February 13, 2013

Innovative Strategies To Increase Cancer Screening

According to a 2010 study by the Centers for Disease Control and Prevention and the National Cancer Institute, overall cancer screening rates in the United States remain below national targets and disparities persist among racial and ethnic groups. Efforts to increase screening can help identify early treatable cancers and reduce morbidity and mortality due to cancer.

The featured Innovations describe three programs that used innovative strategies to increase colorectal, cervical, and skin cancer screening rates among specific target populations.

The featured QualityTools include a toolkit to help health care professionals improve cancer screening rates in their practice and resources for health care consumers and communities to promote screening. January 30, 2013

Medical Home Models for Specialty Care

Use of the patient-centered medical home model in primary care settings can improve quality, reduce costs, and increase accessibility of health care. Providers are now applying principles of the medical home to the delivery of specialty care in an effort to provide comprehensive, coordinated care and improve health outcomes.

The featured Innovations examine how three different providers adapted the primary care medical home model to specialty care, including a community-based oncology practice that redesigned its care delivery processes, a pediatric center serving children with special health care needs, and a statewide medical home program that improved access to comprehensive pregnancy care for Medicaid beneficiaries.

The featured QualityTools provide resources to support the integration of the patient-centered medical home model into specialty care. January 16, 2013

Patient-Centered Hospital Design

Patient-centered hospital design can improve patient care and satisfaction, as well as quality of services, safety, and employee retention. Studies have found links between improved design and reductions in medication errors, patient falls, and hospital-acquired infections. Institutions are finding that patient-centered hospital design improves their bottom line at the same time that it raises patient satisfaction.

The featured Innovations showcase efforts to implement patient-centered hospital design. One hospital used playful room design and distraction techniques to help pediatric patients through radiology treatments without sedation; a second used natural light, soft colors, plants, art, and music to help patients feel comfortable and heal faster. An infusion center based its patient-centered redesign on the results of a patient survey, which highlighted the need for more comfortable furniture; softer lighting; natural, warm wall colors; spacious and warm waiting areas; and happy, nature-inspired artwork.

The featured QualityTools provide guidance and the rationale for designing patient-centered hospitals and tools to help improve patient-centered care. December 19, 2012

Reducing Health Disparities Among Children

Low-income, urban, and minority children often have poor access to appropriate health care and experience higher rates of asthma, obesity, and other chronic health conditions. In addition to lack of adequate health insurance, cultural and linguistic barriers prevent many children from receiving equal care.

The featured innovations describe efforts to reduce health disparities among children, including a program that provided culturally competent asthma care to Latino families, a state policy that increased access to Medicaid coverage for uninsured children, and a medical center’s use of text messaging to increase vaccination rates among low-income minority children.

The featured QualityTools present resources and information to help health care providers and other organizations deliver culturally appropriate services and improve care for at-risk children. December 05, 2012

Using Information Systems To Promote Prevention

Many Americans do not receive recommended preventive care services, and lack of preventive care can affect health outcomes and lead to increased use of health care services.

The featured Innovations describe ways that health information technologies can be used to enhance provision of preventive services, including a program that enables standing orders for vaccinations and screenings, a system that encourages Medicare patients to schedule their Annual Wellness Visit, and an interactive preventive health record that identifies specific care needs for patients.

The featured QualityTools include a smartphone application to promote healthy weight and tools to improve adherence to guidelines for electronic and interactive preventive health records. November 21, 2012

Reducing Inappropriate Antibiotic Use

Inappropriate prescribing leads to increased resistance to and reduced effectiveness of antibiotic medications. Physicians and patients may be unaware of guidelines on the use of antibiotics for viral infections, and patients and parents may not realize that their inappropriate use can be ineffective and can cause harm.

The featured Innovations describe efforts to reduce inappropriate antibiotic prescribing, including a health plan that provided regular performance feedback to physicians, a telemedicine-based antimicrobial stewardship program, and an educational program designed to support physicians employing shared decisionmaking with patients.

The featured QualityTools provide information and resources that can help clinicians reduce inappropriate antibiotic use. November 07, 2012

Health Care for Underserved Populations

Individuals that lack adequate health insurance, are low-income, or reside in rural areas often cannot access preventive and primary care services and do not have a regular source of care. As a result, health problems may go undiagnosed and/or untreated, increasing the long-term risk of serious illness and death among the medically underserved.

The featured Innovations describe three programs that provided medical care and patient education to persons with limited means of accessing such services, thereby improving their health status and facilitating access to follow up care.

The featured QualityTools provide information and resources that address disparities in medically underserved communities. October 24, 2012

Integrated End-of-Life Care

The aging of baby boomers and an increased need to contain hospital costs in the United States has led many organizations to fine tune their services for patients who are in need of palliative care. Most patients prefer to remain in their home at this time of their life; palliative and coordinated care can help them maintain control of their care choices, avoid inpatient and emergency department costs, and increase their satisfaction with their end-of-life care.

The featured Innovations describe two programs that used palliative care to help elderly and terminally ill patients make greater use of hospice and home care services. A third program coordinated care for Medicare patients and their families, allowing them to define their wishes and options for end-of-life care, increase their use of hospice services, and reduce the incidence of inpatient stays.

The featured QualityTools provide educational, clinical, and organizational resources and information to help ensure better care for patients and their families as they face end-of-life issues. October 10, 2012

Increasing Patient Involvement in Health Care

An increasing number of health care systems and providers offer services and tools that encourage and empower patients to take an active role in their own health care. The ability to access medical records, test results, and other health information online can increase patient involvement and facilitate patient—provider communication.

The featured Innovations describe two programs that provided patient access to online medical records via secure patient portals and a program that offered patients access to routine laboratory tests between visits, enhancing patient engagement and satisfaction.

The featured QualityTools provide resources and information to help patients and consumers make health care decisions and communicate effectively with providers. September 26, 2012

State Health Care Legislation and Statewide Initiatives

State legislative initiatives play an important role in efforts to improve health care services and patient outcomes. Statewide programs that demonstrate the value of health care innovation can provide models for other states seeking to achieve similar goals.

The featured policy Innovations describe four different state programs- one that reduced hospital-acquired infection rates in New York, one that boosted hospital nurse staffing in California, one that supported development of patient-centered medical homes in Maryland, and a program that improved services for persons with mental illness in Florida.

The featured QualityTools include a toolkit for state health care reform, materials to support state efforts in reducing avoidable rehospitalizations, and an online dashboard about state initiatives in health information technology. September 12, 2012

Workforce Development and the Role of Community Health Workers

The composition of the health care workforce continues to evolve to meet the needs of patients within a changing health care environment. Policies and programs designed to leverage the unique skill sets of community members and health workers can play an important role in the development and expansion of the health care workforce.

The featured Innovations describe the development of a new staff position for community members who assist health care teams in primary care settings and after hospital discharge, and a consortium in Minnesota that developed a scope of practice, a statewide curriculum, and a certificate program for community health workers.

The featured QualityTools include a toolkit to help rural communities evaluate opportunities for developing a community health worker program, and an instruction manual for training community health workers. August 29, 2012

Enhancing Primary Care Access After Emergency Department Visits

Visits to the emergency department (ED) for nonemergent conditions result in unnecessary health costs and overcrowding, and often indicate poor primary care access for those who can least afford to pay for health care.

