AHRQ Views Blog Posts
October 9, 2018
AHRQ Stats: Disparities in Health Care
About 55 percent of health care quality measures improved overall between 2000 and 2014-2015 for blacks. However, the most recent data show that about 40 percent of quality measures remain worse for blacks compared with whites. (Source: AHRQ, 2017 National Healthcare Quality and Disparities Report.)
- AHRQ Views Blog Posts.
- Antimicrobial Education Program Lowers Prescribing in Outpatient Hemodialysis Centers.
- AHRQ Grantee Profile: Jeffrey Linder, M.D., M.P.H., Analyzes Prescription Practices To Improve Antibiotic Stewardship.
- Register Now for Oct. 23 Webcast on Patient Safety Surveys.
- Highlights From AHRQ’s Patient Safety Network.
- Decision Aids Help Clinicians, Health Systems Use Evidence in Systematic Reviews.
- Register Now for TeamSTEPPS Online Course To Improve Safety and Quality in Office Settings.
- AHRQ in the Professional Literature.
New Support for the Next Generation of Learning-Health-System Researchers
Director Gopal Khanna, M.B.A., co-authors a blog post with Joe V. Selby, M.D., M.P.H., director of the Patient-Centered Outcomes Research Institute, about a joint initiative to support the training of clinician and research scientists to conduct patient-centered outcomes research within learning health systems. Grant awards will support researchers who collaborate with health system leaders to produce novel insights and evidence that can be implemented rapidly in practice to improve patient outcomes and system performance. The 11 institutions awarded $40 million in grants over five years represent a new, driving force to accelerate health system performance and improvements in patient outcomes.
Caring for the Healers
David Meyers, M.D., AHRQ’s chief medical officer, highlights the agency’s ongoing efforts to address the challenge of physician burnout. Through the agency’s EvidenceNOW initiative, AHRQ is using its expertise in practice improvement research to explore how to support primary care practices in building clinician well-being. A new paper in the Journal of General Internal Medicine (JGIM) from EvidenceNOW’s national evaluation team indicated that, in a survey of more than 10,000 primary care team members in over 1,350 primary care practices nationwide, burnout was reported by over 20 percent of respondents. AHRQ is a member of the National Academy of Medicine’s (NAM) Action Collaborative on Clinician Well-Being and Resilience and recently contributed to a NAM discussion paper on establishing a research agenda on clinician burnout. Dr. Meyers was among authors of a recent paper that provided practical suggestions for health care systems in choosing appropriate tools for measuring clinician burnout.
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Outpatient hemodialysis centers that took part in a study to ensure the appropriate use of antimicrobial drugs decreased the use of these medications without a negative effect on patients, an AHRQ-funded study found. Previous studies in hospital settings showed stewardship programs designed to reduce the unnecessary use of antimicrobial drugs have lowered prescribing by about 20 percent while reducing infections caused by multidrug-resistant organisms. The initiatives have also reduced adverse drug events and costs. Programs had not been developed in hemodialysis facilities, however, where infection rates were among the highest of all patient groups. The AHRQ study showed an antimicrobial stewardship program in six hemodialysis centers was associated with a 6 percent monthly average reduction in prescribing over 12 months. The stewardship program resulted in recommended changes in 30 of the 145 antimicrobial drug courses reviewed. Changes in drug use were not associated with changes in overall rates of hospital admission or of bloodstream infections. Access the abstract of the article in Infection Control & Hospital Epidemiology.
AHRQ Grantee Profile: Jeffrey Linder, M.D., M.P.H., Analyzes Prescription Practices To Improve Antibiotic Stewardship
Our newest grantee profile explores how the AHRQ-funded research of Jeffrey Linder, M.D., M.P.H., chief of the Division of General Internal Medicine and Geriatrics and Michael A. Gertz Professor of Medicine at Northwestern University, has advanced the practice of antibiotic stewardship. Dr. Linder has examined the prescription rate of antibiotics for acute respiratory infections in a variety of medical settings and tested interventions to help providers better adhere to clinical guidelines. Dr. Linder’s latest research, presented at IDWeek 2018, analyzed more than 500,000 prescriptions from 514 outpatient clinics and found that clinicians prescribed antibiotics without an infection-related diagnosis nearly half of the time, a serious public health concern because it could lead to the further development of antibiotic-resistant bacteria and other organisms. Access Dr. Linder’s profile and profiles of other AHRQ grantees.
