National Healthcare Quality and Disparities Report
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- Ambulatory Care and Surgery (1)
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- (-) Care Management (11)
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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 11 of 11 Research Studies DisplayedManges KA, Wallace AS, Groves PS
Ready to go home? Assessment of shared mental models of the patient and discharging team regarding readiness for hospital discharge.
A critical task of the inpatient interprofessional team is readying patients for discharge. Assessment of shared mental model (SMM) convergence can determine how much team members agree about patient discharge readiness and how their mental models align with the patient's self-assessment. The objective of this study was to determine the convergence of interprofessional team SMMs of hospital discharge readiness and identify factors associated with these assessments.
AHRQ-funded; HS026116.
Citation: Manges KA, Wallace AS, Groves PS .
Ready to go home? Assessment of shared mental models of the patient and discharging team regarding readiness for hospital discharge.
J Hosp Med 2021 Jun;16(6):326-32. doi: 10.12788/jhm.3464..
Keywords: Hospital Discharge, Teams, Care Management, Shared Decision Making, Hospitals
Wang G, Wignall J, Kinard D
An implementation model for managing cloud-based longitudinal care plans for children with medical complexity.
In this study, the investigators aimed to iteratively refine an implementation model for managing cloud-based longitudinal care plans (LCPs) for children with medical complexity (CMC). They conducted iterative 1-on-1 design sessions with CMC caregivers (ie, parents/legal guardians) and providers between August 2017 and March 2019. The investigators concluded that utilizing the management strategies, described in the article, when implementing cloud-based LCPs had the potential to improve team-based care across settings.
AHRQ-funded; HS024299.
Citation: Wang G, Wignall J, Kinard D .
An implementation model for managing cloud-based longitudinal care plans for children with medical complexity.
J Am Med Inform Assoc 2021 Jan 15;28(1):23-32. doi: 10.1093/jamia/ocaa207..
Keywords: Children/Adolescents, Implementation, Chronic Conditions, Care Management, Care Coordination, Health Information Exchange (HIE), Health Information Technology (HIT), Teams
Miller-Rosales C, Rodriguez HP
Interdisciplinary primary care team expertise and diabetes care management.
Researchers examined whether care team role expertise is associated with patients' experiences of chronic care for type 2 diabetes and whether the relationship is stronger for small community health center (CHC) sites. Results of surveys conducted with adults with diabetes that assessed nonphysician team roles involved in managing their chronic care were integrated with clinical and administrative data from 14 CHCs. They found that patients with access to care team expertise in self-management support, including diabetes educators, nutritionists, community health workers, and other general staff report better experiences of chronic care. They concluded that these team roles may reduce barriers to patient self-management and improve patients' overall experiences of chronic care, particularly in small CHC sites.
Citation: Miller-Rosales C, Rodriguez HP .
Interdisciplinary primary care team expertise and diabetes care management.
J Am Board Fam Med 2021 Jan-Feb;34(1):151-61. doi: 10.3122/jabfm.2021.01.200187..
Keywords: Primary Care, Diabetes, Teams, Care Management, Community-Based Practice
Rosa TD, Possin KL, Bernstein A
Variations in costs of a collaborative care model for dementia.
Care coordination programs can improve patient outcomes and decrease healthcare expenditures; however, implementation costs are poorly understood. In this study, the investigators evaluated the direct costs of implementing a collaborative dementia care program. They found that care team navigators caseload was an important driver of service cost. They provide strategies for maximizing caseload without sacrificing quality of care and discuss current barriers to broad implementation that can inform new reimbursement policies.
AHRQ-funded; HS022241.
Citation: Rosa TD, Possin KL, Bernstein A .
Variations in costs of a collaborative care model for dementia.
J Am Geriatr Soc 2019 Dec;67(12):2628-33. doi: 10.1111/jgs.16076.
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Keywords: Dementia, Healthcare Costs, Care Coordination, Elderly, Care Management, Implementation, Teams
Boltey EM, Iwashyna TJ, Hyzy RC
Ability to predict team members' behaviors in ICU teams is associated with routine ABCDE implementation.
In order to support coordination among ICU team members, researchers developed a shared mental model (SMM). After administering a survey at the 2016 MHA Keystone Center ICU workshop, different components of SMMs were measured using five items from a validated survey, each on a 5-point Likert scale. Self-reported routine ABCDE implementation was measured using a single item 4-point Likert scale, and the relationship between SMMs and routine ABCDE implementation measured using logistic regression. The majority of survey respondents reported using the ABCDE bundle routinely. Odds of reporting routine ABCDE implementation significantly decreased when clinicians agreed it was difficult to predict team members' behaviors. The researchers conclude that increased awareness of team members' behaviors may be a mechanism to improve the implementation of complex care bundles such as ABCDE.
AHRQ-funded; HS024552.
Citation: Boltey EM, Iwashyna TJ, Hyzy RC .
Ability to predict team members' behaviors in ICU teams is associated with routine ABCDE implementation.
J Crit Care 2019 Jun;51:192-97. doi: 10.1016/j.jcrc.2019.02.028..
Keywords: Care Management, Critical Care, Hospitals, Intensive Care Unit (ICU), Healthcare Delivery, Teams
Pandian V, Zhen G, Stanley S
Management of difficult airway among patients with oropharyngeal angioedema.
