National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
Data
- Data Infographics
- Data Visualizations
- Data Tools
- Data Innovations
- All-Payer Claims Database
- Healthcare Cost and Utilization Project (HCUP)
- Medical Expenditure Panel Survey (MEPS)
- AHRQ Quality Indicator Tools for Data Analytics
- State Snapshots
- United States Health Information Knowledgebase (USHIK)
- Data Sources Available from AHRQ
Search All Research Studies
AHRQ Research Studies Date
Topics
- Adverse Events (1)
- Arthritis (1)
- Asthma (1)
- Behavioral Health (2)
- Cancer (1)
- Children's Health Insurance Program (CHIP) (5)
- Children/Adolescents (15)
- Chronic Conditions (3)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (3)
- Dental and Oral Health (1)
- Depression (1)
- Elderly (1)
- Electronic Health Records (EHRs) (2)
- Emergency Department (4)
- Evidence-Based Practice (2)
- Healthcare Cost and Utilization Project (HCUP) (2)
- Healthcare Delivery (1)
- Health Information Technology (HIT) (2)
- Home Healthcare (1)
- Hospitalization (1)
- Hospitals (3)
- Implementation (4)
- Long-Term Care (5)
- Medicaid (5)
- Medicare (2)
- Medication (3)
- Medication: Safety (1)
- Mortality (1)
- Nursing Homes (6)
- Obesity (1)
- Obesity: Weight Management (1)
- Organizational Change (1)
- Outcomes (2)
- Pain (1)
- Patient Experience (2)
- Patient Safety (5)
- Payment (1)
- Policy (1)
- Practice Patterns (1)
- Pressure Ulcers (1)
- Primary Care (2)
- Provider Performance (4)
- Quality Improvement (13)
- Quality Indicators (QIs) (17)
- (-) Quality Measures (34)
- Quality of Care (34)
- Registries (1)
- Rehabilitation (1)
- Risk (1)
- Social Determinants of Health (1)
- Surgery (2)
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 34 Research Studies DisplayedChen Z, Gleason LJ, Sanghavi P
Accuracy of pressure ulcer events in US nursing home ratings.
This study investigated the accuracy of the government website Nursing Home Compare (NHC) pressure ulcer measures, which are chief indicators of nursing home patient safety. The authors identified hospital admissions for pressure ulcers and linked them to the nursing home-reported data at the patient level using Medicare fee-for-service beneficiaries who were nursing home residents between 2011 and 2017. Percentages of pressure ulcers that were appropriately reported by stage, long-stay versus short-stay status, and race was calculated. Reporting rates were low for both short-stay (70.2%) and long-stay (59.7%) for stage 2-4 pressure ulcer hospitalizations. Black residents experienced more severe pressure ulcers than White residents. Correlations between claims-based measures and NHC ratings were found to be poor.
AHRQ-funded; HS026957.
Citation: Chen Z, Gleason LJ, Sanghavi P .
Accuracy of pressure ulcer events in US nursing home ratings.
Med Care 2022 Oct;60(10):775-83. doi: 10.1097/mlr.0000000000001763.
AHRQ-funded; HS026957..
AHRQ-funded; HS026957..
Keywords: Elderly, Nursing Homes, Long-Term Care, Pressure Ulcers, Quality Measures, Quality of Care, Patient Safety
Waters TM, Burns N, Kaplan CM
Combined impact of medicare's hospital pay for performance programs on quality and safety outcomes is mixed.
The authors examined the combined impact of Medicare's pay for performance (P4P) programs on clinical areas and populations targeted by the programs, as well as those outside their focus. Using HCUP data, and consistent with previous studies for individual programs, they detected minimal, if any, effect of Medicare's hospital P4P programs on quality and safety. They recommended a redesigning of the P4P programs before continuing to expand them.
AHRQ-funded; HS025148.
Citation: Waters TM, Burns N, Kaplan CM .
Combined impact of medicare's hospital pay for performance programs on quality and safety outcomes is mixed.
