National Healthcare Quality and Disparities Report
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- Burnout (2)
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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 16 of 16 Research Studies DisplayedSklar M, Seijo C, Goldman RE
Beyond checkboxes: a qualitative assessment of physicians' experiences providing care in a patient-centred medical home.
The patient-centered medical home (PCMH) is an innovative approach to health care reform. Despite a well-established process for recognizing PCMH practices, fidelity to, and/or adaptation of, the PCMH model can limit health care and population health improvements. This study explored the connection between fidelity/adaptation to the PCMH model with implementation successes and challenges through the experiences of family and internal medicine PCMH physicians.
AHRQ-funded; HS024192.
Citation: Sklar M, Seijo C, Goldman RE .
Beyond checkboxes: a qualitative assessment of physicians' experiences providing care in a patient-centred medical home.
J Eval Clin Pract 2019 Dec;25(6):1142-51. doi: 10.1111/jep.13136..
Keywords: Patient-Centered Healthcare, Provider: Physician, Provider, Primary Care
Derrett S, Gunter KE, Samaranayaka A
Development and testing of the Provider and Staff Perceptions of Integrated Care (PSPIC) Survey.
The authors developed and tested a 21-item questionnaire titled Provider and Staff Perceptions of Integrated Care Survey. The questionnaire was sent to 2,936 providers and staff at 100 federally qualified health centers and other clinics in Midwestern U.S. States, of which 2,604 were deemed eligible. Four mailings were conducted with a 30% response rate from 97 health centers. Four latent factors were suggested: Teams and Care Continuity, Patient Centeredness, Coordination with External Providers, and Coordination with Community Resources.
AHRQ-funded; HS000084.
Citation: Derrett S, Gunter KE, Samaranayaka A .
Development and testing of the Provider and Staff Perceptions of Integrated Care (PSPIC) Survey.
Med Care Res Rev 2019 Dec;76(6):807-29. doi: 10.1177/1077558717745936..
Keywords: Provider, Care Coordination, Patient-Centered Healthcare, Teams
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
Sklar M, Hatch MR, Aarons GA
A climate for evidence-based practice implementation in the patient-centred medical home.
This paper discusses variations in climate for evidence-based practice (EBP) implementation in patient-centered medical homes (PCMHs) in the United States. The study compared two Rhode Island PCMHs, one a Family Care Center (FCC), and the other an Internal Medicine Clinic (IMC). The FCC staff had more positive attitudes towards EBP than IMC staff. They also reported greater educational support for EBPs than IMC staff and physicians. The importance of removing barriers to EBP implementation was emphasized.
AHRQ-funded; HS024192.
Citation: Sklar M, Hatch MR, Aarons GA .
A climate for evidence-based practice implementation in the patient-centred medical home.
J Eval Clin Pract 2019 Aug;25(4):637-47. doi: 10.1111/jep.13050..
Keywords: Evidence-Based Practice, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Primary Care, Provider
Nocon RS, Fairchild PC, Gao Y
Provider and staff morale, job satisfaction, and burnout over a 4-year medical home intervention.
This study examined the impact of adopting the patient-centered medical home (PCMH) on clinicians and staff at primary care practices. A longitudinal study was done comparing baseline (201) and post-intervention (2013-2014) survey results. Five-hundred thirty-six providers and staff at baseline and 589 were surveyed post-intervention. Almost half of all clinics reported improved better job morale, job satisfaction, and freedom from burnout. However, there were some clinics that saw a decrease in the percentage of providers reporting high job satisfaction and freedom from burnout. Control clinics were not used in this study, so it is impossible to know if results were similar in non-PCMH primary care practices.
AHRQ-funded; HS000084.
Citation: Nocon RS, Fairchild PC, Gao Y .
Provider and staff morale, job satisfaction, and burnout over a 4-year medical home intervention.
J Gen Intern Med 2019 Jun;34(6):952-59. doi: 10.1007/s11606-019-04893-z..
Keywords: Burnout, Patient-Centered Healthcare, Primary Care, Primary Care: Models of Care, Provider, Provider: Clinician, Stress
Monestime JP, Biener AI, Wolford M
AHRQ Author: Wolford M
Characteristics of office-based providers associated with secure electronic messaging use: achieving meaningful use.
The purpose of this study was to identify characteristics of office-based provider used as a usual source of care (USC) associated with secure electronic messaging (SM) use. The investigators concluded that patients were more likely to have visited a USC that exchanged SMs if that practice also used other electronic health records functionalities. The authors indicated that findings suggested that while patients' USC practices were likely to exchange secure messages, there is a disparity in SM use between physician-owned practices, and hospital-owned practices.
AHRQ-authored.
Citation: Monestime JP, Biener AI, Wolford M .
