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Electronic Newsletter

July 23, 2009

AHRQ News and Numbers

The hospitalization rate of patients admitted for treatment of hip, pelvis, and other fractures associated with osteoporosis increased by 55 percent between 1995 and 2006 and cost hospitals $2.4 billion in 2006. [Source: Agency for Healthcare Research and Quality, Healthcare Cost & Utilization Project (HCUP), Osteoporosis Treatments That Help Prevent Broken Bones: A Guide for Women After Menopause.]

Today's Headlines

  1. HHS Secretary Sebelius releases new AHRQ Nationwide Emergency Department Sample data
  2. New AHRQ study finds mixed evidence on use of radiofrequency catheter ablation for treating atrial fibrillation
  3. New snapshots show States vary widely in providing quality health care
  4. HHS Secretary Sebelius releases inaugural health care "success story" about Michigan keystone ICU project
  5. Researchers analyze verbal medical orders
  6. AHRQ launches monthly health advice column and enhanced Web site in Spanish
  7. Task Force found insufficient evidence regarding screening for impaired visual acuity in older adults
  8. AHRQ's National Guideline Clearinghouse™ features new resources to prevent hospital acquired conditions
  9. AHRQ issues an updated individual awards for postdoctoral fellows program funding announcement
  10. AHRQ health IT update—register now for Web conference on role of innovations in health care reform set for July 27
  11. AHRQ offers hands-on training for two of its data resources—HCUP and MEPS
  12. What's new at AHRQ's Health Care Innovations Exchange—children with disabilities?
  13. New AHRQ evidence report on community health worker effectiveness available
  14. AHRQ in the professional literature

1.  HHS Secretary Sebelius Releases New AHRQ Nationwide Emergency Department Sample Data

Department of Health & Human Services (HHS) Secretary Kathleen Sebelius recently announced the release of the new Nationwide Emergency Department Sample, the largest, all-payer emergency department database in the United States. Managed by AHRQ, the Nationwide Emergency Department Sample is designed to help public health experts, policymakers, health care administrators, researchers, journalists and others find the data they need to answer questions about care in U.S. hospital emergency departments. The data found that uninsured persons accounted for nearly one-fifth of the 120 million hospital-based emergency department visits in 2006. AHRQ also released its latest Nationwide Inpatient Sample, the largest, most powerful database on hospital care in the United States, covering all patients, regardless of their type of insurance or whether they were insured. The database provides users with an in-depth look at why patients were hospitalized, the treatments and procedures they received and what happened to them at discharge. The two databases, as well as the 2006 Kids' Inpatient Database on pediatric inpatient care, are part of AHRQ's Healthcare Cost and Utilization Project (HCUP), a Federal-State-industry partnership for building a standardized, multi-state health data system. HCUP databases can be accessed by using the AHRQ online query tool, HCUPnet. Select to read the HHS press release.

2. New AHRQ Study Finds Mixed Evidence on Use of Radiofrequency Catheter Ablation for Treating Atrial Fibrillation

A procedure that sends targeted energy into the heart through a catheter can be used to treat a common type of irregular heartbeat, but little is known about the treatment's long-term benefits and the best methods and circumstances for applying it, according to a new report. The report examines the use of a procedure called radiofrequency catheter ablation to treat a type of irregular heartbeat known as atrial fibrillation. AHRQ's new report, Comparative Effectiveness of Radiofrequency Catheter Ablation for Atrial Fibrillation, found that the procedure has been shown to provide benefits in maintaining normal heart rhythm over short periods of time (up to 1 year) but found little evidence indicating whether the procedure reduces the chance that patients will experience atrial fibrillation over the long term. Select to access the report.

3. New Snapshots Show States Vary Widely in Providing Quality Health Care

AHRQ's annual release of State-by-State quality data continues to give States mixed reviews for the quality of care they provide. As in previous years, AHRQ's 2008 State Snapshots show that no State does well or poorly on all quality measures. The U.S. Department of Health and Human Services is also releasing State-by-State reports on the health care status quo. Select to access the reports. The 2008 State Snapshots provide State-specific health care quality information, including strengths, weaknesses and opportunities for improvement. The state-level information used to create the State Snapshots is drawn from the 2008 National Healthcare Quality Report, which was released in May by HHS Secretary Kathleen Sebelius and contributes to a national portrait of health care quality. Select to access the State Snapshots tool.

4.  HHS Secretary Sebelius Releases Inaugural Health Care "Success Story" About Michigan Keystone ICU Project

HHS Secretary Kathleen Sebelius recently released the first in a series of health care "success story" reports that document innovative programs and initiatives that can serve as models for a reformed American health care system. The inaugural report highlights the Michigan Keystone Intensive Care Unit (ICU) Project, a joint partnership between the Michigan Health & Hospital Association and the Johns Hopkins University. The Michigan Keystone ICU Project helped dramatically reduce the number of health care-associated infections in Michigan, saving over 1,500 lives and $200 million. The goal of the Michigan Keystone ICU project, which was initially funded by AHRQ, was to make patient care safer in over 100 ICUs in the state of Michigan by reducing catheter-related bloodstream infections. To help reduce these infections, clinicians were asked to implement a safety protocol that included a simple checklist. Select to read the HHS press release.

