AHRQ Names New Director of Center for Evidence and Practice Improvement

AHRQ Stats: Avoidable Hospital Stays in Rural Counties

The rate of potentially avoidable hospitalizations in rural counties for all conditions improved from 2,583 per 100,000 people in 2005 to 1,979 per 100,000 people in 2012. (Source: Agency for Healthcare Research and Quality, 2014 National Healthcare Quality and Disparities Report Chartbook on Rural Health Care.)

Today's Headlines

1. AHRQ Names New Director of Center for Evidence and Practice Improvement.
2. AHRQ Study: Children in Families With Mixed Insurance Eligibility More Likely To Lack Insurance and Preventive Health/Dental Care.
3. AHRQ Grants Examine Challenges of Implementing Patient-Centered Medical Homes.
4. New Policies Issued Related to Grant Applications.
5. Call for Proposals: 2016 TeamSTEPPS® National Conference.
6. AHRQ Study Describes Effective Use of Corticosteroids To Reduce Preterm Birth Complications.
7. Featured Case Study: AHRQ Tools Help Wisconsin Hospitals Post Big Quality, Safety Gains.
8. AHRQ in the Professional Literature.

1. AHRQ Names New Director of Center for Evidence and Practice Improvement

Arlene S. Bierman, M.D., M.S., has been named director of AHRQ's Center for Evidence and Practice Improvement. Dr. Bierman is a general internist, geriatrician and health services researcher whose work has focused on improving access, quality and outcomes of health care for older adults with chronic illness in disadvantaged populations. Dr. Bierman has also developed strategies for using performance measurement as a tool for knowledge translation, as well as conducted research to increase policymakers' uptake of evidence. A tenured professor with academic appointments at the University of Toronto, she was the inaugural holder of the Ontario Women's Health Council Chair in Women's Health and a senior scientist in the Li Ka Shing Knowledge Institute at St. Michael's Hospital. She was also principal investigator for the Project for an Ontario Women's Health Evidence-Based Report Card (POWER) study, which provided actionable data to help policymakers and health care providers improve health and reduce health inequities in Ontario. In her new role at AHRQ, Dr. Bierman leads a center that consists of five divisions: the Evidence-Based Practice Center Program; the U.S. Preventive Services Task Force Program; the Division of Decision Science and Patient Engagement; the Division of Health Information Technology and the Division of Practice Improvement. The Center also includes the National Center for Excellence in Primary Care Research.

2. AHRQ Study: Children in Families With Mixed Insurance Eligibility More Likely To Lack Insurance and Preventive Health/Dental Care

An AHRQ-funded study found that Medicaid- and Children's Health Insurance Program (CHIP)-eligible children with siblings who are ineligible for public coverage are more likely to lack health insurance and less likely to receive preventive health and dental care compared with children in families in which all siblings are eligible for the same public insurance program (all-Medicaid or all-CHIP). Using data from AHRQ's Medical Expenditure Panel Survey for 2001-2012, the researchers examined insurance coverage, access to care and health care use for children in families with a mix of either "Medicaid- and CHIP-eligible" children or "eligible and ineligible" children. The authors found no differences between children in Medicaid-CHIP mixed families and children in all-Medicaid- or all-CHIP-eligible families. Differences found for children in eligible-ineligible mixed families persisted even among eligible children who were covered by public insurance. The study, co-authored by AHRQ's Julie L. Hudson, concluded that complications associated with mixed eligibility appear to be related to the difficulties faced by families when only some of their children are eligible for public coverage. The study was published online August 3 in Health Affairs. Read the abstract for the study, "Coverage and Care Consequences for Families Where Children Have Mixed Eligibility for Public Insurance."

3. AHRQ Grants Examine Challenges of Implementing Patient-Centered Medical Homes

Findings from three AHRQ-funded grant projects identify the difficulties facing primary care practices as they transition to patient-centered medical homes (PCMHs). The patient-centered medical home model has potential to transform the delivery of primary care and improve health in the United States. AHRQ's three grants explored distinct challenges of implementing PCMH models: "Transforming Primary Care Practice" grants studied the processes that primary care practices undertake as they transform into PCMHs; "Infrastructure for Maintaining Primary Care Transformation" grants funded state initiatives that provided a quality improvement infrastructure through primary care extension agents; and "Estimating the Costs of Supporting Primary Care Practice Transformation" grants provided stakeholders with information about the costs of implementing and sustaining the redesign of primary care practices.

