National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
Data
- Data Infographics
- Data Visualizations
- Data Tools
- Data Innovations
- All-Payer Claims Database
- Healthcare Cost and Utilization Project (HCUP)
- Medical Expenditure Panel Survey (MEPS)
- AHRQ Quality Indicator Tools for Data Analytics
- State Snapshots
- United States Health Information Knowledgebase (USHIK)
- Data Sources Available from AHRQ
Search All Research Studies
AHRQ Research Studies Date
Topics
- Cancer: Colorectal Cancer (1)
- Care Management (1)
- Children/Adolescents (1)
- Comparative Effectiveness (1)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (1)
- Diabetes (1)
- Diagnostic Safety and Quality (1)
- Electronic Health Records (EHRs) (4)
- Healthcare Delivery (5)
- Health Information Technology (HIT) (5)
- Health Services Research (HSR) (1)
- Long-Term Care (2)
- Medical Errors (1)
- Nursing Homes (3)
- Organizational Change (3)
- Outcomes (2)
- Patient-Centered Healthcare (3)
- Patient-Centered Outcomes Research (1)
- Patient Experience (1)
- Payment (1)
- Practice Patterns (1)
- Pressure Ulcers (1)
- Prevention (1)
- Primary Care (4)
- Primary Care: Models of Care (2)
- Provider Performance (1)
- (-) Quality Improvement (14)
- Quality Measures (2)
- Quality of Care (6)
- Registries (1)
- Teams (1)
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 14 of 14 Research Studies DisplayedZurovac J, Moreno L, Crosson J
Using multifactorial experiments for comparative effectiveness research in physician practices with electronic health record.
This paper identifies the opportunities for using efficient multifactorial designs and electronic health records (EHR) data to evaluate quality-improvement efforts in physician practices. It concludes that the use of efficient multifactor experimental designs, especially coupled with EHR data, has great promise for helping physician practices, hospitals, and other stakeholders conduct rapid-cycle comparative effectiveness research in order to assess alternative ways of implementing various aspects of care.
AHRQ-funded; HS022789.
Citation: Zurovac J, Moreno L, Crosson J .
Using multifactorial experiments for comparative effectiveness research in physician practices with electronic health record.
eGEMS 2013 Dec 30;1(3):1037. doi: 10.13063/2327-9214.1037..
Keywords: Patient-Centered Outcomes Research, Electronic Health Records (EHRs), Health Information Technology (HIT), Quality Improvement, Comparative Effectiveness
Taliani CA, Bricker PL, Adelman AM
Implementing effective care management in the patient-centered medical home.
The investigators explored how a disparate group of patient-centered medical homes (PCMHs) embedded care management in their team care environment to identify best practices. They concluded that PCMHs may want to ensure that care managers are available to meet with patients during visits, support patient self-management, fully leverage the electronic medical record for team messaging and patient tracking, and ensure integration into the care team with office huddles and ongoing communication.
AHRQ-funded; HS019150.
Citation: Taliani CA, Bricker PL, Adelman AM .
Implementing effective care management in the patient-centered medical home.
Am J Manag Care 2013 Dec;19(12):957-64.
.
.
Keywords: Care Management, Diabetes, Healthcare Delivery, Patient-Centered Healthcare, Quality Improvement, Teams
Mukamel DB, Harrington C
Resident satisfaction surveys and clinical quality of care in nursing homes: two sides of the same coin?
The authors of this article believe that quality of nursing homes is a complex, multidimensional construct. Unlike acute care hospitals, where patients are typically treated for one specific condition and stay for a short period of time, the length of stays in nursing homes varies widely. They argue that neither the individual assessment of clinical quality nor evaluation of hotel services are sufficient.
AHRQ-funded; HS021844.
Citation: Mukamel DB, Harrington C .
Resident satisfaction surveys and clinical quality of care in nursing homes: two sides of the same coin?
Aging Health 2013 Dec;9(6):607-9. doi: 10.2217/ahe.13.63..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Long-Term Care, Nursing Homes, Patient Experience, Quality of Care, Quality Improvement, Quality Measures
Begum R, Smith Ryan M, Winther CH
Small practices' experience with EHR, quality measurement, and incentives.
