National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Access to Care (1)
- Adverse Events (1)
- Antibiotics (1)
- Antimicrobial Stewardship (1)
- Burnout (1)
- Care Management (1)
- Children/Adolescents (1)
- Clinician-Patient Communication (1)
- Communication (1)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (1)
- Diabetes (1)
- Electronic Health Records (EHRs) (3)
- Healthcare Costs (1)
- Healthcare Delivery (1)
- Health Information Technology (HIT) (2)
- Health Services Research (HSR) (1)
- Medical Errors (2)
- Medication (1)
- Organizational Change (3)
- Patient-Centered Healthcare (5)
- Patient Experience (1)
- Patient Safety (3)
- Practice Improvement (2)
- Practice Patterns (1)
- (-) Primary Care (17)
- Provider (2)
- Provider: Health Personnel (1)
- Public Reporting (1)
- Quality Improvement (4)
- Quality Indicators (QIs) (2)
- Quality Measures (1)
- (-) Quality of Care (17)
- Respiratory Conditions (1)
- Stress (1)
- Teams (1)
- Workflow (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 17 of 17 Research Studies DisplayedToomey SL, Elliott MN, Schwebel DC
Relationship between adolescent report of patient-centered care and of quality of primary care.
This study investigated whether adolescent self-report of patient-centered care (PCC) varied by patient characteristics and whether receipt of PCC is associated with measures of adolescent primary care quality. It found that adolescent-reported PCC positively correlates with measures of high-quality adolescent primary care. The study provides support for using adolescent-report of PCC as a measure of adolescent primary care quality.
AHRQ-funded; HS020513.
Citation: Toomey SL, Elliott MN, Schwebel DC .
Relationship between adolescent report of patient-centered care and of quality of primary care.
Acad Pediatr 2016 Nov - Dec;16(8):770-76. doi: 10.1016/j.acap.2016.01.006.
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Keywords: Children/Adolescents, Primary Care, Clinician-Patient Communication, Quality of Care, Access to Care
Gray CP, Harrison MI, Hung D
AHRQ Author: Harrison MI
Medical assistants as flow managers in primary care: challenges and recommendations.
Drawing on an empirical study of a large, multispecialty delivery system engaged in reconfiguration of primary care, the authors found that using medical assistants (Mas) as flow managers required overcoming several challenges. These included entrenched social and occupational hierarchies between physicians and MAs, a lack of adequate training and mentorship, and difficulty attracting and retaining talented MAs.
AHRQ-authored; AHRQ-funded; 2902010000221.
Citation: Gray CP, Harrison MI, Hung D .
Medical assistants as flow managers in primary care: challenges and recommendations.
J Healthc Manag 2016 May-Jun;61(3):181-91.
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Keywords: Primary Care, Organizational Change, Practice Improvement, Quality Improvement, Quality of Care, Workflow, Provider
Gidengil CA, Linder JA, Beach S
Using clinical vignettes to assess quality of care for acute respiratory infections.
Overprescribing of antibiotics for acute respiratory infections (ARIs) is common. The objective of this study was to develop and validate a vignette-based method to estimate clinician ARI antibiotic prescribing. The researchers concluded that responses to 3 clinical vignettes can identify clinicians with relatively poor quality ARI antibiotic prescribing. Vignettes may be a mechanism to target clinicians for quality improvement efforts.
AHRQ-funded; HS018419.
Citation: Gidengil CA, Linder JA, Beach S .
Using clinical vignettes to assess quality of care for acute respiratory infections.
Inquiry 2016 Apr 20;53:pii: 0046958016636531. doi: 10.1177/0046958016636531..
Keywords: Antibiotics, Antimicrobial Stewardship, Electronic Health Records (EHRs), Health Information Technology (HIT), Health Services Research (HSR), Medication, Practice Patterns, Primary Care, Quality of Care, Respiratory Conditions
Rabatin J, Williams E, Baier Manwell L
Predictors and outcomes of burnout in primary care physicians.
This study assessed relationships between primary care work conditions, physician burnout, quality of care, and medical errors. It found that burnout is highly associated with adverse work conditions and a greater intention to leave the practice, but not with adverse patient outcomes. Care quality thus appears to be preserved at great personal cost to primary care physicians.
AHRQ-funded; HS011955.
Citation: Rabatin J, Williams E, Baier Manwell L .
Predictors and outcomes of burnout in primary care physicians.
J Prim Care Community Health 2016 Jan;7(1):41-3. doi: 10.1177/2150131915607799.
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Keywords: Provider: Health Personnel, Primary Care, Medical Errors, Patient Safety, Quality of Care
Graetz I, Huang J, Brand R
The impact of electronic health records and teamwork on diabetes care quality.
The researchers examined whether team cohesion among primary care team members changed the association between EHR use and changes in clinical outcomes for patients with diabetes. They found that patients cared for by higher cohesion primary care teams experienced modest but statistically significantly greater EHR-related health outcome improvements, compared with patients cared for by providers practicing in lower cohesion teams.
