October 8, 2008, Issue No.265
AHRQ News and Numbers
Hospitalizations for tuberculosis fell from 15,000 in 1995 to 8,800 in 2006. The number of patients who were hospitalized for other conditions but also who had tuberculosis fell about 10 percent to 49,700 in 2006 from 55,500 in 1995. [Source: Agency for Healthcare Research and Quality, HCUP, Statistical Brief #60: Tuberculosis Stays in U.S. Hospitals, 2006.]
Today's Headlines
- Patient Safety Organization interim guidance now available through AHRQ
- Task Force finds several methods equally effective for colorectal cancer screening
- AHRQ awards $3 million to help reduce central line-associated bloodstream infections in hospital ICUs
- Task Force issues new recommendations on behavioral counseling to prevent sexually transmitted infections
- Behavioral modification programs help obese children manage their weight
- New computer-based tools will help make best use of genetic breast cancer tests
- AHRQ announces new risk-informed intervention patient safety grants
- AHRQ’s 2008 Guide to Clinical Preventive Services now available
- AHRQ releases survey to assess nursing home safety culture
- Chronic care business model toolkit is available
- Registration is open: Meeting for users of AHRQ CAHPS and Patient Safety Culture Surveys on December 3-5
- ECRI Institute 16th Annual Conference on Using Evidence in Policy and Practice set for December 2-3
- 2008 John M. Eisenberg Patient Safety and Quality Award recipients announced
- AHRQ in the professional literature
1. Patient Safety Organization Interim Guidance Now Available Through AHRQ
New interim guidance that outlines how to become a Patient Safety Organization (PSO) is now available from HHS. The interim guidance allows AHRQ to begin receiving applications from qualified entities that wish to become PSOs for the purpose of voluntarily collecting, aggregating, and analyzing patient safety data. PSOs can then provide feedback that will help clinicians improve health care quality. The interim guidance describes how an organization may become a PSO by submitting a form that is available on AHRQ’s PSO Web site. AHRQ’s PSO Web site includes more information explaining the process and instructions for submitting the form either electronically or via U.S. mail. When the organization's certifications are accepted, AHRQ will list the entity as a PSO on the AHRQ PSO Web site. The interim guidance will remain effective until HHS issues a final rule for PSOs, which will then supersede the interim guidance. A final rule is expected to be released by the end of 2008. For more information regarding PSOs, to access the interim guidance, or to read the Notice of Proposed Rulemaking, visit AHRQ’s PSO Web site.
2. Task Force Finds Several Methods Equally Effective for Colorectal Cancer Screening
In a change from its previous recommendation, the U.S. Preventive Services Task Force now recommends that adults age 50 to 75 be screened for colorectal cancer using annual high-sensitivity fecal occult blood testing, sigmoidoscopy every 5 years with fecal occult testing between sigmoidoscopic exams, or colonoscopy every 10 years. The Task Force also recommended against routine colorectal cancer screening in adults between the ages of 76 and 85 because the benefits of regular screening were small compared with the risks. Adults over the age of 85 should not be screened at all because the harms of screening may be significant, and other conditions may be more likely to affect their health or well-being. The recommendation and the accompanying summary of evidence were posted online on October 6 in Annals of Internal Medicine and will appear in the November 4 print edition of the journal. Select to read our press release and select to access the recommendations statement and supporting documents. A print copy of the summary and related material is available by sending an e-mail to ahrqpubs@ahrq.hhs.gov.
3. AHRQ Awards $3 Million to Help Reduce Central Line-Associated Bloodstream infections in Hospital ICUs
AHRQ has awarded $3 million for a contract to help reduce central line-associated bloodstream infections in hospital intensive care units (ICUs). The Health Research & Educational Trust, an affiliate of the American Hospital Association, has been selected to coordinate the new 3-year project, part of HHS’ initiative to reduce health care-associated infections. The program includes tools to help health care professionals identify opportunities to reduce these potential infections and implement policies to make care safer. Select to read our press release.
4. New Recommendations on Behavioral Counseling to Prevent Sexually Transmitted Infections
The Task Force recommends high-intensity behavioral counseling to prevent sexually transmitted infections (STIs) for all sexually active adolescents and for adults at increased risk for STIs. The Task Force also concluded that evidence is insufficient to assess the balance of benefits and harms of behavioral counseling to prevent STIs in non-sexually active adolescents and in adults not at increased risk for STIs. Despite advances in screening, diagnosis, and treatment of STIs, they remain an important cause of death in the U.S. An estimated 19 million new STIs occur in the United States, almost half among people from 15 to 24 years of age. Common sexually transmitted infections include chlamydia, hepatitis B, hepatitis C, herpes, HIV and syphilis and direct medical costs are estimated at $15 billion annually. The recommendation appears in the October 7 issue of the Annals of Internal Medicine. Select to access the recommendations statement and supporting documents. A print copy of the summary and related material is available by sending an e-mail to ahrqpubs@ahrq.hhs.gov.
