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Working for Quality > About the NQS > National Quality Strategy: Overview

National Strategy for Quality Improvement in Health Care

This set of 21 PowerPoint slides provides essential background about the NQS.

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Overview

1: National Quality Strategy: Overview
2. National Quality Strategy (NQS): Introduction
3. National Quality Strategy: Background
4. The Strategy is to Concurrently Pursue Three Aims
5. And Focus on Six Priorities
6. Initial Implementation Activities
7. Upcoming Activities for 2012-2013
8. Priority 1: Making Care Safer by Reducing Harm Caused in the Delivery of Care
9. Priority 2: Ensuring That Each Person and Family are Engaged as Partners in Their Care
10. Priority 2 (continued): Ensuring That Each Person and Family are Engaged as Partners in Their Care
11. Priority 3: Promoting Effective Communication and Coordination of Care
12. Priority 3 (continued): Promoting Effective Communication and Coordination of Care
13. Priority 4: Promoting the Most Effective Prevention and Treatment Practices for the Leading Causes of Mortality, Starting With Cardiovascular Disease
14. Priority 4 (continued): Promoting the Most Effective Prevention and Treatment Practices for the Leading Causes of Mortality, Starting With Cardiovascular Disease
15. Priority 5: Working With Communities to Promote Wide Use of Best Practices to Enable Healthy Living
16. Priority 5 (continued): Working With Communities to Promote Wide Use of Best Practices to Enable Healthy Living
17. Priority 6: Making Quality Care More Affordable by Developing and Spreading New Health Care Delivery Models
18. Priority 6 (continued): Making Quality Care More Affordable by Developing and Spreading New Health Care Delivery Models
19. Highlighted Initiatives
20. Highlighted Initiatives (continued)
21. Questions/Comments?

1: National Quality Strategy

Overview

November 2012

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2: National Quality Strategy (NQS): Introduction

The Affordable Care Act (ACA) requires the Secretary of the Department of Health and Human Services (HHS) to establish a national strategy that will improve:

The delivery of health care services.
Patient health outcomes.
Population health.

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3: National Quality Strategy: Background

The inaugural NQS was published on March 18, 2011 at http://www.healthcare.gov and the Agency for Healthcare Research and Quality (AHRQ) http://www.ahrq.gov/workingforquality/ Web sites.
The NQS is iteratively developed through a transparent, consultative consensus building process among public and private sector stakeholders.
The NQS is a national strategy and serves as a catalyst and compass for nationwide focus.

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4: The Strategy is to Concurrently Pursue Three Aims:

Better Care:	Improve overall quality by making health care more patient-centered, reliable, accessible and safe.
Healthy People/Healthy Communities:	Improve population health 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.

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5: And Focus on Six Priorities:

Making care safer by reducing harm caused in the delivery of care.
Ensuring that each person and family are 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.

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6: Initial Implementation Activities:

Partnership for Patients (patient safety).
Multi-payer Advanced Primary Care Practice Demonstration (care coordination).
Million Hearts (cardiovascular disease prevention and treatment).
Use of HCAHPS patient experience results in Value-Based Purchasing hospital payment (person-centered care).
Community Transformation Grants (working with communications to enable healthy living).
CMS Innovation Center 21 initiatives (development new delivery models).

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7: Upcoming Activities for 2012-2013:

Ongoing collaboration and coordination of efforts with private sector.
Increasing collaboration, coordination, and consultation with state, regional, and local communities.
Setting Aspirational Targets for the additional four priorities .
Establishing plans to address the three cross-cutting strategic opportunities identified by NPP:
- Identify a national strategy for data collection, measurement, and reporting
- Develop organizational infrastructure at the community level that assumes responsibility for improvement efforts.
- Reform payment and delivery systems.

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8: Priority 1: Making Care Safer By Reducing Harm Caused in the Delivery of Care

Long-Term Goals

Reduce preventable hospital admissions and readmissions.
Reduce the incidence of adverse health care-associated conditions.
Reduce harm from inappropriate or unnecessary care.

Hospital Measures	Measure Name/Description	Current Rate	Aspirational Target
Hospital-acquired Conditions	Incidence of measureable hospital-acquired conditions	145 per 1000 admissions*	Reduce preventable HACs by 40% by the end of 2013.
Hospital Readmissions	All-payer 30-day readmission rate	14.4%, based on 32.9 million admissions*	Reduce all readmissions by 20% by the end of 2013.

* Source: AHRQ, CDC, and CMS, March 2012

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9: Priority 2: Ensuring That Each Person and Family Are Engaged as Partners in Their Care

Long-Term Goals

Improve patient, family, and caregiver experience of care related to quality, safety, and access across settings.
In partnership with patients, families, and caregivers—and using a shared decision making process—develop culturally sensitive and understandable care plans.
Enable patients and their families and caregivers to navigate, coordinate, and manage their care appropriately and effectively.

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10: Priority 2 (continued): Ensuring That Each Person and Family Are Engaged as Partners in Their Care

Starter Key Measures

Measure Focus	Measure Name/Description	Current Rate
Timely Care	Adults who needed care right away for an illness, injury, or condition in the last 12 months who sometimes or never got care as soon as wanted	14.1%*
Decision-making	People with a usual source of care whose health care providers sometimes or never discuss decisions with them	15.4%*

* Source: Agency for Healthcare Research and Quality, Center for Financing, Access, and Cost Trends, The Medical Expenditure Panel Survey, 2010.

