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September 23, 2008, Issue No. 264

AHRQ News and Numbers

Hospitalizations for osteoarthritis soared from about 322,000 in 1993 to 735,000 in 2006. [Source: Agency for Healthcare Research and Quality, HCUP, HCUP Facts and Figures, 2006.]

Today's Headlines

  1. Modified insulin most effective for controlling post-meal blood sugar levels
  2. New AHRQ resources help consumers and clinicians prevent dangerous blood clots
  3. HHS designates 11 communities as chartered value exchanges
  4. New studies examine ways to improve colorectal cancer screening
  5. PSO Common Formats Version 0.1 beta now available
  6. New Advances in Patient Safety compendium is available
  7. New AHRQ tool estimates resources needed for emergency response
  8. Guide on adoption of health care innovations is available
  9. Free Web conference on clinical decision support on October 27
  10. Register for AHRQ's September 25 Webcast on CAHPS Clinician & Group Survey
  11. AHRQ in the professional literature

1.  Modified Insulin Most Effective for Controlling Post-Meal Blood Sugar Levels

Pre-mixed insulin analogues, a modified form of conventional pre-mixed human insulin, are more effective than long-acting analogues for controlling high blood sugar levels after meals in patients with type 2 diabetes, according to a new report compiled by AHRQ's Johns Hopkins University Evidence-based Practice Center in Baltimore. Conventional pre-mixed human insulin, however, appears to be equally effective as pre-mixed insulin analogues for lowering blood sugar levels when patients go 8 or more hours without eating. Select to read our press release and select to access the report.

2.  New AHRQ Resources Help Consumers and Clinicians Prevent Dangerous Blood Clots

Two new AHRQ guides can help consumers and clinicians prevent and treat deep vein thrombosis. AHRQ's consumer booklet, Your Guide to Preventing and Treating Blood Clots, is a 12-page easy-to-read resource that helps both patients and their families identify the causes and symptoms of dangerous blood clots, learn how to prevent them, and know what to expect during treatment. It is available in both English and Spanish. The clinician guide, Preventing Hospital-Acquired Venous Thromboembolism: A Guide for Effective Quality Improvement, is a comprehensive tool to help hospitals and clinicians implement processes to prevent blood clots. The 60-page guide details how to start, implement, evaluate, and sustain a quality improvement strategy. It includes case studies, as well as examples of forms for clinicians in the field to use. Select to read our press release. Free, single copies of the guides are available by sending an E-mail to

3.  HHS Designates 11 Communities as Chartered Value Exchanges

HHS Secretary Mike Leavitt welcomed 11 more community collaborations to a growing national movement to build a health care system where consumers, providers, and payers make decisions based on the value and quality of care. These communities will join 14 others as Chartered Value Exchanges—local collaborations of health care providers, employers, insurers, and consumers working jointly to improve care and make quality and price information widely available. The new Chartered Value Exchanges are:

  • Aligning Forces for Quality, York, PA.
  • California Chartered Value Exchange, San Francisco, CA.
  • Colorado Chartered Value Exchange, Denver, CO.
  • eHealth Connecticut, Inc., Middletown, CT.
  • Greater Louisville Value Exchange Partnership, Louisville, KY.
  • Health Improvement Collaborative of Greater Cincinnati and HealthBridge, Cincinnati, OH.
  • Kansas City Quality Improvement Consortium, Kansas City, MO.
  • Michigan Health Information Alliance, Mount. Pleasant, MI.
  • Nevada Partnership for Value-Driven Health Care, Las Vegas, NV.
  • Quality Health First program, managed by the Indiana Health Information Exchange, Indianapolis, IN.
  • Virginia Health Care Alliance, Glen Allen, VA.

Select to read the HHS press release and visit the Value-Driven Health Care Web site for more information.

4.  New Studies Examine Ways to Improve Colorectal Cancer Screening

New studies examining ways to improve the delivery of colorectal cancer screening in primary care settings are reported in the September supplement to Medical Care. The research featured in this supplement, Improving Colorectal Cancer Screening Through Research in Primary Care Settings, was funded over the past 5 years by AHRQ and NIH's National Cancer Institute. The research addresses methods of increasing the rates at which Americans age 50 and older are being screened for colorectal cancer. Major research topics addressed include:

  • Understanding how patients decide to undergo colorectal cancer screening.
  • Evaluating innovative strategies for improving the uptake of colorectal cancer screening in diverse practice settings.
  • Developing methods to increase rates of screening among special populations; and
  • Understanding the implications of newly developed colorectal cancer screening technologies.

About 52,000 people died of colorectal cancer in the United States in 2007, and screening for the disease has been designated a high-priority service by the U.S. Preventive Services Task Force. However, in 2005 only about half of adults aged 50 and older had been screened in accordance with Task Force recommendations. The articles in this supplement describe and evaluate several promising strategies for improving colorectal cancer screening rates within busy primary care practices. Select to access the abstract in PubMed®.

