National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Events (1)
- Ambulatory Care and Surgery (1)
- Behavioral Health (1)
- Burnout (2)
- Cancer (2)
- Care Coordination (1)
- Children/Adolescents (1)
- Communication (1)
- Community-Based Practice (1)
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- Guidelines (1)
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- Health Services Research (HSR) (1)
- Health Systems (2)
- Hospitals (3)
- Implementation (4)
- Learning Health Systems (1)
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- (-) Organizational Change (17)
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- Patient-Centered Outcomes Research (2)
- Patient Safety (3)
- Policy (2)
- Practice Improvement (1)
- Prevention (1)
- Primary Care (6)
- Primary Care: Models of Care (2)
- Provider (1)
- Provider: Clinician (1)
- Provider: Physician (1)
- Quality Improvement (4)
- Quality of Care (6)
- Screening (1)
- Stress (1)
- Substance Abuse (1)
- Surgery (1)
- Surveys on Patient Safety Culture (2)
- Teams (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 17 of 17 Research Studies DisplayedSorra J, Zebrak K, Yount N
Development and pilot testing of survey items to assess the culture of value and efficiency in hospitals and medical offices.
Given rising costs and changing payment models, healthcare organisations are increasingly focused on value and efficiency. The goal of this study was to develop survey items to assess clinician and staff perspectives about the extent to which the organizational culture in hospitals and medical offices supports value and efficiency. The investigators concluded when added to the Agency for Healthcare Research and Quality Surveys on Patient Safety Culture, the item sets they developed extended those surveys by assessing additional dimensions of organizational culture that affect care delivery.
AHRQ-funded; 290201000025I.
Citation: Sorra J, Zebrak K, Yount N .
Development and pilot testing of survey items to assess the culture of value and efficiency in hospitals and medical offices.
BMJ Qual Saf 2022 Jul;31(7):493-502. doi: 10.1136/bmjqs-2020-012407..
Keywords: Surveys on Patient Safety Culture, Organizational Change
Zebrak K, Yount N, Sorra J
Development, pilot study, and psychometric analysis of the AHRQ Surveys on Patient Safety Culture™ (SOPS(®)) workplace safety supplemental items for hospitals.
The purpose of this AHRQ-funded study was to develop and test survey items that can be utilized together with the Agency for Healthcare Research and Quality (AHRQ) Surveys on Patient Safety Culture™ (SOPS(®)) Hospital Survey to evaluate how hospitals’ organizational cultures support workplace safety for both providers and staff. Based on a literature review and qualitative interviews with experts in workplace safety, the researchers identified prime areas of workplace safety culture (workplace hazards, moving patients, workplace aggression, management support for workplace safety, workplace safety reporting, and work stress or burnout) and drafted survey items to evaluate these areas. The survey items were then pilot tested on providers and staff in 28 U.S. hospitals using the SOPS Hospital Survey 2.0. Data from 6,684 respondents was analyzed and demonstrated conceptual convergence among the survey measures. The researchers concluded that both researchers and hospitals can utilize the Workplace Safety Supplemental items to evaluate the dimensions of organizational culture that support provider and staff safety and to pinpoint organizational strengths and areas for improvement.
AHRQ-funded; 233201500026I.
Citation: Zebrak K, Yount N, Sorra J .
Development, pilot study, and psychometric analysis of the AHRQ Surveys on Patient Safety Culture™ (SOPS(®)) workplace safety supplemental items for hospitals.
Int J Environ Res Public Health 2022 Jun 2;19(11). doi: 10.3390/ijerph19116815..
Keywords: Surveys on Patient Safety Culture, Patient Safety, Hospitals, Organizational Change
Yuce TK, Yang AD, Johnson JK
Association between implementing comprehensive learning collaborative strategies in a statewide collaborative and changes in hospital safety culture.
Hospital safety culture remains a critical consideration when seeking to reduce medical errors and improve quality of care. Little is known regarding whether participation in a comprehensive, multicomponent, statewide quality collaborative is associated with changes in hospital safety culture. The purpose of this study was to examine whether implementation of a comprehensive, multicomponent, statewide surgical quality improvement collaborative was associated with changes in hospital safety culture.
