Patient-Team Partnership at Small Primary Care Practices Needs Improvement
August 27, 2019
Editor’s Note: AHRQ News Now will not publish next week. Our next issue will be Sept. 10.
AHRQ Stats: Where Patients Obtain Their Usual Source of Provider Care
Among adults with four or more office visits to their usual source of provider care in 2016, fewer were treated by a physician network owned by a hospital (25 percent) compared with an independent practice (29 percent) or a nonprofit/government clinic (27 percent). (Source: AHRQ, Medical Expenditure Panel Survey Statistical Brief #523: Number of Adult Visits by Characteristics of Practices Identified as Usual Source of Care Providers during 2016—Results from the MEPS Medical Organizations Survey.)
- Patient-Team Partnership at Small Primary Care Practices Needs Improvement.
- Highlights From AHRQ’s Patient Safety Network.
- AHRQ Views Blog Post: Facilitating Transformational Change in Primary Care.
- Register Now: Sept. 10 and Sept. 17 Webinars on Using AHRQ’s Healthcare Cost and Utilization Project.
- Random Chance, Not Better Care, May Explain Hospitals’ Improvement Under Medicare Readmission Reduction Program.
- AHRQ in the Professional Literature.
The level of partnering between clinical teams and patients was only modest in about 200 Colorado and New Mexico practices evaluated from 2015 to 2017, according to a recent article by an AHRQ-funded grantee in the Journal of the American Board of Family Medicine. The study was part of EvidenceNow, an AHRQ initiative to increase the use of evidence and improve care in more than 1,500 small- and medium-sized primary care practices in 12 states. Researchers analyzed surveys from participating practices regarding patient-team partnership activities in an effort to address gaps in partnership strategies. They found that practices with higher levels of patient-team partnership activity were better able to address social needs of their patients, such as engaging patients and families in self-management, linking patients to community resources, soliciting patient input on practice operations and using patient data to inform care delivery. Access the abstract.
AHRQ’s Patient Safety Network (PSNet) highlights journal articles, books and tools related to patient safety. Articles featured this week include:
- Communication between primary and secondary care: deficits and danger.
- How medical error shapes physicians' perceptions of learning: an exploratory study.
- Ensuring effective care transition communication: implementation of an electronic medical record-based tool for improved cancer treatment handoffs between clinic and infusion nurses.
Lessons learned from AHRQ’s EvidenceNOW primary care transformation initiative are included in a recent Annals of Family Medicine supplement and also highlighted in a new AHRQ Views blog post by Bob McNellis, M.P.H., P.A., senior advisor for primary care. EvidenceNow helped primary care practices implement evidence to improve healthcare delivery with a focus on heart health. The initiative not only helped practices expand their capacity to receive and incorporate evidence, it also developed a model to support primary care transformation using practice facilitators, expert consultation, electronic health record support and other resources. Articles in the supplement summarize lessons learned via EvidenceNow and other transformation initiatives. Access the blog post. To receive all blog posts, submit your email address and select “AHRQ Views Blog.”
Register Now: Sept. 10 and Sept. 17 Webinars on Using AHRQ’s Healthcare Cost and Utilization Project
Registration is open for two Healthcare Cost and Utilization Project (HCUP) webinars for health services and policy researchers and other users interested in hospital inpatient and outpatient use and cost data.
- A webinar on Sept. 10 from 2 to 3 p.m. ET will provide an HCUP project overview, explain the HCUP Partnership, discuss the making of the HCUP State and Nationwide databases, and review how to obtain and access the data as well as other HCUP resources.
- A webinar on Sept. 17 from 2 to 3 p.m. ET will introduce attendees to HCUP products and tools, including the free online query tools HCUPnet and Fast Stats, explain how to add value to data with HCUP supplemental files and software, and provide an overview of our publications and associated resources.
Random Chance, Not Better Care, May Explain Hospitals’ Improvement Under Medicare Readmission Reduction Program
An AHRQ-funded study in JAMA Internal Medicine found that a statistical phenomenon known as regression to the mean (RTM), not better quality of care, accounted for nearly three-fourths of readmissions improvements by hospitals previously identified by Medicare as poor performers. RTM occurs when an outcome is measured repeatedly, often by random chance. Shortly after Medicare’s Hospital Readmission Reduction Program (HRRP) took effect in 2011, excess readmissions rates for patients with heart failure, heart attacks and pneumonia began to fall. Researchers who examined data from more than 3,200 hospitals found about three-fourths (74 percent to 86 percent) of the improvements in readmissions at hospitals were explained by the RTM phenomenon. To reduce the role of random chance or luck in classifying hospital performance, Medicare’s HRRP should consider excluding small hospitals that have greater variations in readmissions or calculate readmissions across a greater number of conditions, researchers concluded. Access the abstract.
Lesbian, gay, and bisexual adults report continued problems affording care despite coverage gains. Nguyen KH, Trivedi AN, Shireman TI. Health Aff (Millwood) 2018 Aug;37(8):1306-12. Access the abstract on PubMed®.
The obese colorectal surgery patient: surgical site infection and outcomes. Wahl TS, Patel FC, Goss LE, et al. Dis Colon Rectum 2018 Aug;61(8):938-45. Access the abstract on PubMed®.
Prostate cancer screening—a new recommendation for meaningful physician-patient conversations. Misra-Hebert AD, Kattan MW. JAMA Oncol 2018 Aug 1;4(8):1049-50. Access the abstract on PubMed®.
Functional status in patients requiring nursing home stay after radical cystectomy. Murray KS, Prunty M, Henderson A, et al. Urology 2018 Nov;121:39-43. Epub 2018 Aug 1. Access the abstract on PubMed®.
I-PASS mentored implementation handoff curriculum: implementation guide and resources. O'Toole JK, Starmer AJ, Calaman S, et al. MedEdPORTAL 2018 Aug 3;14:10736. Access the abstract on PubMed®.
Medicaid eligibility expansions may address gaps in access to diabetes medications. Myerson R, Lu T, Tonnu-Mihara I, et al. Health Aff (Millwood) 2018 Aug;37(8):1200-7. Access the abstract on PubMed®.
Coverage for self-employed and others without employer offers increased after 2014. Decker SL, Moriya AS, Soni A. Health Aff (Millwood) 2018 Aug;37(8):1238-42. Access the abstract on PubMed®.
Implementing team-based primary care models: a mixed-methods comparative case study in a large, integrated health care system. Misra-Hebert AD, Perzynski A, Rothberg MB, et al. J Gen Intern Med 2018 Nov;33(11):1928-36. Epub 2018 Aug 6. Access the abstract on PubMed®.