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Am Fam Physician. 2002 Dec 15;66(12):2195-2197.

HHS Issues Recommendations for Increasing Regulatory Efficiency

The Department of Health and Human Services (HHS) Advisory Committee on Regulatory Reform recently released its final report of 255 recommendations for improving and streamlining regulatory requirements across HHS agencies to improve access to quality health care and services. The recommendations involve a broad range of actions, such as ways to: reduce potential obstacles to patients' access to care, reduce the time physicians and other health care professionals must spend on paperwork, improve communication with consumers, and improve the use of technology to promote quality care while ensuring that patients have strong privacy protections. HHS and its agencies have already implemented 26 of these recommendations, including the following: the HHS' Centers for Medicare & Medicaid Services (CMS) launched a new effort to streamline Medicare's paperwork requirements for home health nurses and therapists; Medicare reduced the frequency that hospitals must gather detailed information from Medicare beneficiaries about other insurance; and CMS proposed common-sense improvements to clarify the requirements for hospitals to screen and treat patients in emergency departments. The committee's report is available online at www.regreform.hhs.gov.

AHRQ Initiative Accelerates Process of Turning Research into Practice

The Agency for Healthcare Research and Quality (AHRQ) recently announced the funding of a coordinated set of 22 projects called Partnerships for Quality that will test prototype activities designed to expedite the health system's adoption of research findings that have been proven to improve quality of care for patients. The projects will develop partnerships among researchers, health plans, medical and nursing facilities and services, employers, consumer groups, and professional societies. Funding for fiscal year 2003 totals $2.4 million, which will be distributed to more than 88,000 medical providers; 5,800 hospitals, nursing homes and other health care facilities; and 180 health plans. The projects will test financial incentives and rewards to speed the adoption of recommended hospital patient safety practices; test an innovative team-oriented, practice-based continuing medical education program to improve care for patients with diabetes; build partnerships to promote cooperation in implementing quality-improvement strategies in long-term care facilities; and incorporate validated quality measures into the recertification of family physicians. This initiative is part of AHRQ's overall strategy to have research findings produce real improvements in the quality and outcomes of health care. Other projects in the Partnerships for Quality initiative include the following: those that will help community primary care practices adopt quality-improvement models for treating heart disease, stroke, diabetes, and other conditions; those that will create a national center for value-based purchasing methods; and those that test a bioterrorism simulation model with large health care networks. For more information, visit the AHRQ grants online database at www.gold.ahrq.gov.

IOM Report Recommends Improvements to the Public Health Infrastructure

A new report by the Institute of Medicine (IOM) presents a comprehensive framework for improving the public health care system in the United States by overhauling the funding, organization, and coordination of the federal government public health infrastructure. The report, “The Future of the Public's Health in the 21st Century,” recommends that academia, community organizations, businesses, the media, individual members of society, and others all work in partnership with the government to promote and protect the nation's health. Even with these partnerships, the federal, state, and local governments must still provide adequate and sustained funding for the public health system. The report also recommends that the federal government develop an enhanced health information infrastructure to improve the public health system's ability to gather, process, and share information and that the media donate more prime time to public service announcements. In response to statistics that show there are more than 41 million uninsured Americans, the report calls for the federal government to develop plans for making comprehensive and affordable health insurance available to everyone. The report was sponsored by the Centers for Disease Control and Prevention, the National Institutes of Health, the Health Resources and Services Administration, the Substance Abuse and Mental Health Services Administration, the HHS Office of the Secretary, Assistant Secretary for Planning and Evaluation, and the HHS Office of Disease Prevention and Health Promotion. To read the full text of the report, go online to http://books.nap.edu/books/0309086221/html/index.html.

Booklet Provides Guidelines for Identification and Prevention of Domestic Violence

A new booklet of guidelines, “Identifying and Responding to Domestic Violence: Consensus Recommendations for Child and Adolescent Health,” provides specific recommendations for screening and responding to domestic violence in child health settings. The booklet gives an overview of the impact of domestic violence on children and adolescents and justifies the need for regular and universal screening for domestic violence in child health settings, addresses obstacles that physicians may be confronted with when discussing domestic violence with parents of their patients and adolescents, the screening and response guidelines, and recommendations for creating a clinical environment that effectively responds to domestic violence. The appendix includes position statements and guidelines from several professional organizations on the impact of domestic violence. The booklet was produced by the Family Violence Prevention Fund in partnership with the American Academy of Family Physicians, the American Academy of Pediatrics, the American College of Obstetrics and Gynecology, the Child Witness to Violence Project, and the National Association of Pediatric Nurse Practitioners. The booklet can be downloaded from the Internet by going to endabuse.org/programs/healthcare and clicking on “Consensus Recommendations for Child and Adolescent Clinics.”



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