Data Reveal Uneven Impact of COVID-19 on Urban, Rural Hospitals

AHRQ Stats: Maternal Deaths by Race/Ethnicity

In 2020, out of every 100,000 maternity admissions, an average of 12.2 Black women died—more than double the average of 5.6 deaths for every 100,000 maternity admissions among White women. Hispanic women also faced higher rates of death than White women, with an average of 8.5 deaths for every 100,000 maternity admissions. (Source: AHRQ 2024 Chartbook on Patient Safety [PDF, 4 MB].)

Today's Headlines:

• Data Reveal Uneven Impact of COVID-19 on Urban, Rural Hospitals.
• AHRQ Views Blog Post: Working Together To Tackle Inequities, Centering the Voice of Women.
• Diagnostic Error in Mental Healthcare Common but Not Well Defined.
• New Mental Health Resources From AHRQ.
• New AHRQ Funding Notices.
• Registration Open for Free Safety Program To Improve Antibiotic Use in Telemedicine.
• Highlights From AHRQ’s Patient Safety Network.
• Upcoming AHRQ Webinars.
• New Research and Evidence From AHRQ.
• AHRQ in the Professional Literature.

Data Reveal Uneven Impact of COVID-19 on Urban, Rural Hospitals

The COVID-19 pandemic impacted rural hospitals more significantly than those in urban settings, according to two studies using data from AHRQ’s Healthcare Cost and Utilization Project (HCUP). One study, published in Health Affairs, revealed that 35 percent of rural hospitals experienced more than 20 percent increases or decreases in the daily patient volume during the pandemic, compared with just 13 percent of urban hospitals. Rural hospitals that were most impacted were likely to be small-sized, or owned by State or local governments, or classified as critical access hospitals. The other study, published in JAMA Network Open, found that the odds of in-hospital mortality for sepsis increased by 35 percent at rural hospitals during the pandemic, compared with an increase of 27 percent at urban hospitals. The authors of both studies suggested that tailoring responses to the unique needs of rural hospitals could reduce the uneven impact of future health crises.

AHRQ Views Blog Post: Working Together To Tackle Inequities, Centering the Voice of Women

AHRQ’s support for National Women's Health Week and the potential of empowered women to pursue lives of wellness and resilience is the subject of a new AHRQ Views blog post. The theme aligns with AHRQ’s ongoing efforts to address the healthcare needs of all women. For example, a recent AHRQ-funded evidence report explored how the healthcare community can effectively deliver respectful maternity care. Also highlighted among AHRQ activities is the agency’s EvidenceNow: Managing Urinary Incontinence (UI), an initiative to disseminate strategies in primary care for nonsurgical treatment of UI in women. Access the blog post, authored by Kamila B. Mistry, Ph.D., M.P.H., deputy director for AHRQ’s Office of Extramural Research, Education, and Priority Populations; Emily Chew M.P.H., senior advisor for women’s health and gender research; Kisha I. Coa, Ph.D., M.P.H., division director for priority populations. To receive all blog posts, submit your email address.

Diagnostic Error in Mental Healthcare Common but Not Well Defined

Diagnostic error is well understood to be a problem in mental healthcare, but there is a lack of consensus on how to conceptualize, define and measure errors in diagnosis, according to an AHRQ-funded review published in BMJ Quality & Safety. Researchers summarized the state of research on diagnostic errors in mental health and identify opportunities to align future research with the emerging science of diagnostic safety. They found that few studies used clear definitions or frameworks for understanding diagnostic error in mental health, but several studies of missed, wrong, delayed and disparate diagnosis of common mental disorders have identified various avenues for future research and development. Access the abstract.

New Mental Health Resources From AHRQ

During Mental Health Awareness Month, AHRQ’s Academy for Integrating Behavioral Health and Primary Care is highlighting Integrating Harm Reduction into Primary Care Practices, a resource that emphasizes the importance of helping patients reduce or prevent the harms of substance use. Harm reduction principles and practices prioritize engaging directly with patients with substance use disorders to prevent overdoses and infectious disease, improve physical and mental health and offer appropriate mental health disorder treatment. The Academy is also highlighting Mental Health Awareness Month Resources, which highlight resources from leading mental health agencies and organizations.