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11: Priority 3: Promoting Effective Communication and Coordination of Care

Long-Term Goals

Improve the quality of care transitions and communications across care settings.
Improve the quality of life for patients with chronic illness and disability by following a current care plan that anticipates and addresses pain and symptom management, psychosocial needs, and functional status.
Establish shared accountability and integration of communities and health care systems to improve quality of care and reduce health disparities.

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12: Priority 3 (continued): Promoting Effective Communication and Coordination of Care

Starter Key Measures

Measure Focus	Measure Name/Description	Current Rate
Patient-Centered Medical Home	% of children needing care coordination (list of criteria available) who receive effective care coordination (list of criteria available)	69%*
3-item Care Transition Measure**	During this hospital stay, staff took my preferences and those of my family or caregiver into account in deciding what my health care needs would be when I left. When I left the hospital, I had a good understanding of the things I was responsible for in managing my health. When I left the hospital, I clearly understood the purpose for taking each of my medications.	Data available October 2012**

* Source: HRSA, Maternal and Child Health Bureau; CDC, National Center for Health Statistics, National Survey of Children's Health, 2007.
** This report will be updated online to reflect baseline performance data from the CMS in October 2012.

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13: Priority 4: Promoting the Most Effective Prevention and Treatment Practices For the Leading Causes of Mortality, Starting With Cardiovascular Disease

Long-Term Goals

Promote cardiovascular health through community interventions that result in improvement of social, economic, and environmental factors.
Promote cardiovascular health through interventions that result in adoption of the most healthy lifestyle behaviors across the lifespan.
Promote cardiovascular health through receipt of effective clinical preventive services across the lifespan in clinical and community settings.

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14: Priority 4 (continued): Promoting the Most Effective Prevention and Treatment Practices For the Leading Causes of Mortality, Starting With Cardiovascular Disease

Starter Key Measures

Measure Focus	Measure Name/Description	Current Rate	Aspirational Target
Aspirin Use	People at increased risk of cardiovascular disease who are taking aspirin.	47%*	65% by 2017
Blood Pressure Control	People with hypertension who have adequately controlled blood pressure.	46%**	65% by 2017
Cholesterol Management	People with high cholesterol who have adequately managed hyperlipidemia.	33%**	65% by 2017
Smoking Cessation	People trying to quit smoking who get help.	23%***	65% by 2017

* Source: CDC, National Ambulatory Medical Care Survey (NAMCS) and National Hospital Ambulatory Medical Care Survey (NHAMCS), 2007-2008.
** Source: CDC, National Health and Nutrition Examination Survey (NHANES), 2005-2008.
*** Source: NAMCS, 2005-2008

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15: Priority 5: Working With Communities to Promote Wide Use of Best Practices to Enable Healthy Living

Long-Term Goals

Promote healthy living and well-being through community interventions that result in improvement of social, economic, and environmental factors.
Promote healthy living and well-being through interventions that result in adoption of the most important healthy lifestyle behaviors across the lifespan.
Promote healthy living and well-being through receipt of effective clinical preventive services across the lifespan in clinical and community settings.

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16: Priority 5 (continued): Working With Communities to Promote Wide Use of Best Practices to Enable Healthy Living

Starter Key Measures

Measure Focus	Measure Name/Description	Current Rate
Depression	Percentage of adults who reported symptoms of a major depressive episode (MDE) in the last 12 months who received treatment for depression in the last 12 months	68.3%*
Obesity	Proportion of adults who are obese	35.7%**

* Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2010.
** Source: CDC, National Health and Nutrition Examination Survey (NHANES), 2010.

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17: Priority 6: Making Quality Care More Affordable by Developing and Spreading New Health Care Delivery Models

Long-Term Goals

Ensure affordable and accessible high quality health care for people, families, employers, and governments.
Support and enable communities to ensure accessible, high quality care while reducing waste and fraud.

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18: Priority 6 (continued): Making Quality Care More Affordable by Developing and Spreading New Health Care Delivery Models

Starter Key Measures

Measure Focus	Measure Name/Description	Current Rate
Out of Pocket Expenses	Percentage of people under 65 with out-of-pocket medical and premium expenses greater than 10 percent of income	18.5%*
Health spending per capita	Annual all payer healthcare spending per person	$8,402**

*Source: AHRQ, Center for Financing, Access, and Cost Trends, Medical Expenditure Panel Survey, 2009.
**Source: CMS, Health Expenditure Data, Health Expenditures by State of Residence; 2010.

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19: Highlighted Initiatives

NQS Priority	Highlighted Initiative	Web Site
1. Making care safer by reducing the harm caused in the delivery of care	Partnership for Patients	http://www.healthcare.gov/ center/programs/partnership
2. Ensuring that each person and family is engaged in their care	Consumer Assessment of Healthcare Providers and Systems (CAHPS)	http://www.cms.gov/Hospital- Value-Based-Purchasing
3. Promoting effective communication and coordination of care	Multi-payer Advanced Primary Care Practice Demonstration (MAPCP)	http://www.cms.gov/demoprojectsevalrpts/ md/itemdetail.asp?itemid=cms1230016
4 .Promoting the most effective prevention and treatment practices for the leading causes of mortality, starting with cardiovascular disease	Million Hearts	http://www.millionhearts.hhs.gov

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20: Highlighted Initiatives (continued)

NQS Priority	Highlighted Initiative	Web Site
5. Working with communities to promote best practices for healthy living	Community Transformation Grants (CTG)	http://www.cdc.gov/ communitytransformation/
6. Making quality care more affordable by developing and spreading new Health care delivery models	CMS Innovation Center	http://www.innovations.cms.gov

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21: Questions/Comments?

Contact: nancy.wilson@ahrq.hhs.gov
View: http://www.ahrq.gov/workingforquality

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