June 7, 2011, Issue #69
Quote of the Month
"Project ECHO demonstrates that we can solve the problems of underserved communities by empowering primary care clinicians to provide high-quality specialty care locally. This empowerment—what we call a 'force multiplier effect'—holds promise for reforming health care delivery nationally." (For more information AHRQ's new study, go to item no.1.)
—AHRQ-funded researcher Sanjeev Arora, M.D., liver disease specialist at University of New Mexico Health Sciences Center (UNMHSC) who created Project ECHO.
Patient Safety and Health IT News:
- Technology, Collaboration Help Improve Hepatitis C Outcomes in Community Settings, AHRQ-Funded Study Shows
- AHRQ-Funded Study Shows Physicians View E-prescribing Features as Cumbersome
- Report Describes Lessons from State, Regional Health Information Exchange Projects
- Early Adopters of EMRs, E-Prescribing Offer Lessons to U.S.
- ICUs in Michigan Sustain Zero Blood Stream Infections for Up to 2 Years
- AHRQ Releases Tool to Help Consumers Reduce Medication Errors
- HHS Releases New Online Patient Safety Training Resources for Clinicians and Patient Advocates
- May Issue of AHRQ WebM&M Explores "Second Victims" of Errors
- AHRQ in the Patient Safety and Health IT Professional Literature—Some Useful Citations
AHRQ Patient Safety News:
1. Technology, Collaboration Help Improve Hepatitis C Outcomes in Community Settings, AHRQ-Funded Study Shows
Widely available technology, expert training, and real-time feedback helped ensure that patients treated for Hepatitis C in local communities did as well as patients treated at a university-based medical center, results of a new AHRQ-funded study show. The study was published in the June 2 issue of the New England Journal of Medicine. To bring effective treatment for the Hepatitis C virus (HCV) to underserved areas, researchers at the University of New Mexico Health Sciences Center (UNMHSC) developed a model called Extension for Community Healthcare Outcomes, or ECHO, that brings state-of-the-art medical knowledge to primary care providers and nurses. Using videoconference or teleconference lines, community-based medical teams, including physicians and nurses, take part in weekly clinics with specialists and collaborate on treatment plans using evidence-based treatment approaches. Study authors found that the progression of HCV slowed at a similar rate for patients who were treated at community-based settings as for patients treated at the university clinic (58.2 percent vs. 57.5 percent). Select for the article.
2. AHRQ-Funded Study Shows Physicians View E-prescribing Features as Cumbersome
E-prescribing systems can provide physicians access to important patient information, such as drugs prescribed by physicians in other practices and formulary information that can help reduce insured patients' drug costs, but many physicians are reluctant to use these features because they are viewed as cumbersome and unreliable, according to a new report funded by AHRQ. The report, prepared by researchers at the Center for Studying Health System Change (HSC), is a qualitative study of 24 physician practices using e-prescribing systems. Respondents highlighted two barriers to use: 1) tools to view and use the patient health information are cumbersome to use in some systems; and 2) data are not always seen as useful enough to expend the extra effort to use them. For more information about the HSC Research Brief, Experiences of Physician Practices Using E-Prescribing: Access to Information to Improve Prescribing Decisions, go to http://www.hschange.com/CONTENT/1202/
3. Report Describes Lessons from State, Regional Health Information Exchange Projects
A new report that describes the experiences and lessons from six AHRQ-funded health information exchanges is now available. The six States (Colorado, Delaware, Indiana, Rhode Island, Tennessee, and Utah) were funded under State and regional demonstration contracts to identify and support data-sharing and interoperability activities to improve health care for patients and populations. The report, prepared by AFYA, Inc., Clinovations, and ICF Macro, is available at the National Resource Center for Health IT (NRC) Web site at http://healthit.ahrq.gov/portal/server.pt/document/954515/synthesis_of_lessons_learned_pdf?qid=64506891&rank=1
