AHRQ Quality Indicators Assist Iowa Healthcare Collaborative in Quality Improvement Efforts

The Iowa Healthcare Collaborative (IHC), a provider-led organization dedicated to promoting an Iowa health care culture of continuous improvement, is using AHRQ's Patient Safety Indicators, Inpatient Quality Indicators, and Pediatric Quality Indicators software tools to help educate consumers and providers in the state.

AHRQ's SAS-based software QI tools (Version 3.1) were used to evaluate the Nationwide Inpatient Sample (NIS) and Iowa's State Inpatient Dataset (SID). The Collaborative used two years of NIS data and five years of SID data, measuring Iowa hospitals' performance—in each year individually and then in the five years combined—to establish benchmarks of performance over time. In order to make similar comparisons, both the Iowa and U.S. data sets were limited to 11 diagnosis codes. A total of six procedure codes were also used in the computations.

The data is being used in Iowa as an important tool in measuring improvements in the state. For example, the IHC's Healthcare Associated Infection Workgroup has collected information from hospitals measuring influenza immunization of health care workers in Iowa.

As the Workgroup began developing interventions to attain its self-established goal of 95 percent of workers immunized by 2010, it realized that there was no good source of data that provided that information. To close this information gap, the IHC launched an effort encouraging hospitals to report their influenza immunization rates. Of the 116 hospitals, 100 reported data, with a total influenza immunization rate of 68 percent. Armed with this information, the IHC has a better idea how to achieve the immunization goal.

"Transparency of information is one of the hallmarks of our organization. We've systematically worked over time to engage our provider community in developing their knowledge of the available health data, as well as disseminating both new and previously developed information—like AHRQ's data—to the community," says Gerd Clabaugh, IHC Director of Operations.

IHC initiatives have focused provider-directed efforts toward improvements in communication, data-sharing, and best practices in the areas of quality, patient safety, and value. Another IHC initiative that utilizes AHRQ data is known as the "Lean Learning Community." Lean is a management strategy meant to improve the processes by which an organization carries out its activities.

The IHC documented over $250,000 worth of savings with just one Lean process improvement training opportunity provided to a group of Iowa staff in 11 hospitals. While many of the processes improved during this work were non-clinical, it was clear that process improvement tools can be applied to all manner of health care facility processes, both non-clinical and clinical, with potentially similar-or greater-results.

"Because the data we report reflects actual statewide health care practice, its potential impact is on consumers and providers statewide. Consumers statewide will find our information valuable because our reporting initiatives include health care providers from across Iowa. Similarly, health care providers find IHC a useful resource because our reporting allows comparisons not only with Iowa colleagues and institutions, but with the nation," Clabaugh notes.

He continues, "We will continue expanding the information we report to providers and the community to encourage transparency of health care operations and outcomes. We also aim to provide meaningful information to our provider communities for quality enhancement and process improvement."

IHC was originally formed through a partnership of the Iowa Hospital Association and the Iowa Medical Society. For more information, visit http://www.ihconline.org.