This issue’s featured Innovations describe a public-private consortium and a partnership between an academic medical center and community-based clinics that reduced nonemergent ED visits and increased access to primary care for Medicaid, uninsured, and underinsured patients, resulting in health care savings.

The featured QualityTools include a series of outreach materials used in a Washington State campaign and a guide for providers aimed at reducing avoidable ED visits. August 15, 2012

Innovative Payment Policies

Traditional models of health care financing and delivery can lead to inefficient care and often lack incentives to control high health care costs and improve quality.

This issue’s featured policy Innovations describe an insurer’s contracting program and a medical center’s accountable care organization approach to reduce health care costs and improve quality, in addition to a multispecialty center’s use of innovative policies to enhance access to care among low-income patients.

The featured QualityTools include a decision guide about pay-for-performance for purchasers of health care services and a toolkit designed to assist health plans and providers in implementing a bundled fee payment model. August 01, 2012

Sepsis Management

Sepsis is a common complication of infection that often leads to lengthy hospitalizations and a high risk of death. Early diagnosis of sepsis and prompt treatment with antibiotics can reduce mortality and support improved outcomes.

The featured Innovations describe two programs in California and Delaware that achieved significant reductions in sepsis mortality by supporting timely identification and treatment of patients with the condition.

The featured QualityTools describe two toolkits designed to improve clinical management and reduce mortality in patients with sepsis. July 18, 2012

Reducing Disparities Through Peer Support

According to the 2011 AHRQ National Healthcare Disparities Report, disparities still exist and health care quality and access are suboptimal. While there is not a simple solution to eliminating disparities, leveraging peer networks and the power of peer-to-peer interactions has the potential to improve care and outcomes for vulnerable populations.

The featured Innovations describe a mentor program for African-American veterans with diabetes that improved blood glucose control and an interactive education class for kidney transplant candidates that increased the percentage of African-American patients and people of lower socioeconomic status, who completed the transplant evaluation process.

The featured QualityTools include a toolkit to help organizations and communities work with peers to engage people living with HIV/AIDS in care and treatment, and a guide to assess and promote cultural competency in mental health peer-run programs. July 03, 2012

Clinical-Community Linkages to Improve Chronic Disease Care

Managing chronic diseases such as diabetes, asthma, and cardiovascular disease presents challenges both for maintaining optimal patient health and keeping health care costs in check. Partnerships between clinical practices, health departments, and community organizations can promote the delivery of high-quality health care and improve chronic disease management while controlling costs.

The featured Innovations describe a community-level partnership that used lay health advisers and a public-private initiative that leveraged community health teams to improve chronic disease care.

The featured QualityTools include a toolkit to help communities develop asthma management programs and a toolkit designed to support providers of self-management education programs focused on chronic conditions. June 20, 2012

Support Following Unexpected Clinical Events

Many patients and family members experience an unexpected death or an unexpected clinical event, leading to difficulty understanding and coping with the event. When health care professionals deny and defend their actions and limit communications, patients and/or their family members tend to feel angry and guilty, and want to blame someone.

The featured Innovations describe one hospital program that provides multidisciplinary team support to patients and families who experience an unexpected clinical event, and another program that provides support to clinicians who are the "secondary victims" of unexpected events.

The featured QualityTools describe a toolkit and self-assessment to help health care organizations support and communicate with patients and families around adverse events. Another tool guides health care facilities in organizing institution-wide support for clinicians following adverse events.
June 06, 2012

Health Care Policy Innovations

With this biweekly issue, the AHRQ Health Care Innovations Exchange expands its scope to include health care policy innovations in addition to its current focus on health care service delivery innovations.

Health care policy innovation profiles will describe creative implementations of new or altered governmental or private initiatives that aim to improve health care quality by changing behavior through regulatory mechanisms, incentives, or other means to ensure accountability. We look for policies that are innovative in the context of their setting or target population, and that have important implications for the delivery of patient care.

View the complete inclusion criteria for health care policy innovations or the combined inclusion criteria for health care service delivery and policy innovations.

This issue’s featured Innovations describe an insurer’s incentive and support structure to stimulate quality improvement, a health care policy initiative implemented by the State of Connecticut, and a California state program that supports health care facilities in meeting a legislative mandate.

The featured QualityTools include a legislative toolkit to assist policymakers with the design of health insurance exchanges and resources to support States in developing or improving adverse event reporting systems. May 23, 2012

Coordinating Community Care for Seniors

An increasing number of older adults have physical and mental problems that require assistance with daily living. Most seniors prefer to live independently for as long as possible in their homes. Outreach workers, who know their communities and can connect seniors to available health care and social services, play an important role in helping seniors maintain their independence.

The Featured Innovations describe two programs that provide seniors with care coordination and support, which reduced hospital and nursing home admissions, and a third program that provides care coordination to adults with serious mental illness, which reduced emergency department visits.

The Featured QualityTools provide resources for health care professionals to collaborate with community organizations and to identify services and supports that can be provided at home. May 09, 2012

Pediatric Asthma Care

Pediatric asthma affects nearly 6 million children in the United States, reducing quality of life and often leading to costly emergency department visits and inpatient admissions. Low-income, urban children experience higher asthma-related morbidity due to environmental factors and poor access to appropriate care. Managing pediatric asthma according to existing guidelines can help minimize the potential for negative outcomes.

The featured Innovations describe one program that provided services to urban preschool children in an effort to improve asthma-related outcomes, and two programs that improved pediatric asthma care by increasing adherence to well-established care guidelines.

The featured QualityTools provide parents and health care practitioners with resources to help manage pediatric asthma and improve quality of life. April 25, 2012

Improving the Diet of Low-Income Families

Low-income families face multiple challenges related to eating healthfully, including the relatively high cost of healthy foods, the lack of healthful choices in urban neighborhoods, and limited knowledge on how to prepare nutritious meals. Family-focused interventions can help overcome such barriers and promote healthy diets among low-income populations.

The featured Innovations describe two hospital-based programs— one that enhanced access to healthy foods and another that provided support to parents— aimed at improving the diet and overall health of low-income families.

The featured QualityTools provide information and tools for families, educators, and community leaders related to nutrition and the prevention of childhood overweight and obesity. April 11, 2012

Patient-Centered Care

Recognized by the Institute of Medicine (IOM) as one of the six major domains of quality, patient-centeredness encompasses respect for and responsiveness to the needs, preferences, values, and cultural traditions of the individual patient, in addition to involving patients and families in clinical decisionmaking.

The featured Innovations describe two programs that delivered patient-centered care to vulnerable populations, thereby improving the patient experience and enhancing access to appropriate care.

The featured QualityTools provide clinicians and other stakeholders with resource guides that support a patient-centered approach to medication management. March 28, 2012

Spreading Innovations for Cardiovascular Health

The goal of AHRQ's Health Care Innovations Exchange is to speed the implementation of innovative ways to improve and deliver health care. This issue focuses on cardiovascular health and the spread of innovations, from the infrastructure needed to dissemination strategies.

The Featured Innovations describe programs that developed improvements in the management of cardiovascular disease and chronic conditions.

