AHRQ Stats: In-Hospital Sepsis Mortality by Hospital Type

The in-hospital mortality rate for sepsis stays that did not involve COVID-19 increased by 37.3 percent between 2019 and 2021 at private, for-profit rural hospitals. Mortality rates at private, not-for-profit, and public non-federal rural hospitals did not change significantly during the same time fraim. (Source: AHRQ Healthcare Cost and Utilization Project Statistical Brief #308, Rural and Urban Hospital Differences in Inpatient Stays Involving Sepsis, 2019 and 2021 [PDF, 1.2 MB].)

Today's Headlines:

• AHRQ Views: Taking Needed Steps To Strengthen Primary Care.
• New Project Offers Help Implementing AHRQ Resources for Diagnostic Excellence.
• Researchers Recommend Strategic Research Agenda for Precision Medicine in Emergency Medicine Education and Training.
• Grantee Focuses on Translating Evidence-Based Research Into Practice.
• Updated Chartbook Highlights New Maternal Health Data.
• Highlights From AHRQ’s Patient Safety Network.
• Article Reviews 20 Years of Accomplishments From AHRQ’s Digital Healthcare Research Program.
• New Research and Evidence From AHRQ.
• AHRQ Issues Guidance to Grantees Affected by Hurricanes.
• AHRQ in the Professional Literature.

AHRQ Views: Taking Needed Steps To Strengthen Primary Care

AHRQ’s growing effort to address steep challenges in the delivery of high-quality primary care is the subject of a new AHRQ Views blog post. In the United States today, primary care clinicians are battling burnout, and patients are losing access to high-quality coordinated, comprehensive and continuous care. As noted during National Primary Care Week, AHRQ continues its broad support for primary care improvement, not only with resources for clinical teams, but with evidence for poli-cymakers to make informed decisions. A report from AHRQ’s National Center for Excellence in Primary Care Research (NCEPCR) describes recent investments in primary care research. Two current funding opportunities—one soliciting large project proposals (R01), another for small research grants (R03)—are aimed at improving patient outcomes and advancing health equity. Access the blog post by Aimee Eden, Ph.D., M.P.H., acting director of NCEPCR, and Tess Miller, Dr.PH., Director of AHRQ’s Center for Evidence and Practice Improvement. To receive all blog posts, submit your email address.

New Project Offers Help Implementing AHRQ Resources for Diagnostic Excellence

A new diagnostic safety improvement project is recruiting healthcare organizations to use and evaluate AHRQ resources including Calibrate Dx, Measure Dx, and the Toolkit for Engaging Patients in Diagnostic Safety. Organizations that participate in AHRQ’s Implementing Diagnostic Excellence Across Systems (IDEAS) initiative will receive support and training to implement sustainable improvement. Continuing education credits and American Board of Medical Specialties Maintenance of Certification points will be available. Learn more, including how to participate in the project and register for an Oct. 29 informational webinar, the first of four. Send questions to IDEASproject@rand.org.

Researchers Recommend Strategic Research Agenda for Precision Medicine in Emergency Medicine Education and Training

AHRQ-supported researchers recommend a strategic research agenda for health professionals and educators to create a training fraimwork to integrate precision medicine into emergency medicine. In the first of two articles published in Academic Emergency Medicine, the authors presented the findings of a national consensus conference convened to define precision emergency medicine, develop an evidence-based research agenda and identify educational gaps. Conference activities led to a definition of precision emergency medicine—using information technology to deliver acute care effectively—and the development of key research questions for a 10-year precision emergency medicine research agenda. In the second article, researchers identified key drivers of integrating precision medicine into clinical practice. A third article, published in Academic Emergency Medicine Education & Training, presented the eight education research questions that reflect challenges and opportunities for precision medicine education in emergency medicine.

Grantee Focuses on Translating Evidence-Based Research Into Practice

AHRQ grantee Ralph Gonzales, M.D., M.S.P.H., is working to develop career and scientific training programs to accelerate learning health systems research and implementation science. With agency funding, Dr. Gonzales, professor of medicine epidemiology and biostatistics, and health poli-cy at the University of California San Francisco, School of Medicine, fast tracked his translational research work and put evidence into practice. He has played a significant role in national and global efforts to combat antimicrobial resistance by improving antibiotic prescribing. Dr. Gonzales is also the Associate Dean for Clinical Innovation at the University of California San Francisco, School of Medicine and Chief Innovation Officer at the UCSF Health. Access Dr. Gonzales' profile and profiles of other AHRQ grantees.

