November 2004

 Mission:  To expand the use of information, information technology, management systems, and incentives to foster a health care delivery system that produces the safest, highest-quality health care possible at the lowest possible cost.



HHS reaches out for help on health information exchange


Rural healthcare needs improved information technology


FDA works to advance radio frequency identification technology


Healthcare quality still concerns many Americans


AHRQ Releases Patient Safety Culture Survey


Leapfrog releases results of Hospital Quality and Safety Survey


Shorter hospital shifts reduce errors and improve patient outcomes



Reducing interns' weekly work hours - surprise! - increases sleep and decreases attention failures



16th Annual National Forum on Quality Improvement in Health Care still taking registrations



1.  HHS reaches out for help on health information exchange.  The Office of the National Health Information Technology Coordinator (ONCHIT) has released a request for information seeking public comment regarding how widespread interoperability of health information technologies and health information exchange can be achieved through a National Health Information Network.  ONCHIT is reaching out to gather information regarding how to deploy, operate and sustain a health information exchange.  The public comment period expires on January 18,


2.  Rural healthcare needs improved information technology.  The Institute of Medicine recently released the report Quality Through Collaboration: The Future of Rural Health. It examines the quality of healthcare in rural America. Information technology was among the items the Institute of Medicine listed as a means to address the quality challenges in rural healthcare. The IOM recommended investing in an information and communications technology infrastructure to enhance health and healthcare over the coming decade.


3.  FDA works to advance radio frequency identification technology

The Food and Drug Administration (FDA) is advancing its efforts to improve the safety and security of the nation's drug supply by publishing a compliance policy guide for implementing radio frequency identification (RFID) feasibility studies and pilot programs.  RFID technology uses tiny electronic tags on product packaging to allow manufacturers and distributors to more precisely track drug products as they move through the supply chain.  The FDA is also creating an internal RFID workgroup to monitor RFID adoption in the pharmaceutical industry, identify regulatory issues raised by this technology and to develop methods to deal with those issues.


4.  Healthcare quality still concerns many Americans.  Americans are still highly concerned over the quality of healthcare in America and many feel that it is in decline according to the National Survey on Consumers' Experiences With Patient Safety and Quality Information.  The survey comes five years after the Institute of Medicine released a report entitled To Err Is Human: Building a Safer Health System that concluded that 44,000 to 98,000 Americans die every year in hospitals due to preventable medical errors.  Forty percent of the respondents to the new survey say the quality of health care has gotten worse in the past five years.  A third of the respondents also said that they or a family member have experienced a medical error at some point in their life.  The survey was conducted by the Henry J. Kaiser Family Foundation, the U.S. Agency for Healthcare Research and Quality, and the Harvard School of Public Health.


5.  AHRQ releases patient safety culture survey.  The Agency for Healthcare Research and Quality (AHRQ) has released the new Hospital Survey on Patient Safety Culture.  The new survey is intended to help hospitals and health systems evaluate employee attitudes about patient safety.  The survey provides hospitals and health systems with the basic knowledge and tools needed to conduct a safety culture assessment and with suggestions about how to use that data.  The survey was originally pilot-tested with over 1,400 hospital employees from 21 hospitals to ensure that it was easily understood and relevant.  It was released in partnership with the Department of Defense, the American Hospital Associations and Premier, Inc.


6.  Leapfrog releases results of Hospital Quality and Safety Survey.  The Leapfrog Group, a coalition of purchasers and payers, released results of patient safety and quality assessments of over 1,000 hospitals this week.  The results of the survey of hospitals' compliance with practices endorsed by the National Quality Forum shows wide variation in the rate of adoption of the recommended practices.  For example, while 80% of hospitals have procedures to avoid wrong-site surgery, only 40% have protocols to prevent malnutrition in patients.  Hospital-specific results are available at no cost on the Leapfrog Group's website at


7.  Shorter hospital shifts reduce errors and improve patient outcomes.  Two studies confirm that shortening the length of on-call shifts improves doctors' performance, and in turn, patient outcomes.  In the first study, twenty interns were examined during their two three-week rotations in intensive care units.  The interns were observed during traditional work weeks which included work shifts of 30 consecutive hours scheduled every other night and a special schedule in which work shifts were a maximum of 16 consecutive hours.  In the second study, researchers examined the number of serious medical errors made when doctors worked a traditional schedule with extended (24 hours or more) work shift every other shift (an "every third night" call schedule) as compared to when they worked an intervention schedule that eliminated extended work shifts and reduced the number of hours worked each week.


8.  Reducing interns' weekly work hours - surprise! - increases sleep and decreases attention failures.  Twenty interns were studied during two three-week rotations in intensive care units, each during both the traditional and the intervention schedule.  The intervention schedule required that all interns work less than 80 hours per week, which was, on average, 19.5 hours less per week than their traditional schedule.  The intervention schedule resulted in interns gaining 5.8 hours more sleep per week, as well as more sleep in the 24 hours preceding each working hour.  Interns had less than half the rate of attentional failures while working during on-call nights on the intervention schedule as compared with the traditional scheduleTherefore, the study concluded that eliminating interns' extended work shifts in an intensive care unit significantly increased sleep and decreased attentional failures during night work hours.


9.  16th Annual National Forum on Quality Improvement in Health Care still taking registrations.  The National Forum on Quality Improvement in Health Care draws approximately 4,000 health care leaders from around the world and an additional 6,000 participate via satellite.  This year's forum is December 12 to 15 in Orlando, Florida.  The two-day General Conference (December 14 and 15) features four plenary presentations, more than 100 workshops, a full resource Exhibition Hall, the National Forum Bookstore, quality improvement storyboards, and numerous opportunities for networking.  It will be preceded by two days of "pre-conference" learning labs and mini-courses.  To find out more, go to



The House 21st Century Health Care Caucus thanks the following organizations for their contributions to this newsletter:

HIMSS (Healthcare Information and Management Systems Society) is the healthcare industry's membership organization exclusively focused on providing leadership for the optimal use of healthcare information technology and management systems for the betterment of human health.  HIMSS frames and leads healthcare public policy and industry practices through its advocacy, educational and professional development initiatives designed to promote information and management systems' contributions to ensuring quality patient care.  On the web at (Items 1-5)

The Institute for Healthcare Improvement (IHI) is a not-for-profit organization leading the improvement of health care throughout the world.  Founded in 1991 and based in Boston, MA, IHI is a catalyst for change, cultivating innovative concepts for improving patient care and implementing programs for putting those ideas into action.  Thousands of health care providers participate in IHI's groundbreaking work. To find out more, go to (Item 9)