This study assessed the impact of a quality improvement program to manage patients with difficult airway associated with oropharyngeal angioedema patients called DART (difficult airway response team). This retrospective review compared patient charges from July 2003 to June 2008 (pre-DART) to charges from July 2008 to June 2013 (post-DART). Patient characteristics, airway evaluation, and interventions were compared. There was a higher incidence of patients requiring intubation in the post-DART cohort (67%) versus the pre-DART cohort (39%). The results showed the approach offers adequate time and resources for airway evaluation prior to intervention and allows fewer numbers of attempts to secure an airway.
AHRQ-funded; HS024547.
Citation: Pandian V, Zhen G, Stanley S .
Management of difficult airway among patients with oropharyngeal angioedema.
Laryngoscope 2019 Jun;129(6):1360-67. doi: 10.1002/lary.27622..
Keywords: Care Management, Quality of Care, Quality Improvement, Respiratory Conditions, Teams
Kilbourne AM, Prenovost KM, Liebrecht C
Randomized controlled trial of a collaborative care intervention for mood disorders by a national commercial health plan.
This study investigated the outcomes of a collaborative care intervention for patients with mood disorders. The randomized controlled trial was conducted with Aetna insurance enrollees who were recently hospitalized for unipolar major depression or bipolar disorder. An evidence-based chronic care model (CCM) program was developed that included 10 sessions of a Life Goals self-management program and brief contacts were also made by a care manager. Outcomes measured were changes over 12 months in depression symptoms and mental health-related quality of life through two different short questionnaires. Clinical outcomes improved for patients receiving CCM although there was substantial attrition in the program.
AHRQ-funded; HS021425.
Citation: Kilbourne AM, Prenovost KM, Liebrecht C .
Randomized controlled trial of a collaborative care intervention for mood disorders by a national commercial health plan.
Psychiatr Serv 2019 Mar;70(3):219-24. doi: 10.1176/appi.ps.201800336..
Keywords: Depression, Behavioral Health, Health Insurance, Care Management, Teams, Healthcare Delivery
Holtrop JS, Ruland S, Diaz S
Using social network analysis to examine the effect of care management structure on chronic disease management communication within primary care.
The investigators examined the communication regarding chronic disease care within 24 primary care practices in Michigan and Colorado. They sought to answer the following questions: Do care managers play a key role in chronic disease management in the practice? Does the prominence of the care manager's connectivity within the practice's communication network vary by the type of care management structure implemented? Using surveys, they found that social network analysis provided a useful means of examining chronic disease communication in practice, and highlighted the central role of care managers in this communication when their role structure supported such communication. They concluded that structuring care managers as embedded team members within the practice has important implications for their role in chronic disease communication within primary care.
AHRQ-funded; HS022690.
Citation: Holtrop JS, Ruland S, Diaz S .
Using social network analysis to examine the effect of care management structure on chronic disease management communication within primary care.
J Gen Intern Med 2018 May;33(5):612-20. doi: 10.1007/s11606-017-4247-z.
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Keywords: Care Management, Chronic Conditions, Communication, Primary Care, Teams
Carney RM, Freedland KE, Steinmeyer BC
Collaborative care for depression symptoms in an outpatient cardiology setting: a randomized clinical trial.
The purpose of this study was to determine whether collaborative care (CC) for patients who screen positive for depression during an outpatient cardiology visit results in greater improvement in depression symptoms and better medical outcomes than seen in patients who screen positive for depression but receive only usual care (UC). Tthis trial did not show that CC produces better depression outcomes than UC.
AHRQ-funded; HS018335.
Citation: Carney RM, Freedland KE, Steinmeyer BC .
Collaborative care for depression symptoms in an outpatient cardiology setting: a randomized clinical trial.
Int J Cardiol 2016 Sep 15;219:164-71. doi: 10.1016/j.ijcard.2016.06.045.
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Keywords: Care Management, Cardiovascular Conditions, Depression, Healthcare Delivery, Behavioral Health, Outcomes, Ambulatory Care and Surgery, Teams
Howard HA, Malouin R, Callow-Rucker M
Care managers and knowledge shift in primary care patient-centered medical home transformation.
Based on a health insurance company-sponsored primary care transformation project, this study explores the perceptions of care management from the perspective of providers and practice staff to examine shifts in knowledge and their broader implications for primary care. It demonstrates how the diffusion of clinical power and knowledge production redefine primary care relationships to patients, as traditional hierarchies shift to team-based care.
AHRQ-funded; HS020046; HS01795.
Citation: Howard HA, Malouin R, Callow-Rucker M .
Care managers and knowledge shift in primary care patient-centered medical home transformation.
Hum Organ 2016 Spring;75(1):10-20..
Keywords: Care Management, Patient-Centered Healthcare, Primary Care, Practice Patterns, Teams
Taliani CA, Bricker PL, Adelman AM
Implementing effective care management in the patient-centered medical home.
The investigators explored how a disparate group of patient-centered medical homes (PCMHs) embedded care management in their team care environment to identify best practices. They concluded that PCMHs may want to ensure that care managers are available to meet with patients during visits, support patient self-management, fully leverage the electronic medical record for team messaging and patient tracking, and ensure integration into the care team with office huddles and ongoing communication.
AHRQ-funded; HS019150.
Citation: Taliani CA, Bricker PL, Adelman AM .
Implementing effective care management in the patient-centered medical home.
Am J Manag Care 2013 Dec;19(12):957-64.
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Keywords: Care Management, Diabetes, Healthcare Delivery, Patient-Centered Healthcare, Quality Improvement, Teams