Researcher Akira Nishisaki Designs Quality Improvement Processes To Reduce Harm in Pediatric ICUs

AHRQ Stats: Annual Expenditures for Diet-Related Health Conditions

Treatment for major diet-related conditions among adults accounted for an average of $334 billion in healthcare expenditures per year during 2021 and 2022. Each adult with these conditions received an average of $3,974 in related care annually. (Source: AHRQ Medical Expenditure Panel Survey Statistical Brief #561, Expenditures for Key Diet-Related Health Conditions, 2021-2022.)

Today’s Headlines:

• Researcher Akira Nishisaki Designs Quality Improvement Processes To Reduce Harm in Pediatric ICUs.
• Recording of AHRQ’s Listening Session on Public Safety Indicators Now Available.
• Medicare Plan Choice Impacts Costs of and Access to Care for Older Adults and Younger Beneficiaries With Disabilities.
• New Research and Evidence.
• Submission Window Open for SOPS® and CAHPS® Databases.
• Register for Upcoming Webinars.
• AHRQ in the Professional Literature.

Researcher Akira Nishisaki Designs Quality Improvement Processes To Reduce Harm in Pediatric ICUs

Akira Nishisaki, M.D., a pediatric critical care physician in the Department of Anesthesiology and Critical Care Medicine at the Children’s Hospital of Philadelphia, has dedicated his career to improving the quality of care and outcomes for critically ill or injured children experiencing respiratory failure, the leading cause of death in infants and children. With funding from AHRQ, Dr. Nishisaki has designed and implemented easily modifiable quality improvement processes that make pediatric airway management safer during tracheal intubation—a common but high-risk procedure that helps with breathing when the airway is blocked or damaged.  

Dr. Nishisaki’s AHRQ research began with the National Emergency Airway Registry for Children (NEAR4KIDS), a quality improvement database that documents outcomes of tracheal intubations based on patient, provider and practice factors. Findings from the NEAR4KIDS database served as the foundation for his future research. Using NEAR4KIDS registry data, Dr. Nishisaki’s team created the airway bundle checklist, a tool medical teams could easily use at the patient’s bedside before, during and after tracheal intubation. Later projects focused on specific quality improvement interventions for procedures that occur during tracheal intubation, including video laryngoscope, apneic oxygenation and bag mask ventilation. All three interventions reduced adverse events and continue to be used throughout the NEAR4KIDS network of pediatric intensive care units (ICUs).  

Dr. Nishisaki’s current grant, Smart Checklist Implementation for Pediatric Tracheal Intubations in the ICU-Multicenter Study: SMART PICU, aims to update and digitize the airway bundle checklist developed with his second AHRQ grant. 

Dr. Nishisaki serves as chair of the Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network, the largest nonprofit pediatric ICU clinical research network. He accredits his successful track record and ability to lead the PALISI network to the support he has received from AHRQ.  

Recording of AHRQ’s Listening Session on Public Safety Indicators Now Available

On May 7, AHRQ hosted the Public Listening Session on Opportunities to Update the Patient Safety Indicators, a virtual meeting that gathered more than 700 attendees. Patient Safety Indicators (PSIs) are quality indicators that provide information on potentially avoidable safety events that represent opportunities for improvement in the delivery of care. Speakers from AHRQ, MITRE and UC Davis discussed the history of PSIs and shared interim findings from a gap analysis that aims to identify opportunities for future PSI measurement. Anneliese Schleyer, M.D., M.H.A., a practicing hospitalist and chief medical officer at UW Medicine in Seattle, shared a provider’s perspective on PSI gaps and opportunities. Throughout the session, attendees submitted comments on future PSIs. 

Interested stakeholders still have the opportunity to send in feedback through June 27. Visit the website to submit your comments and access the recording and materials for this event.

Medicare Plan Choice Impacts Costs of and Access to Care for Older Adults and Younger Beneficiaries With Disabilities

Two AHRQ-funded studies explore how different types of Medicare coverage impact beneficiaries’ financial and health outcomes:

• The first study, published in Health Affairs Scholar, examined 3,142 older adults and found that those with a cancer history were more likely to initially select traditional Medicare plus supplemental coverage relative to their counterparts without a cancer history. Compared with selecting traditional Medicare without supplemental coverage, choosing either traditional Medicare with supplemental coverage or Medicare Advantage was associated with lower levels of out-of-pocket spending and a lower probability of fair or poor health.
• The second study, published in The American Journal of Managed Care, focused on 3,249 beneficiaries aged 50 to 64 with long-term disabilities or other qualifying conditions. It revealed that beneficiaries enrolled in traditional Medicare plus supplemental coverage or Medicare Advantage were less likely than those with traditional Medicare without supplemental coverage to experience access and/or affordability issues, including cost-related medication nonadherence, delayed care or difficulty finding a usual source of care. No significant differences were observed among those also eligible for Medicaid.

