July 7, 2011, Issue #70
Quote of the Month
"This was real-time quality assurance and real-time safety inspection at its finest. What do we usually do in health care? We have retrospective quality assurance." (For more information AHRQ's new study, go to item no.6.)
—Gary Kaplan, M.D., CEO of Virginia Mason Medical Center, recalling his hospital's reaction to observing the Toyota production system in action.
Patient Safety and Health IT News:
- New AHRQ Toolkit Helps Medical Practices Examine the Impact of Health IT on Workflow
- E-Health Project Boosts Physicians' Ability to Use Patient Registries, AHRQ-Funded Study Shows
- New Grant Funds Information Technologies to Improve Health of Older Adults
- Web Conference to Examine Clinical Decision Support and Knowledge Management Systems
- New Guide Outlines Strategies to Link Health IT and Patient-Centered Medical Home
- Web Conference Describes Proven Approaches to Improve Quality, Lower Costs
- Campaign Urges Hispanics To Get More Involved In Their Health Care
- Adverse Events Equally Common in Outpatient Settings and Inpatient Settings
- AHRQ in the Patient Safety and Health IT Professional Literature—Some Useful Citations
- Register for AHRQ's 2011 Annual Conference
AHRQ Patient Safety News:
1. New AHRQ Toolkit Helps Medical Practices Examine the Impact of Health IT on Workflow
A new toolkit funded by AHRQ and prepared by the University of Wisconsin-Madison's Center for Quality and Productivity Improvement will assist small-and medium-sized practices in workflow analysis and redesign before, during, and after health information technology (IT) implementation. Workflow Assessment for Health IT includes tools to analyze workflow, provides examples of workflow analysis and redesign, and describes the experiences of other organizations. For more information and a copy of the toolkit go to http://healthit.ahrq.gov/workflow
2. E-Health Project Boosts Physicians' Ability to Use Patient Registries, AHRQ-Funded Study Shows
Massachusetts physicians who took part in a 4-year, $50 million health information technology (IT) program increased their ability to generate and use registries that provide information about laboratory test results and medication use, results of a new AHRQ-funded study show. The ability to use patient registries, or lists of patients with specific conditions, medications or test results, is considered an essential tool for improving health care and is in the "meaningful use" criteria developed by the Centers for Medicare and Medicaid Services. A total of 163 physicians from 134 practices in 3 communities participated in the health IT program between 2005 through 2009. Sponsored by the Massachusetts eHealth Collaborative, the program included consisted of robust electronic health records and work-flow redesign and technical support at no cost to the practices. Compared with all physicians who were surveyed in 2005, all respondents in 2009 were more likely to be able to generate significantly more laboratory and medication registries. The study's abstract, which was published in the July issue of Health Affairs, can be accessed here .
3. New Grant Funds Information Technologies to Improve Health of Older Adults
AHRQ has awarded a 5-year, $10 million grant to the University of Wisconsin for community-based research on the use of communication and information technologies to improve the health and health care services for older adults. The grant aims to create a center of excellence that brings together research teams from various institutions and entities of the aging network. The research will focus on 3 broad themes:
- Using information technologies to extend independence and functioning of older adults and reduce unnecessary health care utilizations.
- Expanding service networks that place individuals and their families at the center.
- Developing innovative approaches to translate evidence into practice.
Select to read the abstract on AHRQ's Health IT Web site.
4. Web Conference to Examine Clinical Decision Support and Knowledge Management Systems
Three researchers will present evidence reviews at a July 20 Web conference on experiences with clinical decision support and knowledge management systems (CDSS/KMS). The findings, gathered from AHRQ's Evidence-Based Practice Centers for Health IT, will address how CDSS/KMS can serve as information tools to bolster clinician decision-making at the point of care. Researchers will also examine the effects of health IT on the medication management process of prescribing, and the impact of consumer health informatics applications on health outcomes. Participants in the Web conference are eligible for 1.5 credit hours of continuing medical education. Select to register for the Web conference.
5. New Guide Outlines Strategies to Link Health IT and Patient-Centered Medical Home
Although health IT and the adoption of electronic health records (EHRs) are important components of the patient-centered medical home (PCMH), major changes in policy and practice are needed to fully realize its potential, according to a new decision-maker brief from AHRQ. They include adding functionalities that support the PCHM, adding meaningful use requirements that support the PCMH for stages 2 and 3 of the EHR incentive program, and funding technical assistance to primary care providers on PCMH transformation through existing mechanism, such as regional extension centers or primary care extension programs. Select to access the decisionmaker brief on AHRQ's PCMH Resource Center Web site.
