AHRQ Health Services Research Projects: Making Health Care Safer in Ambulatory Care
Settings and Long Term Care Facilities (R01)
Department of Health and Human Services
Agency for Health Care Research and Quality
The purpose of this FOA is to support patient safety research projects focused on understanding the epidemiology of patient safety in ambulatory and resident safety in long term care settings, gather evidence on strategies that improve patient and resident safety in these settings, and develop evidence-based tools to facilitate implementation of these strategies. Knowledge gained from these projects will support the development of strategies and tools to deliver quality care that is safe in the ambulatory and long term care settings.
In 1999, the Institute of Medicine (IOM) published a landmark study, “To Err is Human,” which highlighted the magnitude of safety problems in health care. Since the publication of the IOM report, AHRQ has developed, piloted, and refined a robust portfolio of evidence, tools, and measures to improve patient safety. The most significant investments to date have been made in the hospital setting where a patient stays for one or more nights in an inpatient unit for treatment. Substantial research has also focused on safety in emergency room settings where a patient is treated but not admitted to an inpatient unit. A body of research dedicated to patient safety in other settings, including ambulatory and long term care settings, has also emerged, but research and initiatives to improve safety in these settings is more limited than the hospital setting. Ambulatory care takes place in any non-hospital patient setting and includes, but is not limited to physicians’ and practitioners’ offices and clinics. Emergency room settings are not considered ambulatory care settings for the purpose of this announcement. Long term care facilities include nursing homes, assisted living, residential care homes and home care. Ambulatory care sites and long term care facilities are settings with high patient/resident volume and high potential for harm. It is vital to leverage and build on the knowledge gained from the inpatient arena while also recognizing the unique challenges and barriers for ensuring patient safety in these settings. As such, a need exists for more information about the characteristics of patient safety in these settings and the actions that are needed to realize improvements.
To address this issue AHRQ launched a multi-year initiative beginning in fiscal year 2015 to expand the scientific evidence, strategies, and tools that are available for improving patient safety in all health care settings so that people can expect safe care whenever and wherever they receive it (e.g., see http://grants.nih.gov/grants/guide/rfa-files/RFA-HS-15-002.html). With this FOA, AHRQ will focus on two healthcare settings–ambulatory care and long term care facilities. As applicable, work should include a focus on issues that are relevant to underserved and vulnerable populations. Additionally, AHRQ has a specific interest in settings that serve vulnerable populations which include Federally Qualified Health Centers (FQHC), Community Health Centers, safety-net hospital outpatient departments, physician offices and long term care facilities. While disparities in patient safety have been previously documented, studies have been limited with regard to study design and methods needed to generate the evidence regarding factors underlying disparities.
Unique Issues in Patient Safety in Ambulatory Care
The vast majority of healthcare is delivered in ambulatory settings with outpatient visits being more numerous than inpatient stays. There are approximately 1 billion outpatient visits per year in the United States, outnumbering hospital discharges by a factor of more than 30 to 1. Approximately one in ten Americans has an inpatient stay in a year, but the average number of visits to ambulatory care settings for each American is four per year. Because of the complex decentralized organization of ambulatory health care, individuals frequently must seek outpatient care from a variety of settings and providers and thus patients assume more responsibility for coordinating their own care, often obtaining and maintaining information about various aspects of their health care and communicating with more types of health care providers than they do in the inpatient setting. Continuity and coordination of care are spread among an increasing number of providers for episodes of care which may include follow-up of laboratory and other diagnostic tests or referrals to specialists. All of these factors may contribute to the challenges in ensuring patient safety in the ambulatory setting.
|Posted Date:||Aug 27, 2015|
|Creation Date:||Aug 27, 2015|
|Original Closing Date for Applications:||Mar 5, 2018|
|Current Closing Date for Applications:||Mar 5, 2018|
|Archive Date:||Apr 5, 2018|
|Estimated Total Program Funding:|
Nonprofits having a 501(c)(3) status with the IRS, other than institutions of higher education
For profit organizations other than small businesses
Native American tribal governments (Federally recognized)
City or township governments
Public and State controlled institutions of higher education
Special district governments
Private institutions of higher education
Public housing authorities/Indian housing authorities
Independent school districts
Others (see text field entitled “Additional Information on Eligibility” for clarification)
Nonprofits that do not have a 501(c)(3) status with the IRS, other than institutions of higher education
Native American tribal organizations (other than Federally recognized tribal governments)
|Additional Information on Eligibility:||Other Eligible Applicants include the following: Alaska Native and Native Hawaiian Serving Institutions; Asian American Native American Pacific Islander Serving Institutions (AANAPISISs); Eligible Agencies of the Federal Government; Faith-based or Community-based Organizations; Hispanic-serving Institutions; Historically Black Colleges and Universities (HBCUs); Indian/Native American Tribal Governments (Other than Federally Recognized); Non-domestic (non-U.S.) Entities (Foreign Organizations); Regional Organizations; Tribally Controlled Colleges and Universities (TCCUs) ; U.S. Territory or Possession; Non-domestic (non-U.S.) Entities (Foreign Institutions) are not eligible to apply. Non-domestic (non-U.S.) components of U.S. Organizations are not eligible to apply.|
|Agency Name:||Agency for Health Care Research and Quality|
|Description:||The purpose of this Funding Opportunity Announcement (FOA) is to support investigative research projects that examine the epidemiology of patient safety in ambulatory care settings and long term care facilities, gather evidence about strategies that can improve safety in these settings, and develop evidence-based tools to facilitate implementation of these strategies.|
|Link to Additional Information:||http://grants.nih.gov/grants/guide/pa-files/PA-15-339.html|