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Patient Safety

Leapfrog Group Names Safe Hospitals

The Leapfrog Group has published a list of America's top 59 hospitals, based on the results of a survey of 1,200 hospitals that asked about their awareness and action on 30 Safe Practices for Better Healthcare endorsed by the National Quality Forum. Among the hospitals surveyed, nine of 10 have implemented procedures to avoid operating on the wrong part of the body, and eight of 10 require pharmacists to review all medications before filling new drug orders.

Still, the survey revealed widespread safety gaps: more than nine of 10 hospitals have not implemented computer physician order systems that meet Leapfrog's standard; nine of 10 fail to meet standards for performing two high-risk procedures (coronary artery bypass graft surgery and abdominal aortic aneurysm repair); and three of 10 lack procedures for preventing malnutrition in patients and fail to vaccinate their health care workers against the flu.

The survey results are available in a searchable database on the Leapfrog Group Web site for consumer as well as hospital administrator and clinician use.

Health Care Disparities

Webcast Focuses on Language Barriers
A recent webcast hosted by the National Health Law Program and archived on explored ways to overcome language barriers between hospital patients and providers. In conjunction with the webcast, the National Health Law Program has published a guide for providers interested in offering or improving language services. It includes tools to assess patients' needs, a directory of language service providers and training programs, and multilingual clinical resources.

During the webcast, Romana Hasnain-Wynia, Ph.D., vice president of research at the Health Research and Educational Trust, presented the results of a recent national survey that found 63 percent of hospitals treat patients with limited English proficiency on a daily or weekly basis. The majority—88 percent—provide some type of language services, including use of staff translators, telephone translation systems, or bilingual clinicians. Yet, only 3 percent of hospitals receive any direct reimbursement for such services.

Leighton Ku, Ph.D., M.P.H, senior fellow at the Center of Budget and Policy Priorities, discussed ways the federal government could create payment options for language services provided to Medicare beneficiaries.

New Bills Target Minority Health
On September 29, Congressional Delegate Donna Christensen (D-VI) introduced the Health Equity and Justice Act of 2006 (H.R. 6275), which would provide grants to public and private organizations working to address racial and ethnic health disparities in new "health empowerment zones." The bill also includes measures to increase health workforce diversity, expand language services, and improve rural health care.

On the same day, Senators Bill Frist (R-TN) and Edward Kennedy (D-MA) introduced the Minority Health Improvement and Health Disparity Elimination Act (S. 4024). The Senate bill includes similar measures as the House bill, though it also includes a proposal to create a cultural competency "clearinghouse" in the Office of Minority Health. This online database would include "easily searchable, clinically relevant information regarding culturally competent healthcare," including educational and outreach materials, advice on federal regulations, and guidance on reimbursement.

AHRQ to Measure Health Literacy Performance
The Agency for Healthcare Research and Quality (AHRQ) put out a call for survey instruments or questions that measure how effectively health plans, hospitals, group practices, and individual clinicians address their patients' health literacy needs.

Based on the responses, which were due to AHRQ Nov. 15, the agency plans to develop a new module for the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey. The module will solicit patients' perspectives on how well health information is communicated to them by health care professionals. Questions will consider the clarity of written and verbal communications about treatment choices, screening results, and medications; educational techniques; and language and administrative assistance.

Upcoming Health Literacy Conference
On Nov. 29, the Institute of Medicine and the American College of Physicians Foundation will host the fifth annual National Health Communications Conference, to be held at the National Academy of Sciences in Washington, D.C. This year's conference focuses on health literacy, bringing together researchers and other stakeholders to discuss innovative strategies for addressing low health literacy in various health care settings. Results from a new study on the relationship between literacy and understanding of prescription drug labeling will be presented. For a complete list of speakers and topics, or to register, visit the ACP Foundation site.

Health IT

HHS Advisory Group Announces IT Standards
In late October, the American Health Information Community (AHIC) announced that it approved standards for three key uses of health information technology (IT): maintaining personal health data, transmitting clinical lab results to doctors' offices, and managing disease outbreaks through rapid detection, monitoring, and response.

The standards were delivered to AHIC by the federally sponsored Health Information Technology Standards Panel. The panel was asked to review existing specifications among the rapidly proliferating electronic medical record systems now available, and to recommend uniform standards for interoperability. "Interoperability" is the crucial foundation for information-sharing among health providers and plans. Without this standardization, hospitals and doctors may be unwilling to invest in health IT.

President Bush's executive order on health IT mandated that federal agencies will have to adopt the panel's recommendations, though the Department of Health and Human Services has not discussed when this might happen.

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