HHS Secretary Released the National Strategy for Quality Improvement in Health Care Report

March 17, 2011

AHRQ News and Numbers

The number of patients who needed home health care after being discharged from hospitals surged by about 70 percent (2.3 million to 4 million) from 1997 to 2008. [Source: Agency for Healthcare Research and Quality, HCUP Facts and Figures: Statistics on Hospital-Based Care in the United States, 2008.]

Today's Headlines

1. HHS Secretary released the National Strategy for Quality Improvement in Health Care report
2. Clinicians from pediatrics, family medicine and geriatrics appointed to lead the U.S. Preventive Services Task Force
3. Study demonstrates a computer-based order system improves discontinuation of prophylactic antibacterials in surgical patients
4. New resource identifies care coordination measures
5. AHRQ's Health Care Innovations Exchange focuses on improving medication adherence and safety through electronic monitoring
6. New AHRQ Public Reports on Provider Performance for Consumers Web page available
7. Register for AHRQ's Webcast on using CAHPS® sets that address cultural competence and health literacy set for April 5
8. Register for free Web conference on AHRQ's medical office survey on patient safety culture set for April 29
9. AHRQ announces two Centers for Education and Research on Therapeutics fundi
10. AHRQ announces Research Centers for Excellence in Clinical Preventive Services funding
11. AHRQ in the professional literature

1. HHS Secretary Released the National Strategy for Quality Improvement in Health Care Report

HHS Secretary Kathleen Sebelius released the National Strategy for Quality Improvement in Health Care. The Strategy was called for under the Affordable Care Act and is the first effort to create national aims and priorities to guide local, State, and national efforts to improve the quality of health care in the United States. The National Quality Strategy will promote quality health care that is focused on the needs of patients, families, and communities. At the same time, the Strategy is designed to move the system to work better for doctors and other health care providers—reducing their administrative burdens and helping them collaborate to improve care. The Strategy presents three aims:

• Better Care: Improve the overall quality, by making health care more patient-centered, reliable, accessible, and safe.
• Healthy People & Communities: Improve the health of the U.S. population by supporting proven interventions to address behavioral, social, and environmental determinants of health in addition to delivering higher-quality care.
• Affordable Care: Reduce the cost of quality health care for individuals, families, employers, and government

To help achieve these aims, the Strategy also establishes six priorities, to help focus efforts by public and private partners. Those priorities are:

• Making care safer by reducing harm caused in the delivery of care.
• Ensuring that each person and family is engaged as partners in their care.
• Promoting effective communication and coordination of care.
• Promoting the most effective prevention and treatment practices for the leading causes of mortality, starting with cardiovascular disease.
• Working with communities to promote wide use of best practices to enable healthy living.
• Making quality care more affordable for individuals, families, employers, and governments by developing and spreading new health care delivery models.

The National Quality Strategy is designed to be an evolving guide for the Nation as we continue to move forward with efforts to measure and improve health and health care quality, and I hope that you will use it to guide your efforts to improve the quality and safety of health care services. Select to read the National Quality Strategy. Supporting documents are available on the AHRQ Web site.

2. Clinicians from Pediatrics, Family Medicine and Geriatrics Appointed To Lead the U.S. Preventive Services Task Force

The U.S. Preventive Services Task Force (USPSTF) announced the appointments of Virginia A. Moyer, M.D., M.P.H., as chair, and Albert L. Siu, M.D., M.S.P.H., and Michael L. LeFevre, M.D., M.S.P.H., as co-vice chairs of the Task Force. The USPSTF is an independent, volunteer panel of 16 private-sector experts in prevention and primary care that makes recommendations to primary care clinicians about preventive services such as screenings, counseling or preventive medications that may benefit patients before they experience signs or symptoms of a condition. More information about the Task Force and its recommendations, including how to comment on drafts, is available on the U.S. Preventive Services Task Force Web site. AHRQ provides ongoing administrative and technical support to the Task Force. Select to read the press release.

