AHRQ Emphasizes Emergency Preparedness Resources

November 2009

By Terry Rudd
Elsevier Global Medical News

BOSTON -- With pandemic A(H1N1) influenza bearing down on already overcrowded emergency departments, the Agency for Healthcare Research and Quality is rolling out resources to help EDs prepare for the immediate impact--and funding research to improve ED patient flow and care coordination after the flu has faded.

"I think of emergency physicians as ground zero for what's likely to hit and for all the uncertainties that we're collectively facing as a country," Dr. Carolyn M. Clancy, the director of AHRQ, said Oct. 4 at a meeting titled "Improving the Quality and Efficiency of Emergency Care Across the Continuum: A Systems Approach."

AHRQ cosponsored the meeting with the American College of Emergency Physicians, the Society for Academic Emergency Medicine, and the Emergency Medicine Foundation.

To help emergency providers improve surge capacity in the short term, Dr. Clancy outlined resources physicians and planners can access immediately.

AHRQ recently unveiled two interactive computer tools with guidelines for choosing alternate care facilities and determining which patients should be sent to them. The Disaster Alternate Care Facility Selection Tool and the Alternate Care Facility Patient Selection Tool are available online and in Microsoft Excel versions (www.ahrq.gov/prep/acfselection).

Dr. Clancy also high-lighted ACEP's report, "National Strategic Plan for Emergency Department Management of Outbreaks of Novel H1N1 Influ-enza" (www.acep.org/WorkArea/DownloadAsset.aspx?id=45781). In addition, she pointed emergency providers toward a 2007 AHRQ report MidSouth eHealth Alliance, "Mass Medical Care With Scarce Resources: A Commu-nity Planning Guide" (www.ahrq.gov/research/mce).

Looking to emergency preparedness over the longer term, AHRQ is funding research to improve care coordination and patient flow in the ED, she said.

"Fixing patient flow in the emergency department is not just about the emergency department," she told the audience of emergency physicians. "This is not a problem you can solve alone."

The number of individual successes in coordinating and improving emergency care is growing, and AHRQ is funding research in a several of those projects. Dr. Clancy cited the MidSouth eHealth Alliance, an information network in Memphis that combines patient data from the region's major hospitals and safety net clinics. EDs, ambulatory clinics, and hospitals can access the database (ACEPNEWS, October 2009, p. 43).

Dr. Clancy also pointed to the AHRQ-funded ParentLink project at Children's Hospital Boston, which uses computer kiosks that allow parents to provide key medical information about pediatric ED patients.

The challenge in such research projects, however, lies in understanding why interventions work--and then taking the lessons from those individual successes and applying them broadly, she said.

"For too long, health services research has been about describing problems--too many people in the ED, too many uninsured, etc.," she conceded. "Even in those states and communities that are doing well, we often have no idea why. How much is historical accident, and how much is the result of purposeful, planned activity?

"We need to know why it is that some communities are doing better, and what aspect of what they're doing can be replicated elsewhere," Dr. Clancy noted.  

For more resources, visit AHRQ's public health emergency preparedness Web site at www.ahrq.gov/prep.

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