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Working for Quality > About the NQS > Agency-Specific Quality Strategic Plans (continued)

National Strategy for Quality Improvement in Health Care (continued)

National Institutes of Health (NIH) Agency-Specific Quality Strategic Plan

Agency-Specific Quality Strategic Plan Table

  1. Title
  2. Description
  3. Scope of Issue
  4. Rationale for Approach
  5. Metrics/Goals

NQS Aims, Priorities, and Alignment Program / Initiative
Aims

Better Care
Improve quality by making health care more person-centered, reliable, accessible, and safe.

N/A

Healthy People/Healthy Communities
Support proven interventions to address behavioral, social, and environmental determinants of health.

N/A

Affordable Care
Reduce the cost of quality health care for individuals, families, employers, and government.

N/A
Priorities

Making care safer by reducing the harm caused in the delivery of care.

N/A

Ensuring that each person and family are engaged as partners in their care.

  1. Shared Medical Decision Making.
  2. The Shared Medical Decision Making initiative will support research on methods to optimize shared medical decisionmaking by health care providers and patients. While early results are promising, the study of patient decision aids is in its infancy, and aids are available for relatively few medical conditions. There are only a few examples of implementation of shared decisionmaking in clinical practice. Providing guidance on deliberation and assessing patient preference are outside the scope of usual clinical care. In FY 2013, the Office of Behavioral and Social Sciences Research (OBSSR) will partner with NIH Institutes and Centers to launch the initiative. This funding opportunity announcement will support research on the effects of shared decisionmaking on health care costs, patient satisfaction, and patient outcomes, as well as investigation of the feasibility of implementing shared decisionmaking in clinical practice. This program contributes to the NIH Director's Theme 3: Advancing Translational Science. The shared decisionmaking paradigm helps assure that patients receive the best evidence-based treatment.
  3. Decisions about what medical treatments patients should receive are often very complex. Often, the clinical trials literature does not clearly identify a dominant treatment alternative, and treatment choice therefore requires weighing the risks and benefits of alternative treatments, as well as consideration of patient preferences, willingness to assume risk, and degree of support. Many patients are no longer willing to let their treatments be selected for them. A growing societal cry is reflected in the phrase "no decision about me, without me," yet informed consent processes rarely address patient preferences. Moreover, evidence suggests that patients are usually not told about the full range of clinical options, their risks, and benefits.
  4. Shared decisionmaking has been widely advocated as an effective means for reaching agreement on the best strategy for treatment. Through this process, a health care provider and a patient consider personalized information about the options, outcomes, probabilities, and scientific uncertainties of available treatment options, as well as assessing the values patients assign to risks and outcomes. Patient decision support interventions and shared decision aids help patients make decisions by providing information on options. Some of these tools elicit patient values and preferences and help communicate the utility associated with different treatment options.
  5. N/A

Promoting effective communication and coordination of care.

  1. Shared Medical Decision Making.
  2. The Shared Medical Decision Making initiative will support research on methods to optimize shared medical decisionmaking by health care providers and patients. While early results are promising, the study of patient decision aids is in its infancy, and aids are available for relatively few medical conditions. There are only a few examples of implementation of shared decisionmaking in clinical practice. Providing guidance on deliberation and assessing patient preference are outside the scope of usual clinical care. In FY 2013, the Office of Behavioral and Social Sciences Research (OBSSR) will partner with NIH Institutes and Centers to launch the initiative. This funding opportunity announcement will support research on the effects of shared decisionmaking on health care costs, patient satisfaction, and patient outcomes, as well as investigation of the feasibility of implementing shared decisionmaking in clinical practice. This program contributes to the NIH Director's Theme 3: Advancing Translational Science. The shared decisionmaking paradigm helps assure that patients receive the best evidence-based treatment.
  3. Decisions about what medical treatments patients should receive are often very complex. Often, the clinical trials literature does not clearly identify a dominant treatment alternative, and treatment choice therefore requires weighing the risks and benefits of alternative treatments, as well as consideration of patient preferences, willingness to assume risk, and degree of support. Many patients are no longer willing to let their treatments be selected for them. A growing societal cry is reflected in the phrase "no decision about me, without me," yet informed consent processes rarely address patient preferences. Moreover, evidence suggests that patients are usually not told about the full range of clinical options, their risks, and benefits.
  4. Shared decisionmaking has been widely advocated as an effective means for reaching agreement on the best strategy for treatment. Through this process, a health care provider and a patient consider personalized information about the options, outcomes, probabilities, and scientific uncertainties of available treatment options, as well as assessing the values patients assign to risks and outcomes. Patient decision support interventions and shared decision aids help patients make decisions by providing information on options. Some of these tools elicit patient values and preferences and help communicate the utility associated with different treatment options.
  5. N/A

Promoting the most effective prevention and treatment practices for the leading causes of mortality, starting with cardiovascular disease.

