in operational metrics; however, team redesign was leading to improvements in chronic care and prevention and eased provider burden. Redesign and system leaders engaged in more thorough organizational learning. Their responses to challenges helped to strengthen the redesign's prospects, improved the delivery system's position in its labor market, and helped the system prepare to meet emerging requirements for value-based care and population health.
AHRQ-authored; AHRQ-funded; 2902010000341.
Citation: Harrison MI, Grantham S .
Learning from implementation setbacks: identifying and responding to contextual challenges.
Learn Health Syst 2018 Oct;2(4):e10068. doi: 10.1002/lrh2.10068..
Keywords: Organizational Change, Learning Health Systems, Health Systems, Primary Care: Models of Care, Primary Care, Ambulatory Care and Surgery, Implementation