AHRQ’s National Advisory Council Identifies Priority Areas for Quality Improvement

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Editor’s note: The next issue of AHRQ News Now will publish Jan. 10, 2023. Happy holidays!

Today's Headlines:

• AHRQ’s National Advisory Council Identifies Priority Areas for Quality Improvement.
• Medication-Assisted Treatment for Opioid Use Disorder Can Reduce Costs.
• Research Identifies Challenges of Integrating a Mobile Health App Into Electronic Health Record-Enabled Clinical Workflows.
• New AHRQ Resource Answers Clinicians’ Questions About Medications for Alcohol Use Disorder.
• Register for Jan. 11 Webcast on AHRQ’s Consumer Assessment of Healthcare Providers and Systems Surveys.
• Highlights From AHRQ’s Patient Safety Network.
• Register for Jan. 24 Webcast on AHRQ’s New Surveys On Patient Safety Culture™ Workplace Safety Supplemental Item Set for Nursing Homes.
• Interactive Tool Provides New Data on Hospital Trends for COVID-19 and Other Conditions.

AHRQ’s National Advisory Council Identifies Priority Areas for Quality Improvement

In a new series of blog posts, members of AHRQ’s National Advisory Council identified challenges and potential strategies to improve healthcare quality in four priority areas: nursing home/rehabilitation care, behavioral healthcare, home healthcare and hospice care. The Council, comprising private- and public-sector experts, provides advice to the agency director on AHRQ activities and priorities. In an introductory blog, agency Director Robert Otto Valdez, Ph.D., M.H.S.A., emphasized the urgent need for revisiting quality improvement efforts in light of the nation’s rapidly aging and diversifying population. Each of the Council-authored blogs, Dr. Valdez noted, aimed to reflect recent Council discussions about the shifting horizons of American healthcare. Access the blog posts:

• Measuring What Matters: Catalyzing Conversations on the Quality of Long-Term Care.
• Addressing Today's Steep Challenges of Providing High-Quality Behavioral Healthcare.
• Challenges and Opportunities in Home Health Quality Improvement.
• For Hospice Care, a Pressing Need to Ensure Quality for Patients and Families.

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Medication-Assisted Treatment for Opioid Use Disorder Can Reduce Costs

The use of medication as part of a broader program to treat opioid use disorder is effective for lowering Medicaid spending, according to an AHRQ-funded study in Preventive Medicine. Researchers reviewed records of adult patients treated at a safety-net institution in Denver and found that patients with opioid use disorder who initiated medication treatment but were not linked to ongoing care had the highest healthcare costs, while those who received medication treatment for opioid use disorder and were linked to ongoing treatment had the lowest costs. Access the study abstract as well as AHRQ-funded resources for preventing and treating opioid use disorder. They include the Medication-Assisted Treatment for Opioid Use Disorder Playbook, a guide for implementing medication-assisted treatment in primary care and other ambulatory care settings.

Research Identifies Challenges of Integrating a Mobile Health App Into Electronic Health Record-Enabled Clinical Workflows

New research by leaders of AHRQ’s Digital Healthcare Research Division and other experts explores the potential for integrating a patient-centered mobile health app with a health system’s electronic health record (EHR) system. Their article in Applied Clinical Informatics describes challenges of integrating the COVID-19 Tracker, which engages patients by sending text messages, collecting symptom data and providing guidance, with the Epic EHR system at Yale New Haven Health System. Researchers explored the use of HL7’s Fast Healthcare Interoperability Resources (FHIR) Application Program Interface to integrate the app into EHR-enabled clinical workflows. They encountered challenges due in part to the early stages of FHIR development and adoption. Nevertheless, they concluded that FHIR is a promising mechanism for developing publicly available clinical decision support to overcome longstanding barriers and facilitate integration of patient engagement apps with EHRs. Access the abstract.

New AHRQ Resource Answers Clinicians’ Questions About Medications for Alcohol Use Disorder

A new publication from AHRQ provides primary care clinicians with answers to common questions about medications available to address alcohol use disorder (AUD). Evidence has shown that Food and Drug Administration-approved medications are effective treatments for people with AUD, yet medications are prescribed to less than 4 percent of these patients. Primary care settings are frequently entry points for patients seeking help with AUD, and equipping clinicians with information on medications to manage AUD can improve patient well-being. Access the new resource—Overview of Medications Used in the Treatment of Alcohol Use Disorder and Frequently Asked Questions (PDF, 712 KB)—as well as a searchable database on tools to manage unhealthy alcohol use from AHRQ’s Academy for Integrating Behavioral Health & Primary Care.

