This Funding Opportunity Announcement (FOA) invites R01 grant applications for funding to support novel, high-impact studies evaluating the responsiveness of healthcare delivery systems, healthcare professionals, and the overall U.S. healthcare system to the COVID-19 pandemic.
AHRQ is interested in funding critical research focused on evaluating topics such as: effects on quality, safety, and value of health system response to COVID-19; the role of primary care practices and professionals during the COVID-19 epidemic; how the response to COVID-19 affected socially vulnerable populations and people with multiple chronic conditions; and implementation of digital healthcare, including innovations and challenges encountered in the rapid expansion of telehealth response to COVID-19.
AHRQ encourages multi-method, rapid-cycle research with the ability to: produce and disseminate initial findings (e.g. observations, lessons learned, or findings) within 6 months after award and then regularly throughout the remainder of the award period.
In January 2020, a novel coronavirus (SARS-CoV-2) was identified as the causative agent of a now global pandemic of respiratory disease, termed COVID-19. Information about the outbreak is changing rapidly and detailed guidance and epidemiology can be found on the Centers for Disease Control and Prevention website (https://www.cdc.gov/coronavirus/index.html) and other sources.
The outbreak of COVID-19 in the United States has exposed the vulnerability of our public health and healthcare delivery systems to contain and manage rapidly transmissible infectious diseases. The entire U.S. healthcare system including hospitals, health systems, primary and specialty care practices, long term care facilities, and healthcare professionals is under tremendous stress. The healthcare system is responding by rapidly adjusting many aspects of healthcare delivery.
There is an urgent need to evaluate the responsiveness of the U.S. healthcare system as a whole, as well as the effectiveness of the response to the COVID-19 pandemic by healthcare professionals and individual healthcare systems.
This AHRQ funding opportunity invites Large Research (R01) Project applications that focus on pertinent aspects of the responsiveness of the U.S. healthcare system to COVID-19 that are consistent with AHRQ’s mission of producing evidence to make healthcare safer, higher quality, more accessible, equitable and affordable, ensuring that the evidence is understood and used.
Several organizations have identified high interest research questions that relate to the COVID-19 pandemic. For example, AHRQ participated in the development of the Priorities for Rapid-Cycle Evaluations developed by AcademyHealth. In addition, the National Academies of Sciences, Engineering and Medicine has discussed a potential list of emerging infectious disease research topics. These, and other sources, may help to provide applicants with additional context, methods, and justification for their proposed research projects.
For two decades, AHRQ has funded research to improve the health and healthcare for all Americans, and through this funding opportunity, the agency seeks applications that can leverage lessons learned from previous research investments to the challenges resulting from the COVID-19 pandemic.
While AHRQ has identified the following areas of specific interest, these are not all inclusive and applicants may propose any health services research project related to the response to COVID-19 that may lead to improvement in US healthcare delivery.
This funding opportunity is open to relevant research in all healthcare settings, including hospitals, ambulatory care (especially primary care practices), pre-hospital care, long-term and nursing home care, home healthcare, pharmacy, and transitions of care between settings.
A. Research to Improve the Quality of Care Received and Patient Outcomes during and following the COVID-19 Pandemic
AHRQ is interested in research that evaluates how healthcare systems adjusted care delivery, management, decision-making, and operations in response to the COVID-19 pandemic. The focus is not on the clinical questions of medications for treatment or ventilator settings, but on issues such as workforce deployment, space reallocation, communications between settings, and how decisions affected patient and workforce experience and outcomes. In addition, there is interest in understanding how decisions and innovations made during the response can best inform operations in the future, both during normal times and in public health emergencies. While there is interest in all settings of care, there is particular interest in research on changes, innovations, and unintended consequences in primary care.
B. Research to Improve Healthcare Patient Safety during and following the COVID-19 Pandemic
The COVID-19 pandemic presents new challenges to patient and clinician safety, including antibiotic stewardship and prevention of healthcare-associated infections. AHRQ has supported and helped establish a strong foundation of scientific evidence regarding patient safety, and this FOA seeks to leverage and expand this foundation to address new threats. As with past patient safety research initiatives, relevant projects can be considered in three different stages:
- Identification of risks, hazards, and harm to patients and clinicians.
- Design, implementation, dissemination and spread, and evaluation of interventions to improve patient and clinician safety.
- Establishment of strategies to sustain patient safety improvements such as culture, incident/event reporting, measurement, monitoring, and surveillance.
C. Research to Understand How the Response to COVID-19 Affected Socially Vulnerable Populations and People with Multiple Chronic Conditions during and following the COVID-19 Pandemic
An additional area of interest is applications that evaluate how the responsiveness of the U.S. healthcare system to the COVID-19 pandemic by healthcare professionals and healthcare systems impacted socially vulnerable populations. Socially vulnerable populations are those that, due to societal structures, face additional risk from the COVID-19 pandemic. These include, but are not limited to, racial and ethnic minorities other AHRQ Priority Populations (https://www.ahrq.gov/priority-populations/about/index.html), and people living with multiple chronic conditions. This FOA seeks applications that examine social vulnerability specifically in the context of the COVID-19 pandemic, as well as applications that examine how to improve outcomes for populations with high social vulnerability, either through improvement in care delivery (including integration of social and medical care) or policies. Examination of intersectional dimensions that highlights the combined influences of vulnerabilities is encouraged.
D. Research to Understand How Digital Healthcare Innovations Contributed to the Health System Response To COVID-19, Outcomes, and Unintended Consequences
The national response to COVID-19 involved an unprecedented expansion in the use of digital healthcare, including telehealth. This FOA invites applications that seek to understand how digital healthcare innovations impacted, in a positive or negative way, health system and healthcare professional innovation, as well as its role in identifying emerging best practices and answering questions such as how digital healthcare is best adapted to meet the needs of diverse patients, how policy and financing changes made telehealth more or less effective and sustainable, how telehealth solutions differed across settings, what type of workforce is needed to sustain digital healthcare innovations, and what types of training were needed for both patients and clinicians to allow digital solutions to be effective.
Expanded use of digital healthcare may not be without unintended consequences, which may positively or negatively affect quality of care. An area of interest is understanding its implications, for example, rapidly expanded use of telehealth could result in changes in risks for patient safety, such as increasing diagnostic errors.
Research Plans and Dissemination of Findings
AHRQ is interested in funding research that will have an important impact on healthcare practice and policy, both in the short and the long-term. Applicants are required to include a dissemination plan that describes how early research observations, lessons learned, or findings from the work will be disseminated within 6 months after award, then regularly throughout the remainder of the award period. Applicants should present a plan for disseminating results during the proposed award period which does not rely on a no-cost extension.
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