National Healthcare Quality and Disparities Report
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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 25 of 51 Research Studies DisplayedKrefman AE, Ciolino Jd, Kan AK
Rationale and design for Healthy Hearts for Michigan (HH4M): a pragmatic single-arm hybrid effectiveness-implementation study.
The objective of the Healthy Hearts for Michigan (HH4M) study is to promote hypertension management and smoking cessation through practice facilitation and quality improvement efforts. This three-year research program evaluates rural and medically underserved primary care practices’ ability to implement the quality improvement model and tests whether the model improves blood pressure control and tobacco use screening and cessation. Primary care practices in rural and underserved areas of Michigan were recruited to join HH4M. HH4M is part of the multi-state EvidenceNOW: Building State Capacity initiative to provide external support to primary care practices to improve care delivery.
AHRQ-funded; HS027954.
Citation: Krefman AE, Ciolino Jd, Kan AK .
Rationale and design for Healthy Hearts for Michigan (HH4M): a pragmatic single-arm hybrid effectiveness-implementation study.
Contemp Clin Trials Commun 2023 Oct; 35:101199. doi: 10.1016/j.conctc.2023.101199..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Evidence-Based Practice, Patient-Centered Outcomes Research, Primary Care
Schroeder MC, Chapman CG, Chrischilles EA
Generating practice-based evidence in the use of guideline-recommended combination therapy for secondary prevention of acute myocardial infarction.
This study’s goal was to determine if variation in real-world practice of guideline-recommended combination therapy for secondary prevention of acute myocardial infarction (AMI) reflects poor quality-of-care or a balance of outcome tradeoffs among patients. Medicare fee-for-service beneficiaries hospitalized 2007-2008 for AMI were included. Treatment within 30-days post-discharge was grouped into one of eight possible combinations for the three drug classes: beta-blockers, angiotensin-converting enzyme inhibitors/angiotensin-receptor blockers, and statins. Outcomes looked at included one-year overall survival, one-year cardiovascular-event-free survival, and 90-day adverse events. Results were found that each drug combination was observed in the final sample (N = 124,695), with 35.7% having all three, and 13.5% having none. There were both treatment benefits and harms in patients with AMIs with higher rates of guideline-recommended treatment.
AHRQ-funded; HS018381.
Citation: Schroeder MC, Chapman CG, Chrischilles EA .
Generating practice-based evidence in the use of guideline-recommended combination therapy for secondary prevention of acute myocardial infarction.
Pharmacy 2022 Nov 3;10(6). doi: 10.3390/pharmacy10060147..
Keywords: Evidence-Based Practice, Guidelines, Heart Disease and Health, Cardiovascular Conditions, Comparative Effectiveness, Patient-Centered Outcomes Research, Prevention
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
Kowitt SD, Goldstein AO, Cykert S
A heart healthy intervention improved tobacco screening rates and cessation support in primary care practices.
This study investigated the outcomes of an evidence-based cardiovascular disease risk reduction tool called Heart Health Now to improve rates for tobacco cessation screening and counseling in small primary care practices in North Carolina. This tool was developed as part of AHRQ’s EvidenceNow initiative. This stepped wedge, stratified, cluster randomized trial looked at 28 practices that were staffed by 10 or fewer clinicians and had an electronic health record. Heart Health Now consisted of education tools, onsite practice facilitation for a year, and a practice-specific cardiovascular population management dashboard that included monthly, measure-specific run charts to help guide quality improvement. The practices included in their analyses consisted of 78,120 patients, and 17,687 smokers. From pre- to post-intervention, screening rates significantly increased from 82.7 to 96.2%. Cessation support rates also significantly increased from 44.3% to 50.1%. Some of the practices associated with improvement included being in an academic health center or faculty, having more clinicians, and having a lower percentage of White patients.
AHRQ-funded; HS023912.
Citation: Kowitt SD, Goldstein AO, Cykert S .
A heart healthy intervention improved tobacco screening rates and cessation support in primary care practices.
