Hospital Claims Data May Be Inadequate To Track Infection Rates, Study Says

AHRQ Stats: Variations in Opioid Use According to Health Status

While fewer than 9 percent of elderly Americans in excellent health filled any outpatient opioid prescriptions in 2015-2016, nearly 40 percent of those in poor health did. (Source: AHRQ, Medical Expenditure Panel Survey Statistical Brief #515: Any Use and Frequent Use of Opioids among Elderly Adults in 2015-2016, by Socioeconomic Characteristics.)

Today's Headlines:

• Hospital Claims Data May Be Inadequate To Track Infection Rates, Study Says.
• AHRQ-Supported Commentary in JAMA Describes ‘4 Moments of Antibiotic Decision Making’.
• Highlights From AHRQ’s Patient Safety Network.
• New AHRQ 'Data Spotlight' Focuses on Uncontrolled Diabetes Admissions for American Indians, Alaska Natives.
• Searchable Database Provides Access to AHRQ-Funded Articles Published Since 2014.
• AHRQ in the Professional Literature.

Hospital Claims Data May Be Inadequate To Track Infection Rates, Study Says

A new analysis finds that hospital claims data may be inadequate in tracking surgical site infections compared with the Centers for Disease Control and Prevention's National Healthcare Safety Network (NHSN) database, underscoring its importance for evaluating hospital quality. In the study, published in Infection Control & Hospital Epidemiology, researchers compared NHSN data to claims data for infections following colon surgery. They found wide discrepancies between the two data sources, especially among hospitals in the South and those that care for relatively more Medicaid patients. Researchers concluded that a single, agreed-upon national set of definitions and data is of greater importance for public reporting and value-based payment programs. Access the abstract. 

AHRQ-Supported Commentary in JAMA Describes ‘4 Moments of Antibiotic Decision Making’

A commentary supported by AHRQ in JAMA describes the “4 Moments of Antibiotic Decision Making,” one of the core concepts of the AHRQ Safety Program for Improving Antibiotic Use. The "4 Moments," an easy-to-remember structured approach to apply in the acute-care setting or elsewhere, are: 

• Does this patient have an infection that requires antibiotics?
• Have I ordered appropriate cultures before starting antibiotics? What empiric therapy should I initiate? 
• A day or more has passed. Can I stop antibiotics? Can I narrow therapy? Can I change from intravenous to oral therapy?
• What duration of antibiotic therapy is needed for this patient’s diagnosis?

Access the article for more information about the "4 Moments." 

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:

• Racial, ethnic, and socioeconomic disparities in patient safety events for hospitalized children.
• Effects of a communication-and-resolution program on hospitals' malpractice claims and costs.
• Developing a reporting culture: learning from close calls and hazardous conditions.

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 'Data Spotlight' Focuses on Uncontrolled Diabetes Admissions for American Indians, Alaska Natives

The overall hospitalization rate among American Indians and Native Alaskans for uncontrolled diabetes declined about 84 percent between 2000 (58 per 100,000 people) and 2015 (9 per 100,000), according to a new Data Spotlight (PDF, 349 KB) from AHRQ. The analysis, drawn from the agency’s 2017 National Healthcare Quality and Disparities Report, showed the rate has declined for all age groups, including for those 65 and older. The data apply to patients served at Indian Health Service hospitals and others that operate under contract with tribes and tribal organizations (excluding those in the Portland, Oregon, and California regions). Paired with a new infographic, AHRQ’s Data Spotlight supports the agency’s ongoing effort to collect and disseminate statistics to help health systems leaders, researchers, public health advocates and other understand and tackle priority health care challenges.

Searchable Database Provides Access to AHRQ-Funded Articles Published Since 2014

Recently published articles on nurse-patient partnerships, compliance with infection control practices in home health care, and racial/ethnic differences in end-of-life cancer care are among more than 4,600 agency-supported articles now available in the AHRQ Research Studies database. The studies, searchable by keyword, showcase the breadth of the agency’s research endeavors and the diversity of academic journals that have published AHRQ-sponsored research findings. Each database entry includes a title, a brief summary of the research and a link to an abstract on the National Library of Medicine website. 

AHRQ in the Professional Literature

Evaluation of electronic medical records on nurses' time allocation during cesarean delivery. Tan M, Lipman S, Lee H, et al. J Patient Saf 2018 Feb 26. [Epub ahead of print.] Access the abstract on PubMed^®.

Cervical spine imaging and injuries in young children with non-motor vehicle crash-associated traumatic brain injury. Henry MK, French B, Feudtner C, et al. Pediatr Emerg Care 2018 Feb 15. [Epub ahead of print.] Access the abstract on PubMed^®.

Recruiting practices for change initiatives is hard: findings from EvidenceNOW. Sweeney SM, Hall JD, Ono SS, et al. Am J Med Qual 2018 May/Jun;33(3):246-52. Epub 2017 Sep 4. Access the abstract on PubMed^®.

A quantitative observational study of physician influence on hospital costs. Wong H, Karaca Z, Gibson TB. Inquiry 2018 Jan-Dec;55:46958018800906. Access the abstract on PubMed^®.

Quality assurance practices in obstetric care: a survey of hospitals in California. Lundsberg LS, Lee HC, Dueñas GV, et al. Obstet Gynecol 2018 Feb;131(2):214-23. Access the abstract on PubMed^®.

A method for the analysis and visualization of clinical workflow in dynamic environments. Vankipuram A, Traub S, Patel VL. J Biomed Inform 2018 Mar;79:20-31. Epub 2018 Feb 2. Access the abstract on PubMed^®.

Promoting safety mindfulness: recommendations for the design and use of simulation-based training in radiation therapy. Mazur LM, Marks LB, McLeod R, et al. Adv Radiat Oncol 2018 Feb 7;3(2):197-204. eCollection 2018 Apr-Jun. Access the abstract on PubMed^®.

Efficiency of emergency physicians: insights from an observational study using EHR log files. Kannampallil TG, Denton CA, Shapiro JS, et al. Appl Clin Inform 2018 Jan;9(1):99-104. Epub 2018 Feb 7. Access the abstract on PubMed^®.