Research Activities, March 2012, No. 379

Contents

• About Research Activities

Feature Story

• Hospital emergency departments get tips from AHRQ on how to reduce crowding and better triage patients

From the Director

Patient Safety and Quality

• Learning networks can help implement strategies to improve emergency department patient flow
• Trauma patients with hospital-acquired infections have poor outcomes, including increased mortality risk
• Hawaii's experience shows that a national collaborative effort can reduce central line-associated bloodstream infections
• Crisis checklists for the operating room can improve safety and management
• Evaluation of TeamSTEPPS® implementation finds improved teamwork and clinical outcomes
• Guideline management of inpatient cellulitis and cutaneous abscess reduces antibiotic use

Emergency Care

• EMS transport is underused by patients with a certain type of heart attack
• Study characterizes patients receiving out-of-hospital endotracheal intubation

Health Care Costs and Financing

• 24-hour intensivist care in ICUs can lead to cost savings for the sickest patients admitted at night
• Costs of congenital heart operations vary among hospitals
• Pneumococcal disease continues to lead to substantial health care use and costs
• Study provides rare look at patterns of use and spending for physical therapy

Chronic Disease

• Patients with hepatitis C virus infection who adhere to their drug regimen are more likely to show long-term benefit
• Older patients with chronic conditions have greater risk of problems and death following bilateral knee replacement
• Nine percent of adults with hypertension have resistant hypertension
• Routinely collecting clinical data can improve pneumococcal vaccination of rheumatology patients on immunosuppressant drugs

Health Information Technology

• ICU nurses show increasing acceptance of electronic health records
• Pharmacists have limited awareness of the capabilities of their pharmacy information systems
• Study uncovers the time spent on writing and viewing hospital electronic health records
• Electronic health records in community health centers provide a better picture of care than insurance claims data

Comparative Effectiveness Research

• Bone marrow transplant is beneficial for some rare pediatric conditions
• Little evidence for benefit of interventions in the early stage of chronic kidney disease
• Evidence lacking to support surgery for pelvic pain
• More research needed to evaluate self-measured blood pressure monitoring
• Evidence lacking on how to match wheelchairs with patients
• Some diabetes practice guidelines do not reflect all available evidence

Disparities/Minority Health

• Watching patient stories on DVDs improves blood pressure control among blacks
• Study identifies attributes of surgeons more willing to provide charity care

Primary Care

• Growth in the physician assistant workforce will be insufficient to meet future needs of primary care

Child/Adolescent Health

• Despite recommendations against it, early discharge of late-preterm newborns remains common
• Pediatric nurses express differing perspectives on palliative care

Mental Health

• Diagnosis and treatment rates for depression in older adults have grown over time, with medication edging out therapy
• More patients are being prescribed antidepressants by non-psychiatrists and without a psychiatric diagnosis
• Adherence to bipolar medications may also promote adherence to antiretroviral therapy

Elderly/Long-Term Care

• Preventing pressure ulcers in the home requires creative solutions by nurses
• Medicaid nursing home reimbursement affects nursing homes' approach to end-of-life care

Health Literacy

• Health literacy issues less of a problem for patients with dental versus medical conditions

Agency News and Notes

• Hospital stays involving C. difficile infections leveled off after 300 percent increase since 1993
• AHRQ publishes cancer hospitalization statistics
• AHRQ releases pharmacy health literacy modules for faculty

Announcements

• New public reporting funding opportunity
• Opportunities to improve primary care services for adults with complex needs highlighted in new white paper and brief

Research Briefs