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February 20, 2008, Issue No. 250
AHRQ News and Numbers
About 1.3 million women gave birth via cesarean section in 2005, a 38 percent increase over the 800,000 C-sections performed in 1995. Hospitals charged $21.3 billion for patient stays involving vaginal delivery in 2005 and $17.4 billion for those involving birth by C-section. [Source: Agency for Healthcare Research and Quality (AHRQ), HCUP Facts and Figures: Statistics on Hospital-based Care in the United States in 2005.]
- New patient safety proposed regulation aims to improve health care quality and patient safety
- National Conference on Reducing Diagnostic Error in Medicine set for May 31-June 1
- Podcast on health costs and access to quality care
- U.S. Preventive Services Task Force issues recommendations on bacterial vaginosis screening in pregnant women
- Impact analysis of the privacy and security solutions for interoperable health information exchange project
- AHRQ releases evidence report on the utility of monitoring mycophenolic acid in solid organ transplant patients
- AHRQ-sponsored DVD addresses questions after diagnosis, safe medication practices
- Free audio conference on consumer financial incentives set for March 13
- AHRQ in the professional literature
1. New Patient Safety Proposed Regulation Aims to Improve Health Care Quality and Patient Safety
A proposed regulation to improve the quality and safety of health care for all Americans by fostering the establishment of Patient Safety Organizations (PSOs) was announced last week by the U.S. Department of Health and Human Services (HHS). PSOs are private entities recognized by the Secretary to collect and analyze patient safety events reported by health care providers. They are new and separate from all currently existing entities that are addressing health care quality. PSOs would allow for the voluntary reporting of patient safety events without fear of new tort liability. In addition, they would encourage clinicians and health care organizations to voluntarily share data on patient safety events more freely and consistently.
Under the proposal, PSOs can collect, aggregate and analyze data, and provide feedback to help clinicians and health care organizations improve health care quality. "Patient Safety Organizations will help make health care safer for all Americans," HHS Secretary Mike Leavitt said. "By making it easier for patient safety events to be reported and the lessons learned from them to be shared more broadly, patients will ultimately receive safer health care."
AHRQ will administer the rules for listing qualified PSOs, and the Office for Civil Rights (OCR) is responsible for enforcing the confidentiality provisions of the act. "We know that clinicians and health care organizations want to participate in efforts to improve patient care, but they often are inhibited by fears of liability and sanctions," said AHRQ Director Carolyn M. Clancy, M.D. "The proposed regulation provides a framework for Patient Safety Organizations to facilitate a shared-learning approach that supports effective interventions that reduce risk of harm to patients. We want to make the right thing to do the easy thing to do."
After collecting and analyzing sufficient non-identifiable data, AHRQ will publish information on national and regional statistics, including trends and patterns of patient safety events. This information will be published in AHRQ's annual National Healthcare Quality Report. Members of the public are invited to comment on the proposed regulation until April 14, and their feedback will be used to shape the final regulation.
In addition, AHRQ and OCR are planning to host an audio conference on Feb. 29 from 2:00 p.m. to 3:00 p.m., EST, to provide additional details and answer questions about the proposed regulation. The notice of proposed rulemaking was published in the February 12 Federal Register. Select to view the proposed regulation on the Federal eRulemaking Portal. More information can be found on AHRQ's PSO Web site.
2. National Conference on Reducing Diagnostic Error in Medicine Set for May 31-June 1
AHRQ and the American Medical Informatics Association are co-sponsoring the first national meeting dedicated to diagnostic errors in medicine May 31-June 1 in Phoenix. The goals of the meeting are to summarize the current state of the field and approaches to reducing diagnostic errors, examine the role of clinical decision support systems in addressing diagnostic errors, identify and discuss ongoing research on diagnostic errors, stimulate creative thought directed at reducing harm from diagnostic errors, and establish a community of stakeholders interested in reducing diagnostic errors. In addition, experts plan to explore both system-related contributions to errors and cognitive origins. Select for conference details and further information.
3. Podcast on Health Costs and Access to Quality Care
This week's Healthcare 411 podcast reveals the Nation's 10 most expensive medical conditions. AHRQ Director Carolyn M. Clancy, M.D., also is featured in a special segment offering consumers tips for taking medical tests and getting the high quality care they deserve. This podcast is shared with 221 partnership organizations, including members of the National Quality Forum and the National Business Coalition on Health. Shorter versions of these stories also aired on 125 radio stations nationwide.
Select to listen to this podcast and select to read the transcript.
4. U.S.Preventive Services Task Force Issues Recommendations on Bacterial Vaginosis Screening in Pregnant Women
The U.S. Preventive Services Task Force has released 2 recommendations for screening pregnant women for bacterial vaginosis. The Task Force recommends against screening for bacterial vaginosis in pregnant women at low risk for preterm delivery.(D recommendation). The Task Force concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for bacterial vaginosis in asymptomatic pregnant women at high risk for preterm delivery. (I statement). These recommendations are published in the February 5 issue of the Annals of Internal Medicine. Some evidence exists that pregnant women with bacterial vaginosis may be at higher risk for delivering their babies prematurely. The Task Force found that in pregnant women who have bacterial vaginosis, 50 percent of cases resolve without treatment. This recommendation updates the 2001 recommendation on screening for bacterial vaginosis in pregnant women. Select to access the recommendation and supporting material.