5. Researchers Analyze Verbal Medical Orders

A new AHRQ-funded study found that of roughly 973,000 orders that physicians at a large, Midwestern hospital gave nurses over a 12-month period, roughly 20 percent were verbal orders. The hospital transitioned from a paper-based to computerized provider order entry (CPOE) system during the study period. The new study is one of the first to examine how the content of verbal orders or the context in which they are given might increase risk of error. Although more hospitals are converting totally or in part to CPOE, most experts expect verbal medical ordering to continue to be used extensively for the foreseeable future. According to the researchers, who were led by the University of Missouri's Douglas S. Wakefield, Ph.D., five factors potentially contribute to verbal orders causing medical errors—type of care setting; time of day or week; type of communication and related variables, such as the physician's and/or nurse's accent and articulation; the providers' knowledge of the patients for whom the order is being given and previous contact experience between the physician and nurse; and environment including background noise and staffing levels. The study, "An Exploratory Study Measuring Verbal Order Content and Context," was published in the April 2009 issue of Quality and Safety in Health Care. Select to access the abstract in PubMed.®

6. AHRQ Launches Monthly Health Advice Column and Enhanced Web Site in Spanish

AHRQ announced Consejos de Salud Para Tí, (Health Advice for You), a new monthly online health advice column for Spanish-speaking consumers. The column provides evidence-based tips on preventive health, safe and appropriate use of medications and other medical therapies, ways to get better health care, and other key health care issues. The column is part of AHRQ's Información en Español Web site, which has been enhanced and now includes audio and video in Spanish on a wide range of health care issues.

7. Task Force Found Insufficient Evidence Regarding Screening for Impaired Visual Acuity in Older Adults

In an update of its 1996 recommendation, the U.S. Preventive Services Task Force concluded that the current evidence is insufficient to assess the balance of benefits and harms of screening for visual acuity for the improvement of outcomes in older adults. (I statement) The Task Force reviewed evidence published since its last review on screening adults 65 years or older in the primary care setting for visual acuity impairment associated with uncorrected refractive errors, cataracts, and age-related macular degeneration. The recommendation was published in the July 7 issue of Annals of Internal Medicine and is available on the AHRQ Web site.

8. AHRQ's National Guideline Clearinghouse™ Features New Resources to Prevent Hospital Acquired Conditions

AHRQ's National Guideline Clearinghouse™, a repository of over 2,300 evidence-based clinical practice guidelines, now features over 45 new guidelines on CMS-identified hospital-acquired conditions. Hospitals can apply these guidelines to improve processes for preventing these conditions, which are defined as those that occur during a hospital stay—conditions that are not identified in a patient at admission but are present at discharge. These conditions can lead to the harm of patients and an increase in health care costs. To address this issue, Medicare no longer pays hospitals for the additional costs associated with care for a patient deemed to have a hospital acquired condition.

9. AHRQ Issues an Updated Individual Awards for Postdoctoral Fellows Program Funding Announcement

On July 2, AHRQ issued an updated funding opportunity announcement (FOA) that announces AHRQ's intent to continue its Individual Awards for Postdoctoral Fellows (F32) program. It also highlights AHRQ's particular interest in applications that focus on identified priority areas in one of the six AHRQ portfolios: value, prevention/care management, health information technology, comparative effectiveness, patient safety, and innovations and emerging issues. The FOA also provides details regarding the transition of grant applications from paper to electronic submission, beginning with the next submission date (August 8) and continuing with all subsequent standard submission dates. Select to access the updated program announcement.

10. AHRQ Health IT Update—Register Now Web Conference on Role of Innovations in Health Care Reform Set for July 27

Register now for AHRQ's upcoming Web conference on health care innovations led by one of Business Week's "Leaders of the Year," Jeneanne Rae, MB. The event, titled "Will it Work Here? A Decisionmaker's Guide to Adopting Innovations," is hosted by AHRQ's Health Care Innovations Exchange and will be held on July 27, 1:00—2:30 PM (EDT). This free Web conference will address timely issues including what role innovation adoption may play in America's health reform and whether or not health information technology is a wise investment. As the focal point for this Web conference, participants will be introduced to Will It Work Here? A Decisionmaker's Guide to Adopting Innovations to help them assess whether an innovation is a good fit or an appropriate stretch for their health care organization. Experts in change management and innovation adoption will apply the tools in the guide to demonstrate effective innovation adoption decisionmaking. An AHRQ Innovations Exchange profile, Remote Visits by Pediatricians for Sick Children at Inner-City and other Child Care Centers/Schools Reduce Absences and Emergency Department Use, will be explored as an adoption case study. The innovation delivers primary care to a priority population, incorporates a health IT component, and has been proven to reduce emergency department visits once fully implemented.

