Using EHRs to Evaluate Lipid Management Performance Metrics Can Be Problematic, Study Finds
Black patients had higher rates of perforated appendix than whites and other minority patients from 2001 to 2007, but not in more recent years. (Source: Agency for Healthcare Research and Quality, Healthcare Cost and Utilization Project Statistical Brief #159: Trends in Rates of Perforated Appendix, 2001–2010.)
- Using EHRs to Evaluate Lipid Management Performance Metrics Can Be Problematic, Study Finds.
- BMJ Quality & Safety Publishes AHRQ Conference Supplement on Diagnostic Errors.
- AHRQ's New CUSP Module Helps Hospitals Engage Patients and Families in Their Care.
- New CHIPRA Evaluation Highlight Focuses on Quality Measurement.
- AHRQ in the professional literature.
Using electronic health records (EHRs) to determine why providers aren't following lipid management performance measures can be problematic, according to an AHRQ-funded study in the October issue of the American Heart Journal. Researchers at the Duke Clinical Research Institute created a retrospective cohort of 3,779 patients with coronary artery disease from an academic medical center that uses EHRs. The charts of 300 patients chosen at random were reviewed to identify reasons for failure to adhere to lipid management performance measures. Researchers found that this type of assessment is possible, but accuracy is currently limited and may underestimate provider quality of care. Therefore, limitations such as poor specificity of claims data, inability to integrate with clinical data beyond institutional electronic health data, and incomplete information on medication use and intolerances need to be carefully considered before widespread implementation of automated care quality assessment. Select to access the journal abstract on PubMed®.
The range of issues, challenges, and opportunities for reducing diagnostic errors is explored in a special supplement to the October issue of the British Medical Journal's BMJ Quality & Safety. Through a series of 10 papers and a related editorial, the supplement describes the current state of the science for diagnostic error. Topics include educational and research agendas, epidemiology, cognitive biases and human factors issues, costs, and the role of patients in preventing diagnostic error. The supplement was based largely on findings presented at annual Diagnostic Error in Medicine conferences over the past three years. The goals of this AHRQ-supported conference, now in its sixth year, include promoting a better understanding of diagnostic error and fostering the creation of intervention strategies to improve the quality of diagnosis. Select to access the supplement and related editorial.
AHRQ has released a new module for its Comprehensive Unit-based Safety Program (CUSP) to help clinical teams learn how to engage patients and families in their care. Based on a field-tested guide for engaging patients and families, the CUSP Patient and Family Engagement Module includes PowerPoint slides, speaker notes, demonstration videos, and tools to improve communication and patient safety in the hospital setting. The module helps clinicians:
- Explore the roles and characteristics of patient and family advisors.
- Understand the relationship between communication and patient safety.
- Apply IDEAL Discharge Planning.
- Communicate adverse events to patients and family members.
Clinical teams can use this module to foster an environment where patients, family members, and hospital staff are working together as partners to improve the quality and safety of care. Select to access the module.
The fifth Evaluation Highlight from the national evaluation of the Children's Health Insurance Program Reauthorization Act (CHIPRA) Quality Demonstration Grant Program is now available on the AHRQ Web site. This Evaluation Highlight compares and contrasts two projects that use quality measures to drive quality improvement. It features a pay-for-performance program in Pennsylvania that encourages health systems to support quality improvement using electronic health records and a state-led learning collaborative in South Carolina that supports primary care practices to become more focused on data-driven quality improvement. The analysis covers the first two to three years of these five-year demonstration projects, including a year of planning and up to two years of implementation. Select to access Evaluation Highlight No. 5.
Goldberg JB, DeSimone JP, Kramer RS, et al. Impact of preoperative left ventricular ejection fraction on long-term survival after aortic valve replacement for aortic stenosis. Circ Cardiovasc Qual Outcomes 2013 Jan 1; 6(1):35-41. Select to access the abstract on PubMed®.
Darney BG, Weaver MR, VanDerhei D, et al. "One of those areas that people avoid" a qualitative study of implementation in miscarriage management. BMC Health Serv Res 2013 Apr 3; 13:123. Select to access the abstract on PubMed®.
Field TS, Garber L, Gagne SJ, et al. Technological resources and personnel costs required to implement an automated alert system for ambulatory physicians when patients are discharged from hospitals to home. Inform Prim Care 2012; 20(2):87-93. Select to access the abstract on PubMed®.
Vinnard C, Linkin DR, Localio AR, et al. Effectiveness of interventions in reducing antibiotic use for upper respiratory infections in ambulatory care practices. Popul Health Manag 2013 Feb; 16(1):22-7. Select to access the abstract on PubMed®.
Fabbri LM, Boyd C, Boschetto P, et al. How to integrate multiple comorbidities in guideline development: article 10 in Integrating and coordinating efforts in COPD guideline development. Proc Am Thorac Soc 2012 Dec; 9(5):274-81. Select to access the abstract on PubMed®.
Willis JM, Edwards R, Anstrom KJ, et al. Decision support for evidence-based pharmacotherapy detects adherence problems but does not impact medication use. Stud Health Technol Inform 2013; 183:116-25. Select to access the abstract on PubMed®.
Thorpe-Jamison PT, Culley CM, Perera S, et al. Evaluating the impact of computer-generated rounding reports on physician workflow in the nursing home: a feasibility time-motion study. J Am Med Dir Assoc 2013 May; 14(5):358-62. Select to access the abstract on PubMed®.
Jones C, Missanelli M, Dure L, et al. Anticonvulsant medication errors in children with epilepsy during the home-to-hospital transition. J Child Neurol 2013 Mar; 28(3):314-20. Select the access the abstract on PubMed®.
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