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Performance Plans for FY 2003 and 2004 and Performance Report for FY 2002

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Appendix II. Fiscal Year 2002 Performance (Report) Summary

Summary of Performance Objectives (September 5, 2002)

Budget Line 1: Research on Health Costs, Quality, and Outcomes

GPRA Goal 1: Establish research agenda based on user's needs.*
Performance Objective FY Targets Actual Performance Reference*
Objective 1.1: Define direction of FY project funding priorities, in large part, by needs assessment activities. 02:
Agency research agenda covering strategic goal areas for FY 2002 priorities (investigator-initiated research, national quality report, national disparities report) is documented by March 2002 based on consultations with various groups.
Completed. CB
01:
Agency research agenda covering strategic goal areas for FY 2001 priorities (patient safety and informatics) is documented based on consultations with various groups.
Completed. CB
00:
Agency research agenda covering the 3 strategic research goals and the new FY 2000 closing the gap initiatives are documented based on consultations with various groups.
Completed. B:3
99:
Agency research agenda covering the 3 strategic research goals is developed in FY 99 and documented based on consultations with various groups.
Completed. P. 40 and Appendix 5.  

*B is Budget; CB is commitment base, with page number.

GPRA Goal 2: Make significant contributions to the effective functioning of the U.S. health care system through the creation of new knowledge.
Performance Objective FY Targets Actual Performance Reference*
01-02 Objective 2.1: Determine annually the salient findings from research in each of the three areas (outcomes; quality; and cost, access, and use) and develop plan for next steps translation and dissemination. 02:
  • Produce an annual report on at least 18 science advances covering the three research goal areas (outcomes; quality; cost, access, and use).
Completed. CB
  • For each finding, specific steps in translation and dissemination are identified and initiated.
Completed.  
  • Generate 2-3 synthesis reports on research findings and practical applications on Agency priority topics.
Completed.  
01:
Produce an annual report on at least 12 science advances covering the three research goal areas (outcomes; quality; cost, access, and use) For each finding, specific steps in translation and dissemination are identified and initiated. Generate 2-3 synthesis reports on research findings and practical applications on Agency priority topics.
Completed. CB
00 Objective 2.1: Determine annually the salient findings from research in each of the three areas (outcomes; quality; and cost, access, and use) and develop plan for next steps translation and dissemination. 00:
Annual report on science advances in three research goal areas.
Completed. CB
  • At least four major findings in each area that have potential to save significant amounts of money, improve quality, save lives or prevent physical suffering, or change the organization and delivery of health care.
Completed.  
  • For each finding, specific steps in translation and dissemination are identified and initiated.
Completed.  
99 Objective 2.1: Determine the salient findings from research for three priority populations and develop plan for next steps in translation and dissemination. 99:
A report produced that synthesizes research on the major health concerns of at least three priority populations.
Completed.  
Objective 2:2: Achieve significant findings from AHRQ sponsored and conducted research. 02:
Findings from at least 20 AHRQ sponsored or conducted research are used by public and private partners to improve health care.
Completed. CB
01:
Same as 00, except changed to 40 findings.
Completed. CB
00:
Findings from at least 25 AHRQ sponsored or conducted research are published in major peer reviewed professional publications (New England Journal of Medicine, Journal of American Medical Association, etc.); receive national press coverage; are used in Federal or State policymaking; are used by professional associations or health plans as the basis of strategies to achieve quality; or are used to establish coverage decisions by health care purchasers, managed care organizations, or insurers, including Medicare or Medicaid.
400% increase: 250 citations for AHRQ findings (20 listed). 32 examples of major media coverage; 7 examples of usage CB
99:
Findings from at least 10 AHRQ sponsored or funded research are published in major peer reviewed professional publications (New England Journal of Medicine, Journal of American Medical Association, etc.); receive national press coverage; are used in Federal or State policymaking; are used by professional associations or health plans as the basis of strategies to achieve quality; or are used to establish coverage decisions by health care purchasers, managed care organizations, or insurers, including Medicare or Medicaid.
50 citations for AHRQ findings; 7 examples of major media coverage; 7 examples of usage.  
01-02 Objective 2.3: Initiate FY Research Initiatives 02:
Funding of a minimum of 100 projects; 30% of these projects address priority populations.
Completed. B:64

01:
Funding of a minimum of 60 projects in the following areas:

  • 40 projects in reducing medical errors and enhancing patient safety
  • 10 projects in informatics applications in health care
  • 10 projects in quality improvement through improvements in health care working conditions

 
Completed.

