Field Partnerships for Applied Research
ACTION (Accelerating Change and Transformation in Organizations and Networks) is a model of field-based research designed to promote innovation in health care delivery by accelerating the diffusion of research into practice. The ACTION network includes 15 large partnerships and collaborating organizations that provide health care to more than 100 million Americans.
Select for the ACTION Fact Sheet.
Select for Awards in Fiscal Year 2007.
Awards in Fiscal Year 2006
Developing Data and Measurement Capacity
Title: Ambulatory Care Quality Alliance Pilot Project
Partner: RTI International
Description: The Ambulatory Care Quality Alliance (AQA) is a broad-based national coalition of over 125 member organizations representing physicians, consumers, employers, government, health insurance plans, and accrediting and quality improvement organizations. AQA objectives are: (1) to improve health care quality through a process in which key stakeholders agree on a strategy for measuring performance at the physician level; (2) to collect and aggregate data in the least burdensome way; and (3) to report meaningful information to consumers, physicians, and other stakeholders in order to inform choice and improve outcomes. RTI is developing a quantitative analysis plan for the AQA Pilot Project, which the Agency for Healthcare Research and Quality and the Centers for Medicare & Medicaid Services are co-sponsoring at six sites throughout the United States. The plan is being developed to permit robust and maximally generalizable quantitative results and to accomplish efficient pooling of data across the sites.
Period: 04/06-11/06
Funding: $188,015
Health Care Organization and Design
Title: Redesigning Delivery Processes for Efficiency and Value-Implementing, Assessing, and Spreading Redesign Methods and Techniques
Partner: RAND Corporation
Description: This project is implementing and testing interventions that proved themselves in pilot sites in the United Kingdom's National Health Service (NHS). The interventions involve demand components (e.g., smoothing demand, buffering interruptions) and supply components (e.g., changing staff hours or assignments, changing day work routines) for improving quality and efficiency of night work in hospitals. The impact of the demand strategies are being assessed separately from an intervention that uses both supply and demand strategies, as did the NHS project. This project is using a collaborative improvement framework that RAND's partner, the University Healthcare Consortium, has successfully applied to several projects over the last 3 years. RAND will monitor clinical outcomes carefully. Qualitative data will be used to provide feedback to improve implementation, as well as in evaluation of what worked well and why.
Period: 09/06-09/08
Funding: $399,639
Title: Integrating Chronic Care and Business Strategies in the Safety Net
Partner: RAND Corporation
Description: This project is implementing and evaluating changes in safety net organizations that improve both care to individuals with multiple chronic conditions and organizational efficiency by: (1) developing a Chronic Care Model (CCM) and Business Change Package of modified or new implementation tools to assist safety net organizations in integrating the CCM with business strategies aimed at reducing waste and increasing productivity and revenue; (2) evaluating the CCM and Business Change Package and individual implementation tools; and (3) providing time-limited technical assistance to assist pilot sites in implementing the CCM and Business Change Package.
Period: 09/06-09/08
Funding: $ 398,806
Title: Multi-Site Evaluation of Rapid HIV Testing in Emergency Departments
Partner: Health Research and Educational Trust
Description: The purpose of this study, funded by the Centers for Disease Control and Prevention (CDC), is to assess the ability of emergency departments (EDs) to identify undiagnosed HIV-positive individuals and link them into care. Operational information and outcome data are being used in this assessment. Products that result from this study will be used to assist other hospitals in developing and implementing rapid HIV testing programs in the ED. Results and recommendations of the study may assist in programmatic decisionmaking and improve CDC's ability to foster rapid HIV testing programs in EDs across the United States.
Period: 9/06-03/08
Funding: $239,989
Patient Safety
Title: Testing Techniques To Radically Reduce Antibiotic Resistant Bacteria (Methicillin Resistant Staphyloccus aureus, or MRSA)
Partner: Indiana University
Description: The overall purpose of this task order is to measurably reduce hospital-acquired MRSA infections in selected acute care facilities or hospitals by at least 50% and document how this was done in order to help others achieve success in similar settings (i.e., how the barriers that have delayed reductions in MRSA rates have been overcome to achieve needed behavior changes).
Period: 9/06-03/08
Funding: $350,000
Title: Development and Testing of a Rapid Response Team Training Module Within TeamSTEPPS Curriculum
Partner: AIR
Description: Rapid response teams are a subset of medical teams in general and should built upon the knowledge, skills, and attitudes established by the evidence of good teamwork. The Department of Defense and AHRQ have developed an evidence-based curriculum and tool kit for team work development, knowledge and TeamSTEPPS (Strategies & Tools to Enhance Performance and Patient Safety). In this project, a training module for rapid response teams is being designed, developed, implemented, assessed, and made ready for distribution as part of the TeamSTEPPS team training curriculum and support materials.