5.  PSO Common Formats Version 0.1 Beta Now Available

AHRQ has released Common Formats for collecting and reporting patient safety information, including adverse events, near misses, and unsafe conditions. The Common Formats provide common definitions and reporting formats that health care professionals can use to collect and track patient safety information. These Common Formats were authorized by the Patient Safety and Quality Improvement Act of 2005, and they facilitate Patient Safety Organizations' (PSOs) collection of patient safety work product from providers in a standardized manner. The formats will be used by both providers and PSOs to report a comprehensive range of patient safety concerns, capturing both structured and narrative information. AHRQ plans to issue updates and revisions to the Common Formats based upon feedback from users and other stakeholders. The Agency has contracted with the National Quality Forum to assist with gathering and analyzing feedback that will guide future versions of the Common Formats. Select to learn more and to view AHRQ's Common Formats Version 0.1 Beta.

6.  New Advances in Patient Safety Compendium Is Available

AHRQ has published a new compendium of 115 original research papers by our grantees entitled Advances in Patient Safety: New Directions and Alternative Approaches. The four-volume set, which is also available as a searchable CD-ROM, highlights new knowledge and lessons learned in such critical areas as reporting systems, risk assessment, health information technology, clinical process redesign, and medical simulation. The new compendium is a followup to an earlier version published in 2005. A single copy of the printed compendium or the CD-Rom is available by sending an E-mail to

7.  New AHRQ Tool Estimates Resources Needed for Emergency Response

A new AHRQ Web-based interactive tool for hospitals and emergency planners helps identify resource requirements for treating an influx of patients due to major disasters such as an influenza pandemic or a terrorist attack. The Hospital Surge Model provides essential resource information for emergency planning strategies. It is able to estimate, by day, the number and flow of casualties needing medical attention for scenarios selected by users. These scenarios are consistent with the Homeland Security Counsel's National Planning Scenarios. For instance, planners can use the model to estimate:

  • How many patients each hospital unit will need to treat each day following an event.
  • Casualty arrival patterns and peak days of patient care.
  • Day by day use of the personnel, equipment, and supplies needed by each hospital to treat casualties.
  • A daily count of anticipated deaths and patient discharges.

The Hospital Surge Model was developed by AHRQ in collaboration with the Office of the Assistant Secretary for Preparedness and Response. Select for more details on the Hospital Surge Model.

8.  Guide on Adoption of Health Care Innovations Is Available

Will It Work Here? A Decision Maker's Guide to Adopting Innovations is intended to help decisionmakers in hospitals, clinics, nursing homes, and other settings to evaluate innovations. This guide provides a roadmap for navigating the innovation adoption decision process. Specific questions that users can address include:

  • Is the innovation compatible with our organization?
  • Can we build a business case?
  • Are we ready for change?
  • Can we identify innovation champions?
  • How will we sustain the innovation?

A print copy is available by sending an E-mail to

9.  Free Web Conference on Clinical Decision Support on October 27

The AHRQ National Resource Center for Health Information Technology is hosting a series of free 90-minute Web conferences over the next few months that will focus on how clinical decision support—a clinical system, application, or process that helps health professionals make good patient care decisions—can be used to inform and improve health care delivery. The next conference, "Use of Clinical Decision Support and Impact on Workflow," will be on October 27, 2:30 p.m. to 4:00 p.m., EDT, and features AHRQ Health IT Director Jon White, M.D.; Ben-Tzion Karsh, Ph.D., MSIE, University of Wisconsin Department of Industrial Engineering and Systems; Ross Koppel, Ph.D., University of Pennsylvania Department of Sociology, and Center for Clinical Epidemiology and Biostatistics, School of Medicine; and David F. Lobach, M.D., Ph.D., Division of Clinical Informatics, Department of Community and Family Medicine, Duke University. They will discuss existing evidence about the relationship between CDS and workflow, levels and stages, including findings regarding order sets and alerts, specific CDS implementations, their impact on workflow and share lessons learned from those implementations. Select to register Exit disclaimer icon for this event. Detailed registration information for upcoming events will be announced in future issues of this e-newsletter.

10.  Register for AHRQ's September 25 Webcast on CAHPS® Clinician & Group Survey

On September 25, from 1:00-2:30 p.m. EDT, the CAHPS® User Network is presenting a free Webcast, "The Evolution of the CAHPS® Clinician & Group Survey: An Update from AHRQ's CAHPS® Consortium," to discuss several recent developments in the survey. Select for more information and to register.

11.  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. .

Matheny ME, Gandhi TK, Orav EJ, et al. Impact of an automated test results management system on patients' satisfaction about test result communication. Arch Intern Med 2007 Nov 12; 167(20):2233-9. Select to access the abstract in PubMed®.

Joo MJ, Lee TA, Weiss KB. Geographic variation in chronic obstructive pulmonary disease exacerbation rates. J Gen Intern Med 2007 Nov; 22(11):1560-5. Select to access the abstract in PubMed®.

Allen LaPointe NM, Governale L, Watkins J, et al. Outpatient use of anticoagulants, rate-controlling drugs, and antiarrhythmic drugs for atrial fibrillation. Am Heart J 2007 Nov; 154(5):893-8. Select to access the abstract in PubMed®.

Yu F, Housto TK, Ray MN, et al. Patterns of use of handheld clinical decision support tools in the clinical setting. Med Decis Making 2007 Nov-Dec; 27(6):744-53. Select to access the abstract in PubMed®.

Contact Information

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Current as of September 2008


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