BMC Health Serv Res 2022 Jul 28;22(1):958. doi: 10.1186/s12913-022-08348-w..
Keywords: Healthcare Cost and Utilization Project (HCUP), Medicare, Payment, Provider Performance, Hospitals, Quality Indicators (QIs), Quality Measures, Quality Improvement, Quality of Care, Patient Safety
Hoffmann JA, Johnson JK, Pergjika A
Development of quality measures for pediatric agitation management in the emergency department.
This study’s objective was to develop quality measures for pediatric emergency department (ED) agitation management informed by multidisciplinary perspectives. A multidisciplinary panel was created to develop quality measures for pediatric ED agitation management through the modified Delphi method. The panelists included 36 physicians, nurses, social workers, security, child life specialists, hospital data analysts, and parents. Measures were ranked by panelists in importance and feasibility on a 9-point scale during 2 survey rounds, with a teleconference discussion between surveys. Consensus was defined at >75% of panelists ranking a quality measure greater or equal to 7 in importance and median feasibility of greater or equal to 4. Consensus was reached on 20 quality measures that incorporated multidisciplinary perspectives.
AHRQ-funded; HS026385.
Citation: Hoffmann JA, Johnson JK, Pergjika A .
Development of quality measures for pediatric agitation management in the emergency department.
J Healthc Qual 2022 Jul-Aug;44(4):218-29. doi: 10.1097/jhq.0000000000000339..
Keywords: Children/Adolescents, Quality Measures, Quality Indicators (QIs), Quality of Care, Emergency Department
Probst MA, Janke AT, Haimovich AD
Development of a novel emergency department quality measure to reduce very low-risk syncope hospitalizations.
The purpose of this study was to develop a new quality measure to apply with very low risk adult emergency department patients under 50 years of age and with no history of heart disease presenting with syncope. The study found that of the 3,292 patients meeting the study criteria, .46% suffered serious adverse events within 30 days after discharge. When the criteria were applied to the 2019 Nationwide Emergency Department Sample (NEDS) to assess its potential effect (assessing for hospital-level factors associated with hospitalization variation), of the 566,031 patients meeting the criteria, 2.7% were hospitalized. The researchers identified factors associated with increased hospitalization rates, which included a yearly ED volume of more than 80,000 and metropolitan teaching status. The study concluded that the novel syncope quality measure developed by the researchers can evaluate variation in low-value hospitalizations for unexplained syncope.
AHRQ-funded; HS022882.
Citation: Probst MA, Janke AT, Haimovich AD .
Development of a novel emergency department quality measure to reduce very low-risk syncope hospitalizations.
Ann Emerg Med 2022 Jun;79(6):509-17. doi: 10.1016/j.annemergmed.2022.03.008..
Keywords: Emergency Department, Quality Measures, Hospitalization, Quality Indicators (QIs), Quality of Care
Zrelak PA, Utter GH, McDonald KM
Incorporating harms into the weighting of the revised Agency for Healthcare Research and Quality Patient Safety for Selected Indicators Composite (Patient Safety Indicator 90).
The purpose of this study was to reweight AHRQ’s Patient Safety for Selected Indicators Composite (Patient Safety Indicator 90) from weights based solely on the frequency of component Patient Safety Indicators (PSIs) to those that incorporate excess harm reflecting patients' preferences for outcome-related health states. Findings showed that including harms in the weighting scheme changed individual component weights from the original frequency-based weighting. In the reweighted composite, PSIs 11, 13, and 12 contributed the greatest harm. The investigators concluded that reformulation of PSI 90 with harm-based weights is feasible and results in satisfactory reliability and discrimination.
AHRQ-authored; AHRQ-funded; 290201200003I.
Citation: Zrelak PA, Utter GH, McDonald KM .
Incorporating harms into the weighting of the revised Agency for Healthcare Research and Quality Patient Safety for Selected Indicators Composite (Patient Safety Indicator 90).
Health Serv Res 2022 Jun;57(3):654-67. doi: 10.1111/1475-6773.13918..