AHRQ-funded; HS015280; HS021082.
Citation: Graetz I, Huang J, Brand R .
The impact of electronic health records and teamwork on diabetes care quality.
Am J Manag Care 2015 Dec;21(12):878-84.
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Keywords: Diabetes, Electronic Health Records (EHRs), Quality of Care, Primary Care, Teams
Litvin CB, Ornstein SM, Wessell AM
"Meaningful" clinical quality measures for primary care physicians.
The authors systematically solicited recommendations from Meaningful Use (MU) exemplars to inform Stage 3 MU clinical quality measure (CQM) requirements. There was consensus that CQMs should be evidence-based and focus on high-priority conditions relevant to primary care providers. Participants thought the emphasis of CQMs should largely be on outcomes and that reporting of CQMs should limit the burden on providers.
AHRQ-funded; HS022701; HS018984.
Citation: Litvin CB, Ornstein SM, Wessell AM .
"Meaningful" clinical quality measures for primary care physicians.
Am J Manag Care 2015 Oct;21(10):e583-90..
Keywords: Quality Indicators (QIs), Quality Measures, Primary Care, Quality of Care
Magill MK, Ehrenberger D, Scammon DL
The cost of sustaining a patient-centered medical home: experience from 2 states.
This study’s objective was to assess direct personnel costs to practices associated with the staffing necessary to deliver PCMH functions as outlined in the National Committee for Quality Assurance Standards. It found that costs per full-time equivalent primary care clinician associated with PCMH functions varied across practices with an average of $7,691 per month in Utah practices and $9,658 in Colorado practices.
AHRQ-funded; HS022620.
Citation: Magill MK, Ehrenberger D, Scammon DL .
The cost of sustaining a patient-centered medical home: experience from 2 states.
Ann Fam Med 2015 Sep;13(5):429-35. doi: 10.1370/afm.1851..
Keywords: Patient-Centered Healthcare, Healthcare Costs, Quality of Care, Primary Care
Linzer M, Poplau S, Grossman E
A cluster randomized trial of interventions to improve work conditions and clinician burnout in primary care: results from the Healthy Work Place (HWP) Study.
This study aimed to assess if improvements in work conditions reduce clinician stress and burnout. It found that burnout was more likely to improve with workflow interventions and with targeted QI projects than in controls. Also, interventions in communication or workflow led to greater improvements in clinician satisfaction.
AHRQ-funded; HS018160.
Citation: Linzer M, Poplau S, Grossman E .
A cluster randomized trial of interventions to improve work conditions and clinician burnout in primary care: results from the Healthy Work Place (HWP) Study.
J Gen Intern Med 2015 Aug;30(8):1105-11. doi: 10.1007/s11606-015-3235-4..
Keywords: Burnout, Stress, Primary Care, Workflow, Quality Improvement, Quality of Care, Communication
O'Malley AS, Rich EC, Maccarone A
Disentangling the linkage of primary care features to patient outcomes: A review of current literature, data sources, and measurement needs.
This paper reviews key primary care concepts and their definitions, notes the increasingly complex interplay between primary care and the broader health care system, and offers research priorities to support future measurement, delivery and understanding of the role of primary care features on health care costs and quality.
AHRQ-funded.
Citation: O'Malley AS, Rich EC, Maccarone A .
Disentangling the linkage of primary care features to patient outcomes: A review of current literature, data sources, and measurement needs.
J Gen Intern Med 2015 Aug;30 Suppl 3:S576-85. doi: 10.1007/s11606-015-3311-9..
Keywords: Primary Care, Quality of Care
Alexander JA, Markowitz AR, Paustian ML
Implementation of patient-centered medical homes in adult primary care practices.
This study examined the following research questions: Is the level of, and change in, implementation of patient-centered medical home (PCMH) associated with medical surgical cost, preventive services utilization, and quality of care in the following year? Results showed that both level and amount of change are independently and positively associated with measures of quality of care and use of preventive services.
AHRQ-funded; HS019147.
Citation: Alexander JA, Markowitz AR, Paustian ML .
Implementation of patient-centered medical homes in adult primary care practices.
Med Care Res Rev 2015 Aug;72(4):438-67. doi: 10.1177/1077558715579862.
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Keywords: Care Management, Quality of Care, Patient-Centered Healthcare, Primary Care
O'Malley AS, Rich EC
Measuring comprehensiveness of primary care: challenges and opportunities.
This paper discusses challenges to measuring comprehensiveness for a primary care team’s patient panel, presents survey and claims-based measures of comprehensiveness, and provides suggestions for future research. The authors argue that developing valid and reliable measures of comprehensiveness could inform quality improvement efforts and help identify
providers in need of additional support.
providers in need of additional support.
AHRQ-funded.
Citation: O'Malley AS, Rich EC .
Measuring comprehensiveness of primary care: challenges and opportunities.
J Gen Intern Med 2015 Aug;30 Suppl 3:S568-75. doi: 10.1007/s11606-015-3300-z..
