AHRQ Toolkit Can Help Hospitals Lower Preventable Readmissions

Electronic Newsletter, Issue 372

AHRQ's Electronic Newsletter summarizes Agency research and programmatic activities.

March 18, 2013

AHRQ Stats

The aggregate cost for all hospital stays reached almost $376 billion in 2010. (Source: Agency for Healthcare Research and Quality, HCUP Statistical Brief #146: Costs for Hospital Stays in the United States, 2010.)

Today's Headlines

  1. AHRQ Toolkit Can Help Hospitals Lower Preventable Readmissions.
  2. Study Compares TIA and Stroke Patients.
  3. AHRQ’s Health Care Innovations Exchange Focuses on Alternative Care Settings to Reduce Hospital Use.
  4. AHRQ’s March Issue of Web M&M Examines Medication Dosing Errors in Pediatrics.
  5. AHRQ Offers Healthcare Cost and Utilization Project Data Users’ Workshop on May 8.
  6. AHRQ in the professional literature.

 1. AHRQ Toolkit Can Help Hospitals Lower Preventable Readmissions

Every year millions of patients are readmitted to hospitals, and many of those stays could have been prevented. The Re-Engineered Discharge (RED) Toolkit, funded by AHRQ, can help hospitals reduce readmissions rates by replicating the discharge process that resulted in 30 percent fewer hospital readmissions and emergency room visits. Developed at Boston University Medical Center, the newly expanded toolkit provides guidance to implement the RED process for all patients, including those with limited English proficiency and from diverse cultural backgrounds. By helping hospitals plan and monitor the implementation of the RED process, the new toolkit improves smooth and effective transitions from hospital to home. Select to access the toolkit. To order copies of the instructional manual, contact the AHRQ Publications Clearinghouse at AHRQPubs@ahrq.hhs.gov or call 1-800-358-9295.

 2. Study Compares TIA and Stroke Patients

Patients hospitalized for transient ischemic attack (TIA) were as likely as stroke patients to die within 1 year of hospital discharge, according to a study funded in part by AHRQ. The TIA patients were also more likely than stroke patients to be rehospitalized within 1 year for stroke and less likely to be prescribed warfarin, a cholesterol-lowering drug, or diabetes medications upon initial discharge. "Death and Rehospitalization after Transient Ischemic Attack or Acute Ischemic Stroke: One-Year Outcomes from the Adherence Evaluation of Acute Ischemic Stroke-Longitudinal Registry," was published December 25, 2012 in the Journal of Stroke and Cerebrovascular Diseases. Select to access the abstract on PubMed®.

 3. AHRQ’s Health Care Innovations Exchange Focuses on Alternative Care Settings to Reduce Hospital Use

The March 13 issue of AHRQ’s Health Care Innovations Exchange features three programs that reduced hospital use by providing services to specific patient populations in various outpatient settings. One of the featured profiles describes the TIA Rapid Evaluation Center in New Jersey, an outpatient center that provides a timely, comprehensive evaluation of stable patients who have experienced a recent transient ischemic attack (TIA). Rather than admitting these patients to the hospital, emergency department and community-based physicians refer them to the center for tests and a neurological examination. Based on the results, the neurologist develops a personalized plan to reduce the risk of recurrent stroke. During its first 6 months of operation, the center has served 80 percent of stable patients presenting to the hospital with a TIA, providing them with more comprehensive and timely services than those received by similar patients admitted to the hospital. Over the 6-month period, the program has eliminated the need for 36 inpatient admissions, saving more than $150,000. View more innovation profiles about care delivery in outpatient settings to reduce hospital utilization on the Innovations Exchange Web site, which contains more than 750 searchable innovations and 1,500 Quality Tools.

