Government plays many important roles that affect the quality
of health care Americans receive. In fact, the Federal Government
is the largest purchaser and provider of health care services
in the United States. Programs like Medicare and Medicaid, the
Federal Employee's Health Benefits Plan (FEHBA), and the networks
of hospitals and facilities providing care to people in the armed
forces and veterans serve millions of Americans. In addition,
the Federal Government provides billions of dollars in support
of health care research each year, oversees employer-based health
care coverage, and ensures fair competition in the health care
The QuIC's goal is to ensure that all
Federal agencies involved in purchasing, providing, studying,
or regulating health care services are working in a coordinated
way toward the common goal of improving quality of care. Established in March 1998, the
QuIC seeks to:
people with information to assist them in making choices about
the care delivered by Federal providers and purchased on behalf
of Federal beneficiaries.
the infrastructure needed to improve the health care system.
This infrastructure will include knowledgeable and empowered
workers, well-designed systems of care, and useful information
of Health and Human Services (HHS) serves as the chair of the
QuIC. The Director of the Agency for Healthcare Research and Quality
(AHRQ) serves as chairperson for day-to-day operations. In addition
to HHS, the other Federal members of the QuIC are:
- The Departments
of Defense, Veterans Affairs (VA), Labor, and Commerce.
- The Office
of Personnel Management.
- The Office
of Management and Budget.
- The U.S.
- The Federal
Bureau of Prisons.
- The National
Highway Transportation and Safety Administration
- The Federal
emerged from the QuIC's initial discussions:
patient and consumer information on health care quality.
key opportunities for improving clinical quality.
efforts to measure quality of care.
the health care work force.
- Reducing Hazards
in Patient Care.
- Improving Safety
and Quality Through Value-based Purchasing.
Work groups have been established to identify and work on specific projects
within each of these topic areas.
Identifying ways to address the problem of medical errors has been a major focus of QuIC activity. The QuIC developed a response to a report on medical errors issued by the Institute of Medicine (IOM) that included a number of recommendations for Federal action.
The response to the IOM document, the report Doing What Counts for Patient Safety: Federal Actions to Reduce Medical Errors and Their Impact describes more than 100 actions that the QuIC and its participating agencies will takealone, or together with the private sector and State government. These actions will be taken to:
- Create a national focus on reducing errors.
- Develop a knowledge base for learning about errors' causes and effective error prevention.
- Ensure accountability for safe health care delivery.
- Guarantee that patient safety practices are implemented.
group is co-chaired by representatives from two different Federal
agencies and involves all of the Agencies that wish to participate
on the chosen topics.
Co-leaders: Centers for Medicare and Medicaid Services (CMS) and Office
of Personnel Management (OPM)
This group is addressing critical barriers to effective communication
with patients about quality. It will provide an opportunity for
Federal agencies to learn what is most effective in helping people
understand quality issues and how their choices influence the quality
of the services they receive. It will also develop a common vocabulary,
or set of terms, for Federal agencies to use in communicating with
patients and consumers about quality.
Co-leaders: AHRQ and HCFA
The focus of this group will be on developing the "tool box" of
quality measures and risk adjustment methods used by Federal agencies,
particularly those that reflect outcomes of care. The work group
is developing an inventory of all of the measures and risk adjustment
methods being used by Federal agencies, documenting their uses,
strengths and weaknesses, and examining how to institute appropriate
risk adjustment methods to account for factors outside the control
of the delivery system.
Co-leaders: Department of Labor (DoL) and the Health Resources and
Services Administration (HRSA)
This group is determining how to expand and improve the current
methods of ensuring the skills of the health care workforce and
equipping health care workers to improve the care they deliver.
For example, the work group has chosen to begin by improving the
credentialling process for Federal health care providers. This group
is also looking at the relationship between the working conditions
and health and safety of health care employees and the quality of
care delivered. An expert panel is planned for fall 1999 to study
the issue and develop an agenda for further research.
for Improving Clinical Quality
Co-leaders: Departments of Defense (DoD) and Veterans Affairs (VA)
This group has selected diabetes and depression as the first two
areas for which it will mount an effort to improve clinical quality
of care. For diabetes, the work group is focusing its efforts on
having all Federal programs agree to use the Diabetes Quality Indicator
Project measures of care and then to improve health care provider
performance based on these indicators. For depression, the work
group is developing an evidence-based guideline to improve the identification
and treatment of depressed individuals served by Federal health
Co-leaders: DoD and VA
This work group is exploring how its efforts can augment those of
Federal groups already working to develop a standardized language
that will enable computerized comparisons of quality across Federal
agencies. The work group is also examining the potential uses of
telemedicine for helping to improving quality of care, and it is
in the process of developing a site for the QuIC on the World Wide
Web to share information about what the QuIC is doing.
Reducing Hazards in
Co-leaders: AHRQ and VA
This workgroup focuses on reducing hazard in patient care through the coordination of Federal efforts to conduct research on patient safety and by piloting safety improvement strategies. Currently, it serves as a clearinghouse for the patient safety measures being implemented by each Federal organization. Members currently share information on grant announcements for AHRQ and HRSA and serve as members or liaisons to the HHS Patient Safety Task Force, which seeks to develop a common reporting interface and data structure on end-stage renal disease for all HHS agencies. In addition the group is working to develop a validated Patient Safety Culture Assessment.
Improving Safety and
Quality through Value-Based Purchasing
Co-leaders: CMS and DoD
This group assists the Federal Government in enhancing its ability to purchase health care based on quality as well as cost, and to advocate for quality of care on behalf of its constituents. The concept of value-based purchasing is that buyers should hold providers of health care accountable for cost and quality, balancing regulatory approaches with purchasing mechanisms. It focuses on managing the use of the health care system to reduce inappropriate care and to identify and reward the best-perfoming providers.
For More Information
more information about the Quality Interagency Coordination Task
Force and its activities, contact:
AHRQ Publication No. 00-P027
Howard E. Holland
Quality and Patient Safety Activities
Agency for Healthcare Research and Quality
2101 East Jefferson Street, Suite 201
Rockville, MD 20852
Phone: (301) 594-0314
Fax: (301) 594-2283
Replaces AHRQ Publication No. 99-P031
Current as of February 2001
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