AHRQ Electronic Newsletter, February 10, 2015, Issue #458

February 10, 2015, Issue #458 AHRQ Stats: ICU Hospital Care While 27 percent of hospital stays involved intensive care unit (ICU) services in 2011 (among the 29 states reporting), those stays accounted for nearly 48 percent of total hospital charges that year. The average ICU-related hospital stay averaged $61,800 while a non-ICU stay was $25,200. (Source: Agency for Healthcare Research and Quality, Healthcare Cost and Utilization Project Statistical Brief #185, Utilization of Intensive Care Services, 2011.)  Today's Headlines: New Manual Helps Hospitals Improve Medication Reconciliation AHRQ’s Web M&M Explores Complexities in Monitoring Fetal Health Register Now: February Online TeamSTEPPS® Master Trainer Course Register Now: February 24 Webinar on Projects To Inform Stage 3 Meaningful Use Requirements Through Evidence Save the Date: April 28–29 MEPS Data Users Workshop at AHRQ AHRQ’s Health Care Innovations Exchange Focuses on Reducing Non-Urgent Emergency Services New Manual Helps Hospitals Improve Medication Reconciliation The AHRQ-funded Multi-Center Medication Reconciliation Quality Improvement Study (MARQUIS) has produced an implementation manual to help hospitals improve medication reconciliation practices. These improvements can lead to reductions in negative outcomes such as inpatient adverse drug events and readmission rates, which have significant patient safety and financial implications for hospitals. Based on the experiences of five hospitals participating in a three-year project conducted by the Society of Hospital Medicine, MARQUIS identifies best practices for medication reconciliation processes throughout hospital admission, transfer and discharge. It also outlines a framework for assembling a team and developing an implementation strategy adaptable to any hospital system. The MARQUIS implementation manual explains how hospitals can implement a bundle of interventions to improve medication reconciliation using a quality improvement process. The manual includes a site assessment to help implementers understand where to start with the process. Site leaders or pharmacists can use this assessment to help gauge the patient-centeredness of the institution’s medication reconciliation process and begin customization and implementation of the various bundle components. The manual also features accompanying online resources such as a return on investment calculator to help hospitals make the business case for medication reconciliation. AHRQ’s Web M&M Explores Complexities in Monitoring Fetal Health The latest issue of AHRQ Web M&M features a Spotlight Case that examines the risks and benefits of monitoring fetal heart rate tracings during labor. It describes a 29-year-old woman who had an uncomplicated pregnancy with a healthy fetus and presented to the hospital at term (40 weeks) in early labor. She progressed slowly the first night, but the next morning she pushed for approximately two hours without any difficulty or any sign of problems with the fetus. Unfortunately, the newborn was cyanotic and flaccid with very low Apgar scores. The infant required extensive resuscitation but survived and was transferred to the neonatal intensive care unit. In addition, the Perspectives on Safety section features an interview with Mark Graban, M.S., M.B.A., an internationally recognized expert in Lean health care, about applying Lean principles in hospitals to improve safety and decrease waste. The Perspective section features a book excerpt by Paul E. Plsek, M.S., principal, Plsek & Associates, in Roswell, Georgia, describing how integrating innovation and Lean concepts at Virginia Mason Medical Center in Seattle enhanced clinical performance and the patient experience. Register Now: February Online TeamSTEPPS® Master Trainer Course AHRQ is offering TeamSTEPPS Master Training online as an accredited course for health care professionals interested in improving patient safety and health care quality. TeamSTEPPS is an evidence-based teamwork approach to improve communication and teamwork skills among health care professionals. The next training is scheduled for late February, so create an account and begin your precourse preparation now to ensure you begin with your preferred group. Registration is open. Register Now: February 24 Webinar on Projects To Inform Stage 3 Meaningful Use Requirements Through Evidence AHRQ is hosting a webinar February 24 from 12:30 to 2 p.m. ET on recent research to provide evidence to inform the development of proposed