| July 9, 2013, Issue #387 Hospitalization rates of patients undergoing knee replacement roughly doubled between 1997 and 2010 – from 329,000 to 730,000 per 10,000 population. (Source: Agency for Healthcare Research and Quality, Healthcare Cost and Utilization Project Statistical Brief #149, Most Frequent Procedures Performed in U.S. Hospitals, 2010.) AHRQ has announced a new online resource designed to help hospitals engage patients and families in their care. The field-tested strategies outlined in AHRQ's new Guide to Patient and Family Engagement in Hospital Safety and Quality can help hospitals make care better and safer by bridging the communication gaps among patients and families and their health care providers. The guide provides four evidence-based strategies on how patients and family members can (1) advise and train clinicians and hospital staff to work effectively with them, (2) promote better bedside communication to improve quality, (3) participate in bedside shift reports, and (4) manage tasks in preparing to leave the hospital. Each strategy includes educational tools and resources for patients and families, training materials for health care professionals, and real-world examples that show how strategies are being implemented in hospital settings. Select to access AHRQ's press release, the guide, and a 60-second video clip featuring AHRQ's Jeff Brady, M.D., discussing the guide. AHRQ's Registry of Patient Registries (RoPR) is accepting registrations for patient registries. Select to access more information on how to list your registry in the RoPR or select to register for a 1-hour informational webinar on July 23 at 11:00 a.m. ET. RoPR is a database of existing patient registries that was designed with extensive stakeholder participation to promote collaboration, reduce redundancy, and improve transparency in registry-based research. The webinar will introduce the RoPR system and provide step-by-step instructions on listing a registry. Launched in December, RoPR represents a major milestone in efforts to improve efficiency and transparency in registry research. Select to access more information about the rationale for the RoPR and the design process. Questions should be directed to the ROPR team at RoPR@ahrq.hhs.gov. The Office of the National Coordinator (ONC) for Health Information Technology (IT) on July 2 announced the publication of the final version of the Health IT Patient Safety Action and Surveillance Plan. The plan builds on recommendations of the 2011 Institute of Medicine (IOM) report, "Health IT and Patient Safety: Building Safer Systems for Better Care," and provides a roadmap for increasing knowledge of health IT safety and ensuring that health IT is used to make care safer. The plan leverages existing authorities to strengthen patient safety efforts across government programs and the private sector—including health care providers, health IT developers, patient safety organizations (PSOs), and accrediting and oversight bodies. AHRQ will be working together with ONC to collaborate with PSOs, providers, and developers to add a health IT focus to their collection, aggregation, analysis, and mitigation of providers' adverse event reports. AHRQ will also provide guidance to PSOs on how they can work with electronic health record developers to identify and mitigate health IT risks; provide tools and resources to help providers identify, describe, and report health IT-related events and hazards; support the research and development of tools and guidance for using health IT to improve safety and mitigate health IT safety risks; and begin development of Common Formats for ambulatory care that will enhance reporting of health IT events outside the hospital. Select to access more information about the plan and its implementation. Population rates for diagnoses and procedures is one of several functions recently added to AHRQ's Healthcare Cost and Utilization Project's (HCUP) online query system, HCUPnet, which provides free access to select state and national statistics. AHRQ added a capability for researchers to limit results to non-neonatal, non-maternal discharges and operating room procedures. In addition, AHRQ recently updated HCUPnet with statistics from the 2011 Nationwide Inpatient Sample (NIS). The 2011 NIS contains hospital visit data from 46 states and provides estimates that can be used to identify, track, and analyze national trends in health care utilization, access, charges, quality, and outcomes. The full NIS and other HCUP databases can be purchased from the HCUP Central Distributor. The latest issue of AHRQ's Health Care Innovations Exchange features three programs that implemented value-based reimbursement policies at the state level. One profile describes a program that adjusted hospital payment rates based on specific performance metrics. Maryland's Quality-Based