Report Finds Gaps in Evidence for Best Ways To Clean Hospital Rooms

AHRQ Stats: Medicaid Versus Private Insurance

From 2003 to 2012, Medicaid rather than private insurance increasingly became the leading payer of potentially preventable pediatric hospital stays for asthma and diabetes. By 2012, Medicaid paid 58 percent of the asthma stays compared with 36 percent paid by private insurance. That same year, Medicaid paid 47 percent of the diabetes stays while private insurance paid 45 percent of them. (Source: Agency for Healthcare Research and Quality, Healthcare Cost and Utilization Project Statistical Brief #192: Potentially Preventable Pediatric Hospital Inpatient Stays for Asthma and Diabetes, 2003-2012.)

Today's Headlines

1. Report Finds Gaps in Evidence for Best Ways To Clean Hospital Rooms.
2. Opening Plenary Speakers Announced for AHRQ Research Conference; Early Registration Ends Friday.
3. AHRQ's State Snapshots Measure Health Care Quality, Access State By State.
4. "Plain-Language" Health Plan Information Can Help Uninsured People Make Informed Choices, According to New Study.
5. AHRQ Web M&M Examines Challenges in Protecting Patient Privacy.
6. Featured Impact Case Study: AHRQ's Work Supports Army Medical Center Decision To Reinstate Emergency Department Clinical Pharmacist.
7. AHRQ in the Professional Literature.

1. Report Finds Gaps in Evidence for Best Ways To Clean Hospital Rooms

Cleaning of hard surfaces in hospital rooms is a critical step to reducing the risk of healthcare-associated infections, but there is little evidence about what cleaning methods work best, according to a new AHRQ-funded report. The report, "Environmental Cleaning for the Prevention of Healthcare-Associated Infections," includes a review of 80 clinical studies from the last 25 years that address environmental cleaning of high-touch surfaces in hospital rooms to reduce Clostridium difficile, methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE). The researchers found limited studies that directly compare disinfection methods, monitoring strategies or implementation efforts. To advance research in this area, recommendations for future areas of study include examination and comparison of emerging strategies, inclusion of patient colonization and infection rates as outcomes and identification of surfaces posing the greatest risk of pathogen transmission. A summary of the report was published August 10 in the journal Annals of Internal Medicine.

2. Opening Plenary Speakers Announced for AHRQ Research Conference; Early Registration Ends Friday

Don't miss the opening plenary session at the AHRQ Research Conference on October 5 at the Crystal Gateway Marriott Hotel and Convention Center in Crystal City, Virginia. Speakers include Beverley H. Johnson, president and CEO, Institute for Patient- and Family-Centered Care; Alice M. Rivlin, Ph.D., director of the Health Policy Center, Brookings Institution; and Bruce Siegel, M.D., M.P.H., president and CEO of America's Essential Hospitals. The AHRQ Research Conference will once again bring together experts in health services research and policy for sessions focused on addressing today's challenges in improving quality, safety, access and affordability in health care. Early registration ends Friday.

3. AHRQ's State Snapshots Measure Health Care Quality, Access State By State

The overall quality and safety of health care are improving. But which states are showing the most improvement in which areas of care? AHRQs annual State Snapshots provide easy-to-read charts on the strengths, weaknesses and opportunities for improvement in each state and the District of Columbia. The State Snapshots allow users to analyze data from their state in various ways, including types and settings of care, or by select clinical conditions, insurance status, access to care and priority populations. Data are drawn from the 2014 National Healthcare Quality and Disparities Report, which is compiled from more than 200 quality measures and represents the nation's most complete source of data on the use and cost of health care and health insurance coverage. Trend data for most measures span from 2000–2002 to 2010–2012.

4. "Plain-Language" Health Plan Information Can Help Uninsured People Make Informed Choices, According to New Study

Plain-language descriptions can help uninsured adults make informed decisions on selecting health insurance coverage, according to an AHRQ-funded study published in Medical Decision Making. In one of the first studies to test such strategies among uninsured Americans, many of whom are now choosing among insurance plans offered through state and federal health exchanges, researchers surveyed 343 participants from urban, suburban and rural areas on their knowledge and preferences for health plan features and plan choices after viewing sample plans. They reviewed one of three tools: (1) a plain-language table, (2) a plain-language table with graphics that allowed participants to choose which information to view and in what order or (3) a plain-language table with five vignettes on how others used and rated the health plans. Participants across groups selected health plans that matched their preferences for key insurance features. Researchers suggested that health plan materials include plain-language tables and definitions of health insurance terms while being formatted to allow participants to compare health plan features. "A Randomized Trial Examining Three Strategies for Supporting Health Insurance Decisions Among the Uninsured" and abstract were published April 3.