 
B:31-35
B:33
B:36-37

00 Objective 2.3: Implement FY 2000 priority (1) A New Research on Priority Health Issues.
  • Funding of a minimum of 10 projects that address gaps in knowledge about the priority problems faced by Medicare and Medicaid.
43 projects funded B:19-20
  • Funding of a minimum of 10 projects to address eliminating disparities in health care with particular emphasis on disparities that exist for racial and ethnic minorities.
More then 30 projects funded B:50-51
99 Objective 2.3: Initiate FY 99 Research Initiatives Funding of a minimum of 21 projects in:
  • consumers use of information on quality
  • strengthen value-based purchasing
  • measure national health care quality
  • vulnerable populations
  • translating research into practice
56 projects funded.  
Funding of a minimum of 17 projects in:
  • Outcomes for the elderly and chronically ill
  • Clinical preventive services
  • CERTS
  • Improving the quality of children's health
51 projects funded.  
GPRA Goal 3: Foster translation and dissemination of new knowledge into practice by developing and providing information, products, and tools on outcomes; quality; and access, cost, and use of care.
Performance Objective FY Targets Actual Performance Reference*
01-02 Objective 3.1: Maximize dissemination of information, tools, and products developed from research results for use in practice settings.
NOTE: in the FY 2001 plan, objective 3.1 and 3.2 have been consolidated.
02:
  • Number of state and local governments trained and/or receiving technical assistance through User Liaison Program (ULP).
Completed. CB
  • At least 20 partnerships to disseminate and implement research findings are formed with public and private-sector organizations.
Completed.  
  • Synthesis of at least 5 grant portfolio areas on quality of care across Agency goals for persons with chronic care needs produced and disseminated with particular focus on outreach to managed care executives.
Completed.  
01:
  • At least 5 public-private partnerships are formed to implement research findings for decisionmakers.
Completed. CB for all Web site measures and ULP
  • Formation of a minimum of 10 partnerships to support dissemination of AHRQ products through intermediary organizations, such as health plans and professional organizations.
   
  • Number of hits on the Web site.
16.7 million  
  • Number of inquiries handled on Web site.
4,006  
  • Number of uploaded documents.
3,730  
  • Number of State and local governments trained in the understanding and use of health services research findings through ULP Workshops.
425  
00 & 99 Objective 3.1: Promote distribution of AHRQ publications, products, and tools through intermediary organizations. 00:
Formation of a minimum of 5 partnerships to support dissemination of AHRQ products through intermediary organizations, such as health plans and professional organizations.
Over 30 public/private and public/public partnerships formed. CB
99:
Formation of a minimum of 5 partnerships to support dissemination of AHRQ products through intermediary organizations, such as health plans and professional organizations.
Over 30 public/private and public/public partnerships formed.  
01-02 Objective 3.2: Develop and facilitate the use of new tools, talent, products, and implementation methodologies stemming from research portfolio. (This is objective 3.3 in FY 99-00.) 02:
  • Produce evidence summaries for use in Federal direct care provider's efforts to create guidelines.
Completed. CB
  • Evidence-based practice centers (EPCs) will produce a minimum of 18 evidence reports and technology assessments that can serve as the basis for interventions to enhance health outcomes and quality by improving practice.
Completed. CB
  • Fund at least 10 projects in tool and data development.
Completed. CB
01:
  • Produce evidence summaries for use in Federal direct care provider's efforts to create guidelines.
Completed. CB
  • EPCs will produce a minimum of 12 evidence reports and technology assessments that can serve as the basis for interventions to enhance health outcomes and quality by improving practice.
Completed.  
  • Support a minimum of 165 pre- and post-doctoral trainees.
Completed.  
  • Support up to 3 Minority Research Infrastructure Support Program IM-RISP) grants in order to develop the health services research capabilities of traditionally minority-serving institutions.
Completed.  
  • Support up to 6 Building Research Infrastructure and Capacity (BRIC) two-year planning grants in EPSCOR states and states which historically have received little or no research support from AHRQ.
Completed.  
  • Fund at least 10 projects in tool development.
Completed.  
99-00 Objective 3.2: Maximize dissemination of information, tools, and products developed from research results for use in practice settings. (Becomes Objective 3/1 in FY 01.) 00:
  • Number of hits on the Web site
18.8 million hits B:57
  • Number of inquiries handled on Website.
3,500 B:57
  • Number of Uploaded documents
4,400 B:57
  • Reports from user surveys on how the information requested was used.
Completed. B:59
  • Number of State and local governments trained in the understanding and use of health services research findings through User Liaison Program (ULP) Workshops.
State-50
Local-29
CB

