Incorporating Health IT into Workflow Redesign – AHRQ – October 2010

Posted on February 11, 2011. Filed under: Health Informatics | Tags: , |

Incorporating Health IT into Workflow Redesign – AHRQ – October 2010

“Prepared by the University of Wisconsin-Madison’s Center for Quality and Productivity Improvement (CQPI). The report summarizes existing research and evidence related to the impact of health IT on workflow in outpatient settings. Key information obtained from the research will be incorporated into a toolkit to assist small and medium-sized practices in workflow analysis and redesign before, during, and after health IT implementation. The toolkit, Workflow Assessment for Health IT, is expected to be available in January 2011.”

Download the Incorporating Health IT into Workflow Redesign Summary Report (PDF, 1.37 MB)

and the associated Appendix, Incorporating Health IT Into Workflow Redesign Summary Report Appendix F: Tool Compendium (PDF, 1.43 MB)

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Development of Quality Criteria To Evaluate Nontherapeutic Studies of Incidence, Prevalence, or Risk Factors of Chronic Diseases: Pilot Study of New Checklists – AHRQ – January 2011

Posted on February 11, 2011. Filed under: Chronic Disease Mgmt | Tags: |

Development of Quality Criteria To Evaluate Nontherapeutic Studies of Incidence, Prevalence, or Risk Factors of Chronic Diseases: Pilot Study of New Checklists – AHRQ – January 2011

Structured Abstract
Objective. To develop two checklists for the quality of observational studies of incidence or risk factors of diseases.
Study design and setting. Initial development of the checklists was based on a systematic literature review. The checklists were refined after pilot trials of validity and reliability were conducted by seven experts, who tested the checklists on 10 articles.
Results. The checklist for studies of incidence or prevalence of chronic disease had six criteria for external validity and five for internal validity. The checklist for risk factor studies had 6 criteria for external validity, 13 criteria for internal validity, and 2 aspects of causality. A Microsoft Access database produced automated standardized reports about external and internal validities. Pilot testing demonstrated face and content validities and discrimination of reporting vs. methodological qualities. Interrater agreement was poor. The experts suggested future reliability testing of the checklists in systematic reviews with preplanned protocols, a priori consensus about research-specific quality criteria, and training of the reviewers.
Conclusions. We propose transparent and standardized quality assessment criteria of observational studies using the developed checklists. Future testing of the checklists in systematic reviews is necessary to develop reliable tools that can be used with confidence.

Citation
Shamliyan T, Kane RL, Ansari MT, Raman G, Berkman ND, Grant M, Janes G, Maglione M, Moher D, Nasser M, Robinson KA, Segal JB, Tsouros S. Development of the Quality Criteria To Evaluate Nontherapeutic Studies of Incidence, Prevalence, or Risk Factors of Chronic Diseases: Pilot Study of New Checklists. Agency for Healthcare Research and Quality; January 2011. Methods Research Report. AHRQ Publication No. 11-EHC008-EF. Available at http://effectivehealthcare.ahrq.gov/.

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On-Time Quality Improvement Manual for Long-Term Care Facilities – AHRQ – January 2011

Posted on February 11, 2011. Filed under: Aged Care / Geriatrics, Clin Governance / Risk Mgmt / Quality | Tags: |

On-Time Quality Improvement Manual for Long-Term Care Facilities – AHRQ – January 2011

AHRQ = US Agency for Healthcare Research and Quality

“The On-Time Quality Improvement program is a practical approach to quality improvement (QI) in long-term care, embedding QI strategies and best practices into health information technology. This manual is an introduction to the On-Time QI approach. It provides an overview of the tools and process improvements and describes the implementation process. Target users are stakeholders interested in nursing home QI, nursing home leaders responsible for deciding QI priorities, and nursing home personnel responsible for quality improvement.”

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Neurothrombectomy Devices for Treatment of Acute Ischemic Stroke – Agency for Healthcare Research & Quality [US] – technical brief published 18 January 2011

Posted on February 1, 2011. Filed under: Neurology | Tags: , |

Neurothrombectomy Devices for Treatment of Acute Ischemic Stroke – Agency for Healthcare Research & Quality [US] – research begun 20 Feb 2010, technical brief published 18 January 2011

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Comparative Effectiveness Review Methods: Clinical Heterogeneity – AHRQ – 27 September 2010

Posted on October 25, 2010. Filed under: Evidence Based Practice | Tags: , |

Comparative Effectiveness Review Methods: Clinical Heterogeneity – AHRQ – 27 September 2010
AHRQ = Agency for Healthcare Research and Quality [US]

AHRQ’s Effective Health Care Program released a new report, Comparative Effectiveness Review Methods: Clinical Heterogeneity prepared by AHRQ’s RTI International–University of North Carolina Evidence-based Practice Center.  The report explores best practices for addressing clinical heterogeneity in systematic reviews and comparative effectiveness reviews. Patients, clinicians, policymakers, and others assert that systematic reviews typically focus on broad populations and, as a result, often lack information relevant to individual patients or patient subgroups.  The report concluded that clear evidence-based guidance on addressing clinical heterogeneity in systematic reviews and comparative effectiveness reviews is not available currently but would be valuable to AHRQ’s Evidence-based Practice Centers and to others conducting systematic reviews internationally.

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Effectiveness of Recombinant Human Growth Hormone in the Treatment of Cystic Fibrosis – AHRQ – 4 October 2010

Posted on October 15, 2010. Filed under: Respiratory Medicine | Tags: , |

Effectiveness of Recombinant Human Growth Hormone in the Treatment of Cystic Fibrosis

AHRQ = Agency for Healthcare Research & Quality [US]

Press release: 4 October 2010

“Human growth hormone can be used successfully to treat some symptoms of cystic fibrosis, but its impact on the disease itself remains unknown, according to a new report funded by HHS’ Agency for Healthcare Research and Quality (AHRQ).”  …continues

Full Report: Research Review Oct. 4, 2010 PDF 1.1 MB

Appendixes Oct. 4, 2010  PDF 583 KB

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Taking Care of Myself: A Guide for When I Leave the Hospital – AHRQ – 2010

Posted on October 15, 2010. Filed under: Health Systems Improvement, Patient Participation | Tags: , , |

Taking Care of Myself: A Guide for When I Leave the Hospital – AHRQ – 2010

AHRQ = Agency for Healthcare Research and Quality

Taking Care of Myself: A Guide for When I Leave the Hospital is a guide for patients to help them care for themselves when they leave the hospital. The easy-to-read guide can be used by both hospital staff and patients during the discharge process and provides a way for patients to track their medication schedules, upcoming medical appointments, and important phone numbers.

