Agency for Healthcare Research and Quality: A Profile
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What is the Agency for Healthcare Research and Quality?
The Agency for Healthcare Research and Quality (AHRQ) is the lead Federal agency charged with improving the safety and quality of America's health care system. AHRQ develops the knowledge, tools, and data needed to improve the health care system and help Americans, health care professionals, and policymakers make informed health decisions. AHRQ works within the U.S. Department of Health and Human Services (HHS) and with other partners to make sure that the evidence is understood and used in an effort to achieve the goals of better care, smarter spending of health care dollars, and healthier people.
In 1999, an Institute of Medicine report, "To Err Is Human," documented serious patient safety problems in our health care system. In the intervening years, AHRQ has led the Nation in responding to those issues and improving the safety of health care. Using AHRQ's research and how-to tools, the U.S. health care system prevented 1.3 million errors, saved 50,000 lives, and avoided $12 billion in wasteful spending from 2010–2013. But, even with these successes, safety is far from optimal, and AHRQ's work continues.
What are AHRQ’s areas of focus?
- AHRQ invests in research on the Nation's health delivery system that goes beyond the "what" of health care to understand "how" to make health care safer and improve quality..
- There aren't enough specialists to treat everyone who needs care, especially in rural and underserved communities. AHRQ funded an innovative model, called Project ECHO (Extension for Community Healthcare Outcomes), for training and supporting primary care clinicians in rural communities to provide specialized care for their patients. This model has flourished, receiving ongoing funding from the State of New Mexico, spreading to other States, and expanding from its initial focus on hepatitis C into new clinical areas, including mental health and substance abuse, and HIV. It has also been adopted by the Veterans Health Administration as a tool for expanding access to high-quality care for veterans across the country.
- AHRQ's Re-Engineered Discharge (RED) is a structured protocol and suite of implementation tools that helps hospitals rework their discharge processes to reduce readmissions by determining patients' needs and carefully designing and communicating discharge plans. Hospitals using these tools have seen a 30 percent reduction in hospital readmissions and emergency rooms visits.
- AHRQ recently funded three Centers of Excellence to study how high-performing health care systems promote evidence-based practices in delivering care. Health systems in the United States vary tremendously in their ability to produce outcomes that patients care about, such as those for cardiovascular risk factors. However, we know very little about which systems are doing a good job, or about how those systems are achieving superior outcomes. The AHRQ project will help close this research gap and produce information that can be used by health systems throughout the United States to improve patient outcomes.
- AHRQ creates materials to teach and train health care systems and professionals to put the results of research into practice.
- AHRQ supported the development of the Comprehensive Unit-based Safety Program (CUSP), a highly effective method of preventing healthcare-associated infections (HAIs). CUSP combines improvement in safety culture, teamwork, and communication together with a checklist of proven practices for preventing HAIs. AHRQ has promoted the use of CUSP in a series of nationwide projects that addressed various HAIs and produced CUSP toolkits to help clinicians prevent these infections. CUSP was implemented in more than 1,000 U.S. intensive care units (ICUs) to prevent deadly central line-associated bloodstream infections (CLABSI). ICUs that used CUSP methods and tools were able to reduce these bloodstream infections by 41 percent, preventing over 2,100 CLABSI cases, saving more than 500 lives, and avoiding more than $36 million in excess costs. CUSP tools are free, and available on the AHRQ Web site to be adapted and used based on the specific setting.
- In 2015 AHRQ launched an initiative to directly bring the latest scientific research, tools, and support to over 5,000 primary care physicians that will improve the care for over 8 million Americans. AHRQ awarded seven large grants to establish EvidenceNOW, an initiative aligned with Million Hearts® that will provide practice support to over 5,000 primary care physicians with the goal of improving the heart health of millions of patients and improving the capacity of the practices to incorporate new research findings and information into practice.
- AHRQ, in conjunction with the Department of Defense, developed TeamSTEPPS®, a training program designed for health care professionals to improve patient safety, communication, and teamwork skills. AHRQ has trained more than 1,500 individual organizations in the United States through this program and is continuing to provide free training around the country. To increase training capacity, AHRQ has shared the curriculum and tools with the Centers for Medicare & Medicaid Services (CMS), which has tasked the Nation's Quality Improvement Organizations to disseminate this training further throughout the country.
- AHRQ generates measures and data used by providers and policymakers.
- Data from AHRQ's Healthcare Cost and Utilization Project helped to highlight a jump in hospitalizations among Medicare, Medicaid, and private-pay patients for overuse of opioids. AHRQ showed that hospitalization rates more than doubled between 1993 and 2012, when there were more than 700,000 Americans hospitalized for opioid overuse. This warning contributed to HHS' launch of a major multipronged initiative to reduce opioid abuse in 2015.
- AHRQ created and maintains the gold-standard suite of surveys, called the Consumer Assessment of Healthcare Providers and Systems, which provide valid assessments of patients' experience of care in hospitals, nursing homes, and doctors' offices. The hospital industry, patients, and CMS chose the hospital version of the AHRQ survey to be the measure for all of the patient experience elements for CMS' Hospital Quality Initiative. CMS incorporates these results into the Hospital Compare Web tool and its five-star rating system.
- AHRQ's Medical Expenditure Panel Survey data helped the Medicaid and CHIP Payment and Access Commission develop estimates of eligibility for Medicaid and the Children's Health Insurance Program; the Congressional Budget Office also uses AHRQ data in its estimates of the budgetary impact of many Congressional proposals.
How will AHRQ make health care safer and better tomorrow?
AHRQ is beginning work to tackle some of the health care system's greatest challenges, including:
- Reducing antibiotic overuse and eliminating health care-associated infections.
- Improving care for people with multiple chronic conditions.
- Incorporating the latest research findings into electronic health records to facilitate clinical decisionmaking.
- Discovering how to better provide opioid addiction treatment services in rural communities.