          + Meetings held

17 meetings CB

          + Number of attendees

1196 attend CB

          + States represented

50 States + D.C. CB
  • Reports from annual participants on how the information was used in decisionmaking.
Met CB
  • Statistics on usage of National Guideline Clearinghouse including number of hits, requests, organizations, and total users.
Hits: 32,234,401
Requests: 18,207,430
Orgs: 58,803
User sessions 1.5 million
902 respondents
evaluation completed in mid-year 2001
11 examples listed
B:24-25
  • Survey of a sample of NGC users to understand the impact of use on decisions and patient care.
  B:25
  • At least 10 purchasers/businesses use AHRQ findings to make decisions.
   
Goal 3 continued: Objective 3.2 99:
  • Number of hits on the Web site
15.5 million  
  • Number of inquiries handled on Web site.
2,950  
  • Number of Uploaded documents
4,000  
  • Number of State and local governments trained in the understanding and use of health services research findings through User Liaison Program (ULP) Workshops
48 states; 4 territories; 30 county govts.; & 9 city govts.  

          + Meetings held

18  

          + Number of attendees

834  

          + States represented

48  
  • Statistics on usage of National Guideline Clearinghouse including number of hits, requests, organizations, and total users.
13,590,013  
  • At least 5 purchasers/businesses use AHRQ findings to make decisions.
21 examples listed.  

Objective 3.3 (This becomes objective 3.2 in FY 01. Objective 3.3 is discontinued in FY 01.)

99-00 Objective 3.3: Develop and facilitate the use of new tools, talent, products, and implementation methodologies stemming from research portfolio.

00:
  • Demonstration of use of at least 3 AHRQ research findings in systematic efforts to Translate Research Into Practice.
Met  
  • Funding of a minimum of 5 major projects that will develop products, tools, or methodologies for implementing research findings into practice in significant segments of the health care system (i.e., potential to be generalizable across health care systems, provider-types, or clinical areas.)
29 Projects funded  
  • At least 2 new tools, products, or methodologies become available from projects funded between FY 1993 and FY 1996.
23 Listed  
  • Support a five percent increase, at a minimum, in number of pre- and post-doctoral trainees.
40% Increase  
Goal 3, continued: Objective 3.3 99:
  • Evidence-based Practice Centers (EPCs) produce a minimum of 12 evidence reports and technology assessments that can serve as the basis for interventions to enhance health outcomes and quality by improving practice (i.e., practice guidelines, quality measures, and other quality improvement tools). At least four reports are being used by customers to develop practice guidelines or other interventions.
10 produced; 3 in press; 30 under development  
  • The AHRQ software product, CONQUEST 2.0 released in FY 1999 containing new measures, including measures for new conditions, and updated measures. Contract awarded to create Web-based product for more timely updating of information contained within product.
Released March 1999; contract awarded '00  
  • Funding of a minimum of 5 major projects that will develop products, tools, or methodologies for implementing research findings into practice in significant segments of the health care system (i.e., potential to be generalizable across health care systems, provider-types, or clinical areas.)
13 examples provided  
  • At least two new tools, products, or methodologies become available from projects funded between FY 1993 and FY 1996
13 examples provided  
  • Support a minimum of 150 pre- and post-doctoral trainees.
167 trainees  
GPRA Goal 4: Evaluate the effectiveness and impact of AHRQ research and associated activities.
Performance Objective FY Targets Actual Performance Reference*

01-02 Objective 4.1: Evaluate the impact of AHRQ sponsored products in advancing methods to measure and improve health care.

NOTE: 99-00 Objectives 4.1 and 4.2 have been consolidated in the FY 01 plan.

02:
  • Evaluate the impact of the CERTS program in disseminating information regarding therapeutics to at least 3 health care providers or others in order to improve practice.
Completed. CB
  • Evaluation to determine whether AHRQ funded studies in methodological development have been effective in developing at least 3 new research techniques, whether the techniques are being implemented, and how these studies could be improved.
Completed.  
  • Evaluation of the outcomes of the pharmaceutical studies the Agency has funded to assess impact.
   
