Quality of Care

As Obesity Epidemic Escalates, Need for More Screening and Counseling Grows. C. Clancy, Journal of Nursing Care Quality, January-March 2011; 26(1):1-3. Commentary discusses the scope of the obesity epidemic in the United States and new opportunities for counseling and other preventive services made possible by the recent health care reform legislation. (AHRQ 11-R039)

Attributes of a Health Literate Organization. C. Brach, B. Dreyer, P. Schyve, et al., Institute of Medicine of the National Academies Discussion Paper, January 2012. Describes 10 attributes of a health literate organization, that is, an organization that makes it easier for people to navigate, understand, and use information and services to take care of their health. (AHRQ 12-R060)

Can Incentives to Improve Quality Reduce Disparities? K. Ho, E. Moy, C. Clancy, Health Services Research, February 2010; 45(1):1-5. Editorial discusses the ability of quality improvement efforts to reduce disparities in care associated with race, ethnicity, socioeconomic status, and other factors. (AHRQ 10-R051)

Changes in Patient Flow Among Five Hospitals Participating in a Learning Collaborative. M. McHugh, K. Van Dyke, E. Howell, et al., Journal for Healthcare Quality, September 2011; epub. Evaluates the efforts of five hospitals that participated in a collaborative aimed at improving patient flow and reducing emergency department crowding. (AHRQ 12-R003)

Creating a Framework for Getting Quality into the Public Health System. P. Honore, D. Wright, D. Berwick, et al., Health Affairs, April 2011; 30(4):737-745. Describes two reports from the Department of Health and Human Services that define what is meant by public health quality, establish quality aims, and highlight priority areas needing improvement. Provides real-world examples of how a framework of quality concepts can be applied in the National Vaccine Safety Program and in a State office of minority health. (AHRQ 11-R053)

Defining and Measuring Successful Emergency Care Networks: A Research Agenda. S. Glickman, M. Delgado, J. Hirshon, et al., Academic Emergency Medicine, December 2010; 17(12):1297-1305. Explores the concept of integrated emergency care delivery and prioritizes a research agenda for how to best define and measure successful networks of emergency care. (AHRQ 11-R034)

Developing Quality of Care Measures for People with Disabilities: Summary of Expert Meeting. L. Iezzoni, Agency for Healthcare Research and Quality, September 2010, 36 pp. Summarizes the discussion and recommendations from a workshop focused on developing quality of care measures for people with disabilities. (AHRQ 10-0103)

The Diabetes Primary Prevention Initiative Interventions Focus Area: A Case Study and Recommendations. D. Porterfield, L. Hinnant, D. Stevens, et al. American Journal of Preventive Medicine, September 2010; 39(3):235-242. Describes the Diabetes Primary Prevention Initiative Interventions Focus Area (DPPI-IFA), which was funded by the Centers for Disease Control and Prevention in 2005 and involved five State diabetes prevention and control programs, and presents case studies of the five programs. (AHRQ 11-R009)

The Effects of U.S. Hospital Consolidations on Hospital Quality. R. Mutter, P. Romano, H. Wong, International Journal of the Economics of Business, February 2011; 18(1):109-126. Examines the impact of hospital consolidations that occurred in 1999 and 2000 in 16 States on 25 measures of quality, using pre-post, difference-in-difference models. (AHRQ 12-R040)

Emergency Severity Index, Version 4. Agency for Healthcare Research and Quality, November 2011. Presents a five-level emergency department triage algorithm that provides clinically relevant stratification of patients into five groups from most urgent to least urgent on the basis of acuity and resource needs. Updated edition with a new section on using the ESI algorithm with pediatric populations.
Everything You Need to Know, Set of two DVDs (AHRQ 05-0046-DVD)
Implementation Handbook, 2012 Edition. Spiral bound, 104 pp, and poster (AHRQ 12-0014)

Enhancing Board Oversight on Quality of Hospital Care: An Agency Theory Perspective. H. Jiang, C. Lockee, I. Fraser, Health Care Management Review, Apr-Jun 2012; 37(2):144-53. Explores the role and practices of governing boards in quality oversight through the lens of agency theory and compares hospital quality performance in relation to the adoption of those practices. (AHRQ 11-R068)

Enhancing Quality Oversight. H. Jiang, Healthcare Executive, March/April 2010; 25(2):80-83. Discusses the attention being paid by hospitals to quality improvement and the role that hospital boards are playing in these efforts. (AHRQ 10-R068)

