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pbrn.ahrq.gov/evidencenow/projects/heart-health/about/cooperatives/nyc.html
March 01, 2021 - higher mortality rates from almost all diseases, including CVD, compared with residents of higher income neighborhoods … "Working in these very small practices, we are seeing how much they are part of their communities. … The doctors live in the same neighborhoods as their patients. They speak the same language. … When you support a practice like this, you are supporting the wellbeing of a community." … New York City Community Health Survey. http://www.nyc.gov/html/doh/html/data/survey.shtml .
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pbrn.ahrq.gov/sites/default/files/wysiwyg/evidencenow/cooperatives/evidencenow-executive-summary-nyc.pdf
November 01, 2017 - mortality rates from
almost all diseases, including CVD, compared with residents of higher income
neighborhoods … Investigator
“Working in these very small practices, we are seeing how
much they are part of their communities … The doctors live in
the same neighborhoods as their patients. They speak the
same language. … When you support a practice like this, you
are supporting the wellbeing of a community.” … New York City Community Health Survey.
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pbrn.ahrq.gov/cahps/news-and-events/events/2020-meeting-summary.html
December 01, 2020 - Lisa Franchetti, MA, CPHQ, Customer Experience Manager, Neighborhood Health Plan of Rhode Island
Topic … : Improving enrollee experience with a health plan’s customer service
Neighborhood Health Plan (Neighborhood … Neighborhood identified a need to focus on improving customer service by oversampling plan members, analyzing … As a result of these interventions, Neighborhood has achieved and been able to maintain improvements … Natalie McNeal, MBA, MHA, Executive Director, Wellstar Community Hospice
Topic: Improving patient experience
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pbrn.ahrq.gov/news/newsletters/e-newsletter/890.html
November 01, 2023 - AHRQ in the Professional Literature
Neighborhood built environment and sleep health: a longitudinal … study in low-income and predominantly African-American neighborhoods. … Improving identification of Medicaid eligible community-dwelling older adults in major household surveys
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pbrn.ahrq.gov/sites/default/files/wysiwyg/patient-safety/settings/mcc-summit/mcc-summit-arlene.pdf
November 17, 2020 - on
preventing decline, maximizing functioning, and
improving quality of life
7
8
Medical Neighborhood … 9
Health Community
10
Research:
The Science of Care
• What works AND how do we make it work … • Patient Advocates
• Clinicians
• Researchers
• Health System Leaders
• Community Organizations
• Professional … with MCC
�Addressing MCC Across �the Continuum of Risk
Shared Principles of Primary Care
Medical Neighborhood … Health Community
Research: �The Science of Care�
Research Challenges
Who is here today?
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pbrn.ahrq.gov/pbrn-registry/massachusetts-general-primary-care-practice-based-research-network
September 26, 2007 - Mission Statement: The MGPC-PBRN is devoted to providing the highest quality of care to individuals and communities … served by our academic, community-based, and neighborhood health center practices.
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pbrn.ahrq.gov/ncepcr/research/care-coordination/index.html
September 01, 2022 - Literacy
Quality Improvement
Data Resources
Tools and Resources
Research Communities … crucial components of the medical home, including patient-centeredness, care coordination, the medical neighborhood
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pbrn.ahrq.gov/pcor/strategic-framework/stakeholder-engagement.html
July 01, 2023 - Stakeholders include family members and caregivers, patient advocates, community members and organizations … Communities can be defined in social, economic, or geographic terms, such as patient communities, racial … /ethnic communities, percent of the population living below the Federal poverty level, or residents of … an urban or rural neighborhood. … Stakeholder engagement can help define appropriate community representatives to include in the work.
