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��ƵResearch Studies

Research Studies is a compilation of published research articles funded by ��Ƶor authored by ��Ƶresearchers.

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1 to 25 of 96 Research Studies Displayed

Childs E, Swan H, Evans L

��ƵAuthor: Perfetto D, Hogan E

A toolkit to implement opioid quality improvement efforts in primary care: findings from a mixed-methods study.

This study evaluated the How-to-Implement Toolkit for the Six Building Blocks program, which aims to improve opioid management for chronic pain in primary care settings. Eight healthcare organizations with 62 clinics participated in the evaluation. Through interviews and surveys with clinical staff, researchers found that while organizations valued the Toolkit's resources, they preferred having practice facilitator support during implementation. Participants reported using specific tools rather than the entire Toolkit. The findings emphasize the importance of implementation support for opioid quality improvement initiatives in primary care settings. The Toolkit and related resources are available through the ��Ƶ.

AHRQ-authored.

Citation: Childs E, Swan H, Evans L . A toolkit to implement opioid quality improvement efforts in primary care: findings from a mixed-methods study. J Opioid Manag 2025 Jan-Feb; 21(1):29-40. doi: 10.5055/jom.0894..

Keywords: Quality Improvement, Primary Care, Opioids, Medication, Quality of Care, Implementation

Jortberg BT, Dickinson LM, Fernald DH

Improving care for unhealthy alcohol use: results from the Facilitating Alcohol Screening and Treatment (FAST) Colorado Study.

Researchers investigated the effectiveness of virtual practice facilitation of screening, brief intervention, medication-assisted treatment (MAT), or referral for treatment (SBI/RT + MAT) for unhealthy alcohol use and examined the potential added benefits of alcohol use eLearning modules in primary care practices in Colorado. The results provided initial evidence for the successful use of virtual practice facilitation.

AHRQ-funded; HS027079.

Citation: Jortberg BT, Dickinson LM, Fernald DH . Improving care for unhealthy alcohol use: results from the Facilitating Alcohol Screening and Treatment (FAST) Colorado Study. J Am Board Fam Med 2024 Nov-Dec; 37(6):1027-37. doi: 10.3122/jabfm.2024.240048R1..

Keywords: Alcohol Use, Substance Abuse, Screening, Behavioral Health, Primary Care, Quality Improvement, Quality of Care

Cole AM, Keppel GA, Baldwin LM

Implementation strategies used by facilitators to improve control of cardiovascular risk factors in primary care.

This cross-sectional analysis of data was conducted to identify implementation strategies that practice facilitators used and the frequency of use in the Healthy Hearts Northwest (H2N) study to improve the quality of cardiovascular care in primary care. Researchers coded H2N study field notes for a purposeful sample of practices to identify Expert Recommendations for Implementation Change (ERIC) strategies used with each practice. They identified 26 strategies used by facilitators; five strategies were foundational. The researchers concluded that commonly used strategies can help to guide development of core components of practice facilitation strategies.

AHRQ-funded; HS023908.

Citation: Cole AM, Keppel GA, Baldwin LM . Implementation strategies used by facilitators to improve control of cardiovascular risk factors in primary care. J Am Board Fam Med 2024 Aug; 37(3):444-54. doi: 10.3122/jabfm.2023.230312R1..

Keywords: Cardiovascular Conditions, Risk, Primary Care, Quality Improvement, Quality of Care

Quigley DD, Slaughter ME, Qureshi N

Associations of primary care provider burnout with quality improvement, patient experience measurement, clinic culture, and job satisfaction.

This study examined the association between provider burnout and perspectives on quality improvement (QI), patient experience, clinic culture, and job satisfaction among providers at Federally Qualified Health Centers (FQHCs). A cross-sectional survey of 74 providers revealed that 30% reported burnout. Key findings indicated that supportive leadership and lower patient care pressures were linked to reduced burnout. The study suggests fostering provider-team relationships and QI discussions may mitigate burnout, highlighting the need for further research on effective leadership strategies.

AHRQ-funded; HS025920; HS029321.

Citation: Quigley DD, Slaughter ME, Qureshi N . Associations of primary care provider burnout with quality improvement, patient experience measurement, clinic culture, and job satisfaction. J Gen Intern Med 2024 Jul; 39(9):1567-74. doi: 10.1007/s11606-024-08633-w..