Keywords: Primary Care, Quality of Care
Chen LM, Sakshaug JW, Miller DC
The association among medical home readiness, quality, and care of vulnerable patients.
The researchers sought to examine the association among patient-centered medical home (PCMH) readiness, quality, and the care of vulnerable patients. They found that performance at PCMH-ready practices was higher for 3 of 9 quality indicators related to chronic disease management and preventive counseling (beta-blocker or diuretic prescribed for hypertension, diet counseling, exercise counseling).
AHRQ-funded; HS018346; HS020671; HS020927.
Citation: Chen LM, Sakshaug JW, Miller DC .
The association among medical home readiness, quality, and care of vulnerable patients.
Am J Manag Care 2015 Aug;21(8):e480-6..
Keywords: Patient-Centered Healthcare, Patient Safety, Quality of Care, Primary Care
Solberg LI, Stuck LH, Crain AL
Organizational factors and change strategies associated with medical home transformation.
The researchers surveyed leaders of the first 132 primary care practices in Minnesota to achieve medical home certification. The Change Process Capability Questionnaire survey and the Physician Practice Connections survey showed that 80% to 100% of these certified clinics had 15 of the 18 organizational factors important for improving care processes and that 60% to 90% had successfully used 16 improvement strategies.
AHRQ-funded; HS019161.
Citation: Solberg LI, Stuck LH, Crain AL .
Organizational factors and change strategies associated with medical home transformation.
Am J Med Qual 2015 Jul-Aug;30(4):337-44. doi: 10.1177/1062860614532307.
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Keywords: Patient-Centered Healthcare, Primary Care, Practice Improvement, Organizational Change, Quality Improvement, Quality of Care, Healthcare Delivery
Crane S, Sloane PD, Elder N
Reporting and using near-miss events to improve patient safety in diverse primary care practices: a collaborative approach to learning from our mistakes.
This study assessed the feasibility of a near-miss reporting system in primary care practices and to describe initial reports and practice responses to them. It found that all 7 practices successfully implemented the system, reporting 632 near-miss events in 9 months and initiating 32 quality improvement projects based on the reports.
AHRQ-funded; HS019558.
Citation: Crane S, Sloane PD, Elder N .
Reporting and using near-miss events to improve patient safety in diverse primary care practices: a collaborative approach to learning from our mistakes.
J Am Board Fam Med 2015 Jul-Aug;28(4):452-60. doi: 10.3122/jabfm.2015.04.140050..
Keywords: Adverse Events, Medical Errors, Patient Safety, Primary Care, Public Reporting, Quality Improvement, Quality of Care
Martsolf GR, Kandrack R, Schneider EC
Categories of practice transformation in a statewide medical home pilot and their association with medical home recognition.
The researchers aimed to characterize patterns of structural change among 81 primary care practices participating in a statewide medical home pilot. They found that multiple types of practice transformation could be distinguished and higher levels of medical home recognition were associated with practices’ capabilities at baseline, rather than transformation over time.
AHRQ-funded; HS022616.
Citation: Martsolf GR, Kandrack R, Schneider EC .
Categories of practice transformation in a statewide medical home pilot and their association with medical home recognition.
J Gen Intern Med 2015 Jun;30(6):817-23. doi: 10.1007/s11606-014-3176-3..
Keywords: Primary Care, Patient-Centered Healthcare, Quality of Care
Ornstein SM, Nemeth LS, Nietert PJ
Learning from primary care meaningful use exemplars.
This report presents the results of a multimethod study combining an EHR-based clinical quality measurements (CQM) performance assessment, a provider survey, and focus groups among high CQM performers. It concluded that purposeful use of EHR functionality coupled with staff education in a milieu where Quality Improvement is valued and supported is associated with higher performance on CQM.
AHRQ-funded; HS022701; HS018984.
Citation: Ornstein SM, Nemeth LS, Nietert PJ .
Learning from primary care meaningful use exemplars.
J Am Board Fam Med 2015 May-Jun;28(3):360-70. doi: 10.3122/jabfm.2015.03.140219..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Primary Care, Quality Indicators (QIs), Quality of Care
Nembhard IM, Yuan CT, Shabanova V
The relationship between voice climate and patients' experience of timely care in primary care clinics.
The aims of this study were to assess the relationship between organizational climate and patients’ reports of timely care in primary care clinics and to broadly examine the link between staff’s work environment and patient care experiences. It found that clinical and administrative staff (e.g., nurses and office assistants) reported clinics’ climates to be significantly less supportive of voice than did clinical leaders (e.g., physicians).
AHRQ-funded; HS018987; HS016978.
Citation: Nembhard IM, Yuan CT, Shabanova V .
The relationship between voice climate and patients' experience of timely care in primary care clinics.
Health Care Manage Rev 2015 Apr-Jun;40(2):104-15. doi: 10.1097/hmr.0000000000000017..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient Experience, Primary Care, Quality of Care, Organizational Change, Provider