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Topics
- Cardiovascular Conditions (1)
- Electronic Health Records (EHRs) (1)
- Evidence-Based Practice (3)
- Healthcare Delivery (3)
- Health Information Technology (HIT) (1)
- Heart Disease and Health (1)
- Organizational Change (2)
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- Practice Improvement (3)
- (-) Primary Care (10)
- Primary Care: Models of Care (2)
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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 10 of 10 Research Studies DisplayedCohen DJ, Balasubramanian BA, Lindner S
How does prior experience pay off in large-scale quality improvement initiatives?
This study’s goal was to examine the association of prior investment on the effectiveness of organizations delivering large-scale external support to improve primary care. A mixed-methods study was conducted with 7 EvidenceNOW grantees and their recruited primary practices (n = 1720). Data was analyzed on the grantees’ implementation of helping primary care practice improve (1) clinical quality, measured as practices' performance on Aspirin, Blood Pressure, Cholesterol, and Smoking (ABCS); and (2) practice capacity, measured using the Adaptive Reserve (AR) score and Change Process Capacity Questionnaire (CPCQ). Grantees with higher levels of prior experience with and investment in large-scale QI before EvidenceNOW recruited more geographically dispersed and diverse practices. They also had lower baseline ABCS performance (differences ranging from 2.8% for blood pressure to 41.5% for smoking), delivered more facilitation (mean=+20.3 hours), and made greater improvements in practices' QI capacity (CPCQ: +2.04) and smoking performance (+6.43%) than grantees with less experience. Having established networks of facilitators at the start of EvidenceNOW and leadership experienced in supporting this workforce explained their better recruitment, delivery of facilitation, and improvement in outcomes.
AHRQ-funded; HS023940.
Citation: Cohen DJ, Balasubramanian BA, Lindner S .
How does prior experience pay off in large-scale quality improvement initiatives?
J Am Board Fam Med 2022 Dec; 35(6):1115-27. doi: 10.3122/jabfm.2022.AP.220088..
Keywords: Quality Improvement, Primary Care, Quality of Care
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
Sweeney SM, Baron A, Hall JD
Effective facilitator strategies for supporting primary care practice change: a mixed methods study.
Investigators conducted a pragmatic qualitative study with patients who had participated in a health-related social needs (HRSN) intervention. They found that patients were likely to have initial skepticism or reservations about the intervention; they identified 4 positive intervention components regarding patient experience; and they found that patients could be left with feelings of appreciation or hope, regardless of whether they connected with HRSN resources.
AHRQ-funded; HS023940.
Citation: Sweeney SM, Baron A, Hall JD .
Effective facilitator strategies for supporting primary care practice change: a mixed methods study.
Ann Fam Med 2022 Sep-Oct;20(5):414-22. doi: 10.1370/afm.2847..
Keywords: Primary Care, Practice Improvement, Quality Improvement, Quality of Care
Richardson JE, Rasmussen LV, Dorr DA
Generating and reporting electronic clinical quality measures from electronic health records: strategies from EvidenceNOW cooperatives.
This study’s goal was to characterize strategies that seven regional cooperatives participating in the EvidenceNOW initiative developed to generate and report electronic health record (EHR)-based electronic clinical quality measures (eCQMs) for quality improvement (QI) in small-to-medium-sized practices. Findings showed that cooperatives ultimately generated and reported eCQMs using hybrid strategies because they determined that neither EHRs alone nor centralized sources alone could operationalize eCQMs for QI. In order to attain this goal, cooperatives needed to devise solutions and utilize resources that often are unavailable to typical small-to-medium-sized practices.
AHRQ-funded; HS023921.
Citation: Richardson JE, Rasmussen LV, Dorr DA .
Generating and reporting electronic clinical quality measures from electronic health records: strategies from EvidenceNOW cooperatives.
Appl Clin Inform 2022 Mar;13(2):485-94. doi: 10.1055/s-0042-1748145..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Quality Indicators (QIs), Quality Measures, Quality of Care, Evidence-Based Practice, Primary Care
Perry CK, Linder S, Hall J
How type of practice ownership affects participation with quality improvement external facilitation: findings from EvidenceNOW.
This study examined how practice ownership influences participation in external facilitation using data from EvidenceNOW. The authors collected data from practices on practice characteristics and ownership type via surveys and from facilitators on the number of hours, encounters, and months each practice had with a facilitator via facilitation logs. Semi-structured interviewers with EvidenceNOW leadership (n = 12) and facilitators (n = 51) were conducted, and facilitators (n = 64) were observed for patterns of facilitation. In the fully adjusted model, differences by ownership were non-significant. Federally Qualified Health Centers (FQHCs) however, had significantly less participation in facilitation than clinician-owned practices for the measures number of encounters and number of months with encounters.
