Akira Nishisaki, M.D., a pediatric critical care physician in the Department of Anesthesiology and Critical Care Medicine at the Children’s Hospital of Philadelphia, has dedicated his career to improving the quality of care and outcomes for critically ill or injured children experiencing respiratory failure, the leading cause of death in infants and children. With funding from AHRQ, Dr. Nishisaki has designed and implemented easily modifiable quality improvement processes that make pediatric airway management safer during tracheal intubation—a common but high-risk procedure that helps with breathing when the airway is blocked or damaged.  

Dr. Nishisaki’s AHRQ research began with the National Emergency Airway Registry for Children (NEAR4KIDS), a quality improvement database that documents outcomes of tracheal intubations based on patient, provider and practice factors. Findings from the NEAR4KIDS database served as the foundation for his future research. Using NEAR4KIDS registry data, Dr. Nishisaki’s team created the airway bundle checklist, a tool medical teams could easily use at the patient’s bedside before, during and after tracheal intubation. Later projects focused on specific quality improvement interventions for procedures that occur during tracheal intubation, including video laryngoscope, apneic oxygenation and bag mask ventilation. All three interventions reduced adverse events and continue to be used throughout the NEAR4KIDS network of pediatric intensive care units (ICUs).  

Dr. Nishisaki’s current grant, Smart Checklist Implementation for Pediatric Tracheal Intubations in the ICU-Multicenter Study: SMART PICU, aims to update and digitize the airway bundle checklist developed with his second AHRQ grant. 

Dr. Nishisaki serves as chair of the Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network, the largest nonprofit pediatric ICU clinical research network. He accredits his successful track record and ability to lead the PALISI network to the support he has received from AHRQ.

On May 7, AHRQ hosted the Public Listening Session on Opportunities to Update the Patient Safety Indicators, a virtual meeting that gathered more than 700 attendees. Patient Safety Indicators (PSIs) are quality indicators that provide information on potentially avoidable safety events that represent opportunities for improvement in the delivery of care. Speakers from AHRQ, MITRE and UC Davis discussed the history of PSIs and shared interim findings from a gap analysis that aims to identify opportunities for future PSI measurement. Anneliese Schleyer, M.D., M.H.A., a practicing hospitalist and chief medical officer at UW Medicine in Seattle, shared a provider’s perspective on PSI gaps and opportunities. Throughout the session, attendees submitted comments on future PSIs.

Interested stakeholders still have the opportunity to send in feedback through June 27. Visit the website to submit your comments and access the recording and materials for this event.

• The first study, published in Health Affairs Scholar, examined 3,142 older adults and found that those with a cancer history were more likely to initially select traditional Medicare plus supplemental coverage relative to their counterparts without a cancer history. Compared with selecting traditional Medicare without supplemental coverage, choosing either traditional Medicare with supplemental coverage or Medicare Advantage was associated with lower levels of out-of-pocket spending and a lower probability of fair or poor health.
• The second study, published in The American Journal of Managed Care, focused on 3,249 beneficiaries aged 50 to 64 with long-term disabilities or other qualifying conditions. It revealed that beneficiaries enrolled in traditional Medicare plus supplemental coverage or Medicare Advantage were less likely than those with traditional Medicare without supplemental coverage to experience access and/or affordability issues, including cost-related medication nonadherence, delayed care or difficulty finding a usual source of care. No significant differences were observed among those also eligible for Medicaid.