About the Guide
Taking Care of Myself: A Guide for When I Leave the Hospital is adapted from the Project RED (Re-Engineered Discharge), which was funded by the Agency for Healthcare Research and Quality and the National Heart, Lung, and Blood Institute and operated by the Boston University Medical Center. Project RED showed that preparing patients to care for themselves when they leave the hospital can improve patient safety and reduce re-hospitalization rates. Giving patients an easy-to-understand discharge plan is 1 of 11 elements in the RED process.

More information about Project RED and tools to support some of the other elements of the RED can be obtained [on the website]. 

More detailed tools for implementing RED, and revisions of existing tools to ensure that diverse populations—especially patients with limited English proficiency, are now being developed. The tools will be completed by late 2012 and posted on the AHRQ Web site and the Boston University Medical Center’s Project RED Web site.

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Registries for Evaluating Patient Outcomes: A User’s Guide – AHRQ – 2nd ed – 27 September 2010

Posted on October 4, 2010. Filed under: Evidence Based Practice, Health Informatics, Health Mgmt Policy Planning, Patient Safety | Tags: |

Registries for Evaluating Patient Outcomes: A User’s Guide – AHRQ – 2nd ed – 27 September 2010

AHRQ’s Effective Health Care  Program has released the handbook, Registries for Evaluating Patient Outcomes: A User’s Guide 2nd Edition.  Originally published in 2007, the handbook has been completely updated with four new sections addressing emerging topics in registry science:

When To Stop a Registry; Use of Registries in Product Safety Assessment
Linking Registry Data
Technical and Legal Considerations
Interfacing Registries and Electronic Health Records

Gliklich RE, Dreyer NA, eds. Registries for Evaluating Patient Outcomes: A User’s Guide. 2nd ed.
(Prepared by Outcome DEcIDE Center [Outcome Sciences, Inc. d/b/a Outcome] under Contract No.
HHSA29020050035I TO3.) AHRQ Publication No.10-EHC049. Rockville, MD: Agency for Healthcare
Research and Quality. September 2010.

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Industrial and Systems Engineering and Health Care: Critical Areas of Research: Background Report – September 2009

Posted on October 4, 2010. Filed under: Health Systems Improvement | Tags: |

Valdez RS, Brennan PF. Industrial and Systems Engineering and Health Care: Critical Areas of Research: Background Report. (Prepared by the University of Wisconsin-Madison, Madison, WI under Contract No. 290-09-00027U). AHRQ Publication Number 09-0094-EF. Rockville, MD: Agency for Healthcare Research and Quality. September 2009.

A new report funded by AHRQ and the National Science Foundation found multiple opportunities to use industrial and systems engineering (ISyE) to help realize the goals of a new patient-centered health care system.  Industrial and Systems Engineering and Health Care: Critical Areas of Research explores the critical areas of research at the ISyE and health care, with a special emphasis on the supportive role of health IT.  Investing in ISyE research may help in creating a fundamentally better health care delivery system.   Achieving such breakthrough change requires new ISyE methods specific to health care, and integrating knowledge production across countless demonstration projects and small research efforts.   Innovation in health IT has the potential to support ISyE approaches to health systems design and evaluation.  The full report provides a vision of the new health system and a detailed research and action agenda.

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Vulnerable Atherosclerotic Plaque – Technical Brief from the AHRQ Effective Health Care Program – 16 August 2010

Posted on August 27, 2010. Filed under: Cardiol / Cardiothor Surg | Tags: |

Vulnerable Atherosclerotic Plaque – Technical Brief from the AHRQ Effective Health Care Program – 16 August 2010

AHRQ = Agency for Healthcare Research and Quality
AHRQ Publication No. 10-EHC-062-EF 

Medical researchers seeking more precise ways to predict a patient’s susceptibility to heart attacks and strokes are not close to finding a clinically and biologically superior method of doing so, according to a new AHRQ-funded study.  The report examines scientific literature of vulnerable plaques, a concept that proposes that biologically unstable areas of arteries could rupture and form a local blood clot that blocks the flow of blood through the artery to the heart or brain, causing a heart attack or stroke.  However, the report’s authors found substantial challenges in identifying unique characteristics of vulnerable plaques that can reliably be used in clinical practice to identify patients who are at higher risk of developing a heart attack or stroke.  The report was produced by AHRQ’s Tufts Medical Center Evidence-based Practice Center and was published online in Annals of Internal Medicine.  Select to access the full report.

Alsheikh-Ali A, Kitsios GD, Balk E, Mahoney A, Lau J, Ip S. Vulnerable Atherosclerotic Plaque. Technical Brief No. 4 (Prepared by Tufts Evidence-based Practice Center under Contract No. HHSA-290-02-0022-EPC II.) AHRQ Publication No. 10-EHC062-EF. Rockville, MD: Agency for Healthcare Research and Quality. August 2010. Available at: www.effectivehealthcare.ahrq.gov/reports/final.cfm

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Adding ACEIs and/or ARBs to Standard Therapy for Stable Ischemic Heart Disease: Benefits and Harms – Clinician Guide – 9 July 2010

Posted on August 16, 2010. Filed under: Cardiol / Cardiothor Surg | Tags: |

Adding ACEIs and/or ARBs to Standard Therapy for Stable Ischemic Heart Disease: Benefits and HarmsClinician Guide – 9 July 2010

AHRQ = US Agency for Healthcare Research and Quality

Key Clinical Issue
Should standard medical therapy in patients with stable ischemic heart disease be augmented with an ACEI angiotensin-converting enzyme inhibitor) or an ARB (angiotensin II receptor blocker)?

Consumer Guide – 9 July 2010

“ACE Inhibitors” and “ARBs” To Protect Your Heart?

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Home Health Care CAHPS Survey – AHRQ – 2010

Posted on August 16, 2010. Filed under: Chronic Disease Mgmt, Clin Governance / Risk Mgmt / Quality | Tags: |

Home Health Care CAHPS Survey – AHRQ – 2010

AHRQ = US Agency for Healthcare Research and Quality

“The Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Home Health Care Survey, hereafter referred to as the “Home Health Care CAHPS Survey” is designed to measure the experiences of people receiving home health care from Medicare-certified home health agencies.  The Home Health Care CAHPS Survey will be conducted for home health agencies by approved Home Health Care CAHPS Survey vendors.” 