5. AHRQ Web M&M Examines Challenges in Protecting Patient Privacy

The current issue of AHRQ's Web M&M features the case of a hospitalized patient with advanced dementia who was to undergo brain magnetic resonance imaging (MRI) as part of a diagnostic workup for altered mental status. Hospital privacy policy dictated that signout documentation include only patients' initials rather than full name or birth date. In this case, the patient requiring the brain MRI had the same initials as another patient on the same unit with severe cognitive impairment resulting from a traumatic brain injury. The cross-covering resident mixed up the two patients and placed the MRI order in the wrong chart. Because the order for a "brain MRI to evaluate worsening cognitive function" could apply to either patient, neither the bedside nurse nor radiologist noticed the error. The Perspectives on Safety section of the issue includes two features about new insights on safety and health information technology. The first is an interview with Robert M. Wachter, M.D., professor and interim chairman of the Department of Medicine at the University of California, San Francisco, about his new book, “The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine's Computer Age.” The second is an article by researchers at Georgetown University Hospital about health information technology usability design.

6. Featured Impact Case Study: AHRQ's Work Supports Army Medical Center Decision To Reinstate Emergency Department Clinical Pharmacist

Influenced by AHRQ-sponsored research showing how clinical pharmacy services can reduce medication-related errors, the Carl R. Darnall Army Medical Center in Fort Hood, Texas, restarted a clinical pharmacy program in its emergency department. The AHRQ study findings helped identify how emergency pharmacist programs might best be structured.

7. AHRQ in the Professional Literature

Eapen ZJ, Liang L, Shubrook JH,et al. Current quality of cardiovascular prevention for Million Hearts: an analysis of 147,038 outpatients from The Guideline Advantage. Am Heart J 2014 Sep;168(3):398-404. Epub 2014 Jun 9. Select to access the abstract on PubMed®.

Silber JH, Rosenbaum PR, Ross RN, et al. A hospital-specific template for benchmarking its cost and quality. Health Serv Res 2014 Oct;49(5):1475-97. Epub 2014 Sep 8. Select to access the abstract on PubMed®.

Laiteerapong N, Kirby J, Gao Y, et al. Health care utilization and receipt of preventive care for patients seen at federally funded health centers compared to other sites of primary care. Health Serv Res 2014 Oct;49(5):1498-518. Epub 2014 Apr 30. Select to access the abstract on PubMed®.

Datta R, Quan V, Kim D, et al. Protective effect of methicillin-susceptible Staphylococcus aureus carriage against methicillin-resistant S. aureus acquisition in nursing homes: a prospective cross-sectional study. Infect Control Hosp Epidemiol 2014 Oct;35(10):1257-62. Epub 2014 Sep 3. Select to access the abstract on PubMed®.

Eckenrode S, Bakullari A, Metersky ML, et al. The association between age, sex, and hospital-acquired infection rates: results from the 2009-2011 National Medicare Patient Safety Monitoring System. Infect Control Hosp Epidemiol 2014 Oct;35 Suppl 3:S3-9. Select to access the abstract on PubMed®.

Powell ES, Khare RK, Courtney DM, et al. The weekend effect for patients with sepsis presenting to the emergency department. J Emerg Med 2013 Nov;45(5):641-8. Epub 2013 Aug 30. Select to access the abstract on PubMed®.

Hollenbeck BK, Dunn RL, Suskind AM, et al. Ambulatory surgery centers and outpatient procedure use among Medicare beneficiaries. Med Care 2014 Oct;52(10):926-31. Select to access the abstract on PubMed®.

Rundell SD, Bresnahan BW, Heagerty PJ, et al. Mapping a patient-reported functional outcome measure to a utility measure for comparative effectiveness and economic evaluations in older adults with low back pain. Med Decis Making14 Oct;34(7):873-83. Epub 2014 May 14. Select to access the abstract on PubMed®.