Keywords: Healthcare Cost and Utilization Project (HCUP), Patient Safety, Quality Indicators (QIs), Quality Measures, Quality of Care, Adverse Events, Medicare
Milliren CE, Bailey G, Graham DA
Relationships between pediatric safety indicators across a national sample of pediatric hospitals: dispelling the myth of the "safest" hospital.
This observational study aimed to explore the covariance of pediatric hospital quality indicators and evaluate the use of a single composite score. Pediatric hospital performance across 13 safety indicators were extracted from the Pediatric Health Information System, a comparative database of children’s hospitals in the U.S. Patients discharged from 36 hospitals from 2016 to 2019 were included. The authors investigated relationships among patient safety measures from AHRQ pediatric quality indicators and Center for Medicare and Medicaid Services hospital-acquired conditions. They identified 5 orthogonal variance components accounting for 68% of variation in pediatric hospital quality indicators. The ranking comparison and summary found greater within-hospital variation compared with between-hospital variation. They observed discordant rankings among commonly used summary measures and concluded that these measures demonstrate at least 2 underlying variance components.
AHRQ-funded; HS026246.
Citation: Milliren CE, Bailey G, Graham DA .
Relationships between pediatric safety indicators across a national sample of pediatric hospitals: dispelling the myth of the "safest" hospital.
J Patient Saf 2022 Jun 1;18(4):e741-e46. doi: 10.1097/pts.0000000000000938..
Keywords: Children/Adolescents, Quality Indicators (QIs), Quality Measures, Patient Safety, Hospitals, Quality of Care
Ellsworth BL, Metz AK, Mott MM
Review of cancer-specific quality measures promoting the avoidance of low-value care.
The purpose of this study was to explore cancer quality measures to identify and describe those that encourage the avoidance of caner overtreatment and low-value care. The study also aimed to identify gaps that could direct the future development of cancer-specific quality measures. The researchers collected, reviewed, and identified 313 quality measures encouraging the avoidance of low-value cancer care, from six leading quality measures organizations. Of the 313 quality measures identified, 55 (18%) focused on avoidance of low-value care. Quality measure most likely to focus on low-value care included: 13 end-of-life care measures (50%); 12 breast cancer care measures (18%); 9 lung cancer care measures (31%); 8 colon cancer care measures (20%); 5 prostate cancer care measures (38%); and 4 general cancer care measures (3%). The study concluded that the majority of cancer quality measures are not aimed at avoiding cancer over-treatment and low value care, and existing recommendations have not been incorporated in the field.
AHRQ-funded; HS026030.
Citation: Ellsworth BL, Metz AK, Mott MM .
Review of cancer-specific quality measures promoting the avoidance of low-value care.
Ann Surg Oncol 2022 Jun;39(6):3750-62. doi: 10.1245/s10434-021-11303-4..
Keywords: Cancer, Quality Measures, Quality Indicators (QIs), Quality of Care
Bucholz EM, Toomey SL, McCulloch CE EM, Toomey SL, McCulloch CE
Adjusting for social risk factors in pediatric quality measures: adding to the evidence base.
The purpose of this study was to evaluate a method for incorporating social risk variables into a pediatric measure of utilization from the Pediatric Quality Measures Program (PQMP). The researchers utilized data from California Medicaid claims (2015-16) and Massachusetts All Payer Claims Database (2014-2015) to assess health plan performance using the Pediatric Asthma Emergency Department Use measure. The study found that of 133 health plans serving 404,649 pediatric patients with asthma, 7% to 13% changed performance categories after social risk adjustment. Health plans that shifted to higher performance categories cared for lower socioeconomic status (SES) patients, while those that shifted to lower performance categories cared for higher SES patients. The study concluded that adjustment for social risk factors shifted performance rankings on the PQMP Pediatric Asthma Emergency Department Use measure for a large number of health plans.
AHRQ-funded; HS025297; HS025299.
Citation: Bucholz EM, Toomey SL, McCulloch CE EM, Toomey SL, McCulloch CE .