AHRQ-funded; HS023940.
Citation: Perry CK, Linder S, Hall J .
How type of practice ownership affects participation with quality improvement external facilitation: findings from EvidenceNOW.
J Gen Intern Med 2022 Mar;37(4):793-801. doi: 10.1007/s11606-021-07204-7..
Keywords: Quality Improvement, Quality of Care, Primary Care, Practice Improvement
Burstein DS, Liss DT, Linder JA
Association of primary care physician compensation incentives and quality of care in the United States, 2012-2016.
AHRQ-funded; 233201500020I; HS026506; HS028127.
Citation: Burstein DS, Liss DT, Linder JA .
Association of primary care physician compensation incentives and quality of care in the United States, 2012-2016.
J Gen Intern Med 2022 Feb;37(2):359-66. doi: 10.1007/s11606-021-06617-8..
Keywords: Primary Care, Payment, Quality of Care
Hysong Hysong, Arredondo K, Hughes AM
An evidence-based, structured, expert approach to selecting essential indicators of primary care quality.
The purpose of this article was to illustrate the application of an evidence-based, structured performance measurement methodology to identify, prioritize, and generate new measures of health care quality, using primary care as a case example. Subject matter experts identified three fundamental objectives: access, patient-health care team partnerships, and technical quality. The authors indicated that their article provides an actionable guide to applying their Productivity Measurement and Enhancement System, which can be adapted to the needs of various industries, including measure selection and modification from existing data sources, and proposing new measures.
Citation: Hysong Hysong, Arredondo K, Hughes AM .
An evidence-based, structured, expert approach to selecting essential indicators of primary care quality.
PLoS One 2022 Jan 18;17(1):e0261263. doi: 10.1371/journal.pone.0261263..
Keywords: Primary Care, Evidence-Based Practice, Quality Improvement, Quality Indicators (QIs), Quality Measures, Quality of Care
Hemler JR, Edwards ST, Valenzuela S
The effects of major disruptions on practice participation in facilitation during a primary care quality improvement initiative.
This study explored the relationship between disruptions in primary care practices and practice participation in facilitated quality improvement (QI). Using data from EvidenceNOW, findings showed that disruptions are prevalent in primary care, but practices can continue participating in QI interventions, particularly when supported by a facilitator.
AHRQ-funded; HS023940.
Citation: Hemler JR, Edwards ST, Valenzuela S .
The effects of major disruptions on practice participation in facilitation during a primary care quality improvement initiative.
J Am Board Fam Med 2022 Jan-Feb;35(1):124-39. doi: 10.3122/jabfm.2022.01.210205..
Keywords: Primary Care, Practice Improvement, Quality Improvement, Quality of Care, Workforce
McNellis RJ, Genevro JL, Meyers DS
AHRQ Author: McNellis RJ, Genevro JL, Meyers DS
Lessons learned from the study of primary care transformation.
This article discusses the patient-centered medical home (PCMH) model. The authors conclude that the transformation of primary care is essential to achieving the triple aim of better outcomes, better value, and better experience of care, and that the PCMH may be the most viable solution in the current health care environment.
AHRQ-authored.
Citation: McNellis RJ, Genevro JL, Meyers DS .
Lessons learned from the study of primary care transformation.
Ann Fam Med 2013 May-Jun;11 Suppl 1:S1-5. doi: 10.1370/afm.1548.
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Keywords: Patient-Centered Healthcare, Primary Care: Models of Care, Primary Care, Healthcare Delivery, Organizational Change, Quality Improvement, Quality of Care
Taylor EF, Machta RM, Meyers DS
AHRQ Author: Meyers DS, Genevro J
Enhancing the primary care team to provide redesigned care: the roles of practice facilitators and care managers.
This article discusses how practice facilitators and care managers can play important but distinct roles in redesigning and improving care delivery in order to deliver coordinated, accessible, comprehensive, and patient-centered care.
AHRQ-authored.
Citation: Taylor EF, Machta RM, Meyers DS .
Enhancing the primary care team to provide redesigned care: the roles of practice facilitators and care managers.
Ann Fam Med 2013 Jan-Feb;11(1):80-3. doi: 10.1370/afm.1462.
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Keywords: Patient-Centered Healthcare, Primary Care: Models of Care, Primary Care, Healthcare Delivery, Organizational Change, Quality Improvement, Quality of Care