  • Interim assessment of the impact of the management system for tracking project profiles.
Completed.  
  • Qualitative review by experts of results of one major research initiative to assess quality and productivity and potential impact.
Completed. CB
  • Evaluate private sector use of at least 5 AHRQ findings.
Completed.  
  • Identify at least 5 private sector uses of AHRQ findings, and describe any assessment of the impact on clinical practice and/or patient care.
Completed.  

Evidence-based Practice Centers

  • Use of evidence reports and technology assessments to create quality improvement tools in at least 10 organizations.
Completed. CB
  • For at least four evidence reports or technology assessments per year, work with partners to measure how the reports or assessments were used and what impact they had on clinical decision making and patient care.
Completed.  
  • Findings from at least 3 evidence reports or technology assessments will effect State or Federal health policy decisions.
Completed.  
  • Use of evidence reports or technology assessments and access to NGC site formed organizational decision making in at least 4 cases and resulted in changes in health care processes, quality, or health outcomes.
Completed.  

01: Evidence-based Practice Centers

  • Use of evidence reports and technology assessments to create quality improvement tools in at least 10 organizations.
Completed.  
  • For at least four evidence reports or technology assessments per year, work with partners to measure how the reports or assessments were used and what impact they had on clinical decision making and patient care.
Completed.  

Research

  • At least 3 examples of how research informed changes in policies or practices in other federal agencies.
Completed.  
Goal 4 continued: 01 Objective 4.1 Evaluate the impact of AHRQ sponsored products in advancing methods to measure and improve health care. Cont.
  • Findings from at least 3 evidence reports or technology assessments will effect State or Federal health policy decisions.
Completed. CB
  • Use of evidence reports or technology assessments and access to NGC site informed organizational decisionmaking in at least 4 cases and resulted in changes in health care procedures or health outcomes.
Completed.  

Quality Measures

  • Achievable Benchmarks of Care are used for quality improvement activities by Peer Review Organizations
Completed. CB
  • Use of dental performance measures by dental service and insurance organizations.
Completed. CB
  • HCUP quality indicators incorporated into efforts by hospital associations and hospitals to improve the quality of care.
Completed.  

National Guideline Clearinghouse

  • At least 10 users of the National Guideline Clearinghouse will use site to inform clinical care decisions
Completed. CB
  • Guideline development or quality improvement efforts by users will be facilitated through use of NGC in at least 5 cases.
Completed.  
  • NGC information will be used to inform health policy decisions in at least 2 cases.
Completed.  
  • Improvements in clinical care will result from utilization of NGC information in at least 3 cases.
Completed.  

Training Programs

  • Two thirds of former pre- and postdoctoral institutional award trainees are active in the conduct or administration of health services research.
Completed. CB

00 Objective 4.1 (& 4.2): Evaluate the impact of AHRQ sponsored products in advancing methods to measure and improve health care.

* Objectives 4.1 and 4.2 were inadvertently the same. They have been consolidated to simplify the reporting.

00:
  • AHRQ Quality Indicators (QIs) will be redesigned based on consultations with state policy makers, researchers, hospital associations, and others about their past use of the QIs. By the end of March 2001, a new set of quality indicators will be defined and feedback obtained from a new set of AHRQ QI users. In addition, AHRQ will provide access to recent national-level QI information via both the Internet and through published reports, with special focus on disseminating information to hospital users and organizations with responsibility for hospital quality reporting.

AHRQ QIs defined

National-level QI information posted to Internet Sept 2000

CB
  • Use of evidence reports and technology assessments to create quality improvement tools in at least 10 organizations.
16 examples listed  
  • For at least four evidence reports or technology assessments per year, work with partners to measure how the reports or assessments were used and what impact they had on clinical decision making and patient care.
4 examples listed
Completed
 
  • At least three examples of how research informed changes in policies or practices in other Federal agencies.
4 examples listed  
  • AHRQ will report on the extent to which CONQUEST assists those who are charged with carrying out quality measurement and improvement activities and the extent to which it helps further state-of-the-art in clinical performance measurement.
Completed.  
  • CAHPS® has assisted the Health Care Financing Administration (HCFA) in informing Medicare beneficiaries about their health care choices. The use and impact of this information is determined by surveying a sample of these beneficiaries.
Completed.
Results published in July 2001
 
  • At least one quality measure from Q-span (or instances where AHRQ research contributes to the development of measures) are used in the Health Plan Employer Data Information Set (HEDIS) by the National Committee for Quality Assurance (NCQA), measurement activities of the Joint Commission for the Accreditation of Healthcare Organizations (JCAHO), or other organizations monitoring health care quality.
ABC System of performance profiling cited  

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