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New
AMA Ad Calls for Senate to Act Now on Patient Safety IOM:
Increased Access to High-Quality Mammography Needed Evidence-Based
Hospital Design Improves Healthcare Outcomes, Study Finds Author
Argues for Greater Evidence in QI Collaboratives Children
Often Experience Adverse Events in Hospitals, AHRQ Finds NAHIT
Directory Open to Public CDC:
Cancer Mortality Rates Decreasing Oregon
Voluntary Program to Track Errors in ‘05 AHRQ
Soliciting Tools to Revise CAHPS AHRQ
Fact Sheets on Quality Gap Available Online New
AMA Ad Calls for Senate to Act Now on Patient Safety The American
Medical Association has launched an advertising campaign that calls on
Congress to pass the proposed Patient Safety and Quality Improvement Act
(S. 720). “America's
patients are relying on the Senate to take the next step for patient safety,”
AMA President Donald J. Palmisano, M.D. said. “Our current health
care system promotes a culture of shame and blame. We need the Senate
to act now for our patients' safety.” The ad, titled
“Time is Running Out,” says that if the legislation is enacted,
“we can promote patient safety by ensuring that accidents and mistakes
are reported promptly and analyzed—so they won't happen again.”
The House
passed patient safety legislation with last year, and the Senate legislation
unanimously passed in committee with bipartisan support. For more
info, www.ama-assn.org. IOM:
Increased Access to High-Quality Mammography Needed Improving
access to mammography and broadening the pool of medical personnel who
can interpret mammograms offer the greatest potential for immediately
reducing the number of lives lost to breast cancer in the United States,
according to a report from the Institute of Medicine and the National
Research Council of the National Academies. To improve
the quality of cancer screening, the United States should adopt elements
of screening programs that have proven successful in Sweden, the Netherlands,
and the United Kingdom, which have lower rates of false-positive results,
the committee said. The United States also should consider such practices
as requiring double readings of mammograms, interpretation of mammograms
in high-volume centers, and screening services that also integrate treatment,
counseling, and other support services. Tests are
under way to assess the clinical value of ways to refine screening strategies
for high-risk women and to improve the accuracy of mammographic interpretations.
These methods include digital mammography, CAD, ultrasound, and magnetic
resonance imaging. For more
info, http://national-academies.org. Evidence-Based
Hospital Design Improves Healthcare Outcomes, Study Finds An analysis
of more than 400 research studies by the Center for Health Design shows
a direct link between patient health and quality of care and the way a
hospital is designed. The analysis recommends that hospitals improve their
physical design and construction, the ways in which staff does its work,
and their institutional culture in order to create a model health care
environment for the 21st century. The study
cited examples such as Bronson Methodist Hospital in Kalamazoo, MI, which
reduced the rate of hospital-acquired infections by 11 % in new patient
pavilions that featured private rooms and specially located sinks. At
the Barbara Ann Karmanos Cancer Institute in Detroit, medical errors fell
30% on two new inpatient units at that allocated more space for their
medication rooms, re-organized medical supplies, and installed acoustical
panels to decrease noise levels. “Just
as evidence-based medicine is revolutionizing health care treatment, evidence-based
design is transforming the healthcare environment,” said Craig Zimring,
PhD, of the Georgia Institute of Technology and research co-author. For more
info, www.healthdesign.org. Back
to top An article
in the June issue of the Annals of Internal Medicine on quality improvement
collaboratives argues that more effective use of the collaborative method
will require a commitment by users, researchers, and other stakeholders
to rigorous, objective evaluation and the creation of a valid, useful
knowledge and evidence base. Brian S.
Mittman of the Center for the Study of Healthcare Provider Behavior, wrote
that widespread acceptance and reliance on the collaborative approach
are based not on solid evidence but on shared beliefs and anecdotal affirmations
that may overstate the actual effectiveness of the method. He also said
that development of an appropriate evidence base will require improved
conceptions of the nature of quality problems, of quality improvement
processes, and of the types of research needed to elucidate these processes.
