Quality in Practice - A Monthly Newsletter
February 2010
 
Doctor's Office Quality - Care Management 
 
Free February 24 Teleconference Focuses on Avoidable Hospitalizations with HIT
AHRQ-sponsored session features nationally recognized experts.  
 
Register now for a free, 90-minute teleconference highlighting the latest research on leveraging health IT to reduce hospitalizations and to improve transitions in care. Sponspored by the Agency for Healthcare Research and Quality (AHRQ), this Web-based event provides an overview of the current state and challenges IT systems will face in managing transitions in care.
 
Scheduled speakers are Stephen Jencks, MD, MPH, senior fellow at the Institute for Healthcare Improvement; Bryan Jack, MD, representing CDC and AHRQ, who created "Project RED," an innovative hospital discharge program; and Terry Field, DSc, University of Massachusetts and Meyers Primary Care Institute. 
 
The teleconference is Wednesday, February 24, 2 to 3:30 p.m. (CT). To register, go to the AHRQ registration page and select the "Register" option. 
 
 
Improve CRC Screening Rates by Addressing Barriers
Panel identifies out-of-pocket costs, discomfort and access as issues.  
 
Earlier this month, a National Institutes of Health panel issued a draft statement to support improved colorectal cancer (CRC) screenings by helping patients overcome obstacles to these life-saving tests. The panel cited out-of-pocket costs, regular access to health care providers and insurance coverage as key issues affecting a patient's ability and willingness to get CRC screenings. Additionally, the panel noted that screening rates differ across racial and ethnic groups, socioeconomic status and geographic location. The panel recommends targeted strategies for specific populations. 
 
 
Free "Everyday Choices" Prevention-focused Patient Ed Materials from AHA, ADA and ACS
Cancer screenings, healthy living and risk factor information included in communications kits.
 
The "Everyday Choices" patient education communications kits, valued at $400, are available at no cost to physician offices that order through the campaign Web site. This collaborative effort from the American Heart Association (AHA), the American Diabetes Association (ADA) and the American Cancer Society (ACS) strives to educate people about their risks for cancer and chronic disease while encouraging behaviors that prevent disease and illness. Kits include an average of 400 information cards, a pop-up stand, wall mounts and notepads.
 
 

Yes, You Should Get an H1N1 Vaccine
CDC maintains the virus is still a "threat." 
Despite the early and intense flu season, patients should be reminded that flu season typically winds down in May, and with three months left in the flu season, people still should get vaccinated.
 

Most Adults Not Getting the Vaccines They Need
Rates of seniors not getting pneumonia immunization a particular concern.

According to data released by public health experts, 30% of seniors in 36 states had not received a pneumonia vaccine. Other rates of immunization were also extremely low: tetanus, diphtheria and pertussis (2.1%), shingles (under 2%) and seasonal influenza (36%). To boost rates, representatives from the Centers for Disease Control and Prevention and other health organizations recommend that physicians make adult vaccinations part of general physicals or cancer screenings and make a review of vaccinations part of standard care.
 
 
 
Campaign for Kidney Health
 
Chronic Kidney Disease Provider Education:
"Hypertensive and Antihypertensive Agents in CKD" 
Register now for free education event.
 
This free teleconference will focus on hypertension as a cause and complication of chronic kidney disease (CKD), as well as components of hypertensive therapy including the roles of ACEi/ARBs and other agents to control blood pressure. The presenter is Howard Pitluck, MD, MPH, FACS, vice president and CEO of Health Services Advisory Group, Inc. 
 
Two sessions are scheduled: Thursday, February 25, at 11 a.m. (CT) and Wednesday, March 3, at noon (CT). For more information and to register online, click here.
 
 
Learn More About the "30-20-10" Rule for Renal Care
Timely interventions can decrease catheter-only placement in hemodialysis patients.
 

More than 80% of patients initiating hemodialysis in the U.S. in 2006 did so with catheters, which are associated with the worst mortality risk by access type. Learn more about the "30-20-10" rule in this brief overview, which describes opportune points of care management that align with the estimated glomerular filtration. The authors suggest timely patient education and counseling could significantly affect the rate of catheter use in renal patients.

 

What Pharmacists Want You to Know about ACEs and ARBs
Quick one-pager covers the "top 10" of ACE/ARB therapy for the CKD patient.

Developed by pharmacists for the physician, this one-page PDF overview of angiotensin-converting enzyme (ACE) inhibitor and angiotensin-receptor blockers (ARB) covers dosage recommendations, side effects and relevant research findings with regard to treatment for the chronic kidney disease patient. Download from the TMF Kidney Health page.

 
 
Higher Proteinuria Levels Increased Risk for MI, Kidney Failure
Mortality and adverse outcomes are linked to proteinuria.
 
A study focusing on lab registration data that included more than 900,000 adults found an adjusted mortality risk was twofold higher in patients with heavy proteinuria when compared with a group of patients with a similar estimated GFR but without proteinuria. The researchers suggest "future revisions to the classification system for chronic kidney disease should incorporate information from proteinuria."
 

Promising Findings from Diabetes Prevention Study  
Ten-year follow-up shows interventions are sustainable and effective.
  

Intensive lifestyle interventions or metformin therapy can prevent or delay development of type 2 diabetes in high-risk adults, according to recently published research. The article is the first report of the Diabetes Prevention Program Outcomes Study. (posted at Medscape -- free registration required)
 

Patient and Staff Education: Listening for the Bruit
Online audio files can help patients and staff identify warning "sounds" in fistulas.
 

Established arteriovenous fistulas need frequent monitoring to ensure maturation and strengthening. Teaching patients to listen for the "bruit" -- the sound of blood flowing through the fistula -- is part of the patient self-management regimen. New audio files posted on the Fistula First Web site (click on link in right column) clearly demonstrate the differences between a healthy fistula and one with potential problems.

  

Call Us for Free Patient Education Kits
"Save Your Veins" wristbands and "Exercise Your Fistula" interventions focus on empowering patients.

Empower your chronic kidney disease patients to actively participate in their course of treatment by providing them with these free education kits.

The "Save Your Veins" wristband and education card teaches patients the importance of preserving their veins for future vascular access as well as how to communicate this need to health care providers.

For patients preparing for or recovering from fistula surgery, the "Exercise Your Fistula" kit contains an easy-to-read information brochure, tourniquet and kidney-shaped squeeze ball. Clearly labeled "5 minutes, 5 times a day," this kit encourages patients to watch for post-op issues and start a simple exercise program to promote maturation of their fistulas.

To participate in this intervention and receive kits to educate your patients about vein preservation, call TMF's Campaign for Kidney Health at 1-866-439-8863 or e-mail us at KidneyHealth@tmf.org.

 
This material was prepared by TMF Health Quality Institute, the Medicare Quality Improvement Organization for Texas, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents do not necessarily reflect CMS policy. 9SOW-TX-PRE-10-05