Keywords: Primary Care, Burnout, Quality Improvement, Patient Experience, Quality of Care, Provider: Clinician

Meyers D, Miller T, De La Mare J

��ƵAuthor: Meyers D, Miller T, De La Mare J, Makulowich G, Zhan C

What ��Ƶlearned while working to transform primary care.

The authors summarized the effects and lessons learned from AHRQ’s 3-year EvidenceNOW: Advancing Heart Health initiative. Results from an independent national evaluation demonstrated that the EvidenceNOW model successfully boosted capacity of primary care practices to improve quality of care. EvidenceNOW also showed that lasting practice transformation efforts need to be responsive to anticipated and unanticipated changes, relationship-oriented, and not tied to specific diseases or initiatives. The authors concluded that these results argue for a national primary care extension service that provides ongoing support for practice transformation.

AHRQ-authored; AHRQ-funded; 233201500013I.

Citation: Meyers D, Miller T, De La Mare J . What ��Ƶlearned while working to transform primary care. Ann Fam Med 2024 Mar-Apr; 22(2):161-66. doi: 10.1370/afm.3090..

Keywords: Primary Care, Evidence-Based Practice, Practice Improvement, Quality Improvement, Quality of Care

Goldberg DG, Owens-Jasey C, Haghighat S

Implementation strategies for large scale quality improvement initiatives in primary care settings: a qualitative assessment.

This study focused on gaining a comprehensive understanding of perspectives from research participants and research team members on the value of implementation strategies and factors that influenced the AHRQ-funded EvidenceNOW initiative in Virginia. The goal of EvidenceNOW’s Advancing Heart Health in Primary Care initiative is to assist primary care practices in the US in implementing evidence-based practices in cardiovascular care and building capacity for quality improvement. In 2018, the authors conducted 25 focus groups with clinicians and staff at participating practices, including 80 physicians, advanced practice clinicians, practice managers, and other practice staff. They also conducted face-to-face and telephone interviews with 22 research team members, including lead investigators, practice facilitators, physician expert consultants, and evaluators. They used the integrated-Promoting Action on Research Implementation in the Health Services (i-PARIHS) framework in their qualitative data analysis and organization of themes. Implementation strategies that were valued by both practice representatives and research team members included the kick-off event, on-site practice facilitation, and interaction with physician expert consults. Day-to-day activities often overwhelmed clinicians and staff, which hindered their ability to fully participate in the EvidenceNOW initiative.

AHRQ-funded; HS023913.

Citation: Goldberg DG, Owens-Jasey C, Haghighat S . Implementation strategies for large scale quality improvement initiatives in primary care settings: a qualitative assessment. BMC Prim Care 2023 Nov 17; 24(1):242. doi: 10.1186/s12875-023-02200-8..

Keywords: Quality Improvement, Primary Care, Quality of Care, Implementation

Levine AR, Valdez RB, Brooks-LaSure C

��ƵAuthor: Valdez RB

The U.S. Department of Health and Human Services is taking action to strengthen primary care.

This article outlines the U.S. Department of Health and Human Services' (HHS) efforts to strengthen primary care in the United States. The authors emphasize the critical role of effective primary care in improving health outcomes, reducing disparities, and advancing health equity. They highlight the challenges facing primary care, including limited access, workforce shortages, and inadequate research funding. The article describes HHS's adoption of a comprehensive definition of high-quality primary care and outlines a coordinated set of actions to address current challenges. These actions aim to improve equitable access to whole-person care, foster trusted patient-clinician relationships, increase workforce diversity, and enhance cross-sector partnerships. The article introduces HHS's plans for a Primary Care Dashboard to monitor the health of the nation's primary care system and the impact of their interventions. The authors reaffirm the importance of a robust primary care foundation for improving population health and advancing health equity. They call for collective action among stakeholders across various sectors to ensure accessible, comprehensive, and culturally competent primary care throughout the country.

AHRQ-authored.

Citation: Levine AR, Valdez RB, Brooks-LaSure C . The U.S. Department of Health and Human Services is taking action to strengthen primary care. NAM Perspect 2023 Nov 7; 2023. doi: 10.31478/202311b..

