Redesigning Healthcare Delivery

AIR researchers—nurses, physicians, psychologists, sociologists, economists, and public health experts—are at the forefront of understanding and solving the intertwined challenges of healthcare quality, costs, and access. We work to advance high-quality, affordable, patient-centered care through relevant research, results-driven technical assistance, and rigorous evaluations that focus on what matters most to patients, families, clinicians, and other stakeholders.

For example, in a project for the National Institute on Disability, Independent Living, and Rehabilitation Research,  AIR is developing an evidence-based assessment and referral toolkit for opioid use disorder (OUD) to help clinicians improve care of people with disabilities and chronic pain related to musculoskeletal conditions such as arthritis. Bridging research and practice by applying the best science and methods tested in real-world settings is fundamental to improving care delivery and solving public health threats like the opioid epidemic. That’s why AIR established the Center for Addiction Research and Effective Solutions (AIR CARES) to share best practices in response to substance use disorders.

In another example of our efforts to redesign care delivery, AIR is conducting rapid-cycle learning support and evaluation of quality improvement team staffing models for Upstream USA, a nonprofit working to expand economic opportunity and mobility by reducing unplanned pregnancy in the U.S. Upstream partners with states to provide health centers with patient-centered, evidence-based training and technical assistance to help ensure all women have same-day access to the birth control method of their choice. AIR is working with Upstream to design and optimize staffing of the organization’s state-based quality improvement teams in Massachusetts and Washington.

Latest Work

15 May 2020
Brief

The Promise of Telehealth for Addressing COVID-19

The use of telehealth has increased during the current global coronavirus pandemic. The word "telehealth" is sometimes used interchangeably with "telemedicine," but these terms mean different things. This brief explores those differences, how remote health care services work and for what conditions, and what policy changes have occurred to expand access to remote health care.
Project

Meeting the Growing Need for Clinicians to Care for People with Arthritis

The number of Americans living with arthritis continues to grow beyond the field of rheumatology’s capacity to provide needed care. AIR is working with the Arthritis Foundation to explore whether patients will accept advanced practice providers such as nurse practitioners and physician assistants as an option to fill the growing shortage of rheumatologists.
Project

Understanding Facilitators and Barriers to Vaccination in Rural Communities

National surveys show that vaccination rates for young children (19–35 months old) in rural areas are lower for nearly all recommended vaccines. AIR is conducting a qualitative study for the Centers for Disease Control and Prevention to understand facilitators of and barriers to vaccination in rural U.S. communities.
Project

Emergency Triage, Treat, and Transport Learning System

Currently, Medicare only pays for emergency ground ambulance services when beneficiaries are transported to specific types of facilities, most often a hospital emergency department, creating an incentive to transport all beneficiaries to the hospital even when more appropriate alternative treatment options are available. AIR is contributing to the development of a learning system funded by the Centers for Medicare & Medicaid Services to support the voluntary, 5-year model designed to give ambulance care teams greater flexibility to address emergency care needs of Medicare fee-for-service beneficiaries following a 911 call.
Project

Evaluation and Learning Support for Upstream Initiatives in Massachusetts and Washington

Upstream is a fast-growing nonprofit working to reduce unplanned pregnancy by expanding access to contraceptive options. Through state-based quality improvement teams, Upstream provides health centers with patient-centered, evidence-based training and technical assistance to help ensure all women have same-day access to the birth control method of their choice.
Project

Understanding Omissions of Care in Nursing Homes

Research shows that a substantial portion of patient harms are avoidable, and that omission of care is a significant factor in many adverse events in nursing homes. The goal of this project was to review, summarize, and synthesize existing approaches related to omissions of care in nursing homes into a single definition and to present the evidence about omissions of care in useful ways for identifying when and how they occur, which omissions lead to which consequences, how omissions can be monitored, and what strategies are effective in preventing them.
Project

