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Electronic Newsletter

March 3, 2009

AHRQ News and Numbers

Americans visited a hospital outpatient department or office-based provider for high cholesterol 300 percent more often in 2006 than they did in 1996. Trauma related disorders and mental disorders prompted the most visits in 2006, just as they did in 1996. [Source: Agency for Healthcare Research and Quality, MEPS Household Component Tables.]

Today's Headlines

10-State Project to Study Methods to Reduce Central Line-Associated Bloodstream Infections in Hospital ICUs
AHRQ Releases Diabetes Cost Calculator
AHRQ Releases Recommendations for a National Emergency Evacuation System
Task Force Found Insufficient Evidence Regarding Whole-Body Skin Examinations to Prevent Skin Cancer
New article on Insufficient Evidence Recommendations of the Task Force
New Evidence Report on HER2 Testing to Manage Patients with Breast Cancer Is Available
Special AHRQ-Funded Journal Issue Highlights Impact of Health IT on Child Health
AHRQ's Third Annual Conference Set for September 13-16
Call for Papers—Payment Reform
Call for Nominations for 2009 John M. Eisenberg Patient Safety and Quality Awards Program
Highlights from Our Most Recent Monthly Newsletter
AHRQ in the Professional Literature

1. 10-State Project to Study Methods to Reduce Central Line-Associated Bloodstream Infections in Hospital ICUs

As part of an AHRQ-funded project, hospital associations in 10 states have been selected to participate in a program to test methods of reducing central-line associated blood stream infections in hospital intensive care units (ICUs). The states are California, Colorado, Florida, Massachusetts, Nebraska, North Carolina, Ohio, Pennsylvania, Texas, and Washington. In addition, the California Hospital Patient Safety Organization, the North Carolina Center for Hospital Quality and Patient Safety, and the Ohio Patient Safety Institute will participate in the project. The hospital associations and patient safety groups were chosen to participate based on their capability and infrastructure to implement the safety protocols being tested in the project. In addition, they provide a broad geographic representation. Last October, AHRQ awarded a 3-year, $3 million contract to the Health Research & Educational Trust, an affiliate of the American Hospital Association, to coordinate the project. The project will continue the work that originated at the Johns Hopkins University School of Medicine in Baltimore and was later implemented statewide in Michigan by the Johns Hopkins Quality and Safety Research Group and the Michigan Health & Hospital Association. The project will implement a comprehensive unit-based patient safety program across the 10 states to help prevent infections related to the use of central line catheters. Select to read our press release announcing participating States and our earlier press release on the award of the contract.

2. AHRQ Releases Diabetes Cost Calculator

AHRQ released a new tool, Diabetes Cost Calculator for Employers, that is designed to help you better estimate how you can save money while still paying health care costs for your employees who have diabetes. The Diabetes Cost Calculator will allow you to estimate your bottom-line costs for diabetes care and calculate the savings you could realize through better management of the disease. The tool makes these estimates based on the type, location, and size of a business and other factors including:

Number of people with diabetes
Annual diabetes-related medical cost
Annual diabetes-related productivity costs
Potential savings associated with better management of diabetes

AHRQ developed the Diabetes Cost Calculator in response to a request from the Mid-Atlantic Business Group on Health and in partnership with the National Business Coalition on Health. Select to access the calculator.

3. AHRQ Releases Recommendations for a National Emergency Evacuation System

AHRQ released a new report today, Recommendations for a National Mass Patient and Evacuee Movement, Regulating, and Tracking System, which recommends developing a coordinated multi-jurisdictional evacuation system that builds on existing resources and procedures available at the State, local, and Federal level. To develop a national system to locate, track, and regulate patients and evacuees leaving disaster areas, the report recommends collecting eight essential data elements to identify each patient or evacuee, their health status, and location from existing data sources like hospitals. It also recommends collecting baseline inventory levels of key resources such as available hospital beds and ambulances or other medical transportation. The report was developed by AHRQ with funding from HHS Office of the Assistant Secretary for Preparedness and Response and with critical input and leadership from the Department of Defense.

4. Task Force Found Insufficient Evidence Regarding Whole-Body Skin Examinations to Prevent Skin Cancer

The U.S. Preventive Services Task Force found insufficient evidence to determine if the benefits outweighed the harms of performing a whole-body skin examination by a primary care clinician or patient skin self-examination for the early detection of cutaneous melanoma, basal cell cancer, or squamous cell skin cancer. This recommendation applies to the adult general population without a history of premalignant or malignant lesions or familial syndromes, or at very high risk for melanoma. The Task Force reviewed published studies and could not find enough evidence to determine whether detecting skin cancer early reduces death from the disease. The Task Force also concluded that information was limited about the ability of primary care providers to perform adequate examinations in the context of usual care. However, the Task Force does suggest that clinicians should remain alert for skin lesions with malignant features that are noted while performing physical examinations for other purposes. In 2001, the Task Force also found insufficient evidence to recommend for or against routine screening for skin cancer by using a total-body skin examination for early detection of skin cancer. The full statement appears in the February 3 issue of the Annals of Internal Medicine. The recommendation and materials for clinicians are available on the AHRQ Web site.

