   |
|
|
|
AHRQ
Launches Quality Measures Clearinghouse For Quality Initiative
DC
Health System Launches Test Of Online Prescription Project One
In Four Affected By Medication Errors Outpatient
Rx Drug-Related Injuries Are Common In Older Patients CDC:
Southerners, African Americans More Likely To Die From Stroke Commonwealth
Fund Announces Patient Communication, Quality Initiative Many
Concerned About Capacity To Handle Chronic Conditions New
Institute To Examine Quality Of U.S. Medical Education AHA
Toolkit Helps Hospitals Practice Evidence-Based Medicine USP
Guide Helps Consumers Manage Benefits And Risks Of Medicines Study:
Children’s Medical Errors More Common In Complex Cases AHRQ
Launches Quality Measures Clearinghouse For Quality Initiative The Agency
for Healthcare Research and Quality has launched a Web-based National Quality
Measures Clearinghouse. The new site serves as a one-stop shop for physicians,
hospitals, health plans and others interested in quality measures. It features
evidence-based quality measures and measure sets available to evaluate and improve
the quality of health care. According to
Nancy Foster, American Hospital Association senior associate director for health
policy, the clearinghouse should be extremely helpful as hospitals work to identify
scientifically valid quality measures as part of the National Hospital Quality
Information Initiative. Under the voluntary initiative announced in December,
AHA is collaborating with accrediting organizations, government agencies, Quality
Improvement Organizataions, and consumer groups to collect and share with consumers
standardized quality measures of patient care in hospitals. The initiative
will start with 10 common measures approved by the Centers for Medicare and Medicaid
Services, Joint Commission on Accreditation of Healthcare Organizations, and National
Quality Forum. For more info,
www.qualitymeasures.ahrq.gov. DC
Health System Launches Test Of Online Prescription Project A comprehensive
e-prescribing pilot project, launched recently in the Washington, D.C./Baltimore
area, is designed to eliminate medication errors caused by illegible handwriting
and other preventable prescribing complications. The Council
for Affordable Quality Healthcare (CAQH), a nonprofit alliance of health plans
and networks; DrFirst, a provider of IT solutions for physicians and hospitals;
and MedStar Health, the region’s largest health system, announced a system to
improve patient safety and reduce stumbling blocks that have historically hindered
physician adoption of e-prescribing programs. During the
year-long pilot, 200 physicians will use the system to write an estimated 1 million
prescriptions, MedStar said. Physicians recruited for the project include affiliates
of MedStar Health and existing users of DrFirst’s e-prescribing technology. All
area pharmacies will accept prescriptions written using the system, and several
have reportedly agreed to assist with analyzing the impact of the pilot on reducing
pharmacists’ workloads, MedStar said. In addition
to eliminating errors due to illegible handwriting, the system enables physicians
to screen for drug-drug and drug-allergy interactions at the point of care. If
a physician prescribes a medication that would interact adversely with another
medication that a patient is taking, or an allergy that the person has, the system
flags the potential problem immediately. The system’s security functions also
ensure patient privacy, MedStar said. The system
provides physicians with instant access to their patients’ prescription drug coverage
information through CAQH’s Formulary DataSource, an electronic database that includes
formulary data for most of the area’s major health plans. Participating
physicians can use the system to submit prescriptions directly to area pharmacies
from any computer, desktop or handheld that is connected to the Internet, or via
fax. Pharmacies will monitor the process to measure the system’s effectiveness
in reducing time spent filling prescriptions, preventing adverse drug and allergy
interactions, filling prescriptions accurately and complying with insurance formularies. "This
pilot program will demonstrate that e-prescribing is the future of healthcare,
driving safer, higher-quality and more cost-effective solutions in the healthcare
industry," said John Bartos, senior vice president at DrFirst. The system
will be free to physicians during the pilot, but future costs are unknown. Some
e-prescribing systems charge monthly fees from $30-$50, reports said. The MedStar
initiative joins other efforts to cut errors through electronic prescription systems.
