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Pediatric quality measures receive $13.4 million from AHRQ and CMS for testing

Six Pediatric Quality Measures Program (PQMP) grantees have been given $13.4 million to test new pediatric quality measures over the next four years. The money is being provided by CMS and The Agency for Healthcare Research and Quality (AHRQ) with funds from the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).CMS Logo

“Medicaid and Children’s Health Insurance Programs (CHIP) give millions of children in the United States a healthy start,” said Vikki Wachino, director at the Center for Medicaid and CHIP Services, in a press release. “Through efforts such as this PQMP funding, we are able to advance states’ efforts to measure and report meaningful improvements in the quality of care for children.”

The pediatric measures were created by the PQMP Centers for Excellence with the goal of creating a portfolio of evidence-based, consensus pediatric quality measures available to public and private purchasers of children’s health care services. Grantees will be expected to test the feasibility and usability of the measures in in real-world settings at the state, health plan, and provider levels.

“The PQMP Centers of Excellence provided us with valid measures of children’s health care quality. This next step of research will help us test these measures in real-world settings,” said AHRQ director Andy Bindman, MD. “The ultimate goal is to improve children’s health throAHRQ-logough better health care, at lower costs, at both the federal and state level.”



AHRQ toolkit teaches how to face up to medical errors

Medical errors happen too often, and can cause irreversible and irreparable injury to patients when they do. While there is a myriad of ways to try and prevent errors from happening, every hospital needs to have policies in place for when they occur.

A common approach of responding to medical errors is to hide the details of them from patients, also known as the “deny-and-defend” strategy. Often this is done out of fear that a patient or their family will get angry and sue if they find out a mistake was made during their care. There’s also the possibility that the hospital would have to foot the bill for any follow-up care necessitated by the mistake, or waive a patient’s bills.

That said, studies have found that patients are more inclined to sue if they think their physician has been hiding something from them. Therefore, the Agency for Healthcare Research and Quality (AHRQ) published an online toolkit this May that suggests that physicians do the exact opposite. The toolkit,Communication and Optimal Resolution (CANDOR), emphasizes openness with patients and family when a mistake happens.

Some hospitals are now having physicians and medical students go through role-playing scenarios where they have to explain a mistake to a patient or their family. MedStar Health, a provider in Maryland and Washington, D.C., created a “Go Team” of physicians trained in disclosing medical errors that remains on standby to provide support to staff when they need to tell a patient about a mistake.

“We felt horrible that we couldn’t openly talk to patients and families … our attorneys would tell us we can’t do that because we’re going to give them all the information that will cause us to lose a lawsuit,” David Mayer, vice president of MedStar told Kaiser Health Media.  “There were no winners”

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Medical errors and HACs on the decline

A new report from the Agency for Healthcare Research and Quality’s (AHRQ) found that medical error rates have dropped 28% in the past decade. To determine medical error trends, the Chartbook on Patient Safety compared the number of medical malpractice payment reports between 2004 and 2014, finding a yearly decline in medical error rates save a minor spike in 2013.AHRQ logo

Hospital-acquired condition (HAC) rates are also in decline, albeit more gradually. The AHRQ found that 121 per 1,000 discharges contracted an HAC in 2014 as compared to the 145 per 1,000 in 2010. Pressure ulcers rates saw the biggest decrease, dropping from 1.3 million events annually to 1 million. There was also an improvement in approximately 60% of quality measures, 80% of person-centered care measures, and 60% of measures for effective treatment, patient safety, and healthy living.

Read the Chartbook on Patient Safety for more data, graphs, and information on national healthcare quality.

AHRQ issues final rule for patient safety organizations

Hi AHAP members,

The Agency for Healthcare Research and Quality (AHRQ) issued its final rule for Patient Safety Organizations (PSO) last week. The final rule provides some finality to the Patient Safety and Quality Improvement Act of 2005, which provided for the creation of PSOs. The PSOs are supposed to encourage hospitals to voluntarily submit data and other information to a PSO so that the industry as a whole will benefit. Those facilities who participate in a PSO are afforded some legal protections.

The final rule did not change much from the proposed rule issued in February. However, some additions were made, including the need for a PSO to inform its providers if the PSO inappropriately releases confidential patient safety work product (PSWP), and increased flexibility in how a PSO differentiates itself from its parent organization. Some changes include additions to the list of which organizations cannot become a PSO, and more flexibility of how PSOs can store PSWP.

The final rule will become effective January 19, 2009. Until then, the Interim Guidance issued by the AHRQ will serve as the effective rule. To read more, click here.

Happy Thanksgiving!