Issue link: https://beckershealthcare.uberflip.com/i/1149353
30 QUALITY IMPROVEMENT & MEASUREMENT How this St. Louis hospital cut C-section rates with better communication By Anne-Marie Kommers S SM Health St. Mary's Hospital in St. Louis has reduced its cesarean section rate to 12 percent, in part due to improved provider communica- tion, according to a case study from the Agency for Healthcare Research and Quality. St. Mary's implemented AHRQ's TeamStepps training program for employees in its obstetrics department in 2007. The program emphasizes communication and teamwork among hospital workers to improve patient care and safety. For every obstetrics patient at St. Mary's, the charge nurse and chief resident lead interdisciplinary "huddles" to discuss patient progress with nurses, obstetricians, neonatologists and anesthesiologists. Team members decide whether the patient's care needs to be adjusted with input from the bedside nurse and the patient. The hospital tries to avoid risky C-section deliveries when possible, particu- larly for first-time mothers. Still, around 75 percent of mothers who first deliv- er via C-section deliver vaginally in subsequent pregnancies at St. Mary's. n 'Weekend effect' on hospital care quality a myth, study suggests By Anuja Vaidya T he "weekend effect," defined as differences in patient outcomes for those admitted on weekends com- pared to admissions on weekdays, may not be a "reliable indicator of care quality" on weekends, according to a study published in BMJ Open. Researchers reviewed seven databases for studies investigating the weekend effect on mortality, adverse events, length of hospital stay or patient satisfaction. ey searched the databases from January 2000 to April 2015 and updated the search in one data- base, Medline, to include studies through November 2017. ey included 68 studies involving 640 mil- lion admissions. Of these, 24 were conduct- ed in the United Kingdom and 22 in the United States. Researchers found that on weekends: • Fewer patients are admitted to hos- pitals. • ose who are admitted are more severely ill. • ere are differences in care pathways before and aer admission. e evidence regarding the weekend effect on adverse events and length of stay is "weak and inconsistent, and that on patient satisfaction is sparse," the authors wrote. Additionally, researchers observed that the weekend effect appeared greater for elective than emergency or maternity procedures. "e weekend effect is unlikely to have a single cause or to be a reliable indicator of care quality at weekends," the study authors concluded. n AHRQ aims to prevent 1M diagnostic errors annually by 2025 By Anne-Marie Kommers T he Agency for Healthcare Research and Quality hopes to prevent 1 million diagnostic errors per year by 2025, according to a blog post on the organization's website. Diagnostic errors currently impact about 12 million Americans, and medical malpractice claims cost over $100 billion annually. AHRQ's plan comes partly in response to the National Academy of Medicine's 2015 re- port Improving Diagnosis in Healthcare, which identified several causes of diagnostic errors, including miscommunication and a lack of transparency in healthcare workplaces. With the aid of $2 million in Congressional funding, AHRQ will focus its research on what it calls the "Big Three" disease categories linked to half of all diagnostic errors: vascular events, cancer and infection. Research findings can help develop tools that reduce diagnostic errors. AHRQ research-based strategies include Patient Safety Learning Labora- tories, a Health Services Research project, a guide to improving laborato- ry testing and the AHRQ QuestionBuilder App, which allows patients to prepare questions before appointments to improve diagnosis timing and accuracy. n