Researchers, journal editors, and funding agencies must also cooperate
to ensure that published evaluations are relevant, comprehensive, and
cumulative, Mittman said. For more
info, http://www.annals.org/cgi/content/abstract/140/11/897. Children
Often Experience Adverse Events in Hospitals, AHRQ Finds Children
in hospitals often experience adverse patient safety events—such
as medical injuries or errors—in the course of their care, according
to a study from the Agency for Healthcare Research and Quality. The study,
which uses the recently developed Patient Safety Indicators (PSIs) to
focus on children in hospitals, examined 5.7 million hospital discharge
records for children under age 19 from 27 states, drawn from the 2000
Healthcare Cost and Utilization Project State Inpatient Database. In total,
the PSIs identified 51,615 patient safety events involving children in
hospitals during 2000. Children up to 1 year old were consistently and
significantly more likely to experience many of the events identified
by the PSIs than older children, and children whose primary insurance
was Medicaid were also more likely to experience several of the PSI events. The prevalence
of patient safety events resulting in injuries among children also had
an impact on the length of stay, charges and the rate of in-hospital deaths.
The researchers estimate that if all deaths among pediatric patients who
experience a medical injury are attributed to those injuries, then the
records in their analysis alone account for 4,483 deaths among hospitalized
children in the year 2000 alone. The report,
“Pediatric Patient Safety in Hospitals: A National Picture in 2000,”
is published in the June issue of Pediatrics. For more
info, www.pediatrics.org. Back
to top The National
Alliance for Health Information Technology has opened its comprehensive
directory of health care information technology standards to the public.
Alliance member Johnson & Johnson will underwrite maintenance and
expansion costs of the directory for two years. Since launching
a beta version for members in April, the NAHIT has expanded the directory
to include 850 voluntary and mandatory standards and electronic links
to more than 200 standards development organizations. The alliance also
is developing members-only content to make the information even more useful,
including detailed summaries and evaluations of standards. For more
info, www.nahit.org. CDC:
Cancer Mortality Rates Decreasing A surveillance
of cancer mortality rates between 1990-2000 found that while cancer remains
the second leading cause of death in the United States, there was an overall
declining trend in mortality rates. Researchers said the trend is due
to progress in cancer prevention, early detection and treatment. The study
found that the mortality rate for breast cancer decreased 2.3% per year
and prostate cancer decreased 2.6% per year, while lung and bronchus cancer
decreased 1.7% per year. CDC officials
said the study indicates that more effective tobacco-cessation programs
are necessary to reduce lung and bronchus cancer mortality among women
and sustain the decrease in lung and bronchus cancer mortality among men.
They also called for continued research in primary prevention, screening
methods and therapeutics. For more
info, www.cdc.gov/mmwr/preview/mmwrhtml/ss5303a1.htm. Back
to top The Oregon
Patient Safety Commission is organizing a voluntary reporting program
early that will track medical errors at hospitals and collect information
about how those errors could have been prevented, according to an Associated
Press report. The data
gathered from participating hospitals will be distributed in reports and
potentially posted on a website. But the program is voluntary so hospitals
can report errors without concerns of unintended consequences such as
litigation. For more
info, www.dhs.state.or.us/publichealth/hsp/patientsafety/index.cfm. AHRQ
Soliciting Tools to Revise CAHPS The Agency
for Healthcare Research and Quality took the first public step toward
creating a patient perception of care tool for measuring care provided
in the ambulatory setting. AHRQ officials
said they plan to review existing tools and redesign its Consumer Assessment
of Health Plans (CAHPS) tool to capture patients' ambulatory care experiences
and perceptions at the various levels of ambulatory health care delivery,
such as services provided by individual primary care providers, sites
of care, group practices and health plans. For more
info, www.access.gpo.gov/su_docs/fedreg/a040610c.html. AHRQ
Fact Sheets on Quality Gap Available Online The Agency
for Healthcare Research and Quality announced that fact sheets on closing
the quality gap are available online. These fact sheets are based on reviews
conducted by the agency’s Evidence-based Practice Center at the
University of California at San Francisco and Stanford University.
Copies are
available at www.ahrq.gov/qual/errorsix.htm
and print versions are available via e-mail at ahrqpubs@ahrq.gov.  Home :: Inside AHQA :: For The Media :: Public Policy :: Advancing Quality :: Quality Connections :: SiteMap
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