Monday, March 21, 2011

Examples of AHRQ-funded dissertation projects

AHRQ's Health Services Research Dissertation Grant Program: New Starts

Fiscal Year 2010

This fact sheet presents information about AHRQ's research dissertation grant program and briefly describes the 16 dissertation grant awards funded by the Agency in Fiscal Year 2010.
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The mission of the Agency for Healthcare Research and Quality is to improve the safety, quality, efficiency, and effectiveness of health care for all Americans. To help achieve the Agency's mission, AHRQ supports extramural research grants and contracts, research training, conference grants, and intramural activities.
AHRQ is committed to fostering the next generation of health services researchers who will focus their time and expertise on some of the most important problems facing our Nation's health care system. An important component of this effort is the Agency's dissertation research grant program, which provides 1-year awards to full-time predoctoral students enrolled in accredited research doctoral programs in the United States, including Puerto Rico and other U.S. Territories and possessions.
To qualify for dissertation awards, students must be U.S. citizens or permanent residents by the time of the grant award and must have completed all of their doctoral requirements by the time they submit a dissertation grant application.
This fact sheet provides brief descriptions of the 16 dissertation grant awards funded by AHRQ in fiscal year 2010. Each entry includes the project title, grantee's name and institution, his or her area of focus, the grant number and project period, and a short description of the project.

Project Descriptions

The Anticipatory Effects of Medicare Part D on Drug Utilization.

Abby Elizabeth Alpert, doctoral candidate in Economics, University of Maryland, College Park. AHRQ grant HS019681; project period August 1, 2010-September 29, 2011. This research will examine the effects on beneficiary behavior of the announcement in 2003 of forthcoming changes in the Medicare Part D program for prescription medication benefits for the elderly, given that the actual program did not begin until 3 years later. The goal of the project is to estimate the causal anticipatory effects of Part D on drug utilization. Estimating the utilization effect of Part D is important for evaluating whether the primary aims of the policy—expanding access to prescription drugs—were achieved and for assessing the program's future financial solvency.

An Evaluation of the Effectiveness and Process of a Rapid Response Team

Tanya Elise Lord, doctoral candidate in Clinical and Population Health Research, University of Massachusetts Medical School. AHRQ grant HS019118; project period June 1, 2010-August 30, 2011. This research will evaluate the effectiveness of a rapid response system (RRS) using a before and after study designed to measure changes in rates of cardiac arrest, unanticipated intensive care unit (ICU) admission from the floors, hospital mortality, and code calls to the floor. The goal is to provide valid measures of the effectiveness of the intervention and inform the ongoing national discussion about the benefits and costs of RRS. The findings ultimately may contribute to a more efficient allocation of the relevant public health resources.

Central Venous Catheter (CVC)-Related Bloodstream Infections in Pediatric Oncology Patients

Rita Secola, doctoral candidate in Nursing, University of California, Los Angeles. AHRQ grant HS019103; project period June 1, 2010-May 31, 2011. The purpose of this study is to determine if a specialized central venous catheter (CVC) team intervention will reduce CVC-related bloodstream infections in pediatric oncology patients. The goal is to improve a nursing model of care and outcomes for pediatric oncology patients.

Creating a Foundation for the Design of Culturally Informed Health Information Technology

Rupa Valdez, doctoral candidate in Industrial and Systems Engineering, University of Wisconsin at Madison. AHRQ grant HS018809; project period February 1, 2010-January 31, 2011. This research will generate design considerations to guide the development of consumer health information technology (IT) that will facilitate interaction between culturally diverse patients and members of their social networks. This project seeks to create a foundation for a design strategy that leads to culturally informed consumer health IT. Consumer health IT shows great promise to engage patients and members of their social network and promote their active participation in improving patients' health.

Exploring the Intersection Between Patient Safety Culture and Hospital Nursing Practice

Patricia Groves, doctoral candidate in Nursing, University of Missouri, Columbia. AHRQ grant HS018725; project period March 1, 2010-April 30, 2011. This research will examine how organizational context (communicated structures of rules and resources) constrain and enhance the ability of individual hospital staff nurses to keep patients safe. The project seeks to advance knowledge about safety and safety culture in hospitals. This study will provide information about how hospitals might improve or strengthen their safety culture to enhance the ability of nurses to keep patients safe.

Exploring Organizational Mechanisms for Success in Quality Improvement

Sean O'Neill, doctoral candidate in Policy Analysis, RAND Corporation. AHRQ grant HS018799; project period March 1, 2010-February 28, 2011. This research will explore the fundamental mechanisms leading to success in quality improvement (QI) that, if better understood, could help in the effort to make successful QI replicable and scalable. The project represents an important first step in discovering and exploring the decisionmaking processes of quality improvement intervention (QII) teams over the entire course of a QII.

A General Mechanism for Explaining Physician's Responses to Patients' Requests

Matthew Test-Wojteczko, doctoral candidate in Health Services Research and Policy, University of Rochester. AHRQ grant HS018797; project period September 30, 2010-June 30, 2011. This research will explore why physicians' responses to patients' requests persistently vary, even under controlled experimental conditions. The project seeks to expand the Healthy 2020 goal of increasing satisfaction with health care providers' communication skills in interactions with elderly populations.

