AHRQ releases the 2008 National Healthcare Quality and Disparities Reports

AHRQ. May 6th, 2009
2008 National Healthcare Quality & Disparities Reports
For the sixth year in a row, the Agency for Healthcare Research and Quality (AHRQ) has produced the National Healthcare Quality Report (NHQR) and the National Healthcare Disparities Report (NHDR). These reports measure trends in effectiveness of care, patient safety, timeliness of care, patient centeredness, and efficiency of care. The reports present, in chart form, the latest available findings on quality of and access to health care.

The National Healthcare Quality Report tracks the health care system through quality measures, such as the percentage of heart attack patients who received recommended care when they reached the hospital or the percentage of children who received recommended vaccinations. The National Healthcare Disparities Report summarizes health care quality and access among various racial, ethnic, and income groups and other priority populations, such as children and older adults.

So are we "Crossing the Quality Chasm?"

Some highlights from the reports:

• Healthcare is suboptimal and continues to improve at a slow pace.

• Reporting of hospital quality is leading improvement but safety is lagging.

• Health care quality measurement is evolving, but much work remains.

• Disparities persist in health care quality and access.

• Magnitude and patterns are different within subpopulations.

• Some disparities exist across multiple priority populations.

Although we are seeing some gains in improvement, we are challenged to sustain our gains and accelerate our efforts. The reports draw on lessons learned from other sectors about improvement.

Some common themes presented:

• Constancy of purpose is essential
There is no quick fix, we must remain disciplined in our approach with continued vigilance

• We must form Partnerships
Simultaneous efforts are required by multiple stakeholders

• Measurement is vital to improvement
Focus on quality, focus on results


To learn more the reports can be found here:

National Healthcare Quality Report 2008

National Healthcare Disparities Report 2008

All Staff Message from the Director

The following is an all staff message sent today by William B. Walker, M.D., Director and Health Officer, Contra Costa Health Services.

As we begin a new week, I want to share some information related to the H1N1 influenza outbreak. (We are no longer referring to it as swine influenza at the request of the federal government.)

As of today, we do not have a major increase in the number of probable cases (there are now eight.) There will no doubt be more. There are now five schools closed and there may be more closures as more test results come back, based on evolving guidelines from the State and the Centers for Disease Control and Prevention. Symptoms for most cases in the United States have been relatively mild, and preliminary work in analyzing the virus itself shows it lacks the components that made the 1918 virus so deadly. (Updated information is on our website at www.cchealth.org including a list of the closed schools.)

Last Friday, our initial shipment of Tamiflu – the antiviral for treating the disease – arrived from the federal Strategic National Stockpile. Adequate amounts have been distributed to all our local hospitals to be used by medical staff according to guidelines we are providing.

While I am cautiously optimistic about the disease not becoming unmanageable, there have been influenza outbreaks in the past where a relatively mild wave has been followed by a much more severe one, so it is too soon to relax our vigilance. And school closures certainly cause considerable problems for children, parents and other caretakers so we want to proceed with investigation of the problem in this area very cautiously and in consultation with the school community.

We are continuing to monitor the number of new cases, and in the days and weeks ahead we should know more about the virus and the outbreak. Meanwhile, continue to be vigilant about hand washing and other methods of preventing the spread of the disease. Please stay home if you are sick. People have asked about the use of masks. In general, they are not effective except for health care workers working directly with patients with influenza symptoms. It is not necessary or effective for others to use masks.

As we move into our second full week of the emergency, one thing I feel very positive about is the progress we’ve made internally and with our partners in responding. CCHS staff has been outstanding in their professional and efficient actions. Public Health (assisted by others) has staffed our Department Operations Center, preparing comprehensive plans for our response, making home visits to test suspected cases, working with schools, providers and partners to get out accurate information, shifting through avalanches of information to cull out critical directives and coordinating with our regional counterparts. Our Public Health Lab is in high gear testing samples to comply with CDC’s request that local health
departments step up surveillance.

