New AHRQ Report Highlights Hospitals' Progress in Reducing Bloodstream Infections
Patient Safety and Health IT Newsletter, Issue #73
To our readers:
To better provide you with up-to-the-minute news about AHRQ's patient safety and health information technology (IT) programs, we will begin sending health IT and patient safety updates separately. Therefore, the October 2011 issue of AHRQ's Patient Safety and Health IT e-newsletter will be the final one you will receive in this combined format.
However, you will continue to receive updates from AHRQ on both patient safety and health IT activities unless you change your subscriber profile.
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Quote of the Month
"If I had not started asking questions of my doctor, I honestly think I'd be dead today."
—Baltimore resident Bill Lee, a patient who is featured in the new AHRQ public awareness initiative that encourages communication between clinicians and patients. (For more on this topic, go to item No. 2).)
- New AHRQ Report Highlights Hospitals' Progress in Reducing Bloodstream Infections
- AHRQ Launches Initiative to Encourage Better Communication Between Clinicians and Patients
- EHR Use Results in Higher Quality Care, AHRQ-Funded Study Find
- EHR Decision Support Tool Saved Physicians Time, Errors in Retrieving Clinical Information
- Frequent Encounters with Doctors Leads to Better Care for Diabetes Patients, AHRQ-Funded Study Shows
- AHRQ-Funded Projects Aim To Improve Patient Safety Through Simulation Research
- AHRQ Seeks Data Submissions for Medical Office Survey on Patient Safety Culture Comparative Database
- AHRQ Health IT Activities in 2010 Highlighted in New Report
- AHRQ in the Professional Literature
A newly updated report from AHRQ highlights progress by hospitals taking part in a national effort to reduce the incidence of central line-associated bloodstream infections (CLABSI) by implementing a Comprehensive Unit-based Safety Program (CUSP). Eliminating CLABSI: A National Patient Safety Imperative–Second Progress Report on the National On the CUSP: Stop BSI Project provides an update on the impact of the project and the number of State hospital associations, hospitals, and hospital teams that are implementing the clinical and safety culture changes proven to reduce these infections. Adult intensive care units included in this report are drawn from 32 states and territories, and more than 750 hospitals. This is an increase of 10 states and 400 hospitals since November 2010. The first progress report, released in April 2011, found that CLABSI rates had decreased by an average of 35 percent. The most recent report, released in August, indicates that rates have dropped by 33 percent, suggesting that rates are continuing to decrease but at a slower rate. Select to access the report.
A new AHRQ initiative with the Ad Council encourages clinicians and patients to engage in open communication to ensure safer care and better outcomes. AHRQ has long supported patients getting more involved in their health care, and this effort builds on previous public education campaigns with the Ad Council that encouraged patients to ask questions. In the new campaign, clinicians are reminded that a "simple question can reveal as much medical information as a medical test." The campaign also includes a series of videos featuring actual patients and clinicians who discuss why asking questions and sharing information is so important. Other elements of the campaign include an interactive tool that lets patients create a personalized list of questions based on their health condition; a new brochure that helps patients be more prepared before, during and after their appointment; and upcoming ads about the campaign for clinicians that will appear in a variety of print and online journals, including the New England Journal of Medicine, the Journal of the American Medical Association, and others. Select for more information on the new initiative.
Patients who are treated by physicians using electronic health records (EHRs) were significantly more likely to receive care that corresponds to accepted treatment standards and get better care than patients treated by physicians who rely on paper records, a new AHRQ-funded study concludes. The study, published in the September 1 issue of the New England Journal of Medicine, examined physician practices in the Cleveland, OH, area that treated more than 27,000 adults with diabetes. Regardless of insurance mix, practices using EHRs showed higher achievement of care and outcome standards and greater improvement in diabetes care. Nearly half (43.7 percent) of the patients at EHR practice sites had diabetes outcomes that met at least four of the five standards, compared to 15.7 percent of patients at paper-based practice sites. Annual improvements in meeting care standards and quality outcomes were faster in practices with EHRs than paper-based practices. Select to access the article.