Characteristics of office-based providers associated with secure electronic messaging use: achieving meaningful use.
Int J Med Inform 2019 Apr 4;129:43-48. doi: 10.1016/j.ijmedinf.2019.04.002..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Medical Expenditure Panel Survey (MEPS), Patient-Centered Healthcare, Provider
McCreedy EM, Kane RL, Gollust SE
Patient-centered guidelines for geriatric diabetes care: potential missed opportunities to avoid harm.
Clinicians strive to deliver individualized, patient-centered care. However, these intentions are understudied. This research explored how patient characteristics associated with a high risk-to-benefit ratio with hypoglycemia medications affected decision making by primary care clinicians. The investigators found that primary care clinicians often chose to intensify glycemic control despite individual patient factors that warranted higher glycemic targets based on existing guidelines.
AHRQ-funded; HS000011.
Citation: McCreedy EM, Kane RL, Gollust SE .
Patient-centered guidelines for geriatric diabetes care: potential missed opportunities to avoid harm.
J Am Board Fam Med 2018 Mar-Apr;31(2):192-200. doi: 10.3122/jabfm.2018.02.170141..
Keywords: Diabetes, Elderly, Patient-Centered Healthcare, Guidelines, Evidence-Based Practice, Shared Decision Making, Medication, Primary Care, Practice Patterns, Provider: Physician, Provider: Clinician, Provider
Purnell TS, Marshall JK, Olorundare I
Provider perceptions of the organization's cultural competence climate and their skills and behaviors targeting patient-centered care for socially at-risk populations.
As part of a cultural competence needs assessment study at a large academic health care system, the study authors conducted a survey among 1,220 practicing physicians to assess their perceptions of the organization's cultural competence climate and their skills and behaviors targeting patient-centered care for culturally and socially diverse patients.
AHRQ-funded; HS024600.
Citation: Purnell TS, Marshall JK, Olorundare I .
Provider perceptions of the organization's cultural competence climate and their skills and behaviors targeting patient-centered care for socially at-risk populations.
J Health Care Poor Underserved 2018;29(1):481-96. doi: 10.1353/hpu.2018.0032..
Keywords: Cultural Competence, Patient-Centered Healthcare, Provider, Vulnerable Populations
Kim LY, Rose DE, Soban LM
Primary care tasks associated with provider burnout: findings from a Veterans Health Administration survey.
The purpose of this study was to investigate (1) the extent to which primary care providers (PCPs) share responsibility for 14 discrete primary care tasks with other team members, and (2) which, if any, of the primary care tasks performed by the PCPs (without reliance on team members) are associated with PCP burnout.
AHRQ-funded; HS000046.
Citation: Kim LY, Rose DE, Soban LM .
Primary care tasks associated with provider burnout: findings from a Veterans Health Administration survey.
J Gen Intern Med 2018 Jan;33(1):50-56. doi: 10.1007/s11606-017-4188-6..
Keywords: Healthcare Delivery, Health Services Research (HSR), Patient-Centered Healthcare, Primary Care, Provider, Workforce
Rhoten BA
Conceptual issues surrounding body image for oncology nurses.
This paper discusses conceptual issues surrounding cancer survivors’ body image. It targets oncology nurses so they may have a better understanding of the historic overview of body image conceptualization, as well as a more contemporary, cancer-specific approach to understanding how this population of patients may be particularly affected.
AHRQ-funded; HS022990.
Citation: Rhoten BA .
Conceptual issues surrounding body image for oncology nurses.
Oncol Nurs Forum 2017 Sep 1;44(5):534-36. doi: 10.1188/17.onf.534-536..
Keywords: Cancer, Patient-Centered Healthcare, Provider, Quality of Life
Harrison KL, Dzeng E, Ritchie CS
Addressing palliative care clinician burnout in organizations: a workforce necessity, an ethical imperative.
Clinician burnout reduces the capacity for providers and health systems to deliver timely, high quality, patient-centered care and increases the risk that clinicians will leave practice. Efforts to mitigate and prevent burnout currently focus on individual clinicians. However, analysis of the problem of burnout should be expanded to include both individual- and systems-level factors as well as solutions; comprehensive interventions must address both.
AHRQ-funded; HS023681.
Citation: Harrison KL, Dzeng E, Ritchie CS .
Addressing palliative care clinician burnout in organizations: a workforce necessity, an ethical imperative.
J Pain Symptom Manage 2017 Jun;53(6):1091-96. doi: 10.1016/j.jpainsymman.2017.01.007.
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Keywords: Burnout, Palliative Care, Patient-Centered Healthcare, Provider: Clinician, Provider: Physician, Provider
Frasso R, Golinkoff A, Klusaritz H
How nurse-led practices perceive implementation of the patient-centered medical home.
