Practice-based Research Network Business Opportunities with ACOs and Other Health Care Systems: Training and Technical Assistance (PDF - 739 KB)quality improvement (QI) efforts. With their experience designing, executing, and evaluating QI activities, PBRNs are well positioned to provide their expertise to others via training or technical assistance. This document describes existing and anticipated QI synergies between PBRNs and ACOs and similar organizations.
Opportunities for Integrating MOC Part IV Requirements into PBRN Practices (PDF - 2.6 MB)
The PBRN Resource Center developed a resource document with input from experts in practice-based research and from medical specialty boards. This document provides information about the Maintenance of Certification (MOC) process that physicians undertake to retain board certification. The goal of the document is to help PBRNs align their infrastructure and activities to support physicians in meeting MOC Part IV (quality/practice improvement) requirements. PBRNs have the potential to serve as a partner to all clinicians—particularly physicians, physician assistants, and nurse practitioners—who have a professional expectation to engage in quality/practice improvement as a part of their commitment to patients. The document will help PBRNs understand the potential synergy between their current infrastructure and activities that support their members in meeting MOC Part IV requirements from primary care medical specialty boards.
Using Rapid-Cycle Research to Reach Goals: Awareness, Assessment, Adaptation, Acceleration (PDF - 1.96 MB)
The PBRN Resource Center developed a document which provides resources and advice for conducting rapid-cycle research. Drawing on the experience of practice-based research networks (PBRNs), Using Rapid-Cycle Research to Reach Goals: Awareness, Assessment, Adaptation, Acceleration describes methods for identifying problems that need to be solved, solutions that work in real world settings and study methods that can accelerate the research cycle. Changes in the delivery of primary care make it necessary to consider changes in the way research is conducted. Using Rapid-Cycle Research to Reach Goals: Awareness, Assessment, Adaptation, Acceleration helps research teams plan rapid-cycle studies that are practical and actionable. An accompanying webinar was held on September 9, 2015. The webinar slides and recording are accessible here.
Additional Tools and Resources
Below are additional PBRN-relevant tools and resources. Select a topic for more information.
- Chronic Care
- Health IT
- Health Literacy/Dissemination
- Institutional Review Boards (IRBs)
- Patient and Family Engagement
- Patient Safety
- Practice Facilitation
- Quality Improvement
Integrating Chronic Care and Business Strategies in the Safety Net: A Toolkit for Primary Care Practices and Clinics
Improving care for the chronically ill is one of the most pressing health needs of our time. To help more safety net organizations implement the Chronic Care Model effectively and sustainably, the Agency for Healthcare Research and Quality (AHRQ) contracted with Group Health's MacColl Institute, RAND Health, and the California Health Care Safety Net Institute (SNI) to develop a toolkit. The Integrating Chronic Care and Business Strategies in the Safety Net toolkit informs safety net providers on how to redesign their systems of care along the lines of the Chronic Care Model while attending to their financial realities.
The toolkit provides a step-by-step practical approach to guide primary care teams through quality improvement. The toolkit:
- Sequences and describes the specific practice changes involved in Chronic Care Model implementation.
- Integrates strategies designed to improve the business case for quality improvement.
- Links more than 60 commonly used quality improvement tools with the relevant changes.
- Includes examples from practices that have made quality improvement pay.
Toolkit for Implementing the Chronic Care Model in an Academic Environment
These materials enable implementation of the Chronic Care Model in academic health care settings. The tools and lessons learned from four organizations that participated in the Academic Chronic Care Collaborative are provided here for readers to adapt and replicate in teaching medical residents and improving care for patients with chronic illnesses.
AHRQ Health IT Website
AHRQ's Health IT Portfolio develops and disseminates evidence to inform policy and practice on how health information technology can improve the quality of health care.
AHRQ's Accessible Health Information Technology (IT) for Populations with Limited Literacy: A Guide for Developers and Purchasers of Health IT
This guide and checklist are intended for developers and purchasers of health information (IT) that is designed to be accessed and used by consumers. As most health IT developers have little knowledge of populations with limited literacy and of the technical standards and aspects of accessible health IT design, this guide and checklist provide a structure, strategies, and other resources for the development of these technologies. Similarly, purchasers of health IT (e.g., heath plans, pharmaceutical companies, foundations, and other non-profit organizations) that desire to make technologies available to limited-literacy adults, can use this guide and checklist to evaluate a health IT product. For those purchasers who contract out the development of their product, this guide can be used to direct and validate the developer's work.
