October 6, 2010, Issue #61
Quote of the Month
"Close attention to the patterns of our system failures can be contentious but absolutely necessary, and we'll need to couple that with a kind of creativity to try new solutions on the smallest level based on these patterns. That is the challenge that all of us face." (For more information on Dr. Gawande's plenary speech at AHRQ's recent annual meeting, go to item no. 1.)
AHRQ Patient Safety and Health IT News:
- Dr. Atul Gawande discusses challenges in health care with attendees at AHRQ's annual conference
- New version of the AHRQ Quality Indicators software now available
- Using electronic health records help identify adverse drug events in outpatient settings
- New guide can help secure electronic patient-provider communication systems
- AHRQ in the patient safety and health IT professional literature—some useful citations
Watch and Download AHRQ Videos on YouTube
1. Dr. Atul Gawande Discusses Challenges in Health Care with Attendees at AHRQ's Annual Conference
Atul Gawande, M.D., renowned surgeon, author, and innovator, was the featured speaker for the September 28 plenary session at the 2010 AHRQ Annual Conference. Dr. Gawande told the audience that after "two decades chronicling the patterns and recording the symptoms and pathologies of our systems of health care delivery," it is now time to move from being "diagnosticians" to providing solutions. Health services research has shown that solutions are within reach. For example, his AHRQ-funded research showed that when surgical team members introduce themselves and use safety checklists before and after surgery, error rates plummet. He believes research can also help local health care systems reduce overuse of inappropriate services, such as imaging and surgery, and reduce inappropriate emergency department and hospital use. Research may also provide answers for how to improve care for the terminally ill and chronically disabled, he added. AHRQ's fourth annual conference, "Better Care, Better Health: Delivering on Quality for All Americans," which drew more than 1,800 researchers and others was held on September 26-29 in Bethesda, Maryland. Information on presentations and other post-conference materials will soon be posted on the conference Web site.
2. New Version of the AHRQ Quality Indicators Software Now Available
AHRQ has released a new version (4.1b) of the AHRQ Quality Indicators (QIs) software that includes revisions to complement the SAS® and Windows software. AHRQ's QIs are measures of health care quality that make use of readily available hospital inpatient administrative data. The AHRQ QIs consist of four modules measuring various aspects of quality: prevention QIs; inpatient QIs; patient safety indicators; and pediatric QIs. Software and user guides for all four modules are available to assist users in applying the QIs to their own data. Select to access the 4.1b version (PDF File; Plugin Software Help) of the software.
3. Using Electronic Health Records Help Identify Adverse Drug Events in Outpatient Settings
Adverse drug events (ADEs) are common in ambulatory care settings. One study estimated the incidence of medication errors in outpatients at 27 per 100 patients over a 4-week period, higher than in hospitalized patients. However, ADEs may be difficult to identify in routine practice, as patients are not monitored as closely as in the inpatient setting. For example, a recent study screened electronic medical records for evidence of ADEs using an outpatient monitoring system, and identified one ADE for every seven patient-years. This shows that computerized monitoring can be an effective approach for identifying ambulatory ADEs, but results may rely on the thoroughness and accuracy of the documentation within the electronic health record. Findings of the study, led by Tejal Gandhi, M.D., and David Bates, M.D., of Brigham and Women's Hospital Division of General Internal Medicine, Boston, can be found in the June issue of the Journal of Patient Safety. Select to access an abstract of the study, quot;Outpatient adverse drug events identified by screening electronic health records.quot;
4. New Guide Can Help Secure Electronic Patient-Provider Communication Systems
As patients become increasingly interested in managing their health through Internet-based technologies, health care organizations face significant challenges in meeting the need for highly personal and sensitive communication. An AHRQ-funded study, "Issues and Questions to Consider in Implementing Secure Electronic Patient-Provider Web Portal Communications Systems," published in the July issue of the International Journal of Medical Informatics, developed a framework that can be used as a guide for organizations looking to employ secure electronic patient-provider communication systems. Select to read the abstract.
5. AHRQ in the Patient Safety and Health IT Professional Literature—Some Useful Citations
We are providing the following hyperlinks to abstracts of journal articles describing AHRQ-funded research. If you are having problems accessing the abstracts because of firewalls or specific settings on your individual computer systems, you should ask your technical support staff for possible remedies.
Agarwal R, Angst CM, DesRoches CM, et al. Technological viewpoints (frames) about electronic prescribing in physician practices. J Am Med Inform Assoc 2010 Jul-Aug; 17(4):425-31. Select to access the abstract.
Encinosa WE, Bernard D, Dor A. Does prescription drug adherence reduce hospitalizations and costs? The case of diabetes. Adv Health Econ Health Serv Res 2010; 22:151-73. Select to access the abstract.
McConnochie KM, Wood NE, Herendeen NE, et al. Telemedicine in urban and suburban childcare and elementary schools lightens family burdens. Telemed J E Health 2010 Jun; 16(5):533-42. Select to access the abstract.
Morgan DJ, Lomotan LL, Agnes K, et al. Characteristics of healthcare-associated infections contributing to unexpected in-hospital deaths. Infect Control Hosp Epidemiol 2010 Aug; 31(8):864-6. Select to access the abstract.
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- Taking Medications Safety.
- Questions to Ask Before Surgery.
- Tips for Going Home from the Hospital.
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Current as of October 2010
Patient Safety and Health Information Technology E-Newsletter. October 6, 2010, Issue No. 61. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/ptsnews/ptsnews61.htm