N/A

Working with communities to promote wide use of best practices to enable healthy living.

  1. Annual Dissemination and Implementation Science Meeting and Training Institute on Dissemination and Implementation Science.
  2. The goal of the annual NIH Conference on the Science of Dissemination and Implementation is to facilitate growth in the research base by providing a forum for communicating and networking about the science of dissemination and implementation.
  3. There is a recognized need to close the gap between research evidence and clinical and public health practice and policy. Dissemination and implementation research in health seeks to find how this is best accomplished, and is gaining momentum as a field of scientific inquiry.
  4. Researchers, evaluators, and implementers who are interested in identifying opportunities and strategies for overcoming obstacles for dissemination and implementation research and evaluation are encouraged to attend this meeting. The goal is to engage in dialogue, exchange ideas, explore contemporary topics, and challenge one another to identify and test research approaches that will advance dissemination and implementation science.
  5. N/A

Making quality care more affordable for individuals, families, employers, and governments by developing and spreading new health care delivery models.

N/A
Areas of Coordination or Alignment

Demonstration of coordination or alignment with other federal agencies (i.e., involvement of other agencies in program planning or execution, mechanisms for sharing best practices, steps to reduce duplication of effort).

N/A

Demonstration of coordination or alignment with the private sector or States (i.e., stakeholder meetings, public comment periods, open-door forums, workshops).

N/A

Use of measures or benchmarks for performance measures and/or monitoring that align with the NQS.

To be determined by HHS leadership.

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Substance Abuse and Mental Health Services Administration (SAMHSA) Agency-Specific Quality Strategic Plan

Brief Introduction/Overview

SAMHSA's mission is to reduce the impact of substance abuse and mental illness on America's communities. To achieve this mission, SAMHSA has identified eight strategic initiatives to focus the Agency's work on improving lives and capitalizing on emerging opportunities. Each initiative has at least two measures: one population based and one SAMHSA specific. The population-based measures are aspirational and will require broad change in partnership with other systems, levels of government, private organizations, and the American people. The SAMHSA-specific measures are closely tied to SAMHSA-funded programs and provide more immediate targets for the work described in these initiatives.

SAMHSA is also developing a National Behavioral Health Quality Strategy with six priorities that focus on behavioral health while aligning with the NQS. These priorities include 1) promote the most effective prevention, treatment, and recovery practices for behavioral health disorders; 2) ensure that behavioral health care is consumer and family centered; 3) encourage effective coordination within behavioral health care systems and between the behavioral health care system and primary care and social service systems; 4) assist communities in the use of best practices to support healthy living; 5) make behavioral health care safer by reducing harm caused in the delivery of services; and 6) foster affordable, quality behavioral health care for individuals, families, employers, and governments by developing and advancing new delivery models.

Agency-Specific Quality Strategic Plan Table

  1. Title
  2. Description
  3. Scope of Issue
  4. Rationale for Approach
  5. Metrics/Goals

NQS Aims, Priorities, and Alignment Program / Initiative
Aims

Better Care
Improve quality by making health care more person-centered, reliable, accessible, and safe.

N/A

Healthy People/Healthy Communities
Support proven interventions to address behavioral, social, and environmental determinants of health.

N/A

Affordable Care
Reduce the cost of quality health care for individuals, families, employers, and government.

N/A
Priorities

Making care safer by reducing the harm caused in the delivery of care.

  1. Strategic Initiative 7 (SI-7): Data, Outcomes, and Quality.
  2. This initiative realizes an integrated data strategy and a national framework for quality improvement in behavioral health care that will inform policy, measure program impact, and lead to improved quality of services and outcomes.
  3. Discrete service systems can limit access to appropriate care, lead to uneven quality in service delivery and coordination, and increase information silos.
  4. Better use and availability of data will enable providers to more fully understand individual needs and provide person-centered care that works for consumers. Using a range of data effectively will drive accountability, leading to higher-quality, safer, more accessible, and more reliable care.
  5. The goal is to increase the number of States adopting the Behavioral Health Barometer for planning and reporting purposes.

Ensuring that each person and family are engaged as partners in their care.