AHRQ National Webinar: Electronic Health Record Functionality Needed to Better Support Primary Care
The AHRQ PBRN Resource Center hosted a webinar on needed Electronic Health Record (EHR) functionality to support the delivery of primary care. An expert panel discussed the need for EHRs to move beyond documentation to interpreting and tracking information over time, supporting patient partnering activities, enabling team-based care, and allowing providers to use population-management tools to facilitate care delivery.
The session provided an interactive presentation on the publication, “Electronic health record functionality needed to better support primary care,” Krist AH, et al. J Am Med Inform Assoc 2014;0:1–8. doi:10.1136/amiajnl-2013-002229
AHRQ National Webinar: Harnessing Health Information Technology to Assist Individuals and Teams
The AHRQ PBRN Resource Center hosted a webinar featuring three innovative strategies for harnessing health information technologies (health IT) to help patients and primary care teams improve care processes and outcomes. These strategies were also featured in the April-June 2014 Journal of Ambulatory Care Management’s Special Issue on Primary Care Practice-Based Research Networks.
The presenters provided insights on how health IT can support the information needs of primary care teams and their patients. The presenters also highlighted the problem-solving perspectives of practice-based research networks on how to utilize health information technology to facilitate access to care, encourage patient engagement, and improve health care quality.
Workflow Assessment for Health IT Toolkit
The Workflow Assessment for Health IT toolkit assists small and medium sized practices in workflow analysis and redesign before, during, and after health IT implementation. The toolkit also includes tools to analyze workflow, examples of workflow analysis and redesign, and stories of other practices™ experiences with health IT and workflow.
AHRQ Health Literacy Universal Precautions Toolkit
The Agency for Healthcare Research and Quality is proud to announce the publication of the Health Literacy Universal Precautions Toolkit. The toolkit is based on the principles of universal precautions, or specific actions that providers can take to make health information more understandable for all patients. It is designed to be used by all levels of staff in practices providing primary care for adults and/or pediatric patients.
AHRQ Quick-Start Guide to Dissemination for Practice-Based Research Networks
The Agency for Healthcare Research and Quality has developed a Quick-Start Guide (PDF - 162 KB) that describes the dissemination planning and implementation process. Dissemination refers to the process of sharing research findings with stakeholders and wider audiences, and is crucial for the success and sustainability of practice-based research networks (PBRNs). This Quick-Start Guide contains links to resources that can help guide PBRNs through the phases of dissemination.
Health Literacy Online: A Guide to Writing and Designing Easy-to-Use Health Web Sites
The U.S. Department of Health and Human Services' Office of Disease Prevention and Health Promotion (ODPHP) has written a research-based how-to guide for creating health Web sites and Web content for the millions of Americans with limited literacy skills and limited experience using the Web. The strategies in this guide complement accepted principles of good Web design and thus have the potential to improve the online experience for all users, regardless of literacy skills. This guide is written for Web designers, Web content specialists, and other public health communication professionals. It offers an overview of how to: 1. Deliver online health information that is actionable and engaging. 2. Create a health Web site that's easy to use, particularly for people with limited literacy skills and limited experience using the Web. 3. Evaluate and improve your health Web site with user-centered design.
NCI announces guide to communicating data to lay audiences
The workbook (PDF - 2.1 MB), based on the groundbreaking book Making Data Talk: Communicating Public Health Data to the Public, Policy Makers, and the Press written by NCI communication researchers, provides key information, practical suggestions, and examples that can be applied to many public health issues.
Written Materials Toolkit
The Toolkit for Making Written Material Clear and Effective is a health literacy resource from the Centers for Medicare and Medicaid Services (CMS). As shown below, this 11-part Toolkit provides a detailed and comprehensive set of tools to help you make written material in printed formats easier for people to read, understand, and use.
The AHRQ PBRN Resource Center supports a listserv dedicated to IRB issues for PBRNs, including working with multiple IRBs. To join the IRB listserv, please send an email to PBRN@ahrq.hhs.gov with "Join IRB Listserv" in the subject line.