Stage 3 Meaningful Use objectives. The expert panel will discuss projects assessing the feasibility of selected proposed objectives related to care coordination, interoperability and patient and family engagement. Determination of continuing education credit through Professional Education Services Group is pending. Registration is open. Save the Date: April 28–29 MEPS Data Users Workshop at AHRQ Mark your calendars for a two-day, hands-on data users workshop on the Medical Expenditure Panel Survey (MEPS) April 28–29 in Rockville, Maryland. Day one of the workshop will consist of lectures designed to provide a general overview of MEPS, including information about survey design, file content and the construction of analytic files. Particular emphasis will be on health care utilization, expenditures and medical conditions. On day two, a laptop will be provided for each participant to use to apply the knowledge gained from the previous day's lectures and work with programmers and analysts on MEPS data. To fully benefit from the second day, participants should have some prior knowledge of MEPS. A basic knowledge of SAS software is desirable, but not essential. A full program description, registration form and logistical information will be available on the Workshops & Events page of the MEPS website in late February. AHRQ’s Health Care Innovations Exchange Focuses on Reducing Non-Urgent Emergency Services The latest issue of AHRQ’s Health Care Innovations Exchange focuses on the Exchange’s new Emergency Services Learning Community, featuring profiles about reducing the use of emergency services for non-urgent conditions. One of the profiles describes a program run by MedStar Mobile Healthcare, an emergency medical service provider in Fort Worth, Texas. MedStar uses mobile health care paramedics to provide in-home and telephone-based support to patients who frequently call 911 and to other patient populations who are at risk for potentially preventable admissions or readmissions. Four additional programs serve individuals with congestive heart failure, patients who can be managed transitionally at home versus with an overnight observational admission, in-home hospice patients who are at risk for hospice revocation and home health agencies as a support to prevent unnecessary visits to the emergency department. These programs have significantly reduced the number of 911 calls, potentially preventable emergency department visits and hospital admissions. This innovation is part of a cluster of select profiles in the Innovations Exchange’s Emergency Services Learning Community.  AHRQ in the Professional Literature Schwartz AL, Landon BE, Elshaug AG, et al. Measuring low-value care in Medicare.JAMA Intern Med. 2014 Jul;174(7):1067-76. Select to access the abstract on PubMed®.  Stahl JE, Balasubramanian HJ, Gao X, et al. Balancing clinical experience in outpatient residency training. Med Decis Making. 2014 May;34(4):464-72. Epub 2014 Mar 17. Select to access the abstract on PubMed®.  Kenik J, Jean-Jacques M, Feinglass J. Explaining racial and ethnic disparities in cholesterol screening. Prev Med. 2014 Aug;65:65-9. Epub 2014 May 5. Select to access the abstract on PubMed®. Panozzo CA, Becker-Dreps S, Pate V, et al. Direct, indirect, total, and overall effectiveness of the rotavirus vaccines for the prevention of gastroenteritis hospitalizations in privately insured US children, 2007-2010. Am J Epidemiol. 2014 Apr 1;179(7):895-909. Epub 2014 Feb 26. Select to access the abstract on PubMed®.  Kindermann DR, Mutter RL, Cartright-Smith L, et al. Admit or transfer? The role of insurance in high-transfer-rate medical conditions in the emergency department. Ann Emerg Med. 2014 May;63(5):561-571.e8. Epub 2013 Dec 15. Select to access the abstract on PubMed®. McGarry BE, Strawderman RL, Li Y. The care span: Lower Hispanic participation in Medicare Part D may reflect program barriers. Health Aff. 2014 May;33(5):856-62. Select to access the abstract on PubMed®.  Jonsson Funk M, Visco AG, Weidner AC, et al. Long-term outcomes of vaginal mesh versus native tissue repair for anterior vaginal wall prolapse.Int Urogynecol J. 2013 Aug;24(8):1279-1285. Epub 2013 Feb 12. Select to access the abstract on PubMed®. Lieberthal RD. Analyzing the health care cost curve: a case study. Popul Health Manag. 2013 Oct;16(5):341-8. Epub 2013 May 14. Select to access the abstract on PubMed®. Contact Information Please address comments and questions about the AHRQ Electronic Newsletter to Jeff.Hardy at: (301) 427-1802 or Jeff.Hardy@ahrq.hhs.gov.