Iowa Healthcare Collaborative - Past, Present, and Future Use of AHRQ Slide presentation from the AHRQ 2009 conference. On September 14, 2009, Lance Roberts made this presentation at the 2009 Annual Conference. Select to access the PowerPoint® presentation (818 KB) (Plugin Software Help).Slide 1 Iowa Healthcare Collaborative—Past, Present, and Future Use of AHRQ Quality IndicatorsLance Roberts2009 AHRQ Annual ConferenceSeptember 14, 2009100 E. Grand Ave., Ste. 360 . Des Moines, IA 50309-1800Office: 515.283.9330 . Fax: 515.698.5130www.ihconline.org Slide 2 Past—Historical Perspective2004Iowa Hospital Association (hospitals) and the Iowa Medical Society (doctors) form IHCCornerstonesPromote Responsible Public Reporting – “Iowa Report” Supportive State Policy—IHA collects data, IHC researchAlign and Equip Providers on Quality and ValueEngage the Community for Clinical ImprovementRaise the Standard of Care Slide 3 Public Reporting PolicyResponsible Public Reporting Policy Engage stakeholders—Data Committee Importance to measure and report—(STEEEP), variation, or overall poor performanceScientific acceptability of measure properties NQF—endorsementAHRQ TieringUsability—understandable, useful for decision makingFeasibility—data are readily available, low burden Slide 4 Historical Perspective2005 Iowa Report10 AHRQ QIs—aggregate Iowa performance compared to US, Midwest, Low/High US states2008 Iowa Report16 Hospital-level and 18 aggregate QIs Slide 5 Iowa Report- From Data/Measures to Clinical DomainsProvider-focused Public ReportClinical Category—Measures:Cardiovascular Conditions—Heart AttackCardiovascular Conditions—Heart FailureCardiovascular Conditions—StrokePneumonia ConditionHip FractureMedical and Surgical—Patient SafetyPostoperative CarePrevention of Blood ClotsPrevention of Healthcare-Associated InfectionsUtilizationObstetric / Neonatal CarePediatric—Patient SafetyPatient Experience in Hospital—HCAHPS Survey Provider Private ReportAHRQ Quality IndicatorsClinical CategoryClinical CategoryClinical CategoryData / Research BaseAHRQ CMS Primary SourcesData Sources:HCUP—Nationwide Inpatient Sample (NIS), Iowa State Inpatient Databases (SID)CMS Hospital Compare—Hospital Quality InitiativeIowa Healthcare Collaborative—Primary Data Collection: Healthcare-Associated Infection (HAI) Prevention Slide 6 AHRQ Quality IndicatorA screen shot of the Current "look" of AHRQ QI hospital-level table in Iowa Report is shown. Slide 7 Private Hospital Reports—AHRQ Quality Indicators Slide 8 Collaborative Quality Improvement OpportunitiesIowa Stakeholders Maternal Birth-related Trauma Multiple year underperformerResearch—Roberts, Ely, Ward; Factors Contributing to Maternal Birth-related Trauma, 2007Difficult to convene an Obstetrical Trauma WorkgroupHospitals/Systems involved in QI—using hospital-level QI reports and our research Slide 9 Collaborative Quality Improvement OpportunitiesIowa Stakeholders Anesthesiologists Another specialty interested in measurement and QIPSI 1 Descriptive Statistics—2002-2006 SIDDescriptive study of adverse eventsE9386—"Peripheral Nerve and Plexus Blocking Anesthetics"Sharing list of NQF-endorsed anesthesia-related measuresDemotion of PSI 1—Complications of Anesthesia Slide 10 Collaborative Quality Improvement OpportunitiesIowa Stakeholders Emergency Care—Aortic Aneurysm/DissectionCardiologists Reaction to media reportsInterest in comparative private/public reporting Slide 11 What Does Future Look Like?AHRQ's Tools that May Assist Collaboratives / States Consumer Reporting Tools—MONAHRQPilot—Adding clinical data to administrative dataER—PSIs, PQIsEfficiency measures (potentially all-payer readmission)Health PlanMedicaid Home and Community-Based Services2007 State Snapshots: Methods. Derived from 2007 National Healthcare Quality Report. March 2008. Rockville, MD: Agency for Healthcare Research and Quality. http://statesnapshots.ahrq.gov/. Slide 12 What Does Future Look Like?Value—"Business Case" and "Value" of collaborative QI effortsWorking with AHRQ researchers and tools—Iowa SID, NIS, HCUP Cost-to-Charge Ratio filesMatching Software—match patients with adverse event to similar patients without Are adverse events associated to excess .. LOS? From 2004 to 2007—Avoided approx. 929 daysMortality? Avoided Approx. 10—16 deathsCharges? Avoided Approx. $3.9 millionCost?How many events are Present on Admission (POA)? Slide 13 AHRQ Support / Tools We ValueAHRQ QI Support An efficient mode to receive help on use of tools E.g.—PSI 3—Decubitus UlcerAHRQ Quality Indicator Learning Institute (QILI) An effective collaborative for AHRQ QI Users Affected our Data Committee Policies Tiering, NQF-endorsement, Coding issues, ValidationIncluded information in reports to Iowa legislature Slide 14 How Else Can AHRQ Help?Healthcare-Associated Infections—gaining a lot of attention CAUTIC-Diff — Iowa trend is similar to National trendPotential 2008 attributable cost savings if Iowa C-Diff reduced by 10% $1.5—$2.2 MillionIowa IP's—use SID/NIS if possible!!Research will help shapeIowa Statewide HAI PlanCosts based on CDC Report:Scott, DR (CDC), The Direct Medical Costs of Hais in US Hospitalls and the Benefits of Prevention. http://www.cdc.gov/ncidod/dhqp/pdf/Scott_CostPaper.pdf Slide 15 How Else Can AHRQ Help?Improve Documentation Use of AHRQ Support Line may be reduced if documentation is improvedContinue AHRQ QILI Focus on equipping users for responsible public reportingHighlight/integrate other supportive tools—HCUP software, statistical briefs, State Snapshots, AHRQ HAI Web page Slide 16 Thank You100 E. Grand Ave., Ste. 360 . Des Moines, IA 50309-1800Office: 515.283.9330 . Fax: 515.698.5130www.ihconline.org Current as of December 2009 Internet Citation: Iowa Healthcare Collaborative - Past, Present, and Future Use of AHRQ . December 2009. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/events/conference/2009/roberts/index.html
Back