Facilitators and Barriers to the Implementation of Patient Flow Improvement Strategies. K. Van Dyke, M. McHugh, J. Yonek, D. Moss, Quality Management in Health Care, July/September 2011; 20(3):223-233. Discusses the results of a study to identify common facilitators and barriers to the implementation of patient flow improvement strategies in hospital emergency departments, as well as successful approaches for overcoming the barriers. (AHRQ 12-R031)

Getting to Zero: New Resources Aim to Reduce Health Care-Associated Infections. C. Clancy, American Journal of Medical Quality, July-August 2010, 25(4):319-321. Commentary discusses recent progress in efforts to reduce health care-associated infections and describes HHS's expanded efforts in this area through newly awarded grants and contracts. (AHRQ 10-R079)

Health Literacy Impact on Patient-Provider Interactions Involving the Treatment of Dental Problems. L. Cohen, A. Bonito, C. Eicheldinger, et al., Journal of Dental Education, September 2011; 75(9):1218-1224. Examines several health literacy-related markers among patients seeking treatment in hospital emergency departments and physician and dentist offices for dental problems and injuries. (AHRQ 12-R001)

High Versus Lower Quality Hospitals: A Comparison of Environmental Characteristics and Technical Efficiency. R. Mutter, V. Valdmanis, M. Rosko, Health Services and Outcomes Research Methodology, December 2010; 10(3-4):134-153. Examines whether hospitals providing high-quality care are associated with different environmental and organizational factors than hospitals providing lower quality of care. (AHRQ 12-R072)

Highlights: 2011 National Healthcare Quality and Disparities Reports. Agency for Healthcare Research and Quality, March 2012, 34 pp. Focuses on six national priorities for improving health care quality and reducing disparities in health and health care, and discusses health care strategies that can be employed to work toward those goals. (AHRQ 12-0005-1)

High-Performance Work Systems in Health Care Management, Part 1: Development of an Evidence-Informed Model. A. Garman, A. McAlearney, M. Harrison, et al., Health Care Management Review, July-September 2011; 36(3):201-213. Describes a conceptual model developed on the basis of prior research from health care as well as other industries that could be used to inform important contextual considerations for improving health care quality. (AHRQ 11-R065)

High-Performance Work Systems in Health Care Management, Part 2: Qualitative Evidence from Five Case Studies. A. McAlearney, A. Garman, P. Song., et al., Health Care Management Review, July-September 2011; 36(3):214-226. Discusses the use of high-performance work systems in health care organizations and describes the contributions of such systems to quality of care and patient safety improvements. (AHRQ 11-R066)

Improving Patient Flow and Reducing Emergency Department Crowding: A Guide for Hospitals. Agency for Healthcare Research and Quality, October 2011, 44 pp. Presents step-by-step instructions for use by hospitals in planning and implementing emergency department patient flow improvement strategies. (AHRQ 11(12)-0094)

Kidney-Related Diseases and Quality Improvement: AHRQ’s Role. C. Clancy, Clinical Journal of the American Society of Nephrology, October 2011; 6(10):2531-2533. Describes patient-centered care and discusses AHRQ’s role in quality improvement activities related to kidney disease. (AHRQ 11-R077)

Leveraging Certified Nursing Assistant Documentation and Knowledge to Improve Clinical Decision Making: The On-Time Quality Improvement Program to Prevent Pressure Ulcers. S. Sharkey, S. Hudak, S. Horn, W. Spector, Advances in Skin & Wound Care, April 2011; 24(4):182-188. Explains the On-Time Quality Improvement for Long-Term Care Program, a practical approach to embed health information technology into quality improvement in long-term care facilities to support front-line clinical decisionmaking and proactive intervention for pressure ulcer prevention. (AHRQ 11-R049).

Measuring Patient-Centered Communication in Cancer Care: A Literature Review and the Development of a Systematic Approach. L. McCormack, K. Treiman, D. Rupert, et al., Social Science & Medicine, April 2011; 72(7):1085-1095. Describes a comprehensive inventory of domains and subdomains for patient-centered communication and discusses considerations for developing measures of patient-centered communication for use in research, quality assessment, and surveillance. (AHRQ 11-R054)

Methodological Considerations in Generating Provider Performance Scores for Use in Public Reporting: A Guide for Community Quality Collaboratives. Agency for Healthcare Research and Quality, September 2011, 106 pp. Reviews a number of the key methodological decision points community quality collaboratives face in producing public reports of health care providers’ performance on measures of quality, cost, and resource use; patient experience; and health outcomes. (AHRQ 11-0093)