The Featured QualityTools provide resources that consumers can use to assess their cardiovascular health and health care professionals can use to spread innovations. March 14, 2012

Improving Health of Urban, Low-Income Populations

Residents of urban, low-income communities often face multiple barriers to accessing preventive health care services and specialty care for chronic conditions, which can contribute to health disparities.

The featured Innovations describe three programs that used different community-based approaches to enhance access to care and improve health status of urban, low-income populations.

The featured QualityTools provide information and resources that address the needs of economically disadvantaged individuals. February 29, 2012

Caregiver Support

February 15, 2012

Mental Health Care for Underserved Populations

Underserved populations face multiple barriers to accessing mental health care, often lacking regular, high quality treatment and support. Intensive care coordination for underserved individuals in need of mental health services can address barriers to care and reduce disparities.

The featured Innovations describe three programs that enhanced access to necessary services and provided care coordination to improve mental health outcomes among underserved populations.

The featured QualityTools contain resources and tools that aim to increase cultural competence in providing mental health care services to specific communities. February 01, 2012

Remote Monitoring of Chronic Conditions

Ongoing monitoring of chronically ill individuals, especially older patients, can allow providers to intervene in a timely fashion, helping to prevent exacerbations and complications, reduce care costs, and keep patients in their homes. However, relatively few health systems have the capacity to monitor chronically ill individuals who live in the community.

The featured Innovations describe three programs that used remote monitoring devices or equipment to track patients' health conditions in community settings.

The featured QualityTools provide resources designed to set up remote health care programs, including retinopathy screening and telehealth centers. January 18, 2012

Culturally Tailored Programs

Health interventions that are culturally tailored take into account the beliefs, values, and circumstances of specific cultural groups. Developing programs in a culturally relevant context can improve their effectiveness, particularly in traditionally underserved communities.

The featured Innovations describe three programs that delivered culturally tailored services to promote behavior change and improve health status among their target populations.

The featured QualityTools provide resources to support the development of culturally tailored diabetes and tobacco control programs. December 21, 2011

Redesigning Care Processes Through Technology

Information technology is increasingly being used to improve patient care processes and outcomes. Systems that facilitate access to comprehensive patient information before and during patient visits can enhance the ability of clinicians to provide efficient and systematic care management.

The featured Innovations describe how two providers leveraged the use of technology to redesign care processes, leading to greater adherence to recommended care and improved outcomes.

The featured QualityTools provide resources and tutorials to support the adoption of health information technology by physician offices and health care organizations. December 07, 2011

Partnerships to Improve Care Coordination

The American medical system is extraordinarily fragmented and difficult to navigate. The average Medicare patient sees seven different doctors, according to the New England Journal of Medicine. Partnerships are an important strategy to enhance care coordination for patients.  Partnerships exist between primary care practices and specialty practices, primary care practices and community-based organizations, and between community based organizations and multidisciplinary health care teams.

The featured Innovations describe two programs that have implemented strategic partnerships to enhance care coordination for seniors and veterans.

The featured QualityTools offer a guide on how to create an ideal transition home and a toolkit to prepare your organization for care transitions for seniors. November 23, 2011

Patient Engagement

Patient engagement is an ongoing process in which patients take an active role in their own health care. Many factors—including personal skills, motivation, and behaviors—affect an individual's ability to effectively engage in care.

The featured Innovations describe one program that used a storytelling approach and another program that provided text messaging to encourage behavior change among vulnerable populations, leading to greater patient engagement and improved outcomes.

The featured QualityTools provide resources to help health care professionals partner with patients and families to involve them in care, and information to assist health care consumers in communicating effectively with providers about their health care. November 09, 2011

Algorithm-Based Treatment Decision Support

Treatment algorithms, also referred to as practice guidelines, are a series of treatment steps, each of which is defined by the clinical response of the patient to the preceding step. Algorithms are often integrated into computerized clinical decision support systems in patient care settings.

The featured Innovations describe how two different hospitals are using algorithms to improve patient care. The first hospital uses an algorithm to guide test ordering to detect a life-threatening condition while the second hospital uses an algorithm to detect medical errors in trauma treatment.

The featured QualityTools present a range of algorithms that support decision-making in the prevention, treatment, and evaluation of various health conditions and diseases.
  October 26, 2011

Evaluation and Treatment of Alcohol Dependence

Individuals with alcohol dependence are often hospitalized and may require treatment for acute intoxication or to reduce the risk of alcohol withdrawal symptoms. Alcohol and drug dependence are generally considered to be chronic disorders that require some form of continuing care after initial treatment and stabilization to reduce the risk of relapse.

The featured Innovations describe two hospital programs that improved care and reduced length of stay for patients with alcohol dependence, and one outpatient program that provided continuing care services to help individuals avoid relapses.

The featured QualityTools provide resources for clinicians, substance abuse counselors, and program administrators to help improve the treatment of substance use disorders. October 12, 2011

Reducing Hospital-Acquired Infections

Nearly 1.7 million hospital-acquired infections (HAIs) occur annually, leading to approximately 99,000 deaths every year, according to the Centers for Disease Control and Prevention (CDC). (Adobe Reader is required to view or print the PDF. Download a free copy here. ) Recent efforts have demonstrated that infections can be controlled and significantly reduced through relatively simple measures.

The featured Innovations describe three programs that have reduced HAIs by implementing infection control measures ranging from weekly rounds to a set of common protocols and practices.

The featured QualityTools describe two toolkits designed to assist health care professionals in implementing infection control measures in hospitals. September 28, 2011

Smoking Cessation Programs

Despite progress in reducing tobacco use, in 2010 nearly one in five adults smoked cigarettes, according to the Centers for Disease Control and Prevention.

Treatments such as counseling and use of medications can be effective, but many tobacco users lack awareness of or access to smoking cessation resources, especially among low-income and underserved individuals.

The featured Innovations describe two programs that led to increased use of smoking cessation resources and higher quit rates.

The featured QualityTools provide practical approaches for treating tobacco dependence in the clinical setting and for achieving tobacco-free hospitals and health systems. September 14, 2011

Home Health Programs

Home health visitation programs offer a range of services to improve the health status of individuals and families. These include assessments, education, and support, which create healthier environments for families to thrive. 

The featured profiles describe two programs that provide home visits to conduct asthma assessments and health literacy education for low-income parents.

The featured tools describe workbooks, training aids, and toolkits for home health providers. August 31, 2011

Palliative Care

Palliative care relieves suffering and improves quality of life for patients with serious conditions and their family caregivers. It involves symptom and pain management, shared decisionmaking, practical and psychosocial support, and coordination across care settings. Palliative care services are typically provided by multidisciplinary teams that consult with patients and family members to address their complex needs.

The featured Innovations describe three programs that deliver palliative care in different settings.

The featured QualityTools provide health care professionals with resources and tools to support the development and quality improvement of palliative care programs. August 17, 2011

Reducing Readmissions in Special Settings

Hospital readmissions are costly and often avoidable with better care transitions between hospitals and different care settings. According to a recent study, 23.5 percent of all patients discharged to skilled nursing facilities in 2006 were rehospitalized within 30 days, at a total cost of $4.34 billion per year to the Medicare program.

The featured Innovations describe three different programs that reduced hospital readmissions from long-term residential care and skilled nursing facilities, leading to significant cost savings.