The Impact of Medical Inflation on Guaranteed Renewable Health Insurance

Robert Dan Lieberthal, doctoral candidate in Economics, University of Pennsylvania. AHRQ grant HS018835; project period March 1, 2010-March 31, 2011. This research will examine the impact of medical inflation on the premiums and solvency of guaranteed renewable individual health insurance. The project seeks to improve health insurance practices for health insurance payers. This study will determine the optimal investment policy for guaranteed renewable individual health insurance.

The Impact of Nursing Workforce Organization on Outcomes of Hospitalized Children

Heather Tubbs-Cooley, doctoral candidate in Nursing, University of Pennsylvania. AHRQ grant HS018802; project period June 1, 2010-May 31, 2011. This research will explore the relationship between hospital nursing organization and patient outcomes for children hospitalized with common conditions; examine the differences in outcomes between children's and general hospitals; and explore the joint effects of hospital nursing organization and hospital type (children versus general) on pediatric outcomes. The project seeks to provide information about relationships between nursing care and pediatric patient outcomes to enhance the safety of hospital care for this population.

The Magnet Journey: Understanding the Role of Unit Culture in EBP Adoptions

Kim M. Schippits, doctoral candidate in Economics, Emory University. AHRQ grant HS018233; project period February 1, 2010-April 30, 2011. The purpose of this exploratory study is to understand how nursing unit culture affects the emergence and maintenance of evidence-based nursing practices in the hospital setting. Evidence-based practice (EBP) has been identified as a cornerstone of safe and effective health care and has been related to recent improvements in several critical outcomes, including ventilator associated pneumonia, central line-associated infections, and surgical site infections. This study will begin to identify how the magnet culture affects the emergence and maintenance of EBP implementation that will improve the quality, safety, and effectiveness of care provided.

Nursing Home Compare: Predictors and Impact of Differing Organization Response

Jennifer Meagher, doctoral candidate in Social Policy/Health Policy, Brandeis University. AHRQ grant HS018836; project period June 1, 2010-May 31, 2011. This research will explore the effects and consequences of the public reporting of nursing home quality in order to build knowledge about these types of market-based health care quality improvement policies. The project will seek to evaluate the long-term effects of a policy intended to improve nursing home quality.

Patient Handoffs Between Emergency Department and Inpatient Physicians

Phillip Brian Hilligoss, doctoral candidate in Information Sciences, University of Michigan at Ann Arbor. AHRQ grant HS018758; project period May 1, 2010-April 30, 2011. This research will follow a grounded research theory methodology involving semi-structured interviews and ethnography to examine admission handoffs between physicians in the emergency department (ED) and various inpatient services of a large U.S. tertiary teaching hospital. The project seeks to contribute to the growing discourse on the standardization of patient handoffs in hospitals by examining the sources and nature of variation in the transitions of patients from the ED to inpatient services in a tertiary teaching hospital. This study will provide a conceptual framework that will guide practitioners as they look for ways to improve handoff practices within their own services and institutions.

Pharmacists of Conscience: Ethical Decisionmaking and Consistency of Care

Elizabeth Chiarello, doctoral candidate in Sociology, University of California at Irvine. AHRQ grant HS019703; project period September 30, 2010-August 31, 2011. This research will examine how pharmacists make challenging ethical decisions in their work. Pharmacists who work in settings with different laws, organizational policies, and political communities help determine how these dimensions influence decisionmaking. The goal is to understand how pharmacists make choices and the effects of their decisionmaking processes on patient safety and access to care.

Providing Hospice Care for Children: An Organizational Study

Lisa Lindley, doctoral candidate in Nursing, University of North Carolina, Chapel Hill. AHRQ grant HS020164; project period September 30, 2010-September 29, 2011. The goal of this study is to describe the provision of hospice care to children and examine the effects of institutional forces and financial performance on provision of hospice care to children while controlling for organizational and market factors. The project seeks to inform the development of policies aimed at expanding access and delivery of hospice care for children. Understanding and improving access to hospice care will offer terminally ill children and their families the opportunity to receive comprehensive and individualized care that promotes comfort, peace, and dignity at the end of life.

Understanding Processes of Care and Patient Safety Outcomes in Nursing Homes

Kali Thomas, doctoral candidate in Gerontology, University of South Florida. AHRQ grant HS019671; project period September 1, 2010-August 31, 2011. This research will examine the relationships between top management's ratings of nursing home patient safety culture (a structural attribute) and objective measures of safe processes of care and resident outcomes. The goal is to understand the relationships that exist among patient safety culture, processes of care, and patient safety outcomes.

Where the Rubber Meets the Road: Middle Managers Role in Innovation

Sarah Abigail Birken, doctoral candidate in Health Policy and Management, University of North Carolina, Chapel Hill. AHRQ grant HS19107; project period June 1, 2010-May 31, 2011. This research will assess the role of middle managers in innovation implementation in health care organizations. Theory suggests that middle managers in organizations that provide job resources may reciprocate with increased commitment to innovation implementation. The project seeks to identify high-leverage ways for health care organizations to facilitate the translation of evidence into practice and contribute to a growing body of literature on implementation effectiveness.

More Information

For more information about the Agency for Healthcare Research and Quality, please visit the AHRQ Web site at For more specific information on funding for dissertation grants and other training programs, including answers to commonly asked questions, please visit
For specific programmatic questions, please contact:
Brenda A. Harding, MA
Health Scientist Administrator
Agency for Healthcare Research and Quality (AHRQ)
540 Gaither Road, Suite 2006
Rockville, Maryland 20850
AHRQ Publication No. 11-P009-EF
Current as of March 2011

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