Learning Health System Panel to Inform and Encourage Use of Evidence Reviews

Too often, significant lags occur in moving evidence of the best ways to deliver care into routine practice. AIR is working with a panel of 11 diverse learning health systems to gather ideas, feedback, and recommendations on evidence topics, products, and tools to help health systems integrate evidence-based findings into routine operations.
Project

Improving Assessment of Opioid Use Disorder (OUD) for People with Disabilities and Chronic Arthritis Pain

The rapid growth in opioid overdoses has put a spotlight on prescribing patterns, with increased pressure on clinicians to reduce opioid prescribing, especially for long-term management of chronic, noncancer pain. As part of a grant provided by National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR), AIR is working to lay the groundwork for primary care providers and specialists to accurately assess opioid use disorder in people with disabilities who are taking opioids long term to manage musculoskeletal pain.
Project

Expanding Medication-Assisted Treatment for Opioid Use Disorder in Rural Primary Care

Oklahoma is among the states hardest hit by a combination of national trends in nonmedical uses of opioid prescription drugs, past-year heroin use, and opioid-related mortality. AIR recently led and evaluated a project for the Agency for Healthcare Research and Quality—Increasing Access to Medication-Assisted Treatment Among Rural Providers—to train rural Oklahoma primary care clinicians to identify and treat patients with opioid use disorders using medication-assisted treatment, an evidence-based intervention that combines behavioral therapy and medication to treat substance use disorders.
Project

Strong Start for Mothers and Newborns Evaluation

Babies born prematurely are a growing public health problem with significant consequences for families and an estimated cost to society of at least $26 billion each year. The Strong Start for Mothers and Newborns initiative tested and evaluated enhanced prenatal care interventions for women at risk for preterm birth. The goal was to improve quality of care and reduce rates of preterm birth and low-birthweight infants while reducing costs to Medicaid during pregnancy, birth and the infant’s first year.
10 Feb 2016
Toolkit

Triple Aim Measurement Toolkit for Health Centers

What can community health centers do to demonstrate value to stakeholders—such as payers, providers, and patients—in a changing payment landscape? The Triple Aim Measurement Toolkit helps health centers measure and analyze health outcomes, patient experience, and cost together
Project

Studying Lean Implementation in Different Healthcare Settings

The mandate to create efficiency and lower the costs of healthcare has led many hospital and healthcare system leaders to search for new and unique management strategies, often from other industries. AIR helped fill the gaps in knowledge about how a healthcare organization’s environment, structure, and culture may inhibit or enhance successful diffusion and integration of Lean training, tools, and activities.
Project

Understanding Barriers to Testing for Women with Gestational Diabetes

Nearly 10 percent of pregnant women develop gestational diabetes, and up to 30 percent of those will develop Type 2 diabetes as they age. Yet many of these women do not check their blood glucose levels as often as they should. AIR researchers studied why women at high risk avoid testing.
Project

Addressing Unnecessary Antibiotic Use in Nursing Homes

High rates of antibiotic use have been linked to the growth of healthcare associated infections as well as multi-drug resistant organisms—both of which can be life threatening to elderly patients. Along with a team of experts in nursing home care and antibiotic stewardship, AIR developed a guide that will provide nursing homes with a set of easy to use tools to implement antimicrobial stewardship practices.
Project

Graduate Nurse Education (GNE) Demonstration

Advanced practice registered nurses (APRNs) provide critical access to primary care across the country, especially in underserved areas. The Centers for Medicare & Medicaid Services encouraged five hospitals to partner with schools of nursing and provided reimbursement for the reasonable cost of providing clinical training to APRN students added as a result of the demonstration. AIR evaluated the effectiveness of the demonstration in providing clinical training in community-based settings.
Project

TeamSTEPPS™

The Agency for Healthcare Research and Quality and the Department of Defense have worked with AIR since 2002 to identify best practices and set the standard for medical team training. A major result of this partnership was the development of TeamSTEPPS, or Team Strategies and Tools for Enhancing Performance and Patient Safety.