New Research and Evidence

• White Paper: Making Healthcare Safer IV: Summary of Findings on Patient Safety Practices and Ratings by a Technical Expert Panel, 2024-2025.
• Research Protocol: Pharmacologic and Nonpharmacologic Treatments for Posttraumatic Stress Disorder: An Update of the PTSD Repository Evidence Base.

Submission Window Open for SOPS® and CAHPS® Databases

• Surveys on Patient Safety Culture® (SOPS) Data Submission—Ambulatory surgery centers (ASCs) that administered and collected data for AHRQ’s ASC Survey on Patient Safety Culture between July 2023 and June 2025 are invited to submit data for AHRQ’s SOPS Ambulatory Surgery Center Database from June 2 to June 20. Participating ASCs will receive feedback reports, comparing their results with aggregated, de-identified data from all database participants. Visit the website for the survey and supporting materials and to learn more about database submission. 
• Consumer Assessment of Healthcare Providers and Systems® (CAHPS) Data Submission—Voluntary data submission for AHRQ’s CAHPS Health Plan Survey Database is open from June 2 to June 27. Organizations that administered the CAHPS 5.1 or 5.1H Health Plan Survey between June 29, 2024, and June 27, 2025, are eligible to submit data. The database is accepting submissions for the Adult Medicaid survey, the Child Medicaid or Children’s Health Insurance Program (CHIP) survey without the Children with Chronic Conditions Item Set and the Child Medicaid or CHIP survey with the Item Set. Learn more about submission requirements and data specifications on the website.

Register for Upcoming Webinars

• AHRQ Safety Program for HAI Prevention: CLABSI Recruitment Webinar.
  • June 11, 1:30-2 p.m. ET. 
  • June 24, noon-12:30 p.m. ET. 
• June 18, 3-4:30 p.m. ET: AHRQ Academy: From Bottlenecks to Breakthroughs: Innovations in Behavioral Health Integration.
• June 25, 1-2 p.m. ET: New CAHPS Tools for Patient Experience Measurement.

AHRQ in the Professional Literature

Comparative effectiveness and safety of the JAK Inhibitors and biologic disease-modifying antirheumatic drugs in treating children with nonsystemic juvenile idiopathic arthritis: a Bayesian meta-analysis of randomized controlled trials. Li Y, Huang B, Andorf S, et al. ACR Open Rheumatol 2025 Feb;7(2):e11788. Access the abstract on PubMed®.

Validity evidence of a resuscitation team leadership assessment measure for use in actual trauma resuscitations. Rosenman ED, Grand JA, Fernandez R. AEM Educ Train 2025 Apr;9(2):e11061. Epub 2025 Apr 7. Access the abstract on PubMed®.

Use of sensitivity analyses to assess uncontrolled confounding from unmeasured variables in observational, active comparator pharmacoepidemiologic studies: a systematic review. Latour CD, Delgado M, Su IH, et al. Am J Epidemiol 2025 Feb 5;194(2):524-35. Access the abstract on PubMed®.

Cardiometabolic risk in pediatric patients with intellectual and developmental disabilities. Nolan MB, Asche SE, Barton K, et al. Am J Prev Med 2025 Mar;68(3):429-36. Epub 2024 Nov 29. Access the abstract on PubMed®.

Assessing methotrexate adherence in juvenile idiopathic arthritis using electronic health record-linked pharmacy dispensing data. Abel D, Anderson D, Kallan MJ, et al. Arthritis Care Res 2025 Mar;77(3):300-8. Epub 2024 Oct 25. Access the abstract on PubMed®.

Impact of the Affordable Care Act on access to accredited facilities for cancer treatment. Sabik LM, Kwon Y, Drake C, et al. Health Serv Res 2024 Dec;59(6):e14315. Epub 2024 May 2. Access the abstract on PubMed®.

The Complete Inpatient Record Using Comprehensive Electronic Data (CIRCE) project: a team-based approach to clinically validated, research-ready electronic health record data. Schneider ALC, Ginestra JC, Kerlin MP, et al. Learn Health Syst 2025 Jan;9(1):e10439. Epub 2024 Jun 18. Access the abstract on PubMed®.

Unsupervised machine learning analysis to identify patterns of ICU medication use for fluid overload prediction. Henry K, Deng S, Chen X, et al. Pharmacotherapy 2025 Feb;45(2):76-86. Epub 2025 Jan 3. Access the abstract on PubMed®.