5. Behavioral Modification Programs Help Obese Children Manage Their Weight
AHRQ released a new report, Effectiveness of Weight Management Programs in Children and Adolescents, that shows obese school-age kids and teens can lose weight or prevent further weight gain if they participate in medium- to high-intensity behavioral management programs. Researchers found that after completing weight management programs, obese children would weigh between 3 pounds and 23 pounds less, on average, than obese children not involved in such programs. Among those enrolled, the weight difference would be greatest among heavier children as well as in those enrolled in more intensive programs. Researchers also found that weight improvements could be maintained for up to a year after the program ended. The report also showed that adding prescription drugs to a behavioral weight management program helped extremely obese adolescents lose weight. However, no studies evaluated maintenance of weight loss after drug treatment ended. Select to read our press release and select to access the report. A print copy is available by sending an e-mail to ahrqpubs@ahrq.hhs.gov.
6. New Computer-Based Tools Will Help Make Best Use of Genetic Breast Cancer Tests
A new AHRQ-funded project will lead efforts to develop, implement, and evaluate four computer-based decision-support tools to help clinicians and patients to use more efficiently or effectively genetic tests to evaluate and treat breast cancer. The first pair of tools will assess whether a woman with a family history of cancer should be tested for BRCA1 and BRCA2 gene mutations. Knowing whether a woman has inherited these gene mutations may help determine her chances of developing certain kinds of cancer, especially breast cancer. The second pair of tools, for women already diagnosed with breast cancer, will help determine which patients are appropriate for a Gene Expression Profiling (GEP) test. GEP test results can help evaluate which patients are at a high risk of cancer recurrence and therefore are good candidates for chemotherapy, in addition to other appropriate treatments. Select to read our press release and select to access information about the project.
7. AHRQ Announces New Risk-informed Intervention Patient Safety Grants
AHRQ has announced over $3.7 million in awards for patient safety grants focusing on risk-informed interventions. The objectives of these 3-year projects are to identify, develop, test, and implement safe practice interventions in ambulatory care settings. Findings and lessons learned about the challenges and barriers to developing and implementing these interventions through toolkits will be shared so that they may be adapted and/or adopted by other health care organizations. Select for more information.
8. AHRQ’s 2008 Guide to Clinical Preventive Services Now Available
AHRQ has released the Guide to Clinical Preventive Services 2008, which highlights recommendations from the U.S. Preventive Services Task Force. In addition to previous recommendations, this year’s Guide provides new Task Force recommendations released during 2007 on aspirin or nonsteroidal anti-inflammatory drugs for the primary prevention of colorectal cancer; screening for carotid artery stenosis; screening for chronic obstructive pulmonary disease using spirometry; counseling about proper use of motor vehicle occupant restraints and avoidance of alcohol use while driving; screening for illicit drug use; screening for lipid disorders in children; and, screening for sickle cell disease in newborns. The guide contains evidence-based recommendations that have been adapted for a pocket-size book, making it easier for clinicians to consult the recommendations in their daily practice. Recommendations are presented in an indexed, easy-to-use format, with at-a-glance charts. Recommendation statements and supporting statements from the Task Force are available on the AHRQ Web site. Select to download a copy of the guide. A print copy of the Guide is available by sending an e-mail to ahrqpubs@ahrq.hhs.gov.
9. AHRQ Releases Survey to Assess Nursing Home Safety Culture
AHRQ has released the Nursing Home Survey on Patient Safety Culture to help nursing homes assess safety culture, track changes in resident safety over time, and evaluate the impact of safety interventions. The new evidence-based survey assesses nursing home staff opinions of patient safety culture in the nursing home. The survey is part of a toolkit that includes a user’s guide that explains the survey process, and the survey materials. The survey measures 12 important dimensions related to resident safety culture, including communication openness, compliance with procedures, feedback and communication about incidents, handoffs, and nonpunitive response to mistakes. It is important to note that the survey was developed for use in nursing home facilities; it is not intended for use in assisted living, rehabilitation, community care, or independent living facilities. Select to access the survey and other toolkit materials. Free technical assistance for survey administration is available by sending an e-mail to safetyculturesurveys@ahrq.hhs.gov.