AHRQ-funded; HS024516.
Citation: Yuce TK, Yang AD, Johnson JK .
Association between implementing comprehensive learning collaborative strategies in a statewide collaborative and changes in hospital safety culture.
JAMA Surg 2020 Oct;155(10):934-40. doi: 10.1001/jamasurg.2020.2842..
Keywords: Hospitals, Patient Safety, Organizational Change, Quality Improvement, Quality of Care, Implementation
Knerr S, West KM, Angelo FA
Organizational readiness to implement population-based screening and genetic service delivery for hereditary cancer prevention and control.
Programs conducting population-based screening and genetic service delivery for hereditary cancer prevention and control are rare in practice. The authors interviewed individuals instrumental in implementing seven unique clinical programs conducting either universal tumor screening for Lynch Syndrome or routine family history screening and provision of genetic services for hereditary breast and ovarian cancer in the United States. Their findings suggest that developing interventions targeting change efficacy and cultivating practice change champions may be two promising ways to increase uptake of population-based hereditary cancer screening and genetic service delivery in clinical practice.
AHRQ-funded; HS022982.
Citation: Knerr S, West KM, Angelo FA .
Organizational readiness to implement population-based screening and genetic service delivery for hereditary cancer prevention and control.
J Genet Couns 2020 Oct;29(5):867-76. doi: 10.1002/jgc4.1216.
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Keywords: Cancer, Screening, Genetics, Prevention, Guidelines, Healthcare Delivery, Organizational Change, Implementation
Poghosyan L, Ghaffari A, Liu J
Organizational support for nurse practitioners in primary care and workforce outcomes.
Lack of organizational support in healthcare settings has been linked to high levels of clinician stress, burnout, and job dissatisfaction. Little research exists on organizational support for nurse practitioners. In this study, the researchers investigated the relationship between organizational support and nurse practitioner outcomes, including job satisfaction, intent to leave, and quality of care. The investigators concluded that nurse practitioners from primary care practices with higher levels of organizational support were more likely to be satisfied with their jobs, have less intent to leave their jobs, and report better quality of care.
AHRQ-funded; HS024758.
Citation: Poghosyan L, Ghaffari A, Liu J .
Organizational support for nurse practitioners in primary care and workforce outcomes.
Nurs Res 2020 Jul/Aug;69(4):280-88. doi: 10.1097/nnr.0000000000000425..
Keywords: Provider: Clinician, Provider, Primary Care, Burnout, Stress, Workforce, Organizational Change
Smith JD, Rafferty MR, Heinemann AW
Pragmatic adaptation of implementation research measures for a novel context and multiple professional roles: a factor analysis study.
In this study, the investigators examined the internal consistency, factor structure, and structural invariance of four well-validated measures of inner setting factors across four groups of respondents. The items in these measures were adapted as part of an evaluation of a large-scale organizational change in a rehabilitation hospital, which involved transitioning to a new building and a new model of patient care, facilitated by a significant redesign of patient care and research spaces.
AHRQ-funded; HS025077.
Citation: Smith JD, Rafferty MR, Heinemann AW .
Pragmatic adaptation of implementation research measures for a novel context and multiple professional roles: a factor analysis study.
BMC Health Serv Res 2020 Mar 30;20(1):257. doi: 10.1186/s12913-020-05118-4..
Keywords: Implementation, Health Services Research (HSR), Organizational Change
Heeringa J, Mutti A, Furukawa MF
AHRQ Author: Furukawa MF
Horizontal and vertical integration of health care providers: a framework for understanding various provider organizational structures.
The authors conducted a narrative review of 10 years of literature to identify definitional components of key organizational structures in the United States. They found that U.S. policymakers seek to promote provider integration and coordination. They conclude that emerging evidence suggested that organizational structures, composition, and other characteristics influence cost and quality performance. They recommend future research to examine systematically the role of organizational structure in cost and quality outcomes.
