Both Hysterectomies and Myomectomies for Fibroid Removal Improve Quality of Life

AHRQ Stats: Colon Cancer Screenings

Among women ages 50–64, 61.2 percent received colon cancer screening in 2015, compared with only 56.2 percent of men in the same age group. (Source: AHRQ, Research Findings #41: Use of Clinical Preventive Services in the United States: Estimates from the Medical Expenditure Panel Survey (MEPS), 2015).

Today's Headlines:

• Both Hysterectomies and Myomectomies for Fibroid Removal Improve Quality of Life.
• Inaccurate or Delayed Diagnoses Resulted in 34 Percent of Malpractice Cases Involving Serious Harm.
• Learn How HCA Healthcare Improved System Processes To Provide Better Care .
• Highlights From AHRQ’s Patient Safety Network.
• AHRQ Study Identifies Nearly Two Dozen Measures for Improving Organizations’ Health Literacy.
• Featured Studies on the Nation's Health Systems.
• AHRQ in the Professional Literature.

Both Hysterectomies and Myomectomies for Fibroid Removal Improve Quality of Life

Women who underwent surgery to treat uterine fibroids showed improvements in their symptoms and quality of life six to 12 weeks after having either hysterectomies or myomectomies, according to a new AHRQ-funded study in Obstetrics & Gynecology. While hysterectomies to treat fibroids result in the removal of all or part of the uterus, and often other organs, myomectomies result in removal of  fibroids without taking out the healthy tissue of the uterus. Researchers who surveyed nearly 1,300 women, ages 18 to 54, at eight clinical sites found that improvements in quality of life measures were similar for both procedures. Study results will allow providers to help their patients make decisions about their surgery options based on their personal preferences, researchers concluded. The study used data from “Comparing Options for Management: PAtient-Centered REsults for Uterine Fibroids (COMPARE-UF), the largest multisite registry on fibroid procedures ever conducted in the United States. The registry was funded by AHRQ and the Patient-Centered Outcomes Research Institute.

Inaccurate or Delayed Diagnoses Resulted in 34 Percent of Malpractice Cases Involving Serious Harm

Inaccurate or delayed diagnoses are the most common, most catastrophic and most costly of medical errors, according to new research funded by the Society for Diagnosis in Medicine (SIDM). The study, published in the journal Diagnosis, found that 34 percent of malpractice cases resulting in serious harm are due to inaccurate or delayed diagnoses. Researchers also found that 74 percent of inaccurate or delayed diagnoses that result in permanent disability or death are attributable to three disease categories: cancer, vascular events and infections. Improving diagnosis in medicine is a priority for AHRQ, which is working with SIDM and others in the field to apply evidence-based patient safety strategies, predictive analytics, personalized and precision medicine and new technologies at the point of care. AHRQ’s research efforts have led to the development of numerous practical tools and resources to improve diagnostic safety. 

Learn How HCA Healthcare Improved System Processes To Provide Better Care

HCA Healthcare, a for-profit healthcare system based in Nashville, is among organizations featured in a series of AHRQ case studies on learning health systems. HCA organized staff and resources so that learning and knowledge translate into better data and better care in its 185 hospitals. “We measure everything,” said Jonathan Perlin, M.D., chief medical officer at HCA. “We want to understand the leading practice if an entity is performing particularly well. What can we learn?" Find out more in AHRQ’s HCA case study (PDF, 135.4 KB), and learn more about AHRQ’s support of learning health systems. 

Highlights From AHRQ’s Patient Safety Network

AHRQ’s Patient Safety Network (PSNet) highlights journal articles, books and tools related to patient safety. Articles featured this week include:

• Association of coworker reports about unprofessional behavior by surgeons with surgical complications in their patients.
• How often do prescribers include indications in drug orders? Analysis of 4 million outpatient prescriptions.
• Intravenous infusion administration: a comparative study of practices and errors between the United States and England and their implications for patient safety.

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).

AHRQ Study Identifies Nearly Two Dozen Measures for Improving Organizations’ Health Literacy

An AHRQ-funded project recently identified 22 quality improvement measures to help healthcare organizations monitor strategies to improve patients’ health literacy. Instead of developing new organizational health literacy measures, researchers sought to identify measures already shown to help patients understand health information, navigate the healthcare system, engage in the healthcare process and manage their health. A literature review, field interviews and other tactics helped researchers identify and evaluate 233 quality improvement measures overall. An expert panel found 22 measures were useful, meaningful, feasible and effective. Study authors concluded that future efforts should be aimed at generating measures for additional health literacy topics. Access the abstract for the study, published in HLRP: Health Literacy Research and Practice. 

Featured Studies on the Nation's Health Systems

AHRQ's Comparative Health System Performance Initiative funds studies about how healthcare delivery systems promote evidence-based practices and patient-centered outcomes research in delivering care. Publications include:

• How do healthcare professionals working in accountable care organisations understand patientactivation and engagement? Qualitative interviews across two time points.
• Evaluation of an intervention to reduce low-value preoperative care for patients undergoing cataract surgery at a safety-net health system.
• The influence of leadership facilitation on relational coordination among primary care team members of accountable care organizations.

Access the initiative's Compendium of U.S. Health Systems, 2016, the first publicly available database that gives researchers, policymakers and healthcare administrators a snapshot of the nation's health systems. 

AHRQ in the Professional Literature

Outpatient parenteral antimicrobial therapy in pediatric Medicaid enrollees. Goldman JL, Richardson T, Newland JG, et al. J Pediatric Infect Dis Soc 2017 Mar 1;6(1):65-71. Access the abstract on PubMed®.

Do clinicians understand quality metric data? An evaluation in a Twitter-derived sample. Govindan S, Chopra V, Iwashyna TJ. J Hosp Med 2017 Jan;12(1):18-22. Access the abstract on PubMed®.

Meta-analysis of interventions to reduce adverse drug reactions in older adults. Gray SL, Hart LA, Perera S, et al. J Am Geriatr Soc 2018 Feb;66(2):282-8. Epub 2017 Dec 19. Access the abstract on PubMed®.

Multiple chronic conditions and disparities in 30-day hospital readmissions among nonelderly adults. Basu J, Hanchate A, Koroukian S. J Ambul Care Manage 2018 Oct/Dec;41(4):262-73. Access the abstract on PubMed®.

Patient portal use among older adults: what is really happening nationwide? Nahm ES, Zhu S, Bellantoni M, et al. J Appl Gerontol 2018 May 1:733464818776125. [Epub ahead of print.] Access the abstract on PubMed®.

Conversion of the Agency for Healthcare Research and Quality's quality indicators from ICD-9-CM to ICD-10-CM/PCS: the process, results, and implications for users. Utter GH, Cox GL, Atolagbe OO, et al. Health Serv Res 2018 Oct;53(5):3704-27. Epub 2018 May 30. Access the abstract on PubMed®.

Hospitals' adoption of intra-system information exchange is negatively associated with inter-system information exchange. Vest JR, Simon K. J Am Med Inform Assoc 2018 Sep 1;25(9):1189-96. Access the abstract on PubMed®.

Patient characteristics associated with severe hypoglycemia in a type 2 diabetes cohort in a large, integrated health care system from 2006 to 2015. Misra-Hebert AD, Pantalone KM, Ji X, et al. Diabetes Care 2018 Jun;41(6):1164-71. Epub 2018 Mar 16. Access the abstract on PubMed®.