11. AHRQ Offers Hands-On Training for Two of Its Data Resources—HCUP and MEPS

Register now for AHRQ's Joint HCUP and MEPS Data Users Workshop to be held on September 28-29. The training is designed to teach health services researchers about two AHRQ data resources: the Medical Expenditure Panel Survey (MEPS) and the Healthcare Cost and Utilization Project (HCUP), and to facilitate their use of data from them. Participants will have an overview of the two data resources on the first day, and hands-on training on one of the data resources on the second day. The course will take place at AHRQ in Rockville, Maryland. Attendance both days is recommended but in some cases is not required. Select for more information and to register. Please register early as space is limited.

12. What's New at AHRQ's Health Care Innovations Exchange—Children with Disabilities?

Service delivery for children with disabilities is the topic of the newest issue of the AHRQ Health Care Innovations Exchange Web site. 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. The Innovations Exchange contains more than 300 searchable innovations and 1,400 searchable QualityTools. Don't forget to visit the Spotlight for expert commentary, human interest stories, and other opportunities to connect with this program. You can access past issues of "What's New" on topics such as mental health, women's health, management of asthma, obese and overweight youth, and culturally competent care.

13. New AHRQ Evidence Report on Community Health Worker Effectiveness Available

A new AHRQ evidence report says that community health workers can improve appropriate use of some cancer screening services among minority and low-income patients and may improve their health knowledge. However, the report could not determine other ways these workers impact health behaviors, health outcomes, or utilization of other health services because of conflicting or absent study findings. Researchers led by Meera Viswanathan, Ph.D., of the AHRQ-supported Research Triangle Institute International-University of North Carolina Evidence-based Practice Center, reviewed studies on the effectiveness of community workers compared to other health education methods, such as health care interventions such as nurse-led education, mass-marketing of health information, and usual care. Specifically, the researchers found evidence that community health workers can be effective for improving people's knowledge on preventive health measures. Community health workers also seem to increase use of cervical cancer screening, mammography screening, and asthma self-management. However, the researchers did not find evidence that community health workers were more effective than other health care interventions when it comes to getting people into the clinic for clinical breast examination, colorectal cancer screening, management of their chronic diseases, and for most maternal and child health indicators. Select to access the report, Outcomes of Community Health Worker Interventions.

14. AHRQ in the Professional Literature

We are providing the following hyperlinks to journal abstracts through PubMed® for your convenience. Unfortunately, some of you may not be able to access the abstracts because of firewalls or specific settings on your individual computer systems. If you are having problems, you should ask your technical support staff for possible remedies.

Sampson M, Shojania KG, McGowan J, et al. Surveillance search techniques identified the need to update systematic reviews. J Clin Epidemiol 2008 Aug; 61(8):755-62. Select to access the abstract in PubMed.®

Newsome BB, McClellan WM, Allison JJ, et al. Racial differences in competing risks of mortality and ESRD after acute myocardial infarction. Am J Kidney Dis 2008 Aug; 52(2):251-61. Select to access the abstract in PubMed.®

Liang H, Tomey K, Chen D, et al. Objective measures of neighborhood environment and self-reported physical activity in spinal cord injured men. Arch Phys Med Rehabil 2008 Aug; 89(8):1468-73. Select to access the abstract in PubMed.®

Waitzkin H, Schillaci M, Willging CE. Multimethod evaluation of health policy change: an application to Medicaid managed care in a rural state. Health Serv Res 2008 Aug; 43(4):1325-47. Select to access the abstract in PubMed.®

Horswell RL, Wascom CK, Cerise FP, et al. Diabetes mellitus medication assistance program: relationship of effectiveness to adherence. J Health Care Poor Underserved 2008 Aug;19(3):677-86. Select to access the abstract in PubMed.®

Meier FA, Zarbo RJ, Varney RC, et al. Development and validation of a taxonomy of defects. Am J Clin Pathol 2008 Aug; 130(2):238-46. Select to access the abstract in PubMed.® Select to access the abstract

Kemper AR, Boyle CA, Aceves J, Dougherty D, et al. Long-term follow-up after diagnosis resulting from newborn screening: statement of the US Secretary of Health and Human Services' Advisory Committee on Heritable Disorders and Genetic Diseases in Newborns and Children. Genet Med 2008 Apr; 10(4):259-61. Select to access the abstract in PubMed.®

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Current as of July 2009

Internet Citation:

AHRQ Electronic Newsletter, July 23, 2009, Issue #278. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/enews/enews278.htm

 
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