J Prev 2022 Jun;43(3):375-86. doi: 10.1007/s10935-022-00672-5..
Keywords: Tobacco Use, Tobacco Use: Smoking Cessation, Screening, Primary Care, Evidence-Based Practice, Heart Disease and Health, Cardiovascular Conditions
Shields AD, Battistelli J, Kavanagh L
Staying current: developing just-in-time evidence-ased learning objectives for a maternal cardiac arrest simulation curriculum.
The authors’ objective was to review the latest evidence on resuscitation care for maternal cardiac arrest (MCA) and to gain expert consensus on best practices to inform an evidence-based curriculum. A multidisciplinary panel of stakeholders in MCA developed an evidence-based simulation training, Obstetric Life Support™ (OBLS). The researchers found that a novel three-step process including reaffirmation of evidence process, systematic review, and a modified Research and Development technique resulted in unanimous consensus from experts in MCA resuscitation on existing and new just-in-time best practices to inform the learning objectives for an evidence-based curriculum.
AHRQ-funded; HS026169.
Citation: Shields AD, Battistelli J, Kavanagh L .
Staying current: developing just-in-time evidence-ased learning objectives for a maternal cardiac arrest simulation curriculum.
Cardiol Cardiovasc Med 2022 Jun;6(3):245-54. doi: 10.26502/fccm.92920260..
Keywords: Evidence-Based Practice, Education: Curriculum, Simulation, Heart Disease and Health, Cardiovascular Conditions, Women, Education: Academic
Mills J, O'Dowd N
AHRQ Author: Mills J
Healthy diet and physical activity for cardiovascular disease prevention in adults with cardiovascular risk factors.
This “Putting Prevention into Practice: An Evidence Based Approach” paper is a case study with questions and answers related to healthy diet and physical activity for cardiovascular disease prevention in adults with cardiovascular risk factors.
AHRQ-authored.
Citation: Mills J, O'Dowd N .
Healthy diet and physical activity for cardiovascular disease prevention in adults with cardiovascular risk factors.
Am Fam Physician 2021 Oct 1;104(4):411-12..
Keywords: U.S. Preventive Services Task Force (USPSTF), Heart Disease and Health, Cardiovascular Conditions, Prevention, Lifestyle Changes, Risk, Evidence-Based Practice, Guidelines, Case Study
Berry CA, Nguyen AM, Cuthel AM
Measuring implementation strategy fidelity in HealthyHearts NYC: a complex intervention using practice facilitation in primary care.
This study measured implementation strategy fidelity for the HealthyHearts NYC intervention program, an AHRQ-funded program that uses practice facilitation (PF) to improve adoption of cardiovascular disease evidence-based guidelines in primary care practices. Data from 257 practices measured fidelity using 4 categories: frequency, duration, content, and coverage. Almost all (94.2%) of practices received at least the 13 PF visits with an average 26.3 hours spent at each site by facilitators. Most practices (95.7%) completed all Task List items, and 71.2% were educated on all Chronic Care Models, with the majority (65.8%) receiving full coverage.
AHRQ-funded; HS023922.
Citation: Berry CA, Nguyen AM, Cuthel AM .
Measuring implementation strategy fidelity in HealthyHearts NYC: a complex intervention using practice facilitation in primary care.
Am J Med Qual 2021 Jul-Aug;36(4):270-76. doi: 10.1177/1062860620959450..
Keywords: Implementation, Heart Disease and Health, Cardiovascular Conditions, Primary Care, Practice Improvement, Quality Improvement, Quality of Care, Evidence-Based Practice, Patient-Centered Outcomes Research, Primary Care: Models of Care
Pham-Singer H, Onakomaiya M, Cuthel A
Using a customer relationship management system to manage a quality improvement intervention.
HealthyHearts New York City (HHNYC), one of 7 cooperatives funded through the Agency for Healthcare Research and Quality's EvidenceNOW initiative, evaluated the impact of practice facilitation on implementation of the Million Hearts guidelines for cardiovascular disease prevention and treatment. Tracking the intervention required a system to facilitate process data collection that was also user-friendly and flexible. Coupled with protocols and training, a strategically planned and customizable customer relationship management system (CRMS) was implemented to support the quality improvement intervention with 257 small independent practices.