“AHRQ released a new tool designed to measure patients’ experiences with Medicare-certified home health agencies, is being implemented by the Centers for Medicare and Medicaid Services on a voluntary national basis beginning in October 2010.  The Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Home Health Care Survey captures patients’ perceptions on areas such as patient care, communication between providers and patients, specific care issues (e.g., medications, home safety, and pain), and overall rating of care.  It is currently available in five languages: English, Spanish, Chinese, Russian, and Vietnamese.  The survey is designed to meet the following goals:  

Create incentives for home health agencies to improve their quality of care through public reporting of survey results.
Hold health care providers accountable by informing the public about the providers’ quality of care.
Produce standardized data on patients’ perspectives of care that allow objective and meaningful comparisons between home health agencies on domains that are important to consumers.”

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Selecting Quality and Resource Use Measures: A Decision Guide for Community Quality Collaboratives – AHRQ – 2010

Posted on August 16, 2010. Filed under: Clin Governance / Risk Mgmt / Quality | Tags: , , |

Selecting Quality and Resource Use Measures: A Decision Guide for Community Quality Collaboratives – AHRQ – 2010

AHRQ = US Agency for Healthcare Research and Quality

“Selecting quality of care and resource use measures is an important and challenging task for organizations striving to improve the quality of health care in their communities. This Decision Guide is designed to inform readers about the most critical issues to consider when selecting and adopting such performance measures.”

AHRQ Publication No. 09(10)-0073

Contents

List of Stakeholder Questions
Acknowledgments
Copyright Information
Foreword: Improving Quality One Community at a Time
Introduction
Part I. Introduction to Performance Data
Part II. Introduction to Measures of Quality
Part III. Introduction to Resource Use/Efficiency Measures
Part IV. Selecting Quality and Resource Use Measures
Part V. Interpreting Quality and Resource Use Measures
Appendixes
Appendix A. Measure Evaluation Framework
Appendix B. Contacts for Chartered Value Exchanges
Appendix C. Glossary
References

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Technical Brief: Percutaneous Heart Valve Replacement – AHRQ – 2 August 2010

Posted on August 11, 2010. Filed under: Cardiol / Cardiothor Surg | Tags: |

Technical Brief: Percutaneous Heart Valve Replacement – AHRQ – 2 August 2010

Risks, Benefits of Emerging Heart Valve Replacement Technique Not Fully Understood – AHRQ – 2 August 2010

AHRQ = US Agency for Healthcare Research and Quality

Full text of the Technical Brief on Percutaneous Heart Valve Replacement

“A newer, less invasive method of heart valve replacement shows promise and may be appropriate for patients who cannot tolerate traditional open heart surgery, but research is needed to understand its potential risks and benefits, according to a new study funded by the Department of Health & Human Services’ (HHS) Agency for Healthcare Research and Quality (AHRQ).

The report finds that percutaneous heart valve replacement, a procedure in which a replacement valve is implanted through a catheter rather than by open heart surgery, is a realistic option for some patients with heart valve disease, especially older or sicker patients. The report found that percutaneous heart valve replacement may be a safe and effective alternative to open heart surgery, especially in the short term, for those patients. However, information is lacking on the potential long-term benefits and risks of this procedure, particularly compared with open heart valve replacement surgery. The report did not conclude that any of the seven valves studied is safer or more effective than another.

The report was produced by the Duke Evidence-based Practice Center for AHRQ, a leading Federal agency conducting comparative effectiveness research. Results of the report were published online today in Annals of Internal Medicine. Heart valve disease—a narrowing of the heart valve—is blamed for approximately 20,000 deaths a year.”

…continues on the site

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New AHRQ Guides Offering Hospitals Advice on Emergency Evacuation, Assessment and Recovery Are Available – 2010

Posted on August 3, 2010. Filed under: Disaster Management | Tags: |

New AHRQ Guides Offering Hospitals Advice on Emergency Evacuation, Assessment and Recovery – AHRQ = US Agency for Healthcare Research and Quality

Hospital Evacuation Decision Guide

Hospital Assessment and Recovery Guide 

“Two new guides are now available to help hospital planners and administrators make important decisions about how to protect patients and health care workers and assess the physical components of a hospital when a natural or manmade disaster, terrorist attack, or other catastrophic event threatens the soundness of a facility.  The guides examine how hospital personnel have coped under emergency situations in the past to better understand what factors should be considered when making evacuation, shelter-in-place, and reoccupation decisions.  Hospital Evacuation Decision Guide and Hospital Assessment and Recovery Guide are intended to supplement hospital emergency plans, augment guidance on determining how long a decision to evacuate may be safely deferred and provide guidance on how to organize an initial assessment of a hospital to determine when it is safe to return after an evacuation.  The reports were developed by AHRQ with funding from the Health Resources and Services Administration and the Office of the Assistant Secretary for Preparedness and Response.”

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Comparative Effectiveness and Safety of Radiotherapy Treatments for Head and Neck Cancer – AHRQ – 2010

Posted on August 3, 2010. Filed under: Oncology | Tags: , |

Comparative Effectiveness and Safety of Radiotherapy Treatments for Head and Neck Cancer

Press release  Advanced Type of Cancer Radiation Reduces Side Effects, but Impact on Controlling Cancer Is Unclear

AHRQ = Agency for Healthcare Research and Quality [US]

“An advanced type of cancer radiation is more successful than traditional radiation in avoiding “dry mouth” when treating head and neck cancers, but it is unknown whether the treatment is better or worse at reducing the size of tumors, according to a new AHRQ comparative effectiveness review.  The report finds that intensity-modulated radiation therapy (IMRT) leads to fewer cases of xerostomia, commonly known as dry mouth, than other types of radiation.  Xerostomia, a potential side effect to radiation when salivary glands are damaged, can affect basic functions like chewing, swallowing and breathing; senses such as taste, smell and hearing; and can significantly alter a patient’s appearance and voice.  However, the report did not find evidence that IMRT is more successful than any other kind of radiation therapy in reducing tumors.  Many scientists consider IMRT to be theoretically better able to target cancerous cells while sparing healthy tissues, but more research is needed.  The comparative effectiveness review, Comparative Effectiveness and Safety of Radiotherapy Treatments for Head and Neck Cancer, was authored by the Blue Cross and Blue Shield (BC/BS) Association, Technology Evaluation Center in Chicago.”

