AHRQ-Funded Research Explores Structure and Impact of Patient Characteristics in Assisted-Living

AHRQ Stats: Financial Barriers to Care Among Racial/Ethnic Groups

The percentage of Hispanic people who reported being without a usual source of care in 2018 due to financial or insurance reasons was nearly double that for Black populations and more than double that for White populations. (Source: AHRQ, 2021 National Healthcare Quality and Disparities Report, D-37 [PDF, 8.1 MB])

Today's Headlines:

• AHRQ-Funded Research Explores Structure and Impact of Patient Characteristics in Assisted-Living Communities.
• New Resources Support Nursing Homes’ Efforts To Navigate Challenges of COVID-19.
• Challenges in the Technical Landscape for Patient-Centered Clinical Decision Support.
• AHRQ Announces Interest in Funding Research on Primary Care.
• Highlights From AHRQ’s Patient Safety Network.
• Apply by April 22 To Present Research at National Meeting on Racial Health Equity in Social Care.
• AHRQ in the Professional Literature.

AHRQ-Funded Research Explores Structure and Impact of Patient Characteristics in Assisted-Living Communities

AHRQ-funded researchers proposed that the model of care in assisted-living facilities be reimagined if the facilities are to exist as affordable options that provide quality, person-centered care in a suitable environment. The increasing involvement of the real estate, hospitality and healthcare sectors has raised concerns about the variability, quality and standards for assisted living, according to the study in The Journal of the American Medical Directors Association. Researchers concluded that while the intent to promote person-centered care and quality of life has remained a priority, those constructs have become mired under tensions related to models of assisted living, regulation, financing, resident acuity and the workforce. Expanding on this topic, these AHRQ-funded researchers also investigated:

• Using Medicare enrollment data to identify beneficiaries in assisted living.
• Health care use and outcomes in assisted living communities: race, ethnicity, and dual eligibility.
• Coronavirus disease 2019 (COVID-19) in assisted living communities: neighborhood deprivation and state social distancing policies matter.

New Resources Support Nursing Homes’ Efforts To Navigate Challenges of COVID-19

Three new online resources from AHRQ are available to help nursing homes adopt best practices aimed at controlling and preventing infection and improving the emotional well-being of staff and residents:

• Best Practices Guide for COVID-19 Infection Control and Prevention in Nursing Homes (PDF, 1.1 MB) highlights guidance related to screening and monitoring, testing and responding, and quarantine and isolation.
• Best Practices for Promoting Mental Health and Emotional Well-Being Among Nursing Home Staff (PDF, 1 MB) offers examples of how administrators can take action aimed at making emotional well-being part of nursing home culture.
• Best Practices for Promoting Emotional Well-Being in Nursing Home Residents (PDF, 1 MB) provides guidance to nursing home leaders and staff about engaging residents and reducing isolation while maintaining necessary infection control and prevention practices.

These resources were developed via AHRQ’s Nursing Home COVID-19 Action Network.

Challenges in the Technical Landscape for Patient-Centered Clinical Decision Support

An AHRQ-funded review identified seven technical challenges that are barriers to making patient-centered clinical decision support (CDS) tools more standards-based and shareable among care teams. CDS includes computerized alerts and reminders to clinicians and patients, clinical guidelines, patient data reports, diagnostic support and reference information, among other tools. Patient-centered CDS has potential to enable the timely delivery of evidence-based guidelines at the point of care and support shared decision-making, However, researchers identified persistent challenges in the development and implementation of patient-centered CDS, including translating clinical guidelines, standardizing insertion points in clinical workflows, and capturing, standardizing and integrating patient-generated health data. Access the article in the journal JAMIA.