5. New article on Insufficient Evidence Recommendations of the Task Force

The U.S. Preventive Services Task Force seeks to provide reliable and accurate evidence-based recommendations to primary care clinicians. In response to clinicians' frustration with the lack of guidance provided by the Task Force when the evidence is insufficient to make a recommendation ("I" statement), the Task Force has a new plan to commission its Evidence-based Practice Centers to collect information in four "domains" relevant to clinical decisions about prevention and to report this information routinely. This article presents the process and rationale used to select these domains, along with illustrations of the potential use of the information by clinicians to guide clinical decision making when evidence is insufficient. The full article appears in the February 3 issue of the Annals of Internal Medicine and is available on the AHRQ Web site.

6. New Evidence Report on HER2 Testing to Manage Patients with Breast Cancer Is Available

AHRQ has released a new evidence report that found insufficient evidence to indicate whether one test method is superior to others when evaluating the status of patients' human epidermal growth factor receptor-2 (HER2) gene. Evidence is lacking because best practices for tissue processing and guidelines on different laboratory test methods to evaluate HER2 have only been recently standardized. The report, HER2 Testing to Manage Patients with Breast Cancer or Other solid Tumors, was produced by AHRQ's Blue Cross and Blue Shield Association Evidence-based Practice Center in Chicago. Select to access the report. A print copy is available by sending an e-mail to ahrqpubs@ahrq.gov.

7. Special AHRQ-Funded Journal Issue Highlights Impact of Health IT on Child Health

The January supplement issue of Pediatrics, funded by AHRQ, features 14 articles on the enormous impact the use of health IT has on the quality of health care for children. The special issue also points out the challenges that need to be overcome to realize fully the potential of health IT to improve the quality and efficiency of health care. Many of the articles found in the supplement were commissioned as part of a conference held in March 2006 in Orlando, FL, cosponsored by AHRQ, the National Initiative for Children's Healthcare Quality, the Public Health Informatics Institute, and the All Children's Hospital Foundation. Below are links to abstracts of select articles:

It is Time! Accelerating the Use of Child Health Information Systems to Improve Child Health by Fairbrother G and Simpson LA. Select to access the abstract.
Alliance for Pediatric Quality: Creating a Community of Practice to Improve Health Care for America's Children by Miles PV, Miller M, Payne DM, Perelman R, Saffer M, and Zimmerman E. Select to access the abstract.
Linking Children's Health Information Systems: Clinical Care, Public Health, Emergency Medical Systems, and Schools by Hinman AR, and Davidson AJ. Select to access the abstract.
The Public Role in Promoting Child Health Information Technology by Conway PH, White PJ, Clancy C. Select to access the abstract.

8. AHRQ's Third Annual Conference Set for September 13-16

Save the Date! AHRQ's 2009 Annual Conference, "Research to Reform: Achieving Health System Change," will be held September 13-16 at the North Bethesda Marriott, in Bethesda, MD. The conference will feature exciting opportunities to learn about AHRQ's latest research aimed at accelerating system-wide improvements in the quality, safety, efficiency, and effectiveness of care. Conference sessions will feature leading experts involved in AHRQ-sponsored research and implementation projects. A complete agenda of these sessions and other activities is currently in development. Watch for more information about registration and hotel accommodations in a future newsletter. Select to see presentations from the 2008 Annual Conference.

9. Call for Papers-Payment Reform

AHRQ is calling for original papers on payment reform for a special theme issue of the journal, Health Services Research (HSR). Experts agree that changing the way providers are paid must be part of the solution to the problems of rising costs, falling access, and uncertain quality in health care, but little comparable evidence has been published to date about the intended and unintended consequences of different approaches. AHRQ, which is partnering with HSR, is especially interested in papers on comparative evidence, but also wants research, evaluations, or policy analyses papers, as well as models, simulations, and theoretical work. The deadline to submit manuscripts is June 23 at 5 p.m. PST. The anticipated publication date in print for the HSR Theme Issue on payment reform is August 2010. Select for details to submit papers.

10. Call for Nominations for 2009 John M. Eisenberg Patient Safety and Quality Awards Program

The Joint Commission and the National Quality Forum are accepting applications for the 2009 John M. Eisenberg Patient Safety and Quality Awards, which recognize individuals and health care organizations that are making significant contributions in improving the safety and quality of patient care. Select for more information on the awards, including categories of awards, nomination forms, and information on past award recipients, access the Joint Commission's Web site. The deadline for submitting nominations is April 20.

11. Highlights from Our Most Recent Monthly Newsletter

The February issue of Research Activities is available online. Key articles include:

Subsidies and education about the value of health insurance may help encourage the uninsured to enroll in health plans.
Education about the value of health insurance and subsidies to assist with premium payments may encourage enrollment in health insurance plans. Single workers with weak or uncertain preferences for health insurance were less likely to have jobs that offered coverage or to enroll in coverage when it was offered compared with those with strong tastes for health insurance.