More Than 80 Percent of Antibiotics Prescribed Before Dental Procedures Are Unnecessary, Analysis Concludes

AHRQ Stats: Hospitalization for Mental and Substance Use Disorders

Nearly 10 million hospital stays in 2016 involved a mental and substance use disorder (MSUD). Six percent of all U.S. hospitalizations involved a principal diagnosis of MSUD (2.2 million stays) while 22 percent had a secondary diagnosis (7.7 million stays). (Source: AHRQ, Healthcare Cost and Utilization Project Statistical Brief #249: Inpatient Stays Involving Mental and Substance Use Disorders, 2016.) 

Today's Headlines

• More Than 80 Percent of Antibiotics Prescribed Before Dental Procedures Are Unnecessary, Analysis Concludes.
• Highlights From AHRQ’s Patient Safety Network.
• Platforms Designed for Information Sharing Among Providers Improved Electronic Health Record Use.
• St. Louis Hospital Reduced C-Section Rate After Using TeamSTEPPS Training.
• AHRQ in the Professional Literature.

More Than 80 Percent of Antibiotics Prescribed Before Dental Procedures Are Unnecessary, Analysis Concludes

An AHRQ-funded study found that about 81 percent of nearly 169,000 antibiotic prescriptions given to patients before a dental procedure to prevent cardiac infections were considered unnecessary by current guidelines. Preventive antibiotics are recommended for dental patients with a number of serious conditions to prevent secondary infections, such as infective endocarditis. Researchers reviewed dental procedure records between 2011 and 2015 using a national health claims database to find patients who had been given antibiotics. Of those who had received a prescription, more than 80 percent did not have a qualifying, high-risk cardiac diagnosis and no risk of further infection, making those prescriptions unnecessary. The researchers noted that orthopedic implants, tooth implant procedures and procedures completed in the western United States were significantly associated with antibiotic overuse. The risk of overuse was also higher for female patients. Researchers recommended using antibiotic stewardship in dental offices to reduce misuse. Access the abstract of the article published in JAMA Network Open.

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:

• Estimating the attributable cost of physician burnout in the United States.
• Patients' conceptualizations of responsibility for healthcare: a typology for understanding differing attributions in the context of patient safety.
• Dangers of diagnostic overshadowing.

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).

Platforms Designed for Information Sharing Among Providers Improved Electronic Health Record Use

AHRQ-funded researchers have concluded that a “social knowledge network” can improve providers’ use of electronic health record medication reconciliation technology. Social knowledge networks are learning platforms that enable providers in diverse subgroups and care settings to exchange information about patient care. The network studied in this research consisted of email updates, a discussion forum, a reporting tool and learning sessions used across inpatient and outpatient settings. Researchers found the platform improved measures of meaningful use of electronic health record medication reconciliation technology and concluded that a social knowledge network helps identify strategies for creating learning health systems. Access an abstract of the article in the Journal of Healthcare Leadership.

St. Louis Hospital Reduced C-Section Rate After Using TeamSTEPPS Training

Staff at SSM Health St. Mary's Hospital in St. Louis used AHRQ’s TeamSTEPPS training to improve teamwork and communication, helping reduce the cesarean section rate for low-risk, first-time mothers to 12 percent. The hospital relies on huddles—one component of TeamSTEPPS—to help reduce communication errors and keep patients safe during labor and delivery. Access the Impact Case Study. 

AHRQ in the Professional Literature

Results of a Medicare bundled payments for care improvement initiative for chronic obstructive pulmonary disease readmissions. Bhatt SP, Wells JM, Iyer AS, et al. Ann Am Thorac Soc 2017 May;14(5):643-8. Access the abstract on PubMed®.

Evaluation of a pilot implementation to integrate alcohol-related care within primary care. Bobb JF, Lee AK, Lapham GT, et al. Int J Environ Res Public Health 2017 Sep 8;14(9). Access the abstract on PubMed®.

A user-centered glucose-insulin data display for the inpatient setting. Bowen ME, Rumana U, Killgore EA, et al. Stud Health Technol Inform 2017;245:684-8. Access the abstract on PubMed®.

Health care quality measures for children and adolescents in foster care: feasibility testing in electronic records. Deans KJ, Minneci PC, Nacion KM, et al. BMC Pediatr 2018 Feb 22;18(1):79. Access the abstract on PubMed®.

Perspectives and uses of the electronic health record among US pediatricians: a national survey. Doberne JW, Redd T, Lattin D, et al. J Ambul Care Manage 2017 Jan/Mar;40(1):59-68. Access the abstract on PubMed®.

Road to the future: priorities for child health services research. Fairbrother G, Dougherty D, Pradhananga R, et al. Acad Pediatr 2017 Nov - Dec;17(8):814-24. Epub 2017 Apr 28. Access the abstract on PubMed®.

Qualitative experience of sleep in individuals with spinal cord injury. Fogelberg DJ, Leland NE, Blanchard J, et al. OTJR (Thorofare N J) 2017 Apr;37(2):89-97. Epub 2017 Feb 14. Access the abstract on PubMed®.

An analysis of diagnoses that drive readmission: what can we learn from the hospitals in Southern New England with the highest and lowest readmission performance? Goldberg EM, Morphis B, Youssef R, et al. R I Med J (2013). 2017 Aug 1;100(8):23-8. Access the abstract on PubMed®.