Adjusting for social risk factors in pediatric quality measures: adding to the evidence base.
Acad Pediatr 2022 Apr;22(3s):S108-s14. doi: 10.1016/j.acap.2021.09.023..
Keywords: Children/Adolescents, Quality Measures, Quality of Care, Risk, Social Determinants of Health
Olin SS, Freed GL, Scholle SH
Aligning to improve pediatric health care quality.
The authors presented a population health framework for collaboration and coordination across the delivery system to improve care quality, with quality measures as key tools for monitoring and incentivizing collaboration and alignment of efforts across levels, based on each entity's sphere of influence within the Applegate Alignment Framework.
AHRQ-funded; HS025296; HS025292.
Citation: Olin SS, Freed GL, Scholle SH .
Aligning to improve pediatric health care quality.
Acad Pediatr 2022 Apr;22(3s):S115-s18. doi: 10.1016/j.acap.2021.08.021..
Keywords: Children/Adolescents, Quality Improvement, Quality Measures, Quality Indicators (QIs), Quality of Care, Medicaid
Cope EL, Johnson M, Khan M
AHRQ Author: Mistry KB
Contextual factors affecting implementation of pediatric quality improvement programs.
Researchers assessed the role of contextual factors in influencing the efforts of 5 diverse quality improvement projects as part of the Pediatric Quality Measure Program (PQMP) directed by AHRQ. In a mixed methods study, they conducted semistructured interviews, followed by structured worksheets, of 5 PQMP grantees. They found that using a determinant framework, such as the Tailored Implementation for Chronic Diseases, is valuable in facilitating comparisons across heterogeneous projects, allowing identification of key contextual factors influencing the implementation of pediatric quality measures across a diverse range of clinical topics and settings.
AHRQ-authored.
Citation: Cope EL, Johnson M, Khan M .
Contextual factors affecting implementation of pediatric quality improvement programs.
Acad Pediatr 2022 Apr;22(3S):S81-S91. doi: 10.1016/j.acap.2021.08.016..
Keywords: Children/Adolescents, Quality Measures, Quality Improvement, Quality of Care, Implementation
Mistry KB, Sagatov RDF, Schur C
AHRQ Author: Mistry KB, Sagatov RDF
Design and implementation of the Pediatric Quality Measures Program 2.0.
This AHRQ-authored research discusses the design and implementation of the Pediatric Quality Measures Program (PQMP) 2.0. The PQMP was established in response to the Children’s Health Insurance Program Reauthorization Act of 2009. AHRQ and CMS awarded 6 grants to Centers of Excellence (COEs) and a contract to facilitate collaboration and learning across the COEs. The COEs partnered with stakeholders from multiple levels to field test real-world implementation and refinement of pediatric quality measures and quality improvement initiatives. A PQMP Learning Collaborative (PQMP-LC) consisting of AHRQ, CMS, the 6 COEs, and L&M Policy Research, LLC was created to complete literature reviews, conduct key informant interviews, and collect data to develop reports to address the Research Foci. It also aided with development of measure implementation and quality improvement toolkits; conceptualized an implementation science framework, analysis, and roadmap; and facilitated dissemination of learnings and products. The various products created are intended to support the uptake of PQMP measures and inform future pediatric measurement and improvement work.
AHRQ-authored.
Citation: Mistry KB, Sagatov RDF, Schur C .
Design and implementation of the Pediatric Quality Measures Program 2.0.
Acad Pediatr 2022 Apr;22(3s):S59-S64. doi: 10.1016/j.acap.2021.12.021..
Keywords: Children/Adolescents, Medicaid, Children's Health Insurance Program (CHIP), Quality Measures, Quality Improvement, Quality of Care, Implementation
Parast L, Burkhart Q, Bardach NS
Development and testing of an emergency department quality measure for pediatric suicidal ideation and self-harm.