A decision support tool generated by an electronic health record (EHR) that collects clinical information on ambulatory diabetes care saved primary care physicians more than 4 minutes compared to the conventional method of searching on multiple EHR screens, an AHRQ-funded study has found. Writing in the September/October 2011 issue of the Annals of Family Medicine, researchers at the University of Missouri family medicine department created an EHR-generated diabetes "dashboard" with the technology company Cerner. The dashboard collects important diabetes clinical data on one page and mirrors the information sought by national organizations to benchmark high-quality diabetes care. Physicians using the dashboard located the 10 data elements within 1.3 minutes, compared to 5.5 minutes among physicians searching multiple EHR screens. Physicians who used the dashboard correctly identified the data requested 100 percent of the time, compared to 94 percent for physicians using the conventional method. Select for the article.
More frequent physician-patient encounters may lead to quicker control of type 2 diabetes measurements and improved outcomes, a study funded in part by AHRQ shows. Published in the September 26 issue of the Archives of Internal Medicine, the study compared the electronic medical records (EMRs) of 26,496 patients who had encounters with their primary care physicians over 1 to 2 weeks versus encounters over 3 to 6 months. Doctor-patient encounters included face-to-face interactions, as well as remote communication, such as telephone calls. More physician contact improved diabetes management across the board. The authors note, however, that increased patient encounters could increase demand on health care resources. Select for the abstract.
AHRQ-funded simulation research creates a safe learning environment in which researchers and practitioners can test new clinical processes and enhance their individual and team skills. In 2011, AHRQ funded 11 multi-year demonstration grants to evaluate the use and effectiveness of various simulation approaches and the role they can play in improving the safety and quality of health care delivery. Grant research topics include simulations of cardiac surgery, pediatric resuscitation methods, steps to recognize sepsis, and techniques for teaching femoral arterial access used for coronary artery stent placement. These projects will inform providers, health educators, payers, policymakers, patients, and the public about the effective use of simulation in improving patient safety. Select for more information.
AHRQ's Medical Office Survey on Patient Safety Culture is a tool for medical offices to use to assess clinician and staff opinions about the culture of patient safety in their medical offices. Medical offices that have administered the AHRQ survey can register and submit their data to the new comparative database by October 15. The database is a central repository for survey data from medical offices, health care systems, or survey vendors that have administered the AHRQ medical office survey instrument. It will produce comparative results among users to help medical offices identify strengths and opportunities for improvement in their patient safety culture. Select for .
Completing a grant implementation program that focused on bringing health IT to rural hospitals and community-based health care settings was among the key accomplishments in 2010 of AHRQ's health IT portfolio, according a newly published annual report. AHRQ's health IT portfolio staff, grantees and contractors also completed three of six contracts that support the Agency's 5-year State and regional demonstrations in health IT, which support data sharing and exchange activities to improve health care at the State or regional level. Projects funded by the health IT portfolio focus on three key goals: improving health care decision-making, supporting patient-centered care, and improving medication management. They represent a diverse range of technologies and care settings and located in organizations in 36 States and the District of Columbia. To date AHRQ has funded $103.6 million in grants and $71.8 million in contracts. Select to access the 2010 annual report.
The following hyperlinks to journal abstracts through PubMed® are listed below for your convenience.
Hoeksema LJ, Bazzy-Asaad A, Lomotan EA, et al. Accuracy of a computerized clinical decision-support system for asthma assessment and management. J Am Med Inform Assoc 2011 May 1; 18(3):243-50. Select to access the abstract on PubMed®.
Bertakis KD, Azari R. Patient-centered care is associated with decreased health care utilization. J Am Board Fam Med 2011 May-Jun; 24(3):229-39. Select to access the abstract on PubMed®.
Grossman JM, Boukus ER, Cross DA, et al. Physician practices, e-prescribing and accessing information to improve prescribing decisions. Res Brief 2011 May;(20):1-10. Select to access the abstract on PubMed®.