May 6, 2025, Issue #956 
 
 AHRQ Stats:       Proportionate Healthcare Expenditures Among High Spenders Between 2018 and 2022, 21.7 percent of healthcare       expenditures were associated with the top 1 percent of spenders. The       bottom 50 percent of spenders accounted for less than 3 percent of       expenditures. (Source: AHRQ Medical Expenditure Panel Survey Statistical       Brief #560, Concentration of Healthcare Expenditures and       Selected Characteristics of People with High Expenses, United States       Civilian Noninstitutionalized Population, 2018–2022.) Today's Headlines:
 The Kaiser Permanente (KP) School of Anesthesia in       Pasadena, Calif., uses AHRQ’s Surveys on Patient Safety Culture (SOPS®)       to improve ambulatory care and expand doctoral students’ education. The       school has used the SOPS Hospital Survey in the past and       recently conducted an analysis of nationwide data from the SOPS Ambulatory Surgery Center Survey. Using the findings, school officials are working to improve patient       safety and training for certified registered nurse anesthetists (CRNAs)       using TeamSTEPPS.
  AHRQ surveys are available for hospitals, medical       offices, nursing homes, community pharmacies and ambulatory surgery       centers (ASCs). The ASC survey is designed to get feedback from the staff       about the culture of patient safety where they work.
  “Each year, KP School of Anesthesiology students must       complete rigorous projects clinically relevant to nurse anesthesiology,”       explained Mark Gabot, D.N.P., CRNA, faculty advisor for the project. “I       worked with the hospital SOPS survey a couple of years ago. This time, I       wanted to do something on a larger scale. We reached out to AHRQ and were       able to get access to the nationwide ASC data for 2021 through 2023. Both       certified registered nurse anesthetists (CRNAs) and physician       anesthesiologists had completed the surveys,” he said.
  The project helped identify strengths and areas for       improvement, as well as create best-practice recommendations for patient       safety from an anesthesia-informed perspective. After reviewing the data,       the team recommended regular use of ASC SOPS and TeamSTEPPS,       establishment of a “just culture” for anesthesia practitioners and       implementation of a patient safety reporting system.
  In response to the project results, the KP School of       Anesthesia is improving its TeamSTEPPS training program. “Every year, we       conduct TeamSTEPPS training for our students to promote that just       culture,” Dr. Gabot said. “Thanks to this project, we’re actually       reformatting our TeamSTEPPS approach and education to reflect what the       team found in the secondary analysis study.”   Methicillin-resistant Staphylococcus aureus (MRSA) is one of the most invasive and deadly multidrug-resistant         organisms. Preventing MRSA and surgical site infections is a complex         patient safety issue that requires a multifaceted effort. AHRQ’s new MRSA Prevention Toolkit: Targeting SSI provides extensive resources, including PowerPoint presentations,         facilitator guides, one-page summary documents and staff and patient         training materials to help your facility get started or supplement your         existing MRSA reduction efforts for cardiac, hip and knee replacement         and spinal fusion surgeries.    |  
 Researchers for an AHRQ-funded study in         Clinical Infectious         Diseases developed a new sepsis overtreatment surveillance         metric and subsequently established the validity and usefulness of         electronic health record data–derived criteria. The measure identified         a 22.5 percent overtreatment in 113,764 adult patients admitted to the         emergency department with suspected sepsis who received intravenous         antibiotics within three hours of admission without a blood culture         sepsis test. Further, the instrument found that 7.6 percent of patients         were overtreated and received antibiotics within one hour after         admission. The results showed that the average number of antibiotic         days, average length of stay and hospitality mortality rate were all         higher for patients who received antibiotic overtreatment, and also         showed a higher incidence of Clostridioides difficile infection within six months of discharge. Access         the abstract.    |  
 In 2022, 21.7 percent of healthcare spending was done       by the highest 1 percent of spenders. Each year, AHRQ gathers the most       up-to-date information on high spenders and makes it available through       our data visualization series. Now updated with 2022 statistics, this interactive tool makes it easy to       track the most common conditions, demographics, payers and service types       associated with high spending. Explore the latest data and check out the       highlights in our associated statistical brief.   