AHRQ-funded; HS023922.
Citation: Pham-Singer H, Onakomaiya M, Cuthel A .
Using a customer relationship management system to manage a quality improvement intervention.
Am J Med Qual 2021 Jul-Aug;36(4):247-54. doi: 10.1177/1062860620953214..
Keywords: Quality Improvement, Quality of Care, Implementation, Evidence-Based Practice, Cardiovascular Conditions, Heart Disease and Health, Primary Care
Tuzzio L, O'Meara ES, Holden E
Barriers to implementing cardiovascular risk calculation in primary care: alignment with the consolidated framework for implementation research.
The uptake of cardiovascular disease risk calculators in primary care has been slow despite the recommendation in national cardiovascular disease prevention guidelines. Identifying the barriers to the implementation of cardiovascular disease risk calculators is essential for promoting their adoption. In this study, the authors qualitatively analyzed structured physician educator notes written during an outreach education intervention with 44 small- and medium-sized primary care clinics that participated in the Agency for Healthcare Research and Quality‒funded EvidenceNOW Healthy Hearts Northwest trial.
AHRQ-funded; HS023908.
Citation: Tuzzio L, O'Meara ES, Holden E .
Barriers to implementing cardiovascular risk calculation in primary care: alignment with the consolidated framework for implementation research.
Am J Prev Med 2021 Feb;60(2):250-57. doi: 10.1016/j.amepre.2020.07.027..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Primary Care, Risk, Evidence-Based Practice, Implementation
McKinney WT, Schaffhausen CR, Schladt D
Designing a patient-specific search of transplant program performance and outcomes: feedback from heart transplant candidates and recipients.
The Scientific Registry of Transplant Recipients provides transplant program-specific information, but it is unclear what patients and stakeholders need to know. Acceptance criteria for the candidate waitlist and donor organs vary by program and region, but there is no means to search for programs by the clinical profiles of recipients and donors. The authors examined variability in program-specific characteristics that could influence access to transplantation.
AHRQ-funded; HS026379; HS024527.
Citation: McKinney WT, Schaffhausen CR, Schladt D .
Designing a patient-specific search of transplant program performance and outcomes: feedback from heart transplant candidates and recipients.
Clin Transplant 2021 Feb;35(2):e14183. doi: 10.1111/ctr.14183..
Keywords: Transplantation, Surgery, Heart Disease and Health, Cardiovascular Conditions, Registries, Patient-Centered Outcomes Research, Evidence-Based Practice, Decision Making
Stillman AE, Gatsonis C, Lima JAC
Coronary computed tomography angiography compared with single photon emission computed tomography myocardial perfusion imaging as a guide to optimal medical therapy in patients presenting with stable angina: the RESCUE trial.
Coronary computed tomography angiography compared with single photon emission computed tomography myocardial perfusion imaging as a guide to optimal medical therapy in patients presenting with stable angina: the RESCUE trial.
AHRQ-funded; HS019403.
Citation: Stillman AE, Gatsonis C, Lima JAC .
Coronary computed tomography angiography compared with single photon emission computed tomography myocardial perfusion imaging as a guide to optimal medical therapy in patients presenting with stable angina: the RESCUE trial.
J Am Heart Assoc 2020 Dec 15;9(24):e017993. doi: 10.1161/jaha.120.017993..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Imaging, Comparative Effectiveness, Evidence-Based Practice
Nguyen AM, Cuthel AM, Rogers ES
Attributes of high-performing small practices in a guideline implementation: a multiple-case study.
This study called HealthyHearts NYC was a stepped wedge randomized control trial that tested the effectiveness of practice facilitation in small primary care practices in adopting cardiovascular disease guidelines. The practice-level benchmark desired was having 70% or greater of hypertensive patients having controlled blood pressure. A mixed methods multiple-case study design was used and implemented at 6 small practices. The investigator’s first key finding was that the high-performing and improved practices in their study looked and acted similarly during the intervention implementation. Three key attributes of these practices were found to be: 1) advanced use of electronic health records; 2) dedicated resources and commitment to quality improvement; and 3) an actively engaged lead clinician and office manager.