Contra Costa Regional Medical Center has been holding twice-daily briefings with their managers to share updates on the latest directives and deploy staff appropriately. The Emergency Department has expanded its space to serve residents who are concerned about the influenza outbreak. Our Health Centers are working to identify patients with symptoms and conduct appropriate tests. Our Health Plan Advice Nurse Unit has fielded hundreds of calls from concerned patients and community members and is working with their pharmacy local provider networks. Emergency Medical Services continues to survey local hospitals to monitor emergency room activity and emerging trends. Information Systems converted our internal Incident Response Information System to a web-based application available 24/7 so
our Emergency Management Team can monitor our ongoing response from anywhere.

Fed by all of those working on the response, our Community Education and Information Unit is continually posting information on our website, blast faxing alerts to our partners and using social media like Twitter to get out our messages. Amazing as it is, in the Google search process, our website is number 20 worldwide for the search “flu pandemic” and number 11 worldwide for "gripe pandemica.”

It has been an impressive example of how an integrated health department can work together.

William B. Walker, M.D., Director and Health Officer
Contra Costa Health Services

Social Media and Us

The world is changing. Are we keeping up?

See how we're using social media at Contra Costa Health Services by clicking here.


I found this link to Hospital Crisis Communications and Social Media and on Marc Miyashiro's blog The Bridge. It's on social media and it's use at Innovis Health in Fargo, North Dakota. I think you'll find the post interesting. It gives us all something to think about when we think about communicating. I have been following CDC, and CCHS on Twitter this weekend. The quick brief updates are easy to follow. There may be something to this?

Update from Dr. Walker

Twitter Instant Update [subscribe]

"H1N1 media briefing today at 3:30pm. http://tinyurl.com/cen7he" about an hour ago

We are continuing our daily briefings at CCRMC in Building One, Conference Room One at 9AM on Saturday and Sunday and 9AM and 4PM daily on weekdays.

For updates on H1N1 virus and Contra Costa County please go to the Contra Costa Health Services website.

H1N1

As you know, there is a national health emergency in place. The outbreak of swine flu in Mexico has been deadly and has caused a shut down of normal operations in that country.
There have also been 5 states in the United States so far that have confirmed cases.
We are in preparation mode for further information and/or action plans.
At this point, at CCRMC and Health Centers, we are doing the following:

1) Respiratory precautions,
2) Appropriate testing and cultures
3) Capacity planning with regional partners
4) Frequent informational updates.

There will be twice daily open huddles--9AM and 4PM, in Conference Room One, Building 1 starting today at 4PM.

Any questions, call Anna Roth 370-5101.

Jeffrey V. Smith, MD, JD
Executive Director
Contra Costa Regional Medical CenterAnd Health Centers

FRAGILES “El futuro es hoy; mañana es mañana”: A new post from Pedro Delgado

Wanted to draw your attention to a new post from Pedro Delgado the Sub-Director, HSC Safety Forum in Northern Ireland.

FRAGILES

“El futuro es hoy; mañana es mañana”

Sing Out Loud

As we begin week two of our Value Stream Mapping, we continue our journey toward the reliable delivery of care that is always safe, timely, patient-centered, effective, efficient and equitable. I want to thank everyone for your genuine interest and tireless efforts as we move forward. I know it isn't always easy.

I offer two very brief examples of those who, when faced with criticism and resistance, stood their ground. I have added links to both examples if you want to learn more.

"To fly, we have to have resistance" -Maya Ying Lin


Maya Yin Lin, was a 20-year-old student from Yale University who faced significant criticism of her design for what has become the most-visited memorial in Washington DC, The Vietnam Veterans Memorial. In the midst of tremendous challenge, Lin remained focused in her vision and after extensive review from several government agencies, her design was chosen… yet Lin wasn't even mentioned at the dedication ceremony.

Lin has since gone on to design all over the world. A few examples of her work includes the Civil Rights Memorial in Montgomery, Alabama and an Academy Award-winning documentary Maya Lin: A Strong Clear Vision. In 2003, Lin served on the selection committee for the World Trade Center Site Memorial Competition.

"I want to be like Elaine Paige"- Susan Boyle

This one seems a bit light-hearted, but I found it wonderful and inspirational to watch Susan Boyle – as people sat laughing at her and making fun of her – stand tall and sing out loud.
Here is the link to her video.