Diagnostic Errors Are Common in Seriously Ill Hospitalized Adults

Access the report, plus additional AHRQ infographics.

Today's Headlines:

• Diagnostic Errors Are Common in Seriously Ill Hospitalized Adults.
• Neonatal Antibiotic Stewardship Associated With Drop in Pediatric Antibiotic Use.
• Grantee Thomas McGinn Explores Strategies To Improve Patient Care.
• Enroll Now for Program on Improving Antibiotic Use in Telemedicine.
• AHRQ’s Patient Safety Network Offers New Ways To Access Research Findings.
• New Research and Evidence From AHRQ.
• Register for Jan. 24 Webinar on Best Practices for Administering Surveys on Patient Safety Culture®.
• AHRQ in the Professional Literature.

Diagnostic Errors Are Common in Seriously Ill Hospitalized Adults

A random sample of patients from academic medical centers across the country who had either been transferred to the intensive care unit or died in the hospital showed that 23 percent of the patients had a delayed or missed diagnosis, according to an AHRQ-funded study in JAMA Internal Medicine. The researchers concluded that three-quarters of these diagnostic errors contributed to temporary or permanent harm, including death in about one in 15 of the cases. Study authors also concluded the research provides data that can be used to improve patient safety by coaching physicians, improving communication between healthcare teams and patients and developing more accurate diagnostic tools and techniques. The data may also be useful in designing artificial intelligence that can summarize lengthy medical records, suggest alternative diagnoses when patients fail to improve and ensure that the correct tests are ordered. Access the abstract.

Neonatal Antibiotic Stewardship Associated With Drop in Pediatric Antibiotic Use

Antibiotic stewardship efforts have yielded a 34 percent relative reduction in antibiotic use in neonatal intensive care units (NICUs), from 55 percent in 2009 to just under 36 percent in 2021, according to a study co-authored by an AHRQ-supported scholar. Researchers assessing trends in antibiotic use among nearly 1.4 million infants admitted to 735 U.S. academic and community NICUs over a 13-year period also found that days of antibiotic therapy decreased from 374 per 1,000 patient days in 2009 to 192 in 2021, an almost 49 percent reduction. The analysis suggested that declines in ampicillin and gentamicin use reflected the reach of national calls for improving neonatal antibiotic stewardship. Access the abstract.

Grantee Thomas McGinn Explores Strategies To Improve Patient Care

The newest AHRQ grantee profile highlights the work of Thomas McGinn, M.D., M.P.H., who has developed clinical prediction rules or decision aids for clinicians to make evidence-based, cost-effective care decisions at the point of care. These tools, which can be integrated into electronic health records, are designed to help clinicians make decisions such as whether to prescribe antibiotics or order a scan. Dr. McGinn, who serves as executive vice president of physician enterprise at CommonSpirit Health, a nonprofit health system with care sites in 24 states, credits AHRQ with “truly getting it from the beginning” and understanding why clinical prediction rules are important and how technology intersects with them. Access Dr. McGinn’s profile and profiles of other AHRQ grantees.

Enroll Now for Program on Improving Antibiotic Use in Telemedicine

The AHRQ Safety Program for Telemedicine: Improving Antibiotic Use is recruiting primary and urgent care practices and retail clinics that use telemedicine for a no-cost, 18-month national program to strengthen antibiotic prescribing practices. The program will begin in June and provide expert coaching to promote sustainable improvements and improved patient satisfaction through actionable, evidence-based guidance. Participants may receive continuing education credits, continuing medical education credits and American Board of Internal Medicine Maintenance of Certification points through live and/or self-paced materials. Access the program portal to enroll or register for one of several brief informational webinars.

AHRQ’s Patient Safety Network Offers New Ways To Access Research Findings

Enhancements to AHRQ’s Patient Safety Network (PSNet) now allow users to search patient safety research publications in eight clinical areas ranging from COVID-19 to nurse care to palliative care. Improvements also include new search and filter tools, plus a two-step registration process for access to features like continuing medical education credits, tailored content and “private libraries” for users to save and access article collections. Each week, PSNet highlights journal articles, books and tools related to patient safety. Articles featured recently include:

• Interprofessional staff perspectives on the adoption of OR black box technology and simulations to improve patient safety: a multi-methods survey.
• Patient safety in remote primary care encounters: multimethod qualitative study combining Safety I and Safety II analysis.
• Parents' understanding of medication at discharge and potential harm in children with medical complexity.

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).

New Research and Evidence From AHRQ

• Systematic Review: Respectful Maternity Care.
• Systematic Review: Social and Structural Determinants of Maternal Morbidity and Mortality: An Evidence Map.

Register for Jan. 24 Webinar on Best Practices for Administering Surveys on Patient Safety Culture®

Registration is open for a webinar on Jan. 24 from 1 to 2 p.m. ET on best practices for administering AHRQ’s Surveys on Patient Safety Culture® (SOPS®). Speakers will discuss the SOPS Surveys and Databases, how to get started on administering the surveys, and increasing your response rates. The Surveys on Patient Safety Culture are a suite of surveys that assess provider and staff opinions about patient safety culture in hospitals, outpatient medical offices, nursing homes, community pharmacies and ambulatory surgery centers

AHRQ in the Professional Literature

Improving mixed-integer temporal modeling by generating synthetic data using conditional generative adversarial networks: a case study of fluid overload prediction in the intensive care unit. Rafiei A, Ghiasi Rad M, Sikora A, et al. Comput Biol Med 2024 Jan;168:107749. Epub 2023 Nov 22. Access the abstract on PubMed®.

Plan selection, enrollee risk, and health spending on the Patient Protection and Affordable Care Act individual marketplaces, 2019. Treasure G, Anderson DM, Hatcher L, et al. JAMA Netw Open 2023 Mar 1;6(3):e234529. Access the abstract on PubMed®.

County-level barriers in the COVID-19 vaccine coverage index and their associations with willingness to receive the COVID-19 vaccine across racial/ethnic groups in the U.S. Fernandez JR, Strassle PD, Richmond J, et al. Front Public Health 2023 Oct 12;11:1192748. Access the abstract on PubMed®.

A survey of technology abandonment in US nursing homes. Powell KR, Farmer M, Liu J, et al. J Am Med Dir Assoc 2024 Jan;25(1):6-11. Epub 2023 Oct 11. Access the abstract on PubMed®.

Intravenous to oral antibiotic switch therapy among patients hospitalized with community-acquired pneumonia. Deshpande A, Klompas M, Guo N, et al. Clin Infect Dis 2023 Jul 26;77(2):174-85. Access the abstract on PubMed®.

Management of fall risk among older adults in diverse primary care settings. Shear K, Rice H, Garabedian PM, et al. J Appl Gerontol 2023 Nov;42(11):2219-32. Epub 2023 Jun 30. Access the abstract on PubMed®.

Pediatric firearm injury emergency department visits from 2017 to 2022: a multicenter study. Hoffmann JA, Carter CP, Olsen CS, et al. Pediatrics 2023 Dec;152(6). Epub 2023 Nov 6. Access the abstract on PubMed®.

Completion of recommended tests and referrals in telehealth vs in-person visits. Zhong A, Amat MJ, Anderson TS, et al. JAMA Netw Open 2023 Nov;6(11):e2343417. Access the abstract on PubMed®.