For instance, the Rhode Island Quality Institute will start a pilot program in
May allowing any doctor in the state to electronically communicate with about
70% of the state’s pharmacies. For more info,
www.medstarhealth.org. One
In Four Affected By Medication Errors Almost one
in four Americans reported that they or a family member have received the wrong
medication at some point from a healthcare professional, according to the latest
AmerisourceBergen Index. Opinion Research
Corporation conducted the quarterly telephone survey from Jan. 23-26 on behalf
of AmerisourceBergen, a drug wholesaler dedicated to the pharmaceutical supply
channel. The survey
of 1033 adults nationwide explored a variety of issues related to patient safety,
including the best ways to prevent medication errors, safety hazards in hospitals,
and the priority hospitals place on patient safety. Seventy-five
percent of respondents said they favored the use of barcode technologies as a
way to reduce medication errors. This technology garnered even more support from
18-34-year-olds, with 82 percent in this age group saying the government should
require drug manufacturers and companies that repackage drugs to put barcodes
on all prescription medications. For more info,
www.amerisourcebergen.com. Outpatient
Rx Drug-Related Injuries Are Common In Older Patients Medicare patients
treated in the outpatient setting may suffer as many as 1.9 million drug-related
injuries a year because of medical errors or adverse drug reactions not caused
by errors, according to medical researchers sponsored by the federal Agency for
Healthcare Research and Quality and the National Institute on Aging. About 180,000
of these injuries are life-threatening or fatal, and more than half are preventable,
said the researchers, who based the estimates on a study of over 30,000 Medicare
enrollees followed during 1999-2000. "This
is one of the first systematic examinations of the scope and causes of drug-related
injuries to older patients in outpatient care," said AHRQ Director Carolyn
M. Clancy, M.D. "The findings from this important study can help reduce their
risks of drug-related injuries by providing information needed for the development
and testing of prevention strategies using system-based approaches." The researchers
identified 1,523 drug-related injuries or "adverse drug events." Nearly
38% of the adverse drug events were characterized as serious, life-threatening,
or fatal. About 28% of all the drug injuries were considered preventable by a
panel of physician reviewers, as were 42% of the serious, life-threatening or
fatal injuries. When the researchers
analyzed why the preventable adverse drug events occurred, they found that 58%
involved errors made when prescribing medications, such as ordering the wrong
drug or dose, not educating the patient adequately about the medicine, or prescribing
a medication for which there was a known interaction with another drug the patient
was already taking. The investigators
also found 61% of preventable adverse drug events involved mistakes made in monitoring
medications, such as inadequate laboratory monitoring or a delayed response to
symptoms of drug toxicity in the patient. However, the failure of patients to
adhere to medication instructions contributed to over 20% of the preventable drug-related
injuries. The study was
published in the March 5 issue of the Journal of the American Medical Association. On the inpatient
side, research sponsored by AHRQ has revealed that lack of communication among
team members is the basis of most medical errors reported to a web-based incident
reporting system being used by 15 hospital intensive care units. The findings
were revealed at an AHRQ media briefing on the agency’s web-based journal that
educates providers about medical errors in a blame-free environment. For more info,
http://jama.ama-assn.org. CDC:
Southerners, African Americans More Likely To Die From Stroke The first county-by-county
atlas of U.S. stroke deaths confirmed that Southerners and African Americans are
more likely than other Americans to die of a stroke. The Centers
for Disease Control and Prevention report showed that blacks are 40% more likely
than whites to die of a stroke. South Carolina, Arkansas, Georgia, Tennessee and
North Carolina had the highest rates of death by stroke, the third-leading cause
of U.S. deaths after heart disease and cancer. Northeastern
states and Florida had the lowest stroke death rates in the CDC Stroke Atlas.
The report, which covered data from 1991 to 1998, confirmed racial and ethnic
disparities long known by doctors. Experts suspect
blacks have more strokes because they have higher rates of high blood pressure,
the leading risk factor for strokes. Also, blood-pressure lowering drugs have
been less effective for blacks. Doctors suspect
the South has a higher stroke rate because it has more poor communities with less
access to health care and greater risk factors such as obesity, smoking and lack
of physical activity. The overall
stroke death rate for adults 35 and older was 121 per 100,000 people. The range
among states varied from 89 per 100,000 people in New York to 169 per 100,000
in South Carolina. For more info,
www.cdc.gov. In another
federal study of health disparities, researchers funded by AHRQ determined that
African Americans and people with less education die six years earlier than whites
and people who have higher education. A few diseases
in particular account for most of these socioeconomic and racial disparities,
according to the study published in the Nov. 14 New England Journal of Medicine.
The researchers found that smoking-related diseases caused most of the deaths
among people with fewer years of education, while high blood pressure, HIV, diabetes,
and trauma caused the most deaths among African Americans. Targeting these
diseases could help to reduce these and other health disparities, the study’s
authors said. For more info,
www.nejm.org.
Commonwealth
Fund Announces Patient Communication, Quality Initiative The Commonwealth
Fund has unveiled a new grant program designed to identify causes and consequences
of poor communication in medical settings and to evaluate methods to address communication
barriers for underserved patients. Previous work
by The Commonwealth Fund shows that minorities experience difficulties communicating
with their health care providers. Patients who do not speak English well, or those
who speak English fluently but who may have low health literacy, report communication
problems such as not understanding medical instructions or not being treated with
respect by their caregivers. Breakdowns
in communication can result in poor compliance with physicians’ advice, confusion
for patients in navigating the complex medical system, or medical errors. Patient Communication
and Quality of Care is a new initiative within the Fund’s Quality of Care for
Underserved Populations program. The program will award up to five grants of up
to $125,000 each. For more info,
www.cmwf.org/programs/underservedrfp.asp.