The researchers surveyed clinicians participating in Health eHearts, a cluster-randomized trial of the effect of a financial incentive and quality improvement (QI) assistance program on measures of cardiovascular care compared with the effect of providing quality reports and QI assistance. No differences were detected between groups regarding agreement with selected clinical measures or their relevance to the patient population.
AHRQ-funded; HS019164; HS018275.
Citation: Begum R, Smith Ryan M, Winther CH .
Small practices' experience with EHR, quality measurement, and incentives.
Am J Manag Care 2013 Nov;19(10 Spec No):eSP12-8..
Keywords: Health Information Technology (HIT), Electronic Health Records (EHRs), Quality Improvement, Primary Care, Practice Patterns
Henriksen K, Brady J
AHRQ Author: Henriksen K, Brady J
The pursuit of better diagnostic performance: a human factors perspective.
Improving diagnostic performance is increasingly recognised as a multifaceted challenge. This paper addresses a few of these challenges, including questions that focus on who owns the problem, treating cognitive and system shortcomings as separate issues, why knowledge in the head is not enough, and what we are learning from health information technology and the use of checklists. The authors propose a systems engineering approach making use of rapid-cycle prototyping and simulation, and they call for the formation of substantive partnerships with those in disciplines beyond the clinical domain.
AHRQ-authored.
Citation: Henriksen K, Brady J .
The pursuit of better diagnostic performance: a human factors perspective.
BMJ Qual Saf 2013 Oct;22 Suppl 2:ii1-ii5. doi: 10.1136/bmjqs-2013-001827.
.
.
Keywords: Diagnostic Safety and Quality, Health Information Technology (HIT), Medical Errors, Health Information Technology (HIT), Quality Improvement
Clancy CM
AHRQ Author: Clancy CM
Children's electronic health records: has the tipping point arrived?
This article describes an electronic health record (EHR) format developed by AHRQ and CMS in consultation with experts from the American Academy of Pediatrics and the American Academy of Family Physicians. Organized around 22 topic areas, this format includes information about needed functionality, best practices, and applicable data standards that can be used as a starting point for EHR developers.
AHRQ-authored.
Citation: Clancy CM .
Children's electronic health records: has the tipping point arrived?
J Comp Eff Res 2013 Jul;2(4):359-61. doi: 10.2217/cer.13.44.
.
.
Keywords: Children/Adolescents, Electronic Health Records (EHRs), Children/Adolescents, Quality Improvement
Werner RM, Konetzka RT, Kim MM
Quality improvement under nursing home compare: the association between changes in process and outcome measures.
The researchers tested the extent to which improvements in outcomes of care are explained by changes in nursing home processes. Of the 5 outcome measures examined, they found that only improvements in the percentage of nursing home residents in moderate or severe pain were associated with changes in nursing home processes of care. They concluded that understanding the mechanism behind improvements in nursing home outcomes may be key to successfully achieving broad quality improvements across nursing homes.
AHRQ-funded; HS021861.
Citation: Werner RM, Konetzka RT, Kim MM .
Quality improvement under nursing home compare: the association between changes in process and outcome measures.
Med Care 2013 Jul;51(7):582-8. doi: 10.1097/MLR.0b013e31828dbae4.
.
.
Keywords: Nursing Homes, Long-Term Care, Quality Improvement, Quality Measures, Quality of Care, Provider Performance, Outcomes
DeVoe JE, Stenger R
Aligning provider incentives to improve primary healthcare delivery in the United States.
This critical review uses a theoretical framework from game-theory models to discuss some of the dominant primary care provider payment models and how they create 'prisoner's dilemmas' that have stalled past reform efforts, then illustrates an escape from the dilemma. It concludes that a blend of guaranteed payment and selective incentives designed to encourage primary care providers to deliver high quality care, efficient and equitable care and to eliminate incentives towards over-servicing could reach outcomes leading to shared benefits for everyone involved.
