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On January 17, 2008, Marjorie Shofer gave an overview of the Agency for Healthcare Research and Quality (AHRQ) at the State Healthcare Quality Improvement Workshop. This is the text version of the event's slide presentation. Please select the following link to access the slides: (PowerPoint® File, 900 KB; PDF File, 350 KB; PDF Help).

Slides: 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 | 13 | 14 | 15


Slide 1: AHRQ: Your Science Partner for Quality Improvement

State Healthcare Quality Improvement Workshop

January 17-18, 2008
Margie Shofer
Agency for Healthcare Research and Quality

On the top of the slide are the logos for the Department of Health & Human Services and the AHRQ logo. The Department of Health & Human Services logo is an artistic image of an eagle with the outlined profile of faces. The AHRQ logo reads, "AHRQ - Agency for Healthcare Research and Quality: Advancing Excellence in Health Care, www.ahrq.gov."

This presentation uses a template with a blue background and a header with the AHRQ and Department of Health & Human Services logos on the left.

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Slide 2: What AHRQ Does

  • Funds and produces a broad base of scientific research
  • Creates tools to make evidence-based decisions
  • Promotes improvements in clinical and health systems practices and informs public policy

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Slide 3: AHRQ Mission

To improve the quality, safety, efficiency and effectiveness of health care for all Americans

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Slide 4: Using Evidence in Health Decision Making- Quality

National Healthcare Quality and Disparities Reports

  • NHQR/DR mandated by Congress
  • National Healthcare Quality Report - annual report on national trends in the quality of health care
  • National Healthcare Disparities Report - annual report on health care disparities related to racial/ethnic and socioeconomic factors
  • State Snapshots— reports focusing on quality and disparities in each state.

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Slide 5: Using Evidence — Efficiency

Limiting reimbursed drugs to 3/month caused individuals with chronic illnesses to forgo filling prescription drugs necessary to keep them healthy, and caused an increase in other services such as hospital stays and nursing home admissions.

Source: Fortess, Soumerai, McLaughlin et al, Journal American Geriatric Society, June 2001

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Slide 6: Using Evidence — Efficiency

  • Eliminating dental reimbursement for adult emergency services increased hospital emergency room department use by 12 percent.
  • Emergency departments were used to treat a range of problems from abscesses and cysts to periodontitis and broken teeth.

Source: Cohen, Manski and Magder et al, Journal of the American Dental Association, June 2002

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Slide 7: Using Evidence — Safety

Motorcyclists in States without universal helmet laws are more likely to die during hospitalizations, sustain severe traumatic brain injury, be discharged to long-term care facilities and lack private health insurance.

Source: Coben, Steiner and Miller, Accident Analysis and Prevention, January 2007

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Slide 8: Using Evidence — Safety (continued)

  • Extended-duration work shifts pose safety hazards for interns.
  • Eliminating extended work shifts and reducing the number of hours interns work per week can reduce serious medical errors in the intensive care unit.
  • In the first year following implementation of the ACGME duty-hour standards, interns commonly reported noncompliance with these requirements.

Sources:
Barger, LK et al, Extended work shifts and the risk of motor vehicle crashes among interns, New England Journal of Medicine, January 2005
Landrigan CP et al, Effect of reducing interns' work hours on serious medical errors in intensive care units, New England Journal of Medicine, October, 2004
Landrigan CP et al, Interns' compliance with accreditation council for graduate medical education work-hour limits, Journal of the American Medical Association, September 6, 2006

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Slide 9: Using Evidence - Effectiveness

Treating Gastric Reflux (GERD)

  • Medicines called proton pump inhibitors (PPI) (for example the "purple pill", Nexium) work better than other medicines such as Tagamet and Zantac in treating GERD. But PPIs are more likely to cause side effects such as headache or diarrhea.
  • Studies show that, overall, each PPI works about as well as another for relieving symptoms.

Source: Comparative Effectiveness of Management Strategies For Gastroesophageal Reflux Disease, AHRQ Publication No. 06-EHC003-EF, December 2005

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Slide 10: Using Evidence - Effectiveness (continued)

Pay for Performance Guide for Purchasers

  • Includes 20 questions for purchasers to address when considering pay for performance, and reviews options and any available evidence that may inform their decision making.
  • Also discusses potential effects and unintended consequences of pay for performance.

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Slide 11: Using Evidence — Effectiveness (continued)

Consumer Financial Incentives: A Decision Guide for Purchasers

  • Reviews application of incentives to 5 types of consumer decisions: (1) Selecting a high value provider, (2) Selecting a high value health plan, (3) Deciding among treatment options, (4) Reducing health risks by seeking preventive care, and (5) Reducing health risks by decreasing or eliminating high-risk behavior

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Slide 12: Sharing Health Innovations

  • New initiative to share and learn about innovative ways to improve quality of health care delivery comprised of:
     — A searchable collection of innovations in health care delivery.
     — An array of opportunities to learn about innovation and the adoption process and to participate in learning networks with people who share similar challenges.
  • Website - http://www.innovations.ahrq.gov/

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Slide 13: Health Care Innovations

This slide is a screenshot of the AHRQ "Health Care Innovations Exchange" home page. The AHRQ Health Care Innovations Exchange is a new program designed to support health care professionals in sharing and adopting innovations that improve health care quality.

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Slide 14: Selective State-Based Projects

  • Medicaid Medical Directors Learning Network
  • Medicaid Care Management Learning Network
  • NGA Policy Academy on Quality
  • Health Information Technology state projects

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Slide 15: Staying in Touch

  • AHRQ Website— www.ahrq.gov
  • Order publications
  • Call or email anytime!

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AHRQ Advancing Excellence in Health Care