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Quality & safety in the literature: May 2020
  1. Ashwin Gupta1,2,
  2. Jennifer Meddings1,2,3,
  3. Nathan Houchens1,2
  1. 1 Medicine Service, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan, USA
  2. 2 Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA
  3. 3 Department of Pediatrics and Communicable Diseases, University of Michigan Medical School, Ann Arbor, Michigan, USA
  1. Correspondence to Dr Ashwin Gupta, Internal Medicine, VA Ann Arbor Healthcare System, Ann Arbor, MI 48109, USA; ashwing{at}med.umich.edu

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Healthcare quality and safety span multiple topics across the spectrum of academic and clinical disciplines. Keeping abreast of the rapidly growing body of work can be challenging. In this series, we provide succinct summaries of selected relevant studies published in the last several months. Some articles will focus on a particular theme, while others will highlight unique publications from high-impact medical journals.

Key points

  • An improvement intervention combining transitional care programmes and self-management support for patients following hospitalisation for chronic obstructive pulmonary disease (COPD) resulted in more COPD-related acute care events and worse health-related quality of life. JAMA. 8 October 2019

  • Implementation of the Camden Core Model, the programme which gave rise to the interest in ‘hotspotting’ and developing healthcare plans for ‘superutilizers’ of health services, did not reduce 180-day hospital readmission rates. N Engl J Med. 1 January 2020

  • In a study of electronic health record (EHR) use in the ambulatory setting, researchers found that, on average, US physicians use the EHR for over 15 min per patient encounter. AnnIntern Med. 14 January 2020

Effect of a hospital-initiated program combining transitional care and long-term self-management support on outcomes of patients hospitalized with chronic obstructive pulmonary disease: a randomized clinical trial

JAMA. 8 October 2019

In December 2018, Aboumatar and colleagues1 published an evaluation which appeared to demonstrate that the combination of a 3-month hospital-initiated transitional care programme and self-management support reduced chronic obstructive pulmonary disease (COPD)-related acute care events and resulted in an improvement in quality of life. Soon after publication, the authors became aware of a programming error in the analytic data sets for statistical analysis. The error itself resulted in a reversal of the findings, from the positive effect previously published to a harmful effect from the intervention. In a letter to the editor in October 2019,1 the study authors acknowledged the error, requested retraction of the previously published article, explained the aetiologies of the programming errors, and discussed measures …

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Footnotes

  • Twitter @nate_houchens

  • Funding JM's research was supported by AHRQ grant K08HS019767 from 2010–2015 and is currently supported by AHRQ grants P30HS024385 and R01HS018334, as well as funding from the VA National Center for Patient Safety and the Centers for Disease Control and Prevention. JM's research has recently been supported by contracts with the Health Research & Educational Trust (HRET) involving the prevention of CAUTI, funded by AHRQ and the Centers for Disease Control and Prevention, and the Centers for Medicare and Medicaid Services. JM was also a recipient of the 2009–2015 National Institutes of Health (NIH) Clinical Loan Repayment Program. AG received funding from the Moore Foundation. All authors are salaried employees of the University of Michigan and the VA Ann Arbor Healthcare System.

  • Competing interests Honoraria: JM has reported receiving honoraria from hospitals and professional societies devoted to complication prevention for lectures and teaching related to prevention and value-based purchasing policies involving catheter-associated urinary tract infection and hospital-acquired pressure ulcers. Intellectual property/product development: JM's research involves development of products to improve patient safety by reducing hospital-acquired complications. Her team has a provisional patent involving one of these products that aims to reduce urinary catheter-associated complications, and has recently applied for a patent involving a device to reduce hospital-acquired pressure ulcers. She has no associations with any companies or manufacturers, has no ownership in a commercial entity, and receives no royalties.

  • Patient consent for publication Not required.

  • Provenance and peer review Commissioned; internally peer reviewed.

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