Four benchmark institutions have demonstrated the efficacy of health information technologies in improving quality and efficiency. Whether and how other institutions can achieve similar benefits, and at what costs, are unclear.

Objective. To measure organizations' implementation of Chronic Care Model (CCM) interventions for chronic care quality improvement (QI). Data Sources/Study Setting. Monthly reports submitted by 42 organizations participating in three QI collaboratives to improve care for congestive heart failure, diabetes, depression, and asthma, and telephone interviews with key informants in the organizations. Study Design. We qualitatively analyzed the implementation activities of intervention organizations as part of a larger effectiveness evaluation of yearlong collaboratives. Key study variables included measures of implementation intensity (quantity and depth of implementation activities) as well as fidelity to the CCM. Data Collection/Extraction Methods. We developed a CCM-based scheme to code sites' intervention activities and criteria to rate their depth or likelihood of impact. Principal Findings. The sites averaged more than 30 different change efforts each to implement the CCM. The depth ratings for these changes, however, were more modest, ranging from 17 percent to 76 percent of the highest rating possible. The participating organizations significantly differed in the intensity of their implementation efforts ( po.001 in both quantity and depth ratings). Fidelity to the CCM was high. Conclusions. Collaborative participants were able, with some important variation, to implement large numbers of diverse QI change strategies, with high CCM fidelity and modest depth of implementation. QI collaboratives are a useful method to foster change in real world settings.

Background-Numerous interventions have been shown to increase physical activity, but have not been ranked by effectiveness or cost.

Despite substantial challenges, there was evidence of broad success at implementation and maintenance of quality improvement for depression treatment in primary care.

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The business value of online consumer reviews has emerged in recent year as one of utmost importance for hotel marketers. This study examines how online consumer reviews affect offline hotel popularity. Using time-series data of 56,284 hotel reviews posted for more than 1000 hotels listed on TripAdvisor, this paper estimates the effect of factors of online consumer review, including quality, quantity, consistency, and recency, on the offline hotel occupancy (i.e. how popular the hotel is among consumers). The empirical evidence shows the relative effect of online consumer review factors on offline hotel popularity when controlling for other hotel characteristics. In particular, the effect of review quality lasts for at least a couple of quarters, whereas that of other online consumer review factors remains short-term. The findings provide a managerial basis to improve the online presence of hotels on social media platforms by strategically utilizing important review factors.

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IMPORTANCE Few stroke survivors meet recommended cardiovascular goals, particularly among racial/ethnic minority populations, such as Black or Hispanic individuals, or socioeconomically disadvantaged populations. OBJECTIVE To determine if a chronic care model-based, community health worker (CHW), advanced practice clinician (APC; including nurse practitioners or physician assistants), and physician team intervention improves risk factor control after stroke in a safety-net setting (ie, health care setting where all individuals receive care, regardless of health insurance status or ability to pay). DESIGN, SETTING, AND PARTICIPANTS This randomized clinical trial included participants recruited from 5 hospitals serving low-income populations in Los Angeles County, California, as part of the Secondary Stroke Prevention by Uniting Community and Chronic Care Model Teams Early to End Disparities (SUCCEED) clinical trial. Inclusion criteria were age 40 years or older; experience of ischemic or hemorrhagic stroke or transient ischemic attack (TIA) no more than 90 days prior; systolic blood pressure (BP) of 130 mm Hg or greater or 120 to 130 mm Hg with history of hypertension or using hypertensive medications; and English or Spanish language proficiency. The exclusion criterion was inability to consent. Among 887 individuals screened for eligibility, 542 individuals were eligible, and 487 individuals were enrolled and randomized, stratified by stroke type (ischemic or TIA vs hemorrhagic), language (English vs Spanish), and site to usual care vs intervention