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December 3, 2008, Issue No. 267
AHRQ News and Numbers
Women are more likely than men to be hospitalized for chest pain for which doctors cannot find a cause. In 2006, there were 477,000 women admitted to U.S. community hospitals for unspecified chest pain compared with 379,000 admissions for men. [Source: Agency for Healthcare Research and Quality (AHRQ), HCUP Facts and Figures, 2006.]
- New report recommends strategies to reduce medical resident fatigue-related errors and improve training
- Final rule for Patient Safety Organizations issued
- Some pregnancy-related complications minimized for women who have had weight-loss surgery
- AHRQ and AARP team to provide AHRQ preventive health guides for Spanish-speakers over 50
- New Spanish-language guide explains safe and effective use of blood thinners
- New inventory of HHS quality measures released
- New AHRQ report shows factors that drive or prevent consumers from using health IT
- Highlights from our most recent monthly newsletter
- AHRQ's free notification service brings news and information to your E-mail inbox
- AHRQ in the professional literature
1. New Report Recommends Strategies to Reduce Medical Resident Fatigue-Related Errors and Improve Training
Fatigued medical residents need protected sleep periods and increased supervision of work hour limits to improve patient safety and the training environment, according to a new Institute of Medicine (IOM) report funded by AHRQ. The report is the result of a 15-month study by an IOM committee that reviewed the relationship between residents' work schedules, their performance and the quality of care they provide. The study confirms that scientific evidence shows acute and chronically fatigued residents are more likely to make mistakes. As potential solutions, the report recommends several changes to the existing Accreditation Council for Graduate Medical Education's 80-hour-per-week limit on work hours, including protected sleep periods for residents. Other recommendations in the report include increased supervision of work hours, guaranteed days off to permit adequate recovery after working long shifts, reasonable on-call periods, stronger moonlighting restrictions, and safe transportation provided by hospitals to residents who are too fatigued to drive home. The IOM committee also calls for increased resident training on better communication during handovers and more involvement of residents in patient safety activities and adverse event reporting. Select to read our press release
2. Final Rule for Patient Safety Organizations Issued
The Department of Health & Human Services (HHS) issued a final rule for Patient Safety Organizations (PSOs), which is now available on the AHRQ PSO Web site. The rule becomes effective on January 19, 2009, and provides final requirements and procedures for PSOs—new entities with which clinicians and health care providers can work to collect, aggregate and analyze data, within a legally secure environment of privilege and confidentiality protections, to identify and reduce patient care risks and hazards. As outlined in the Patient Safety Act, AHRQ administers provisions governing PSO operations, and HHS' Office for Civil Rights enforces the confidentiality provisions of the Act. Select to access our press release and the November 21 Federal Register notice.
3. Some Pregnancy-Related Complications Minimized for Women Who Have Had Weight-Loss Surgery
Women who undergo weight-loss surgery (bariatric surgery) and later become pregnant after losing weight may be at lower risk for pregnancy-related diabetes and high blood pressure than pregnant women who are obese, according to new AHRQ findings published in the November 19 issue of JAMA. The findings are part of an evidence review that was performed by AHRQ's Southern California Evidence-Based Practice Center at RAND. The evidence review was conducted at the request of the American College of Obstetricians and Gynecologists. Select to read our press release and select to access the report. A print copy is available by sending an E-mail to firstname.lastname@example.org.
4. AHRQ and AARP Team to Provide AHRQ Preventive Health Guides for Spanish-Speakers over 50
Two new checklists to help Spanish-speaking men and women over the age of 50 decide which preventive medical tests they need and when they need to get them are now available from AHRQ and AARP. The checklists, Mujeres: sigan sanas después de los 50 and Hombres: sigan sanos después de los 50, show at a glance the evidence-based recommendations from the U.S. Preventive Services Task Force regarding screening tests, preventive medicines, and healthy lifestyle behaviors for people 50 and older. Both checklists also provide numerous health tips, such as eating a healthy diet and exercising. The English-language versions, Men: Stay Healthy at 50+, Your Checklists for Health and Women: Stay Healthy at 50+, Your Checklists for Health, also are available. All four checklists and the two wall charts are available by sending an E-mail to email@example.com.