AHRQ-funded; HS023922.
Citation: Nguyen AM, Cuthel AM, Rogers ES .
Attributes of high-performing small practices in a guideline implementation: a multiple-case study.
J Prim Care Community Health 2020 Jan-Dec;11. doi: 10.1177/2150132720984411..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Primary Care, Evidence-Based Practice, Guidelines, Implementation
Halladay JR, Weiner BJ, In Kim J
Practice level factors associated with enhanced engagement with practice facilitators; findings from the Heart Health Now study.
In this analysis, the authors explored the practice and facilitator factors associated with greater team engagement at the mid-point of a 12-month practice facilitation intervention focused on implementing cardiovascular prevention activities in practice. Using data from the EvidenceNow initiative's NC Cooperative, named Heart Health Now, they found that their analysis provided information for practice facilitation stakeholders to consider when determining which practices may be more amendable to embracing facilitation services.
AHRQ-funded; HS023912.
Citation: Halladay JR, Weiner BJ, In Kim J .
Practice level factors associated with enhanced engagement with practice facilitators; findings from the Heart Health Now study.
BMC Health Serv Res 2020 Jul 28;20(1):695. doi: 10.1186/s12913-020-05552-4.
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Keywords: Heart Disease and Health, Cardiovascular Conditions, Primary Care, Primary Care: Models of Care, Patient-Centered Healthcare, Evidence-Based Practice, Teams
Spellberg B, Chambers HF, Musher DM
Evaluation of a paradigm shift from intravenous antibiotics to oral step-down therapy for the treatment of infective endocarditis: a narrative review.
The requirement of prolonged intravenous antibiotic courses to treat infective endocarditis (IE) is a time-honored dogma of medicine. However, numerous antibiotics are now available that achieve adequate levels in the blood after oral administration to kill bacteria. Moreover, prolonged intravenous antibiotic regimens are associated with high rates of adverse events. In this study, PubMed was reviewed to determine whether evidence supports the notion that oral step-down antibiotic therapy for IE is associated with inferior outcomes compared with intravenous-only therapy.
AHRQ-funded; HS025690.
Citation: Spellberg B, Chambers HF, Musher DM .
Evaluation of a paradigm shift from intravenous antibiotics to oral step-down therapy for the treatment of infective endocarditis: a narrative review.
JAMA Intern Med 2020 May;180(5):769-77. doi: 10.1001/jamainternmed.2020.0555..
Keywords: Antibiotics, Medication, Evidence-Based Practice, Cardiovascular Conditions, Heart Disease and Health
Nguyen AM, Cuthel A, Padgett DK
How practice facilitation strategies differ by practice context.
The purpose of this study was to identify contextual factors that drive facilitators' strategies to meet practice improvement goals, and how these strategies are tailored to practice context. This study was conducted as part of a larger study, HealthyHearts New York City, which evaluated the impact of practice facilitation on adoption of cardiovascular disease prevention and treatment guidelines.
AHRQ-funded; HS023922.
Citation: Nguyen AM, Cuthel A, Padgett DK .
How practice facilitation strategies differ by practice context.
J Gen Intern Med 2020 Mar;35(3):824-31. doi: 10.1007/s11606-019-05350-7..
Keywords: Quality Improvement, Evidence-Based Practice, Heart Disease and Health, Cardiovascular Conditions, Primary Care, Quality of Care, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Primary Care: Models of Care
Dhruva SS, Ross JS, Mortazavi BJ
Association of use of an intravascular microaxial left ventricular assist device vs intra-aortic balloon pump with in-hospital mortality and major bleeding among patients with acute myocardial infarction complicated by cardiogenic shock.