New AHRQ Funding Notices

• A Notice of Intent (NOI) signals AHRQ’s intention to invite grant applications that support healthcare safety by determining whether and how certain breakthrough uses of artificial intelligence (AI) systems can affect patient safety, and how AI systems can be safely implemented and used.
• A Special Emphasis Notice (SEN) announces AHRQ’s interest in health services research to improve care delivery, access, quality, equity and health outcomes for older adults. The SEN builds on AHRQ’s prior work, including the Optimizing Health and Function as We Age Roundtable Report (PDF, 1.7 MB).

Registration Open for Free Safety Program To Improve 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 program to strengthen antibiotic prescribing practices. The program will begin in June and provide evidence-based guidance to improve antibiotic prescribing and patient satisfaction. 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 more information, including how to sign up for an informational webinar on May 21, noon to 12:30 pm ET.

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:

• Entangled in complexity: an ethnographic study of organizational adaptability and safe care transitions for patients with complex care needs.
• Comparative evaluation of LLMs in clinical oncology.
• Application of trigger tools for detecting adverse drug events in older people: a systematic review and meta-analysis.
• Patients' perspectives on quality and patient safety failures: lessons learned from an inquiry into transvaginal mesh in Australia.

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).

Upcoming AHRQ Webinars

• May 21, noon to 1 p.m. ET: Understanding and Operationalizing the National Action Alliance Aim #1: Advance Organizational Safety Strategies Using National Action Plan Foundations will highlight recent activities of the public–private collaboration developed to improve safety across all healthcare settings.
• May 23, 3:30 to 4:30 p.m. ET: Using AHRQ’s Surveys on Patient Safety Culture® Hospital Survey and Workplace Safety Item Set will highlight how the Indiana Hospital Association used AHRQ’s Surveys on Patient Safety Culture® (SOPS®) Hospital Survey and Workplace Safety Supplemental Item Set to assess patient safety culture and workplace safety.

New Research and Evidence From AHRQ

• Rapid Evidence Product: Active Surveillance Culturing of Clostridiodes difficile and Multidrug-Resistant Organisms: Methicillin-Resistant Staphylococcus aureus, Carbapenem-Resistant Enterobacterales, and Candida auris.

AHRQ in the Professional Literature

Rural-urban differences in mortality among mechanically ventilated patients in intensive and intermediate care. Harlan EA, Venkatesh S, Morrison J, et al. Ann Am Thorac Soc 2024 May;21(5):774-81. Access the abstract on PubMed®.

Addressing pregnancy and parenting in mental health care: perspectives of women with serious mental illness. Fenwick K, Dossett EC, Gitlin R, et al. Health Affairs 2024 Apr;43(4):582-9. Access the abstract on PubMed®.

Evaluation of critical care pharmacist evening services at an academic medical center. Chase AM, Forehand CC, Keats KR, et al. Hosp Pharm 2024 Apr;59(2):228-33. Epub 2023 Nov 1. Access the abstract on PubMed®.

Antibiotic stewardship interventions for urinary tract infections in outpatient settings: a narrative review. Grigoryan L, Trautner BW. Infect Dis Clin North Am 2024 Jun;38(2):277-94. Epub 2024 Apr 4. Access the abstract on PubMed®.

Sociotechnical feasibility of natural language processing-driven tools in clinical trial eligibility prescreening for Alzheimer's disease and related dementias. Idnay B, Liu J, Fang Y, et al. J Am Med Inform Assoc 2024 Apr 19;31(5):1062-73. Access the abstract on PubMed®.

Medication safety event reporting: factors that contribute to safety events during times of organizational stress. Cohen TN, Berdahl CT, Coleman BL, et al. J Nurs Care Qual 2024 Jan-Mar;39(1):51-7. Epub 2023 May 9. Access the abstract on PubMed®.

COVID-19-associated acute kidney injury and longitudinal kidney outcomes. Aklilu AM, Kumar S, Nugent J, et al. JAMA Intern Med 2024 Apr;184(4):414-23. Access the abstract on PubMed®.

Building a regional pediatric asthma learning health system in support of optimal, equitable outcomes. Beck AF, Seid M, McDowell KM, et al. Learn Health Syst 2024 Apr;8(2):e10403. Epub 2023 Dec 11. Access the abstract on PubMed®.