Improved Preventive Care in Nursing Homes Could Potentially Reduce Hospitalizations by 60 Percent, AHRQ Study Finds

Electronic Newsletter, Issue 390

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

July 29, 2013


AHRQ Stats

Nearly one in five patients with lower-extremity amputations, heart valve procedures, or wounds, infections, or burns needing debridement were readmitted to the hospital within 30 days of being discharged in 2010. (Source: Agency for Healthcare Research and Quality: Healthcare Cost and Utilization Project Statistical Brief #154, Readmissions to U.S. Hospitals by Procedure, 2010). In addition, nearly one in four patients diagnosed with congestive heart failure, schizophrenia, or acute kidney failure were readmitted within 30 days of discharge in 2010. (Source: Agency for Healthcare Research and Quality: Healthcare Cost and Utilization Project Statistical Brief #153, Readmissions to U.S. Hospitals by Diagnosis, 2010). A new infographic [PDF File, Plugin Software Help] illustrates these data.

Today's Headlines

  1. Improved Preventive Care in Nursing Homes Could Potentially Reduce Hospitalizations by 60 Percent, AHRQ Study Finds.
  2. AHRQ Study Examines Hospitals' HAI Safety Culture Based on Staff Characteristics.
  3. EDM Forum Focuses on Lessons Learned Using Electronic Data.
  4. Register Now for August 6 AHRQ Webinar on Using Health IT to Improve Patient Care in Practice-Based Research Networks.
  5. Register Now for August 14 AHRQ Webinar about System-wide Implementation of TeamSTEPPS®.
  6. AHRQ's Patient Safety Network Primer Identifies Sources of Diagnostic Errors and Steps for Prevention.
  7. AHRQ in the professional literature.

1. Improved Preventive Care in Nursing Homes Could Potentially Reduce Hospitalizations by 60 Percent, AHRQ Study Finds

A new AHRQ-funded study found that 60 percent of hospitalizations of long-stay nursing home residents could potentially have been avoided with appropriate preventive care. The study applied a nursing home–specific measure that doubled the estimate of potentially avoidable hospitalizations based on Ambulatory Case Sensitive Conditions data. The study's broader measure includes conditions that could have been avoided with appropriate preventive care, such as injuries, dehydration, and urinary tract, blood, respiratory, and gastrointestinal infections. The nursing home-–specific measure also identified additional nursing home patients at high risk, including those with renal disease or pressure ulcers or who received catheter or ostomy care. The study showed that nursing homes with fewer quality deficiencies and in states with higher Medicaid reimbursement had fewer avoidable hospitalizations. The study, “Potentially Avoidable Hospitalizations for Elderly Long-stay Residents in Nursing Homes,” was published in the August issue of Medical Care. Select to access the PubMed® abstract.

2. AHRQ Study Examines Hospitals' HAI Safety Culture Based on Staff Characteristics

Although they have a lot of patient contact, health care technicians may not be doing enough to prevent infections and improve safety when compared with other staff, according to an AHRQ-funded study that examined the patient safety culture at five hospitals across the United States. The study found that frontline staff (aides, medical technologists, and phlebotomists) were less aware of hospital efforts to monitor infections and the presence of an interdisciplinary approach to patient safety. Noting that the safety culture for infection prevention varied more by hospital than by the hospital staff's position or experience, the study suggested tailoring safety education programs to the needs of each hospital rather than to the characteristics of its staff. The study—“Does Health Care Role and Experience Influence Perception of Safety Culture Related to Preventing Infections?”—was published in the July issue of the American Journal of Infection Control. Select to access the PubMed® abstract.

3. EDM Forum Focuses on Lessons Learned Using Electronic Data

AHRQ this week announced the release of the Electronic Data Methods Forum's (EDM's) second special supplement with Medical Care, titled “The Electronic Data Methods Forum, 2013: Advancing the National Dialogue on Use of Electronic Clinical Data to Improve Patient Care and Outcomes.” The supplement features 13 papers that highlight challenges and successes using electronic health records for comparative effectiveness research, standardizing terminologies in adherence, protecting patient privacy, and improving synergy between research and clinical care. AHRQ's Effective Health Care Program established the EDM Forum to advance the national dialogue on use of electronic clinical data to conduct comparative effectiveness research, improve quality, and develop clinical decision support systems. Select to access the supplement.  

4. Register Now for August 6 AHRQ Webinar on Using Health IT to Improve Patient Care in Practice-Based Research Networks

AHRQ will host a 90-minute webinar on August 6 from 2:30 to 4:00 p.m. ET on using health IT to improve care within Practice-Based Research Networks (PBRNs). PBRNs work with practicing clinicians to ask and answer clinical and organizational questions central to primary health care delivery.