Keywords: Primary Care, Quality Improvement, Quality of Care

McHugh M, Heinrich J, Philbin S

Declining participation in primary care quality improvement research: a qualitative study.

This qualitative study’s aim was to identify factors leading primary care practices to decline participation in quality initiative (QI) projects, and strategies to improve the feasibility and attractiveness of QI projects in the future. The authors contacted 109 representatives of practices that had declined participation in 1 of 4 AHRQ-funded EvidenceNOW projects. The representatives were invited to either participate in a 15-minute interview or complete a 5-question questionnaire. Representatives from 31 practices responded. Reasons for declining included staff turnover, staffing shortages, and general time constraints, exacerbated by the pandemic, preventing participation in the QI projects. Secondary reasons included challenges with electronic health records, an expectation of greater financial compensation for participation, and confidence in the practices' current care practices. Tying participation to value-based programs and offering greater compensation were identified as strategies to facilitate recruitment. However, none of the respondents’ recommendations addressed the primary issues of staffing challenges and time constraints.

AHRQ-funded; HS027954.

Citation: McHugh M, Heinrich J, Philbin S . Declining participation in primary care quality improvement research: a qualitative study. Ann Fam Med 2023 Sep-Oct; 21(5):388-94. doi: 10.1370/afm.3007..

Keywords: Quality Improvement, Primary Care, Quality of Care, Practice Improvement, Organizational Change, Evidence-Based Practice

Lindner SR, Balasubramanian B, Marino M

Estimating the cardiovascular disease risk reduction of a quality improvement initiative in primary care: findings from EvidenceNOW.

The purpose of this study was to estimate decreases in 10-year atherosclerotic cardiovascular disease (ASCVD) risk associated with EvidenceNOW, an initiative spanning multiple states that sought to improve cardiovascular preventive care by providing supportive interventions such as practice facilitation to address the “ABCS”: (A)spirin for high-risk patients, (B)lood pressure control for hypertensive people, (C)holesterol management, and (S)moking screening and cessation counseling. The researchers conducted an analytic modeling study that combined 1) data from 1,278 EvidenceNOW practices collected from 2015 to 2017; (2) patient-level information of 1,295 individuals who participated in the 2015 to 2016 National Health and Nutrition Examination Survey; and (3) 10-year ASCVD risk prediction equations. The study found the average 10-year ASCVD risk of these patients before intervention was 10.11%. Improvements in ABCS due to EvidenceNOW reduced their 10-year ASCVD risk to 10.03% which would prevent 3,169 ASCVD events over 10 years and $150 million in 90-day direct medical costs.

AHRQ-funded; HS023940.

Citation: Lindner SR, Balasubramanian B, Marino M . Estimating the cardiovascular disease risk reduction of a quality improvement initiative in primary care: findings from EvidenceNOW. J Am Board Fam Med 2023 May 8; 36(3):462-76. doi: 10.3122/jabfm.2022.220331R1..

Keywords: Cardiovascular Conditions, Primary Care, Evidence-Based Practice, Patient-Centered Outcomes Research, Quality Improvement, Quality of Care, Blood Pressure

McHugh M, Philbin S, Carroll AJ

An approach to evaluating multisector partnerships to support evidence-based quality improvement in primary care.

This study’s goal was to describe an approach for evaluating the development and effectiveness of a multisector partnership using data from the first year of the Healthy Hearts for Michigan (HH4M) Cooperative, a multisector partnership of nine organizations tasked with designing and implementing evidence-based QI strategies for hypertension management and tobacco cessation in 50 rural primary care practices. A 49-item survey focused on factors that facilitate or hinder multisector partnerships, drawing on implementation science and partnership, engagement, and collaboration research was developed. All 44 members of the HH4M Cooperative (79.5% response rate) were surveyed, interviews conducted with 14 members. Having a clear purpose and trust and respect among members were the strengths reported. A need for common terminology, clarification of roles and functions, and improvement in communication across workgroups were areas for improvement. The Cooperative’s biggest challenge was the lack of engagement from physician practices due to capacity constraints, exacerbated by the COVID-19 pandemic.

AHRQ-funded; HS027954.

Citation: McHugh M, Philbin S, Carroll AJ . An approach to evaluating multisector partnerships to support evidence-based quality improvement in primary care. Jt Comm J Qual Patient Saf 2023 Apr;49(4):199-206. doi: 10.1016/j.jcjq.2023.01.002.

