GHLI Programs in the United States of America
GHLI conducts ongoing research aimed at improving health care quality in the United States, including programs focused on health outcomes for patients with heart attacks (survival and readmission), and organizational factors associated with high quality hospice care. GHLI faculty pioneered the ‘positive deviance approach’ to improving health care quality in the U.S., and is now using this method in international settings such as Ethiopia. Positive deviance focuses on identifying the practices that are associated with top performance and understanding how they are adopted in a particular group or community.
For this work, GHLI brings diverse expertise to understanding health care, including public health, economics, organizational psychology, medicine, nursing, social work, biostatistics, and anthropology. The team also uses traditional and innovative approaches to research, with a particular focus on practical knowledge that can be applied in policy and practice.
Since 1999, GHLI faculty have engaged in research to better understand the key factors that contribute to positive health outcomes for people who have suffered heart attacks. Faculty have made important contributions to the scientific evidence on quality improvement and dissemination of best practices and have collaborated closely with national organizations to launch major national quality campaigns in cardiovascular care. One current research project, the Survival after Acute Myocardial Infarction study, will identify factors that may be related to better hospital performance in care for patients with heart attacks. The first phase of the study, published in the Annals of Internal Medicine, consisted of interviews with 158 hospital staff most closely involved with heart attack care at 11 high performing and low performing hospitals across the U.S. The team found few differences in what protocols the hospitals used in treating heart attacks, but important differences in the hospital internal environment, such as how they approached problem solving and learning within the organization.
The GHLI research team is concluding a comprehensive national study of quality of hospice care, working in collaboration with the National Cancer Institute, Agency for Healthcare Research and Quality, and Connecticut Hospice, Inc., with implications for palliative care service delivery around the world.
Links to GHLI Research Articles
Top Performing Hospitals in AMI
Health and Social Services Expenditures: Associations with Health Outcomes