  1. Strategic Initiative 1 (SI-1): Prevention of Substance Abuse and Mental Illness.
  2. This initiative creates communities where everyone takes action to promote emotional health and reduce the likelihood of mental illness, substance abuse (including tobacco), and suicide.
  3. By 2020, mental and substance use disorders will surpass all physical diseases as a major cause of disability worldwide.
  4. If communities and families can intervene earlier—before mental and substance use disorders are typically diagnosed—future disorders can be prevented or the symptoms can be mitigated.
  5. The goal is to reduce the percentage of children and youth aged 12 to 20 years who report past 30-day substance use (including improper use of prescription drugs) and decrease the percentage of children and youth aged 12 to 17 years who report a major depressive episode in the past year.

Promoting effective communication and coordination of care.

  1. Strategic Initiative 5 (SI-5): Health Reform.
  2. This initiative increases access to high-quality prevention, treatment, and recovery services; reduces disparities regarding the availability of services for mental and substance use disorders; and supports integrated, coordinated care.
  3. Individuals with a mental disorder are twice as likely to be uninsured as those without a mental disorder.
  4. This initiative focuses on enhancing access to services and effective referral arrangements for people living with mental and/or substance use disorders across all health care settings, through a “whole person approach.”
  5. The goal is to increase rates of insurance coverage among people with mental and substance use disorders.

Promoting the most effective prevention and treatment practices for the leading causes of mortality, starting with cardiovascular disease.

  1. Strategic Initiative 4 (SI-4): Recovery Support.
  2. This initiative partners with people in recovery from mental and substance use disorders and family members to guide the behavioral health system and promote individual-, program-, and system-level approaches.
  3. Thirty three percent of people who report dropping out of treatment indicate they might have stayed longer in substance abuse treatment if they had received practical assistance, help with areas of life functioning, and better individualized services.
  4. An individual's ability to have a successful, satisfying, and healthy life integrated in a community is fostered through the availability of and appropriate use of prevention, health, clinical treatment, and recovery support services.
  5. The goal is to improve the health status of individuals with co-occurring physical and behavioral health conditions.

Working with communities to promote wide use of best practices to enable healthy living.

  1. Strategic Initiative 1 (SI-1): Prevention of Substance Abuse and Mental Illness.
  2. This initiative creates communities where everyone takes action to promote emotional health and reduce the likelihood of mental illness, substance abuse (including tobacco), and suicide.
  3. By 2020, mental and substance use disorders will surpass all physical diseases as a major cause of disability worldwide.
  4. If communities and families can intervene earlier—before mental and substance use disorders are typically diagnosed—future disorders can be prevented or the symptoms can be mitigated.
  5. The goal is to reduce the percentage of children and youth aged 12 to 20 years who report past 30-day substance use (including improper use of prescription drugs) and decrease the percentage of children and youth aged 12 to 17 years who report a major depressive episode in the past year.

Making quality care more affordable for individuals, families, employers, and governments by developing and spreading new health care delivery models.

  1. Strategic Initiative 5 (SI-5): Health Reform.
  2. This initiative increases access to high-quality prevention, treatment, and recovery services; reduces disparities regarding the availability of services for mental and substance use disorders; and supports integrated, coordinated care.
  3. Individuals with a mental disorder are twice as likely to be uninsured as those without a mental disorder.
  4. This initiative focuses on enhancing access to services and effective referral arrangements for people living with mental and/or substance use disorders across all health care settings, through a “whole person approach.”
  5. The goal is to increase rates of insurance coverage among people with mental and substance use disorders.
Areas of Coordination or Alignment

Demonstration of coordination or alignment with other federal agencies (i.e., involvement of other agencies in program planning or execution, mechanisms for sharing best practices, steps to reduce duplication of effort).

HHS Tobacco Prevention and Control Working Group (a collaboration with CDC, FDA, NIH [including the National Cancer Institute], CMS, IHS, Administration for Children and Families, Administration on Aging, HRSA, and offices within HHS).

Demonstration of coordination or alignment with the private sector or States (i.e., stakeholder meetings, public comment periods, open-door forums, workshops).

SAMHSA's Strategic Initiative on Public Awareness and Support articulates a clear strategy to engage the public through multiple communications channels and satisfy current customer needs, in the format information is desired.

Use of measures or benchmarks for performance measures and/or monitoring that align with the NQS.

To be determined by HHS leadership.

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A Federal Government Web site managed by the Agency for Healthcare Research and Quality