Registration is open for an Oct. 23 webcast from 1 to 1:50 p.m. ET on AHRQ’s Surveys on Patient Safety Culture™ (SOPS™), designed for new SOPS Survey users. Webinar speakers will include Jeff Brady, M.D., director of AHRQ’s Center for Quality Improvement and Patient Safety, and will provide an overview of the SOPS program, the surveys, supplemental items, databases and available user resources. For questions or comments, email the SOPS User Network at SafetyCultureSurveys@westat.com or call (888) 324-9749.
AHRQ’s Patient Safety Network (PSNet) highlights journal articles, books and tools related to patient safety. Articles featured this week include:
- Impact of fatigue and insufficient sleep on physician and patient outcomes: a systematic review.
- Patient safety culture, health information technology implementation, and medical office problems that could lead to diagnostic error.
- Hospital staffing and health care–associated infections: a systematic review of the literature.
Decision aids can help clinicians and health systems make fuller use of evidence available in systematic reviews, an AHRQ-funded study published in BMJ Evidence-Based Medicine found. Researchers at AHRQ’s Mayo Clinic Evidence-based Practice Center (EPC) Program developed two decision aids—one for health systems and one for clinicians and patients. The tools were based on the EPC’s systematic review on the management of anxiety in children, in addition to feedback interviews of health system representatives, clinicians and patients. After respondents agreed the decision aids could help with decision-making, researchers concluded that the uptake of evidence by health systems as well as clinicians and patients can be enhanced by developing tools that provide contextual and implementation information about clinical care. This study was part of an AHRQ EPC program initiative designed to develop ways to make the reviews more useful to health systems. Access the study abstract and an AHRQ report about the study.
Registration is open for a free TeamSTEPPS® patient safety training course and is designed to enhance communication and teamwork skills among office-based professionals. Attendees may receive credit for quality improvement under the Merit-based Incentive Payment System. Participants may begin precourse work now and will earn free continuing education credits for completing the training modules. Master Trainer certificates will be awarded for completing course requirements.
Impact of Medicaid expansion on cardiac surgery volume and outcomes. Charles EJ, Johnston LE, Herbert MA, et al. Ann Thorac Surg 2017 Oct;104(4):1251-8. Epub 2017 May 26. Access the abstract on PubMed®.
The clinical status and economic savings associated with remission among patients with rheumatoid arthritis: leveraging linked registry and claims data for synergistic insights. Curtis JR, Chen L, Greenberg JD, et al. Pharmacoepidemiol Drug Saf 2017 Mar;26(3):310-19. Epub 2016 Dec 28. Access the abstract on PubMed®.
Development and validation of the Agency for Healthcare Research and Quality measures of potentially preventable emergency department (ED) visits: the ED Prevention Quality Indicators for general health conditions. Davies S, Schultz E, Raven M, et al. Health Serv Res 2017 Oct;52(5):1667-84. Epub 2017 Mar 30. Access the abstract on PubMed®.
Key factors in obstetric delivery decision-making among Asian and Pacific Islander women by English proficiency. Davis CM, Guo M, Miyamura J, et al. Hawaii J Med Public Health 2017 Oct;76(10):279-86. Access the abstract on PubMed®.
A tutorial on the use of instrumental variables in pharmacoepidemiology. Ertefaie A, Small DS, Flory JH, et al. Pharmacoepidemiol Drug Saf 2017 Apr;26(4):357-67. Epub 2017 Feb 27. Access the abstract on PubMed®.
Application of a risk score to identify older adults with community-onset pneumonia most likely to benefit from empiric pseudomonas therapy. Frei CR, Rehani S, Lee GC, et al. Pharmacotherapy 2017 Feb;37(2):195-203. Epub 2017 Feb 3. Access the abstract on PubMed®.
Automatic and hierarchical segmentation of the human skeleton in CT images. Fu Y, Liu S, Li H, et al. Phys Med Biol 2017 Apr 7;62(7):2812-33. Epub 2017 Feb 14. Access the abstract on PubMed®.
The costs of fall-related injuries among older adults: annual per-faller, service component, and patient out-of-pocket costs. Hoffman GJ, Hays RD, Shapiro MF, et al. Health Serv Res 2017 Oct;52(5):1794-1816. Epub 2016 Sep 1. Access the abstract on PubMed®.