All Entries in the "AHRQ" Category
HHS awards $17 million to projects dedicated to preventing healthcare-associated infections
Last week the Department of Health and Human Services (HHS) announced it awarded $17 million to specific projects in the name of fighting healthcare-associated infections (HAI). Of the total award, $8 million will specifically fund the national expansion of the Keystone Project, a program that successfully reduced the rate of central line-associated bloodstream infections (CLABSI) in Michigan hospitals within 18 months, saving 1,500 lives. The coordination of the program in all 50 states is being run through the American Hospital Association’s Health Research & Educational Trust. Last year, the Agency for Healthcare Research and Quality expanded the Keystone Project to 10 states.
The remaining $9 million will be spent on strategies to reduce other HAIs. In collaboration with the Centers for Disease Control and Prevention, HHS will fund projects that will investigate methods for:
- Reducing Clostridium difficile infections through a regional hospital collaborative.
- Reducing the overuse of antibiotics by primary care clinicians treating patients in ambulatory and long-term care settings.
- Evaluating two ways to eliminate MRSA in ICUs.
- Improving the measurement of the risk of infections after surgery.
- Identifying national-, regional- and state-level rates of HAIs that are acquired in the acute care setting.
- Reducing infections caused by Klebsiella pneumoniae Carbapenemase-producing organisms by applying recently developed recommendations from CDC’s Healthcare Infection Control Practices Advisory Committee.
- Standardizing antibiotic use in long-term care settings (two projects).
- Implementing teamwork principles for frontline health care providers.
I see the Keystone Project as one of the major successes in recent years in the patient safety world. Not only does it reduce the chance for patient harm from an HAI, but it reduces the excessive amount of money that is spent on HAIs each year—a $6.5 billion expenditure. There are lots of patient safety standards out there, but this project has guided facilities in lowering CLABSI rates by using succinct steps with an emphasis on building a culture of safety and top-down leadership engagement.
Has your hospital become involved yet in this project?
AHRQ adds health literacy questions to CAHPS data set
The Agency for Research and Healthcare Quality (AHRQ) has released a set of 29 questions to be added to the CAHPS (Consumer Assessment of Healthcare Providers and Systems) Clinician and Group Survey that address health literacy. The set of questions was created in conjunction with Healthy People 2010, a national health promotion and disease prevention initiative. The questions touch on the following topics:
- Communication with doctors
- Communication about health problems and concerns
- Communication about medicines
- Communication about tests
- Communication about forms
- Disease self-management
Research shows that only 12% of adults are fully health literate. The AHRQ’s definition of health literacy is “patients’ ability to obtain, process, and understand the basic health information and services they need to make appropriate health decisions.” In recent years there’s been a greater push to make it the part of the physician’s and clinical team’s responsibility to educate patients about their health issues. The questions were designed as an assessment tool to help clinicians measure if their efforts are paying off and patients are in fact becoming more health literate, and it was also designed to be a quality improvement tool.
To find the set of health literacy CAHPS questions, and more about them, click here. Do you think your facility would add these health literacy questions to its existing set of CAHPS questions?
AHRQ says that more patients are leaving against medical advice
More news from the AHRQ–this time, however, patients may be acting as a threat to themselves. An August report from the Healthcare Cost and Utilization Project says that between 1997 and 2007, the number of patients who left the hospital against medical advice rose 39%. Although the 368,000 people who did leave against medical advice represent only 1.2% of all hospital patients, the readmission rate for these patients is significantly higher than for the rest of the patient population—not to mention these patients immediately put themselves at high medical risk.
Patients leave against medical advice for many reasons. The report makes it clear that it’s necessary to get to the bottom of why patients might leave against medical advice, because that holds the key to making sure they complete their hospital stays in the future. Often the reasons may be related to external factors, like financial obligations or family emergencies versus perception of poor treatment, but it’s important to address these external factors as well in order to provide the safest care.
Have you had any experience with patients who left against medical advice? How have you addressed this issue as a medical staff?
AHRQ launches HAI information Web site
The Agency for Healthcare Research and Quality launched a Web page on Friday full of resources and information about preventing healthcare-acquired infections (HAI). The site pulls together tools and data from many different resources, including itself, the Centers for Disease Control and Prevention, the Centers for Medicare & Medicaid Services, and Health and Human Services’ National Action Plan on HAIs. The site also contains links to other groups and resource material in which providers may be interested.
AHRQ spearheads effort to bring patient voice into error reporting
The Agency for Healthcare Research and Quality (AHRQ) is leading an effort to give patients a voice in error reporting. I wrote this article for HealthLeaders Media last week, and a longer version will be appearing in the September Briefings on Patient Safety. It discusses how the AHRQ is working with a couple of groups to design a consumer reporting system. 2009 brought us Patient Safety Organizations, formalized reporting opportunities for healthcare professionals, but often missing from the discussion about how medical errors occur is that of the patient. However, patients offer a viewpoint that is unique–one that observes the entire continuum of care. Healthcare providers are at the disadvantage of only knowing what happens when a patient is under his or her care, and not once that patient has moved on.