The authors sought to develop and test a new quality measure assessing timeliness of follow-up mental health care for youth presenting to the emergency department (ED) with suicidal ideation or self-harm. Using Medicaid administrative data, they concluded that this new ED quality measure may be useful for monitoring and improving the quality of care for this vulnerable population; however, they recommended future work in order to establish the measure's predictive validity using more prevalent outcomes such as recurrence of suicidal ideation or deliberate self-harm.
AHRQ-funded; HS025291.
Citation: Parast L, Burkhart Q, Bardach NS .
Development and testing of an emergency department quality measure for pediatric suicidal ideation and self-harm.
Acad Pediatr 2022 Apr;22(3s):S92-s99. doi: 10.1016/j.acap.2021.03.005..
Keywords: Children/Adolescents, Emergency Department, Behavioral Health, Quality Measures, Quality Indicators (QIs), Quality of Care
Huo T, Li Q, Cardel MI
AHRQ Author: Mistry K
Enhancing quality measurement with clinical information: a use case of body mass index change among children taking second generation antipsychotics.
The authors sought to examine the extent to which body mass index (BMI) was available in electronic health records for Florida Medicaid recipients aged 5 to 18 years taking Second-Generation Antipsychotics (SGAP). They concluded that meeting the 2030 CMS goal of digital monitoring of quality of care will require continuing expansion of clinical encounter data capture to provide the data needed for digital quality monitoring. Using linked electronic health records and claims data allows identifying children at higher risk for SGAP-induced weight gain.
AHRQ-authored; AHRQ-funded; HS025298.
Citation: Huo T, Li Q, Cardel MI .
Enhancing quality measurement with clinical information: a use case of body mass index change among children taking second generation antipsychotics.
Acad Pediatr 2022 Apr;22(3S):S140-S49. doi: 10.1016/j.acap.2021.11.012..
Keywords: Children/Adolescents, Electronic Health Records (EHRs), Health Information Technology (HIT), Medication, Obesity, Obesity: Weight Management, Quality Measures, Quality of Care
Morden E, Byron S, Roth L
Health plans struggle to report on depression quality measures that require clinical data.
This study examined challenges and opportunities for reporting 5 HEDIS measures which used electronic clinical data to assess adolescent and perinatal depression care quality. Two learning collaboratives were convened with 10 health plans from 5 states. The authors conducted analysis of notes from collaborative meetings and individual calls with health plans to identify key challenges and strategies for reporting. The challenges most reported included: 1) lack of access to clinical data sources where the results of patient-reported tools were documented; 2) unavailability of the results of patient-reported tools in usable data fields; 3) lack of routine depression screening and ongoing assessment occurring in provider practices.
AHRQ-funded; HS025296.
Citation: Morden E, Byron S, Roth L .
Health plans struggle to report on depression quality measures that require clinical data.
Acad Pediatr 2022 Apr;22(3s):S133-s39. doi: 10.1016/j.acap.2021.09.022..
Keywords: Children/Adolescents, Depression, Behavioral Health, Quality Indicators (QIs), Quality Measures, Quality of Care
Leyenaar JK, Esporas M, Mangione-Smith R
How does pediatric quality measure development reflect the real world needs of hospitalized children?
This study examined to what extent do the Pediatric Quality Measures Program (PQMP) reflect the real world needs of hospitalized children. The authors discussed recent advances in pediatric quality measurement in the context of the current epidemiology of pediatric hospitalization in the US. The history of PQMP is discussed, including AHRQ’s role from 2011 to 2016 as the manager of cooperative agreement grants to seven academic medical centers to develop the initial set of evidence-based quality measures designed to improve children’s quality of care. During the second phase (2016 to 2020), 6 institutions were funded to implement and disseminate these quality measures, with a goal of determining their feasibility and usability. The majority of these measures were developed at large children’s hospitals. However, 20% of children live in rural areas not near a children’s hospital. Among all general hospitals that admit children, 80% have pediatric volumes of less than 375 hospitalizations per year. Unique strategies will be needed to evaluate healthcare quality at these hospitals. The role of interhospital transfer to larger children’s hospitals is also discussed and how it impacts quality of care.
AHRQ-funded; HS025291.
