New AHRQ Toolkit Helps Hospitals Reduce Surgical Site Infections
December 19, 2017
Editor’s note: AHRQ News Now will not publish on Dec. 26 or Jan. 2. Our next issue will be published Jan. 9. Happy Holidays!
AHRQ Stats: Trends in Dental Expenses
The average annual expense for dental care was $696 in 2015. That compares with $374 ($564 when adjusted for inflation) in 1996. (Source: AHRQ, Medical Expenditure Panel Survey Research Findings #38: Dental Services: Use, Expenses, Source of Payment, Coverage and Procedure Type, 1996-2015.)
- New AHRQ Toolkit Helps Hospitals Reduce Surgical Site Infections.
- Hospital Stays for Hepatitis C Increase Most Among Baby Boomers.
- Patients Need Help To Better Understand Test Results Available From Online Portals.
- Highlights From AHRQ’s Patient Safety Network.
- Evidence Review Affirms Treatments for Uterine Fibroids and Discusses Risks of Using Morcellators.
- Studies Examine Effectiveness of Strategies To Prevent Cognitive Decline and Dementia.
- Jan. 25 Webinar Focuses on Better Design of Electronic Health Records.
- Free Continuing Education Credits Available for TeamSTEPPS Course on Office-Based Care.
- AHRQ in the Professional Literature.
AHRQ’s new Toolkit To Promote Safe Surgery helps hospitals reduce surgical site infections (SSIs). Based on the experiences of frontline providers in approximately 200 hospitals that participated in a national implementation project and successfully reduced SSIs, the toolkit was adapted from AHRQ’s Comprehensive Unit-based Safety Program (CUSP) to the surgical setting. Toolkit strategies can help prevent infections that may occur with colorectal surgery and hysterectomies, two surgical procedures tracked by the Centers for Medicare & Medicaid Services for hospital-acquired conditions.
Hospital stays involving hepatitis C increased 67 percent among “Baby Boomer” patients (ages 52–72) between 2005 and 2014, more than any other age group, according to a new AHRQ statistical brief. During the same period, hepatitis C hospital stays increased 15 percent among people 18 to 51 and 12 percent among people older than 72. The hepatitis C virus is the most common chronic bloodborne pathogen in the United States. Hospital stays involving hepatitis C nearly tripled from 2010 through 2015, likely due to increased needle use associated with the nation's opioid epidemic, the authors noted. AHRQ’s analysis, based on data from the agency’s Healthcare Cost and Utilization Project, quantified trends for adults 18 years and older, including those with and without key co-occurring diagnoses for hepatitis B, HIV and alcoholic liver disease. Access the statistical brief.
Even though many patients have access to online portals to get timely results of medical tests, most do not receive enough information to help them understand test results, a new AHRQ-funded study found. Researchers also found that patients who receive an abnormal test result are twice as likely to have negative emotions and call their physicians compared with patients whose test results were normal. Researchers examined patients’ experiences with online portals based on 95 interviews with adults between 2015 and 2016 at four large Veterans Administration outpatient clinics in Houston. Nearly two-thirds (63 percent) did not receive any explanatory information or interpretation of tests results, and nearly half (46 percent) conducted online searches for further information about their results. Researchers concluded that simply providing access to test results through patient portals is insufficient to enhancing patients’ experience of care and called for additional strategies to help patients interpret and manage their online test results. Access the abstract of the study published in the Journal of American Medical Informatics Association.
AHRQ’s Patient Safety Network (PSNet) highlights journal articles, books and tools related to patient safety. Articles featured this week include:
- Association of overlapping surgery with increased risk for complications following hip surgery.
- Efficiency and thoroughness trade-offs in high-volume organizational routines: an ethnographic study of prescribing safety in primary care.
- Closing the loop: a guide to safer ambulatory referrals in the EHR era.
A range of treatments including surgery and medications is effective for removing or shrinking uterine fibroids, but a woman should discuss her individual needs and preferences with her doctor before choosing a treatment, according to a new AHRQ report. About 26 million U.S. women between 15 and 50 have at least one uterine fibroid, which is a growth that forms in the uterine muscle. Fibroids are noncancerous but can cause severe pain, cramping, excessive bleeding and anemia. Treatment choices often are made according to a woman’s age and desire to maintain her fertility, as several treatments can cause infertility. AHRQ’s report also reviewed evidence about the risk of spreading an unsuspected cancer of the uterus during uterine fibroid surgery. Evidence shows the use of a power morcellator—an instrument that divides and removes tissue masses during laparoscopic surgery—might spread a hidden cancer and reduce survival odds.