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MONAHRQ – Innovative Software Cuts Costs and Time for States to Report Hospital Quality Information to the Public

Posted on August 3, 2010. Filed under: Clin Governance / Risk Mgmt / Quality, Health Informatics | Tags: |

Innovative Software Cuts Costs and Time for States to Report Hospital Quality Information to the Public

Info copied from AHRQ emailed newsletter

AHRQ = Agency for Healthcare Research and Quality

“AHRQ unveiled MONAHRQ – My Own Network Powered by AHRQ—a free, MS Windows-based software application that significantly reduces the cost and time a state, hospital or other organization would need to spend to compile, analyze and post data on quality of hospital care, its cost, and how that care is used.  MONAHRQ allows users to create a customized Web site with the data that can be used for internal quality improvement or reporting quality information to the public.  A state, or other organization, referred to as the host user, can download MONAHRQ from AHRQ’s Web site and enter its own hospital administrative data, which includes such elements as patient characteristics, diagnoses, procedures, health insurance type and charges. MONAHRQ processes that information and then creates a Web site that the host user can customize by selecting a specific color scheme, inserting logos and using other features. “

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New Patient Centered Medical Home Web Site Launched – US – AHRQ – 2010

Posted on August 3, 2010. Filed under: Community Services, Health Mgmt Policy Planning | Tags: |

New Patient Centered Medical Home Web Site Launched – US – AHRQ – 2010                                          
 
AHRQ = Agency for Healthcare Research and Quality

“AHRQ announces the launch of a new Web site devoted to providing objective information to policymakers and researchers on the patient centered medical home.  The Patient Centered Medical Home Web site provides users with searchable access to a rich database of publications and other resources on the medical home and exclusive access to the AHRQ-funded white papers focused on critical medical home issues including: Necessary But Not Sufficient: The HITECH Act and Health Information Technology’s Potential to Build Medical Homes, Engaging Patients and Families in the Medical Home, Integrating Mental Health Treatment Into the Patient Centered Medical Home.”

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Advances in Patient Safety: New Directions and Alternative Approaches – 16 July 2010

Posted on July 21, 2010. Filed under: Clin Governance / Risk Mgmt / Quality, Patient Safety | Tags: |

Advances in Patient Safety: New Directions and Alternative Approaches – 16 July 2010

“The Bookshelf’s Advances in Patient Safety collection has added 115 articles in the 4-volume set Advances in Patient Safety: New Directions and Alternative Approaches that represents years of study by AHRQ-funded patient safety researchers and others. It includes articles on reporting systems, risk assessment, safety culture, medical simulation, patient safety tools and practices, health information technology, medication safety, and other topics related to improving patient safety.”

Agency for Healthcare Research & Quality

Vol. 1: Assessment
Vol. 2: Culture and Redesign
Vol. 3: Performance and Tools
Vol. 4: Technology and Medication Safety

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New Study Finds Rotator Cuff Injuries Treatable, but Evidence Unclear Whether Surgery Is Preferable – July 2010 – AHRQ

Posted on July 8, 2010. Filed under: Orthopaedics | Tags: |

New Study Finds Rotator Cuff Injuries Treatable, but Evidence Unclear Whether Surgery Is Preferable
Press Release Date: July 5, 2010

“Injuries to the rotator cuff are treatable, but it is unclear which treatment option—surgery or nonsurgical treatments such as exercise or medication—is best, according to a new comparative effectiveness report published by the Department of Health & Human Services’ (HHS) Agency for Healthcare Research and Quality (AHRQ).

Tears to the shoulder’s rotator cuff, which is composed of four muscle-tendon units, are common among older adults. Rotator cuff tears can cause significant pain and limit arm motion.

The report, prepared for AHRQ by the University of Alberta Evidence-based Practice Center and published today in Annals of Internal Medicine, examined treatment and rehabilitative options for rotator cuff tears. It found that all treatments, either surgical or nonsurgical, result in improvement, but found few differences between interventions. It also did not find evidence indicating ideal timing of surgery.”  …continues on the site

In conjunction with the new report, AHRQ will soon publish plain-language summary guides about treating rotator cuff tears for patients, clinicians and policymakers. Summary guides on numerous clinical topics and other information and background on the Effective Health Care Program can be found” [on the site].

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Hospital Evacuation Decision Guide and Hospital Assessment and Recovery Guide – AHRQ – 24 June 2010

Posted on June 25, 2010. Filed under: Disaster Management | Tags: |

Hospital Evacuation Decision Guide  and  Hospital Assessment and Recovery Guide  –  AHRQ – 24  June 2010

New AHRQ Guides Offer Hospitals Advice on Emergency Evacuation, Assessment and Recovery

“Two new guides are now available to help hospital planners and administrators make important decisions about how to protect patients and health care workers and assess the physical components of a hospital when a natural or manmade disaster, terrorist attack, or other catastrophic event threatens the soundness of a facility. Published by the U.S. Department of Health and Human Services’ (HHS) Agency for Healthcare Research and Quality (AHRQ), the guides examine how hospital personnel have coped under emergency situations in the past to better understand what factors should be considered when making evacuation, shelter-in-place, and reoccupation decisions.”

…continues

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Selecting Quality and Resource Use Measures – A Decision Guide for Community Quality Collaboratives – AHRQ – May 2010

Posted on June 22, 2010. Filed under: Clin Governance / Risk Mgmt / Quality, Patient Participation | Tags: |

Selecting Quality and Resource Use Measures – A Decision Guide for Community Quality Collaboratives – AHRQ – May 2010

“Selecting quality of care and resource use measures is an important and challenging task for organizations striving to improve the quality of health care in their communities. This Decision Guide is designed to inform readers about the most critical issues to consider when selecting and adopting such performance measures.”

Agency for Healthcare Research and Quality (AHRQ)   Select to download print version (PDF File, 777 KB)

Prepared by: Patrick Romano, M.D., M.P.H., Petter Hussey, Ph.D., and Dominique Ritlery, M.P.H.
AHRQ Publication No. 09(10)-0073

Contents
List of Stakeholder Questions
Acknowledgments
Copyright Information
Foreword: Improving Quality One Community at a Time
Introduction
Part I. Introduction to Performance Data
Part II. Introduction to Measures of Quality
Part III. Introduction to Resource Use/Efficiency Measures
Part IV. Selecting Quality and Resource Use Measures
Part V. Interpreting Quality and Resource Use Measures
Appendixes

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Innovative Software Cuts Costs and Time for States to Report Hospital Quality Information to the Public – AHRQ – 3 June 2010

Posted on June 4, 2010. Filed under: Clin Governance / Risk Mgmt / Quality, Patient Participation | Tags: , , , |

Innovative Software Cuts Costs and Time for States to Report Hospital Quality Information to the Public
Press Release Date: June 3, 2010

“The Department of Health & Human Services’ (HHS’s) Agency for Healthcare Research and Quality (AHRQ) today unveiled MONAHRQ—My Own Network Powered by AHRQ—a free, MS® Windows®-based software application that significantly reduces the cost and time a State, hospital or other organization would need to spend to compile, analyze and post data on quality of hospital care, its cost and how that care is used. MONAHRQ allows users to create a customized Web site with data that can be used for internal quality improvement or reporting quality information to the public.

