New AHRQ Resource Helps Identify Potentially Missed Diagnoses

Today’s Headlines:

• New AHRQ Resource Helps Identify Potentially Missed Diagnoses.
• Research Findings Report Describes Trends in Insurance Benefits From Private Employers.
• Webinar Recording Now Available: Leveraging Partnerships With Patients and Families To Improve Care.
• AHRQ-Funded Studies Confront Gaps in Patient Safety Culture and Practice.
• Intervention Integrates Cannabis Use Disorder Screening Into Primary Care.
• Register for Upcoming Webinars.
• AHRQ Stats: Prepandemic Chronic Conditions and Long COVID.  
• AHRQ in the Professional Literature.

New AHRQ Resource Helps Identify Potentially Missed Diagnoses

AHRQ has released a new diagnostic excellence resource to help health systems, researchers, and other users identify potential missed opportunities for diagnosis at a population level. The Symptom–Disease Pair Analysis (SPADE) Tool provides a standardized way to examine diagnostic processes using routinely available claims data. The initial release focuses on stroke and heart attack, allowing users to estimate how often hospital admissions for these conditions occur shortly after emergency department visits for related symptoms, or how often such admissions were preceded by those visits. The tool does not require access to electronic health records and includes clear specifications and user guidance to support implementation. It can also be adapted to other symptom–disease pairs for local quality improvement and research. The SPADE resource is now available on the AHRQ Quality Indicators website.

Research Findings Report Describes Trends in Insurance Benefits From Private Employers

Average employer-sponsored health insurance premiums increased by 2.5 percent for family plans, 3.7 percent for single plans, and 4.9 percent for employee-plus-one coverage from 2023 to 2024. A new research findings report, using data collected from AHRQ’s Medical Expenditure Panel Survey–Insurance Component, highlights trends in offers, enrollment, and costs of insurance available through private employers. It also compares findings from small and large firms—in 2024, deductible amounts were about 25 percent higher in small versus large firms, with deductibles for small-firm family plans averaging $5,087 compared with $3,920 at large firms, and single-plan deductibles averaging $2,474 compared with $2,007. Explore recent changes in private health insurance and how they compare between small firms with fewer than 50 employees and large firms with 50 or more employees as far back as 2008. 

Webinar Recording Now Available: Leveraging Partnerships With Patients and Families To Improve Care

Patients and families should be not only recipients of care but also be leveraged as partners in improving the healthcare experience. In a recent webinar hosted by AHRQ’s Consumer Assessment of Healthcare Providers and Systems (CAHPS®) team, guest speakers shared insights and practical strategies to involve patients and families in care and quality improvement practices. They discussed the Patient-Centered Outcomes Research model, which positions patients as research partners, and shared examples of projects that used Experience-Based Co-Design to improve services in maternal and pediatric care. Speakers stressed the need to measure the impact of partnerships, formalize family engagement models, and celebrate contributions to sustain momentum in quality improvement. To learn more, access the webinar. 

AHRQ-Funded Studies Confront Gaps in Patient Safety Culture and Practice

Healthcare Leaders and Frontline Staff See Patient Safety Differently

Higher proportions of healthcare executives view patient safety at their facilities positively, compared with clinicians and care aides, according to an AHRQ-supported study in the Journal of Patient Safety. Using data from AHRQ’s 2021–22 Hospital Survey on Patient Safety Culture—including more than 245,000 respondents from 371 hospitals—the study found that significantly higher proportions of executives positively rated all 10 measures than staff in other roles. Physicians had the lowest overall view of patient safety culture, including the lowest proportions of positive ratings of leader support (78%), communication openness (72%), reporting safety events (70%), and learning (66%). Care aides reported the lowest proportions of positive ratings of teamwork (78%), staffing and work pace (39%), and response to error (56%). The authors noted that employees furthest from day-to-day operations had the most favorable views and suggested strengthening cross-role communication and observation to improve the culture of patient safety.

No Clear Strategy Identified To Reduce Harm Caused by Clinician Fatigue

Strategies to reduce patient harm caused by clinician fatigue and sleepiness due to hours of service require more research, according to an AHRQ-funded study published in the Journal of Patient Safety and Risk Management. The study found most interventions have focused primarily on work schedules, including limiting the number of hours worked in a shift or total over a week and ensuring adequate time for recovery between shifts. Additionally, most studies focused on the resident physician population. Few studies have addressed fatigue risk management interventions beyond scheduling, but some interventions addressed lighting, breaks, and scheduled napping. Some strategies seemed to help, while others showed no clear benefits for patient safety. Access the journal abstract and an associated AHRQ report.