 4. AHRQ’s March Issue of Web M&M Examines Medication Dosing Errors in Pediatrics

The March 2013 issue of AHRQ Web M&M features a Spotlight Case describing the case of a 17-month-old toddler brought to the emergency department for treatment of an eye infection. A prescription for an oral antibiotic was written, based on a calculation of the patient’s weight in kilograms (25 kg), instead of pounds (25 lbs or 11.3 kg). The mother, a medical student, recognized the implications of the error the following day and had the prescription changed to reflect the correct weight in pounds. Upon further investigation, the hospital discovered that the patient’s weight in kilograms had been entered into the electronic medical record and had not been identified by other providers during the ED visit. A commentary on the case is provided by Seth J. Bokser, M.D., associate professor for pediatrics at University of California-San Francisco Medical School. The Perspectives on Safety section features an interview with David M. Gaba, M.D., professor of anesthesia at Stanford University School of Medicine and an international leader in health care simulation. Physicians and nurses can receive free CME, CEU, or training certification by taking the Spotlight Quiz. Select to read the current issue of AHRQ Web M&M.

 5. AHRQ Offers Healthcare Cost and Utilization Project Data Users’ Workshop on May 8

AHRQ is conducting a full-day, intermediate-level workshop to provide hands-on experience with Healthcare Cost and Utilization Project (HCUP) databases and tools. The course will feature a brief overview of HCUP and a demonstration of HCUPnet, a free online querying tool that provides instant access to HCUP statistics. Faculty will present step-by-step instruction on working with HCUP databases to conduct revisit analyses using HCUP data. Participants will use computers loaded with subsets of HCUP State Inpatient Databases (SID) and State Emergency Department Databases (SEDD), and will run SAS programs on the HCUP databases; all SAS programs will be provided. Faculty will be available for consultation on how HCUP data can support participants’ research interests. Instructional and reference materials will be distributed and discussed. The workshop will be held at AHRQ headquarters in Rockville, MD. Deadline for registration is April 29 or until the class is full. There is no charge for the workshop. Select to register for the workshop.

 6. AHRQ in the Professional Literature

Sittig DF, Singh H. Electronic health records and national patient-safety goals. N Engl J Med 2012 Nov 8; 367(19):1854-1860. Select to access the abstract on PubMed®.

Marcum ZA, Pugh MJ, Amuan ME, et al. Prevalence of potentially preventable unplanned hospitalizations caused by therapeutic failures and adverse drug withdrawal events among older veterans. J Gerontol A Biol Sci Med Sci 2012 Aug; 67(8):867-874. Select to access the abstract on PubMed®.

Poon EG, Kachalia A, Puopolo AL, et al. Cognitive errors and logistical breakdowns contributing to missed and delayed diagnoses of breast and colorectal cancers: a process analysis of closed malpractice claims. J Gen Intern Med 2012 Nov; 27(11):1416-1423. Select to access the abstract on PubMed®.

You WB, Wolf M, Bailey SC, et al. Factors associated with patient understanding of preeclampsia. Hypertens Pregnancy 2012; 31(3):341-349. Select to access the abstract on PubMed®.

Saag KG, Mohr PE, Esmail L, et al. Improving the efficiency and effectiveness of pragmatic clinical trials in older adults in the United States. Contemp Clin Trials 2012 Nov; 33(6):1211-1216. Select to access the abstract on PubMed®.

Anderson ML, Peterson ED, Brennan JM, et al. Short- and long-term outcomes of coronary stenting in women versus men: results from the National Cardiovascular Data Registry centers for Medicare & Medicaid Services cohort. Circulation 2012 Oct 30; 126(18):2190-2199. Select to access the abstract on PubMed®.

Karaca Z, Wong HS, Mutter RL. Duration of patients' visits to the hospital emergency department. BMC Emerg Med 2012 Nov 6; 12(1):15. Select to access the abstract on PubMed®.

Chin CT, Wang TY, Li S, et al. Comparison of the prognostic value of peak creatine kinase-MB and troponin levels among patients with acute myocardial infarction: a report from the Acute Coronary Treatment and Intervention Outcomes Network Registry-Get With The Guidelines. Clin Cardiol 2012; 35(7):424-429. Select to access the abstract on PubMed®.

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Page last reviewed March 2013
Internet Citation: AHRQ Toolkit Can Help Hospitals Lower Preventable Readmissions: Electronic Newsletter, Issue 372. March 2013. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/newsletters/e-newsletter/372.html