Answering AHA Research Questions - 2010 to 2012
AHA Resources

Research Question #1 What are the most effective and efficient ways for hospitals and health systems to integrate care and improve performance (financial, clinical, service, patient and staff experience) along the continuum of care (e.g., implementing care coordination across all settings of care)?

Project Name/Study
Summary of Findings
Health Care Leader Action Guide to Reduce Avoidable Readmissions
Health Research & Eductaional Trust (HRET)
This guide provides a step-by-step approach for hospital leaders to examine their current rate of readmissions, assess and prioritize improvement opportunities, develop an action plan for implementation, and monitor their hospital's progress in reducing avoidable readmissions.
Clinical Integration - The Key to Real Reform
AHA TrendWatch
This AHA TrendWatch highlights the importance of clinical integration in achieving the goals of health system reform and discusses the role of information technology, payment changes, and overcoming legal barriers to clinical integration. It also describes examples of clinical integration models.
Eliminating Harm in a Large, Integrated System
Hospitals in Pursuit of Excellence (HPOE)

Henry Ford Health System leaders analyzed the major causes of harm within the organization and divided them into four categories: infection-related harm, procedure-related harm, medication-related harm and other preventable harm.

In 2008, the system launched two major collaborative efforts targeted at reducing readmissions and improving perinatal care. System leaders also recruited clinicians with expertise in harm reduction to lead smaller pilot projects in individual units. Over time, successful pilot projects have been adapted for use throughout the system, and the board and executive leadership team has continued to identify new areas of focus for harm reduction.


Research Question #2 What organizational characteristics, structures, and processes lead to a high-performing system of care (e.g., the implementation of specific HIT components, specific horizontal and vertically integrated system practices, and clinical and functional integration across a health system that produces benchmark outcomes)?

Project Name/Study
Summary of Findings
A Guide to Achieving High-Performance in Multi-Hospital Health Systems
Health Research & Eductaional Trust (HRET)
This guide identifies best practices associated with high performing health systems. With support from the Commonwealth Fund, HRET conducted an analysis of publicly available quality information and findings from interviews with health care system leaders and identified three major themes, four major best practice categories and seventeen specific best practices associated with high performance.
Using Work Force Practices to Drive Quality Improvement
Health Research & Eductaional Trust (HRET)
This guide provides hospital leaders and human resources staff information about four high performance work practices that have the potential to improve an "organization's capacity to effectively attract, select, hire, develop, retain, and deploy personnel in ways that best support a high-performing health care system." The four practices discussed include organizational engagement, staff acquisition and development; frontline empowerment, and leadership alignment and development.
Health Care Leader Action Guide on Implementation of Electronic Health Records
Health Research & Eductaional Trust (HRET)
This guide provides hospital leaders with an understanding of the challenges of implementing electronic health records (HER) and provides information on high-level categories that hospital leaders should consider when planning and implementing EHRs. The high-level categories include: developing a strategic plan, performing a gap analysis, developing a high-level project plan, initiating culture change, redesigning workflow processes, and implementation.
The Road to Meaningful Use:What it Takes to Implement Electronic Health Record Systems in Hospitals
AHA TrendWatch
This TrendWatch Report provides an overview of the challenges and opportunities in achieving meaningful use through the implementation of electronic health records. It summarizes the federal funding available through the American Recovery and Reinvestment Act of 2009 (ARRA), describes the role that EHRs can play in improving patient care by facilitating better communication and provides case studies of successful implementation models. The report closes with key policy questions that should be considered as health systems work to achieve meaningful use through electronic health records.


Research Question #3 What are the most promising practices and system design elements for reducing health disparities, considering all factors such as organizational elements and social determinants?

Project Name/Study
Summary of Findings
Achieving Cardiac Excellence
Hospitals in Pursuit of Excellence (HPOE)
Hollywood, Fla.-based Memorial Healthcare System set out to reach 100 percent compliance with CMS cardiac indicators, regardless of the racial or ethnic background of their patients. Within six months, they were able to eliminate disparities in related care.
Addressing Diabetes Among the Latino Population
Hospitals in Pursuit of Excellence (HPOE)
Kaiser Permanente Colorado is collecting data using patient self-identified race, ethnicity and preferred language to identify disparities in clinical outcomes and reduce health risks of diabetes among Latino patients. The plan includes a collaborative management process for at-risk patients and an evidence-based therapy intervention.
Addressing Disparities in Cardiac Care Among African American Populations
Hospitals in Pursuit of Excellence (HPOE)
Detroit-based Sinai-Grace Hospital set out to improve cardiovascular care for the African-American patient population with effective, replicable quality improvement strategies. So far, the program has maintained equality in the provision of evidence-based quality care measures to all patients.


Research Question #4 What is the role of the hospital in a new community environment that provides more efficient and effective health care (e.g., what are the redesigned structures and models, the role and implementation of accountable care organizations, the structures and processes needed to implement new payment models such as bundled payments, and how do organizations transition to this new role)?

Project Name/Study
Summary of Findings
Bundled Payment - AHA Research Synthesis Report
AHA Committee on Research
This report summarizes the current evidence base literature for bundled payments and identifies the key issues for consideration before bundled payment can be widely implemented.
Early Learnings from the Bundled Payment Acute Care Episode Demonstration Program
Health Research & Eductaional Trust (HRET)
This report describes the Centers for Medicare and Medicaid Services Acute Care Episode Bundled Payment Demonstraton Project. The demonstration project is testing the impact of bundling Part A and B payments for episodes of care on quality, coordination, and efficiency of care. The report summarizes the lessons learned to date from demonstration sites and identifies key questions that remain to be answered.
Accountable Care Organizations - AHA Research Synthesis Report
AHA Committee on Research

This report provides an overview of Accountable Care Organizations (ACOs) , a discussion of their potential impact, key questions to consider in developing ACOs, and a review of the core competencies needed to be an effective ACO.

Patient-Centered Medical Home - AHA Research Synthesis Report
AHA Committee on Research
This report provides an overview of key features of the Patient-Centered Medical Home (PCMH), summarizes current federal, state, and private sector PCMH models, and discusses the role of hospitals interested in developing a PCMH.
Social Workers Enhance Post-Discharge Care for Seniors
Hospitals in Pursuit of Excellence (HPOE)
Staff from Rush University Medical Center’s Older Adult Programs and Case Management Department teamed up to create the Enhanced Discharge Planning Program (EDPP). The program calls for social workers to phone patients and caregivers after discharge to ensure they are receiving the services detailed in their discharge plan and to investigate any unanticipated needs. If necessary, social workers intervene to help patients resolve problems and connect patients and caregivers to health care providers and community-based services.



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