AHRQ-authored; AHRQ-funded.
Citation: Heeringa J, Mutti A, Furukawa MF .
Horizontal and vertical integration of health care providers: a framework for understanding various provider organizational structures.
Int J Integr Care 2020 Jan 20;20(1):2. doi: 10.5334/ijic.4635.
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Keywords: Health Systems, Healthcare Delivery, Patient-Centered Healthcare, Care Coordination, Organizational Change, Policy
Israel N, McMillen JC, Adams DR
Development of quality management capacity in child-serving nonprofit agencies.
In this study, the authors explored quality management capabilities and their development at nine different child serving agencies. Respondents described four emergent core quality management capabilities, although none of the nine agencies excelled at all four. The researchers discussed quality management capability and implications for research, policy, and practice.
AHRQ-funded; HS000084.
Citation: Israel N, McMillen JC, Adams DR .
Development of quality management capacity in child-serving nonprofit agencies.
Adm Policy Ment Health 2020 Jan;47(1):94-106. doi: 10.1007/s10488-019-00971-w..
Keywords: Children/Adolescents, Behavioral Health, Organizational Change, Quality Improvement, Quality of Care
Smith ME, Wells EE, Friese CR
Interpersonal and organizational dynamics are key drivers of failure to rescue.
This qualitative study of providers from hospitals with high and low rescue rates identified key factors that providers believe influence the successful rescue of surgical patients. These factors are: teamwork, action taking, psychological safety, recognition of complications, and communication. Providers surveyed agreed on two targets for improvement: delayed recognition of developing complications, and poor interprofessional communication and inability to express clinical concerns. The authors conclude that, to improve perioperative outcomes, hospitals and payers should shift their attention to improving early detection and increasing communication effectiveness when major complications occur.
AHRQ-funded; HS023621; HS024403.
Citation: Smith ME, Wells EE, Friese CR .
Interpersonal and organizational dynamics are key drivers of failure to rescue.
Health Aff 2018 Nov;37(11):1870-76. doi: 10.1377/hlthaff.2018.0704..
Keywords: Adverse Events, Communication, Hospitals, Mortality, Organizational Change, Patient Safety, Surgery
Brimhall KC, Mor Barak ME
The critical role of workplace inclusion in fostering innovation, job satisfaction, and quality of care in a diverse human service organization.
Using a sample of 213 participants within 21 departmental units in a diverse human service organization, the authors performed multilevel path analysis to examine the critical role of workplace inclusion in fostering innovation, job satisfaction, and quality of care in a diverse human service organization.
AHRQ-funded; HS024650.
Citation: Brimhall KC, Mor Barak ME .
The critical role of workplace inclusion in fostering innovation, job satisfaction, and quality of care in a diverse human service organization.
Hum Serv Organ Manag Leadersh Gov 2018 Nov/Dec;42(5):474-92..
Keywords: Quality of Care, Workforce, Organizational Change
Carpenter D, Hassell S, Mardon R
Ambulatory Surgery, Cost-Effectiveness, Health Care Costs, Evidence-based Practice, Organization and Administration
This paper describes the concept of using learning communities to support adoption of health care innovations. The authors assert that the learning community model of group learning can serve as an effective method to support dissemination and implementation of innovations, and to achieve desired outcomes in local settings.
AHRQ-funded; 290201100001C.
Citation: Carpenter D, Hassell S, Mardon R .
Ambulatory Surgery, Cost-Effectiveness, Health Care Costs, Evidence-based Practice, Organization and Administration
Jt Comm J Qual Patient Saf 2018 Oct;44(10):566-73. doi: 10.1016/j.jcjq.2018.03.010..
Keywords: Organizational Change, Patient-Centered Healthcare, Quality Improvement, Quality of Care
Wagner EH, LeRoy L, Schaefer J
AHRQ Author: Zhan C, Meyers D.
How do innovative primary care practices achieve the quadruple aim?