10. Chronic Care Business Model Toolkit Is Available
AHRQ has released a set of free, online tools to help safety-net hospitals improve their quality of patient care and financial returns. The toolkit, Integrating Chronic Care and Business Strategies in the Safety Net, is designed to improve patient satisfaction and loyalty; increase staff satisfaction and retention; streamline workflow; enhance efficiency; position practices to capture pay-for performance and quality improvement bonuses; and improve financial return. The Chronic Care and Business Strategies in the Safety Net Toolkit includes a collection of useful flow charts, worksheets, slides, fact sheets, and other forms developed by AHRQ, the Institute for Healthcare Improvement, the California Healthcare Foundation, the American Medical Association, and others. The goal of the toolkit is to improve clinical performance as well as enhance the financing structures that support care delivered to the chronically ill regardless of the size and landscape of the practice.
11. Registration is Open: Meeting for Users of AHRQ CAHPS and Patient Safety Culture Surveys on December 3-5
On December 3-5, AHRQ will hold a joint meeting for users of the Consumer Assessment of Healthcare Providers and Systems (CAHPS) family of surveys and users of the AHRQ patient safety culture surveys for hospitals, nursing homes, and medical offices. The meeting will be held at the Doubletree Paradise Valley Resort in Scottsdale, AZ. The meeting will be December 4-5 and the CAHPS College will be on December 3. Registration is free. Select to register. The CAHPS program develops standardized surveys of patients' experiences with health plans, medical groups, hospitals, nursing homes, individual clinicians, and other providers. The program also offers guidance on how to use the survey results to improve quality of care and report useful information to consumers. Select for more information about CAHPS. The patient safety culture surveys are tools that staff in hospitals, nursing homes, and medical offices can use to assess their patient safety culture, track changes in patient safety culture over time, and evaluate the impact of patient safety interventions. AHRQ released the hospital patient safety culture survey in 2004 and plans to issue the surveys for nursing homes and medical offices this fall. Select for more information about the culture surveys.
12. ECRI Institute 16th Annual Conference on Using Evidence in Policy and Practice Set for December 2-3
AHRQ’s ECRI Institute Evidence-based Practice Center is sponsoring their 16th annual conference on "How Effective is Value-Based Purchasing in the Public and Private Sectors?" on December 2-3 in Washington, DC. This conference will examine whether there is sufficient precision in the definition of "value-based" programs, and in ways to measure value, to support significant initiatives in the public and private sectors. AHRQ Director, Carolyn M. Clancy, M.D., is a guest speaker. Select to register.
13. 2008 John M. Eisenberg Patient Safety and Quality Award Recipients Announced
The National Quality Forum and The Joint Commission announced the 2008 recipients of the annual John M. Eisenberg Patient Safety and Quality Awards. This year’s awards also feature a new honorary award for individual achievement. The honorees, by award category, were for Individual Achievement: Michael R. Cohen, R. Ph., M.S., Sc.D., Institute for Safe Medication Practices, Huntington Valley, PA; Research: The RAND Corporation and University of California at Los Angeles School of Medicine, Los Angeles, CA; Innovations in Patient Safety and Quality at a National Level: National Coordinating Council for Medication Error Reporting and Prevention, Rockville, MD; Innovations in Patient Safety and Quality at the Local Level: Anthem Blue Cross and Blue Shield of Virginia, subsidiary of WellPoint Inc., Richmond, VA, and New York City Health and Hospitals Corporation, New York, NY, and Honorary Award for Individual Achievement: Dennis S. O’Leary, M.D., The Joint Commission.
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.
Ho PS, Kroll T, Kehn M, et al. Health and housing among low-income adults with physical disabilities. J Health Care Poor Underserved 2007 Nov; 18(4):902-915. Select to access the abstract on PubMed®.
Rivara FP, Anderson ML, Fishman P. et al. Intimate partner violence and health care costs and utilization for children living the home. Pediatrics 2007 Dec; 120(6):1270-1277. Select to access the abstract on PubMed®.
Davenport DL, Henderson WG, Mosca CL, et al. Risk-adjusted morbidity in teaching hospitals correlates with reported levels of communications and collaboration on surgical teams but not with scale measures of teamwork climate, safety climate, or working conditions. J Am Coll Surg 2007 Dec; 205(6):778-784. Select to access the abstract on PubMed®.
Noël PH, Parchman ML, Williams JW Jr., et al. The challenges of multimorbidity from the patient perspective. J Gen Intern Med 2007 Dec; 22(Suppl 3):419-424. Select to access the abstract on PubMed®.
Ay H, Benner T, Arsava EM, et al. A computerized algorithm for etiologic classification of ischemic stroke: the Causative Classification of Stroke System. Stroke 2007 Nov; 38(11):2970-2984. Select to access the abstract on PubMed®.
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Current as of October 2008
Internet Citation:
AHRQ Electronic Newsletter, October 8, 2008, Issue No.265. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/enews/enews265.htm
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