Four AHRQ-funded articles published today in the Annals of Internal Medicine provide updated evidence on the effectiveness of interventions to prevent cognitive decline and Alzheimer’s-type dementia. They are:
- “Does Cognitive Training Prevent Cognitive Decline?: A Systematic Review”.
- “Over-the-Counter Supplement Interventions to Prevent Cognitive Decline, Mild Cognitive Impairment, and Clinical Alzheimer-Type Dementia: A Systematic Review”.
- ”Pharmacologic Interventions to Prevent Cognitive Decline, Mild Cognitive Impairment, and Clinical Alzheimer-Type Dementia: A Systematic Review”.
- “Physical Activity Interventions in Preventing Cognitive Decline and Alzheimer-Type Dementia: A Systematic Review”.
The articles are based on a comprehensive evidence review published earlier this year by AHRQ’s Evidence-based Practice Center Program.
Registration is open for an AHRQ webinar Jan. 25 from 2:30 to 4 p.m. ET to discuss the design and use of electronic health records (EHRs) to ease provider burden related to cognitive workloads. Presenters will discuss the use of EHRs to support physician-patient interactions and effective EHR design to improve both clinical workflow and patient follow-up. In particular, the webinar will focus on best designs for blood clot prevention alerts and abnormal pap smears. Participants may earn 1.5 hours of free continuing medical education credits or continuing education units.
Register now for AHRQ’s free TeamSTEPPS® for Office-Based Care Online course, which focuses on enhancing communication and teamwork skills among office-based professionals to improve patient safety and quality. Participants may begin pre-course work now and will earn free continuing education credits for each activity completed. Master Trainer certificates will be awarded for completing all course requirements. TeamSTEPPS for Office-Based Care offers tools and strategies to help health care professionals enhance team knowledge and performance in a medical office setting. It is intended for individuals who play a key role in leading and assisting office-based practices with quality improvement and practice transformation efforts. Watch the video to learn more or email questions to firstname.lastname@example.org.
Using health-system-wide data to understand hepatitis B virus prophylaxis and reactivation outcomes in patients receiving rituximab. Schmajuk G, Tonner C, Trupin L, et al. Medicine (Baltimore) 2017 Mar;96(13):e6528. Access the abstract on PubMed®.
Effectiveness of active and passive warming for the prevention of inadvertent hypothermia in patients receiving neuraxial anesthesia: a systematic review and meta-analysis of randomized controlled trials. Shaw CA, Steelman VM, DeBerg J, et al. J Clin Anesth 2017 May;38:93-104. Epub 2017 Jan 31. Access the abstract on PubMed®.
Prime time for shared decision making. Spatz ES, Krumholz HM, Moulton BW. JAMA 2017 Apr;317(13):1309-10. Access the abstract on PubMed®.
Effectiveness of a comprehensive mental skills curriculum in enhancing surgical performance: results of a randomized controlled trial. Stefanidis D, Anton NE, Howley LD, et al. Am J Surg 2017 Feb;213(2):318-24. Epub 2016 Nov 22. Access the abstract on PubMed®.
Standardizing disease-specific quality of life measures across multiple chronic conditions: development and initial evaluation of the QOL Disease Impact Scale (QDIS®). Ware JE Jr., Gandek B, Guyer R, et al. Health Qual Life Outcomes 2016 Jun 2;14:84. Access the abstract on PubMed®.
Cost effectiveness of a government supported policy strategy to decrease sodium intake: global analysis across 183 nations. Webb M, Fahimi S, Singh GM, et al. BMJ 2017 Jan 10;356:i6699. Access the abstract on PubMed®.
Factors associated with hospital participation in Centers for Medicare and Medicaid Services' Accountable Care Organization programs. Chukmaitov AS, Harless DW, Bazzoli GJ, et al. Health Care Manage Rev 2017 Sep 15. [Epub ahead of print.] Access the abstract on PubMed®.
Obesity and the transformation of monoclonal gammopathy of undetermined significance to multiple myeloma: a population-based cohort study. Chang SH, Luo S, Thomas TS, et al. J Natl Cancer Inst 2016 Dec 31;109(5). Print 2017 May. Access the abstract on PubMed®.