Toolkit Roadmap

AHRQ Quality Indicators™ Toolkit for Hospitals

The AHRQ QI Toolkit for Hospitals is a free set of tools designed to support hospitals in assessing and improving the quality and safety of care they provide. Tools are available to support work in each sequence of improvement steps. This Toolkit Roadmap will help you get started. For each key improvement step, it identifies the tools provided in the Toolkit to support your work. For each tool, the Roadmap gives a brief description of the tool and identifies additional relevant information.

Sections of the Hospital QI Toolkit

Section A: Determining Readiness To Change.

SectionAction StepsTool That Supports ActionAudiencesLead Role
A.1.Getting To Know the PSIs/IQIs.

Tool A.1a. Fact Sheet on Inpatient Quality Indicators (IQI)

Tool A.1b. Fact Sheet on Patient Safety Indicators (PSI)

All Hospital Board and Staff MembersSenior Staff and Quality Leaders
A.2.Help Board members and relevant staff understand the importance and financial and clinical implications of the AHRQ Quality Indicators. (The "notes" view in PowerPoint® has additional instructions for using this tool.)

Tool A.2. Board/Staff PowerPoint® Presentations on the Quality Indicators

Board Members, Senior Management Staff, Quality StaffQuality Leaders
A.3.Assess your hospital's organizational infrastructure and its readiness to support effective implementation efforts.

Tool A.3. Getting Ready for Change Self-Assessment

Senior Management Staff and Quality LeadersSenior Staff and Quality Leaders

Section B: Applying QIs to the Hospital Data.

SectionAction StepsTool That Supports ActionAudiencesLead Role

B.1.

Perform the QI calculations using the AHRQ 4.1 software.

Tool B.1. Applying the AHRQ Quality Indicators to Hospital Data

Quality and Safety Leaders, Data Analysts, Statisticians, and Programmers

Quality Leaders, Data Analysts

B.2.

Review this example of the output from the AHRQ QI 4.1 software.

Tool B.2a. IQI and PSI Rates Generated by the AHRQ SAS Programs

Tool B.2b. IQI and PSI Rates Generated by the AHRQ Windows QI Software

Data Analysts or Programmers calculating rates; Quality Leaders

Data Analysts, with Quality Leaders

B.3.

Use this PowerPoint® to understand and review the AHRQ QI data, trends, and rates.

Tool B.3a. Excel® Worksheets for Charts on Data, Trends, and Rates To Populate the PowerPoint® Presentation

Tool B.3a. Instructions

Tool B.3b. PowerPoint® Presentation: The AHRQ Quality Indicators, Results, and Discussion of Data Analysis

Quality Leaders, Senior Leaders, Analysts

Quality Leaders

B.4

Understand documentation and coding issues that affect PSI and IQI rates.

Tool B.4. Documentation and Coding for Patient Safety Indicators

Providers, Clinical Documentation Specialists, Coders, Quality Leaders

Quality Leaders

B.5

Analyze the hospital's performance on the QIs by assessing trends in rates and using benchmark comparisons.

Tool B.5 Assessing Indicator Rates Using Trends and Benchmarks

Quality and Safety Staff, Senior Leaders, Hospital Board, Analysts

Quality Leaders

Section C: Identifying Priorities for Quality Improvement.

SectionAction StepsTool That Supports ActionAudiencesLead Role

C.1.

Determine direction of organizational focus and decisions about which QIs should be addressed.

Tool C.1. Prioritization Matrix

Tool C.1. Instructions

Senior Leaders and Quality Staff

Senior Leaders and Quality Staff

C.2.

Review this example of a completed prioritization matrix.

Tool C.2. Prioritization Matrix Example

Senior Leaders and Quality Staff

Senior Leaders and Quality Staff

Section D: Implementing Improvements.

SectionAction StepsTool That Supports ActionAudiencesLead Role

D.1.

Evaluate current systems in place, modifications to existing protocols and electronic order sets, and development of new systems and processes of care.

Tool D.1. Improvement Methods Overview

Multidisciplinary improvement team

Quality Leaders

D.2.

Define the implementation team and its goals.

Tool D.2. Project Charter

Multidisciplinary improvement team

Quality Leaders

D.3.

Understand actions taken by other hospitals to help improve performance on the QIs.

Tool D.3. Examples of Effective PSI Improvement Strategies

Multidisciplinary improvement team

Quality Leaders

D.4.

Identify existing best practices that may help in assessing options for action.

Tool D.4. Selected Best Practices and Suggestions for Improvements (for 8 PSIs):

Multidisciplinary improvement team

Quality Leaders

D.5.

Understand the extent to which current practices align with best practices.

Tool D.5. Gap Analysis

Multidisciplinary improvement team

Quality Leaders

D.6.

Assign team responsibilities and set timeline.

Tool D.6. Implementation Plan

Multidisciplinary improvement team

Quality Leaders

D.7.

Measure progress in improving work and clinical care processes.

Tool D.7. Implementation Measurement

Multidisciplinary improvement team

Quality Leaders

D.8.

Understand what worked in the implementation process and what needs improvement.

Tool D.8. Project Evaluation and Debriefing

Multidisciplinary improvement team

Quality Leaders

Section E: Monitoring Progress for Sustainable Improvement.

SectionAction StepsTool That Supports ActionAudiencesLead Role

E.1.

Conduct an ongoing, standardized process for reporting trends in the measures developed and acting upon issues identified by those trends.

Tool E.1. Monitoring Progress for Sustainable Improvement

Quality Staff

Quality Leaders

Section F: Analyzing Return on Investment.

SectionAction StepsTool That Supports ActionAudiencesLead Role

F.1.

Estimate the return on investment from the interventions implemented to improve performance on the QIs.

Tool F.1. Return on Investment Estimation

Senior Leaders, including the Chief Financial Officer

 

Section G: Using Other Resources.

SectionAction StepsTool That Supports ActionAudiencesLead Role

G.1.

Obtain further guidance for conducting effective quality improvements.

Tool G.1. Available Comprehensive Quality Improvement Guides

Quality Staff and Improvement Team

Quality Leaders

G.2.

Identify specific analytic or action tools to use in improvement processes.

Tool G.2. Specific Tools To Support Change

Quality Staff and Improvement Team

Quality Leaders

G.3.

Review this case study for an example of how one hospital used the toolkit.

Tool G.3. Case Study of PSI Improvement Implementation

Senior Leaders, Quality Staff, Improvement Team

Quality Leaders

Current as of July 2012
Internet Citation: Toolkit Roadmap: AHRQ Quality Indicators™ Toolkit for Hospitals. July 2012. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/systems/hospital/qitoolkit/qiroadmap.html