AHRQ Electronic Newsletter, August 12, 2015, Issue #482

August 12, 2015, Issue #482 AHRQ Stats: Pediatric Hospital Stays Among pediatric asthma and diabetes patients, the rate of hospital stays that could have been prevented increased 21 percent from 2008 to 2012. That reversed trends in 2003 to 2008, when the rate of preventable hospital stays declined 34 percent for asthma patients and 16 percent for diabetes patients. (Source: Agency for Healthcare Research and Quality, Healthcare Cost and Utilization Project Statistical Brief #192: Potentially Preventable Pediatric Hospital Inpatient Stays for Asthma and Diabetes, 2003-2012.) Today's Headlines: New Data Resource on Employer-Sponsored Insurance Shows No Significant Change in Premium Growth Rates in 2014 AHRQ Study Identifies Opportunities to Improve Support Programs for Clinicians Involved in Adverse Events Designing Web Applications for Older Health Consumers – Easier Said Than Done Coverage Alone Might Not Reduce Dental Emergency Department Visits, AHRQ Study Indicates Register Now: Online TeamSTEPPS Master Trainings Featured Impact Case Study: New York City Uses AHRQ’s TeamSTEPPS®, Other AHRQ Resources To Advance Patient Safety New Data Resource on Employer-Sponsored Insurance Shows No Significant Change in Premium Growth Rates in 2014 Premiums for employer-sponsored insurance in 2014 grew an average of 3.9 percent for family policies and 4.7 percent for single and employee-plus-one policies, according to a new chartbook based on data from AHRQ’s Medical Expenditure Panel Survey-Insurance Component (MEPS-IC). These annual growth rates were not statistically different from the 2012 to 2013 increases (3.5 percent for single coverage, 3.5 percent for employee-plus-one coverage and 3.6 percent for family coverage). The MEPS-Insurance Component 2014 Chartbook describes trends in employer coverage, premiums and benefits from 2003 to 2014. The chartbook presents easily accessible graphs and maps to facilitate comparison of long term trends and to visualize state data previously released only in tables. The chartbook is based on data from private-sector employers in the MEPS-Insurance Component, an annual survey of private employers and state and local governments that is designed to be representative of all 50 States and the District of Columbia. While other sources have also provided estimates for 2014, AHRQ's large sample allows for state-level estimates and estimates by firm sizes affected by distinct Affordable Care Act provisions. AHRQ Director Rick Kronick, Ph.D., has published a blog providing more detail about the chartbook. AHRQ Study Identifies Opportunities to Improve Support Programs for Clinicians Involved in Adverse Events A majority of health care organizations have programs to provide emotional support to health care workers after adverse events, but features vary widely and there are substantial opportunities to improve services, according to a study by AHRQ. Clinicians involved in medical errors are often referred to as “second victims” because they can experience persistent negative effects such as guilt, embarrassment, self-doubt and fear that can have serious consequences on their well-being, work performance and patient safety. Researchers conducted an electronic survey of 575 members of the American Society for Healthcare Risk Management, including risk managers, executives, patient safety officers, directors of quality and compliance officers, to ascertain how they would characterize the structure and performance of their provider support program, if a program was available. Investigators found that while 74 percent of health care organizations maintain a support system, they vary widely and many lack important elements recommended by national standards. The study underscores the need for health care organizations to provide support systems for health care workers involved in adverse events. The study and abstract, “Risk Managers' Descriptions of Programs to Support Second Victims After Adverse Events,” were published online April 17 in the Journal of Healthcare Risk Management. Designing Web Applications for Older Health Consumers – Easier Said Than Done Consumers older than 65 may have difficulty using Web applications to identify providers that meet their needs, according to an AHRQ-funded study. Researchers created a Web application that enabled Rhode Island consumers to compare home health agencies based on information such as services offered and health outcomes. They conducted usability testing of the Web application using two focus groups, totaling 14 older consumers looking for information about home health agencies and six hospital case managers. Investigators noted that while Web applications are a cost-effective way to disseminate information, it is important to ensure that people with low literacy, low health literacy and low computer proficiency can access, understand and use these applications. Although the researchers based their initial design on best practices, user testing showed that they overestimated the extent to which older adults were familiar with using computer applications. Researchers subsequently adopted simpler navigation and additional user prompts. The study and abstract were published in the May 15 issue of the journal eGEMS (Generating Evidence & Methods to improve patient outcomes). Coverage Alone Might Not Reduce Dental Emergency Department Visits, AHRQ Study Indicates More Americans may gain dental coverage under Medicaid, but access to dental providers remains a challenge, according to a new AHRQ-funded study. The Affordable Care Act extends Medicaid coverage to millions of Americans, but in many states adult dental coverage is not included. The study indicated Medicaid dental coverage could result in fewer emergency department (ED) visits because patients with that coverage are more likely to visit a dentist for care that can prevent the need for costly ED visits for dental conditions. The study examined county-level rates of ED visits for nontraumatic dental conditions in 29 states in 2010 in relation to dental provider density and Medicaid coverage of nonemergency dental services. It found that higher dental provider density was associated with lower rates of dental ED visits by patients with Medicaid in rural counties but not in urban counties, where most dental ED visits occurred. The study and abstract, “Medicaid Dental Coverage Alone May Not Lower Rates of Dental Emergency Department Visits,” were published in the August issue of the journal Health Affairs. Register Now: Online TeamSTEPPS Master Trainings TeamSTEPPS® (Team Strategies and Tools to Enhance Performance and Patient Safety) is an evidence-based approach to improve communication and teamwork among health care teams. TeamSTEPPS Master Trainers serve within their institutions to help prepare for, implement and champion the TeamSTEPPS teamwork approach. Those interested in becoming TeamSTEPPS Master Trainers are encouraged to register free of charge for TeamSTEPPS online learning. Participants who wish to be certified as Master Trainers must complete 11 learning modules and conduct a virtual “teach-back” session with one of AHRQ’s TeamSTEPPS Master Trainers. Registration is open. Featured Impact Case Study: New York City Uses AHRQ’s TeamSTEPPS®, Other AHRQ Resources To Advance Patient Safety New York City Health and Hospitals Corporation uses TeamSTEPPS, the Hospital Survey on Patient Safety Culture and the Emergency Severity Index to improve patient care and safety in HHC’s 11 acute care hospitals, five nursing homes, six diagnostic and treatment centers, and more than 70 primary care sites. TeamSTEPPS strategies helped reduce catheter-associated urinary tract infections by 98 percent at one facility.