2011 National Reports on Quality and Disparities Agency for Healthcare Research and Quality, March 2012. Reports focus on quality of care and disparities in health care in America, overall and for AHRQ's priority populations. National Healthcare Quality Report 2011. 228 pp. Finds that health care quality and access are suboptimal, urgent attention is warranted to ensure improvements in quality, and progress is uneven with respect to eight national priority areas. (AHRQ 12-0005) National Healthcare Disparities Report 2011. 252 pp. Finds that health care quality and access are suboptimal, especially for minority and low-income groups, quality is improving but access and disparities are not improving, and urgent attention is warranted to ensure progress on reducing disparities. (AHRQ 12-0006)

New Federal Policy Initiatives to Boost Health Literacy Can Help the Nation Move Beyond the Cycle of Costly Crisis Care. H. Koh, D. Berwick, C. Clancy, Health Affairs, February 2012; 32(2):434-443. Reviews the new opportunities that recent landmark Federal policies have created to improve health literacy. (AHRQ 12-R050)

Preventing Healthcare-Associated Infections: Initiating Promising Solutions and Expanding Proven Ones. C. Clancy, Patient Safety & Quality Healthcare, March/April 2010; 50(2):e-pub. Gives examples of several initiatives that have been successful in lowering the rate of health care-associated infections and discusses new research underway in this area. (AHRQ 10-R067)

Preventing Hospital-Acquired Venous Thromboembolism: A Guide for Effective Quality Improvement. Agency for Healthcare Research and Quality, August 2008, 50 pp. Presents information to help quality improvement (QI) practitioners—such as physicians, pharmacists, nurses, and risk managers—lead an efficient, reliable effort to improve prevention of hospital-acquired venous thrombolism, one of the most critical problems facing hospitalized patients. (AHRQ 08-0075)

Protocol for All: Smaller Hospitals Can Adopt Proven Tools for Reducing Central-Line Infections. C. Clancy. Modern Healthcare, September 2012; 41(37):20. Describes the AHRQ-funded program, the Comprehensive Unit-based Safety Program (CUSP), to reduce central-line associated infections, with an emphasis on participation by small and mid-sized hospitals. (AHRQ 12-R059)

Quality Indicators Brochures
Agency for Healthcare Research and Quality, August 2010. AHRQ Quality Indicators (QIs), measures of health care quality that make use of readily available hospital inpatient administrative data. Available at: http://qualityindicators.ahrq.gov for announcement of updates to AHRQ QI software.
Inpatient QIs. (AHRQ 10-M043-2)
Patient Safety QIs. (AHRQ 10-M043-4)
Pediatric QIs. (AHRQ 10-M043-3)
Prevention QIs. (AHRQ 10-M043-1)

Quality Indicators Toolkit for Hospitals. Agency for Healthcare Research and Quality, January 2012, Web only. Online toolkit designed to help hospitals understand and support use of AHRQ’s Quality Indicators (QIs) to improve quality and patient safety. Provides a general guide to using improvement methods, with a particular focus on the QIs, including the 17 Patient Safety Indicators (PSIs) and the 28 Inpatient Quality Indicators (IQIs). Available at http://www.ahrq.gov/qual/qitoolkit/.

Selecting Quality and Resource Use Measures: A Decision Guide for Community Quality Collaboratives. Agency for Healthcare Research and Quality, May 2010, 95 pp. Serves as an evidence-based primer and decisionmaking framework to guide community-based leaders in their strategic and operational planning related to quality improvement and performance measurement. (AHRQ 09(10)-0073)

State Snapshots AHRQ's State Snapshots provide State-specific health care quality information, including strengths, weaknesses, and opportunities for improvement. State-level information is presented for every State and Washington, DC. Information used to create the Snapshots is derived from AHRQ's National Healthcare Quality Report. The goal is to help State officials and their public- and private-sector partners better understand health care quality and disparities in their State. State Snapshots can be found at http://statesnapshots.ahrq.gov.

Strategies for Addressing Barriers to Publishing Pediatric Quality Improvement Research. J. Van Cleave, D. Dougherty, J. Perrin, Pediatrics, September 2011; 128(3):e678-686. Focuses on identifying barriers to publishing results of pediatric quality improvement (QI) research and providing practical strategies that QI researchers can use to enhance publishability of their work. (AHRQ 12-R084).

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