Medical Wards Adapted Quickly to COVID-19 Pandemic, With Possible Negative Effects

Editor’s Note: This week’s AHRQ News Now is publishing a day early because of Tuesday’s election.

AHRQ Stats: Average Deductibles for Healthcare Coverage

Average individual healthcare deductibles in 2019 were higher in small ($2,386) and medium-sized businesses ($2,441) compared with large businesses ($1,778). (Source: AHRQ, Medical Expenditure Panel Survey Statistical Brief #530, Trends in Health Insurance at Private Employers, 2008-2019.)

Today's Headlines:

• Medical Wards Adapted Quickly to COVID-19 Pandemic, With Possible Negative Effects.
• AHRQ Views Blog Post—Diagnostic Safety in the COVID Era: Let’s Not Squander the Opportunity.
• Highlights From AHRQ’s Patient Safety Network.
• Nearly All Mass Shootings in 2019 Occurred Within a Mile of a Location Frequented by Children.
• AHRQ in the Professional Literature.

Medical Wards Adapted Quickly to COVID-19 Pandemic, With Possible Negative Effects

Many hospitals forced to quickly adapt to the COVID-19 pandemic employed technology in new ways and established respiratory isolation units, an AHRQ study found. Researchers surveyed major U.S. academic medical centers in April and found that nearly all sites implemented isolation units that primarily utilized attending physicians. Half of sites with personal protective equipment data available reported equipment stockpiles of two weeks or less. The vast majority of sites reported less frequent in-room encounters between clinicians and patients. Isolation and room-entry policies focused on providing several care activities at once and using video visits and other technologies to evaluate patients. Some reports of unrecognized or delayed diagnoses indicated adaptations may have led to adverse effects on care. Access the abstract of the study published in the Journal of Hospital Medicine.

AHRQ Views Blog Post—Diagnostic Safety in the COVID Era: Let’s Not Squander the Opportunity

The urgent challenge of improving diagnostic safety in the era of COVID-19 is the subject of a new AHRQ Views blog post by agency Director Gopal Khanna, M.B.A., and Jeffrey Brady, director of AHRQ’s Center for Quality Improvement and Patient Safety. It is estimated that 12 million people per year are affected by diagnostic errors, with approximately four million suffering serious harm. AHRQ regards diagnostic safety as an important new frontier in patient safety research. The agency’s collaboration with the Society to Improve Diagnosis in Medicine underscores AHRQ’s commitment, and a recent publication by AHRQ grantees provides an important framework for considering COVID-19-related diagnostic errors. Access the blog post. To receive all blog posts, submit your email address and select “AHRQ Views Blog.”

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 Diagnostic Quality and Safety/Reducing Diagnostic Error: Measurement Considerations. Final Report.
• Interventions and measurements of highly reliable/resilient organization implementations: a literature review.
• Long-term effects of teamwork training on communication and teamwork climate in ambulatory reproductive health care.

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).

Nearly All Mass Shootings in 2019 Occurred Within a Mile of a Location Frequented by Children

More than 90 percent of mass shootings documented in 2019 occurred within a mile of a school or other location where children gather, according to an AHRQ-funded study published in JAMA Pediatrics. Researchers analyzed 418 mass shootings recorded by the Gun Violence Archive Calendar in 2019 and used Google Maps to measure distances from the locations to the nearest school and points of interest frequented by children. They found that one in five mass shootings occurred within 0.1 miles of a school or point of interest, and 9.6 percent occurred directly at a school or other setting where children gather. Shootings that do not directly expose children to physical harm still place them within proximity of danger and put them at risk of psychological harm caused by indirect exposure to gun violence, the authors concluded. Access the abstract.

AHRQ in the Professional Literature

Evaluating the cost-effectiveness of the ABCDE bundle: impact of bundle adherence on inpatient and 1-year mortality and costs of care. Collinsworth AW, Priest EL, Masica AL. Crit Care Med 2020 Sep 30. [Epub ahead of print.] Access the abstract on PubMed®.

HIV risk, risk perception, and PrEP interest among adolescent girls and young women in Lilongwe, Malawi: operationalizing the PrEP cascade. Hill LM, Maseko B, Chagomerana M, et al. J Int AIDS Soc 2020 Jun;23 Suppl 3(Suppl 3):e25502. Access the abstract on PubMed®.

Dose, timing, and type of infant antibiotic use and the risk of childhood asthma. Donovan BM, Abreo A, Ding T, et al. Clin Infect Dis 2020 Apr 10;70(8):1658-65. Access the abstract on PubMed®.

Effectiveness of patient navigation to increase cancer screening in populations adversely affected by health disparities: a meta-analysis. Nelson HD, Cantor A, Wagner J, et al. J Gen Intern Med 2020 Oct;35(10):3026-35. Epub 2020 Jul 22. Access the abstract on PubMed®.

Hospital ward adaptation during the COVID-19 pandemic: a national survey of academic medical centers. Auerbach A, O'leary KJ, Greysen SR, et al. J Hosp Med 2020 Aug;15(8):483-8. Access the abstract on PubMed®.

Evaluating travel distance to radiation facilities among rural and urban breast cancer patients in the Medicare population. Longacre CF, Neprash HT, Shippee ND, et al. J Rural Health 2020 Jun;36(3):334-46. Epub 2019 Dec 17. Access the abstract on PubMed®.

Association between implementing comprehensive learning collaborative strategies in a statewide collaborative and changes in hospital safety culture. Yuce TK, Yang AD, Johnson JK, et al. JAMA Surg 2020 Oct;155(10):934-40. Access the abstract on PubMed®.

Adverse events present on arrival to the emergency department: the ED as a dual safety net. Griffey RT, Schneider RM, Todorov AA. Jt Comm J Qual Patient Saf 2020 Apr;46(4):192-8. Epub 2020 Jan 18. Access the abstract on PubMed®.