The cost of creating a Web site with this data is estimated to be $300,000 or more, and the time required could be a year, according to States that tested MONAHRQ as it was being developed. With MONAHRQ, that time can be cut to a few days. Currently, many States require that quality data be reported publicly and other States are considering doing so. For example, the Hawaii Health Information Corporation, which tested MONAHRQ, plans to recommend that they use the AHRQ software application for that purpose.

A State, or other organization, referred to as the host user, can download MONAHRQ from AHRQ’s Web site at http://monahrq.ahrq.gov and enter its own hospital administrative data, which includes such elements as patient characteristics, diagnoses, procedures, health insurance type and charges. MONAHRQ processes that information and then creates a Web site that the host user can customize by selecting a specific color scheme, inserting logos and using other features.

“Building on AHRQ’s strong track record of developing innovative quality indicators and hospital reporting tools, MONAHRQ will revolutionize how States and others report data publicly or use it to improve health care quality,” said AHRQ Director Carolyn M. Clancy, M.D. “MONAHRQ also will help consumers make informed decisions about hospital care because they will have access to state-of-the art information.”

A Web site created using MONAHRQ will provide information in four areas:

Quality of care for specific hospitals—provides information about patient safety, patient deaths in the hospital and other quality-related issues to answer questions such as, “Which hospitals have the lowest mortality rates after coronary bypass surgery?”
Provision of services by hospital for health conditions and procedures—provides information about the number of patient discharges, charges, costs and length of hospitalizations for specific hospitals to answer questions such as, “Which hospitals perform the largest numbers of hip replacement surgeries? And what is the cost?”
Potentially avoidable hospitalizations—creates maps of county-by-county rates for potentially avoidable hospitalizations to answer questions such as, “Which counties have the highest rates of hospitalization for uncontrolled diabetes? And how much could be saved if these rates were reduced?”
Rates of health conditions and procedures—provides information about the prevalence of diseases or medical procedures through maps of county-by-county rates for selected conditions and procedures to answer questions such as, “Which counties have the highest rates of lung cancer?”   ”
 
…continues on the site

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Best Practices in Public Reporting No. 1 – How To Effectively Present Health Care Performance Data To Consumers – AHRQ – June 2010

Posted on June 2, 2010. Filed under: Clin Governance / Risk Mgmt / Quality, Patient Participation | Tags: |

Best Practices in Public Reporting No. 1 – How To Effectively Present Health Care Performance Data To Consumers 

The purpose of the Best Practices in Public Reporting series is to provide practical approaches to designing public reports that make health care performance information clear, meaningful, and usable by consumers. Report 1 focuses on the presentation of comparative health care performance data.

Select for Report 2 (on effective use of explanatory information) or Report 3 (on maximizing public awareness).

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Electronic Health Record Usability: Vendor Practices and Perspectives – AHRQ – May 2010

Posted on May 27, 2010. Filed under: Health Informatics | Tags: , |

Electronic Health Record Usability: Vendor Practices and Perspectives – AHRQ – May 2010

McDonnell C, Werner K, Wendel L. Electronic Health Record Usability: Vendor Practices and Perspectives. AHRQ Publication No. 09(10)-0091-3-EF. Rockville, MD: Agency for Healthcare Research and Quality. May 2010.

“One of the key factors driving the adoption and appropriate utilization of electronic health record (EHR) systems is their usability. However, a recent study funded by the Agency for Healthcare Research and Quality (AHRQ) identified information about current EHR vendor usability processes and practices during the different phases of product development and deployment as a key research gap.

To address this gap and identify actionable recommendations to move the field forward, AHRQ contracted with James Bell Associates and the Altarum Institute to conduct a series of structured discussions with selected certified EHR vendors and to solicit recommendations based on these findings from a panel of multidisciplinary experts in this area.

The objectives of the project were to understand processes and practices by these vendors with regard to:

• The existence and use of standards and “best practices” in designing, developing, and deploying products.
• Testing and evaluating usability throughout the product life cycle.
• Supporting postdeployment monitoring to ensure patient safety and effective use.”

…continues

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Health Literacy Universal Precautions Toolkit – [US] AHRQ – April 2010

Posted on May 24, 2010. Filed under: Patient Participation | Tags: , |

Health Literacy Universal Precautions Toolkit – [US] AHRQ – April 2010

Suggested Citation:
DeWalt DA, Callahan LF, Hawk VH, Broucksou KA, Hink A, Rudd R, Brach C. Health Literacy Universal Precautions Toolkit. (Prepared by North Carolina Network Consortium, The Cecil G. Sheps Center for Health Services Research, The University of North Carolina at Chapel Hill, under Contract No. HHSA290200710014.) AHRQ Publication No. 10-0046-EF) Rockville, MD. Agency for Healthcare Research and Quality. April 2010.

The toolkit is based on the principles of universal precautions or specific actions that providers can take to make health information more understandable for all patients.  It is designed to be used by all levels of staff in practices providing primary care for adults and/or children.  The toolkit was developed for AHRQ by University of North Carolina at Chapel Hill.

“Medical care is complicated, and many people struggle with understanding medications, self care, instructions, and followup plans. The way we organize our practice and communicate with patients can help to minimize confusion and lead to better health outcomes. This toolkit is designed to help practices take a systematic approach to reducing the complexity of medical care and ensure that patients can succeed in the health care environment.”

…continues

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Preventing Alzheimer’s Disease and Cognitive Decline – [US] Agency for Healthcare Research and Quality – April 2010

Posted on May 24, 2010. Filed under: Aged Care / Geriatrics, Evidence Based Practice | Tags: , |

Preventing Alzheimer’s Disease and Cognitive Decline – [US] Agency for Healthcare Research and Quality – April 2010

Prepared for: Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services
Prepared by: Duke Evidence-based Practice Center, Durham, North Carolina
AHRQ Publication No. 10-E005

Suggested Citation:
Williams JW, Plassman BL, Burke J, Holsinger T, Benjamin S. Preventing Alzheimer’s Disease and Cognitive Decline. Evidence Report/Technology Assessment No. 193. (Prepared by the Duke Evidence-based Practice Center under Contract No. HHSA 290-2007-10066-I.) AHRQ Publication No. 10-E005. Rockville, MD: Agency for Healthcare Research and Quality. April 2010.

“Objectives: To assess whether previous research on purported risk or protective factors for Alzheimer’s disease (AD) and cognitive decline is of sufficient strength to warrant specific recommendations for behavioral, lifestyle, or pharmaceutical interventions/modifications targeted to these endpoints.”

