October 19, 2012
More than 21,000 hospitalizations among children with cancer occurred in 2009, with leukemia, cancers of the brain and nervous system, and cancers of the bone and connective tissue accounting for the top causes. [Source: Agency for Healthcare Research and Quality, HCUP Statistical Brief #132: Pediatric Cancer Hospitalizations, 2009.]
- AHRQ Director Carolyn Clancy, M.D., headlines Diagnostic Error in Medicine conference in Baltimore in November.
- Supplies and devices are biggest cause of hospital cost increases.
- Report shows promise in detecting surgical site infections.
- Electronic standing orders increase delivery of preventive services.
- Progestogens effective for preventing preterm birth in single pregnancies.
- AHRQ's Health Care Innovations Exchange focuses on increasing patient involvement in health care.
- Health Services Research extends call for papers on health IT.
- AHRQ in the professional literature.
1. AHRQ Director Carolyn Clancy, M.D., Headlines Diagnostic Error In Medicine Conference in Baltimore in November
AHRQ Director Carolyn Clancy, M.D., will be the keynote speaker at the Diagnostic Error in Medicine: 5th International Conference on November 11–14 at the Johns Hopkins University School of Medicine in Baltimore, MD. The conference, sponsored by AHRQ and hosted by the Society to Improve Diagnosis in Medicine and Johns Hopkins, features sessions for physicians, nurses, cognitive scientists, safety officers, risk managers, informatics professionals, clinical and basic investigators, medical educators, and trainees. The conference will explore the current state of diagnostic medicine, review active research, consider emerging educational and research themes that should be implemented to minimize diagnostic errors, and discuss strategies to reduce their incidence and impact. Select for more information and to register .
2. Supplies and Devices Are Biggest Cause of Hospital Cost Increases
Medical supplies and devices represented nearly one-fourth (24.2 percent) of rising hospital costs between 2001 and 2006, according to a new AHRQ-funded study. Among all types of hospital stays, the cost percentage impact for supplies and devices was nearly three times that of operating room services. While rising inpatient costs are typically associated with imaging services such as computed tomography scans and magnetic resonance imaging, those services only contributed a 3.3 percent increase in the cost of an average hospital stay, the study found. Because rising hospitals costs are an ongoing concern, payers and policymakers may want to explore the specific factors driving those costs and the factors associated with them, according to the study authors. The study, "What Hospital Inpatient Services Contributed the Most to the 2001 to 2006 Growth in the Cost per Case?," was published online in Health Services Research on September 4. Select to access the abstract on PubMed®.
3. Report Shows Promise in Detecting Surgical Site Infections
A new AHRQ report explores ways to enhance the detection and surveillance of hospital- - acquired surgical site infections. The report, Improving the Measurement of Surgical Site Infection (SSI) Risk Stratification and Outcome Detection, focuses on the development and testing of a computer-assisted algorithm for retrospective assessment of medical records, laboratory test results, and demographic data to identify patients with potential surgical site infections. The algorithm was able to flag the records that were most likely to report an SSI, reducing reviewers' workload and creating significant savings. Select to read the report.
4. Electronic Standing Orders Increase Delivery of Preventive Services
Implementing electronic standing orders for preventive services increased the delivery of those services, a new AHRQ-funded study concludes. Implementing and Evaluating Electronic Standing Orders in Primary Care Practice: A PPRNet Study, which was published in the September issue of the Journal of the American Board of Family Medicine, describes how electronic standing orders can be used in primary care practices with an electronic health record (EHR) to allow qualified staff to deliver certain types of care. By checking the rules established by the standing orders against the patient's prior record of care, EHRs can produce a list of recommended preventive services. The eight primary care practices that participated in this study developed standing orders using their EHRs for health screenings, immunizations, and diabetes management. As a result, all of the practices improved delivery of six specific services and boosted the workflow and morale or the practices' medical assistants. AHRQ has developed a video that details how this project improved service delivery, staff morale, and clinical workflow. Select to access the journal abstract on PubMed®.