5. Impact Analysis of the Privacy and Security Solutions for Interoperable Health Information Exchange Project
According to "The Privacy and Security Solutions Impact Analysis Report" recently released by the Office of the National Coordinator for Health Information Technology and AHRQ, substantial progress has been made by the 33 States and Puerto Rico participating in the Health Information Security and Privacy Collaboration during the past 18 months in understanding and addressing the variation in business practices, policies, and state laws that affect the electronic exchange of health information. "The Privacy and Security Solutions Impact Analysis Report" provides an assessment of the progress made by states since the inception of the project by comparing the current landscape for privacy and security to the baseline as reported by the state teams in early 2006. The report discusses the impact of work among and between participants in five key areas: legislation, executive orders, leadership and governance, stakeholder education and knowledge, and development of health information exchange networks. The Impact Analysis also describes the collaborative work between States in 7 key areas and it provides a state-by-state discussion of recent progress. Select to review the report.
6. AHRQ Releases Evidence Report on the Utility of Monitoring Mycophenolic Acid in Solid Organ Transplant Patients
A new AHRQ evidence report, The Utility of Monitoring Mycophenolic Acid (MPA) in Solid Organ Transplant Patients, found that published evidence on MPA is inconclusive until evidence exists on routine MPA monitoring in recipients. Stakeholders, including patients, clinicians and insurers, will have to decide on a case-by-case basis whether uncertain benefits are worth the extra time and expense of monitoring. The report was prepared by AHRQ's McMaster University Evidence-based Practice Center, Hamilton, Ontario, Canada.
Select to access the report. A print copy is available by sending an E-mail to email@example.com.
7. AHRQ-Sponsored DVD Addresses Questions After Diagnosis, Safe Medication Practices
Two new AHRQ videos Next Steps After Your Dianosis: Finding Information and Support and Check Your Medicines: Tips for Taking Medicines Safely, help patients answer important questions after a diagnosis and also provide simple steps on how to take medications safely. Produced in collaboration with Healthology, each segment features AHRQ Director Carolyn M. Clancy, M.D. and other experts. Healthology will distribute the videos to their network of 4,500+ Web sites. These include media sites, such as CNN and ABC News, as well as disease specific sites, professional organization sites, hospital sites, patient advocacy sites, internet service providers, non-profits, government and educational sites, and others. Free single copies are available by sending an E-mail to firstname.lastname@example.org.
8. Free Audio Conference on Consumer Financial Incentives Set for March 13
AHRQ is hosting a live audio conference on consumer financial incentives in health care, March 13 from 12:00 p.m. to 1:15 p.m. EST. This free audio conference will provide a thorough overview of findings from AHRQ's new publication, Consumer Financial Incentives: A Decision Guide for Purchasers. Author Adams Dudley, M.D., M.B.A., University of California, San Francisco, and Anne Robinow, an independent consultant and Vice President and General Manager of Patient Choice Healthcare Inc., will share a variety of applied examples from both the private sector and Medicaid and address questions from participants.
Select to access the complete agenda and to register. Select to access the Guide.
9. AHRQ in the Professional Literature
We are providing the following hyperlinks to journal abstracts through PubMed® for your convenience. Unfortunately, some of you may not be able to access the abstracts because of firewalls or specific settings on your individual computer systems. If you are having problems, you should ask your technical support staff for possible remedies.
Lapane KL, Dubé C, Schneider KL, et al. Patient perceptions regarding electronic prescriptions: is the geriatric patient ready? J Am Geriatr Soc 2007 Aug; 55(8):1254-59. Select to read the abstract in PubMed®.
Beach MC, Duggan PS, Moore RD. Is patients' preferred involvement in health decisions related to outcomes for patients with HIV? J Gen Intern Med 2007 Aug; 22(8):1119-24. Select to read the abstract in PubMed®.
Thomas EJ, Taggart B, Crandell S, et al. Teaching teamwork during the Neonatal Resuscitation Program: a randomized trial. J Perinatol 2007 Jul; 27(7):409-14. Select to read the abstract in PubMed®.
Swanson KA, Bastani R, Rubenstein LV, et al. Effect of mental health care and shared decision making on patient satisfaction in a community sample of patients with depression. Med Care Res Rev 2007 Aug; 64(4):416-30. Select to read the abstract in PubMed®.
Smith SR, Wahed AS, Kelley SS, et al. Assessing the validity of self-reported medication adherence in hepatitis C treatment. Ann Pharmacother 2007 Jul-Aug; 41(7):1116-1123. Select to read the abstract in in PubMed®.
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Current as of February 2008