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ACTION Project Awards, Fiscal Year 2010

Field Partnerships for Applied Research

Select for the ACTION Fact Sheet.
Select for Awards in Fiscal Year 2009.

Patient Safety

Title: Effect of the Use of Universal Glove and Gowning on HAI Rates and Antimicrobial Resistant Bacteria
Partner: Yale New Haven Health Services Corporation
ACTION Contact: Beverly Belton, Beverly.belton@ynhh.org
Description: This project's purpose is determining the effectiveness of universal glove and gowning procedures in reducing methicillin-resistant Staphilococcus aureus (MRSA) infections and Clostridium difficile infections in intensive care units. Objectives include documenting the effectiveness, costs, and unintended consequences associated with implementing universal glove and gowning procedures; and disseminating the study findings, including information about the costs and unintended consequences.
Period: 9/10-9/12
Funding: $5,661,987
Deliverables: Report on findings on costs and unintended consequences, final report, dissemination of findings.

Title: Optimizing Preoperative Surgical Antibiotic Prophylaxis for the 21st Century
Partner: University of Iowa
ACTION Contact: Marcia Ward, marcia-m-ward@uiowa.edu
Description: This project aims to determine whether a preoperative antibiotic prophylaxis algorithm that includes the use (including selective use) of antibiotics shown to be effective against resistant gram-positive organisms is effective in reducing the number of surgical site infections (SSIs) attributable to resistant gram-positive organisms. Objectives include conducting an environmental scan of existing preoperative antibiotic prophylaxis algorithms for the prevention of cardiac and orthopedic SSIs; developing one or more new prophylaxis algorithms that incorporate the use of antibiotics with demonstrated effectiveness against resistant gram-positive organisms; and designing and conducting a study to compare the new algorithms against standard algorithms used for administering preoperative antibiotic prophylaxis of SSIs in cardiac and orthopedic surgery.
Period: Base: 8/10-8/11; Option: 8/11-8/13
Funding: Base $455,935; Option $1,332,663
Deliverables: Final report of literature, data, and regimens/algorithms; summary of data safety monitoring board reviews and findings; final algorithms; dissemination plan; conference presentation; final report.

Title: Proactive Risk Assessment in Ambulatory Surgery Centers
Partner: American Institutes for Research
ACTION Contact: Kristin Carman, kcarman@air.org
Description: This project uses sociotechnical probabilistic risk assessment (STPRA) modeling to analyze factors leading to the development of healthcare-associated infections originating in ambulatory surgery centers (ASCs). Researchers use this information to inform the design of an intervention to reduce the likelihood of at least one potential failure. Objectives include identifying a surgical procedure or group of related procedures conducted in an ASC for the STPRA; conducting the STPRA by identifying the failures leading to adverse events; estimating the probability of these failures, and using this information to determine the probability of a surgical site infection (SSI) occurring for the given surgical procedure(s); and using STPRA modeling to identify and design an intervention to reduce the probability of this SSI originating in the ASC setting.
Period: 8/10-12/11
Funding: $316,094
Deliverables: Final report.

Title: Improving Infection Control Practices in End-Stage Renal Disease Facilities
Partner: Health Research & Educational Trust
ACTION Contact: Maulik Joshi, mjoshi@aha.org
Description: This project aims to improve adherence to infection control practices in end-stage renal disease (ESRD) facilities to reduce preventable vascular-access infections. Objectives include development of an infection control worksheet that can be used by ESRD facilities to assess their performance and in surveys to identify adherence to required infection control practices; implementation, evaluation, and revision of the infection control worksheet at a cohort of hemodialysis facilities; development of a Comprehensive Unit-based Safety Program to prevent vascular-access infections and use of data from implementation of the infection control worksheet to assess facility performance.
Period: 9/10-9/12
Funding: $1,522,610
Deliverables: Final composite measures, report on required and best practices, final report.

Title: Using Nursing Home Antibiograms To Improve Antibiotic Prescribing and Delivery
Partners: Task orders were awarded for this topic to both Denver Health & Abt Associates.
ACTION Contacts: Susan Moore, susan_moore@dhha.org; Andrea Hassol, andrea_hassol@abtassoc.com
Description: These task orders assess whether the development of nursing home-specific antibiograms improve empiric antibiotic prescribing practices and delivery within nursing homes and for residents transferred to local emergency departments with presumed bacterial infections. Objectives include developing a standardized method for determining antibiotic susceptibility patterns and developing nursing home-specific antibiograms; implementing the antibiogram within the nursing home and in affiliated emergency departments to guide empiric management of nursing home residents with presumed bacterial infections; and developing a toolkit that will aid nursing homes and affiliated laboratories in creating and maintaining nursing home-specific antibiograms.
Period: 7/10-7/12
Funding: $621,298 (Denver Health) and $458,812 (Abt Associates)
Deliverables: Report on nursing home antbiogram development, implementation, and evaluation. Draft toolkit will include guidance on how to construct, update, and maintain antibiograms.

Title: Patient Safety Education and Training: An Environmental Scan
Partner: American Institutes for Research
ACTION Contact: Kristin Carman, kcarman@air.org
Description: The overall objectives of this initiative are to (1) collect data on and catalog the universe of current, active, and recurring patient safety education and training programs; (2) characterize those programs by salient factors (e.g., sponsor, targeted/eligible audience, program objectives, delivery method, duration, content, cost); (3) provide an easy-to-use, searchable database of the catalog that can be used internally by AHRQ and imported into AHRQ PSNet, without modification, for access by users of that site; and (4) provide analysis, conclusions, and recommendations based on observations/findings and potential future patient safety education and training that may be supported by the Agency.
Period: 2/10-8/11
Funding: $247,675
Deliverables: Taxonomy for environmental scan, electronic searchable database, final report, briefing for AHRQ.