AHRQ-funded; HS014645; HS016181.
Citation: DeVoe JE, Stenger R .
Aligning provider incentives to improve primary healthcare delivery in the United States.
OA Fam Med 2013 Jun 1;1(1):7.
.
.
Keywords: Healthcare Delivery, Payment, Primary Care, Quality Improvement
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.
.
.
Keywords: Patient-Centered Healthcare, Primary Care: Models of Care, Primary Care, Healthcare Delivery, Organizational Change, Quality Improvement, Quality of Care
Merkow RP, Kmiecik TE, Bentrem DJ
Effect of including cancer-specific variables on models examining short-term outcomes.
The objectives of this paper were 1) to examine differences between existing American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) variables and cancer registry variables, and 2) to determine whether the addition of cancer-specific variables improves modeling of short-term outcomes. The researchers found that, although advanced disease stage and neoadjuvant therapy variables were predictors of short-term outcomes, their inclusion did not improve the models.
AHRQ-funded; HS021857.
Citation: Merkow RP, Kmiecik TE, Bentrem DJ .
Effect of including cancer-specific variables on models examining short-term outcomes.
Cancer 2013 Apr 1;119(7):1412-9. doi: 10.1002/cncr.27891.
.
.
Keywords: Cancer: Colorectal Cancer, Outcomes, Quality Improvement, Registries
Kleinman LC, Dougherty D
AHRQ Author: Dougherty D
Assessing quality improvement in health care: theory for practice.
The authors reviewed the role of theory as a means to enhance the practice of quality improvement (QI) research and to propose a novel conceptual model focused on the operations of health care. They concluded that such a theory can promote opportunities for moving the field forward and organizing the planning and interpretation of comparable studies.
AHRQ-authored.
Citation: Kleinman LC, Dougherty D .
Assessing quality improvement in health care: theory for practice.
Pediatrics 2013 Mar;131 Suppl 1:S110-9. doi: 10.1542/peds.2012-1427n.
.
.
Keywords: Quality Improvement, Healthcare Delivery, Organizational Change, Quality of Care, Health Services Research (HSR)
Sharkey S, Hudak S, Horn SD
AHRQ Author: Spector W
Exploratory study of nursing home factors associated with successful implementation of clinical decision support tools for pressure ulcer prevention.
The researchers determined those factors that are associated with nursing homes' success in implementing the On-Time quality improvement (QI) for pressure ulcer prevention program and integrating health information technology (HIT) tools into practice at the unit level. They found that after at least 9 months of implementation effort, 36% of the nursing homes achieved level III of the On-Time QI-HIT program. They concluded that the learning from On-Time QI offers several lessons associated with facility factors that contribute to high level of implementation of a QI-HIT program in a nursing home.
AHRQ-authored; AHRQ-funded; 29020050020.
Citation: Sharkey S, Hudak S, Horn SD .
Exploratory study of nursing home factors associated with successful implementation of clinical decision support tools for pressure ulcer prevention.
Adv Skin Wound Care 2013 Feb;26(2):83-92; quiz p.93-4. doi: 10.1097/01.ASW.0000426718.59326.bb.
.
.
Keywords: Health Information Technology (HIT), Nursing Homes, Pressure Ulcers, Prevention, Quality Improvement
Dixon BE, Rosenman M, Xia Y
A vision for the systematic monitoring and improvement of the quality of electronic health data.
In order to more systematically define, characterize and improve electronic health data quality, the authors propose a novel framework for health data stewardship. Their framework is adapted from prior data quality research outside of health, but it has been reshaped to apply a systems approach to data quality with an emphasis on health outcomes.
AHRQ-funded; HS020909.
Citation: Dixon BE, Rosenman M, Xia Y .
A vision for the systematic monitoring and improvement of the quality of electronic health data.
Stud Health Technol Inform 2013;192:884-8..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), 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.
.
.
Keywords: Patient-Centered Healthcare, Primary Care: Models of Care, Primary Care, Healthcare Delivery, Organizational Change, Quality Improvement, Quality of Care