…continues

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National Healthcare Quality Report – AHRQ – 2010

Posted on April 16, 2010. Filed under: Clin Governance / Risk Mgmt / Quality | Tags: , |

National Healthcare Quality Report 2009 – AHRQ – 2010
Full Report (PDF File, 4.4 MB)

The National Healthcare Quality Report tracks the health care system through quality measures, such as the percentage of heart attack patients who received recommended care when they reached the hospital or the percentage of children who received recommended vaccinations.

AHRQ Publication No. 10-0003
Current as of March 2010

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AHRQ Pharmacy Health Literacy Center – US Agency for Healthcare Research & Quality

Posted on January 7, 2010. Filed under: Patient Participation | Tags: , |

AHRQ Pharmacy Health Literacy Center – AHRQ = US Agency for Healthcare Research & Quality
 
“This site provides pharmacists with recently-released health literacy tools and other resources and assistance from the Agency for Healthcare Research and Quality (AHRQ).”

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Comparative Effectiveness of Core Needle and Open Surgical Biopsy for the Diagnosis of Breast Lesions – final research review – AHRQ US – 15 December 2009

Posted on December 22, 2009. Filed under: Diagnostics, Oncology | Tags: , , |

Comparative Effectiveness of Core Needle and Open Surgical Biopsy for the Diagnosis of Breast Lesions – final research review – AHRQ (US) – 15 December 2009

View PDF 697 kB

Non-surgical Method for Diagnosing Breast Cancer Safe, Nearly as Effective as Surgical Biopsy, New Report Finds
Press Release Date
: December 14, 2009

“Some methods of minimally invasive biopsy for breast cancer are nearly as accurate as surgical biopsy but have much less risk of harms, according to a new report funded by HHS’ Agency for Healthcare Research and Quality (AHRQ).

The report, prepared by the ECRI Institute’s Evidence-based Practice Center under contract to AHRQ’s Effective Health Care Program, compares traditional surgical biopsies with various types of “core needle biopsies,” which involve removing tissue through a special large hollow needle inserted through the skin.”

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Using Health Information Technology To Determine Medication Adherence: Findings from the AHRQ Health IT Portfolio – November 2009

Posted on November 13, 2009. Filed under: Health Informatics, Pharmacy | Tags: |

Samarth A, Grant E. Using Health Information Technology To Determine Medication Adherence: Findings from the AHRQ  Health IT Portfolio. (AHRQ National Resource Center for Health Information Technology under Contract No. 290-04-0016). AHRQ Publication No. 10-0010-EF. Rockville, MD: Agency for Healthcare Research and Quality. November 2009.

Medication Adherence Overview

“Adherence to (or compliance with) a medication regimen is generally defined as the extent to which patients take medications as prescribed by their health care providers.1 Adherence is important to obtaining or maintaining improved health of patients with chronic or severe health conditions. Research has reported a 76-percent discrepancy in adherence between medications prescribed and taken.2 The medication regimen prescribed is intended to maintain the desired level of medications in the bloodstream to achieve the desired result.

Although individual studies exist in the area of adherence of a certain group of patients or to a type of medication, very little peer-reviewed literature is available on the methodology for determining medication adherence in general. :…continues on the website

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Diagnosis and Management of Ductal Carcinoma in Situ (DCIS) – September 2009

Posted on November 10, 2009. Filed under: Oncology | Tags: |

Virnig BA, Shamliyan T, Tuttle TM, Kane RL, and Wilt TJ. Diagnosis and Management of Ductal Carcinoma in Situ (DCIS). Evidence Report/Technology Assessment No. 185 (Prepared by the Minnesota Evidence-based Practice Center under Contract No. 290-02-10064-I). AHRQ Publication No.09-E018. Rockville, MD. Agency for Healthcare Research and Quality. September 2009.

“AHRQ has released a new evidence report that found the incidence of ductal carcinoma in situ—the most common type of breast cancer—has continued to increase in the post-mammography era.  Researchers led by Beth A. Virnig, Ph.D., M.P.H., identified the need to better understand whether it is possible to modify current imaging technologies or screening guidelines to more effectively identify lesions that are unlikely to become clinically problematic, as well as tumors that are likely to contain some invasive component.  While evidence supports treating ductal carcinoma in situ, ongoing trials are exploring the best clinical strategy for treating ductal carcinoma in situ.  The report, Diagnosis and Management of Ductal Carcinoma in Situ, was conducted by AHRQ’s Minnesota University Evidence-based Practice Center and was requested and funded by the NIH’s Office of Medical Applications of Research, for a State-of-the-Science Conference on the topic on September 22-24, 2009.”

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Consumer Engagement in Developing Electronic Health Information Systems – July 2009

Posted on November 10, 2009. Filed under: Health Informatics, Patient Participation | Tags: |

Consumer Engagement in Developing Electronic Health Information Systems – July 2009
Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services

“AHRQ’s National Resource Center for Health Information Technology has released a new resource on consumers’ opinions of electronic health information systems.  The report … provides an in-depth understanding of consumers’ health care awareness, beliefs, perceptions, and fears concerning health IT.  Results of the focus groups suggest that participants were optimistic that health IT would benefit health care quality.  Privacy and security were the main concern of a large majority of participants.  Participants also thought that computers may add efficiency to health care and reduce medical errors, such as those associated with illegible handwriting.  However, some participants were concerned that health IT might make providers more impersonal, devoting more attention to the computer screen and less to the patient.”

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Mass Medical Care with Scarce Resources – The Essentials – September 2009

Posted on November 10, 2009. Filed under: Influenza A(H1N1) / Swine Flu, Public Hlth & Hlth Promotion | Tags: , |

Mass Medical Care with Scarce Resources – The Essentials – September 2009

“This guide from Department of Health & Human Services’ (HHS) Agency for Healthcare Research and Quality (AHRQ) can help community planners prepare for public health emergencies, such as pandemic flu, when demand for medical resources outweighs supply. The guide includes information on ethical and legal issues, and on the provision of services to address pre-hospital, acute hospital care, alternative care sites, and palliative care during a public health emergency.

To illustrate how to apply these basic principles, the guide includes a special section on influenza pandemic preparedness. This new guide is an abbreviated version of Mass Medical Care with Scarce Resources, published by AHRQ in 2007.”

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Implementation of Health Information Technology in Long-Term Care Settings: Finding from the Health IT Portfolio – October 2009

Posted on October 29, 2009. Filed under: Health Informatics | Tags: |

Mohamoud S, Byrne C, Samarth A. Implementation of Health Information Technology in Long-Term Care Settings: Finding from the Health IT Portfolio.(Prepared by the AHRQ National Resource Center for Health IT under ContractNo. 290-04-0016). AHRQ Publication No. 08-0087-EF. Rockville MD: Agencyfor Healthcare Research and Quality. October 2009.

