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Electronic health records in ambulatory care a national survey of physicians. | AHRQ Patient Safety
Implementation of electronic health records (EHRs) is considered a high priority in order to improve patient safety and quality of care. However, EHR uptake has been slow in both hospital and ambulatory settings. This national survey of more than 2000 physicians found that only 17% were using any form of EHR, and only a small proportion of those were using systems with advanced capabilities such as clinician decision support. While users generally viewed EHRs as beneficial for patient care, implementation costs were identified as the major barrier to use of EHR, corroborating findings of prior research.https://psnet.ahrq.gov/resources/resource/7635 - 8k - 2019-03-24 -
Access to prescription opioids Primum Non Nocere: a teachable moment. | AHRQ Patient Safety Network
Insufficient medication counseling and suboptimal prescribing practices contribute to misuse of opioids among patients. Describing a patient who became addicted to prescription opioids as a teenager after finding the medication at home, this commentary illustrates how current prescribing guidelines can address the opioid epidemic in the United States. -
Quality and Safety in Nursing: a Competency Approach to Improving Outcomes, Second Edition. | AHRQ P
The Crossing the Quality Chasm report provided a framework to improve quality and safety in health care. This publication draws on the six aims for quality outlined in the report to review core competencies, knowledge, and attitudes for safe nursing care. Topics covered include nurses as leaders, teamwork, and patient-centered care. -
Two-state collaborative study of a multifaceted intervention to decrease ventilator-associated event
Patients requiring intensive care are particularly vulnerable to preventable adverse events, including health care associated infections. This AHRQ-funded study examined the effect of a collaborative to prevent adverse events in patients requiring mechanical ventilation in 56 intensive care units (ICUs) in 2 states over a 3-year period. The participating ICUs introduced a multifaceted intervention structured around the Comprehensive Unit-based Safety Program, focusing on implementing evidence-based safety processes by explicitly addressing barriers to improvement and engaging in regular data audit and feedback. Participating hospitals were able to significantly reduce the rate of ventilator-associated adverse events (including ventilator-associated pneumonia) over the study period. Although the study is limited by lack of a concurrent control group, the results indicate the power of collaborative efforts to drive large-scale improvement. -
Final Recommendation Statement: Speech and Language Delay and Disorders in Children Age 5 and Younge
This is a webpage on the US Preventive Services Task Force USPSTF site -
Evidence Summary: Vision in Children Ages 6 Months to 5 Years: Screening - US Preventive Services Ta
This is a webpage on the US Preventive Services Task Force USPSTF site -
Improving Diagnosis in Health Care. | AHRQ Patient Safety Network
The National Academy of Medicine (formerly the Institute of Medicine) launched the patient safety movement with the publication of its report To Err Is Human. The group has now released a report about diagnosis, which they describe as a blind spot in health care. Available evidence suggests that most Americans will experience a missed or delayed diagnosis in their lifetime. The committee made several recommendations to improve diagnosis, including promoting teamwork among interdisciplinary health care teams, enhancing patient engagement in the diagnostic process, implementing large-scale error reporting systems with feedback and corrective action, and improving health information technology (as recommended in prior reports). Longer-term recommendations include establishing a work system and safety culture that foster timely and accurate diagnosis, improving the medical liability system to foster learning from missed or delayed diagnoses, reforming the payment system to support better diagnosis, and increasing funding for research in diagnostic safety. The report emphasizes the need for much more effort, and far more resources, at the practice, policy, and research levels to address this pressing safety problem.https://psnet.ahrq.gov/resources/resource/29366 - 8k - 2019-04-02 -
Language Barriers in Health Care. | AHRQ Patient Safety Network
This journal supplement contains articles on how language barriers can affect informed consent as well as the quality and safety of patient care. -
A national implementation project to prevent catheter-associated urinary tract infection in nursing
Catheter-associated urinary tract infections are considered preventable never events. This pre post implementation project conducted in long-term care facilities employed a multimodal intervention, similar to the Keystone ICU project. This sociotechnical approach included checklists, care team education, leadership engagement, communication interventions, and patient and family engagement. The project was conducted over a 2-year period across 48 states. In adjusted analyses, this effort led to a significant decrease in catheter-associated urinary tract infections, despite no change in catheter utilization, suggesting that needed use of catheters became safer. A related editorial declares this project "a triumph" for AHRQ's Safety Program for Long-term Care. -