Citation: Leyenaar JK, Esporas M, Mangione-Smith R .
How does pediatric quality measure development reflect the real world needs of hospitalized children?
Acad Pediatr 2022 Apr;22(3s):S70-s72. doi: 10.1016/j.acap.2021.01.019..
Keywords: Children/Adolescents, Quality Measures, Quality Improvement, Quality of Care, Quality Indicators (QIs), Hospitals
Cabana MD, Robinson K, Plavin J
Partnering to improve pediatric asthma quality.
The purpose of this article was to explore the need for partnering between emergency departments (Eds) and primary care physicians (PCPs) to improve asthma quality measures, practice level improvements for both PCPs and EDs, and ultimately improve outcomes for children with asthma. Proper and timely management of asthma is thought to prevent ED visits, and the responsibility for addressing improvements in PCP performance should be shared by the PCP practices and health care payors and plans. The ability to measure the drivers of asthma-related visits to the ED may be outside of what a PCP practice can address, and so practices must be able to partner with health plans to successfully measure and develop system-wide interventions for quality and outcomes improvement. Although a child’s asthma may be managed in their PCP office, treatment of asthma issues often takes place in an ED setting or urgent care clinic that may be completely isolated from the patient’s PCP provider and system. Health plans can fill in the missing pieces to provide feedback on performance which can reduce ED visits, improve medication adherence and management, and provide actionable and timely data about hospital visits and discharge to PCP practices for quality improvements. Social determinants and comorbidities play a role in addressing ED visits for asthma. Health plan, public health systems, and provider coordination, integration, and partnerships are required to effectively address those issues and improve outcomes. The authors conclude that a systems approach and thoughtful partnerships across disciplines will be required beyond the PCP practice level to improve the outcomes of children with asthma.
AHRQ-funded; HS025297.
Citation: Cabana MD, Robinson K, Plavin J .
Partnering to improve pediatric asthma quality.
Acad Pediatr 2022 Apr;22(3S):S73-S75. doi: 10.1016/j.acap.2021.06.013..
Keywords: Children/Adolescents, Asthma, Chronic Conditions, Emergency Department, Quality Measures, Quality Improvement, Quality of Care
Forrest CB, Simpson L, Mistry KB
AHRQ Author: Mistry KB
PQMP Phase 2: implementation and dissemination.
The authors provide an overview of the articles in this supplement concerning the Children’s Health Insurance Program Reauthorization Act Pediatric Quality Measures Program (PQMP). The articles examine the opportunities and challenges associated with the PQMP 2.0 work of the Centers for Excellence and how findings may advance the science for pediatric quality measurement and improvement, and, ultimately, child health outcomes.
AHRQ-authored.
Citation: Forrest CB, Simpson L, Mistry KB .
PQMP Phase 2: implementation and dissemination.
Acad Pediatr 2022 Apr;22(3s):S55-S58. doi: 10.1016/j.acap.2022.01.012..
Keywords: Children/Adolescents, Medicaid, Children's Health Insurance Program (CHIP), Quality Measures, Quality Improvement, Quality of Care, Implementation
Schur C, Johnson M, Doherty J
AHRQ Author: Mistry KB
Real-world considerations for implementing pediatric quality measures: insights from key stakeholders.
This AHRQ-authored paper describes key stakeholder insights focused on measure implementation and increasing the uptake of Pediatric Quality Measures (PQM). The PQMP Learning Collaborative conducted semistructured interviews with 9 key informants (KIs) presenting states, health plans, and other potential end users. The interviews focused on obtaining KIs’ perspectives on 6 research questions focused on assessing the feasibility and usability of PQM and strengthening the connection between measurement and improvement. The KIs uniformly acknowledged the complexity of the issues raised and pinpointed multiple unresolved issues.
AHRQ-authored; AHRQ-funded; 290201400003I.
Citation: Schur C, Johnson M, Doherty J .
Real-world considerations for implementing pediatric quality measures: insights from key stakeholders.