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New Tools Help Emergency Planners Select Alternate Care Facilities and Transfer Patients During Disasters – AHRQ

Posted on October 27, 2009. Filed under: Disaster Management | Tags: , |

New Tools Help Emergency Planners Select Alternate Care Facilities and Transfer Patients During Disasters
 
AHRQ = US Agency for Healthcare Research & Quality
Info copied from AHRQ’s Electronic Newsletter #284.
 
“AHRQ released two interactive computer tools to help emergency planners and responders select and run alternate care facilities during disaster situations.  In such instances, hospitals experiencing a surge in seriously ill patients requiring acute care may need to transfer less ill patients efficiently to alternate care sites.  Alternate care facilities are locations that can easily and quickly be equipped to augment or replace health care services when hospitals and other traditional care sites are inoperable or overwhelmed.  Potential alternate care sites include college campuses, gymnasiums, schools, community centers, health clubs, convention centers or climate-controlled warehouses.  The two tools allow users to input information on their specific medical care needs and receive feedback on which facilities can become alternate care sites or which patients can appropriately be moved to those sites.  The Disaster Alternate Care Facilities Selection Tool is an interactive worksheet that assists users in selecting sites and identifying what they need to prepare these sites for use. It evaluates the characteristics of several potential facilities and calculates the results into weighted scores, which planners can use to select appropriate sites for care and plan for operations during a disaster.  The Disaster Alternate Care Facility Patient Selection Tool is a decision support tool that matches a hospitalized patient’s clinical needs with the capabilities of an alternate care facility. This information may help clinicians determine which patients might be eligible for discharge or transfer to an alternate care facility to increase a hospital’s capacity for incoming patients.  Select to read our press release and select to access the tools.”

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Summary of Health IT Portfolio 2008 – AHRQ – September 2009

Posted on October 27, 2009. Filed under: Health Informatics | Tags: |

AHRQ = US Agency for Healthcare Research & Quality
Info copied from AHRQ’s Electronic Newsletter #284.
 
AHRQ Releases Key Findings for Health IT Researchers and Implementers – published Sep 2009
 
“AHRQ has developed a new report, Summary of Health IT Portfolio 2008, that highlights key findings from its health IT projects.  The report presents an overview of nearly 150 summaries by strategic and business goals, project milestones, and other characteristics.  It is a valuable tool for health IT researchers and individuals interested in synthesizing health IT research and identifying gaps.  Researchers and implementers of health IT now have access to practical examples for planning and conducting their research and implementing projects. “

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Impact of Consumer Health Informatics Applications – AHRQ

Posted on October 27, 2009. Filed under: Health Informatics, Patient Participation | Tags: |

AHRQ = US Agency for Healthcare Research & Quality
Info copied from AHRQ’s Electronic Newsletter #284.
 
New Evidence Report Shows Consumer Health Informatics Applications Can Improve Health Care Processes
 
AHRQ released a new evidence report, Impact of Consumer Health Informatics Applications, which found that consumer health informatics applications can help improve health care processes, such as medication adherence.  These applications are defined as patient-focused electronic tools to support health improvement, process outcomes, and patient-centered care.  The benefits of using such applications apply to a variety of clinical conditions, including cancer, smoking, diabetes mellitus, physical activity, and mental health disorders.  The report also identified important knowledge gaps in the new and emerging field of consumer health informatics.  Researchers, led by M. Christopher Gibbons, M.D., M.P.H., at AHRQ’s Johns Hopkins University Evidence-based Practice Center, concluded that while the applications offer significant promise and potential to positively impact select clinical outcomes, more research is needed to determine conclusions on impact in many areas.  Select to access the report.

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Vitamin D and Calcium: A Systematic Review of Health Outcomes – AHRQ – August 20

Posted on August 6, 2009. Filed under: Dietetics | Tags: , , , |

New AHRQ Evidence Report on the Health Benefits of Vitamin D and Calcium Available – August 2009
AHRQ= US Agency for Healthcare Research & Quality

“A new AHRQ evidence report of human studies of the possible health benefits of consuming vitamin D and calcium, there appears to be considerable uncertainty as to benefits largely because of conflicting study findings or because specific health outcomes have not been studied.  The review was conducted by the AHRQ’s Tufts Medical Center Evidence-based Practice Center in Boston.  The report, Vitamin D and Calcium: Systematic Review of Health Outcomes, was commissioned by NIH’s Office of Dietary Supplements, FDA, the Public Health Agency of Canada, and Health Canada, to make available independently developed, updated findings for dietary and supplemental calcium, vitamin D, and combinations of the two nutrients for a wide range of health outcomes for possible consideration by a committee of the Institute’s Food and Nutrition Board, which is currently reviewing the 1997 Dietary Reference Intakes recommendations for the amounts of vitamins and minerals that people should consume daily.”

Suggested Citation:
Chung M, Balk EM, Brendel M, Ip S, Lau J, Lee J, Lichtenstein A, Patel K, Raman G, Tatsioni A, Terasawa T, Trikalinos TA. Vitamin D and Calcium: A Systematic Review of Health Outcomes. Evidence Report No. 183. (Prepared by the Tufts Evidence-based Practice Center under Contract No. HHSA 290-2007-10055-I.) AHRQ Publication No. 09-E015. Rockville, MD: Agency for Healthcare Research and Quality. August, 2009.

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Health Information Technology Evaluation Toolkit – 2009 Update Prepared for the (US) Agency for Healthcare Research and Quality – June 2009

Posted on August 2, 2009. Filed under: Health Informatics | Tags: |

Health Information Technology Evaluation Toolkit – 2009 Update Prepared for the (US) Agency for Healthcare Research and Quality – June 2009
AHRQ Publication No. 09-0083-EF

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Clinical Decision Support Systems:State of the Art – Prepared for the Agency for Healthcare Research and Quality (US) – June 2009

Posted on August 2, 2009. Filed under: Health Informatics | Tags: , , |

Clinical Decision Support Systems:State of the Art – Prepared for the Agency for Healthcare Research and Quality (US) – June 2009
AHRQ Publication No. 09-0069-EF

A PDF version of this document is also available. [PDF; 184KB]

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Project RED (Re-Engineered Discharge) – Boston University Medical Center

Posted on June 25, 2009. Filed under: Health Systems Improvement | Tags: , |

Implementing Re-Engineered Hospital Discharges (Project RED)

Frequently Asked Questions from the AHRQ website – June 2009

“The Re-Engineered Hospital Discharge project, known as Project RED, was developed by Brian Jack, M.D., Associate Professor of Family Medicine at Boston University and Timothy Bickmore, Ph.D., Assistant Professor in the College of Computer and Information Science at Northeastern University, through a Partnerships in Implementing Patient Safety grant from the Agency for Healthcare Research and Quality. The project is designed to re-engineer the hospital workflow process and improve patient safety by using a nurse discharge advocate who follows 11 discrete, mutually reinforcing action steps shown to improve the discharge process and decrease hospital readmissions. Patients who have a clear understanding of their after-hospital care instructions, including how to take their medicines and when to make follow-up appointments with their doctors, are 30 percent less likely to be readmitted or visit the emergency department than patients who lack this information, according to a study by Dr. Jack that appeared in the February 3, 2009, Annals of Internal Medicine.