Keywords: Quality Improvement, Evidence-Based Practice, Primary Care, Quality of Care, Patient-Centered Outcomes Research

Quigley DD, Quereshi N, Hays RD

Reasons primary care practices chose patient experience surveys during patient-centered medical home transformation.

This study’s objective was to identify reasons primary care practices chose to implement a patient experience survey during their patient-centered medical home transformation. The authors conducted interviews with a stratified-random sample of 105 of these practices. Fifty-one practices used a Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey and 53 administered another patient survey. The three most common reasons to use a survey were given as: (1) to compare performance against other practices, which requires systematically collected data across large numbers of practices (ie, the Consumer Assessment of Healthcare Providers and Systems survey), (2) participation in an external patient-centered medical home program, and (3) survey administration cost. A second patient survey was used to identify quality improvement needs.

AHRQ-funded; HS016980; HS025920.

Citation: Quigley DD, Quereshi N, Hays RD . Reasons primary care practices chose patient experience surveys during patient-centered medical home transformation. J Ambul Care Manage 2023 Jan-Mar;46(1):34-44. doi: 10.1097/jac.0000000000000442.

Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient-Centered Healthcare, Primary Care, Quality Improvement, Practice Improvement

Cohen DJ, Balasubramanian BA, Lindner S

How does prior experience pay off in large-scale quality improvement initiatives?

This study’s goal was to examine the association of prior investment on the effectiveness of organizations delivering large-scale external support to improve primary care. A mixed-methods study was conducted with 7 EvidenceNOW grantees and their recruited primary practices (n = 1720). Data was analyzed on the grantees’ implementation of helping primary care practice improve (1) clinical quality, measured as practices' performance on Aspirin, Blood Pressure, Cholesterol, and Smoking (ABCS); and (2) practice capacity, measured using the Adaptive Reserve (AR) score and Change Process Capacity Questionnaire (CPCQ). Grantees with higher levels of prior experience with and investment in large-scale QI before EvidenceNOW recruited more geographically dispersed and diverse practices. They also had lower baseline ABCS performance (differences ranging from 2.8% for blood pressure to 41.5% for smoking), delivered more facilitation (mean=+20.3 hours), and made greater improvements in practices' QI capacity (CPCQ: +2.04) and smoking performance (+6.43%) than grantees with less experience. Having established networks of facilitators at the start of EvidenceNOW and leadership experienced in supporting this workforce explained their better recruitment, delivery of facilitation, and improvement in outcomes.

AHRQ-funded; HS023940.

Citation: Cohen DJ, Balasubramanian BA, Lindner S . How does prior experience pay off in large-scale quality improvement initiatives? J Am Board Fam Med 2022 Dec; 35(6):1115-27. doi: 10.3122/jabfm.2022.AP.220088..

Keywords: Quality Improvement, Primary Care, Quality of Care

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 ��Ƶ'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

Sweeney SM, Baron A, Hall JD

Effective facilitator strategies for supporting primary care practice change: a mixed methods study.

Investigators conducted a pragmatic qualitative study with patients who had participated in a health-related social needs (HRSN) intervention. They found that patients were likely to have initial skepticism or reservations about the intervention; they identified 4 positive intervention components regarding patient experience; and they found that patients could be left with feelings of appreciation or hope, regardless of whether they connected with HRSN resources.

AHRQ-funded; HS023940.

Citation: Sweeney SM, Baron A, Hall JD . Effective facilitator strategies for supporting primary care practice change: a mixed methods study. Ann Fam Med 2022 Sep-Oct;20(5):414-22. doi: 10.1370/afm.2847..

Keywords: Primary Care, Practice Improvement, Quality Improvement, Quality of Care

Perry CK, Linder S, Hall J

How type of practice ownership affects participation with quality improvement external facilitation: findings from EvidenceNOW.

This study examined how practice ownership influences participation in external facilitation using data from EvidenceNOW. The authors collected data from practices on practice characteristics and ownership type via surveys and from facilitators on the number of hours, encounters, and months each practice had with a facilitator via facilitation logs. Semi-structured interviewers with EvidenceNOW leadership (n = 12) and facilitators (n = 51) were conducted, and facilitators (n = 64) were observed for patterns of facilitation. In the fully adjusted model, differences by ownership were non-significant. Federally Qualified Health Centers (FQHCs) however, had significantly less participation in facilitation than clinician-owned practices for the measures number of encounters and number of months with encounters.