AHRQ Announces Interest in Funding Research on Primary Care

A Special Emphasis Notice from AHRQ signals the agency’s interest in receiving health services research grant applications to advance the science of primary care. Revitalizing the nation’s primary care system is critical to achieving AHRQ’s mission of improving the quality, safety, accessibility, equity and affordability of healthcare. AHRQ’s overall goal is to invest in research that provides evidence about how to improve the delivery of primary care, projects that create and test tools and training that support primary care improvement, and studies that advance the development of primary care research methods. Using R01, R18 and R03 grant mechanisms, the agency will fund projects that develop, implement and evaluate interventions and models of care, including those targeting the specific needs and challenges of disadvantaged populations and people living with multiple chronic conditions. Access more information about AHRQ funding opportunities.

Highlights From AHRQ’s Patient Safety Network

AHRQ’s Patient Safety Network (PSNet) highlights journal articles, books and tools related to patient safety. Articles featured this week include:

• Error reduction in trauma care: Lessons from an anonymized, national, multicenter mortality reporting system.
• Association between operative autonomy of surgical residents and patient outcomes.
• Patient harm and institutional avoidability of out-of-hours discharge from intensive care: an analysis using mixed methods.

Review additional new publications in PSNet’s current issue or access recent cases and commentaries in AHRQ’s WebM&M (Morbidity and Mortality Rounds on the Web).

Apply by April 22 To Present Research at National Meeting on Racial Health Equity in Social Care

Proposals are now being accepted for September and October presentations at the multipart 2022 National Research Meeting: Racial Health Equity in Social Care. The event, partially funded by AHRQ and hosted by the Social Interventions Research and Evaluation Network (SIREN), is intended to examine how racism impacts social care programs and social care research. SIREN seeks proposals for 50-minute meeting sessions and 12-minute research presentations. Proposals are welcome from social care practitioners, payers, policymakers, funders and advocates. Submissions are particularly encouraged from people with lived experiences of racism and economic challenges, or those that shed light on people with such experiences and perspectives. Proposals are due April 22. The virtual meetings are scheduled Sept. 15, Sept. 27 and Oct. 12.

AHRQ in the Professional Literature

Maintaining face mask use before and after achieving different COVID-19 vaccination coverage levels: a modelling study. Bartsch SM, O'Shea KJ, Chin KL, et al. Lancet Public Health 2022 Mar 8. [Epub ahead of print.] Access the abstract on PubMed®.

Importance of long-term follow-up after endoscopic management for upper tract urothelial carcinoma and factors leading to surgical management. Mohapatra A, Strope SA, Liu N, et al. Int Urol Nephrol 2020 Aug;52(8):1465-9. Epub 2020 Mar 11. Access the abstract on PubMed®.

Design and study protocol for a cluster randomized trial of a multi-faceted implementation strategy to increase the uptake of the USPSTF hypertension screening recommendations: the EMBRACE study. Moise N, Phillips E, Carter E, et al. Implement Sci 2020 Aug 8;15(1):63. Access the abstract on PubMed®.

Risks of bariatric surgery among patients with end-stage renal disease. Montgomery JR, Waits SA, Dimick JB, et al. JAMA Surg 2019 Dec;154(12):1160-2. Access the abstract on PubMed®.

The impact of a population-based system of care intervention on enhanced prenatal care and service utilization among Medicaid-insured pregnant women. Roman LA, Raffo JE, Strutz KL, et al. Am J Prev Med 2022 Feb;62(2):e117-e27. Epub 2021 Oct 24. Access the abstract on PubMed®.

Parent experience and cost savings associated with a novel tele-physiatry program for children living in rural and underserved communities. Davidson L, Haynes SC, Favila-Meza A, et al. Arch Phys Med Rehabil 2022 Jan;103(1):8-13. Epub 2021 Aug 21. Access the abstract on PubMed®.

An observational study of workflows to support fecal testing for colorectal cancer screening in primary care practices serving Medicaid enrollees. Mojica CM, Gunn R, Pham R, et al. BMC Cancer 2022 Jan 25;22(1):106. Access the abstract on PubMed®.

Implementation of an antibiotic stewardship program in long-term care facilities across the US. Katz MJ, Tamma PD, Cosgrove SE, et al. JAMA Netw Open 2022 Feb;5(2):e220181. Access the abstract on PubMed®.