The featured QualityTools provide resources and tools for improving transitions of care and reducing avoidable rehospitalizations. August 03, 2011

Clinical & Community Linkages

A long-term goal of AHRQ is to foster linkages between clinical practices and community organizations to enhance the delivery of preventive services. By increasing access to health care and community services, these linkages can improve health outcomes and reduce disparities.

The featured Innovations describe two programs that increased access to culturally competent services through a comprehensive approach that included linkages.

The featured QualityTools offer resources to build clinical and community partnerships, including an assessment of community health needs.  July 20, 2011

Health IT in Care Coordination

Patients often receive fragmented care that is delivered across multiple providers and organizations. Health information technology is increasingly being used to improve care coordination by enabling the timely and effective exchange of clinical information between providers.

The featured Innovations describe three programs that use electronic systems in the coordination of care, with a focus on patient referrals and care transitions.

The featured QualityTools provide guidance for the electronic exchange of health information and other resources to support coordinated care. July 06, 2011

Medical Electronic Alerts

Medical electronic alerts are being integrated into clinical decision support systems, electronic health records (EHRs), and electronic prescribing to improve patient safety and quality of care. Clinicians receive alerts or reminders at the point of care to take specific actions such as ordering a test or confirming the patient is not at risk for a drug-drug interaction. However, as one program discovered, it is important to be selective about the number and type of electronic alerts to have a positive impact on physician behavior.

The featured Innovations describe three programs that use electronic alerts or reminders along with clinical guidelines or other best practices to improve patient care and physician performance.

The featured QualityTools provide standard approaches to improve the usability of EHRs and frequently asked questions about clinical decision support systems. June 22, 2011

Health Care for Prisoners

Prison inmates are vulnerable to infectious diseases, including HIV and Hepatitis C, and other health problems. More than 70 percent of the approximately 700,000 people released from U.S. Federal and State prisons each year have chronic medical, substance abuse, and other mental health problems. The need for treatment often competes with other important issues, such as finding housing, obtaining employment, and reuniting with their families. In addition, few programs are available to help recently released prisoners access medical and social services.

The featured Innovations describe three programs that provide medical and/or social services for prisoners or ex-prisoners with infectious or chronic diseases.

The featured QualityTools describe three tools health care professionals can use to treat offenders with chronic diseases. June 08, 2011

Patient Self-Management

Self-management is an important aspect of health care for individuals with chronic conditions. Patients and their families often have to learn and follow complex medical regimens, and make challenging changes in lifestyle, such as weight loss or increasing exercise. Through collaboration, patients, family, and providers share information, understand the patient’s goals, and create a plan that can be used to guide care at home and in the clinical setting.

The featured Innovations describe three programs that implemented one or more of the components of self-management that led to increased knowledge, adopting healthy behavior, and/or goal-setting.

The featured QualityTools describe three practical resources that health care professionals can use to support patients in self-management. May 25, 2011

Cultural Competence

Health care professionals increasingly encounter patients from diverse cultures and ethnic backgrounds, yet they are often ill-equipped to understand and respond effectively to the patient's cultural needs. Health care organizations can facilitate the cultural competence of their staff by establishing a set of congruent policies, attitudes, and behaviors that promote effective cross-cultural interactions and patient outcomes.

The featured Innovations describe three programs that have implemented strategies to increase providers' cultural and/or linguistic competence.

The featured QualityTools describe practical resources on cultural competence for providers. May 11, 2011

Health in Underserved Women

Medically underserved women have difficulty accessing and using health care services, which increases their risk of serious health problems and even death. Women are more likely to be medically underserved if they reside in rural or geographically remote areas, have a physical or mental disability or low literacy, belong to a minority and/or speak a minority language, and are low-income, homeless, elderly, lesbian, migrant workers, immigrants, or refugees.

The featured Innovations describe three programs that provided health care services, including screening and information, to medically underserved women.

The featured QualityTools describe online health and wellness resources for women, including rural women. April 27, 2011

Text Messaging & Sexual Health

The number of cell phone users has increased dramatically worldwide, making it easier to send mobile text messages. Public health agencies are using text messaging to communicate sexual health information and prevent sexually transmitted infections, especially among young people.

The featured Innovations describe three text messaging programs in England and the United States that provide sexual health information such as testing locations or test results.

The featured QualityTools summarize and link to Web resources on sexual and reproductive health text messaging programs. April 13, 2011

Core Measures in Hospitals

On average, public hospitals have performed more poorly than private hospitals on four core measures involving clinical care for a heart attack, heart failure, pneumonia, and surgical care that are reported to the Centers for Medicare and Medicaid Services (CMS). The gap in performance measures may be due to public hospitals having more patients with complex physical and social needs, smaller budgets, or older infrastructure, according to The Commonwealth Fund.

The recommended clinical care processes are evidence-based and have been proven to be effective in improving patient outcomes, making it imperative that all patients receive the recommended treatment.

The featured Innovations describe three programs implemented by health systems to improve their hospitals' performance on the four clinical care core measures.

The featured QualityTools describe three practical tools that hospitals can use to track their progress on core measures. March 30, 2011

Healthy Weight in Children

Nationwide, the prevalence of obesity among children and adolescents has more than tripled in recent decades. New strategies to promote healthy weight in children include policy-level initiatives and the implementation of practice changes by providers, schools, and communities to encourage the adoption of healthier lifestyles.

The featured Innovations describe a multi-sector, collaborative, statewide initiative that implemented new legislation, policies, and a social marketing campaign to promote behavior change and help halt the increase in childhood obesity.

The featured QualityTools provide toolkits and resources for families, community organizations, health care professionals, and employers to help promote healthy weight in children. March 16, 2011

eMedication Monitoring

Electronic systems and devices are increasingly being used to monitor and evaluate medication-related processes such as ordering, administration, and medication reconciliation.

The featured Innovations describe three programs that utilized electronic systems in various ways to improve medication safety, reduce costs, and increase medication adherence.

The featured QualityTools provide information and guidelines related to telepharmacy, medication reconciliation, and safe, appropriate medication use among older adults. March 02, 2011

Refugee Health

Refugees flee their homelands for many reasons, including violent conflicts, political or religious persecution, and famine. Refugees who settle in the United States often have disproportionate physical and/or mental health problems due to past traumatic experiences, refugee camp conditions, lack of access to health care, and economic hardships.

The featured Innovations describe three programs that enable refugees to receive health care and social and rehabilitative services that are culturally competent.

The featured QualityTools describe three toolkits that providers can use to educate refugees about lead poisoning prevention in children, nutrition, and healthy living. February 16, 2011

Personal Health Records

Personal health records (PHRs) allow health care consumers to collect and maintain complete, updated health information that is easily accessible and can be shared with caregivers and health care providers. The use of PHRs can increase patients’ engagement in managing their own health care and can enhance provider efficiency, leading to improved quality of care.

The featured Innovations describe three programs that utilized personal health record systems in various ways to improve care.

The featured QualityTools provide resources and tools to assist health care consumers in creating their own personal health records. February 02, 2011

Mental Illness Care

Individuals with mental illness often relapse and are hospitalized when they don't adhere to their medications, lack supportive services, and/or abuse substances.

Care coordinators play a vital role in reducing hospital readmissions by helping individuals with psychiatric conditions obtain mental health, medical, and social services.