Register for Jan. 11 Webcast on AHRQ’s Consumer Assessment of Healthcare Providers and Systems Surveys

Registration is open for “Understanding Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Surveys: A Primer for New Users,” an AHRQ webcast Jan. 11 from 1 to 2 p.m. ET. Speakers will provide an overview of CAHPS surveys, highlight their focus on patients’ priorities, describe how they build on current research in survey development and administration, and discuss how healthcare organizations use survey results to improve patient experience.

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:

• Cohort study of diagnostic delay in the clinical pathway of patients with chronic wounds in the primary care setting.
• Reducing potential errors associated with insulin administration: an integrative review.
• Examination of maternal near-miss experiences in the hospital setting among Black women in the United States.
• Factors that affect opioid quality improvement initiatives in primary care: insights from ten health systems.

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).

Register for Jan. 24 Webcast on AHRQ’s New Surveys On Patient Safety Culture^™ Workplace Safety Supplemental Item Set for Nursing Homes

Registration is open for a webcast on Jan. 24 at 1 p.m. ET on AHRQ’s new Surveys on Patient Safety Culture^™ (SOPS®) Workplace Safety Supplemental Item Set for Nursing Homes. The new item set assesses staff perceptions of workplace safety, including workplace hazards, inappropriate resident behavior toward staff and work stress/burnout. Speakers will provide background on the importance of workplace safety in nursing homes, an overview of the supplemental item set and results from a pilot test in 48 nursing homes, and will highlight one healthcare organization’s experience. 

Interactive Tool Provides New Data on Hospital Trends for COVID-19 and Other Conditions

AHRQ has updated the HCUP Visualization tool on hospitalizations, an interactive visualization displaying state-specific monthly trends in inpatient stays for related multiple health conditions including COVID-19. This visualization, part of the Healthcare Cost and Utilization Project (HCUP), now includes full-year 2021 data from 32 states plus the District of Columbia and additional data from 15 states through the first quarter of 2022. The tool makes it simple for nonresearchers to make comparisons across states and by patient characteristics and states. The underlying data tables and methods have also been updated and are available on the HCUP Summary Trend Tables page.

AHRQ in the Professional Literature

Temporal trends in postoperative and ventilator-associated pneumonia in the United States. Metersky ML, Wang Y, Klompas M, et al. Infect Control Hosp Epidemiol Epub 2022 Nov 3. Access the abstract on PubMed®.

Shared decision-making for drug-drug interactions: formative evaluation of an anticoagulant drug interaction. Gomez Lumbreras A, Reese TJ, Del Fiol G, et al. JMIR Form Res 2022 Oct 19;6(10):e40018. Access the abstract on PubMed®.

Clinical decision support improves blood culture collection before intravenous antibiotic administration in the emergency department. Dutta S, McEvoy DS, Rubins DM, et al. J Am Med Inform Assoc 2022 Sep 12;29(10):1705-14. Access the abstract on PubMed®.

Utility of automated data-adaptive propensity score method for confounding by indication in comparative effectiveness study in real world Medicare and registry data. Kumamaru H, Jalbert JJ, Nguyen LL, et al. PLoS One 2022 Aug 15;17(8):e0272975. Access the abstract on PubMed®.

Financial contributions and experiences of non-spousal, employed family caregivers. Keita Fakeye MB, Samuel LJ, Wolff JL. J Appl Gerontol 2022 Dec;41(12):2459-68. Epub 2022 Jul 15. Access the abstract on PubMed®.

Association of parent preventive care with their child's recommended well-child visits. Angier H, Kaufmann J, Heintzman J, et al. Acad Pediatr 2022 Nov-Dec;22(8):1422-8. Epub 2022 Apr 1. Access the abstract on PubMed®.

Quality of antibiotic prescribing in a large direct-to-patient telehealth program: an observational study. Cuellar A, Pomeroy JML, Burla S, et al. J Gen Intern Med 2022 Sep;37(12):3202-4. Epub 2022 Jan 19. Access the abstract on PubMed®.

A pragmatic method for measuring inpatient complications and complication-specific mortality. Blike GT, Perreard IM, McGovern KM, et al. J Patient Saf 2022 Oct 1;18(7):659-66. Epub 2022 Feb 8. Access the abstract on PubMed®.