Study Finds High Rates of Errors, Missed Opportunities for Diagnosing Pediatric Patients

AHRQ Stats: Kidney Failure Hospitalizations in the Midwest

Hospital stays for acute kidney failure grew 79 percent in the Midwest from 2005 to 2014, the largest increase of any region. (Source: AHRQ, Healthcare Cost and Utilization Project Statistical Brief #231: Acute Renal Failure Hospitalizations, 2005-2014.)  

Today's Headlines:

• Study Finds High Rates of Errors, Missed Opportunities for Diagnosing Pediatric Patients.
• Primer Summarizes Benefits, Safety Concerns Related to Electronic Health Records.
• Highlights From AHRQ's Patient Safety Network.
• New AHRQ Views Blog Post on Antibiotic Awareness Week: Why It Matters.
• Chartbook on Rural Health Care: Quality of Care Improved in Rural Areas.
• New Research and Evidence From AHRQ.
• AHRQ Releases TeamSTEPPS 2.0 to Improve Patient Safety in Long-Term Care.
• AHRQ in the Professional Literature.

Study Finds High Rates of Errors, Missed Opportunities for Diagnosing Pediatric Patients

Diagnostic errors and missed diagnoses are common in pediatric practices, according to an AHRQ-funded study. Researchers analyzed data from 25 pediatric practices during a 5-month period in 2015. They found diagnostic error rates of 54 percent for pediatric patients with elevated blood pressure and 11 percent for patients with abnormal laboratory values. The rate of missed opportunities was 62 percent for adolescents with an opportunity to evaluate for depression. The results were among the first to provide national estimates on the frequency of pediatric diagnostic errors and missed opportunities for diagnosis. Study authors concluded that practitioners should work to measure and reduce these high-frequency errors to avoid care delays and patient harm. Access the abstract of the study, which was published in Academic Pediatrics.

Primer Summarizes Benefits, Safety Concerns Related to Electronic Health Records

A new AHRQ primer summarizes the positive effects of electronic health records (EHRs) on patient safety as well as unintended patient safety concerns. The research review found EHRs have decreased medication errors, improved adherence to guidelines, and improved attitudes toward patient safety as well as job satisfaction among physicians and nurses. But the review also identified new safety concerns related to data entry. For instance, users could be distracted when entering information into parts of the application that are confusing, or they may not provide complete documentation. In addition, security measures may limit opportunities for nurses or pharmacists to prevent or correct prescription errors. Access the full report, Patient Safety Primer: Electronic Health Records.

Highlights From AHRQ's Patient Safety Network

AHRQ's Patient Safety Network (PSNet) highlights journal articles, books and tools related to patient safety. Articles featured this week include:

• Improving admission medication reconciliation with pharmacists or pharmacy technicians in the emergency department: a randomized controlled trial.
• A contemporary medicolegal analysis of outpatient medication management in chronic pain.
• Efficiency and safety of speech recognition for documentation in the electronic health record.

Review additional new publications in PSNet's current issue or access recent cases and commentaries in AHRQ's WebM&M (Morbidity and Mortality Rounds on the Web).

New AHRQ Views Blog Post on Antibiotic Awareness Week: Why It Matters

In a new AHRQ Views blog post, James I. Cleeman, M.D., Director of AHRQ's Healthcare-Associated Infections Program, highlights Antibiotic Awareness Week. The observance, sponsored by HHS' Centers for Disease Control and Prevention, is a key component of national efforts to improve antibiotic stewardship in the United States. Dr. Cleeman uses the occasion to discuss the importance of antibiotic medications to our Nation's health system; the threat of antibiotic resistance; and AHRQ efforts to promote antibiotic stewardship.

Chartbook on Rural Health Care: Quality of Care Improved in Rural Areas

According to AHRQ's new Chartbook on Rural Health Care, quality of care has improved for those living in rural areas. The chartbook is part of the 2016 AHRQ National Healthcare Quality and Disparities Report, which tracks trends in effectiveness and timeliness of care, patient safety, patient-centeredness, disparities and efficiency of care. The chartbook shows that the quality of care for those living in rural areas improved for 53 percent of those measures. It also found that in 2014, the percentage of people who used a hospital, emergency room, or clinic as a source of ongoing health care was higher for residents of rural areas compared with residents of large metropolitan areas. Between 1999 and 2015, suicide rates increased from 17 to 25 per 100,000 among whites living in rural areas and 21 to 34 per 100,000 American Indian and Alaska Natives living in rural areas.

New Research and Evidence From AHRQ

Spanish translations of research summaries for consumers:

• Tratamiento y prevención de infecciones por C. difficile (Treating and Preventing C. difficile Infections).
• Ácidos grasos omega-3 y la enfermedad cardiovascular (Omega-3 Fatty Acids and Cardiovascular Disease).
• Manejo del insomnia (Managing Insomnia Disorder).

AHRQ Releases TeamSTEPPS 2.0 to Improve Patient Safety in Long-Term Care

AHRQ has updated its TeamSTEPPS® training for long-term care facilities.  Now called TeamSTEPPS 2.0 for Long-Term Care, the curriculum updates have improved the usability and flow of materials, added training scenarios to reflect health care issues in long-term care settings, and added a new measurement module to help teams track progress. The update also brings this version of the TeamSTEPPS "train-the-trainer" curriculum in line with changes made to TeamSTEPPS 2.0 for hospital-based teams.  Users may download and/or print all the free TeamSTEPPS 2.0 for Long-Term Care materials for training in any post-acute or long-term care facility.

AHRQ in the Professional Literature

Keep it going: maintaining health conversations using relational and instrumental approaches. Traino HM, Siminoff LA. Health Commun 2016;31(3):308-19. Epub 2015 Sep 1. Access the abstract on PubMed®.

Racial and ethnic disparities in diabetes screening between Asian Americans and other adults: BRFSS 2012-2014. Tung EL, Baig AA, Huang ES, et al. J Gen Intern Med 2017 Apr;32(4):423-29. Epub 2016 Nov 15. Access the abstract on PubMed®.

Discrepancies in communication versus documentation of weight-management benchmarks: analysis of recorded visits with Latino children and associated health-record documentation. Turer CB, Barlow SE, Montano S, et al. Glob Pediatr Health. 2017 Feb 6;4:2333794x16685190. eCollection 2017. Access the abstract on PubMed®.

Effect of preoperative opioid exposure on healthcare utilization and expenditures following elective abdominal surgery. Waljee JF, Cron DC, Steiger RM, et al. Ann Surg 2017 Apr;265(4):715-21. Access the abstract on PubMed®.

Longer periods of hospice service associated with lower end-of-life spending in regions with high expenditures. Wang S, Hsu SH, Huang S, et al. Health Aff 2017 Feb 1;36(2):328-36. Access the abstract on PubMed®.

Impacts of geographic distance on peritoneal dialysis utilization: refining models of treatment selection. Wang V, Maciejewski ML, Coffman CJ, et al. Health Serv Res 2017 Feb;52(1):35-55. Epub 2016 Apr 7. Access the abstract on PubMed®.

Serum creatinine trajectories for community- versus hospital-acquired acute kidney injury. Warnock DG, Powell TC, Siew ED, et al. Nephron 2016;134(3):177-82. Epub 2016 Jul 26. Access the abstract on PubMed®.

Patient-health care professional gender or race/ethnicity concordance and its association with weight-related advice in the United States. Yang HY, Chen HJ, Marsteller JA, et al. Patient Educ Couns 2016 Feb;99(2):271-8. Epub 2015 Aug 29. Access the abstract on PubMed®.