Voluntary data submission for AHRQ’s Consumer       Assessment of Healthcare Providers and Systems (CAHPS) Health Plan Survey       Database is open from June 2 to June 27. Organizations that administered       the CAHPS 5.1 or 5.1H Health Plan Survey between June 29, 2024, and June       27, 2025, are eligible to submit data. The database is accepting       submissions for the Adult Medicaid survey, the Child Medicaid or       Children’s Health Insurance Program (CHIP) survey without the Children       with Chronic Conditions Item Set and the Child Medicaid or CHIP survey       with the Item Set. Participating organizations will receive a private       feedback report comparing their results with aggregated data from other       participants and access to database products that support quality       improvement and research. Learn more about submission requirements and       data specifications at AHRQ’s CAHPS Database website.   AHRQ’s National Center for Excellence in Primary Care       Research Webinar, “The Role of Primary Care in Maternal Health: Factors       that Impact Perinatal Care Experience and Outcomes,” held March 6,       explored key factors affecting perinatal care. Speakers from Oregon       Health & Science University, University of Michigan and Harvard       School of Public Health emphasized the need for respectful maternal care.       All speakers agreed that better care coordination and communication are       critical to improving maternal and infant health outcomes. The panelists       answered audience questions on strategies for implementing respectful       maternity care training, integrating primary care follow-up into       postpartum care models and evaluating the health and economic impacts of       Medicaid extension on postpartum outcomes. Access the recording and presenter materials for this event.   - May 7, 1–2:30 p.m. ET: AHRQ Public Listening            Session on Opportunities to Update the Patient Safety Indicators. AHRQ is conducting a gap analysis to identify opportunities to            improve and expand Patient Safety Indicators, including into new            care settings and populations. This webinar will share the interim            findings of the analysis, featuring initial reactions from Sue            Sheridan, M.I.M., M.B.A., and Peter Pronovost, M.D., Ph.D. Feedback            is welcome from a broad range of stakeholders.
 - May 8, 11–11:30 a.m. ET, and May 14, 2–2:30 p.m.            ET: AHRQ Safety Program            for HAI Prevention: CLABSI Recruitment Webinars. Learn how participants in the program will receive expert support to            prevent infections and promote safety culture.
 - May 13, noon–1 p.m. ET: Implementing CMS’            Patient Safety Structural Measure (PSSM). This            webinar from the National Action Alliance for Patient and Workforce            Safety will include leaders on the front line of PSSM implementation            and delve into tools and resources that support implementation of            the five domains of the PSSM: Leadership Commitment, Strategic            Planning and Organizational Policy, Culture of Safety and Learning            Health System, Accountability and Transparency, and Patient and            Family Engagement.
 
  | AHRQ in the       Professional LiteratureChanges in blood pressure, medication       adherence, and cardiovascular-related health care use associated with the       2018 angiotensin receptor blocker recalls and drug shortages among       patients with hypertension. Callaway Kim K, Roberts ET, Donohue JM, et       al. J Manag Care Spec       Pharm. 2025 May;31(5):461-71. Access the abstract on PubMed®.
  Designing health care provider-centered       emergency department interventions: participatory design study. Seo W, Li       J, Zhang Z, et al. JMIR Form Res. 2025 Apr 21;9:e68891. Access the abstract on PubMed®.
  Between-visit asthma symptom monitoring       with a scalable digital intervention: a randomized clinical trial. Rudin       RS, Plombon S, Sulca Flores J, et al. JAMA Netw Open. 2025 Apr 1;8(4):e256219. Access the abstract on PubMed®.
  Challenges of managing pediatric       polypharmacy in a pediatric complex care program: a qualitative pilot       study. Reedy J, Thompson T, Begum A, et al. J Am Pharm Assoc. 2025 Mar 22. [Epub       ahead of print.] Access the abstract on PubMed®.
  NICU parent and staff advocacy to address       parental mental health. Klawetter S, Gievers L, McEvoy CT, et al. Clin Pediatr. 2025       Feb;64(2):247-56. Epub 2024 Jun 10. Access the abstract on PubMed®.
  Methodology of a social network survey in       primary care practices with medical home attributes. Dixon J, Turi E,       Pollifrone M, et al. J Ambul Care Manage. 2025 Apr-Jun;48(2):84-94. Epub 2025 Feb       24. Access the abstract on PubMed®.
  User-centered design of a       preference-driven patient activation tool for optimizing depression       treatment in integrated primary care settings (The Transform DepCare       Study). Dauber-Decker KL, Serafini MA, Monane R, et al. J Gen Intern Med. 2025       Feb;40(2):556-68. Epub 2024 Jun 4. Access the abstract on PubMed®.
  Development of an evidence- and       consensus-based Digital Healthcare Equity Framework. Hatef E, Hudson       Scholle S, Buckley B, et al. JAMIA Open. 2024 Dec;7(4):ooae136. Epub 2024 Nov 15. Access the abstract on PubMed®. Contact Information For comments or questions       about AHRQ News Now, contact Karen Fleming-Michael, (301) 427-1798 or Karen.FlemingMichael@ahrq.hhs.gov.  |