Health Care Quality Still Improving Slowly, But Disparities and Gaps in Access to Care Persist, According to New AHRQ Reports
Patient Safety and Health IT Newsletter, Issue #66
Quote of the Month
"Far too many patients continue to suffer preventable harm from these respirator-linked pneumonias. This study documents one of the largest, most robust and longest sustained reductions in these infections." (For more information on AHRQ's new study, go to item no.2.)
— AHRQ-funded researcher Sean M. Berenholtz, M.D.,an associate professor of anesthesiology and critical care medicine at The Johns Hopkins University School of Medicine and Bloomberg School of Public Health, Baltimore
- Health care quality still improving slowly, but disparities and gaps in access to care persist, according to new AHRQ reports
- Rates of pneumonia dramatically reduced in patients on ventilators in Michigan intensive care units
- AHRQ's Health Care Innovations Exchange features personal health records
- AHRQ Healthcare 411 podcast on the benefits of e-prescribing
- New AHRQ resource list helps hospitals get up to speed on safety culture
- AHRQ in the patient safety and health IT professional literature—some useful citations
1. Health Care Quality Still Improving Slowly, But Disparities and Gaps in Access to Care Persist, According to New AHRQ Reports
Improvements in health care quality continue to progress at a slow rate—labout 2.3 percent a year; however, disparities based on race and ethnicity, socioeconomic status and other factors persist at unacceptably high levels, according to AHRQ's . The reports, which are mandated by Congress, show trends by measuring health care quality for the nation using a group of credible core measures. The data are based on more than 200 health care measures categorized in several areas of quality: effectiveness, patient safety, timeliness, patient-centeredness, care coordination, efficiency, health system infrastructure, and access. Gains in health care quality were seen in a number of areas, with the highest rates of improvement in measures related to treatment of acute illnesses or injuries. For example, the proportion of heart attack patients who underwent procedures to unblock heart arteries within 90 minutes improved from 42 percent in 2005 to 81 percent in 2008. Other very modest gains were seen in rates of screening for preventive services and child and adult immunization; however, measures of lifestyle modifications such as preventing or reducing obesity, smoking cessation and substance abuse saw no improvement. Select to access our press release and the . Print copies of the reports are available by sending an E-mail to firstname.lastname@example.org.
2. Rates of Pneumonia Dramatically Reduced in Patients on Ventilators in Michigan Intensive Care Units
Hospital staff in Michigan intensive care units (ICUs) cut by more than 70 percent the rate of pneumonia in patients who are on ventilators by using a targeted quality improvement initiative funded by AHRQ. This reduction in the rate of ventilator-associated pneumonia was sustained for the duration of the study's follow-up, a period of up to two and a half years. The quality improvement initiative, known as the Comprehensive Unit-based Safety Program, includes tools to improve communication and teamwork among ICU staff teams and implement practices based on guidelines by the Centers for Disease Control and Prevention, such as checklists and hand washing, to reduce rates of catheter-related bloodstream infections and ventilator-associated pneumonia. The program also measures whether ICUs reduce healthcare-associated infections and reports these results so they can improve care. The study, "Collaborative Cohort Study of an Intervention to Reduce Ventilator-Associated Pneumonia in the Intensive Care Unit," led by Sean M. Berenholtz, M.D., M.H.S., and Peter J. Pronovost, M.D., Ph.D., both of The Johns Hopkins University School of Medicine, Baltimore, was published in Infection Control and Hospital Epidemiology and includes data from 112 ICUs in Michigan. Select to access AHRQ's press release.
3. AHRQ's Health Care Innovations Exchange Features Personal Health Records
AHRQ's Health Care Innovations Exchange website includes new innovations from three programs that used personal health record systems in various ways to improve care. In one program, physicians at the Palo Alto Medical Foundation used a comprehensive, integrated electronic and personal health record system to gain immediate access to each patient's full medical record during visits, provide patient education, write prescriptions, monitor patient progress, and complete other tasks. In another program, Howard University's Diabetes Treatment Center offers patients access to a free online personal health record to assist in monitoring blood sugar, blood pressure, weight, cholesterol, and other clinical indicators. In the third program, Wind Youth Services offers a Web-based personal health information service to homeless and runaway adolescents aged 11 to 22 years. Also featured on the website are three QualityTools—Health Shack™, Personal Health Record (PHR) Checklist, and myPHR—that serve as resources to assist health care consumers in creating their own personal health records. To learn more on these tools and the details of each program, go the AHRQ Health Care Innovations Exchange Web site.
4. AHRQ Healthcare 411 Podcast on the Benefits of E-prescribing
AHRQ recently released a 60-second podcast to over 1,000 radio stations about electronic prescribing systems (E-prescribing) and how they can help prevent medication errors and may save patients money on approved prescription drugs. Select to listen to the Healthcare 411 podcast or access the transcript. To access any of AHRQ's podcasts and special reports or to sign up for a free subscription to the series and receive notice of all future AHRQ podcasts, visit our Healthcare 411 series main page.
5. New AHRQ Resource List Helps Hospitals Get Up to Speed on Safety Culture
Hospitals working to improve the safety culture of their organization have a new Web-based resource that provides practical information on the patient safety dimensions used in AHRQ's Hospital Survey on Patient Safety Culture (HSOPS). The resource list is organized by the dimensions assessed in the HSOPS, such as teamwork within units, overall perceptions of safety, and feedback and communication about errors. It contains links to useful tools and examples that organizations can use to help improve their safety culture. A list of general resources from leading public and private groups involved in patient safety is also included. Select to access the resource list
6. AHRQ in the Patient Safety and Health IT Professional Literature—Some Useful Citations
We are providing the following hyperlinks to abstracts of journal articles describing AHRQ-funded research. If you are having problems accessing the abstracts because of firewalls or specific settings on your individual computer systems, you should ask your technical support staff for possible remedies.
Pham JC, Gianci S, Battles J, et al. Establishing a global learning community for incident-reporting systems. Qual Saf Health Care 2010 Oct; 19(5):446-51. Select to access the abstract.
Seidling HM, Schmitt SP, Bruckner T, et al. Patient-specific electronic decision support reduces prescription of excessive doses. Qual Saf Health Care 2010 Oct; 19(5):e15. Select to access the abstract.
Sittig DF, Singh H. A new sociotechnical model for studying health information technology in complex adaptive healthcare systems. Qual Saf Health Care 2010 Oct; 19 Suppl 3:i68-i74. Select to access the abstract.
Wessell AM, Litvin C, Jenkins RG, et al. Medication prescribing and monitoring errors in primary care: a report from the Practice Partner Research Network. Qual Saf Health Care 2010 Oct; 19(5):e21. Select to access the abstract.
Do You Know How AHRQ's Research Is Being Used?
We are always looking for ways in which AHRQ-funded research, products, and tools have changed people's lives, influenced clinical practice, improved policies, and affected patient outcomes. These impact case studies describe AHRQ research findings in action and are used in testimony, budget documents, and speeches. If your AHRQ-funded research has had an impact on health care policy, clinical practice, or patient outcomes, we would like to know. Contact AHRQ's Impact Case Studies Program at Jane.Steele@ahrq.hhs.gov or (301) 427-1243 with your impact stories.