Iowa Healthcare Collaborative Improves Public Reporting With AHRQ Guidance

May 2010

The Iowa Healthcare Collaborative participated in AHRQ's Knowledge Transfer Quality Indicators (QI) Learning Institute, which hosted monthly Web conferences, online discussions, and document-sharing on topics related to publicly reporting hospital quality data. As a participant, the Iowa Healthcare Collaborative learned about QI reporting resources and tools that enabled the Collaborative to improve its public reporting program.

AHRQ's publication "Guidance on Using the AHRQ QI for Hospital-Level Comparative Reporting" was particularly useful to the Collaborative. The Collaborative used the tool in discussions with its Data Committee to select measures for public reporting efforts and to help decide what measures to include in public reporting mechanisms. Finally, AHRQ's publication helped the Collaborative write an "Iowa Comprehensive Heart Disease and Stroke Health Plan" with its stakeholders.

The publication describes AHRQ's assignment of QIs to one of four tiers based on current evidence. It also identifies gaps for public reporting and notes which QIs are National Quality Forum-endorsed. These factors help decisionmakers select appropriate indicators for public reporting.

Iowa Healthcare Collaborative's Data Coordinator, Lance Roberts, notes, "This document made selecting QIs more efficient. AHRQ has done the research that, in the past, we have had to prepare for decisionmakers, which is time-consuming and difficult. It is beneficial to go into a meeting with concise information about AHRQ's research criteria and evidence-based recommendations."

The Iowa Healthcare Collaborative also leveraged information presented during one of the Web conferences to assess changes in patient safety indicator rates between analyses with and without present-on-admission codes. This helped the Collaborative make a decision about which indicators were most suitable for public reporting efforts, given that Iowa's coding would more accurately help depict true hospital performance.

Through the QI Learning Institute's Web conferences, the Collaborative also learned about AHRQ's "Model Reports, Version 1." These reports provide a template for comparing information on hospital performance based on the AHRQ QIs.

There are two model reporting templates: one based on health topics and one based on composite indicators. The Collaborative used the health topics model report as validation to include both volume and mortality rates side by side in its public reports for select AHRQ Inpatient QIs. The reports also reaffirmed the Collaborative's decision to reorganize its report, categorizing each of the measures by clinical topics.

The Web conferences on consumer evaluation capability helped the Collaborative verify its current approach to making Iowa's public report more useful to consumers and providers. The Iowa report includes simple cost-effective features to make it more useful and accessible to consumers.

Roberts notes, "Prior to participation in the QI Learning Institute, the primary audience for Iowa's report was providers. We followed the literature on the QIs and public reporting ourselves and refrained from reporting QIs we might have included because we did not have the data, collaboration, and advice provided by participating in the Learning Institute. Now, the Collaborative has designed and formatted the reports to be more consumer-friendly."

"Guidance on Using the AHRQ QI for Hospital-Level Comparative Reporting" can be viewed at:

"Model Reports, Version 1" and development memorandum can be viewed at:

Impact Case Study Identifier: 
AHRQ Product(s): HCUP-Nationwide Inpatient Sample, HCUP-Patient Safety Indicators, Healthcare Cost and Utilization Project (HCUP), Quality Indicators Learning Institute
Topics(s): Quality
Geographic Location: Iowa
Implementer: Iowa Healthcare Collaborative
Date: 05/01/2010
Page last reviewed October 2014