The Project RED toolkit includes the following:

Training Manual—This workbook for health professionals details how to deliver a safe and effective hospital discharge.
After Hospital Care Plan Sample Form—The After Hospital Care Plan is designed to clearly present the information needed by patients to prepare them for the days between discharge and the first visit with their ambulatory care physician.
Computerized Workstation to Print the After Hospital Care Plan—This document describes the computerized workstation and the process used to create and print the After Hospital Care Plan.”

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Outcomes of Genetic Testing in Adults with a History of Venous Thromboembolism. Evidence Report/Technology Assessment – AHRQ – June 2009

Posted on June 25, 2009. Filed under: Cardiol / Cardiothor Surg, Genomics | Tags: , |

AHRQ = US Agency for Healthcare Research & Quality

Segal JB, Brotman DJ, Emadi A, Necochea AJ, Samal L, Wilson LM, Crim MT, Bass EB.
Outcomes of Genetic Testing in Adults with a History of Venous Thromboembolism. Evidence Report/Technology Assessment No. 180. (Prepared by Johns Hopkins University Evidence-based Practice Center under contract no. HHSA 290-2007-10061-I). AHRQ Publication No. 09-E011. Rockville, MD. Agency for Healthcare Research and Quality.Value of Genetic Testing for Preventing Blood Clots Unproven

AHRQ released a new evidence report that found insufficient evidence to conclude that genetic testing for two gene mutations in adults with a history of blood clots helps to prevent a condition known as deep-vein thrombosis or to improve other clinical outcomes.  The report, a summary of which will be published in the June 17 issue of JAMA, also failed to find any benefit from genetic testing of family members of patients who have at least one of the two mutations — known as Factor V Leiden (FVL) and prothrombin G20210A — as well as a history of deep-vein thrombosis.   The evidence report was requested and supported by CDC’s Office of Public Health Genomics (OPHG).  The Evaluation of Geno mic Applications in Practice and Prevention Working Group, established by OPHG in 2005, will use this evidence report and other evidence to make recommendations on the validity and utility of genetic tests for FVL and prothrombin G20210A. This report, titled Outcomes of Genetic Testing in Adults with a History of Venous Thromboembolism, was conducted by AHRQ’s Johns Hopkins Evidence-based Practice Center in Baltimore.

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AHRQ Issues Recommendations for Safeguarding Children During Public Health Emergencies

Posted on April 17, 2009. Filed under: Child Health / Paediatrics, Disaster Management | Tags: |

AHRQ (US Agency for Healthcare Research & Quality) released two new tools designed to protect and care for children who are in a hospital or a school during a public health emergency.

The first tool, Pediatric Hospital Surge Capacity in Public Health Emergencies, consists of guidelines to assist pediatric hospitals in converting from standard operating capacity to surge capacity and help community hospital emergency departments provide care for large numbers of critically ill children.

The second tool, School-Based Emergency Preparedness: A National Analysis and Recommended Protocol, is a national model for school-based emergency response planning.

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AHRQ Releases New Survey to Assess Medical Office Safety Culture

Posted on April 17, 2009. Filed under: Clin Governance / Risk Mgmt / Quality, Patient Safety | Tags: |

AHRQ (US Agency for Healthcare Research & Quality) released a new free, evidence-based tool to help organizations assess how their staff views different areas of patient safety.  The survey, Medical Office Survey on Patient Safety Culture, captures opinions from all levels of staff on important dimensions that relate to patient safety and quality issues, communication about error, communication openness, information exchange with other settings, office processes and standardization, organizational learning, staff training, teamwork, and work pressure and pace.  It includes survey forms and a user’s guide that explains the survey process, discussing such topics as overall project planning, data collection procedures and analysis and report creation.

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Recommendations for a National Mass Patient and Evacuee Movement, Regulating, and Tracking System March 2009

Posted on April 16, 2009. Filed under: Disaster Management | Tags: |

AHRQ = US Agency for Healthcare Research & Quality

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 de veloped 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.

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AHRQ Releases New Evidence Report on Back Pain – February 2009

Posted on April 8, 2009. Filed under: Complementary & Altern Care, Orthopaedics, Physiotherapy | Tags: |

US Agency for Healthcare Research & Quality – Complementary and Alternative Medicine in Back Pain Utilization, was conducted by AHRQ’s McMaster University Evidence-based Practice Center and funded by the National Institutes of Health’s National Center for Complementary and Alternative Medicine.

Structured Abstract

Objectives: This systematic review was undertaken to evaluate which complementary and alternative medicine (CAM) therapies are being used for persons with back pain in the United States.
Data Sources: MEDLINE®, EMBASE®, CINAHL® and Cochrane Central® and a variety of CAM specific databases were searched from 1990 to November 2007. A grey literature search was also undertaken, particularly for clinical practice guidelines (CPG) related to CAM.
Review Methods: Standard systematic review methodology was employed. Eligibility criteria included English studies of adults with back pain, and a predefined list of CAM therapies.
Results: A total of 103 publications were evaluated; of these 29 did not present CAM therapy use stratified for back pain. There were a total of 65 utilization studies, 43 of which were American. Four publications evaluated the concurrent use of four or more CAM therapies and these suggest that chiropractic/manipulation is the most frequently used modality followed by massage and acupuncture. A limited number of publications evaluated utilization rates within multiple regions of the back and show that CAM was used least for treating the thoracic spine and most for the low back. However, rates of use of massage were similar for neck and lower back regions. Concurrent use of different CAM or conventional therapies was not well reported.
From 11 eligible CPG, only one (for electro-acupuncture) provided recommendations for frequency of use for low back pain of all acuity levels.
Eighteen cost publications were reviewed and all but one publication (cost-effectiveness) were cost identification studies. There is limited information on the impact of insurance coverage on costs and utilization specific to back pain.
Conclusions: There are few studies evaluating the relative utilization of various CAM therapies for back pain. For those studies evaluating utilization of individual CAM therapies, the specific characteristics of the therapy, the providers, and the clinical presentation of the back pain patients were not adequately detailed; nor was the overlap with other CAM or conventional treatments.

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