4. Early Adopters of EMRs, E-Prescribing Offer Lessons to U.S.
The United Kingdom and the Netherlands were among the first countries to achieve high rates of adoption of electronic medical records (EMRs) and electronic prescribing. Their experiences offer lessons for the United States, as health providers and policymakers launch a national program to adopt these innovations. The report, prepared by the RAND Corporation, is available on the NRC Web site at: http://healthit.ahrq.gov/portal/server.pt/document/954562/electronicprescribinguknetherlands_pdf?qid=64824107&rank=1
5. ICUs in Michigan Sustain Zero Blood Stream Infections for Up to 2 Years
Intensive care units (ICUs) in both large and small hospitals stopped central line-associated bloodstream infections for up to 2 years after using a targeted quality improvement initiative funded in part by AHRQ. The initiative, Comprehensive Unit-based Safety Program, was implemented through the Keystone Intensive Care Unit Project in Michigan hospitals. The study, "The Ability of Intensive Care Units to Maintain Zero Central Line-Associated Bloodstream Infections," published in the May 9 issue of the Archives of Internal Medicine, found that hospital ICUs eliminated central line-associated bloodstream infections for up to 2 years or more. The researchers found that 60 percent of the 80 ICUs evaluated went 1 year or more without an infection, and 26 percent achieved 2 years or more. Smaller hospitals sustained zero infections longer than larger hospitals. Select to read our press release and for more information on the Comprehensive Unit-based Safety Program.
6. AHRQ Releases Tool to Help Consumers Reduce Medication Errors
Three out of four Americans are not following their doctor's advice when it comes to taking prescription medication, according to U.S. Surgeon General Dr. Regina Benjamin. AHRQ and the National Council on Patient Information and Education have released a revised guide to help patients learn more about how to take medicines safely. "Your Medicines: Be Smart. Be Safe" is a booklet that includes a detachable, wallet-sized card that can be personalized to help patients keep track of all medicines they are taking, including vitamins and herbal and other dietary supplements. Available in English and Spanish, the guide includes questions that patients can ask their doctors about their medications. Select to access a copy of the guide.
7. HHS Releases New Online Patient Safety Training Resources for Clinicians and Patient Advocates
The HHS Office of Healthcare Quality has released Partnering to Heal: Teaming Up Against Healthcare-Associated Infections, an interactive learning tool for clinicians, health professional students, and family caregivers. The training videos include information on basic protocols for universal precautions and isolation precautions to protect patients, visitors, and practitioners from the most common disease transmissions. The training promotes six key behaviors: teamwork, communication, hand washing, vaccination against the flu, appropriate use of antibiotics, and proper insertion, use, and removal of catheters and ventilators. These resources support the new Partnership for Patients, a national public-private partnership with hospitals, medical groups, consumer groups and employers that aims to prevent millions of injuries and complications in patient care over the next 3 years. Select to access the videos.
8. May Issue of AHRQ WebM&M Explores "Second Victims" of Errors
The May issue of AHRQ Web M&M features a Spotlight Case involving a critically ill child transferred to a tertiary hospital by a referring hospital that had missed signs of cerebral edema, raising the question of whether to disclose the errors of other facilities. A commentary on the case is provided by Thomas H. Gallagher, M.D., University of Washington, and an expert in conflicts of interest in the doctor-patient relationship. The Perspectives on Safety section features in interview with Albert Wu, M.D., M. P. H., Johns Hopkins University, who coined the term "second victim" to describe the toll that serious medical errors take on health providers. In the accompanying perspective, Susan Scott, R.N., M.S. N., University of Missouri, discusses efforts to ameliorate the impact of errors on providers. Physicians and nurses can receive free CME, CEU or training certification by taking the Spotlight Quiz.
9. 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.
Roberts LL, Ward MM, Brokel JM, et al. Impact of health information technology on detection of potential adverse drug events at the ordering stage. Am J Health Syst Pharm 2010 Nov 1; 67(21):1838-46. Select to access the abstract on PubMed.®.
Powell ES, Khare RK, Courtney DM, et al. Volume of emergency department admissions for sepsis is related to inpatient mortality: results of a nationwide cross-sectional analysis. Crit Care Med 2010 Nov; 38(11):2161-8. Select to access the abstract on PubMed.®.
Wen KY, Gustafson DH, Hawkins RP, et al. Developing and validating a model to predict the success of an IHCS implementation: the Readiness for Implementation Model. J Am Med Inform Assoc 2010 Nov-Dec; 17(6):707-13. Select to access the abstract on PubMed.®.
Current as of June 2011
Patient Safety and Health Information Technology E-Newsletter. June 7, 2011, Issue No. 69. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/ptsnews/ptsnews69.htm