April 7, 2011, Issue #67
Quote of the Month
"The Affordable Care Act sets America on a path toward a higher quality health care system so we stop doing things that don't work for patients and start doing more of the things that do work." (For more information on this announcement, go to item no. 1.)
—HHS Secretary Kathleen Sebelius, in releasing the National Strategy for Quality Improvement in Health Care on March 21.
AHRQ Patient Safety and Health IT News:
- HHS Releases National Strategy for Quality Improvement in Health Care Report
- AHRQ Updates Agency's PSNet and WebM&M Web Sites: Improved Navigation and Search and Browse Functions
- New Report Highlights Hospitals' Progress in Reducing Bloodstream Infections
- New Guide Helps TeamSTEPPS Trainers Learn How to Teach Simulation
- AHRQ Releases Common Formats for Patient Safety Reporting in Skilled Nursing Facilities
- Register for Free April 29 Web Conference on AHRQ's Medical Office Survey on Patient Safety Culture
- First-Year Implementation Costs of EHR system Tops $48,000 Per Physician
- Study Demonstrates a Computer-Based Order System Improves Discontinuation of Prophylactic Antibacterials in Surgical Patients
- Podcast Highlights Program That Uses Telemedicine to Reduce Missed School Days
- AHRQ in the Patient Safety and Health IT Professional Literature—Some Useful Citations
AHRQ Patient Safety and Health IT News:
1. HHS Releases National Strategy for Quality Improvement in Health Care Report
Department of Health & Human Services (HHS) Secretary Kathleen Sebelius released the National Strategy for Quality Improvement in Health Care. The strategy was called for under the Affordable Care Act and is the first effort to create national aims and priorities to guide local, State, and national efforts to improve the quality of health care in the United States. The National Quality Strategy will promote quality health care that is focused on the needs of patients, families, and communities. At the same time, the strategy is designed to move the system to work better for doctors and other health care providers—reducing their administrative burdens and helping them collaborate to improve care. The strategy presents three aims:
- Better Care: Improve the overall quality, by making health care more patient-centered, reliable, accessible, and safe.
- Healthy People and Communities: Improve the health of the U.S. population by supporting proven interventions to address behavioral, social, and environmental determinants of health in addition to delivering higher-quality care.
- Affordable Care: Reduce the cost of quality health care for individuals, families, employers, and government.
To help achieve these aims, the strategy also establishes six priorities, to help focus efforts by public and private partners. Those priorities are:
- Making care safer by reducing harm caused in the delivery of care.
- Ensuring that each person and family is engaged as partners in their care.
- Promoting effective communication and coordination of care.
- Promoting the most effective prevention and treatment practices for the leading causes of mortality, starting with cardiovascular disease.
- Working with communities to promote wide use of best practices to enable healthy living.
- Making quality care more affordable for individuals, families, employers, and governments by developing and spreading new health care delivery models.
The National Quality Strategy is designed to be an evolving guide for the Nation as it moves forward with efforts to measure and improve health and health care quality. Select to read the National Quality Strategy. Supporting documents are available on the AHRQ Web site.
2. AHRQ Updates Agency's PSNet and WebM&M Web Sites: Improved Navigation and Search and Browse Functions
AHRQ has updated and enhanced the AHRQ PSNet and AHRQ WebM&M Web Sites. AHRQ Patient Safety Network (AHRQ PSNet) is a Web-based resource featuring the latest news and essential resources on patient safety. The site offers weekly updates of patient safety literature, news, tools, and meetings ("What's New"); Patient Safety Primers; and a vast set of carefully annotated links to important research and other information on patient safety ("The Collection"). Supported by a robust patient safety taxonomy and Web architecture, AHRQ PSNet provides powerful searching and browsing capability, as well as the ability for diverse users to customize the site around their interests ("My PSNet"). AHRQ WebM&M (Morbidity and Mortality Rounds on the Web) is the online journal and forum on patient safety and health care quality. This site features expert analysis of medical errors reported anonymously by our readers, Perspectives on Safety, and interactive learning modules on patient safety ("Spotlight Cases"). CME and CEU credit are available. AHRQ WebM&M and AHRQ PSNet launched in 2003 and 2005, respectively. Together the Web sites receive more than 2 million visits annually. The new look includes updated design elements, new summary displays, enhanced search functionality, and easier access to all content. To learn more visit http://www.psnet.ahrq.gov and http://www.webmm.ahrq.gov.
3. New Report Highlights Hospitals' Progress in Reducing Bloodstream Infections
A new report released by AHRQ highlights the progress that has been achieved by hospitals taking part in a national effort to reduce the incidence of central line-associated bloodstream infections (CLABSI) by implementing a Comprehensive Unit-based Safety Program (CUSP). Eliminating CLABSI: A National Patient Safety Imperative—A Progress Report on the National On the CUSP: Stop BSI Project provides an update on the impact of the project and the number of State hospital associations, hospitals, and hospital teams that are implementing the clinical and safety culture changes proven to reduce CLABSI. Adult intensive care units that began participating in the project in 2009, drawn from more than 350 hospitals in 22 States, have reduced their CLABSI rates by an average of 35 percent. More than 700 hospitals and 1,100 hospital teams have been recruited to participate in the program since its inception in 2009. To download a copy of the report, select http://www.ahrq.gov/qual/onthecusprpt/.