This study examines outcomes among patients undergoing percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) complicated by cardiogenic shock. Two interventions are compared: intravascular microaxial left ventricular assist devices (LVADs) versus intra-aortic balloon pumps (IABPs). The American College of Cardiology’s National Cardiovascular Data Registry was used to identify patients with AMI complicated by cardiogenic shock from hospitals participating in the CathPCI and Chest Pain-MI registries and identified 28,304 patients. Over the study period (2015 to 2017), LVAD was used in 6.2% of patients and IABP in 29.9%. LVAD was shown to have higher rates of in-hospital death and major bleeding complications compared to IABP.
AHRQ-funded; HS022882; HS025402; HS025517; HS026379.
Citation: Dhruva SS, Ross JS, Mortazavi BJ .
Association of use of an intravascular microaxial left ventricular assist device vs intra-aortic balloon pump with in-hospital mortality and major bleeding among patients with acute myocardial infarction complicated by cardiogenic shock.
JAMA 2020 Feb 25;323(8):734-45. doi: 10.1001/jama.2020.0254..
Keywords: Medical Devices, Heart Disease and Health, Cardiovascular Conditions, Mortality, Adverse Events, Registries, Patient Safety, Patient-Centered Outcomes Research, Evidence-Based Practice
Kelly JP, DeVore AD, Wu J
Rhythm control versus rate control in patients with atrial fibrillation and heart failure with preserved ejection fraction: insights from get with the guidelines-heart failure.
Researchers analyzed the Get With The Guidelines - Heart Failure (GWTG-HF) registry linked to Medicare claims data to describe current treatments for rate versus rhythm control and subsequent outcomes in patients with heart failure with preserved ejection fraction and atrial fibrillation. They found that rhythm control in patients aged 65 and older with heart failure with preserved ejection fraction and AF was associated with a lower risk of one-year all-cause mortality. They recommended future prospective randomized studies to explore this potential benefit.
AHRQ-funded; HS021092.
Citation: Kelly JP, DeVore AD, Wu J .
Rhythm control versus rate control in patients with atrial fibrillation and heart failure with preserved ejection fraction: insights from get with the guidelines-heart failure.
J Am Heart Assoc 2019 Dec 17;8(24):e011560. doi: 10.1161/jaha.118.011560.
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Keywords: Heart Disease and Health, Cardiovascular Conditions, Guidelines, Evidence-Based Practice, Registries, Patient-Centered Outcomes Research
Goldstone AB, Chiu P, Baiocchi M
Interfacility transfer of Medicare beneficiaries with acute type a aortic dissection and regionalization of care in the United States.
Researchers investigated the hypothesis that regionalizing care at high-volume hospitals for acute type A aortic dissections will lower mortality. Operative mortality and long-term survival were compared for Medicare beneficiaries diagnosed with an acute type A aortic dissection who were transferred versus not transferred, underwent surgery at high-volume versus low-volume hospitals, and were rerouted versus not rerouted to a high-volume hospital for treatment. The researchers found that, despite delaying surgery, a regionalization policy that transfers patients to high-volume hospitals was associated with a 7.2% absolute risk reduction in operative mortality. They recommended that policymakers evaluate the feasibility and benefits of regionalizing the surgical treatment of acute type A aortic dissection in the United States.
AHRQ-funded; HS022192.
Citation: Goldstone AB, Chiu P, Baiocchi M .
Interfacility transfer of Medicare beneficiaries with acute type a aortic dissection and regionalization of care in the United States.
Circulation 2019 Oct 8;140(15):1239-50. doi: 10.1161/circulationaha.118.038867..
Keywords: Transitions of Care, Medicare, Heart Disease and Health, Cardiovascular Conditions, Patient-Centered Outcomes Research, Risk, Evidence-Based Practice, Mortality, Hospitals
Sterling MR, Echeverria SE, Commodore-Mensah Y
Health equity and implementation science in heart, lung, blood, and sleep-related research: emerging themes from the 2018 Saunders-Watkins Leadership Workshop.