The webinar will highlight three PBRN successes, including:

  • Connecting to health information exchange (HIE) in primary care.
  • Creating and sharing electronic after-visit summaries.
  • Using technology to inform HPV vaccination decisions.

The expert panel will include Alexander Fiks, M.D., Co-Medical Director of the Children's Hospital of Philadelphia Pediatric Research Consortium; Zsolt Nagykaldi, Ph.D., Associate Professor of Family and Preventive Medicine at the University of Oklahoma Health Sciences Center; Valory Pavlik, Ph.D., Associate Professor and Interim Vice Chair of Research at Baylor College of Medicine in Houston; and Brian Yeaman, M.D.,Chief Medical Informatics Officer from Norman (OK) Regional Health Center. Rebecca Roper, M.S., M.P.H., Director of AHRQ's PBRN Initiative, will moderate.

Select to register for this free webinar.  

5. Register Now for August 14 AHRQ Webinar about System-wide Implementation of TeamSTEPPS®

AHRQ will host a 1-hour webinar on August 14 from 1:00 p.m. to 2:00 p.m. ET featuring lessons learned from leaders at a large New York health system who have implemented TeamSTEPPS® systemwide.  Leaders from North Shore Long Island Jewish Health System, including Lily Thomas, Ph.D., R.N., Vice President of System Nursing Research, and Catherine Galla, R.N., Associate Vice President of Nursing Initiatives, will present the system's approach to implementing AHRQ's team training curriculum. Their presentations will:

  • Illustrate the system's unique TeamSTEPPS implementation story.
  • Describe the phases of TeamSTEPPS implementation.
  • Recognize three barriers to and proactive solutions for implementing TeamSTEPPS.

Select to register for this free webinar.  

6. AHRQ's Patient Safety Network Primer Identifies Sources of Diagnostic Errors and Steps for Prevention

A Harvard Medical Practice Study found that diagnostic errors accounted for 17 percent of preventable errors in hospitalized patients, and a systematic review of autopsy studies covering four decades found that approximately 9 percent of patients experienced a major diagnostic error that went undetected while the patient was alive. Taken together, these studies imply that thousands of patients die every year due to diagnostic errors. A new primer available on AHRQ's Patient Safety Network identifies the cognitive biases and health system problems leading to diagnostic errors and steps to prevent both. Select to access the full patient safety primer, titled “Diagnostic Errors."

7. AHRQ in the Professional Literature

Lee BY, Bartsch SM, Wong KF, et al. The importance of nursing homes in the spread of methicillin-resistant Staphylococcus aureus (MRSA) among hospitals. Med Care 2013 Mar; 51(3):205-15. Select to access the abstract on PubMed®. 

Thompson RT, Bennett WE Jr, Finnell SM, et al. Increased length of stay and costs associated with weekend admissions for failure to thrive. Pediatrics 2013 Mar; 131(3):e805-e810. Select to access the abstract on PubMed®. 

Tjia J, Field TS, Mazor KM, et al. Dementia and risk of adverse warfarin-related events in the nursing home setting. Am J Geriatr Pharmacother 2012 Oct; 10(5):323-30. Select to access the abstract on PubMed®. 

Curtis JR, Sharma P, Arora T, Bharat A, Barnes I, Morrisey MA, Kilgore M, Saag KG, et al. Physicians' explanations for apparent gaps in the quality of rheumatology care: results from the U.S. Medicare Physician Quality Reporting System. Arthritis Care Res 2013 Feb; 65(2):235-43. Select to access the abstract on PubMed®. 

Anderson CB, Penson DF, Ni S, et al. Centralization of radical prostatectomy in the United States. J Urol 2013 Feb; 189(2):500-6. Select to access the abstract on PubMed®. 

Sanders RC Jr, Giuliano JS Jr, Sullivan JE, et al. Level of trainee and tracheal intubation outcomes. Pediatrics 2013 Mar; 131(3):e821-e828. Select to access the abstract on PubMed®. 

Stundner O, Kirksey M, Chiu YL, Mazumdar M, et al. Demographics and perioperative outcome in patients with depression and anxiety undergoing total joint arthroplasty: a population-based study. Psychosomatics 2013 Mar; 54(2):149-57. Select to access the abstract on PubMed®.

Vavalle JP, Lopes RD, Chen AY, et al. Hospital length of stay in patients with non-ST-segment elevation myocardial infarction. Am J Med 2012 Nov; 125(11):1085-94. Select to access the abstract on PubMed®.

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Page last reviewed July 2013
Internet Citation: Improved Preventive Care in Nursing Homes Could Potentially Reduce Hospitalizations by 60 Percent, AHRQ Study Finds: Electronic Newsletter, Issue 390. July 2013. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/newsletters/e-newsletter/390.html