The featured Innovations describe three programs that used care coordinators to assess, monitor, and connect individuals with mental illness to needed services.

The featured QualityTools provide practical tools to assist providers in improving communication and care coordination for individuals with mental illness. January 19, 2011

Phone-Based Care Management

Telephone care management programs can help reduce medical costs and can lead to improved patient care, medication adherence, and patient satisfaction. The process typically involves nurses who call patients to provide education about specific medical conditions and therapeutic options, to assess symptoms, and to support individuals in health care decisionmaking.

The featured Innovations describe three programs that utilized a telephone-based approach to deliver care to specific patient populations.

The featured QualityTools provide clinicians with information about the use of telephone care for the management of specific conditions. December 22, 2010

Workplace Wellness

Many workplaces offer programs for employees to support behavior change to improve their health and reduce associated health risks. Typical employee wellness activities include health fairs, health education, medical screenings, health coaching, weight management, wellness newsletters, and onsite fitness programs and/or facilities.

The featured Innovations describe workplace programs that address two common employee health problems—diabetes and substance abuse.

The featured QualityTools provide practical tools for employers to address overweight and obesity in the workplace and create a tobacco-free workplace. December 08, 2010

Baldrige Award

This issue’s featured Innovations were developed by organizations that are past recipients of an award from the Baldrige Performance Excellence Program, a public-private partnership led by the National Institute of Standards and Technology. Congress created the Baldrige National Quality Award in 1987 to promote excellence in organizational performance. Although this Presidential Award is not given for innovation or specific services, the Innovations featured here represent the work of organizations previously recognized as health care performance leaders by the Baldrige program.

The featured QualityTools provide links to Baldrige program resources and tools that can assist health care organizations in the pursuit of performance excellence.
November 24, 2010

eBehavioral Health

Cognitive behavioral therapy (CBT) is effective in treating depression and anxiety disorders. However, individuals who could benefit from CBT may not have access to a therapist or avoid seeing a therapist due to stigma. These patients can benefit from new technologies that enable them to have remote access to CBT.

The featured Innovations describe two electronic methods of improving behavioral health: a mobile phone application with CBT exercises and Internet-enabled instant messaging with a CBT-trained therapist.

The featured QualityTools describe telepsychiatry guidelines and electronic patient safety alerts.
November 10, 2010

Childhood Obesity

Childhood obesity is a significant, growing problem that has severe health consequences for our nation’s youth. According to the White House Task Force on Childhood Obesity Report to the President (Adobe Reader is required. Download a free copy here. ), obesity has more than tripled among children and adolescents since 1980, from 5% to 17%. Recent approaches to address the problem have focused on increasing family involvement and access to recreational activities to build healthier lifestyles.

The featured Innovations describe programs that used a family-centered approach and referrals to community exercise programs to promote healthy weight among children and adolescents.

The featured QualityTools provide policymakers, physicians, and parents with resources and information to manage and prevent childhood obesity. October 27, 2010

Community Services for Seniors

Senior citizens want to live independently as long as possible. However, their ability to manage daily tasks is diminished by falls, fractures, and disability associated with chronic conditions and modifiable risk factors. Home- and community-based services for seniors can improve their health and prevent further decline.

The featured Innovations describe an in-home physical therapy program and a senior center self-management and coaching program that improved overall functioning of seniors.

The featured QualityTools offer health care professionals, community planners, and family caregivers practical tools to help seniors stay in their homes and communities. October 13, 2010

Medication Management

Inappropriate medication use, adherence problems, and medication administration errors increase the risk of adverse events and can lead to unnecessary medical costs. The use of software-based screening protocols and medication reviews by pharmacists can help identify medication problems or concerns, improve appropriate use, and reduce the potential for errors.

The featured Innovations describe three programs that implemented medication management processes to reduce the risk of errors and adverse events.

The featured QualityTools provide guidelines and tools to improve medication safety and use in various care delivery settings. September 29, 2010

Inpatient Flow Strategies

Wait times in hospital emergency departments (EDs) have increased dramatically, with implications for the health and health care of millions of people. Hospitals can use the Input/Throughput/Output Model of Patient Flow   (Adobe Reader is required to view or print the PDF. Download a free copy here. ) to create a work plan for systematically assessing patient flow problems.

The featured Innovations describe three hospital programs that used inpatient flow strategies to solve the problem of patient overcrowding.
September 15, 2010

Community Care Coordination

Identifying at-risk individuals and connecting them to appropriate care can improve health outcomes and reduce health disparities. Community care coordination aims to improve the quality, efficiency, and coordination of health care and social services for at-risk populations. Such programs often use community health workers or navigators to help coordinate services.

The featured Innovations describe three programs that used the Pathways© model of community care coordination to connect at-risk individuals to needed services, thereby improving health outcomes.

The featured QualityTools provide resources that can assist communities in their efforts to improve the quality and coordination of health care services. September 01, 2010

Health IT in Rural Communities

Residents of rural communities often have limited access to appropriate, high quality care due to distance and a shortage of hospitals, physicians, and medical specialists that serve rural populations. Health information technology (health IT) applications, such as telehealth, electronic medical records (EMRs), and health information exchanges, can help rural communities overcome the unique challenges they face in the provision of health care.

The featured Innovations describe three programs that utilized health information technologies to improve health outcomes in rural areas.

The featured QualityTools provide resources and tools to support planning and implementation of health IT applications in various health care settings. August 18, 2010

Integrated Primary Care

"Integrated primary care" refers to the integration of behavioral health services--mental health, substance abuse, and health behavior change strategies--with primary care services. The level of integration can vary depending on whether both services are coordinated, co-located, or integrated into one treatment plan.

The featured Innovations describe three programs that developed integrated primary care services to address the needs of vulnerable patient populations.

The featured QualityTools describe learning modules and toolkits on how to develop integrated primary care services. August 04, 2010

Language/Culture Matching

The proportion of the U.S. population with limited English proficiency (LEP) has nearly doubled from 1980 to 2000, and is projected to increase. Research has shown that language and cultural barriers complicate physician-patient communication and adversely affect health care quality.

To address this problem, new programs are matching patients with providers or health coaches who fit their language and/or cultural preferences, which can improve patient satisfaction and health outcomes. 

The featured Innovations describe three programs that took different approaches to addressing patients' language and cultural needs.

The featured QualityTools describe practical resources designed to improve communication with a diverse patient population. July 21, 2010

Chronic Disease Management

Chronic diseases such as heart disease, cancer, and diabetes are responsible for 7 of 10 deaths annually and account for 75 percent of the nation’s health spending, according to the U.S. Department of Health and Human Services. However, most chronic diseases can be prevented and/or managed.

The featured Innovations describe three programs designed to prevent and/or manage chronic diseases and improve clinical outcomes.

The featured QualityTools provide clinicians and patients with practical guidance on ways to prevent and/or manage chronic diseases, including asthma and diabetes. July 07, 2010

Shared Decisionmaking

In shared decisionmaking, both the patient and clinician share information, participate in the decisionmaking process, and agree on the best strategy for treatment. The clinician provides personalized information, tools, and/or decision aids to help the patient understand available treatment options, and encourages the patient to consider his or her personal values in making treatment-related decisions.

The featured Innovations describe three programs that have provided shared decisionmaking tools and support to patients.