This article discusses the key themes from a 2-day workshop that was held at the National Institutes of Health in May 2018 to promote health equity and implementation science in heart, lung, and sleep-related research. This inaugural workshop was named the Saunders-Watkins Leadership Workshop. Recommendations are offered for the future direction of this research.
AHRQ-funded; HS000066.
Citation: Sterling MR, Echeverria SE, Commodore-Mensah Y .
Health equity and implementation science in heart, lung, blood, and sleep-related research: emerging themes from the 2018 Saunders-Watkins Leadership Workshop.
Circ Cardiovasc Qual Outcomes 2019 Oct;12(10):e005586. doi: 10.1161/circoutcomes.119.005586..
Keywords: Implementation, Evidence-Based Practice, Disparities, Patient-Centered Outcomes Research, Cardiovascular Conditions, Heart Disease and Health, Respiratory Conditions, Sleep Problems
Bath J, Smith JB, Kruse RL
Association of neutrophil-to-lymphocyte ratio with outcomes after elective abdominal aortic aneurysm repair.
This study investigated postoperative outcomes from elective abdominal aortic aneurysm surgery (AAA) repair using neutrophil-to-lymphocyte ratio as the predictor. Inpatients from the Cerner Health Facts database undergoing elective AAA repair from 2008 to 2015 were selected using ICD-9 procedure codes. Patients with a high postoperative NLR experienced longer hospital stays; higher rates of in-hospital death; high rates of renal failure, cardiac problems, respiratory problems, and infection compared to patients with a low postoperative NLR. The authors recommend future study of NLR to help provide clinically important risk profiles.
AHRQ-funded; HS022140.
Citation: Bath J, Smith JB, Kruse RL .
Association of neutrophil-to-lymphocyte ratio with outcomes after elective abdominal aortic aneurysm repair.
J Vasc Nurs 2019 Sep;37(3):213-20. doi: 10.1016/j.jvn.2019.06.001..
Keywords: Cardiovascular Conditions, Heart Disease and Health, Surgery, Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice
Rogers ES, Cuthel AM, Berry CA
Clinician perspectives on the benefits of practice facilitation for small primary care practices.
This study examined the effectiveness of practice facilitation to improve cardiovascular disease in 257 small independent primary care practices (SIPs) enrolled in the AHRQ-funded EvidenceNOW initiative called HealthyHearts. These SIPs were enrolled in HealthyHearts NYC in New York City. Interviews were conducted with SIPs with 3 or fewer office staff and their answers were compared with interviews with practices with more than 3 office staff. Three facilitation benefits were found to the most important, including 1. Creating awareness of quality gaps; 2. Connecting practices to information, resources, and strategies, and; 3. Optimizing the HER for QI goals.
AHRQ-funded; HS023922.
Citation: Rogers ES, Cuthel AM, Berry CA .
Clinician perspectives on the benefits of practice facilitation for small primary care practices.
Ann Fam Med 2019 Aug 12;17(Suppl 1):S17-s23. doi: 10.1370/afm.2427..
Keywords: Primary Care, Provider: Clinician, Provider: Physician, Provider, Quality Improvement, Quality of Care, Cardiovascular Conditions, Heart Disease and Health, Evidence-Based Practice, Patient-Centered Healthcare, Patient-Centered Outcomes Research
Knierim KE, Hall TL, Dickinson LM
Primary care practices' ability to report electronic clinical quality measures in the EvidenceNOW Southwest Initiative to Improve Heart Health.
The objective of this study was to determine how quickly primary care practices can report electronic clinical quality measures (eCQMs) and to identify the practice characteristics associated with faster reporting. Examining the EvidenceNOW Southwest initiative, the researchers’ results showed that the time to report eCQMs varied by measure and practice type, with very few practices reporting quickly. Additional support for practices to succeed in new programs that require eCQM reporting was recommended.
AHRQ-funded; HS023904.
Citation: Knierim KE, Hall TL, Dickinson LM .
Primary care practices' ability to report electronic clinical quality measures in the EvidenceNOW Southwest Initiative to Improve Heart Health.