Reimbursement (QBR) program adjusts individual hospital payment rates each year based on that hospital's performance on a set of metrics in three areas: adherence to evidence-based care processes in four care domains (heart attack, heart failure, pneumonia, and surgical care), the patient care experience across eight dimensions of care, and overall risk-adjusted mortality. Worse-performing hospitals lose up to 0.5 percent of revenue, and better performers earn up to a similar amount. The QBR program has generated improvements in performance on all process-of-care measures, reduced variations in performance on these measures across hospitals, and served as a catalyst for cross-hospital efforts to boost Hospital Consumer Assessment of Healthcare Providers and Systems, or HCAHPS, scores. Select to access more innovation profiles and tools related to value-based reimbursement on the Innovations Exchange Web site, which contains more than 775 searchable innovations and 1,525 quality tools. Among older patients with mild symptoms from atrial fibrillation, both treatment strategies intended to slow heart rate to a normal range (rate control) and strategies to restore normal heart rhythm (rhythm control) result in comparable rates of all-cause mortality, cardiovascular mortality and stroke, according to a new research review by AHRQ's Effective Health Care Program. The review finds that rate-control strategies are superior to rhythm-control strategies for reducing hospitalizations from cardiovascular events. Although there are a limited number of studies that assessed comparable rate-control therapies and outcomes, there is strong evidence showing the benefit of calcium channel blockers (verapamil or diltiazem) compared with digoxin for ventricular rate control. Because of the wide range of options within each strategic treatment approach for atrial fibrillation, additional studies are needed to evaluate the comparative safety and effectiveness of individual antiarrhythmic medications and procedures, especially within specific subgroups of patients. Select to access the research review, Treatment of Atrial Fibrillation. Inaccurate transfer of clinical information during patient handoffs and signouts has been linked to adverse clinical events within hospitals from the emergency department to the intensive care unit, according to a patient safety primer available on AHRQ's Patient Safety Network (PSNet). The primer introduces concepts that can be used to implement structured handoff and signout procedures. It also identifies existing guidelines and innovative strategies for the handoff process. Select to access the full patient safety primer, titled "Handoffs and Signouts." | AHRQ in the Professional LiteratureStrasberg HR, Del Fiol G, Cimino JJ. Terminology challenges implementing the HL7 context-aware knowledge retrieval ('Infobutton') standard. J Am Med Inform Assoc 2013 Mar; 20(2):218-23. Select to access the abstract on PubMed.® Keenan G, Yakel E, Dunn Lopez K, et al. Challenges to nurses' efforts of retrieving, documenting, and communicating patient care information. J Am Med Inform Assoc 2013 Mar; 20(2):245-51. Select to access the abstract on PubMed.®
Cohen MR, Smetzer JL, Westphal JE, et al. Risk models to improve safety of dispensing high-alert medications in community pharmacies. J Am Pharm Assoc 2012 Sep-Oct; 52(5):584-602. Select to access the abstract on PubMed.®
Braithwaite D, Zhu W, Hubbard RA, et al. Screening outcomes in older U.S. women undergoing multiple mammograms in community practice: does interval, age or comorbidity score affect tumor characteristics or false positive rates? J Natl Cancer Inst 2013 Feb 5. Select to access the abstract on PubMed.®
Yamauchi M, Carlson MJ, Wright BJ, et al. Does health insurance continuity among low-income adults impact their children's insurance coverage? Matern Child Health J 2013 Feb; 17(2):248-55. Select to access the abstract on PubMed.®
Qian F, Osler TM, Eaton MP, et al. Variation of blood transfusion in patients undergoing major noncardiac surgery. Ann Surg 2013 Feb; 257(2):266-78. Select to access the abstract on PubMed.®
Campo M, Shiyko MP, Margulis H, et al. Effect of a safe patient handling program on rehabilitation outcomes. Arch Phys Med Rehabil 2013 Jan; 94(1):17-22. Select to access the abstract on PubMed.®
Winthrop KL, Baddley JW, Chen L, Liu L, Grijalva CG, Delzell E, Beukelman T, Patkar NM, Xie F, Saag KG, Herrinton LJ, Solomon DH, Lewis JD, Curtis JR. Association between the initiation of anti-tumor necrosis factor therapy and the risk of herpes zoster. JAMA 2013 Mar 6; 309(9):887-95. Select to access the abstract on PubMed.®
Contact Information Please address comments and questions about the AHRQ Electronic Newsletter to Linwood Norman at: (301) 427-1248 or Linwood.Norman@ahrq.hhs.gov. |
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