High prevalence of medication discrepancies between home health referrals and Centers for Medicare a
Medication reconciliation at the time of hospital discharge is a key patient safety practice. This study found a high prevalence of discrepancies between older patients' hospital discharge medication lists and home health care providers' medication lists. The authors conclude that more work is needed to enhance care coordination to ensure accurate medication reconciliation for recently hospitalized older adults. -
From board to bedside: how the application of financial structures to safety and quality can drive a
Improving safety in health care organizations requires commitment from senior leadership and governance. It also requires an organizational structure that facilitates identifying and addressing safety issues. This study describes the organizational structure used at Johns Hopkins Medicine to prioritize improving quality, safety, and value. The organization developed a reporting and oversight framework using four key principles: governance from the hospital board's dedicated patient safety and quality committee, shared accountability between the board and clinical leadership, a consolidated quality performance statement to ensure transparency around goals and priorities, and internal audits to ensure reliability and accuracy of safety and quality data. The authors provide examples of how this framework was used to address safety issues such as health care associated infections. An earlier article described Johns Hopkins' success at achieving consistently high performance on accountability measures. -
The Patient-Centered Medical Home: Strategies to Put Patients at the Center of Primary Care | PCMH R
The Patient-Centered Medical Home: Strategies to Put Patients at the Center of Primary Care February 2011 AHRQ Publication No. 11-0029 Prepared For: A ... -
HCUP State Ambulatory Surgery and Services Databases (SASD) File Composition
HCUP State Ambulatory Surgery and Services Databases (SASD) File Composition This section describes the types of hospitals and types of records includ ...https://hcup-us.ahrq.gov/db/state/sasddist/sasd_multi.jsp - 9k - 2019-04-01 -
Clinical reasoning education at US medical schools: results from a national survey of internal medic
In recent years, diagnostic error has gained widespread attention as a major patient safety issue. Addressing cognitive biases as part of medical education may help reduce diagnostic error. Researchers sought to characterize clinical reasoning educational programs at United States medical schools and to understand the attitudes of internal medicine clerkship directors around the instruction of clinical reasoning. Survey responses were received from 91 out of 123 members of the Clerkship Directors in Internal Medicine. Respondents generally felt that clinical reasoning should be formally taught throughout medical education and that more time should be set aside for doing so. More than 50% of the respondents indicated that their institution did not have dedicated time for teaching clinical reasoning. Both limited curricular time and lack of faculty capable of teaching in this area were cited as barriers. The authors suggest that additional resources should be dedicated to teaching clinical reasoning in medical education. A PSNet perspective provides an update on diagnostic error. -
Implementing an electronic medical record with computerized prescriber order entry at a critical acc
This commentary discusses how health information technology can affect safety in a critical access hospital from a pharmacy perspective. -
Double checking: a second look. | AHRQ Patient Safety Network
Manual double checking of high-risk medication administration is a standard safety practice at most hospitals, despite limited data regarding its effectiveness. This qualitative study found that health care providers had differing conceptions of what double checking actually meant in practice, and they perceived that efficiency was impaired significantly by this process. -
State Documentation of Racial and Health Disparities to Inform Strategic Action: Summary
State Documentation of Racial and Health Disparities to Inform Strategic Action: Summary Search HCUP Home What is HCUP? Overview of HCUP On-line H ...https://hcup-us.ahrq.gov/reports/race/stand_alone_r_e_rpt.jsp - 26k - 2019-04-01 -
State Documentation of Racial and Ethnic Health Disparities to Inform Strategic Action
State Documentation of Racial and Ethnic Health Disparities to Inform Strategic Action Search HCUP Home What is HCUP? Overview of HCUP On-line HCU ...https://hcup-us.ahrq.gov/reports/race/annotatedslidesforR_E_report2.jsp - 11k - 2019-04-01 -
Adapting a National Curriculum to Better Collect Race and Ethnicity Data in New Mexico Hospitals
Adapting a National Curriculum to Better Collect Race and Ethnicity Data in New Mexico Hospitals A conference poster describing a process for improvin ...https://hcup-us.ahrq.gov/datainnovations/raceethnicitytoolkit/nm7.jsp - 12k - 2019-04-01 -
State and Regional Demonstration Projects (2004-2011) | AHRQ National Resource Center; Health Inform
You are here Home Funded Projects Past Initiatives State and Regional Demonstration Projects (2004-2011) | More Search AHRQ-Funded Projects AHRQ-Funde ...