Intervention Integrates Cannabis Use Disorder Screening Into Primary Care

Adult primary care provides opportunities for systematic screening and symptom assessment for cannabis use disorder (CUD), but getting patients to remain in treatment is a challenge, according to an AHRQ-funded study in the American Journal of Preventive Medicine. Conducted across 19 randomized adult primary care practices in the Kaiser Permanente Washington healthcare system, the intervention—featuring electronic health record prompts, practice facilitation, and performance feedback—significantly increased screening rates and identification of patients who continued to use cannabis despite experiencing clinically significant impairment or distress. New CUD diagnoses rose from 10 per every 10,000 patients to 17, and treatment initiation doubled from 0.4 per every 10,000 visits to 1. However, patient engagement in treatment did not improve. Researchers noted the findings underscore the feasibility and value of routine cannabis screening in primary care to enhance early detection and treatment initiation. The findings also highlight the need for more interventions to address persistent challenges in maintaining long-term treatment engagement and stigma about cannabis-related care. Access the study.

Register for Upcoming Webinars

• AHRQ Safety Program for HAI Prevention: CAUTI Informational Webinar:
  • January 13, 3–3:30 p.m. ET.
  • January 22, 2–2:30 p.m. ET.
• January 15, 1–2 p.m. ET: CAHPS End-of-Life Care Survey Webcast.
• January 20, 1–3 p.m. ET: AHRQ Evidence-based Practice Center Program Grand Rounds Session on Workplace Safety and Well-Being.

AHRQ Stats: Prepandemic Chronic Conditions and Long COVID

In early 2024, among adults with chronic respiratory conditions that began before 2020, 7.5 percent of adults who had been diagnosed with emphysema were currently experiencing Long COVID, as did 6.2 percent of those diagnosed with asthma prior to the COVID-19 pandemic. (Source: AHRQ Medical Expenditure Panel Survey Research Findings Report #53, Sources of Health Insurance Among Adults With Long COVID: Estimates From the Medical Expenditure Panel Survey.) 

AHRQ in the Professional Literature

Improving situational awareness during interfacility transport using a transport monitoring and communication application: a simulation-based pilot study. Cook M, Umoren R, Steinlage E, et al. J Patient Saf 2025 Oct 1;21(7 supp):S65-S71. Epub 2025 Aug 8. Access the abstract on PubMed®.

Design and development of an intervention to improve the quality and safety of pediatric dental sedation: a human-centered design approach. Zouaidi K, Yeager J, Bangar S, et al. J Patient Saf 2025 Oct 1;21(7Supp):S72-S80. Epub 2025 Sep 23. Access the abstract on PubMed®.

Two decades of diagnostic safety research: advances, challenges, and next steps. Khan S, Bradford A, Cifra CL, et al. Diagnosis 2025 Nov 1;12(4):549-56. Epub 2025 Oct 7. Access the abstract on PubMed®.

A framework for defining diagnostically challenging conditions identifiable through electronic algorithms. Olson APJ, Sloane J, Zimolzak A, et al. Diagnosis 2025 Oct 27. [Epub ahead of print.] Access the abstract on PubMed®.

Impact of a collaboration-focused intervention to prevent healthcare-associated infections before and during the COVID-19 pandemic. Jones KM, Greene MT, Meddings J, et al. Clin Infect Dis 2025 Sep 16;81(2):358-68. Access the abstract on PubMed®.

Employment, income, the ACA, and health insurance coverage of working-age adults during the first year of the COVID-19 pandemic: a reassessment. Escarce JJ, Rünger D, Campbell JM, et al. Health Serv Res 2025 Oct;60(5):e14646. Epub 2025 Jun 3. Access the abstract on PubMed®.

Utilization of dysphagia services among older adults hospitalized with pneumonia in a large sample of US hospitals. Sevitz JS, Griffin M, Rogus-Pulia N, et al. J Am Geriatr Soc 2025 Nov;73(11):3484-94. Epub 2025 Sep 27. Access the abstract on PubMed®.

Early clinical evaluation of a vendor developed pediatric artificial intelligence sepsis model in the emergency department. Kandaswamy S, Orenstein EW, Muthu N, et al. J Am Med Inform Assoc 2025 Oct;32(10):1542-51. Access the abstract on PubMed®.