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Wednesday, December 05, 2007 9:00 PM

Newscast: Lead Story - High Quality Health Care

(opening music)

Rand: This is Healthcare 411 for the week of December 5, 2007.

Debra: Healthcare 411 is produced by AHRQ, the Agency for Healthcare Research and Quality, part of the U.S. Department of Health and Human Services. I’m Debra James.

Rand: And I’m Rand Gardner. Coming up: In today’s News and Numbers, new AHRQ data finds HIV-related hospitalizations are on the decline for younger Americans, but hospitalizations among older people with HIV are on the rise.

Debra: An AHRQ report recommends that community call centers should play a bigger role in emergency response.

Rand: A new DVD explains why designing and building hospitals for safety and quality is better not only for the patients but also for the hospital’s bottom-line.

Debra: And Dr. Clancy talks about how to spot high quality health care in this week’s segment of Navigating the Health Care System. More after this.


[Begin PSA: Play it Safe, Don’t Play Around with Medicine]

Woman: Hmm, was that three pills four times a day or four pills three times a day? Do I need to wake at 2 a.m. to take one? If I missed taking the last dose should I take two doses now? Is it okay to take my vitamins with the pills? You know, I’m feeling better. Maybe I don’t need these pills anymore at all.

Narrator: Play it safe, don’t play around with medicine. If you have questions talk with your doctor or pharmacist.

[End PSA]



Rand: And now for the numbers. Every year we observe World Aids Day on December 1 to mark observance of an ongoing, critically important health care issue. More than 38 million people worldwide have HIV and AIDS. But recent reports find that many of them are living longer and staying out of the hospital. The latest AHRQ research shows that U.S. hospitals stays for HIV-positive infants under age two dropped nearly two thirds or 64 percent - between 1998 and 2005. Hospitalizations for older children, teens, and adults under age 45 are also on the decline. Researchers believe that a primary reason is life-prolonging drugs commonly known as the "AIDS cocktail that have reduced HIV-related health complications sometimes common for people with weakened immune systems. However, hospital visits for people over age 45 are on the increase - but not necessarily due to their HIV status. Researchers attribute the increase to other chronic conditions older HIV patients seem to develop as they live longer.

Debra: Where would you turn for urgent information in a public health emergency? The closest place may be your own phone. In the event of a public health crisis such as flu epidemic, a new report from AHRQ recommends expanding how we currently use poison control centers, nurse advice lines, drug information centers and health agency hotlines to help people quarantined at home. The report, named Adapting Community Call Centers for Crisis Support, is designed to help community call centers respond to callers concerned about their health risks. The call centers also can help with information on medications, how to take them, and explain potential adverse reactions. Call center staff also could be trained to identify callers who could benefit from referral to mental health services. For more information on AHRQ’s emergency preparedness reports and toolkits are available on the internet at www.ahrq.gov/prep.

Rand: Can the design of a hospital affect the quality of the care it delivers? Is it really possible that factors such as noise reduction or better lighting can improve patient satisfaction and even decrease medical errors? Scientific evidence says it can. AHRQ has released a new DVD called Transforming Hospitals: Designing for Safety and Quality that provides evidence to help hospital officials and architects design safer, high quality hospitals. This two-part DVD illustrates the value of designing the health care environment with patients and staff in mind. Not only does evidence-based hospital design increase patient safety, satisfaction and quality of care, but it also improves staff recruitment and retention efforts and overall employee satisfaction. Free copies of the new DVD are available through AHRQ’s Web site at www.ahrq.gov. Coming up, Navigating the Health Care System with Dr. Carolyn Clancy.


Debra: Recent research shows quality health care can help people stay healthy and recover faster if they become sick. However, all too often, people do not get the high-quality health care they deserve. Here to offer tips for navigating the health care system is AHRQ Director Dr. Carolyn Clancy. Dr. Clancy, what is health care quality?

Dr. Clancy: Health care quality is the right care, for the right person, at the right time, every time. This applies to getting medicines, tests and counseling that you need and also make sure that you get the services that give you the best results. We know a lot more about what health care quality means than we did just ten years ago, and as our knowledge of health care quality evolves, we gain a much better understanding of the types of treatments that work best whether it’s for a serious disease, a chronic condition, or a common childhood illness.

Debra: Can you give me an example?

Dr. Clancy: One great example is ear infections in children. They’re one of the most common reasons that parents bring their kids to the doctor’s office. Often because children have pain and a fever and they’re crying, parents expect providers to prescribe antibiotics. But we now know that more than 80% of children with ear infections get better within three days without antibiotics. We also know prescribing antibiotics too often can make the bacteria that cause some ear infections resistant to antibiotics. This means that future ear infections may be harder to treat. So, this example clearly shows that getting a prescription for an antibiotic to treat an ear infection is not always the best treatment. High quality health care depends on striking a balance in the tests and medicines that you receive.

Debra: What do you mean by striking a balance?

Dr. Clancy: Quality health care, the right care for the right person at the right time, should avoid overuse, under use and misuse of services. So high quality care means that you get all the proper routine screenings you need, like screening for high blood pressure. However, it also ensures that you’re not getting tests that you don’t need or that may actually harm you, and high quality care avoids issues like prescription medications with dangerous interactions.

Debra: What can I do, as a patient, to make sure that I’m getting quality care?

Dr. Clancy: There are a number of steps that you can take. First and foremost, ask questions. It’s very, very important to ask questions until you’re satisfied that you understand. For example, if you’re scheduled to have a medical test, here are some of the questions that you might want to ask: What is the test for? Why are we doing this? How is the test done? What are the benefits and risks of having this test? When will I get the results? And what will these results tell me?

Debra: So, be proactive and ask questions. What else should I be doing?

Dr. Clancy: You need to make sure you understand the information or the answers to the questions presented to you, especially information about medications. Also, another very important step is to make sure that you get the results of any test that you have done.

Debra: It seems like what you are saying is that part of ensuring you get high-quality health care is being involved in the health care that you and your family get.

Dr. Clancy: That’s right. It’s very important for people to be involved in their own health care. AHRQ has a booklet called Guide to Health Care Quality How to Know It When You See It. The book contains information on how to make quality a key factor in all your health care decisions.

Debra: Thank you Dr. Clancy. Copies of the booklet are available on the AHRQ Web site at www.ahrq.gov/consumer.


Rand: That’s it for the week. For more information on these and other health-related stories and topics go to www.ahrq.gov.

Debra: Healthcare 411 is produced by AHRQ, the Agency for Healthcare Research and Quality, part of the U.S. Department of Health and Human Services. For Rand Gardner, I’m Debra James. Please join us for the next edition of Healthcare 411.

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