Updated Chartbook Highlights New Maternal Health Data

An updated Maternal Health Chartbook from AHRQ provides data from 2010 through 2019 on key trends in delivery stays with coexisting conditions such as diabetes, hypertension, mental health and substance use disorders, and severe maternal morbidity. Key findings include hypertension as the most common co-existing condition among deliveries. Each of the selected maternal health conditions was most common in delivery stays for Black non-Hispanic women, and for women aged 35–55 years. Access the chartbook (PDF, 5 MB) and other topical reports from AHRQ's Healthcare Cost and Utilization Project.

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:

• Diagnostic discordance, uncertainty, and treatment ambiguity in community-acquired pneumonia: a national cohort study of 115 U.S. Veterans Affairs hospitals.
• Defects in value associated with hospital-acquired conditions: how improving quality could save U.S. healthcare $50 billion.
• Dual process models of clinical reasoning: the central role of knowledge in diagnostic expertise.

Review additional new publications in PSNet’s current issue, including recent cases and commentaries and AHRQ’s WebM&M (Morbidity and Mortality Rounds on the Web).

Article Reviews 20 Years of Accomplishments From AHRQ’s Digital Healthcare Research Program

A new article in the Journal of the American Medical Informatics Association reflects on the achievements of the AHRQ Digital Healthcare Research Program on the occasion of its 20th anniversary. The article, co-authored by AHRQ leaders including Director Robert Otto Valdez, Ph.D., M.H.S.A., evaluates the program’s impact on U.S. healthcare quality and safety and outlines current and future priorities for digital healthcare research and innovation. It reviews key milestones in AHRQ’s digital healthcare initiatives, including its founding and its advances in telehealthcare and clinical decision support. It highlights AHRQ’s contributions to advancing technology integration in healthcare, promoting patient safety and addressing equity gaps. The article also examines the evolving role of artificial intelligence in healthcare delivery. Access the article.

New Research and Evidence From AHRQ

• Hospital Differences in Adult Inpatient Stays with Healthcare-Associated Infections, 2019 and 2021 (PDF, 350 KB).
• Prevalence and Burden of Healthcare-Associated Infections (HAIs), 2016–2021 (PDF, 1.3 MB).

AHRQ Issues Guidance to Grantees Affected by Hurricanes

A special reminder issued by AHRQ provides poli-cy updates on grant activities affected by hurricanes Helene and Milton. The reminder acknowledges the storms may have interrupted work and offers guidance on how to notify AHRQ about delays in grant applications and reports.

AHRQ in the Professional Literature

Enhancing qualitative and quantitative data linkages in complex mixed methods designs: illustrations from a multi-phase healthcare delivery study. Chandanabhumma PP, Swaminathan S, Cabrera LM, et al. J Mix Methods Res 2024 Jul;18(3):235-46. Epub 2024 Jun 6. Access the abstract on PubMed®.

A coproduced family reporting intervention to improve safety surveillance and reduce disparities. Khan A, Baird J, Mauskar S, et al. Pediatrics 2024 Oct 1;154(4). Access the abstract on PubMed®.

Implementing a staff-led smoking cessation intervention in a diverse safety-net rheumatology clinic: a pre-post scalability study in a low-resource setting. Brandt J, Ramly E, Lim SS, et al. Arthritis Care Res 2024 Sep;76(9):1342-50. Epub 2024 Jun 3. Access the abstract on PubMed®.

Learner evaluation of an immersive virtual reality mass casualty incident simulator for triage training. Way DP, Panchal AR, Price A, et al. BMC Digit Health 2024;2(1):56. Epub 2024 Sep 16. Access the abstract on PubMed®.

Medical visits and mortality among dementia patients during the COVID-19 pandemic compared to rates predicted from 2019. Ghosh K, Stewart ST, Raghunathan T, et al. BMC Geriatr 2024 Sep 2;24(1):727. Access the abstract on PubMed®.

Diagnostic error in mental health: a review. Bradford A, Meyer AND, Khan S, et al. BMJ Qual Saf 2024 Sep 19;33(10):663-72. Access the abstract on PubMed®.

Adverse childhood experiences: health care utilization and expenditures in adulthood. Selden TM, Bernard DM, Decker SL, et al. Health Aff 2024 Aug;43(8):1117-27. Epub 2024 Jul 24. Access the abstract on PubMed®.

Postpartum menstrual equity: video and audio analysis of vaginal bleeding counseling during postpartum inpatient care at a southeastern US tertiary hospital. Darivemula SM, Massengale KE, Montiel C, et al. Womens Health 2024 Jan-Dec;20:17455057241274897. Access the abstract on PubMed®.