The Patient-Centered Medical Home (PCMH) defines excellent primary care but there is little empiric evidence that helps practices, payers, or policy makers understand how high-performing practices have improved outcomes. This paper reports findings from 38 high-performing practices. The authors describe how these practices execute 8 functions that collectively meet patient needs.
AHRQ-authored.
Citation: Wagner EH, LeRoy L, Schaefer J .
How do innovative primary care practices achieve the quadruple aim?
J Ambul Care Manage 2018 Oct/Dec;41(4):288-97. doi: 10.1097/jac.0000000000000249..
Keywords: Primary Care, Patient-Centered Healthcare, Practice Improvement, Organizational Change, Patient-Centered Outcomes Research
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
McDonald KM, Rodriguez HP, Shortell SM
Organizational influences on time pressure stressors and potential patient consequences in primary care.
This study examines organizational determinants and patient consequences of time pressure, theorizing two types of time pressure and based on analysis of data from surveys of care team members and their patients. Measures of the two types - encounter-level and practice-level - were not correlated, nor predicted, which supported the hypothesis. Different organizational factors are associated with each type.
AHRQ-funded; HS024075.
Citation: McDonald KM, Rodriguez HP, Shortell SM .
Organizational influences on time pressure stressors and potential patient consequences in primary care.
Med Care 2018 Oct;56(10):822-30. doi: 10.1097/mlr.0000000000000974..
Keywords: Organizational Change, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Primary Care
Skinner D, Franz B, Howard J
The politics of primary care expansion: lessons from cancer survivorship and substance abuse.
The purpose of this study was to understand the perspectives of primary care innovators treating patient populations not traditionally considered to be within the purview of primary care. The authors indicated that their study findings suggested that the politics surrounding entrenched professional identities contributed to barriers faced by conference participants in their efforts to provide innovative care for these nontraditional populations. Specifically, obstacles surfaced in relation to sharing patients across disciplinary boundaries, which resulted in issues of possessiveness, a questioning of provider qualifications, and a lack of interprofessional trust.
AHRQ-funded; HS021287.
Citation: Skinner D, Franz B, Howard J .
The politics of primary care expansion: lessons from cancer survivorship and substance abuse.
J Healthc Manag 2018 Sep-Oct;63(5):323-36. doi: 10.1097/jhm-d-16-00030..
Keywords: Primary Care, Primary Care: Models of Care, Patient-Centered Healthcare, Cancer, Substance Abuse, Policy, Healthcare Delivery, Organizational Change, Quality of Care
Hung DY, Harrison MI , Truong Q
AHRQ Author: Harrison MI
Experiences of primary care physicians and staff following lean workflow redesign.
The researchers examined the work experiences of primary care physicians and staff after implementing Lean-based workflow redesigns. They found that both physicians and nonphysician staff reported higher levels of engagement and teamwork after implementing redesigns. However, the subjects also experienced higher levels of burnout and perceptions of the workplace as stressful.
AHRQ-authored; AHRQ-funded; 290201000022I.
Citation: Hung DY, Harrison MI , Truong Q .
Experiences of primary care physicians and staff following lean workflow redesign.
BMC Health Serv Res 2018 Apr 10;18(1):274. doi: 10.1186/s12913-018-3062-5.
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Keywords: Primary Care, Workflow, Burnout, Organizational Change, Provider: Physician, Teams
Martsolf GR, Ashwood S, Friedberg MW
Linking structural capabilities and workplace climate in community health centers.
This study examined the relationship between workplace climate and structural capabilities. Twenty-five community health centers (CHCs) were surveyed to determine workplace climate. CHC directors and adult primary care clinicians and staff were surveyed. Positive attributes included a manageable workload, staff relationships, a quality improvement orientation, and manager readiness. Lower electronic record functionality did not seem to improve workplace climates.
AHRQ-funded; HS020120.
Citation: Martsolf GR, Ashwood S, Friedberg MW .
Linking structural capabilities and workplace climate in community health centers.
Inquiry 2018 Jan-Dec;55:46958018794542. doi: 10.1177/0046958018794542..
Keywords: Community-Based Practice, Organizational Change, Quality Improvement, Quality of Care