Issue Brief Highlights Nurses’ Role in Diagnostic Process
August 9, 2022
AHRQ Stats: Health Insurance Deductibles Between 2020 and 2021
Compared with 2020 levels, average deductibles for single employer-sponsored health insurance increased by 3 percent in 2021, and family coverage deductibles increased by 3.9 percent. (Source: AHRQ, Medical Expenditure Panel Survey Statistical Brief #543, Trends in Health Insurance at Private Employers, 2008-2021.)
- Issue Brief Highlights Nurses’ Role in Diagnostic Process.
- Study Shows Favorable Outcomes for Newly Eligible Adults With Disabilities in Medicaid Expansion States.
- EvidenceNOW Cooperatives With High Experience Report Greater Clinical Improvement.
- Highlights From AHRQ’s Patient Safety Network.
- Apply by Aug. 12: AHRQ Seeks New Director of Patient Safety.
- New Research and Evidence From AHRQ.
- AHRQ in the Professional Literature.
Issue Brief Highlights Nurses’ Role in Diagnostic Process
A new AHRQ issue brief highlights nurses’ unique position to contribute to the diagnostic process in emergency departments. Diagnosis traditionally has been viewed as an individual activity, usually performed by physicians, and has not always capitalized on the wisdom of nurses, trainees and patients and families. The brief describes the theory of distributed cognition, which asserts that knowledge can be distributed effectively over a community of individuals. It highlights how nurses can contribute to the diagnostic process based on their understanding of the organization of work in emergency departments, the flow of information, and the diverse tools and supportive materials used in care. The authors provide a new physician-nurse model of diagnosis, strategies to improve communication and recommendations to improve diagnosis, and suggest future areas of research. Access the new issue brief and additional AHRQ issue briefs on diagnostic safety topics.
Study Shows Favorable Outcomes for Newly Eligible Adults With Disabilities in Medicaid Expansion States
For adults with disabilities, Medicaid expansion was associated with significant increases in full-year Medicaid coverage and primary care services such as flu shots, as well as lowered out-of-pocket spending, according to a new study funded by AHRQ and the HHS Assistant Secretary for Planning and Evaluation (ASPE). Adults with disabilities often have additional healthcare needs but can face barriers to getting care. AHRQ and ASPE researchers used 2008-2018 data from AHRQ’s Medical Expenditure Panel Survey and simulated Medicaid eligibility to identify 11,261 newly eligible adults aged 26 to 64 years. They found that compared with adults without disabilities, newly eligible adults with disabilities were more like to have full-year Medicaid coverage and receive primary and preventive services. Access the abstract in Health Services Research.
EvidenceNOW Cooperatives With High Experience Report Greater Clinical Improvement
Primary care clinics in EvidenceNow Cooperatives with strong existing infrastructure and relationships saw greater improvements in aspirin use, blood pressure control, cholesterol management and smoking cessation support (ABCS) than those in cooperatives with limited clinical relationships and training infrastructure at the launch of the initiative, according to an AHRQ-funded study in The Journal of the American Board of Family Medicine. AHRQ’s EvidenceNow: Advancing Heart Health initiative used seven regional cooperatives to provide practice coaching and other quality improvement support to enhance heart health services in primary care practices. On average, the new study concluded, ABCS improved by up to 9 percentage points at high-experience cooperatives, compared to just under 3 percentage points at those with low experience. Researchers concluded that long-term investment that establishes regionwide organizations with infrastructure and experience to support primary care practices is associated with more consistent delivery of facilitation support, and greater improvement in practice capacity and some clinical outcomes. Access the abstract.
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 anesthesiologist staffing ratio with surgical patient morbidity and mortality.
- Employee silence in health care: Charting new avenues for leadership and management.
- Criminal liability for nursing and medical harm.
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).
Apply by Aug. 12: AHRQ Seeks New Director of Patient Safety
AHRQ is seeking applicants to serve as director of the agency’s Center for Quality Improvement and Patient Safety (CQuIPS). The CQuIPS director serves as a key adviser to the AHRQ director and is a member of AHRQ’s Senior Leadership Team. The CQuIPS director will plan and direct a comprehensive research agenda to evaluate the nation’s healthcare quality and safety. Other responsibilities include overseeing research to assess consumer and provider perceptions of healthcare culture, services and systems, and developing and testing measures, tools and methods to evaluate and improve safety and quality. The CQuIPS director also serves as the agency’s patient safety spokesperson. A clinical background is preferred. Aug. 12 is the application deadline. Learn more about this vacancy and others at AHRQ:
- Social Science Analyst, Center for Quality Improvement and Patient Safety. Application deadline: Aug. 9.
- Supervisory Health Scientist Administrator, Center for Evidence and Practice Improvement. Application deadline: Aug. 15.
- Supervisory Physician – Division Director, Center for Evidence and Practice Improvement. Application deadline: Aug. 23.
New Research and Evidence From AHRQ
Systematic review (open for comment): Nutrition as Prevention for Improved Cancer Health Outcomes
AHRQ in the Professional Literature
Hospitals that report severe sepsis and septic shock bundle compliance have more structured sepsis performance improvement. Bolte TB, Swanson MB, Kaldjian AM, et al. J Patient Saf 2022 Jul 17. [Epub ahead of print.] Access the abstract on PubMed®.
Electrocardiographic findings associated with early clinical deterioration in acute pulmonary embolism. Weekes AJ, Raper JD, Thomas AM, et al. Acad Emerg Med 2022 Jun 24. [Epub ahead of print.] Access the abstract on PubMed®.
Foreword: respectful, equitable, and supportive postpartum care. Tully KP, Stuebe AM. Clin Obstet Gynecol 2022 Sep 1;65(3):538-49. Epub 2022 Jul 7. Access the abstract on PubMed®.
Expanding access to medications for opioid use disorder through locally-initiated implementation. Wyse JJ, Mackey K, Lovejoy TI, et al. Addict Sci Clin Pract 2022 Jun 20;17(1):32. Access the abstract on PubMed®.
Can right ventricular assessments improve triaging of low risk pulmonary embolism? Raper JD, Thomas AM, Lupez K, et al. Acad Emerg Med 2022 Jul;29(7):835-50. Epub 2022 Apr 23. Access the abstract on PubMed®.
How does pediatric quality measure development reflect the real world needs of hospitalized children? Leyenaar JK, Esporas M, Mangione-Smith R. Acad Pediatr 2022 Apr;22(3s):S70-S72. Access the abstract on PubMed®.
Interventions for malnutrition in hospitalized adults: a systematic review and meta-analysis. Uhl S, Siddique SM, Bloschichak A, et al. J Hosp Med 2022 Jul;17(7):556-64. Epub 2022 Jun 21. Access the abstract on PubMed®.
Staying current: developing just-in-time evidence-based learning objectives for a maternal cardiac arrest simulation curriculum. Shields AD, Battistelli J, Kavanagh L, et al. Cardiol Cardiovasc Med 2022 Jun;6(3):245-54. Epub 2022 May 23. Access the abstract on PubMed®.