Acad Pediatr 2022 Apr;22(3S):S76-S80. doi: 10.1016/j.acap.2021.04.007..
Keywords: Children/Adolescents, Medicaid, Children's Health Insurance Program (CHIP), Quality Measures, Quality Improvement, Quality of Care, Implementation
Shenkman E, Mistry KB, Davis D
AHRQ Author: Mistry KB
Stakeholder engagement: bridging research and policy to improve measurement and dental care for children in Medicaid.
The University of Florida Child Health Quality (CHeQ) initiative, funded by the Agency for Health Care Research and Quality (AHRQ)/Centers for Medicare and Medicaid Services (CMS) Pediatric Quality Measurement Program, examined measures that states use to evaluate quality of oral health care for children in Medicaid and the Children’s Health Insurance Program (CHIP). This paper discusses stakeholder engagement in bridging research and policy to improve measurement and dental care for children in Medicaid.
AHRQ-authored; AHRQ-funded; HS025298.
Citation: Shenkman E, Mistry KB, Davis D .
Stakeholder engagement: bridging research and policy to improve measurement and dental care for children in Medicaid.
Acad Pediatr 2022 Apr;22(3S):S65-S67. doi: 10.1016/j.acap.2021.08.012..
Keywords: Children/Adolescents, Dental and Oral Health, Medicaid, Children's Health Insurance Program (CHIP), Quality Measures, Quality Improvement, Quality of Care
Richardson JE, Rasmussen LV, Dorr DA
Generating and reporting electronic clinical quality measures from electronic health records: strategies from EvidenceNOW cooperatives.
This study’s goal was to characterize strategies that seven regional cooperatives participating in the EvidenceNOW initiative developed to generate and report electronic health record (EHR)-based electronic clinical quality measures (eCQMs) for quality improvement (QI) in small-to-medium-sized practices. Findings showed that cooperatives ultimately generated and reported eCQMs using hybrid strategies because they determined that neither EHRs alone nor centralized sources alone could operationalize eCQMs for QI. In order to attain this goal, cooperatives needed to devise solutions and utilize resources that often are unavailable to typical small-to-medium-sized practices.
AHRQ-funded; HS023921.
Citation: Richardson JE, Rasmussen LV, Dorr DA .
Generating and reporting electronic clinical quality measures from electronic health records: strategies from EvidenceNOW cooperatives.
Appl Clin Inform 2022 Mar;13(2):485-94. doi: 10.1055/s-0042-1748145..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Quality Indicators (QIs), Quality Measures, Quality of Care, Evidence-Based Practice, Primary Care
Konetzka RT, Davila H, Brauner DJ
The quality measures domain in Nursing Home Compare: is high performance meaningful or misleading?
The Federal Centers for Medicare and Medicaid Services publishes a Nursing Home Compare (NHC) web site that provides information to compare nursing homes across the nation. Since NHC began reporting the percent of nursing home residents suffering adverse outcomes, the negative outcomes decreased dramatically. However, the validity of scores has been questioned for nursing homes that score well on facility-reported measures but scored poorly on inspections. The study purpose was to determine whether nursing homes with these “discordant” scores are better than nursing homes that score poorly across all domains. The researchers analyzed national data from 2012- 2016, conducted in-depth interviews and observations of 12 nursing homes in 2017 to 2018, and studied nursing home performance trajectories over time. Both qualitative and quantitative methods were utilized and interpreted together. The study found that facilities identified as discordant took part in more quality improvement (QI) activities than those identified as poor performers, but those QI activities were lower-resource improvements and not of the type and scope that would impact improvements across other quality domains. It was determined that the poor-performing facilities appeared to lack the leadership and staff continuity required for even low-resource improvements. The study concluded that while high performance on quality measures using facility-reported data is mostly meaningful, and the quality measures domain should continue to be utilized in Nursing Home Compare, facilities identified as discordant still have quality defects.
AHRQ-funded; HS024967.
Citation: Konetzka RT, Davila H, Brauner DJ .
The quality measures domain in Nursing Home Compare: is high performance meaningful or misleading?
