Safety First

AHRQ: Telehealth can improve safety and quality

Telehealth can improve patient safety and quality of care, but implementation is not easy, concludes a new report by the Agency for Health Care Research and Quality. The findings are based on grant recipients serving primarily low-income rural areas with high rates of chronic illness in Arkansas, California, Minnesota, Montana, New Mexico, New York, Oklahoma, Pennsylvania, Tennessee and Texas.

Several participating providers claimed that integrating telehealth with their electronic health record systems offered many “critical benefits” and helps facilitate the provision of team-based care. However, certain providers experienced technical challenges with telehealth equipment. For example, one provider said several patients became frustrated and stopped using a home monitoring device because it failed to work on a regular basis. In addition, AHRQ called for reimbursement guidelines to help spur widespread acceptance of telehealth as a cost category for reimbursement.

Leah Binder, CEO of the Leapfrog Group, speaks with David Harlow about hospital-acquired infections

In an interview earlier this week with David Harlow of HealthBlawg, Leah Binder previewed some of the concerns likely to be aired at next week's Chasing Zero Summit in DC.

AHRQ releases information about common definitions and reporting formats for PSOs

The Patient Safety Act of 2005 outlines a means of collecting patient safety data for analysis from all types of healthcare organizations. The Agency for Healthcare Research and Quality (AHRQ) released in the August 29 Federal Register information about common formats of the data. The information sets out how healthcare organizations should submit data related to patient safety events. These include:

• Incidents—patient safety events that reached the patient, whether or not there was harm
• Near misses or close calls—patient safety events that did not reach the patient
• Unsafe conditions

The AHRQ worked with the Federal Patient Safety Work Group to develop the common formats. The common formats can be found on the Privacy Protection Center Web site.

To read more about this announcement, click here.

[ via Patient Safety Monitor ]

AHRQ seeks proposals for research to speed health care improvement

The Agency for Healthcare Research and Quality seeks ideas on priority topics and activities to address in a new innovations research portfolio to speed improvements in the organization, delivery and management of health care. For more information, see the agency’s request for information.

World Health Organization Issues Checklist for Making Surgery Safer

The World Health Organization (WHO) recently issued guidelines aimed at reducing complications and deaths from the rising numbers of operations now being performed. Several studies have shown that in industrial countries major complications occur in 3 percent to 16 percent of inpatient surgical procedures, and permanent disability or death rates are about 0.4 percent to 0.8 percent.

The guidelines are a list of simple safety checks that WHO says could reduce the rate of surgical complications by 50 percent. The list offers simple checks to improve anesthetic safety practices, avoid infections and improve communication among members of surgical teams.

AHRQ Director Carolyn Clancy, M.D., spoke at a WHO meeting on June 25 to discuss the history of the National Surgical Quality Improvement Program (NSQIP)—the first national, validated, outcome-based, risk-adjusted, and peer-controlled program for the measurement and enhancement of the quality of surgical care. In her speech, Dr. Clancy explained that NSQIP served as the basis for Surgical Care Improvement Project (SCIP), an initiative of Federal government agencies, hospitals, physicians, nurses, and private groups dedicated to improving the safety of surgical care by reducing postoperative complications.

SCIP has set a goal of reducing surgical complications nationwide by 25 percent by 2010. Read WHO’s press release and view the checklist.

NIOSH brochure offers tips for reducing occupational stress in hospitals

A new brochure from the National Institute for Occupational Safety and Health examines potential causes and health effects of occupational stress in hospitals, and suggests work practices that can help reduce it. A combination of organizational change and stress management “is often the most successful approach for reducing stress at work,” the authors note.

[ via AHA News Now ]

FDA to regulate look-alike/sound-alike drugs

The Food and Drug Administration (FDA), under a congressional mandate, is working on a pilot project to better sort out the way in which drug names are approved, reports The Times, a New Jersey newspaper. The FDA has taken this step to cut down on the number of medical errors directly relating from medications that look and sound alike. Currently the FDA rejects between 35% and 40% of medication names that are initially proposed. However, the current system is not catching the 1,500 medication names that have been implicated in look-alike/sound-alike errors, the article says.

A 2006 Institute of Medicine report attributed 25% of the 1.5 million medical errors that were related to drugs as having to do with similar-sounding or looking names. The new process in development by the FDA forces drug companies proposing new drug names to have done adequate research to prove that there is not already a drug on the market that could be confused with the proposed medication.

To read the article, click, here.

[ via Patient Safety Monitor ]

What We Talk about When We Talk about Quality

A new toolkit, distributed free of charge by the National Business Group on Health, promotes clear communication on what constitutes quality health care. Incorporating accessible language, photos, and design features vetted by rigorous communication research, the toolkit will help employers and employees make better sense of the concept of evidence-based medical care.

For the full story, click here.

Study: P4P has little effect on quality

A new study finds that pay-for-performance has little effect on improving health care quality, according to www.amednews.com.

The most recent study, published in the July/August Health Affairs, compared 81 Massachusetts physician groups eligible for quality incentives with 73 that were not.

The 5,350 physicians analyzed were statistically indistinguishable. Everyone's quality improved, whether or not they stood to earn a bonus, which varied from $200 to $2,500 per quality measure.

For more information, click here.

AHRQ estimates surgical errors cost $1.5 billion annually

A new study by the Agency for Healthcare Research and Quality published in the July 28 Health Services Research estimates that preventable errors that occur during surgery cost employers $1.5 billion annually. "Eliminating medical errors and their after effects must continue to be top priority for our health care system," said AHRQ director Caroline Clancy.

The study estimates that insurance companies spend an additional $28,281 for patients who experienced acute respirator failure and an additional $19,480 for patients who contract a post-operative infection. It also estimates that one in 10 patients who died within 90 days of their surgery died from a preventable error.

To read more results, click here.

[ via Patient Safety Monitor ]