Presentation on theme: "Irene Fraser, Ph.D., Director"— Presentation transcript:
1 AHRQ Patient Safety Measurement: Overview; Patient Safety Indicators Example Irene Fraser, Ph.D., DirectorCenter for Delivery, Organization and MarketsAHRQ Annual MeetingSeptember 10, 2012
2 Transparency and public reporting Three Paths to Safety, Quality and Value– Good Measures and Data Are Central for EachTransparency and public reportingPay-for-performance and payment reformProvider-based redesign and quality improvementAlso important for state and national tracking
3 AHRQ Roles in Patient Safety Measures and Data Develops and maintains measuresQuality Indicators (Patient Safety module)Patient Safety Organizations and Common FormatsCHIPRATracks progress, provides data for analysisHealthcare Cost and Utilization Project (HCUP)National Healthcare Quality and Disparities ReportsState SnapshotsMaintains Measure ClearinghouseCreates tools: e.g. MONAHRQApplies tools to quality improvementPartnership for PatientsMillion Hearts CampaignCollaborates to align measures
4 Challenge for Measures & Data: Need to Integrate Best from 3 Worlds Scope, uniformity, affordability of enhanced claims dataClinical depth of medical recordsPotential “new world” of the EHRBut 3 need to join the same universe
5 Quality IndicatorsMeasures developed by AHRQ for use with all-payer billing dataAbout 50 endorsed by NQFUnder continuous review and improvementUsed extensively by statesCMS using in Hospital Compare, VBPUsed in Partnership for Patients, Million Hearts Campaign
7 Two-thirds of the US Has Access to a Public Report in their State Using AHRQ’s Quality Indicators to Report Hospital QualityWIWAIANYMEMNVTILOROHNHMANVRINJMDCAKYUTMSCOAZFLOKLATX26 states use for hospital-level reportsAdditional states report area-level measures
8 Free MONAHRQ tool for public reporting, analysis (My Own Network Powered by AHRQ)Download MONAHRQ from monahrq.ahrq.govLoad your local hospital discharge dataMONAHRQLoad sets ofpre-calculated measures*Select customization optionsOutput a healthcare reporting websiteQI software is an important dissemination tool. Few (if any?) other measure developers supply such a tool.Lets QI users calculate QIs using their own data.-- Helps organizations use their own data.-- Calculates QIs locally – AHRQ does not handle data or measure results.-- Minimizes resources needed to calculate QIs.-- Helps ensure QIs are calculated correctly and consistently.-- Helps ensure use of state-of-the-art measures: AHRQ is responsible for research and updates, all users benefit.MONAHRQ runs on your desktopYou host the site:Public, private, your choice* Hospital Compare measures, HCAHPS survey measures, AHRQ Quality Indicators, others?8
9 Six States Now Use MONAHRQ HawaiiNevadaMaineIndianaKentuckyUtahNevada MONAHRQ site
10 New Toolkit Supports Efforts To Improve Quality and Safety Guides hospitals in using the AHRQ Inpatient and Patient Safety Quality Indicators™ to improve careExplains the quality improvementprocess and offers tools“Introduction and Roadmap” helps various users identify the best resources for their needsAvailable at
11 Meeting Challenge Requires Multiple Bridges Between…HIT WorldEMR WorldClinical dataHealth Info. ExchangesMeasure developersMedicare and Medicaid dataAnd…Quality worldClaims data worldClaims dataState data orgs.Data developersPrivate payer data
12 AHRQ Work to Bridge these Divides Work w/ NQF to add measures to EMR, clinically enrich current measuresSupport HIEsResearch, pilots on adding clinical to claims dataARRA grants to continue this workHIT-Value Conference: “Creating a Plan to Get the Best from Both Worlds”New measures for using enhanced data
13 Enhancing Clinical Robustness of Billing Data Research:Adding a few clinical data elements (especially POA and lab values) significantly improves quality assessment using billing data (Pine, et al, JAMA 2007)Data Pilots ( ) Established feasibility of linking electronic clinical lab data to billing data and collecting POA in 3 states (FL, MN, VA)Toolkits for other statesLab data toolkit addresses all facets of the data collection process.POA toolkit will include business case for POA (including example HAC reports), and tools to improve quality of dataState-wide grant initiativesSix projects will expand clinical linkages and improve race and ethnicity data funded under ARRAMeasures: Enhancing Quality Indicators to include POA and Lab Values
14 Process for Developing and Maintaining an AHRQ Quality Indicator 1. Development of New QI Measure Sets (or Improvement of Existing Sets)RetireCo-steward2. Validation of New QI Measure Sets6. AssessmentHarmonizeMaintain & Enhance5. Maintenance, Enhancement & Technical Support Measure of Sets3. Submission of New QI Measures to NQF*4. Tool Development
15 Patient Safety Indicators: Looking Ahead Major goalsContinue to improve existing measuresAdd new ones (e.g. Emergency Department)Move to ICD10 provides opportunity for further precision, advancesWork to mobilize best of all measurement approaches in aligned effort.
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