3. Study Demonstrates a Computer-Based Order System Improves Discontinuation of Prophylactic Antibacterials in Surgical Patients

The proper administration of antibacterial wound prophylaxis can reduce the risk of postoperative surgical wound infection. However, repeated doses of antibacterials given in the postoperative clinical setting may increase hospital antibacterial resistance for the recovering patient. According to a new AHRQ-funded study, the use of a Computerized Provider Order Entry system, designed to assist physicians and other health professionals with decision making tasks, proved effective in increasing the proportion of surgical patients who have antibacterial wound prophylaxis discontinued within the appropriate time frame. The study, "Effectiveness of an information technology intervention to improve prophylactic antibacterial use in the postoperative period," conducted by researchers at the University of Pennsylvania School of Medicine was published in the March 1 issue of the Journal of the American Medical Informatics Association. Select to access the abstract on PubMed ® .

4. New Resource Identifies Care Coordination Measures

AHRQ has released a new resource for researchers interested in measuring care coordination, an emerging field of quality measurement. The Care Coordination Measures Atlas identifies more than 60 measures for assessing care coordination that include the perspectives of patients and caregivers, health care professionals and health system managers. To help users easily identify measures that are relevant to their work, the measures are mapped to a conceptual framework for understanding care coordination measurement. In addition to researchers, measure developers, accountable care organizations, and others responsible for measuring care coordination will find the atlasuseful in identifying currently available measures to assess care coordination activities, as well as gaps in existing measures that can be addressed in future work. Select to access the atlas.

5. AHRQ's Health Care Innovations Exchange Focuses on Improving Medication Adherence and Safety through Electronic Monitoring

This week's issue from AHRQ's Health Care Innovations Exchange features three innovations that show how electronic systems improved medication safety, reduced costs, and increased medication adherence. For example, an electronic medication monitoring system designed by the Center for Connected Health in Boston (a subsidiary of Partners Healthcare, a nonprofit integrated delivery system) increased medication adherence in patients with uncomplicated hypertension through visual and auditory reminders, phone calls for missed doses or refills, and weekly and monthly progress reports on adherence for patients to share with providers. The innovations are complemented by QualityTools on telepharmacy, medication reconciliation, and safe, appropriate medication use among older adults. Select to read this issue and more on the AHRQ Health Care Innovations Exchange Web site. More innovations related to electronic monitoring of medication-related processes are available on AHRQ's Health Care Innovations Exchange, which contains more than 550 searchable innovations and 1,575 searchable QualityTools.

6. New AHRQ Public Reports on Provider Performance for Consumers Web Page Available

AHRQ announced a new Public Reporting Web Page featuring resources on public reporting of provider performance information for consumers. The resources include MONAHRQ, innovative software for creating a public report developed by AHRQ a sampler of model public report elements, a comprehensive guide for public report card sponsors, and a decision guide for report card developers about selecting quality of care and resource use measures, as well as other tools and reports on public reporting. Select to access AHRQ's new Public Reporting Web page.

7. Register for AHRQ's Webcast on Using CAHPS® Sets that Address Cultural Competence and Health Literacy Set for April 5

Register for AHRQ's Webcast, titled Using CAHPS® Items Sets that Address Cultural Competence and Health Literacy on April 5 at 1:00—2:30 p.m. EDT. This free Webcast, hosted by the CAHPS® User Network, will discuss incorporating supplemental items on health literacy and cultural competence into the CAHPS Clinician and Group Survey. The Webcast features AHRQ's Cindy Brach, MPP, Senior Health Policy Researcher; Robert Weech-Maldonado, Ph.D., MBA, Professor and L.R. Jordan Endowed Chair, Department of Health Services Administration, University of Alabama at Birmingham; and Beverly Weidmer, Ph.D., Survey Director, Survey Research Group, RAND.

8. Register for Free Web Conference on AHRQ's Medical Office Survey on Patient Safety Culture Set for April 29

Registration is now open for a free 60-minute Web conference on Using the AHRQ Medical Office Survey on Patient Safety Culture on April 29 from 1:00 to 2:00 p.m. EDT. The session will cover survey development, lessons learned from implementation, and preliminary comparative results. We will also discuss how patient safety culture perceptions differ between physicians and other medical office staff and how medical office characteristics affect survey results. Also, learn how and when you can submit data to a national comparative database on the survey.