JAMA Netw Open 2019 Aug 2;2(8):e198569. doi: 10.1001/jamanetworkopen.2019.8569..
Keywords: Primary Care, Quality Indicators (QIs), Quality Measures, Quality Improvement, Quality of Care, Heart Disease and Health, Cardiovascular Conditions, Patient-Centered Outcomes Research, Evidence-Based Practice, Electronic Health Records (EHRs), Health Information Technology (HIT)
Parchman ML, Anderson ML, Coleman K
Assessing quality improvement capacity in primary care practices.
The Healthy Hearts Northwest (H2N) Study is part of an AHRQ initiative to build quality improvement (QI) capacity in primary care with a focus on cardiovascular risk factors. The three main risk factors are appropriate aspirin use, blood pressure control, and tobacco screening/cessation. A practice facilitator (PF) met with clinicians and staff in the participating practices to discuss the results for each item on the Quality Improvement Capacity Assessment (QICA) scale. The score was associated with prior experience managing change and moderately associated with two of the three risk factors: aspirin use and blood pressure control. The QICA was found to be a useful assessment tool to measure QI capacity within a practice.
AHRQ-funded; HS023908.
Citation: Parchman ML, Anderson ML, Coleman K .
Assessing quality improvement capacity in primary care practices.
BMC Fam Pract 2019 Jul 25;20(1):103. doi: 10.1186/s12875-019-1000-1.
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Keywords: Cardiovascular Conditions, Evidence-Based Practice, Heart Disease and Health, Outcomes, Patient-Centered Outcomes Research, Primary Care, Quality of Care, Quality Improvement
Hoch JM, Fatusin O, Yenokyan G
Feeding methods for infants with single ventricle physiology are associated with length of stay during stage 2 surgery hospitalization.
The purpose of this paper was to identify types of feeding methods following stage 2 palliation and their influence on length of stay. Results showed that feeding methods established at admission for stage 2 palliation are not likely to change by discharge, and that length of stay is more likely to be impacted by tube feeding and intubation history than by age or weight-for-age z score at admission. Recommendations included a better understanding for selection of feeding methods and their impact on patient outcomes in order to develop evidence-based guidelines to decrease variability in clinical practice patterns and to provide appropriate counseling to caregivers.
AHRQ-funded; HS021114.
Citation: Hoch JM, Fatusin O, Yenokyan G .
Feeding methods for infants with single ventricle physiology are associated with length of stay during stage 2 surgery hospitalization.
Congenit Heart Dis 2019 May;14(3):438-45. doi: 10.1111/chd.12742.
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Keywords: Nutrition, Newborns/Infants, Children/Adolescents, Hospitalization, Surgery, Heart Disease and Health, Cardiovascular Conditions, Evidence-Based Practice, Patient-Centered Outcomes Research
Lindner S, Solberg LI, Miller WL
Does ownership make a difference in primary care practice?
This study looked into whether ownership of a primary care practice makes a difference in structural characteristics, quality improvement practices, and cardiovascular preventive care. This analysis was done was part of an evaluation of the EvidenceNOW: Advancing Heart Health in Primary Care Initiative by AHRQ. Physician-owned practices, health system or medical group practices, and Federally Qualified Health Centers (FQHCs) were compared using 15 survey-based measures, and 4 electronic health record-based cardiovascular disease (CVD) prevention quality measures known as ABCS (aspirin prevention, blood pressure control, cholesterol management, and smoking cessation support). Physician-owned practices were solo 45% of the time as opposed to 8.1% for health system practices and 12.8% for FQHCs. FQHCs were more likely to use quality improvement practices followed by health system practices. ABCS use was similar across ownership types with the exception of smoking cessation support.
AHRQ-funded; HS023940.
Citation: Lindner S, Solberg LI, Miller WL .
Does ownership make a difference in primary care practice?
J Am Board Fam Med 2019 May-Jun;32(3):398-407. doi: 10.3122/jabfm.2019.03.180271..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Primary Care, Evidence-Based Practice, Quality Improvement, Quality of Care, Healthcare Delivery