AHRQ National Webinar: Strategies to Support Cooperation of Multiple Organizations’ Institutional Review Boards (IRBs)
The AHRQ hosted a webinar on various types of Institutional Review Board (IRB) cooperation that can be pursued to support practice-based research. The presenters defined and described processes for ceding review to a lead IRB, serving as the IRB of record and participating in reliant IRB review. The presenters also gave examples of how practice-based research networks have successfully implemented these processes.
Critical IRB Reference Material:
- Greene SM, Braff J, Nelson A, Reid RJ. The process is the product: a new model for multisite IRB review of data-only studies. IRB: Ethics & Human Research, 2010;32(3):1-6.
- Cola PA, Reider C, Strasser JE. Ohio CTSAs Implement a Reliant IRB Model for Investigator-Initiated Multicenter Clinical Trials. Clin Transl Sci., Jun 2013; 6(3): 176–178.
- Marsolo K. Approaches to facilitate institutional review board approval of multicenter research studies. Med Care, July 2012;50 Suppl:S77-81.
- Graham DG, Pace W, Kappus J, Holcomb S, Galliher JM, Duclos CW, Bonham AJ. Institutional Review Board Approval of Practice-based Research Network Patient Safety Studies. In: Henriksen K, Battles JB, Marks ES, et al., editors. Advances in Patient Safety: From Research to Implementation (Volume 3: Implementation Issues). Rockville (MD): Agency for Healthcare Research and Quality (US); 2005 Feb.
- Additional reference material.
IRBShare is a joint IRB review model for multisite studies. This approach has letters of acceptance from the DHHS Office of Human Research Protections and the Association for Accreditation of Human Research Protection Programs.
AHRQ National Webinar: Patient Engagement in Primary Care
The AHRQ PBRN Resource Center hosted a webinar on patient engagement in primary care. The presenters discussed the engagement of patients and families in the medical home (including the pediatric medical home), the development of the Patient Voices Network, and the impact that activated patients can have on research, quality improvement efforts, and the delivery of primary care.
Positioning the Family and Patient at the Center: A Guide to Family and Patient Partnership in the Medical Home
The goal of this monograph (PDF - 1.1 KB), developed from case studies of 17 pediatric practices, is to provide pediatric health providers with the resources they need to implement the patient- and family-centered medical home model. This monograph will be of interest to health professionals, patients, families, planners, and policymakers.
Guide to Patient and Family Engagement in Hospital Quality and Safety
AHRQ developed this evidenced-based resource to help hospitals partner with patients and their families to improve the quality and safety of the healthcare they deliver. Detailed guidance and customizable tools are available to assist with implementation and evaluation of each recommended strategy.
The Medical Office Survey on Patient Safety Culture
In response to medical offices interested in a survey that focuses on patient safety culture in their offices, AHRQ sponsored the development of the Medical Office Survey on Patient Safety Culture. This survey is designed specifically for outpatient medical office providers and staff and asks for their opinions about the culture of patient safety and health care quality in their medical offices.
The survey was designed for medical offices with at least three providers (physicians, either M.D. or D.O.; physician assistants; nurse practitioners; and other providers licensed to diagnose medical problems, treat patients, and prescribe medications). Survey administration in solo practitioner or two-provider offices is not recommended because it would not be possible to maintain the confidential nature of individual responses. In small offices, rather than administering the survey, it can be used as a tool to initiate open dialog or discussion about patient safety and quality issues among providers and staff.
Patient Safety Network
This Patient Safety Network is a continuously updated, annotated and carefully selected collection of patient safety news, literature, tools, and resources. You can click on new journal/magazine/newspaper articles on patient safety, or search the patient safety database for a particular subject of interest.
AHRQ’s Practice Facilitation Handbook
The Practice Facilitation Handbook (PDF - 2.43 MB) is designed to assist in the training of new practice facilitators as they begin to develop the knowledge and skills needed to support meaningful improvement in primary care practices. It evolved from the Agency for Healthcare Research and Quality’s Integrating Chronic Care and Business Strategies in the Safety Net toolkit. That toolkit was developed to aid safety net practices in implementing the Chronic Care Model, now commonly referred to as the Care Model, in their practices.
