Research Activities, February 2014
News and Notes
AHRQ report shows how health information technology can improve care quality and delivery
Appropriate implementation and use of health IT systems such as electronic health records, personal health records, and health information exchange systems can support the delivery of ambulatory care, according to a new AHRQ report. Findings and Lessons from the AHRQ Ambulatory Safety and Quality Program documents the findings of more than 50 research projects that investigated how health IT applications can improve quality, enable quality measurement, enhance care delivery for people living with complex care needs, and enhance patient-centered care. Multiple studies showed positive impacts on process, intermediate, health, and economic outcomes.
New AHRQ toolkit designed to improve safety of fragile newborns
A new guide, Transitioning Newborns from NICU to Home: A Resource Toolkit, is available to help improve the safety of infants born preterm or with complex congenital conditions as they transition from the neonatal intensive care unit (NICU) to their home. Funded by AHRQ, the toolkit features information on how hospitals can create programs in which a health coach serves as a teacher and facilitator who encourages open communication with the parents or caregivers to identify their needs and concerns and facilitate followup medical care for the infant by primary care providers.
Using the toolkit, (www.ahrq.gov/professionals/systems/hospital/nicu_toolkit) the health coach can customize a broad range of information for each family. Included are approximately 30 fact sheets, directed to either the clinician or the infant's family, on topics such as managing breathing and feeding problems.
HCUP Releases 2011 Nationwide Emergency Department Sample
AHRQ's Healthcare Cost and Utilization Project (HCUP) has released its 2011 National Emergency Department Sample (NEDS). The NEDS is the largest all-payer emergency department (ED) database in the United States. The NEDS was created to enable analyses of ED use patterns and support public health professionals, administrators, policymakers, and clinicians in their understanding and decisionmaking regarding this critical source of health care. Constructed using records from both the HCUP State Emergency Department Databases and the State Inpatient Databases, the 2011 NEDS contains data from nearly 29 million ED visits and encompasses all encounter data from more than 922 hospital-based EDs in 30 States. It approximates a 20-percent stratified sample of EDs from community hospitals. Weights are provided to calculate national estimates pertaining to the 131 million ED visits that took place in 2011. The NEDS has many research applications, since it contains information on hospital and patient characteristics, geographic region, and the nature of the ED visits. The database includes information on all visits to the ED, including persons covered by Medicare, Medicaid, private insurance, and the uninsured.
More information about the NEDS can be found on the HCUP-US Web site at http://hcup-us.ahrq.gov/nedsoverview.jsp.
New guide available for implementing N-of-1 trials
A new publication from AHRQ's Effective Health Care Program, Design and Implementation of N-of-1 Trials: A User's Guide, is an informational resource to researchers, health care providers, patients, and other stakeholders, to improve understanding of n-of-1 trials and strengthen the quality of evidence that is generated when an n-of-1 trial is conducted. The aim of this user's guide is to identify key decisions and tradeoffs in the design and implementation of n-of-1 trials, particularly when used for patient-centered outcomes research. This guide explains how to apply n-of-1 trials in a sustainable way, outlining indications, potential benefits, and barriers; human subject issues; financial considerations; statistical design and analysis factors; recommended information technology infrastructure for implementation; and training and engagement of providers and patients. Each chapter also includes a checklist to help clinicians and investigators determine if key considerations are met.
Each of the six chapters can be downloaded for free from the Effective Health Care Program Web site at www.effectivehealthcare.ahrq.gov.