The featured QualityTools include decision aids and tools for patients to increase their knowledge about treatment options, and tools for clinicians to assist patients in making health care decisions. June 23, 2010

Medical Error Reporting

Since the 1999 Institute of Medicine Report publicized that up to 98,000 patients die annually due to often preventable medical errors, many hospitals have initiated programs to increase medical reporting of errors and reduce costs associated with additional patient care and malpractice lawsuits.  Effective programs have changed the hospital culture from blame and denial to transparency and open communication. 

The featured Innovations describe three programs that initiated new patient safety processes, including full disclosure of medical errors, open communication with patients, and corrective actions.

The featured QualityTools describe practical resources for reporting medical errors and communicating harm to patients. June 09, 2010

Connecting Health Care and Social Services

Patients with multiple and complex health conditions, mental health problems, and/or limited English proficiency often need a range of social services and support to manage their conditions. Health care providers and organizations can help patients connect to behavioral health services, social support, financial assistance programs, and other services that address their specific needs.

The featured Innovations describe three different programs that help vulnerable populations access needed social services.

The featured QualityTools help health care providers refer patients to services and to identify community-based resources. May 26, 2010

Clinical Decision Support Tools

Clinical decisionmaking has become increasingly complex. Health care professionals are turning to decision support tools defined broadly as clinical systems, applications, or processes to optimize clinical decisionmaking at the point of care. These tools range from computerized alerts and reminders, clinical guidelines, and order sets to documentation templates, diagnostic support, and patient data reports.

The featured Innovations describe three different programs that have used clinical decision support tools to improve the quality of patient care.

The featured QualityTools provide health care professionals with a range of practical clinical decision support tools. May 12, 2010

Coaches/Patient Navigators

Coaches in health care settings work with patients to make behavior changes and with health care professionals to make process improvements that can lead to better health outcomes. Patient navigators help individuals understand how the health care system works and gain access by removing barriers to health care.

The featured Innovations describe three different programs that utilized coaching to improve health outcomes among different patient populations.

The featured QualityTools provide tools and resources that can help support patient navigation programs and coaches in health care settings.
April 28, 2010

Reducing Youth Health Disparities

Youth, especially among racial and ethnic minorities, experience higher rates of diseases, injuries, and violence than Whites and fewer opportunities to achieve optimal health.  Youth health risk factors include poor dietary choices, low levels of physical activity, lack of dental care, and substance abuse. 

The featured Innovations describe three different programs that addressed health disparities among youth.

The featured QualityTools provide best practices, tools, and information that can help reduce health disparities among youth. April 14, 2010

Waste Reduction

Reducing waste and improving efficiency in health care delivery can reduce costs and improve health care quality. Inefficient processes waste limited health care resources that could otherwise improve health outcomes. Improvement strategies include implementing evidence-based practices and improving clinical process design and management.

The featured Innovations describe three programs that implemented activities to reduce waste and improve health care delivery processes.

The featured QualityTools provide health care organizations with resources and tools to identify and reduce waste and track associated cost savings. 
March 31, 2010

Medical Homes

The trend in primary care delivery toward patient-centered medical homes has gained the attention of policymakers.  The recently enacted health care reform legislation would expand practice- and community-based medical home demonstration projects through Medicare.

The featured Innovations describe three medical home programs that improved patient access to care and quality of care. 

The featured QualityTools provide practical resources to develop patient-centered medical homes. March 17, 2010

Delivering Culturally Competent Care

Health care services that respect and respond to diverse patients' health beliefs, practices, and cultural and linguistic needs can produce positive health outcomes and reduce health disparities.

The Health and Human Services Office of Minority Health has established national standards for culturally and linguistically appropriate services.  Health care organizations receiving federal funding are required to meet the linguistic standards, and national, federal, and state accrediting agencies are encouraged to mandate the cultural competence standards.

The featured Innovations show how three programs implemented cultural and/or linguistic services to meet the needs of diverse patient populations.

The featured QualityTools provide several practical resources to develop health care services for diverse patient groups. March 03, 2010

Pressure Ulcers

Pressure ulcers are a common problem across health care settings. The incidence of pressure ulcers varies by clinical setting: 0.4% to 38.0% for hospitals, 2.2% to 23.9% for long-term care, and 0% to 17% for home care, according to a 2003 article published in the Journal of the American Medical Association.   

The estimated cost to treat a pressure ulcer is between $500 and $40,000. Yet, pressure ulcers can be managed and prevented. 

The featured Innovations describe two programs that reduced hospital-acquired pressure ulcers by implementing new quality improvement measures. 

The featured QualityTools provide practitioners with practical resources to prevent and reduce pressure ulcers. February 17, 2010

Health Promotion and Disease Prevention

Health promotion activities are designed to encourage healthy behaviors and reduce the risk factors associated with diseases and chronic conditions. Health education combined with related organizational, economic, and political interventions can enable individuals and communities to improve their health.

The featured Innovations describe three programs that implemented a range of health promotion activities to improve patient outcomes.  

The featured QualityTools provide health professionals with practical tools to plan and implement health promotion activities. February 03, 2010

Care Coordination

Americans are living longer with multiple conditions and being cared for by multiple providers. Coordinating care as patients move from one health care setting to another or between a primary care professional and specialists is essential to avoid duplication of efforts, conflicting plans of care, and over-, under-, or mis-use of medications. 

The featured Innovations show how three care coordination programs are increasing efficiency, effectiveness, and patient satisfaction.

The featured QualityTools provide resources to help health care providers better coordinate patients’ care between settings.

January 20, 2010

Nursing Leadership

Nurses need professional opportunities to develop their leadership skills such as serving in various clinical roles and engaging in quality improvement initiatives. 

The featured innovations describe leadership roles nurses play across patient care settings.

The featured QualityTools describe practical resources to assist nurses in leadership roles. December 23, 2009

Integrating Mental Health Care and Primary Care

People with mental health problems are more likely to visit their primary care doctors than mental health professionals. Yet, mental health problems are often overlooked in primary care settings due to time constraints and lack of training.   

The featured innovations describe a remote mental health consultation service for patients seen in primary care settings and the use of support services to encourage primary care providers to refer patients with behavioral problems to community-based organizations.  

The featured QualityTools provide primary care practitioners a range of mental health resources. December 09, 2009

Social Media

Social media applications ranging from text messaging to social networking are increasingly being used by health care providers to improve patient care. 

The featured innovations describe mobile phone and text messaging programs to improve self-management of chronic diseases and increase awareness and testing for sexually-transmitted diseases. 

The featured QualityTools describe a range of Web sites offering health information and resources. November 25, 2009

Elderly Health

The elderly (age 65 and over) have complex health and social needs. Almost 75 percent of the elderly have at least one chronic illness, while roughly one-half have at least two. Many elderly patients take multiple medications, with some taking as many as 10 on a daily basis.

The featured innovations describe programs that focus on improving care coordination, influenza and pneumonia vaccination rates, and nursing home quality.

The featured QualityTools offer a range of practical resources that complement the featured innovations. November 11, 2009

Health Literacy

Nearly one in two adults living in the United States has limited health literacy, which affects their ability to obtain, process, and understand basic health information, according to a 2004 Institute of Medicine report. The highest rates of limited health literacy are among people who are older, low-income, medically underserved, and minorities. 