9. AHRQ Announces Two Centers for Education and Research on Therapeutics

AHRQ issued two Funding Opportunity Announcements (FOAs) for new opportunities under its Centers for Education and Research on Therapeutics (CERTs). The Centers for Education and Research on Therapeutics Scientific Forum seeks applications for the establishment of a scientific forum with the primary goal of ensuring research synergy and collaboration among the CERTs Research Centers with each other and with stakeholders and partners in the larger therapeutics research and education community. AHRQ anticipates awarding one award of up to $900,000 total costs per year for 5 years. Select to access the announcement.

The Centers for Education and Research on Therapeutics Research Centers seeks Research Program Cooperative Agreement applications for CERTs Research Centers (RCs) that propose a body of work addressing a minimum of three of the five programmatic interest areas: comparative effectiveness, patient safety, tool development, enhancement, and/or validation, health care system interventions, and translation of research findings into practice or policy. The proposed work of a CERTs RC is required to fall within a Center-proposed theme that unifies 3 to 5 major projects proposed by the RC to be conducted over the 5-year period of the grant. Applicants must also propose a core infrastructure that will support not only their proposed work, but also allow the future development and conduct of additional projects and activities with other funding sources and partners. AHRQ intends to commit $5.1 million in FY2011 to fund up to 6 awards ranging from $800,000 to $1,000,000 in annual total costs. Of these, dedicated funding is anticipated to support one Center focusing on health information technology and one center focusing on patient safety. Project periods will be 5 years. Select to read the announcement. Letters of intent for these FOAs are due on April 20 and applications are due on May 18.

10. AHRQ Announces Research Centers for Excellence in Clinical Preventive Services Funding

AHRQ is seeking applications from organizations to become a Research Centers for Excellence in Clinical Preventive Services. This Funding Opportunity Announcement focuses on one of three programmatic areas: patient safety; health equity; or health care system implementation. These Centers will complement the efforts of other Federal investments in prevention and public health by focusing on the role of the formal health care system and particularly primary care, in: improving the health of all Americans; increasing the effectiveness, safety, and efficiency of the health care system; and improving patient experience, through the implementation of evidence-based clinical preventive services. The goal of this initiative is to support high quality, multidisciplinary programs of innovative research that will move forward the nation's emerging National Prevention Strategy. Select to read the announcement. Letters of intent is due on April 29 and applications are due on May 23.

11. AHRQ in the Professional Literature

We are providing the following hyperlinks to journal abstracts through PubMed® for your convenience. Unfortunately, some of you may not be able to access the abstracts because of firewalls or specific settings on your individual computer systems. If you are having problems, you should ask your technical support staff for possible remedies.

Basco WT Jr, Ebeling M, Hulsey TC, et al. Using pharmacy data to screen for look-alike, sound-alike substitution errors in pediatric prescriptions. Acad Pediatr 2010 Jul-Aug; 10(4):233-7. Select to access the abstract on PubMed®.

Yawn BP, Pace W, Dietrich A, et al. Practice benefit from participating in a practice-based research network study of postpartum depression: a national research network (NRN) report. J Am Board Fam Med 2010 Jul-Aug; 23(4):455-64. Select to access the abstract on PubMed®.

Nishisaki A, Donoghue AJ, Colborn S, et al. Effect of just-in-time simulation training on tracheal intubation procedure safety in the pediatric intensive care unit. Anesthesiology 2010 Jul; 113(1):214-23. Select to access the abstract on PubMed®.

Patel MR, Greiner MA, Dimartino LD, et al. Geographic variation in carotid revascularization among Medicare beneficiaries, 2003-2006. Arch Intern Med 2010 Jul 26; 170(14):1218-25. Select to access the abstract on PubMed®.

Concannon TW, Kent DM, Normand SL, et al. Comparative effectiveness of ST-segment-elevation myocardial infarction regionalization strategies. Circ Cardiovasc Qual Outcomes 2010 Jul 27. Select to access the abstract on PubMed®.

Kimmel AD, Weinstein MC, Anglaret X, et al. Laboratory monitoring to guide switching antiretroviral therapy in resource-limited settings: clinical benefits and cost-effectiveness. J Acquir Immune Defic Syndr 2010 Jul; 54(3):258-68. Select to access the abstract on PubMed®.

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