Prevention/Care Management

Title: A Model for Enhancing Throughput at the Division of the Strategic National Stockpile Points of Disposition Sites via Use of Telehealth Strategies
Partner: Denver Health
ACTION Contact: Susan Moore, susan_moore@dhha.org
Description: The intent of this project is to develop, implement, and test a model to apply telehealth technologies as a tool to enhance the medical screening process at points of dispensing in response to an anthrax attack. Using protocols and algorithms developed for an anthrax scenario and taking appropriate social and cultural factors into account, the model will provide an example to health departments of how to establish linkages to telehealth providers, identify symptoms, and provide medical advice for the population in the affected area that requires prophylaxis. The model should build upon and augment materials currently available from AHRQ and other trusted sources to support the efforts of medical countermeasure dispensing.
Period: 9/10-3/12
Funding: $197,999
Deliverables: Environmental scan, pilot test, evaluation report, final report.

Title: Multimedia Resources: Self-Management Support Guidance for Primary Care Clinicians and Patients
Partners: Abt Associates
ACTION Contacts: Terry Moore, BDU@abtassoc.com
Description: Abt is performing an environmental scan of existing self-management support literature and programs. Although a spectrum of self-management activities and topics will be examined, one focus will be on communicating best ways for living a healthy lifestyle (including nutrition, physical activity, tobacco cessation, and stress management). Abt is using this information to learn best practices for developing materials for both clinicians and patients. An expert panel meeting will be held to assess the results of the scan and get feedback on the development of the materials. The culmination of the scan and input from the meeting will lead to the development of materials that will be tested with focus groups as needed.
Period:1/10-12/11
Funding: $549,991
Deliverables: Environmental scan of existing self-management support materials, best methods for supporting provider and patient education on self-management, and electronic materials for primary care clinicians (and possibly for patients, depending on gaps in available materials); findings on best practices from technical expert panel meeting on encouraging and enhancing self-management support by primary care clinicians; multimedia materials; focus group testing of pilot materials.

Health Information Technology

Title: Health IT Hazard Manager
Partner: Abt Associates
ACTION Contact: Terry Moore, BDU@abtassoc.com
Description: In consultation with nationally recognized health care informatics specialists, safety engineers, human factors engineers, database designers, health IT vendors, and provider organizations, Abt is designing and beta testing a health IT hazard manager—a tool for recording, categorizing, tracking, and reporting health IT-related hazards. The health IT hazard manager will be scalable for use as the infrastructure for a national clearinghouse of health IT-related hazards, near misses, and safety incidents. Each provider organization contributing data to the clearinghouse will be able to see and manage its own list of hazards and see an aggregated list of hazards reported by other customers of its vendors (deidentified to protect the anonymity of the providers), as well as a complete list of hazards reported by all providers (deidentified to protect the anonymity of providers and vendors). Similarly, each vendor will be able to see all the hazards attributed to its products (deidentified) and will be able to use this information for product improvement. National policymakers in the Department of Health and Human Services and researchers will see all of the accumulated hazards (deidentified) and support efforts to mediate or ameliorate such hazards in future generations of health IT.
Period: 08/10-2/12
Funding: $763,135
Deliverables: Fully programmed, Web-enabled, tested health IT hazard manager.

Title: Comparative Effectiveness of Health Care Delivery Systems for American Indians and Alaska Natives Using Enhanced Data Structure
Partner: Denver Health
ACTION Contact: Susan Moore, susan_moore@dhha.org
Description: The study objective is to develop the data infrastructure, supporting programming, and supporting documentation for the creation of longitudinal datasets for use in conducting comparative effectiveness research (CER); and to use the resulting datasets to perform CER on use of advanced practice pharmacy to reduce cardiovascular disease risk among American Indian/Alaska Native adults with diabetes and/or cardiovascular disease.
Period: 09/10-9/12
Funding: $3,070,882
Deliverables: CER dataset, data infrastructure documentation, study reports, PowerPoint presentations, committee meetings, dissemination report, scientific workshop, manuscripts.

Value Portfolio

Title: Understanding Consumer's Use of Web-Based Public Reports
Partner: University of California, San Francisco
ACTION Contact: Claire Brindis, claire.brindis@ucsf.edu
Description: The study will inform a national/local dialog on the future of quality reports and their role in effectively engaging consumers and improving quality of care. To frame and spur this dialog, a series of papers will be commissioned and expert and stakeholder input about these papers will be systematically collected and integrated. The final deliverables will be a series of papers on key issues affecting the future of public reporting that reflect the combined wisdom and expertise of the initial paper authors and of all the experts and stakeholders whose input was sought.
Period: 7/10-6/12
Funding: $109,654
Deliverables: Six papers (see description above)

Title: Health Plan CAHPS® Item Set for Addressing Health Literacy
Partner: RAND Corporation
ACTION Contact: Robin Weinick, rweinick@rand.org
Description:The objective of this task order is to develop and publish a set of supplemental items to the Health Plan CAHPS® Survey that addresses health literacy.
Period: 4/10-8/12
Funding: $259,698
Deliverables: Environmental scan, stakeholder meeting report, summary of call for measures responses, cognitive test version of item set, Spanish cognitive test version of item set, field test plan and final report, final item set, dissemination plan, and final report.

Current as of January 2011
Internet Citation: ACTION Project Awards, Fiscal Year 2010: Field Partnerships for Applied Research. January 2011. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/research/findings/factsheets/translating/action10/index.html