The featured innovations describe different approaches health professionals used in community-based settings to improve health literacy.  

The featured QualityTools provide several resources to assess patient's health literacy and address patients with low health literacy. October 28, 2009

Oral Health Disparities

Oral health disparities persist in the U.S. population for many reasons, including complex cultural and social processes that affect oral health and access to effective dental health care. Infrequent preventive care and high rates of dental disease are associated with minority status, low socioeconomic status, and unemployment.

The featured innovations describe programs aimed at reducing oral health disparities in two vulnerable populations — older homeless adults and refugees.

The featured QualityTools provide oral health resources, including a toolkit and an educational video to assist health professionals working with vulnerable populations. October 14, 2009

Healthcare-Associated Infections

In American hospitals alone, healthcare-associated infections (HAIs) account for an estimated 1.7 million infections and 99,000 associated deaths each year, according to a 2009 report from the Centers for Disease Control and Prevention. (If you don't have the software to open this PDF, download free Adobe Acrobat Reader® software.)

Implementing infection control practices can significantly reduce HAIs associated with catheters, central lines, ventilators, MRSA, Clostridium difficile, and surgical sites.   

The featured innovations describe several initiatives to reduce HAIs, including the AHRQ-funded ICU hospital collaborative (Michigan Keystone ICU Project) that saved an estimated 1,800 lives, 140,000 hospital days, and at least $270 million over a 5-year period. 

The featured QualityTools provide practical ways to reduce HAIs, including a central line care team insertion checklist. September 30, 2009

Developmental Disabilities

People with developmental disabilities experience chronic conditions due to physical or mental impairments such as loss of vision, hearing impairment, cerebral palsy or autism. Although these disabilities occur by age 22, they usually last a lifetime and interfere with major life activities such as language, mobility, learning, self-help, and independent living, according to the CDC's National Center on Birth Defects and Developmental Disabilities.

The featured innovations describe two programs that deliver important health care services or health education to adults with developmental disabilities.

The featured QualityTools provide practical resources for schools and parents to support children with autism and special needs. September 16, 2009

Worksite Wellness

Despite rising health care costs, employee health is worsening. This combination of factors threatens corporate viability and the sustainability of the American health care system. As the largest provider of health care coverage, employers offer the potential to exert transformative leadership, according to the U.S. Workplace Wellness Alliance.

The featured innovations describe a variety of employer-initiated programs designed to improve employee health and reduce health care costs. 

The featured QualityTools provide practical resources to assess and promote employee health. September 02, 2009

The Patient-Centered Medical Home

A Patient-Centered Medical Home (PCMH) provides an interdisciplinary coordinated approach to delivering primary care and other services to patients based on their needs. There are currently more than two dozen different PCMH pilot projects and as many different models represented across the country.

The featured innovations describe two medical home programs that serve different populations.

The featured QualityTools provide practical resources to facilitate the implementation of medical homes. August 19, 2009

Long-Term Care

The U.S. Government Accountability Office has found that one-fourth of the country's 16,000 nursing homes have serious deficiencies that cause actual harm to residents or place their health and safety at risk.

The featured innovations describe quality improvement efforts to reduce high rates of ventilator-associated pneumonia, pressure ulcers, and staff turnover at long-term care facilities.

The featured QualityTools provide practical information and resources to improve long-term care. August 05, 2009

Integrating Health Information Technology with Care Delivery

The Institute of Medicine has recommended that hospitals and medical groups adopt electronic medical record (EMR) systems, electronic order entry and prescribing, and other process improvements to improve patient care and safety. However, physicians have been slow to adopt health information technology (HIT) due to time and financial constraints.

The featured innovations describe programs that implemented HIT systems—one used financial incentives to increase physician use—and improved care delivery.

The featured QualityTools provide practical information and resources to facilitate HIT use. July 20, 2009

Reducing Hospital Readmission Rates

Hospital readmissions are common and costly. One in five Medicare patients were readmitted to a hospital within 30 days of being discharged in 2003 and 2004, which generated an estimated total of $17.4 billion in hospital payments in 2004, according to an April 2, 2009 New England Journal of Medicine article.

The featured innovations describe two programs that reduced hospital readmission rates and a third one that did not reduce readmission rates. Both types of innovation experiences offer important lessons learned. The featured QualityTools provide practical discharge planning tools. July 06, 2009

Service Delivery Changes in Caring for Children with Disabilities

About 14 percent of all children in the United States are at increased risk of chronic physical, developmental, behavioral or emotional conditions that require multiple health care services, according to a Maternal and Child Health Bureau survey. Yet, children with disabilities often do not receive adequate services. 

The featured innovations describe innovative programs that improve access to needed services for children with disabilities. The featured QualityTools describe practical tools to better identify children with disabilities. June 22, 2009

Women's Health

Programs that use community health workers and telephone consultations may help women at-risk for health problems especially in underserved communities. The featured innovations describe the use of these components to advance women's health while the featured QualityTools describe practical aides to women's health.
June 08, 2009

Mental Health Care

Half of all lifetime cases of mental illness begin by age 14, and despite effective treatments, individuals typically don't seek and receive treatment until several years later, according to a study funded by the National Institute of Mental Health. 

The featured innovations and QualityTools describe a range of mental health programs and approaches to improving detection, diagnosis and treatment. May 25, 2009

Implementing Evidence-Based Clinical Practice Guidelines

Clinical practice guidelines are more likely to lead to quality care when they are evidence-based and actionable.  AHRQ's National Guideline Clearinghouse has more than 2,000 current guidelines that meet specific criteria. 

The featured innovations and QualityTools describe a range of guideline implementation strategies and ways to improve guideline adherence. May 11, 2009

Management of Asthma

Asthma is a common disease that affects an estimated 22 million Americans including more than 6 million children, according to the CDC's National Center for Health Statistics.

The featured content describes innovations and QualityTools that focus on asthma education and self-management. April 27, 2009

Prevention Through Screening

The featured content describes innovations and QualityTools that focus on integrating screening and other preventive services with clinical patient care. April 13, 2009

Improving the Health of Obese and Overweight Youth

More than 23 million children and adolescents are overweight or obese in the United States. They are at increased risk of heart disease and stroke, diabetes, asthma and certain types of cancer, according to the Robert Wood Johnson Foundation's program on obesity.
 
The featured content describes innovative programs and QualityTools to help obese youth achieve a healthy weight and life-style.
March 30, 2009

Teamwork and Communication

Patient safety experts have identified effective teamwork as an essential factor in reducing medical errors. Encouraging team approaches to health care delivery can increase communication timeliness and accuracy and reduce adverse events. 

The featured profiles describe programs designed to enhance teamwork and communication. March 16, 2009

Culturally Competent Care

According to the National Center for Cultural Competence, providing culturally competent health care services requires an understanding of: 

• cultural beliefs, values, traditions and practices;
• culturally defined, health-related needs of individuals, families and communities;
• culturally based belief systems of the etiology of illness and disease and those related to health and healing; and
• attitudes toward seeking help from health care providers.

