Organization and Delivery

Accelerating Change and Transformation in Organizations and Networks (ACTION): Field Partnerships for Applied Research
Accelerating Change and Transformation in Organizations and Networks II (ACTION II)
Informed Decisions Toolbox: Finding and Using Management Research Evidence
Opportunities for Advancing Delivery System Research
System Design: AHRQ Resources

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Research Findings

Research Activities, October 2012:
Physicians' implicit racial attitudes influence prescribing of opioids for black children

Research Activities, September 2012:
Minority-serving hospitals have problems with quality of care and patient satisfaction

Research Activities, July 2012:
Although the patient-centered medical home is a promising model of care, more studies are needed to assess its effectiveness
AHRQ report finds teamwork and followup as strengths of medical offices but work pressure and pace are problematic

Research Activities, June 2012:
Contact isolation of new patients reduces adherence to process-of-care quality measures for pneumonia

Research Activities, April 2012:
Performance measures for gastroenterology can lead to improved accountability

Research Activities, March 2012:
Hospital emergency departments get tips from AHRQ on how to reduce crowding and better triage patients
Learning networks can help implement strategies to improve emergency department patient flow

Research Activities, February 2012:
Patient flow strategies may help to address emergency department crowding

Research Activities, January 2012:
Experts call for integrating mental health into primary care
Primary care coordination is more difficult for patients who see many specialists
Accessible services in primary care practices promote preventive health screenings and care
Duplicate medication order errors increase after computerized provider order entry is implemented
New study finds e-prescribing is safe and efficient, but barriers remain

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Research Activities, December 2011:
Moving adolescents with sickle cell disease from pediatric to adult care hampered by lack of knowledgeable adult hematologists

Research Activities, August 2011:
High performance on quality measures linked to financial benefits for nursing homes

Research Activities, July 2011:
Hospitals with a teamwork culture have better patient safety climates
Guideline familiarity does not equal guideline adherence
Mandated increases in nurse staffing levels unevenly affect uncompensated care growth rates in California hospitals

Research Activities, June 2011:
Organizational culture distinguishes top-performing hospitals in patient outcomes from heart attack

Research Activities, May 2011:
Social media use is one of many innovations in care delivery transforming the frontlines of care
Practice setting, ownership, and specialty all affect volume of charity care provided by physicians
Primary care physicians spend a fifth of their time in patient care activities outside of office visits

Research Activities, April 2011:
Provider's communication style boosts results for acupuncture on arthritic knees
Various factors influence the adoption of ergonomics in health care organizations

Research Activities, March 2011:
Most process-of-care events do not harm transplant patients, but they boost costs and lengthen hospital stays
When health plans share physicians, they may have less incentive to improve care quality
Children with a medical home more likely to receive health screenings and advice

Research Activities, February 2011:
Many factors are likely to slow the adoption of pay for performance in dentistry
Nearly one-third of emergency department visits involve nonideal care events
Nurse-facilitated guided care for elders and their caregivers leads to improved perceptions of quality of care
Primary care physicians' performance ratings depend on the makeup of their patient population

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Research Activities, November 2010:
Black and Hispanic Medicare patients with hip fracture wait longer for surgery than white patients

Research Activities, October 2010:
Regional health information exchanges must do more to attract small practices
Study recommends disclosure of medical mistakes that affect multiple patients

Research Activities, August 2010:
Women want clinicians to talk about the risk medications pose to an unborn child

Research Activities, June 2010:
Home visits help pregnant, Medicaid-insured women alleviate depressive symptoms
Nursing homes using more agency staff have lower quality of care
Nursing home physicians and nurses struggle with communication barriers
Physician-pharmacist teams can help lower blood pressure
Personality factors play a role in responsiveness to disease self-management programs
Doctors underprescribe warfarin to prevent strokes in patients with atrial fibrillation and heart failure
Higher nurse-patient ratios result in societal cost benefits for some hospital areas
Medicare Advantage enrollees are admitted to hospitals with higher mortality rates than Medicare fee-for-service enrollees

Research Activities, May 2010:
Emergency department treatment of asthma with systemic corticosteroids is not always timely
Team-based care of patients with hypertension improves control of blood pressure
General hospitals are stepping up specialty services in response to competition from single specialty hospitals