6. Web Conference Describes Proven Approaches to Improve Quality, Lower Costs
Adopting the Toyota production system, in which auto workers are empowered to stop an assembly line to immediately address potential quality problems in real time, was a key ingredient in an innovative management approach developed at Virginia Mason Medical Center, Seattle, WA, that emphasized quality, safety, and attention to patients' needs. Details of its implementation and its success were shared by CEO Gary Kaplan, M.D., at a June 20 Web conference sponsored by the Partnership for Patients, and National Quality Forum. The Partnership for Patients is a public-private collaboration that aims to decrease the incidence of healthcare-acquired conditions and reduce the rate of hospital re-admissions by specific percentages by 2013. Additional successful examples using the Toyota, or lean, production system were highlighted by John Toussaint, M.D., President and CEO of ThedaCare Center for Healthcare Value, Appleton, WI. The Web conference was the first in an 8-part series aimed to help organizations achieve these goals. Upcoming Webinars will focus on reducing re-admissions through care transitions (July 6), preventing adverse drug events (July 19), and reducing infections in intensive care units (August 3). Click here to listen to the archived Webinar or register for upcoming ones.
7. Campaign Urges Hispanics To Get More Involved In Their Health Care
AHRQ and the Ad Council have launched a multimedia Spanish-language campaign to encourage Hispanics to get more involved in their health care and to talk to their doctors about their medical concerns. Conoce las Preguntas, or Know the Questions, features TV, radio, print and Web ads that offer tips to help Hispanics prepare for medical appointments by thinking about questions to ask their doctors. Hispanics tend to seek medical treatment advice from friends, co-workers, and casual acquaintances rather than going to the doctor unless they are very sick, AHRQ research has shown. AHRQ's recently published 2010 National Healthcare Disparities Report found that, compared with whites, the percentage of Hispanics who regularly get important screening tests to check for diabetes or cancer is not improving. The campaign supports the HHS Action Plan to Reduce Racial and Ethnic Health Disparities, the Department's first-ever strategic action plan to reduce health disparities among racial and ethnic minorities in the U.S. Select for more information on the campaign.
8. Adverse Events Equally Common in Outpatient Settings and Inpatient Settings
A new study confirms that the incidence of adverse events in the outpatient setting deserves the same scrutiny as those that occur in the inpatient setting. According to a retrospective analysis of more than10,000 malpractice claims paid and reported to the National Practitioner Data Bank in 2009, adverse events in the outpatient setting accounted for 43%, events in the inpatient setting accounted for 47%, and 9% involved events in both settings. The most common reason for a claim paid in the outpatient setting was diagnostic (45%); in the inpatient setting, the most common reason was surgical (34%). Major injury and death were the two most common outcomes in both settings. The study abstract was reported in the June 15 issue of the Journal of the American Medical Association. Select to access the abstract on PubMed.®.
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, contact your technical support staff for possible remedies.
Saverno KR, Hines LE, Warholak TL, et al. Ability of pharmacy clinical decision-support software to alert users about clinically important drug-drug interactions. J Am Med Inform Assoc 2011 Jan; 18(1):32-7. Select to access the abstract on PubMed.®.
Reynolds C, Quan V, Kim D, et al. Methicillin-resistant Staphylococcus aureus (MRSA) carriage in 10 nursing homes in Orange County, California. Infect Control Hosp Epidemiol 2011 Jan; 32(1):91-3. Select to access the abstract on PubMed.®.
Nylund CM, Goudie A, Garza JM, et al. Clostridium difficile infection in hospitalized children in the United States. Arch Pediatr Adolesc Med 2011 Jan 3. Select to access the abstract on PubMed.®.
Goldman LE, Walker R, Miglioretti DL, et al. Accuracy of diagnostic mammography at facilities serving vulnerable women. Med Care 2011 Jan; 49(1):67-75. Select to access the abstract on PubMed.®
10. Register for AHRQ's 2011 Annual Conference
AHRQ's fifth annual conference, AHRQ: Leading Through Innovation and Collaboration, will be held from September 18-21, 2011, at the Bethesda North Marriott Hotel & Conference Center, Bethesda, MD. Speakers include pioneers who are leading systemic change based on innovative approaches to solving safety, quality and access issues. The event will emphasize how AHRQ is leading change in addressing today's challenges in improving access to care, quality and cost, as well as partnering with others at the forefront of these issues. For more information about the conference and to register, please visit the AHRQ Annual Conference Web site.
Current as of July 2011
Patient Safety and Health Information Technology E-Newsletter. July 7, 2011, Issue No. 70. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/ptsnews/ptsnews70.htm