4. New Policies Issued Related to Grant Applications

AHRQ and the National Institutes of Health have issued new policy notices related to grant applications. The notices provide guidance pertaining to instructions and forms; updated training table formats and introduction of the xTRACT electronic management system; enhancements to the peer review process; font guidelines for new applications; and the implementation of rigor and transparency in research grant applications and career development grant applications.

5. Call for Proposals: 2016 TeamSTEPPS® National Conference

AHRQ is pleased to announce that the 2016 TeamSTEPPS® National Conference will take place on June 8-10, 2016, in Washington, D.C. The TeamSTEPPS National Implementation Team is seeking proposals for concurrent breakout sessions and posters. TeamSTEPPS advocates are encouraged to share their unique experiences and new ideas with more than 500 industry professionals expected to attend the conference. Registration and information about hotel accommodations will be announced soon.

6. AHRQ Study Describes Effective Use of Corticosteroids To Reduce Preterm Birth Complications

Corticosteroids can reduce complications of preterm birth, but not all eligible women receive them, according to an AHRQ-funded study. The study identifies the key processes and supports needed to ensure that a treatment known as antenatal corticosteroids (ANCS) is given to eligible expectant mothers. In this study, researchers conducted focus groups and interviews with providers, including nurses, obstetricians, physician trainees and certified nurse midwives. Six themes supporting reliable implementation of ANCSs emerged: presence of a high-reliability culture, processes that emphasize high reliability, timely and efficient administration process, involvement of multiple disciplines, evidence of benefit that supports antenatal corticosteroid use and benefit is recognized at all levels of the care team. The article, "Reliable Implementation of Evidence: A Qualitative Study of Antenatal Corticosteroid Administration in Ohio Hospitals," and abstract were published June 8 in BMJ Quality & Safety.

7. Featured Case Study: AHRQ Tools Help Wisconsin Hospitals Post Big Quality, Safety Gains

Several AHRQ resources, including the Re-engineered Discharge (RED) Toolkit and the Comprehensive Unit-based Safety Program (CUSP), have been used by Wisconsin hospitals to help improve the quality and safety of care for more than 4,400 patients at a savings of $45.6 million through 2013, according to the Wisconsin Hospital Association. The case study is available here.

8. AHRQ in the Professional Literature

Galarraga JE, Mutter R, Pines JM. Costs associated with ambulatory care sensitive conditions across hospital-based settings. Acad Emerg Med 2015 Feb;22(2):172-81. Epub 2015 Jan 29. Select to access the abstract on PubMed®.

Laws MB, Lee Y, Rogers WH, et al. Provider-patient communication about adherence to anti-retroviral regimens differs by patient race and ethnicity. AIDS Behav 2014 Jul;18(7):1279-87. Select to access the abstract on PubMed®.

Begum R, Smith Ryan M, Winther CH, et al. Small practices' experience with EHR, quality measurement, and incentives. Am J Manag Care 2013 Nov;19(10 Spec No):eSP12-8. Select to access the abstract on PubMed®.

Bergeron AR, Webb JR, Serper M, et al. Impact of electronic prescribing on medication use in ambulatory care. Am J Manag Care 2013 Dec;19(12):1012-7. Select to access the abstract on PubMed®.

Guy GP Jr, Machlin SR, Ekwueme DU, et al. Prevalence and costs of skin cancer treatment in the U.S., 2002-2006 and 2007-2011. Am J Prev Med 2015 Feb;48(2):183-7. Epub 2014 Nov 10. Select to access the abstract on PubMed®.

Bailey SR, O'Malley JP, Gold R, et al. Receipt of diabetes preventive services differs by insurance status at visit. Am J Prev Med 2015 Feb;48(2):229-33. Epub 2014 Nov 6. Select to access the abstract on PubMed®.

Zhang S, Senteio C, Felizzola J, et al. Racial/ethnic disparities in antiretroviral treatment among HIV-infected pregnant Medicaid enrollees, 2005-2007. Am J Public Health 2013 Dec;103(12):e46-53. Epub 2013 Oct 17. Select to access the abstract on PubMed®.

Chen J, Hsieh AF, Dharmarajan K, et al. National trends in heart failure hospitalization after acute myocardial infarction for Medicare beneficiaries: 1998-2010. Circulation 2013 Dec 17;128(24):2577-84. Epub 2013 Nov 4. Select to access the abstract on PubMed®.