Research Activities, April 2010:
Patients admitted to the hospital on weekends wait for major procedures
Rural and urban residents have similar perceptions of health care quality, despite differences in care delivery
The stability of a usual source of care is important to the care of low-income children
Primary care patients who see physician assistants and nurse practitioners are as complex as those who see doctors
Two-thirds of State and local government workers get their health plans from their employers

Research Activities, March 2010:
Pain management in emergency departments has improved but can still be better
Primary care organizational characteristics are linked to the self-management behaviors of patients with diabetes
Beta blockers are underused in patients receiving implantable cardioverter defibrillators
More than half of all hospital procedures are outpatient

Research Activities, February 2010:
Patients who are treated with empathy during office visits get over colds faster
Medicaid drug restrictions may lead to adverse events for psychiatric patients
Trauma triage system tends to overestimate injury severity
Use of bedside ultrasound by hospital emergency departments is not yet common practice in California

Research Activities, January 2010:
Failure to order and follow up medical tests are leading causes of diagnostic errors
Physicians in practices focused on quality improvement are less likely to be dissatisfied and stressed
Black physicians are less likely to have implicit preferences for blacks or whites
Most Mexican patients prefer their rheumatologist to make treatment decisions for them
Youths initially diagnosed with ADHD receive an array of medications
Use of electronic prescribing has expanded among Massachusetts physicians

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Research Activities, December 2009:
Telemedicine reduces children's emergency department visits for nonemergency problems
Electronic patient-provider messaging is linked to good diabetes control
Certain types of hospitals are more likely to use computerized physician order entry
Staff willingness to change and adapt is important when implementing electronic pharmacy systems

Research Activities, November 2009:
Safety awareness and technological adoption are keys to managing test results in family medicine offices
Evaluating team member perceptions can help guide future failure mode and effects analysis activities
Certain patients are more likely to e-mail their physicians

Research Activities, October 2009:
Physician-owned single specialty hospitals may prod nearby hospitals to increase nurse staffing levels
Primary care nurses who convey warmth and caring enhance patient satisfaction with care

Research Activities, September 2009:
Uninsured and partially insured patients with diabetes are less likely to be screened at Federally Qualified Health Centers
Community health workers can help poor and minority groups access some cancer screening services
Primary care practice structure affects control of risk factors for cardiovascular disease among patients with diabetes

Research Activities, August 2009:
Making medication administration a dedicated activity free of interruptions could improve long-term care drug safety
Public reporting of nursing home care improves care delivery
Hospital system type affects mortality rates

Research Activities, July 2009:
More comprehensive American Indian and Alaska Native diabetes education programs are linked to better diabetes care
Fewer than half of patients with diabetes are referred for lifestyle counseling, nutrition, and exercise
Electronic medication administration records improve communication and decisionmaking in nursing homes Several practices of hospital governing boards are linked to improved quality of care
Examining processes, not outcomes, improves patient safety in hospitals
Study underscores the positive impact of patient-centered care delivered by nurses on cancer patient outcomes
Patients who are connected to their doctors tend to receive care that adheres to guidelines

Research Activities, June 2009:
Clinician interviews are the best method to determine whether patients with kidney failure are also depressed
Women with cardiac symptoms are more likely than men to experience delays in emergency care
Weekly telephone calls help patients with limited English proficiency and literacy self-manage diabetes
Nurse-led disease management of heart failure is cost-effective in ethnically diverse urban communities
Minority children from disadvantaged families use more urgent care and less preventive care for their asthma
Health information systems need to address pediatric needs

Research Activities, April 2009:
A novel system lets rural hospitals obtain a remote pharmacist's review of medication orders around-the-clock
The chronic care model improves care delivery and patient outcomes, but practices need better tools to implement it
Hospital outpatient department and office-based provider visits for high cholesterol and other conditions soared in a decade

Research Activities, March 2009:
Strategies are needed to improve immunization rates among adolescents, especially those with high-risk conditions
Available resources, not competition, drive nursing homes to advertise
Impact of direct-to-consumer advertising on drug use varies depending on the drug, scope of advertising, and culture

Research Activities, February 2009:
Social support did not yield better health results in study of patients with diabetes
Telephone coaching following hospitalization for acute coronary syndrome adds little to in-hospital counseling
Most office-based psychiatrists are providing medication rather than psychotherapy to their patients
Mental health counseling remains persistently low from adolescence into young adulthood

Research Activities, January 2009:
Integrated mental and physical health services may help people with depression

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