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Table 1-1: Issues Raised and Potential Solutions Related to the Nation

Future Directions for the National Healthcare Quality and Disparities

Table 1-1. Issues Raised and Potential Solutions Related to the National Healthcare Reports and Their Related Products

Issues RaisedPotential Solutions
The Need to Identify the Most Important Opportunities for Concerted National Action
  1. The NHQR and NHDR do not sufficiently direct readers on what to focus quality improvement efforts.
  2. The reports may not use the most impactful measures for bringing about quality improvement.
  3. Disparities elimination should not be considered as a separate issue from quality improvement.
  4. The NHQR and NHDR passively report data rather than being action-oriented.
  5. Access to health care is not addressed as a quality issue in the NHQR, only a disparities issue in the NHDR.
  6. Important measurement areas are missing in both the NHQR and NHDR.
  1. Establish national priority areas and give guidance on setting a hierarchy among measures.
  2. Make the measure selection criteria more explicit and the selection process more transparent.
  3. Have one report rather than two reports or improve shared content across the NHQR and NHDR.
  4. Establish goals for priority areas and provide benchmarks for individual measures; tell a story by defining a problem, describing through measurement, and providing examples of intervention; integrate intervention activities in text and through online linkages; highlight evidence-based policies that could accelerate progress.
  5. Consider access as part of the NHQR as well as the NHDR.
  6. Examine the current quality framework for continued applicability.
The Need to Develop Measures and Data Sources to Support Monitoring of "High-Impact" Areas
  1. Measures used in the NHQR and NHDR reflect available data sources, but additional measures and data sources are desirable.
  2. Data are inadequate to identify poor quality of health care within and between all population groups.
  3. Improved measures and data may be available in some locales rather than on a national basis.
  1. Identify or develop measures for areas with the greatest potential quality improvement impact and identify or develop additional data sources that satisfy those measures.
  2. Increase the availability of race, ethnicity, and language need data along with health care quality data.
  3. Consider the use of additional subnational data in the NHQR and NHDR.
The Need to Increase Understanding and Visibility of Report Content in Both Print and Web-based Forms
  1. The presentation and content of the NHQR and NHDR do not adequately serve the primary audience for these reports (i.e., Congress).
  2. Multiple audiences use the NHQR and NHDR and associated online products but the needs of these audiences are different.
  3. Many pertinent parties that could be involved in implementation or reporting activities do not know about the reports.
  4. The NHQR and NHDR draw the most attention when they are first released but lose visibility thereafter.
  5. A great deal of data is available in the NHQR and NHDR but it is difficult to find all of the pieces related to a specific topic.
  6. There is insufficient attention in the NHQR and NHDR to the needs of priority populations.
  7. Graphic displays and summary measures in the NHQR and NHDR do not always convey information in a readily understandable manner—either for the key message each is trying to provide to audiences or adequate statistical analytics for researchers.
  8. A lot of data are available in the NHQR and NHDR, but some users desire more detail and the ability to manipulate the primary data themselves.
  1. Reorient the Highlights section of the NHQR and NHDR.
  2. Better align reports and products associated with the NHQR and NHDR to serve the needs of multiple audiences.
  3. Market the NHQR and NHDR to additional audiences; optimize online search strategies.
  4. Sustain interest over time through improved and targeted dissemination; provide content in additional formats with more easily digestible collections of information that could be more widely distributed (e.g., fact sheets or topic-specific products with more detailed analyses dedicated to specific populations, conditions, and types of care or settings).
  5. Improve organization of print documents and improve content access for the State Snapshots (e.g., best state performance) and NHQRDRnet.
  6. Expand information on priority populations in reports to extent feasible and provide additional, more detailed collections of information for specific populations in special reports, fact sheets, or online.
  7. Improve graphic displays in the NHQR and NHDR.
  8. Guide users of the NHQR and NHDR to more detailed datasets underlying the reports, tools for analysis, and a guide on "how to" apply data; provide links to additional complementary and expanded data sources that are not necessarily reflected in the reports.

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Current as of December 2010
Internet Citation: Table 1-1: Issues Raised and Potential Solutions Related to the Nation: Future Directions for the National Healthcare Quality and Disparities . December 2010. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/research/findings/final-reports/iomqrdrreport/futureqrdrtab1-1.html