Gerontologist 2022 Feb 9;62(2):293-303. doi: 10.1093/geront/gnab054..
Keywords: Nursing Homes, Long-Term Care, Provider Performance, Quality Indicators (QIs), Quality Measures, Quality of Care
Schwartz ML, Rahman M, Thomas KS
Consumer selection and home health agency quality and patient experience stars.
The objective of this study was to compare the impact of the introduction of two distinct sets of star ratings, quality of care, and patient experience, on home health agency (HHA) selection. The investigators concluded that the introduction of quality of care and patient experience stars were associated with changes in HHA selection; however, the strength of these relationships was weaker than observed in other health care settings where a single star rating was reported.
AHRQ-funded; HS026440.
Citation: Schwartz ML, Rahman M, Thomas KS .
Consumer selection and home health agency quality and patient experience stars.
Health Serv Res 2022 Feb;57(1):113-24. doi: 10.1111/1475-6773.13867..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Home Healthcare, Patient Experience, Quality Measures, Quality of Care, Provider Performance, Quality Indicators (QIs)
Joseph JM, Gori D, Curtin C
Gaps in standardized postoperative pain management quality measures: a systematic review.
Poor pain control in patients can lead to chronic pain, chronic opiate use or addiction, and patient suffering, making postoperative pain an important clinical issue. The researchers state that it is unclear whether measures for managing pain after surgery exist, warranting the study goal of assessment of the availability of postoperative pain management quality measures, including National Quality Forum-endorsed measures. In November 2019, the researchers conducted a systematic literature review using the National Quality Forum Quality Positioning System, the Agency for Healthcare Research and Quality Indicators, and the Centers for Medicare and Medicaid Services Measures Inventory Tool databases, to identify quality measures for the period between March 11, 2015, and March 11, 2020. The review identified 19 pain management quality measures, 5 of which were endorsed by the National Quality Forum. Three of the non-endorsed measures were specific to postoperative pain, with none of the endorsed measures specific to post-operative pain. The study concluded that there is a need for published, endorsed, rigorous postoperative pain quality measures.
AHRQ-funded; HS024096; HS027434.
Citation: Joseph JM, Gori D, Curtin C .
Gaps in standardized postoperative pain management quality measures: a systematic review.
Surgery 2022 Feb;171(2):453-58. doi: 10.1016/j.surg.2021.08.004..
Keywords: Pain, Surgery, Quality Measures, Quality of Care, Practice Patterns
Merkow RP, Massarweh NN
Looking beyond perioperative morbidity and mortality as measures of surgical quality.
The authors discussed the problems with a contemporaneous focus on morbidity and mortality as surgical quality measures and offered potential alternative options which could better refine and evolve surgical quality measurement, including process measures, value-based measures, patient-centered measures, and health equity.
AHRQ-funded; HS026385.
Citation: Merkow RP, Massarweh NN .
Looking beyond perioperative morbidity and mortality as measures of surgical quality.
Ann Surg 2022 Feb;275(2):e281-e83. doi: 10.1097/sla.0000000000004966..
Keywords: Surgery, Quality Measures, Quality of Care, Mortality
Schmajuk G, Li J, Evans M
Quality of care for patients with systemic lupus erythematosus: data from the American College of Rheumatology RISE Registry.
Although multiple national quality measures focus on the management and safety of rheumatoid arthritis, few measures address the care of patients with systemic lupus erythematosus (SLE). In this study, the objective was to apply a group of quality measures relevant to the care of patients with SLE, and use the American College of Rheumatology's Rheumatology Informatics System for Effectiveness (RISE) registry to assess nationwide variations in care.
AHRQ-funded; HS024412.
Citation: Schmajuk G, Li J, Evans M .
Quality of care for patients with systemic lupus erythematosus: data from the American College of Rheumatology RISE Registry.
Arthritis Care Res 2022 Feb;74(2):179-86. doi: 10.1002/acr.24446..
Keywords: Chronic Conditions, Quality Measures, Quality of Care