5. Progestogens Effective for Preventing Pre-term Birth in Single Pregnancies
A new research review from AHRQ's Effective Health Care Program found that that there is moderate evidence that progestogen treatments such as 17 alpha-hydroxyprogesterone caproate (17-OHP) prevent pre-term birth when used for women who are having only one child and who have a history of spontaneous preterm birth. Progestogen is a hormone that inhibits the uterus from contracting and is involved in maintaining pregnancy. A lack of research is available to evaluate progestogens' influence on near-term outcomes like neonatal death and birth defects. These findings can be found in the research review, Progestogens for Prevention of Preterm Birth.
6. AHRQ's Health Care Innovations Exchange Focuses on Increasing Patient Involvement in Health Care
The October 10 issue of AHRQ's Health Care Innovations Exchange features three profiles about innovative programs that increase patients' involvement in health care. Two programs provide patient access to online medical records via secure patient portals, and one program offers patients access to routine laboratory tests between visits, enhancing engagement and satisfaction. One profile describes an initiative known as OpenNotes®, in which doctors invite patients to access their notes detailing medical office visits via secure patient portal linked with their electronic medical record system. Patients may read a note to develop a better understanding of their care; to discuss aspects of the visit with the doctor at the next office visit; to act on self-management, treatment, and other recommendations included in the note; or to share the note with others, including family members and other providers. More than 1,000 primary care doctors and 20,000 of their patients at Beth Israel Deaconess Medical Center in Boston, Geisinger Health System in Pennsylvania, and Harborview Medical Center in Seattle participated in a 12-month demonstration project of OpenNotes®. Early feedback from this project suggests that the program generated high levels of satisfaction among patients and the doctors who volunteered to participate. Select to read more innovation profiles related to patient involvement in health care on AHRQ's Health Care Innovations Exchange Web site, which contains more than 725 searchable innovations and 1,500 QualityTools.
7. Health Services Research Extends Call for Papers on Health IT
Health Services Research has extended a request for papers for its special issue on health information technology. The issue will feature research that demonstrates trends in adoption and meaningful use of health IT and its role in enabling improvements in health care delivery and outcomes. Topics of special interest include building HIT infrastructure, developing innovative approaches to performance measurement, and translating short term health IT investments into measurable improvements in cost, quality and population health. The deadline for submissions is December 28. Select for more information .
8. AHRQ in the Professional Literature
We are providing the following hyperlinks to journal abstracts through PubMed® for your convenience. Access to the abstracts may be blocked because of firewalls or specific settings on individual computer systems. If you are having problems, ask your technical support staff for possible remedies.
Belsky DW, Moffitt TE, Houts R, et al. Polygenic risk, rapid childhood growth, and the development of obesity: evidence from a 4-decade longitudinal study. Arch Pediatr Adolesc Med 2012 Jun 1; 166(6):515-21. Select to access the abstract on PubMed®.
Etchegaray JM, Thomas EJ. Comparing two safety culture surveys: Safety Attitudes Questionnaire and Hospital Survey on Patient Safety. BMJ Qual Saf 2012 Jun; 21(6):490-8. Select to access the abstract on PubMed®.
Gershon RR, Dailey M, Magda LA, et al. Safety in the home healthcare sector: development of a new household safety checklist. J Patient Saf 2012 Jun; 8(2):51-9. Select to access the abstract on PubMed®.
Hazlehurst B, McBurnie MA, Mularski RA, et al. Automating care quality measurement with health information technology. Am J Manag Care 2012 Jun; 18(6):313-19. Select to access the abstract on PubMed®.
Faricy L, Page T, Ronick M, et al. Patterns of empiric treatment of Chlamydia trachomatis infections in an underserved population. Fam Med 2012 Jun; 44(6):408-15. Select to access the abstract on PubMed®.
Murphy CR, Eells SJ, Quan V, et al. Methicillin-resistant Staphylococcus aureus burden in nursing homes associated with environmental contamination of common areas. J Am Geriatr Soc 2012 Jun; 60(6):1012-18. Select to access the abstract on PubMed®.
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Current as of October 2012
AHRQ Electronic Newsletter, October 19, 2012, Issue 356. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/enews/enews356.htm