AHRQ-Funded Researchers Recommend Interventions To Help Avoid Pneumonia in Bypass Surgery Patients

AHRQ Stats

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Today's Headlines:

• AHRQ-Funded Researchers Recommend Interventions To Help Avoid Pneumonia in Bypass Surgery Patients.
• AHRQ Grantee Profile Highlights Work of Urmimala Sarkar, M.D., M.P.H., To Advance Health Equity Through Innovation.
• Highlights From AHRQ’s Patient Safety Network.
• Webinar on New Edition of Registries Guide.
• Issue Brief Finds Mixed Evidence on Checklists To Reduce Diagnostic Errors.
• New Research and Evidence From AHRQ.
• AHRQ in the Professional Literature.

AHRQ-Funded Researchers Recommend Interventions To Help Avoid Pneumonia in Bypass Surgery Patients

A bundle of precautions can limit inpatient pneumonia in patients undergoing coronary artery bypass graft, or CABG, an AHRQ-funded study has found. The precautions—including preoperative nasal and oral prophylaxis against infection, early extubation, encouraging patients to walk as soon as possible after surgery and avoiding postoperative bronchodilator therapy—were detailed in a study published in Annals of Thoracic Surgery. Researchers developed a set of recommendations for patients undergoing CABG, then encouraged implementation of the recommendations in 18 centers in Michigan—some of which had pneumonia frequencies as high as 6.8 percent before the precautions were tried. Among nearly 2,500 CABG patients for whom the recommendations were offered in 2016 and 2017, 98.4 percent had at least one recommendation implemented. Pneumonia occurred in 2.4 percent of all study patients. Access the abstract.

AHRQ Grantee Profile Highlights Work of Urmimala Sarkar, M.D., M.P.H., To Advance Health Equity Through Innovation

AHRQ’s latest grantee profile features Urmimala Sarkar, M.D., M.P.H., a professor in the Division of General Internal Medicine at the University of California, San Francisco. Dr. Sarkar is using innovative health information technology to improve patient safety and care delivery for diverse patients. Learn more about Dr. Sarkar’s work and access additional AHRQ grantee profiles.

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 patient handoffs and transitions through adaptation and implementation of I-PASS across multiple handoff settings.
• Hospital- and system-wide interventions for health care-associated infections: a systematic review.
• Prevalence and characterisation of diagnostic error among 7-day all-cause hospital medicine readmissions: a retrospective cohort study.

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).

Webinar on New Edition of Registries Guide

A webinar on Sept. 29 from 2:30 to 3:30 p.m. ET will introduce AHRQ’s Registries for Evaluating Patient Outcomes: A User’s Guide Fourth Edition. The online resource, also available as an e-book, provides best practices to guide registry design, operation, analysis and evaluation. Registries collect patient data to study various aspects of a disease, such as treatment patterns and variations in care. Registries may also assess treatment effectiveness, monitor safety and measure quality. The fourth edition of the user’s guide includes updates on registry planning, design, operations and analysis. It also provides guidance for addressing technical and cultural shifts in the clinical research environment since the first edition, including widespread use of electronic health record systems and the emergence of patient-centered outcomes research.

Issue Brief Finds Mixed Evidence on Checklists To Reduce Diagnostic Errors

A new AHRQ-funded issue brief on diagnostic safety reviews the status of evidence on the value of checklists to reduce diagnostic errors. Checklists are considered a promising intervention because they can support clinicians in their diagnostic decision-making by helping them take correct diagnostic steps and ensuring that possible diagnoses are not overlooked. However, research on the use of checklists in diagnostic safety is still in its infancy, and thus far evidence of effectiveness is mixed, so the authors concluded that checklists to improve diagnostic reasoning are not yet ready for use in clinical practice. Previous AHRQ-funded issue briefs explored telediagnosis for acute care and operational measurement of diagnostic safety.

New Research and Evidence From AHRQ

• Systematic Review: Therapies for Clinically Localized Prostate Cancer.
• Methods Report: Developing Consistent and Useful Quality Improvement Study Data Extraction for Health Systems.

AHRQ in the Professional Literature

Effectiveness of copper-impregnated solid surfaces on lowering microbial bio-burden levels in an acute care hospital. Chatterjee P, Williams MD, Coppin JD, et al. Open Forum Infect Dis 2020 Aug;7(8). Epub 2020 Jun 19. Access the abstract on PubMed®.

Validation of histoplasmosis enzyme immunoassay to evaluate suspicious lung nodules. Shipe ME, Deppen SA, Sullivan S, et al. Ann Thorac Surg 2020 Jul 16. [Epub ahead of print.] Access the abstract on PubMed®.

Development of a rubric for assessing delayed diagnosis of appendicitis, diabetic ketoacidosis and sepsis. Michelson KA, Williams DN, Dart AH, et al. Diagnosis 2020 Jun 25. [Epub ahead of print.] Access the abstract on PubMed®.

Does a reduction in readmissions result in net savings for most hospitals? An examination of Medicare's Hospital Readmissions Reduction Program. Yakusheva O, Hoffman GJ. Med Care Res Rev 2020 Aug;77(4):334-44. Epub 2018 Aug 24. Access the abstract on PubMed®.

Implementing a social determinants screening and referral infrastructure during routine emergency department visits, Utah, 2017-2018. Wallace AS, Luther B, Guo JW, et al. Prev Chronic Dis 2020 Jun 18;17:E45. Access the abstract on PubMed®.

Mechanisms of decision-making in preoperative assessment for older adult prostate cancer patients-a qualitative study. Kierkegaard P, Vale MD, Garrison S, et al. J Surg Oncol 2020 Mar;121(3):561-9. Epub 2019 Dec 23. Access the abstract on PubMed®.

Racial and ethnic differences in emergency department pain management of children with fractures. Goyal MK, Johnson TJ, Chamberlain JM, et al. Pediatrics 2020 May;145(5):e20193370. Epub 2020 Apr 20. Access the abstract on PubMed®.

The use of psychiatric econsults in primary care. Golberstein E, Joseph JM, Druss BG, et al. J Gen Intern Med 2020 Feb;35(2):616-7. Epub 2019 May 14. Access the abstract on PubMed®.