Quality Interagency Coordination Task Force QuIC Fact Sheet

The goal of the Quality Interagency Coordination Task Force (QuIC) is to ensure that all Federal agencies that purchase, provide, study, or regulate health care services are working in a coordinated way toward the common goal of improving the quality of care. The QuIC seeks to provide information to help people make choices, to improve the care purchased and delivered by the Government, and to develop the infrastructure needed to improve the health care system.

The Federal Government plays many important roles that affect the quality of health care Americans receive. In fact, the Federal Government is the largest purchaser and provider of health care services in the United States. Programs like Medicare and Medicaid, the Federal Employee's Health Benefits Plan (FEHBA), and the networks of hospitals and facilities providing care to people in the armed forces and veterans serve millions of Americans. In addition, the Federal Government provides billions of dollars in support of health care research each year, oversees employer-based health care coverage, and ensures fair competition in the health care market.

The goal of the Quality Interagency Coordination Task Force (QuIC), which was established in March 1998, is to ensure that all Federal agencies involved in purchasing, providing, studying, or regulating health care services are working in a coordinated way toward the common goal of improving quality of care. The QuIC seeks to:

• Provide people with information to assist them in making choices about their care.
• Improve the care delivered by Federal providers and purchased on behalf of Federal beneficiaries.
• Develop the infrastructure needed to improve the health care system. This infrastructure will include knowledgeable and empowered workers, well-designed systems of care, and useful information systems.

Composition

The Secretary of Health and Human Services (HHS) serves as the chair of the QuIC. The Director of the Agency for Healthcare Research and Quality (AHRQ) serves as chairperson for day-to-day operations. In addition to HHS, the other Federal members of the QuIC are:

• The Departments of Defense, Veterans Affairs (VA), Labor, and Commerce.
• The Office of Personnel Management.
• The Office of Management and Budget.
• The U.S. Coast Guard.
• The Federal Bureau of Prisons.
• The National Highway Transportation and Safety Administration.
• The Federal Trade Commission.

Key Activities

These themes emerged from the QuIC's initial discussions:

1. Improving patient and consumer information on health care quality.
2. Identifying key opportunities for improving clinical quality.
3. Improving efforts to measure quality of care.
4. Developing the health care work force.
5. Improving information systems.
6. Reducing hazards in patient care.
7. Improving Safety and Quality through Value-Based Purchasing.

Work groups have been established to identify and work on specific projects within each of these topic areas.

Identifying ways to address the problem of medical errors has been a major focus of QuIC activity. The QuIC developed a response to a report on medical errors issued by the Institute of Medicine (IOM) that included a number of recommendations for Federal action.

The response to the IOM document, the report Doing What Counts for Patient Safety: Federal Actions to Reduce Medical Errors and Their Impact, describes more than 100 actions that the QuIC and its participating agencies will take—alone, or together with the private sector and State government. These actions will be taken to:

• Create a national focus on reducing errors.
• Develop a knowledge base for learning about errors' causes and effective error prevention.
• Ensure accountability for safe health care delivery.
• Guarantee that patient safety practices are implemented.

Work Groups

Each work group is co-chaired by representatives from two different Federal agencies and involves all of the Agencies that wish to participate on the chosen topics.

Patient and Consumer Information
Co-leaders: Centers for Medicare & Medicaid Services (CMS) and Office of Personnel Management (OPM)
This group is addressing critical barriers to effective communication with patients about quality. It will provide an opportunity for Federal agencies to learn what is most effective in helping people understand quality issues and how their choices influence the quality of the services they receive. It will also develop a common vocabulary, or set of terms, for Federal agencies to use in communicating with patients and consumers about quality.

Improving Quality Measurement
Co-leaders: AHRQ and CMS
The focus of this group will be on developing the "tool box" of quality measures and risk adjustment methods used by Federal agencies, particularly those that reflect outcomes of care. The work group is developing an inventory of all of the measures and risk adjustment methods being used by Federal agencies, documenting their uses, strengths and weaknesses, and examining how to institute appropriate risk adjustment methods to account for factors outside the control of the delivery system.

Developing the Workforce
Co-leaders: Department of Labor (DoL) and the Health Resources and Services Administration (HRSA)
This group is determining how to expand and improve the current methods of ensuring the skills of the health care workforce and equipping health care workers to improve the care they deliver. For example, the work group has chosen to begin by improving the credentialling process for Federal health care providers. This group is also looking at the relationship between the working conditions and health and safety of health care employees and the quality of care delivered. An expert panel was held in fall 1999 to study the issue and develop an agenda for further research.

Key Opportunities for Improving Clinical Quality
Co-leaders: Departments of Defense (DoD) and Veterans Affairs (VA)
This group has selected diabetes and depression as the first two areas for which it will mount an effort to improve clinical quality of care. For diabetes, the work group is focusing its efforts on having all Federal programs agree to use the Diabetes Quality Indicator Project measures of care and then to improve health care provider performance based on these indicators. For depression, the work group is developing an evidence-based guideline to improve the identification and treatment of depressed individuals served by Federal health care programs.

Improving Information Systems
Co-leaders: DoD and VA
This work group is exploring how its efforts can augment those of Federal groups already working to develop a standardized language that will enable computerized comparisons of quality across Federal agencies. The work group is also examining the potential uses of telemedicine for helping to improving quality of care.

Reducing Hazards in Patient Safety
Co-leaders: AHRQ and VA
This workgroup focuses on reducing hazard in patient care through the coordination of Federal efforts to conduct research on patient safety and by piloting safety improvement strategies. Currently, it serves as a clearinghouse for the patient safety measures being implemented by each Federal organization. Members currently share information on grant announcements for AHRQ and HRSA and serve as members or liaisons to the HHS Patient Safety Task Force, which seeks to develop a common reporting interface and data structure on end-stage renal disease for all HHS agencies. In addition the group is working to develop a validated Patient Safety Culture Assessment.

Improving Safety and Quality through Value Based Purchasing
Co-leaders: CMS and DoD
This group assists the Federal Government in enhancing its ability to purchase health care based on quality as well as cost, and to advocate for quality of care on behalf of its constituents. The concept of value-based purchasing is that buyers should hold providers of health care accountable for cost and quality, balancing regulatory approaches with purchasing mechanisms. It focuses on managing the use of the health care system to reduce inappropriate care and to identify and reward the best-performing providers.

For More Information

To obtain more information about the Quality Interagency Coordination Task Force and its activities, contact:

Howard E. Holland
Quality and Patient Safety Activities
Agency for Healthcare Research and Quality
540 Gaither Road, Suite 2000
Rockville, MD, 20850
Phone: (301) 427-1857
Fax: (301) 427-1873
Howard.Holland@AHRQ.HHS.gov

Information is also available by visiting the Task Force's Web site: http://www.quic.gov