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pbrn.ahrq.gov/cahps/quality-improvement/index.html
October 01, 2023 - benefits of expanding teamwork to include patients and families, health care practices, and medical neighborhoods
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pbrn.ahrq.gov/ncepcr/research/care-coordination/pcmh/define.html
August 01, 2022 - Literacy
Quality Improvement
Data Resources
Tools and Resources
Research Communities … Building on the work of a large and growing community, the Agency for Healthcare Research and Quality … , will build virtual teams linking themselves and their patients to providers and services in their communities … elements of the broader health care system, including specialty care, hospitals, home health care, and community … Engaging Patients and Families in the Medical Home (PDF, 651 KB)
Coordinating Care in the Medical Neighborhood
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pbrn.ahrq.gov/sops/databases/pharmacy/submission.html
November 01, 2023 - Pharmacy
Participating in the Community Pharmacy Database
Ambulatory Surgery Center … Pharmacy Survey Database
The SOPS ® Community Pharmacy Database is a central repository for … The SOPS Community Pharmacy Database Report presents aggregated results for all participating community … pharmacies as well as results by community pharmacy and respondent characteristics. … , mass merchandiser pharmacy, or neighborhood drug store pharmacy.
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pbrn.ahrq.gov/talkingquality/explain/share-info/index.html
November 01, 2018 - with; these can include organizations for population subgroups defined by age, gender, race/ethnicity, neighborhood
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pbrn.ahrq.gov/tools-and-resources/pbrn-literature/health-care-contacts-year-suicide-death
January 02, 2022 - prior to death (p < 0.05) tended to be women, individuals of older age (65+ years), those where the neighborhood
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pbrn.ahrq.gov/healthsystemsresearch/hspc-research-study/acknowledgments.html
June 01, 2020 - (Neighborhood Family Practice; Case Western Reserve University)
Stephanie Studenski, M.D., M.P.H.
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pbrn.ahrq.gov/health-literacy/professional-training/shared-decision/webinars/index.html
September 01, 2020 - (Patient-Centered Medical Home and Neighborhood): Current NCQA requirements for PCMHs and ACOs regarding
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pbrn.ahrq.gov/ncepcr/care/coordination.html
August 01, 2018 - National Center
Research Initiatives
Data Resources
Tools and Resources
Research Communities … Linking to community resources.
Working to align resources with patient and population needs. … Coordinating Care in the Medical Neighborhood: Critical Components and Available Mechanisms.
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pbrn.ahrq.gov/sites/default/files/docs/Contextual-Relevancy-and-Research-Collaborations-031215.pdf
September 10, 2015 - organizations, patient
groups, social service agencies, neighborhood groups, faith-
based organizations … Potential Partners
– Public health departments
– Schools & school systems
– Neighborhood groups … CBR & PCOR Learning Resources
• Experienced PBRNs & investigators
• CTSA Community Partnership … Research Scholars Initiative (CRSI)
• Developing a research network of community
organizations … )
• Tufts CTSI:
http://www.tuftsctsi.org/Services-and-
Consultation/Community-
Engagement/Community-Engagement-Tools
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pbrn.ahrq.gov/research/findings/studies/index.html
January 01, 2024 - Infections
(59)
Community-Based Practice
(150)
Community Partnerships
(18)
Comparative Effectiveness … Exposure was ZIP code-level Child Opportunity Index (COI), a composite measure of neighborhood resources … Decreasing neighborhood opportunity was associated with increasing hospitalization rates among children … Association of neighborhood opportunity and pediatric hospitalization rates in the United States. … ED, and 60,725 from a rural community ED.
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pbrn.ahrq.gov/news/newsletters/e-newsletter/903.html
March 01, 2024 - Technical Brief (draft open for comment through March 22) Evidence Map on Home and Community-Based Services … Medication management strategies by community-dwelling older adults: a multisite qualitative analysis … Reduced prevalence of childhood asthma after housing renovations in an underresourced community. … Association of neighborhood opportunity and pediatric hospitalization rates in the United States.
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pbrn.ahrq.gov/sites/default/files/wysiwyg/patient-safety/rev-finalreport-update-2021.pdf
January 01, 2021 - transition strategies are part of a broader movement in primary care
toward the development of “medical neighborhoods … While the transition from the hospital to primary care is important, the medical neighborhood
perspective … Readmissions: A Conceptual Framework To Rethink the Role of Primary Care 3
perspectives of the primary care community—community … Community Agency Staff
The perspective of community agencies, affiliated with the primary care sites … Primary care can claim
greater ownership of care transitions as the hub of the medical neighborhood