Period: 9/06-03/08
Funding: $ 347,651
Prevention
Title: Assessing Hepatitis B Vaccination for Adults at Primary Care Settings
Partner: Denver Health
Description: This CDC-funded project is measuring the delivery of adult hepatitis B vaccination in primary care settings, which has been recommended for adults at risk since 1982. The main objectives are: (1) to estimate hepatitis B vaccination coverage among adults seen in primary care, and (2) to determine whether rates of hepatitis B vaccination are different among adults known to be at high risk compared to the rest of the adult population.
Period: 9/06-09/07
Funding: $199,956
Title: Hepatitis B Surface Antigen Screening by Primary Care Providers
Partner: Denver Health
Description: This CDC-funded project is determining: (1) physician practices with respect to screening for hepatitis B virus (HBV) infection (i.e., which patients are being tested); and (2) prevalence of chronic HBV infection among patients in primary care settings (i.e., which patients already have been identified) and how physicians evaluate and follow these patients. The purpose is to provide relevant baseline information for the development of new national recommendations for screening for HBV infection.
Period: 9/06-09/07
Funding: $300,000
Payment and Finance
Title: Multi-Site Coordinated Evaluation of the Impact of Quality-Based Payment Strategies
Partner: Trustees of Boston University
Description: This evaluation focuses on the implementation and impact of pay for performance on physicians across three programs in diverse safety net settings, based on natural experiments. The project includes a pre/post test analysis of the impact of pay-for-performance programs on quality measures; assessment and comparison of providers' attitudes toward pay-for-performance programs with respect to such issues as the clinical relevance of the quality measures, adequacy of the financial incentives, and fairness of the payout formulas; and interviews with senior managers at each study setting who have first hand knowledge of the clinical and financial details of the pay-for-performance programs.
Period: 08/06-02/08
Funding: $298,370
Title: Assessing Physician Incentives for Pay for Performance
Partner: University of California at San Francisco
Description: This project assesses a performance intervention that focuses on the frequency of information feedback and size of incentive payment to health care providers at three sites. A randomized controlled trial feature, which is being implemented at one site, is limited to the frequency of bonus allocation, with one group receiving an annual payment as a one-time bonus after the fact while a second group receives a quarterly payment. Comparison of the effect of physician-level incentives will be made across three sites in an observational study, assessing the impact of using incentive payments at the departmental level versus incentive payments across all physicians.
Period: 09/06-06/08
Funding: $335,589
Emergency Preparedness
Title: Emergency Preparedness Resource Inventory and Surge Model Enhancements
Partner: Abt Associates
Description: The purpose of this project, funded by the Health Resources and Services Administration (HRSA), is to revise two recently developed AHRQ tools—the Emergency Preparedness Resource Inventory (EPRI) tool and the Surge Model—into alignment with the U.S. Department of Homeland Security's Universal Task List and to enhance Abt's previously developed Surge Model by adding a pandemic influenza scenario. EPRI tool allows local or regional planners to assemble an inventory of critical resources that would be useful in responding to a terrorist attack or natural disaster. It is Web-based so that all selected organizations in an area can enter information about their resources. The Surge Model estimates the medical resources needed to treat casualties arising from biological, chemical, nuclear, and radiological attacks. Resources include hospital staff, medical equipment, and medical supplies.
Period: 09/06-09/07
Funding: $499,959
Title: HAvBED2 Delivery of a Sustainable Bed Availability Reporting System
Partner: Denver Health
Description: This HRSA-funded project is refining the real-time hospital bed tracking system, "National Hospital Available Beds for Emergencies and Disasters (HAvBED) System," which was developed by Denver Health under a previous task order. This tracking/monitoring system serves as a potential management tool to assist in a State or region's ability to distribute and care for a surge of patients in the event of a large-scale mass casualty incident. This task order focuses on developing a maintainable working production system that will be deployed to communities that do not have a hospital bed tracking system. The system can be used for planning and response by the Department of Health and Human Services Office of the Assistant Secretary for Public Health Emergency Preparedness and other Federal, regional, State or local command centers. A users' guide for hospitals or other users and a systems operations guide for administering the HAvBED2 system are being developed.
Period: 09/06-09/07
Funding: $ 498,421
Long-term Care
Title: Improving Quality of Care in Long-term Care
Partner: RTI International
Description: The first aim of this project is to use a model of quality improvement to adapt evidence-based interventions that have been used in long-term care and community settings. RTI is developing a multi-component intervention program of medication review, assessment, environmental modification, and exercise to reduce risk factors for falls, as well as fall and fracture rates, among residents of assisted living facilities. The second aim is to assess the program within two matched pairs of assisted living facilities to determine the degree to which the facility implements the intervention; the degree to which residents accept and adhere to the intervention; facility- and resident-level facilitators for and obstacles to implementation and maintenance of the intervention; changes in modifiable resident risk factors and facility fall and fracture rates; and the relationship of implementation and adherence to change in risk factors and fall and fracture rates.
Period: 09/06-09/08
Funding: $449,098
Current as of October 2006
Internet Citation:
ACTION Project Awards: Field Partnerships for Applied Research. October 2006. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/research/actionproj.htm
540 Gaither Road Rockville, MD 20850