5. New Spanish-Language Guide Explains Safe and Effective Use of Blood Thinners
AHRQ released a new pamphlet, Su guia para el trat amiento con Coumadin/warfarina (Your Guide to Coumadin®Warfarin Therapy), to help Spanish-speaking patients know what to expect and watch out for while using the blood thinner Coumadin®/warfarin. This 13-page, easy-to-read brochure educates patients about their medication therapy and potentially dangerous side effects, explains how to communicate effectively with their health care providers and provides tips for lifestyle modifications. It also provides information on remembering when to take the medicine, learning how to stay safe while taking the medicine, maintaining a consistent diet and alerting health care providers to concurrent drugs and/or supplements to avoid any potential adverse interactions. An English-language Your Guide to Coumadin®/Warfarin Therapy also is available. Printed copies are available by sending an E-mail to firstname.lastname@example.org.
6. New Inventory of HHS Quality Measures Released
HHS released its first-ever inventory of quality measures used for reporting, payment, or quality improvement by its agencies and operating divisions. The HHS measure inventory, which is available on AHRQ's National Quality Measures Clearinghouse, is designed to advance collaboration within the quality measurement community and to synchronize measurement. The inventory is available on the clearinghouse Web site. Select to read the HHS press release.
7. New AHRQ Report Shows Factors That Drive or Prevent Consumers from Using Health IT
A new AHRQ evidence report shows there are distinct factors that influence the use and usability of interactive consumer health information technology (health IT) by the elderly, chronically ill, and underserved populations. Researchers found that health IT systems that allow physicians to assess their patients' current health status, treatment plan and goals, and provide new or adjusted treatment advice, are most successfully used. These systems are effective regardless of the type of illness the patient has, their education or income status, location, or type of technology used. Barriers to adoption of health IT systems can occur when patients do not see the benefit of using computer or other interactive technologies for self-managing their health problem. Other barriers include time constraints for the patient, lack of trust in the information received, technical problems, and physician unresponsiveness to questions. Select to read Barriers and Drivers of Health Information Technology Use for the Elderly, Chronically Ill, and Underserved, conducted for AHRQ by the Oregon Health & Science University Evidence-Based Practice Center. A print copy is available by sending an E-mail to email@example.com.
8. Highlights from Our Most Recent Monthly Newsletter
The November issue of Research Activities is available online. Key articles include:
- Studies examine ways to improve delivery of colorectal cancer screening in primary care practice.
About 52,000 people died of colorectal cancer in the United States in 2007. However, in 2005 only about half of adults aged 50 and older had been screened in accordance with U.S. Preventive Services Task Force recommendations.
Other articles include:
- Centers that offer screening mammograms only and have a breast specialist on site provide more accurate readings.
- Minority children are half as likely as white children to receive specialized therapies.
- Study of the benefit of prophylactic antibiotics prior to major surgery raises questions about pay for performance.
Select to read these articles and others.
9. AHRQ's Free Notification Service Brings News and Information to Your E-mail Inbox
AHRQ has a free user-friendly service on its Web site that allows you to receive automatic E-mail notices when there is new information about the Agency, its publications, data, and research results. AHRQ's customizable service offers approximately 60 topic areas—from patient safety to prevention and from health IT to the comparative effectiveness of drugs and medical devices—so you will receive notices only on topics of interest. To find a link to the new service, look for the red envelope icon under the home page banner and select "E-mail Updates." Subscribers only need to sign up for the service once; however, if your interests or E-mail addresses change, you will be able to access and update your account information at any time.
10. 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.
Ma CT, Gee L, Kushel MB. Associations between housing instability and food insecurity with health care access in low-income children. Ambul Pediatr 2008 Jan-Feb; 8(1):50-57. Select to access the abstract in PubMed®.
Hartzema AG, Winterstein AG, Johns TE, et al. Planning for pharmacy health information technology in critical access hospitals. Am J Health Syst Pharm 2007 Feb 1; 64(3):315-321. Select to access the abstract in PubMed®.
Arbogast PG, Kaltenbach L, Ding H, et al. Adjustment for multiple cardiovascular risk factors using a summary risk score. Epidemiology 2008 Jan; 19(1):30-37. Select to access the abstract in PubMed®.
Rodriguez HP, Marsden PV, Landon BE, et al. The effect of care team composition on the quality of HIV care. Med Care Res Rev 2008 Feb; 65(1):88-113. Select to access the abstract in PubMed®.
Rodriguez MA, Heilemann MV, Fielder E, et al. Intimate partner violence, depression, and PTSD among pregnant Latina women. Ann Fam Med 2008 Jan-Feb; 6(1):44-52. Select to access the abstract in PubMed®.
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Current as of December 2008