Many
Concerned About Capacity To Handle Chronic Conditions A new study
finds a majority of physicians, policy makers and the public concerned that the
country’s health care system does not adequately address the needs of people with
chronic medical conditions. The study by
the Johns Hopkins Bloomberg School of Public Health surveyed physicians, adults,
and health policy makers on how well the current health system addresses the needs
of people with chronic conditions. More than 90%
of respondents agreed that chronic conditions affected everyone. A majority of
each group also agreed that it was somewhat or very difficult for people with
chronic conditions to obtain adequate care, with the public most positive about
the current system and policymakers the least. The authors
said that changes in how medical care is financed and delivered are needed to
respond to the identified concerns. The study was
published in the Feb 25 Archives of Internal Medicine. For more info,
http://archinte.ama-assn.org.
New
Institute To Examine Quality Of U.S. Medical Education The Association
of American Medical Colleges has announced a new Institute for Improvement in
Medical Education. During the
last five years, AAMC’s medical education reform activities have mainly focused
on the first phase of medical education—medical school. The new AAMC Institute
will expand those efforts to include subsequent phases of medical education: residency
training and continuing medical education. Ten medical
school deans from around the country have been asked to serve on the Institute’s
Advisory Board. Joseph Martin, M.D., Ph.D., dean of Harvard Medical School, has
been selected to chair the group. Over the next
year, the board will coordinate a comprehensive review of the current state of
medical education in the country, in order to set a strategic direction for reform
across the medical education process. The Advisory Board is expected to release
the results of this review by February 2004. Their findings will serve as a blueprint
for the Institute’s future projects and activities. The Institute
will examine ways to improve medical education curricula, reform the clinical
education of students and residents, enhance public health education in medical
schools, promote professionalism during medical education and training, engage
in international medical education activities, and better meet the need for the
continued professional development of physicians once they enter practice. For more info,
www.aamc.org.
AHA
Toolkit Helps Hospitals Practice Evidence-Based Medicine AHA has sent
all hospitals a patient safety and quality toolkit designed to help hospitals
and their medical staffs practice evidence-based medicine. The kit, "Strategies
for Leadership: Evidence-based Medicine for Effective Patient Care," was
developed with UnitedHealth Foundation. It includes print and CD-ROM copies of
"Clinical Evidence," a BMJ Publishing Group publication containing the
clinical evidence from a variety of medical disciplines. The kit also
contains information on how to use clinical-based evidence in hospitals and in
developing clinical information systems. Recipients
are eligible for a six-month trial subscription to Clinical Evidence Online, which
features monthly updates. For more info,
www.aha.org. USP
Guide Helps Consumers Manage Benefits And Risks Of Medicines The U.S. Pharmacopeia’s
Center for the Advancement of Patient Safety today announced the availability
of "Think It Through: A Guide to Managing the Benefits and Risks of Medicines,"
a free consumer brochure on how to safely use prescription and over-the-counter
medications. The eight-page
brochure educates consumers about the five critical steps in making informed decisions
and safely using medications: talk with your doctor, know your medicines,
read the label and follow instructions, avoid interactions, and monitor your medicine’s
effects. A member of
the Partnership for Safe Medication Use, USP is making this brochure available
in collaboration with the Food and Drug Administration, the National Patient Safety
Foundation, and a number of other national organizations. For more info,
www.usp.org/thinkitthrough.
Study:
Children’s Medical Errors More Common In Complex Cases
Fewer than
3% of hospitalized children encounter reported medical errors, but incidents are
more common in complex cases, according to a new study in the March edition of
Pediatrics. The study,
coming just days after a medical error during a heart-lung transplant surgery
contributed to the death of a 17-year-old girl at Duke University Medical Cetner,
found errors occurred in about 11% of cases involving children with complex medical
conditions, including organ transplants and cancer. About 900 hospitals
and more than 1 million children were involved in errors. Researchers said that
due to underreporting of errors, the true count of mistakes is likely higher. Researchers
said the study will help doctors focus on groups of children that face a higher
risk of medical errors during care. For more info,
www.aap.org.  Home :: Inside AHQA :: For The Media :: Public Policy :: Advancing Quality :: Quality Connections :: SiteMap
|
|
|
Copyright © 2003,
American Health Quality Association. All Rights Reserved. |