4. New Guide Helps TeamSTEPPS™ Trainers Learn How to Teach Simulation
A new guide from AHRQ and Department of Defense provides instruction to master trainers on using simulation-based training when teaching TeamSTEPPS™. Training Guide: Using Simulation in TeamSTEPPS Training offers strategies and tools that can improve team performance and enhance patient safety. The training course is intended as a train-the-trainer program in which key personnel become familiar with the materials and activities so that they can offer the simulation-based TeamSTEPPS training to local health care teams. To download a copy of the guide, visit the TeamSTEPPS™ page.
5. AHRQ Releases Common Formats for Patient Safety Reporting in Skilled Nursing Facilities
AHRQ has released new Common Formats for patient safety reporting in skilled nursing facilities. These new formats complement an existing set of Common Formats, Version 1.1, that are designed to help health care providers collect both generic and event-specific information about incidents, near misses and unsafe conditions in hospital settings. The term "Common Formats" refers to the common definitions and reporting formats, specified by AHRQ, that allow health care providers to collect and submit standardized information regarding patient safety events. The Common Formats apply to all patient safety concerns, including incidents, near misses or close calls, and unsafe conditions. Future versions of the Common Formats are being developed for ambulatory settings, such as surgery centers and medical offices. All of the Skilled Nursing Facilities Formats are currently available as in beta versions for public review and comment via the AHRQ Patient Safety Organization Web site.
6. Register for Free April 29 Web Conference on AHRQ's Medical Office Survey on Patient Safety Culture
Registration is now open for a free 60-minute Web conference on Using the AHRQ Medical Office Survey on Patient Safety Culture on April 29 from 1:00 to 2:00 p.m. EDT. The session will cover survey development, lessons learned from implementation, and preliminary comparative results. Experts will also discuss how patient safety culture perceptions differ between physicians and other medical office staff and how medical office characteristics affect survey results. Also, learn how and when you can submit data to a national comparative database on the survey. Select to register.
Health IT News
7. First-Year Implementation Costs of EHR system Tops $48,000 Per Physician
The average five-physician primary care practice spent $162,000 on implementing and $85,500 maintaining an electronic health records system in the first year, a new AHRQ-funded study finds. The implementation costs took into account hardware and software costs as well as the time and effort to put it into place. Physicians, other clinical staff and non-clinical staff needed 134 hours on average to prepare for the use of the EHR system in clinical encounters. The study, "The financial and nonfinancial costs of implementing electronic health records in primary care practices," was conducted by researchers from Baylor Health Care System, Emory University, and the HealthTexas Provider Network. It was published in the March 2011 issue of Health Affairs. Select to access the abstract on PubMed.®
8. Study Demonstrates a Computer-Based Order System Improves Discontinuation of Prophylactic Antibacterials in Surgical Patients
The proper administration of antibacterial wound prophylaxis can reduce the risk of postoperative surgical wound infection. However, repeated doses of antibacterials given in the postoperative clinical setting may increase hospital antibacterial resistance for the recovering patient. According to a new AHRQ-funded study, the use of a computerized provider order entry system, designed to assist physicians and other health professionals with decision making tasks, proved effective in increasing the proportion of surgical patients who have antibacterial wound prophylaxis discontinued within the appropriate time frame. The study, "Effectiveness of an information technology intervention to improve prophylactic antibacterial use in the postoperative period," conducted by researchers at the University of Pennsylvania School of Medicine was published in the March 1 issue of the Journal of the American Medical Informatics Association. Select to access the abstract on PubMed.®
9. Podcast Highlights Program That Uses Telemedicine to Reduce Missed School Days
A telemedicine program developed at the University of Rochester, New York, is lowering health costs through remote medical consultations for children. The program, called Health-e-Access, lets doctors diagnose and treat children and discuss options with parents and school staff. This approach results in fewer missed days at school for children and a reduction in lost pay for many working parents. A 60-second podcast was sent to more than 1,000 radio programs about the program, which is featured on Healthcare 411.
10. 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.
Speroff T, Nwosu S, Greevy R, et al. Organisational culture: variation across hospitals and connection to patient safety climate. Qual Saf Health Care 2010 Dec; 19(6):592-6. [Supported by grant U18 HS15934 (for Partnerships in Implementing Patient Safety.] Select to access the abstract.
Etchegaray JM, Throckmorton T. Barriers to reporting medication errors: a measurement equivalence perspective. Qual Saf Health Care 2010 Dec; 19(6):e14. [Supported in part by grants 1 P01 HS11544-01 (to the University of Texas Center of Excellence for Patient Safety Research and Practice) and K02 HS17145-02; cites AHRQ publication, Advances in Patient Safety: From Research to Implementation, 2005.] Select to access the abstract.
Chu-Weininger MY, Wueste L, Lucke JF, et al. The impact of a tele-ICU on provider attitudes about teamwork and safety climate. Qual Saf Health Care 2010 Dec; 19(6):e39. [Supported in part by grant R01 HS15234.] Select to access the abstract.
Horsky J, McColgan K, Pang JE, et al. Complementary methods of system usability evaluation: surveys and observations during software design and development cycles. J Biomed Inform 2010 Oct; 43(5):782-90. [Supported by grant 5 R01 HS15169-03.] Select to access the abstract.
Current as of April 2011
Patient Safety and Health Information Technology E-Newsletter. April 7, 2011, Issue No. 67. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/ptsnews/ptsnews67.htm