The purpose of this study was to investigate the implementation of a Patient-Centered Medical Home (PCMH) model in nurse-led primary care practices and to identify facilitators and barriers to the implementation of this model. The investigators indicate that their data suggest two categories of processes that facilitate the integration of PCMH in the nurse-led practice setting: patient-oriented facilitators and organizational facilitators.
AHRQ-funded; HS019150.
Citation: Frasso R, Golinkoff A, Klusaritz H .
How nurse-led practices perceive implementation of the patient-centered medical home.
Appl Nurs Res 2017 Apr;34:34-39. doi: 10.1016/j.apnr.2017.02.005.
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Keywords: Patient-Centered Healthcare, Primary Care, Primary Care: Models of Care, Provider, Provider: Nurse, Quality of Care
Gernant SA, Snyder ME, Jaynes H
The effectiveness of pharmacist-provided telephonic medication therapy management on emergency department utilization in home health patients.
This article's objective is to evaluate the effectiveness of a telephonic medication therapy management (MTM) service on reducing emergency department utilization within a Medicare-insured home health population. The authors found that this pharmacist-delivered telephonic medication therapy management program did not decrease emergency department utilization overall but may further reduce the such risk among patients who are at lower risk of utilization.
AHRQ-funded; HS022119.
Citation: Gernant SA, Snyder ME, Jaynes H .
The effectiveness of pharmacist-provided telephonic medication therapy management on emergency department utilization in home health patients.
J Pharm Technol 2016 Oct 1;32(5):179-84. doi: 10.1177/8755122516660376.
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Keywords: Care Management, Emergency Department, Medication, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Prevention, Provider: Pharmacist, Provider
Tucker CM, Wall WA, Wippold G
Development of an inventory for health-care office staff to self-assess their patient-centered cultural sensitivity.
The researchers sought to determine the psychometric properties of the Tucker-Culturally Sensitive Health Care Office Staff Inventory-Self-Assessment Form (T-CSHCOSI-SAF). They found that this inventory has 2 factors with high internal consistency reliability. They concluded that the T-CSHCOSI-SAF is a useful inventory for health-care office staff to assess their own level of patient-centered cultural sensitivity and that it can be used in the development and implementation of trainings to promote patient-centered cultural sensitivity of health-care office staff.
AHRQ-funded; HS013151; HS010726.
Citation: Tucker CM, Wall WA, Wippold G .
Development of an inventory for health-care office staff to self-assess their patient-centered cultural sensitivity.
Health Serv Res Manag Epidemiol 2016 Apr 27;3. doi: 10.1177/2333392816629600.
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Keywords: Healthcare Delivery, Cultural Competence, Patient-Centered Healthcare, Primary Care, Provider
O'Toole JK, West DC, Starmer AJ
Placing faculty development front and center in a multisite educational initiative: lessons from the I-PASS Handoff study.
The authors describe their experience developing a multi-institutional faculty development program to support the I-PASS (IIPE-PRIS Accelerating Safe Signouts) Study and offer a set of generalizable strategies to guide the creation of other large-scale, multi-institutional faculty development programs. They conclude that the lessons learned inform a set of key strategies that can be applied to a broad range of similar large-scale faculty development projects in the future.
AHRQ-funded; HS019456.
Citation: O'Toole JK, West DC, Starmer AJ .
Placing faculty development front and center in a multisite educational initiative: lessons from the I-PASS Handoff study.
Acad Pediatr 2014 May-Jun;14(3):221-4. doi: 10.1016/j.acap.2014.02.013.
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Keywords: Education: Curriculum, Provider, Patient-Centered Healthcare, Transitions of Care
Bleser WK, Miller-Day M, Naughton D
Strategies for achieving whole-practice engagement and buy-in to the patient-centered medical home.
In this paper the authors describe strategies for obtaining organizational buy-in to and whole-staff engagement of patient-centered medical home (PCMH) transformation and practice improvement. The investigators suggest that their study provides a list of strategies useful for facilitating PCMH transformation in primary care. They assert that these strategies could be investigated empirically in future research, used to guide medical practices undergoing or considering PCMH transformation, and used to inform health care policy makers.
AHRQ-funded; HS019150.
Citation: Bleser WK, Miller-Day M, Naughton D .
Strategies for achieving whole-practice engagement and buy-in to the patient-centered medical home.
Ann Fam Med 2014 Jan-Feb;12(1):37-45. doi: 10.1370/afm.1564..
Keywords: Patient-Centered Healthcare, Organizational Change, Primary Care: Models of Care, Primary Care, Practice Improvement, Provider: Nurse, Provider: Physician, Provider: Clinician, Provider