The featured innovations describe culturally competent programs that serve diverse populations.   March 02, 2009

Improve Patient Safety and Reduce Medical Errors

The rate of medical errors in American hospitals remains high. About 1 million patient safety incidents occurred in approximately 40 million Medicare hospitalizations between 2004 and 2006, according to the Fifth Annual HealthGrades Patient Safety in American Hospitals Study. (If you don't have the software to open this PDF, download free Adobe Acrobat Reader® software.) The Institute of Medicine reported in 2006 that medication errors alone injure at least 1.5 million Americans annually, costing the nation more than $3.5 billion a year.

The featured profiles describe innovative hospital programs designed to improve patient safety and reduce medical errors. February 16, 2009

Improve Patient Care upon Hospital Discharge and Patient Safety during Transfers

In today's fragmented health care system, there is a lack of coordination and continuity of care when patients transition from hospital to home or to another health care institution. The featured innovations describe programs designed to improve patient care upon hospital discharge and patient safety during intra-hospital transfers. February 02, 2009

Using the Pathways Model to Increase Access to Health Care

The featured innovations describe "pathways" programs involving community health workers or counselors who implement action steps to connect at-risk people to needed health care care and services. January 19, 2009

Delivering Health Care to Uninsured and Low-Income People

According to the 2007 U.S. Census Bureau, 45.7 million Americans lack health insurance.

The featured innovations describe programs that are designed to increase access to and use of health care services. December 22, 2008

Improving the Health Literacy of Patients

Ninety million Americans have difficulty understanding and acting on health information, according to the 2004 Institute of Medicine Report: Health Literacy: A Prescription to End Confusion.  

The featured innovations describe health care programs or processes that address the literacy needs of patients. December 08, 2008

Linking Clinical Practices and the Community

The featured innovations focus on improving service coordination and delivery through collaborative arrangements among health care providers and community organizations. November 24, 2008

Improving HIV Prevention, Detection, and Treatment

The featured innovations focus on providing outreach and community-based services to high-risk populations. November 10, 2008

Using Teams to Improve Health Care Delivery

The featured innovations focus on improving access to care through multidisciplinary and culturally competent teams and evidence-based approaches to teamwork. October 27, 2008

Improving the Health and Care of the Elderly

The US Census Bureau has projected that nearly one in five Americans will be age 65 or older by 2030, which will increase the demand for health care services. The featured innovations, by providing outreach to the elderly, preventive services, and care management, may reduce the need for intensive and expensive health care services. October 13, 2008

Cultural Competence

This issue focuses on cultural competence, which embraces the principles of equal access and non-discriminatory practices in service delivery. Cultural competence is achieved by identifying and understanding the needs and help-seeking behaviors of individuals and families, according to the National Center for Cultural Competence. 

The featured innovations describe health care programs that provided culturally and linguistically appropriate outreach and services to diverse patients.

The featured QualityTools provide materials that organizations can use to assess and improve their cultural competence. September 29, 2008

Role of Nurses in Improving Health Care Delivery

The featured innovations describe nurse-led hospital interventions and home health programs in which nurses play a key role. 

The featured QualityTools provide a range of educational resources for nurses and nursing assistants. September 15, 2008

Improving the Health of Children, Adolescents, and Their Families

The featured innovations describe programs that can increase positive health behaviors in youth, reduce risk factors, and improve communication with parents. 

The featured QualityTools educate health care practitioners and parents about ways to prevent diseases. September 01, 2008

Improving the Detection, Diagnosis, and Treatment of Mental Illness

The featured innovations describe collaborative models for integrating behavioral health care with primary care. The featured QualityTools educate practitioners about  common psychiatric disorders, prescribing practices, and community suicide prevention efforts. August 18, 2008

Improving the Care of Elderly in Hospitals, Nursing Homes, and Other Settings

The innovations describe programs aimed at reducing conditions such as delirium and pressure ulcers experienced by the elderly in hospitals and nursing homes. The QualityTools describe best practices and quality improvement methods to care for the elderly. August 04, 2008

Enhancing Patient Safety

The innovations describe programs at local clinics and hospitals aimed at reducing medical and medication errors. The QualityTools present the latest patient safety information from national health care organizations. July 21, 2008

Preventing and Managing Infections in Health Care Settings

The featured innovations describe the bundling of evidence-based practices to reduce infections acquired in hospitals, especially intensive care units. July 07, 2008

Management of Chronic Illnesses

More than 90 million Americans live with a chronic illness and many live with more than one. Seventy-five percent of the nation's aggregate health care spending is devoted to treating chronic illnesses. 

Health care providers and payers have responded to this challenge by developing innovations in disease and/or care management services. June 23, 2008

Health and Health Care Disparities Among Vulnerable Populations

In this issue, the featured innovations and QualityTools address health and health care disparities among vulnerable populations, which are defined by race/ethnicity, socioeconomic status, geography, age, gender, and disability status.

The featured innovations describe initiatives to deliver health services that are culturally and linguistically appropriate to Latinos and American Indians. June 09, 2008

Providing Access to Care in Rural and Community-based Settings

The featured innovations show how to extend specialty health care to rural and underserved populations by using telemedicine and health aides. May 26, 2008

Managing Chronic Health Conditions

An estimated 133 million people — or about one in two Americans — live with a chronic condition such as diabetes, asthma, high blood pressure, or depression. Of that number, about half experience multiple chronic conditions. 

Given that high prevalence, health care organizations are challenged to provide coordinated, efficient, and effective health care to patients with chronic conditions. The featured innovations explain how three health care organizations addressed these challenges. May 12, 2008

Patient Flow Management

Improving patient flow in hospitals increases patient safety, access to care, patient and staff satisfaction, and revenue. 

Overcrowding in hospitals can lead to bottlenecks in patient flow, delays in care, lack of continuity in care, and other inefficiencies.

The featured innovations describe how three hospitals used strategies and flow management principles from the private sector to redesign their health care processes. April 28, 2008

Patient-centered Care

In today's complex, fragmented, and volume-driven health care system, care has become centered around the system rather than the patient.

Patient-centered care, as the Institute of Medicine 2001 report Crossing the Quality Chasm: A New Health System for the 21st Century noted, has the following characteristics: 

•	It involves patients and their loved ones in the design of care.
•	It reliably meets patients' needs and preferences.
•	It ensures that transitions between providers, departments, and health care settings are respectful, coordinated, and efficient.

The featured innovations describe how three institutions integrated patient-centered care into their new programs or initiatives. April 14, 2008

Inaugural Issue

Welcome to the inaugural issue of the AHRQ Health Care Innovations Exchange Web site! 

This issue includes 100 Innovation Profiles that provide windows into a wide range of creative efforts to improve health care delivery in different settings — hospitals, medical offices, nursing homes, community organizations, schools, workplaces, and patient homes. 

Start an exchange with the innovators and other interested change agents by posting comments and questions on these profiles.  Our innovators welcome queries from health care professionals who are seriously considering adopting their innovations. 

This inaugural issue also includes hundreds of QualityTools that have been updated and reformatted consistent with the Innovation Profiles.

Featured in this inaugural issue are the initial six innovations that were posted on the earlier version of the Web site.  We are especially grateful to these first contributors to the Innovations Exchange.  We also feature three new QualityTools.

New issues of the Innovations Exchange Web site will be published every two weeks,  accompanied by an e-mail announcement.  Please sign up for our e-mail updates. 

We look forward to your participation in a vibrant and active Innovations Exchange community.

Last updated: February 13, 2013.