I spoke with Sue Sheridan, of Consumers Advancing Patient Safety, about her involvement with the project. Sheridan, a woman who has had two major medical errors occur to family members, has been a great voice in helping to design what a consumer reporting system might look like. She, along with 17 other experts that are part of a technical expert panel, are helping to advise and mold a possible consumer reporting system. The project also involves extensively interviewing patients and family members who have been victims of medical errors.
You can read the article by clicking here. What are your thoughts about standardizing a method for collecting consumers’ error reports?
Patient Safety Advisory Council can provide fresh view of issues
I saw this advice column written yesterday by Carolyn Clancy, MD, director of the Agency for Healthcare Research and Quality (AHRQ), about how patient safety advisory councils can really open the proverbial eyes of hospitals to how processes can be improved. Patient safety advocates, have helped bring to light some important areas of focus within patient safety for the industry. Patient safety advisory councils can help hospitals get a sense of what gaps exist within their specific community. For example, the AHRQ helped fund a patient safety advisory council at Aurora Healthcare in Milwaukee, WI. The council recommended that Aurora distribute medication lists and bags to each patient as a means of helping patients know which medications they were taking. This step yielded positive results, which you can read about in the column.
The column caught my eye because it mentions CAPS, or Consumers Advancing Patient Safety. I spoke with Sue Sheridan earlier this week for an article I’m writing for an upcoming issue of Briefings on Patient Safety as well as HealthLeaders Media about the importance of letting patients have a voice in error reporting.
Has your hospital taken any steps, such as bringing together a patient safety advisory council, to better involve patients from the community?
AHRQ finds nearly 20% of ED patients are uninsured
The AHRQ announced yesterday that a new data analysis of the The Nationwide Emergency Department Sample shows nearly 1 in 5 emergency department patients are uninsured. The data are taken from 2006. Kathleen Sebelius, secretary of the department of Health and Human Services, said that this statistic highlights the burden that uninsured patients are placing on the nation’s emergency system. Faced with no other option for care, uninsured patients use the emergency department for sicknesses that a primary care physician could handle. Additionally, uninsured patients may wait longer to seek care at the emergency department because they have no option for primary care, which exacerbates their health problems.
“Our health care system has forced too many uninsured, rural and low-income Americans to depend on the emergency room for the care they need,” said Secretary Sebelius in a press release. “We cannot wait for reform that gives all Americans the high-quality, affordable care they need and helps prevent illnesses from turning into emergencies.”
Whenever I find data about emergency department usage, I’m never really surprised. But, as Secretary Sebelius says in her above statement, when will the nation take action to fix this problem that has crippled our emergency departments and treated the uninsured as second class citizens? Perhaps legislation we see coming from the federal government in the coming weeks will provide some sort of solution.
AHRQ releases “state snapshot” quality Web site
I saw this Wall Street Journal Health Blog posting about a resource from the Agency for Healthcare Research and Quality (AHRQ) that I thought readers of this blog might be interested in: State Snapshots. The AHRQ has culled data based on the 2008 National Healthcare Quality Report and broken that data down into state-specific information. Those interested in seeing how their own states stack up against the rest of the states in the country can do so by clicking here and finding specific states via the map of the country.
How does your state match up? Was it what you expected to see?
Penicillin and others in its family may be best for treating MRSA in children
A study published in the June Pediatrics has produced evidence that medications in the beta-lactum family, which includes Penicillin, are just as good at treating MRSA in children than other types of antibiotics that have been used, and may prevent further resistance to antibiotic treatment. The study, funded by the AHRQ, evaluated 2,096 children who had MRSA infections of the skin or soft tissue. Researchers tested the effectiveness of three types of antibiotic on treating the infection.
The researchers concluded that the beta-lactums were just as good as another type of antibiotic at treating the infection in children, and should be used as a first line of defense when treating in the future.
Are your hospital’s patients safe? Depends on who you ask.
A study published earlier this year shows that hospital staff members rate perceived patient safety differently at their own facility. Although this study was published in January of this year in Medical Care, I had not seen the results and thought perhaps you had not seen it either. The researchers surveyed 100% of senior managers and physicians, and 10% of all other staff members about their perceptions of the organization’s patient safety. They analyzed more than 18,000 responses to their survey taken at 92 hospitals.
Turns out, there are fairly substantial differences in perceived levels of patient safety depending on which type of staff member you ask. Overall, 17% of respondents said their organizations lacked a culture of safety. Further, those staff members in the emergency department had a much more negative picture of patient safety within the organization than other staff members; those staff members whose jobs were mostly administrative and nonclinical had a more positive perception of patient safety within the organization. Nurses specifically in the emergency department perceive patient safety to be at a lower level than even other emergency department staff members.
To find the study, click here. You can also find some information through the AHRQ.
