New AHRQ Report Promotes Expanded Role for Primary Care To Reduce Hospital Readmissions

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Today's Headlines:

• New AHRQ Report Promotes Expanded Role for Primary Care To Reduce Hospital Readmissions.
• AHRQ Data Show Growth in Opioid Overdose Rates Among Minority Populations.
• Gram-Negative Bacterial Colonization Not Significantly Reduced by Universal Glove and Gown Requirements.
• New Essays From AHRQ’s PSNet Highlight Roles of Pharmacists, Health Information Technology and Primary Care in Improving Patient Safety.
• Register Now for April 7 Webinar on Using AHRQ’s Survey on Patient Safety Culture Nursing Home Survey.
• AHRQ in the Professional Literature.

New AHRQ Report Promotes Expanded Role for Primary Care To Reduce Hospital Readmissions

Reducing preventable hospital readmissions by expanding primary care practices’ engagement with specialty physicians, hospitals and other partners is the subject of a new AHRQ report. This approach, outlined in Potentially Preventable Readmissions: Conceptual Framework to Rethink the Role of Primary Care, shifts the current emphasis from hospital-based processes to one that increases primary care’s role in timely and effective care coordination. Key changes outlined in the framework include allowing primary care to serve as the key integrator in the post-discharge process; handling post-discharge followup visits differently from a typical office visit; and using a team-based approach to ensure high-quality transitions. Access an AHRQ Views blog post about the framework and more information from AHRQ about preventing readmissions. To receive all blog posts, submit your email address and select “AHRQ Views Blog.”

AHRQ Data Show Growth in Opioid Overdose Rates Among Minority Populations

A new Data Spotlight, which examines overdose deaths from synthetic opioids other than methadone, found that death rates increased 18-fold for non-Hispanic blacks and 12-fold for Hispanics from 2013 to 2017. Non-Hispanic whites experienced a 9-fold increase during the same period. The publication, Blacks Experiencing Fast-Rising Rates of Overdose Deaths Involving Synthetic Opioids Other Than Methadone (PDF), supports AHRQ’s data and analytics initiative to quantify and provide insight into the opioid epidemic. Access all AHRQ Data Spotlights, which focus on measures from the National Healthcare Quality and Disparities Reports. 

Gram-Negative Bacterial Colonization Not Significantly Reduced by Universal Glove and Gown Requirements

An AHRQ-funded study published in the journal Clinical Infectious Diseases concluded that requiring healthcare workers to “glove and gown” when entering any intensive care unit (ICU) patient room did not significantly decrease the presence of new antibiotic-resistant Gram-negative bacteria found in surveillance cultures. Researchers evaluated nearly 40,500 mucosal surface swabs collected at admission and discharge as part of a trial previously conducted in the ICUs of 20 hospitals. That study showed that glove and gown requirements significantly reduced the acquisition of Gram-positive bacteria such as methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci. However, the current study, which was based on reanalysis of the same swab samples, found that decreases in the observed frequencies of the acquisition of some Gram-negative bacterial species were not statistically significant. These results may inform hospital decision-making regarding the potential value of introducing glove and gown requirements. Access the abstract. 

New Essays From AHRQ’s PSNet Highlight Roles of Pharmacists, Health Information Technology and Primary Care in Improving Patient Safety

Three new annual Perspectives on Safety from AHRQ’s Patient Safety Network (PSNet) highlight the roles that pharmacists, health information technology (IT) and primary care each play in improving patient safety. The essays discuss major themes in patient safety research in 2019 and future research needs. In addition to annual perspectives, AHRQ’s PSNet provides ongoing updates on journal articles, books and tools related to patient safety. Articles featured this week include:

• Work system barriers and facilitators in inpatient care transitions of pediatric trauma patients.
• Patient-related factors associated with an increased risk of being a reported case of preventable harm in first-line health care: a case-control study.
• Association of work environment with missed and rushed care: tasks among care aides in nursing homes.

Review additional new publications in PSNet’s current issue or access recent cases and commentaries in AHRQ’s WebM&M (Morbidity and Mortality Rounds on the Web).

Register Now for April 7 Webinar on Using AHRQ’s Survey on Patient Safety Culture Nursing Home Survey

Registration is open for a webinar on April 7 from 12 to 1 p.m. ET on “Improving Safety Culture Using the AHRQ SOPS Nursing Home Survey.” AHRQ’s Surveys on Patient Safety™ (SOPS®), designed to help healthcare organizations, assess how staff members perceive the ability of various aspects of organizational culture to promote a safe patient environment. Speakers will provide information about how toadminister the nursing home survey and the benefits of participating in AHRQ’s SOPS Nursing Home Survey Database. One nursing home’s experience using the survey to improve safety culture will be highlighted.

AHRQ in the Professional Literature

Missing ingredients in shared decision-making? Pavlo AJ, O'Connell M, Olsen S, et al. Psychiatr Q 2019 Jun;90(2):333-8. Access the abstract on PubMed®.

Variation in the desire for cleft revision surgery among children, caregivers, and surgeons. Ranganathan K, Kochkodan JM, Baker MK, et al. Plast Reconstr Surg 2019 Jul;144(1):171-8. Access the abstract on PubMed®.

Association of dermatomyositis with systemic and opportunistic infections in the United States. Ren Z, Laumann AE, Silverberg JI. Arch Dermatol Res 2019 Jul;311(5):377-87. Epub 2019 April 6. Access the abstract on PubMed®.

Shared-patient physician networks and their impact on the uptake of genomic testing in breast cancer. Rotter J, Wilson L, Greiner MA, et al. Breast Cancer Res Treat 2019 Jul;176(2):445-51. Epub 2019 Apr 26. Access the abstract on PubMed®.

Changes in hospital safety following penalties in the US Hospital Acquired Condition Reduction Program: retrospective cohort study. Sankaran R, Sukul D, Nuliyalu U, et al. BMJ 2019 Jul 3;366:l4109. Access the abstract on PubMed®.

Procalcitonin-guided antibiotic discontinuation and mortality in critically ill adults: a systematic review and meta-analysis. Pepper DJ, Sun J, Rhee C, et al. Chest 2019 Jun;155(6):1109-18. Epub 2019 Feb 14. Access the abstract on PubMed®.

A natural language processing algorithm to extract characteristics of subdural hematoma from head CT reports. Pruitt P, Naidech A, Van Ornam J, et al. Emerg Radiol 2019 Jun;26(3):301-6. Epub 2019 Jan 28. Access the abstract on PubMed®.

Tricyclic antidepressant and/or gamma-aminobutyric acid-analog use is associated with fall risk in diabetic peripheral neuropathy. Randolph AC, Lin YL, Volpi E, et al. J Am Geriatr Soc 2019 Jun;67(6):1174-81. Epub 2019 Jan 29. Access the abstract on PubMed®.