National Healthcare Quality and Disparities Report
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- Cardiovascular Conditions (4)
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- (-) Implementation (8)
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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 8 of 8 Research Studies DisplayedPestka DL, Paterson NL, Brummel AR
Barriers and facilitators to implementing pharmacist-provided comprehensive medication management in primary care transformation.
The objective of this study was to identify barriers and facilitators when integrating pharmacist-provided comprehensive medication management (CMM) services into a health system's team-based primary care transformation (PCT) using the Consolidated Framework for Implementation Research. Findings showed that identifying and addressing implementation barriers and facilitators early during PCT rollout was critical to the success of team-based services such as CMM and becoming a learning health system. Further, clinical pharmacists providing CMM represented a valuable interdisciplinary care team member who can help to improve healthcare quality and access to primary care.
AHRQ-funded; HS026379.
Citation: Pestka DL, Paterson NL, Brummel AR .
Barriers and facilitators to implementing pharmacist-provided comprehensive medication management in primary care transformation.
Am J Health Syst Pharm 2022 Jul 22;79(15):1255-65. doi: 10.1093/ajhp/zxac104..
Keywords: Medication, Provider: Pharmacist, Primary Care, Implementation, Practice Improvement
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
Walunas TL, Ye J, Bannon J
Does coaching matter? Examining the impact of specific practice facilitation strategies on implementation of quality improvement interventions in the Healthy Hearts in the Heartland study.
Practice facilitation is a multicomponent implementation strategy used to improve the capacity for practices to address care quality and implementation gaps. In this study, the investigators sought to assess whether practice facilitators use of coaching strategies aimed at improving self-sufficiency were associated with improved implementation of quality improvement (QI) interventions in the Healthy Hearts in the Heartland Study.
AHRQ-funded; HS023921.
Citation: Walunas TL, Ye J, Bannon J .
Does coaching matter? Examining the impact of specific practice facilitation strategies on implementation of quality improvement interventions in the Healthy Hearts in the Heartland study.
Implement Sci 2021 Mar 31;16(1):33. doi: 10.1186/s13012-021-01100-8..
Keywords: Practice Improvement, Quality Improvement, Quality of Care, Implementation, Heart Disease and Health, Cardiovascular Conditions
Sweeney SM, Hemler JR, Baron AN
Dedicated workforce required to support large-scale practice improvement.
Facilitation is an effective approach for helping practices implement sustainable evidence-based practice improvements. Few studies examine the facilitation infrastructure and support needed for large-scale dissemination and implementation initiatives. In this paper, the authors discuss a project by the Agency for Health care Research and Quality in which it funded 7 Cooperatives, each of which worked with over 200 primary care practices to rapidly disseminate and implement improvements in cardiovascular preventive care.
AHRQ-funded; HS023940.
Citation: Sweeney SM, Hemler JR, Baron AN .
Dedicated workforce required to support large-scale practice improvement.
J Am Board Fam Med 2020 Mar-Apr;33(2):230-39. doi: 10.3122/jabfm.2020.02.190261..
Keywords: Practice Improvement, Primary Care, Cardiovascular Conditions, Healthcare Delivery, Quality Improvement, Quality of Care, Prevention, Implementation, Evidence-Based Practice
Ono SS, Crabtree BF, Hemler JR
Taking innovation to scale in primary care practices: the functions of health care extension.
Health care extension is an approach to providing external support to primary care practices with the aim of diffusing innovation. EvidenceNOW was launched to rapidly disseminate and implement evidence-based guidelines for cardiovascular preventive care in the primary care setting. This article describes how cooperatives varied in their approaches to extension and provides early empirical evidence that health care extension is a feasible and potentially useful approach for providing quality improvement.
AHRQ-funded; HS023940.
Citation: Ono SS, Crabtree BF, Hemler JR .
Taking innovation to scale in primary care practices: the functions of health care extension.
Health Aff 2018 Feb;37(2):222-30. doi: 10.1377/hlthaff.2017.1100.
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Keywords: Primary Care, Implementation, Cardiovascular Conditions, Evidence-Based Practice, Healthcare Delivery, Practice Improvement, Quality Improvement, Quality of Care, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Prevention
Hoff T, Scott S
The strategic nature of individual change behavior: how physicians and their staff implement medical home care.
The purpose of this study was to gain insight into patient-centered medical home (PCMH) implementation at the workplace level by understanding better how primary care physicians and staff perceive, experience, and use certain types of PCMH work for adapting to new demands. The investigators indicated that the findings showed that particular forms of PCMH work not only advanced patient care in favorable ways but also enhanced individual and organizational capacity for adapting to this innovative model and its demands.
AHRQ-funded; HS020931.
Citation: Hoff T, Scott S .
The strategic nature of individual change behavior: how physicians and their staff implement medical home care.
Health Care Manage Rev 2017 Jul/Sep;42(3):226-36. doi: 10.1097/hmr.0000000000000109..
Keywords: Patient-Centered Healthcare, Primary Care, Organizational Change, Practice Improvement, Implementation
Quigley DD, Predmore ZS, Chen AY
Implementation and sequencing of practice transformation in urban practices with underserved patients.
Researchers conducted interviews at 14 primary care practices undergoing patient-centered medical home (PCMH) transformation in a large urban federally qualified health center in California and used grounded theory to identify common themes and patterns. They concluded that full PCMH transformation took time and effort and relied on a sequential approach, with an early focus on foundational changes that included use of a robust quality improvement strategy.
AHRQ-funded; HS000029.
Citation: Quigley DD, Predmore ZS, Chen AY .
Implementation and sequencing of practice transformation in urban practices with underserved patients.
Qual Manag Health Care 2017 Jan/Mar;26(1):7-14. doi: 10.1097/qmh.0000000000000118.
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Keywords: Patient-Centered Healthcare, Urban Health, Vulnerable Populations, Practice Improvement, Organizational Change, Quality Improvement, Quality of Care, Primary Care, Healthcare Delivery, Implementation, Teams
Fontaine P, Whitebird R, Solberg LI
Minnesota's early experience with medical home implementation: viewpoints from the front lines.
This study aimed to identify the facilitators and barriers encountered by nine diverse primary care practices selected from the first 80 to achieve patient-centered medical home (PCMH) certification in Minnesota. It found that facilitators to achieve PCMH certification included a requirement for patient involvement, which pushed practices to create patient-centered innovations, and new reimbursement models based on quality indicators for a population.
AHRQ-funded; HS019161.
Citation: Fontaine P, Whitebird R, Solberg LI .
Minnesota's early experience with medical home implementation: viewpoints from the front lines.
J Gen Intern Med 2015 Jul;30(7):899-906. doi: 10.1007/s11606-014-3136-y..
Keywords: Patient-Centered Healthcare, Primary Care, Implementation, Organizational Change, Healthcare Delivery, Practice Improvement, Health Services Research (HSR)