AHRQ-funded; HS023940.

Citation: Perry CK, Linder S, Hall J . How type of practice ownership affects participation with quality improvement external facilitation: findings from EvidenceNOW. J Gen Intern Med 2022 Mar;37(4):793-801. doi: 10.1007/s11606-021-07204-7..

Keywords: Quality Improvement, Quality of Care, Primary Care, Practice Improvement

Hysong Hysong, Arredondo K, Hughes AM

An evidence-based, structured, expert approach to selecting essential indicators of primary care quality.

The purpose of this article was to illustrate the application of an evidence-based, structured performance measurement methodology to identify, prioritize, and generate new measures of health care quality, using primary care as a case example. Subject matter experts identified three fundamental objectives: access, patient-health care team partnerships, and technical quality. The authors indicated that their article provides an actionable guide to applying their Productivity Measurement and Enhancement System, which can be adapted to the needs of various industries, including measure selection and modification from existing data sources, and proposing new measures.

Citation: Hysong Hysong, Arredondo K, Hughes AM . An evidence-based, structured, expert approach to selecting essential indicators of primary care quality. PLoS One 2022 Jan 18;17(1):e0261263. doi: 10.1371/journal.pone.0261263..

Keywords: Primary Care, Evidence-Based Practice, Quality Improvement, Quality Indicators (QIs), Quality Measures, Quality of Care

Hemler JR, Edwards ST, Valenzuela S

The effects of major disruptions on practice participation in facilitation during a primary care quality improvement initiative.

This study explored the relationship between disruptions in primary care practices and practice participation in facilitated quality improvement (QI). Using data from EvidenceNOW, findings showed that disruptions are prevalent in primary care, but practices can continue participating in QI interventions, particularly when supported by a facilitator.

AHRQ-funded; HS023940.

Citation: Hemler JR, Edwards ST, Valenzuela S . The effects of major disruptions on practice participation in facilitation during a primary care quality improvement initiative. J Am Board Fam Med 2022 Jan-Feb;35(1):124-39. doi: 10.3122/jabfm.2022.01.210205..

Keywords: Primary Care, Practice Improvement, Quality Improvement, Quality of Care, Workforce

Quigley DD, Elliott MN, Slaughter ME

Shadow coaching improves patient experience with care, but gains erode later.

Health care organizations strive to improve patient care experiences. Some use one-on-one provider counseling (shadow coaching) to identify and target modifiable provider behaviors. In this study, the investigators examined whether shadow coaching improved patient experience across 44 primary care practices in a large urban Federally Qualified Health Center. The investigators concluded that shadow coaching improved providers' overall performance and communication immediately after being coached.

AHRQ-funded; HS025920.

Citation: Quigley DD, Elliott MN, Slaughter ME . Shadow coaching improves patient experience with care, but gains erode later. Med Care 2021 Nov;59(11):950-60. doi: 10.1097/mlr.0000000000001629..

Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient Experience, Provider Performance, Quality Improvement, Quality of Care, Primary Care

Ye J, Zhang R, Bannon JE

Identifying practice facilitation delays and barriers in primary care quality improvement.

Practice facilitation is an effective approach to implementing quality improvement (QI) interventions in practice-based research networks (PBRNs). Regular facilitator-practice interactions are necessary for successful facilitation and missed engagements may hinder the process of practice improvement. This study employed a mixed-methods approach to characterize the dynamics of practice facilitation and examine facilitation delays and barriers, as well as their association with the achievement of QI program goals in a PBRN initiative.

AHRQ-funded; HS023921.

Citation: Ye J, Zhang R, Bannon JE . Identifying practice facilitation delays and barriers in primary care quality improvement. J Am Board Fam Med 2020 Sep-Oct;33(5):655-64. doi: 10.3122/jabfm.2020.05.200058..

Keywords: Practice Improvement, Primary Care, Quality Improvement, Quality of Care

Quigley DD, Slaughter M, Qureshi N

Practices and changes associated with patient-centered medical home transformation.