The handbook consists of 21 training modules, each 30 to 90 minutes long with varying requirements for pre-session preparation for learners. Each module contains a Trainer’s Guide, which includes a checklist of materials, the learning objectives for the session, and a list of readings and activities designed to develop basic knowledge and skills.
The AHRQ PBRN Resource Center held a webinar with Handbook authors Lyndee Knox (LANet PBRN) and Cindy Brach (AHRQ). Visit the Practice Facilitation Handbook event page for a webinar recording and additional information.
AHRQ's Practice Facilitation Manual
A How-To Guide on Developing and Running a Practice Facilitation Program (PDF - 3 KB)
The Agency for Healthcare Research and Quality recently sponsored the development of a how-to guide for organizations interested in starting a practice facilitation program aimed at improving primary care. The practice facilitation programs described in this guide are designed to work with primary care practices on quality improvement activities, with an emphasis on primary care redesign and transformation. The guide focuses on how to establish and run an effective practice facilitation program, and is intended for organizations or individuals who will develop, design, and administer such programs.
This guide was developed based on information and resources shared by more than 30 experts in the field of practice facilitation. AHRQ convened the expert working group through a series of webinars and conference calls over a nine month period in 2011. These experts provided practical knowledge and hard-won lessons from their experiences in practice facilitation, and shared resources that they developed or found useful.
Virtual Facilitation 101 Website
Case Studies of Exemplary Primary Care Practice Facilitation Training Programs
This resource from the Agency for Healthcare Research and Quality describes three exemplary US-based practice facilitation training programs, focusing in particular on program formation, operation and curricula. These diverse programs were selected for inclusion in the document based on an environmental scan of existing practice facilitation training programs, as well as nominations from experts on the topic. This resource will be useful to groups and individuals who are developing or improving primary care practice facilitation programs; trainers and students in existing programs; and other members of the primary care community, including clinicians and policymakers.
AHRQ National Webinar: PBRN Workforce of the Future
The AHRQ PBRN Resource Center hosted a webinar to discuss the evolving PBRN workforce, and which focused specifically on the role of practice facilitators and research assistants in PBRN member practices in the context of quality improvement.
Care Coordination Measures Atlas
The health care community is struggling to determine how to measure the extent to which care coordination activities are being implemented. AHRQ's Care Coordination Measures Atlas lists existing measures of care coordination, with a focus on ambulatory care, and presents a framework for understanding care coordination measurement. The Atlas is useful for evaluators of projects aimed at improving care coordination and for quality improvement practitioners and researchers studying care coordination.
Improving Your Office Testing Process: A Toolkit for Rapid-Cycle Patient Safety and Quality Improvement
This toolkit offers step-by-step instructions on how to evaluate an office testing process, identify areas where improvement is needed and address those areas. Practical tools are included that can be used to assess office readiness, plan activities, engage patients, audit efforts and incorporate electronic health records. The toolkit also includes a template for practices to ensure that laboratory test results are communicated effectively to patients in English or Spanish.
Opportunities for Integrating MOC Part IV Requirements into PBRN Practices
The PBRN Resource Center has developed a resource document (PDF - 2.55 MB) with input from experts in practice-based research and from medical specialty boards. This document provides information about the Maintenance of Certification (MOC) process that physicians undertake to retain board certification. The goal of the document is to help PBRNs align their infrastructure and activities to support physicians in meeting MOC Part IV (quality/practice improvement) requirements. PBRNs have the potential to serve as a partner to all clinicians—particularly physicians, physician assistants, and nurse practitioners—who have a professional expectation to engage in quality/practice improvement as a part of their commitment to patients. The guide will help PBRNs understand the potential synergy between their current infrastructure and activities that support their members in meeting MOC Part IV requirements from primary care medical specialty boards.
Patient Centered Medical Home (PCMH) Resource Center
The PCMH Resource Center Web site provides policymakers and researchers with access to evidence-based resources about the medical home and its potential to transform primary care and improve the quality, safety, efficiency, and effectiveness of U.S. health care.