Knowing which patient-centered medical home (PCMH) care delivery changes and quality improvement (QI) practices further PCMH implementation is essential. In this study, the investigators used the 2008-2017 National Committee of Quality Assurance (NCQA) PCMH directory of 15,188 primary care practices that received Level 1, 2, or 3 NCQA PCMH recognition to: 1.) construct a stratified national sample of 105 practices engaged in PCMH transformation and 2.) examine their QI practices and PCMH changes associated with PCMH transformation.

AHRQ-funded; HS016980; HS025920.

Citation: Quigley DD, Slaughter M, Qureshi N . Practices and changes associated with patient-centered medical home transformation. Am J Manag Care 2021 Sep;27(9):386-93. doi: 10.37765/ajmc.2021.88740..

Keywords: Patient-Centered Healthcare, Primary Care, Practice Improvement, Healthcare Delivery, Quality Improvement, Quality of Care

Quigley DD, Qureshi N, AlMasarweh L

Using CAHPS patient experience data for patient-centered medical home transformation.

The purpose of this study was to examine how primary care practices used the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey and its patient-centered medical home (PCMH) items during their PCMH transition. The investigators concluded that CAHPS surveys were considered actionable for PCMH transformation and used in standardizing and coordinating care. The CAHPS PCMH items were considered integral to the continuous QI needed for moving beyond formal PCMH recognition and maximizing transformation.

AHRQ-funded; HS016980; HS025920.

Citation: Quigley DD, Qureshi N, AlMasarweh L . Using CAHPS patient experience data for patient-centered medical home transformation. Am J Manag Care 2021 Sep;27(9):e322-e29. doi: 10.37765/ajmc.2021.88745..

Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient Experience, Patient-Centered Healthcare, Primary Care, Practice Improvement, Healthcare Delivery, Quality Improvement, Quality of Care

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

Fagnan LJ, Ramsey K, Kline T

Place matters: closing the gap on rural primary care quality improvement capacity-the Healthy Hearts Northwest study.

This study compared rural independent and health system primary care practices with urban practices to external practice facilitation support in terms of recruitment, readiness, engagement, retention, and change in quality improvement (QI) capacity and quality metric performing. The Healthy Hearts Northwest quality improvement initiative consisting of 135 small or medium-sized primary care practices were used. The practices were stratified by geography, rural or urban, and by ownership. Changes in 3 clinical quality measures (CQMs): appropriate aspirin use, blood pressure (BP) control, and tobacco use screening, were measured at baseline in 2015 and follow-up in 2017. Rural practices were more likely to enroll than urban practices. Rural independent practices had the lowest QI capacity at baseline, making the largest gain in establishing a regular QI process. They made the greatest improvement in meeting the BP control CQM and the smoking cessation metric, from 72.3% to 86.7%.

AHRQ-funded; HS023908; HS023921.

Citation: Fagnan LJ, Ramsey K, Kline T . Place matters: closing the gap on rural primary care quality improvement capacity-the Healthy Hearts Northwest study. J Am Board Fam Med 2021 Jul-Aug;34(4):753-61. doi: 10.3122/jabfm.2021.04.210011..

Keywords: Rural Health, Primary Care, Primary Care: Models of Care, Practice Improvement, Quality Improvement, Quality of Care, Heart Disease and Health, Cardiovascular Conditions

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 ��Ƶ'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

Hung DY, Mujal G, Jin A

Patient experiences after implementing lean primary care redesigns.

The authors examined the effect of Lean primary care redesigns on patient satisfaction with care and timeliness of care received. After implementation of Lean redesigns, they found that patients reported a 44.8 percent increase in satisfaction with the adequacy of time spent with care providers during office visits. They also reported 71.6 percent higher satisfaction with their care provider's ability to listen to their concerns and a 55.4 percent increase in perceived staff helpfulness at the visit. The amount of time elapsed between a patient request for a routine appointment and the scheduled visit day decreased. On the day of the visit, patient wait times to be seen also decreased gradually.

AHRQ-funded; HS024529.

Citation: Hung DY, Mujal G, Jin A . Patient experiences after implementing lean primary care redesigns. Health Serv Res 2021 Jun;56(3):363-70. doi: 10.1111/1475-6773.13605..

Keywords: Patient Experience, Primary Care: Models of Care, Primary Care, Workflow, Quality Improvement, Quality of Care

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