State-specific Health Care Quality Information
The State Snapshots provide State-specific health care quality information, including strengths, weaknesses, and opportunities for improvement. The goal is to help State officials and their public- and private-sector partners better understand health care quality and disparities in their State.
Informed Consent and Authorization Toolkit for Minimal Risk Research
The Agency for Healthcare Research and Quality (AHRQ) has developed the Informed Consent and Authorization Toolkit for Minimal Risk Research to facilitate the process of obtaining informed consent and Health Insurance Portability and Accountability Act (HIPAA) authorization from potential research subjects. This toolkit contains information for people responsible for ensuring that potential research subjects are informed in a manner that is consistent with medical ethics and regulatory guidelines.
International Federation of Primary Care Research Networks (IFPCRN)
The International Federation of Primary Care Research Networks (IFPCRN) was developed in 2001 to support primary health care research throughout the world by providing: mutual support of research networks; an exchange of ideas and methodologies; advocacy for the quality of research in primary care; capacity building; policy and advocacy initiatives, and collaborative research opportunities. Here you can access tools for researchers and IFPCRN publications.
North American Primary Care Research Group (NAPCRG)
NAPCRG is a multi-discipline organization for primary care researchers. Browse this website to find more about NAPCRG goals, membership, news and more.
PBRN Research Good Practices (PRGPs) (PDF - 2.1 KB) is a compendium of recommended research procedures. This compendium is organized into 4 chapters: (1) Building PBRN Infrastructure; (2) Study Development and Implementation; (3) Data Management; and (4) Dissemination Policies. This compendium builds upon previous work (Neale, R01 HS016713) and was developed by network directors and coordinators from 7 PBRNs.
The AHRQ PBRN Resource Center held a National Webinar with the authors of the PRGP resource on September 30, 2014. Visit the PRGP event page for more information.
Program for Readability In Science & Medicine (PRISM)
The Program for Readability In Science & Medicine (PRISM) is a Group Health Research Institute initiative to improve the readability of consent forms and other print materials for health care research study participants.
An online collection of materials to facilitate multi-site collaborations for health research. These collaborations include community-based organizations, academic institutions, or health care delivery settings.
Toolkit for Developing and Conducting Multisite Clinical Trials in Practice Based Research Networks (PBRNs)
This toolkit was created to help researchers interested in conducting clinical trials in a PBRN setting answer questions related to clinical effectiveness, comparative effectiveness and safety. The toolkit was developed in collaboration with the DARTNet Institute Research Steering Committee and the Clinical Translational Science Award (CTSA) PBRN Workgroup of the Community Engagement Key Function Committee.
PBRN Playlist on the AHRQ Primary Care YouTube Channel
This playlist contains video recordings of national webinars hosted by the AHRQ PBRN Resource Center. Webinar topics include: patient engagement in primary care, practice facilitation, electronic health record functionality, and more!
AHRQ National Webinar: Implementing Health Assessments in Primary Care: A How-to Guide
The AHRQ PBRN Resource Center hosted a webinar on an evidence-based guide, released by the Agency for Healthcare Research and Quality, that was developed for primary care doctors, nurse practitioners and physician assistants on how to successfully select, adopt and implement health assessments (HA) in primary care settings. The presenters described how this guide, Health Assessments in Primary Care: A How-to Guide for Clinicians and Staff, may be used to help clinicians decide which health assessments to use, how to integrate them into their daily workflow and how to engage patients.
Health Extension Toolkit
A growing number of institutions and agencies from around the country have sought information about health extension—how it operates, what are its primary care outcomes, and how it can be implemented in their home community or institution. Thus, the creation of a Health Extension Toolkit aimed at states, academic health centers, professional societies and Tribal Nations so they might adopt aspects of health extension’s transformational learning relevant to their own purpose and objectives. This Toolkit was put together from the experiences of 18 states– rural and urban, from all regions of the country– that are pioneering this new concept.
AHRQ Innovations Exchange
The Innovations Exchange helps you solve problems, improve health care quality, and reduce disparities. Use this site to find evidence-based innovations and QualityTools; view new innovations and tools published biweekly; and learn from experts through events and articles.
Prescription for Health
Prescription for Health is PBRN initiative funded by RWJF and supported by AHRQ to promote the incorportation of behavior change services into primary care setting.