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Discontinued Performance Measures Table

Performance Budget Submission for Congressional Justification, Fiscal

This appendix provides more detailed performance information for all HHS measures related to the Agency for Healthcare Research and Quality's budget.

Patient Safety

Quality/Safety of Patient Care

Long Term Goal: By 2010, prevent, mitigate and decrease the number of medical errors, patient safety risks and hazards, and quality gaps associated with health care and their harmful impact on patients.

MeasureFYTargetResult

Identify the Threats

By 2010, patient safety event reporting will be standard practice in 90% of hospitals nationwide.

Outcome

2007

Initiate network of patient safety databases (NPSD) to identify emerging patient safety threats

Dec-07 

95% event reporting in hospitals
2007Continue use of the National Health Quality Report (NHQR), National Healthcare Disparities Report (NHDR), Patient Safety Indicators (PSIs) to monitor and report on changes in patient safety/qualityComplete
2006Use NHQR, NHDR, PSIs to monitor changes in patient safety/quality

2006 National Healthcare Quality Report

2006 National Healthcare Disparities Report

2005Continue support for data standards and taxonomy development for improved patient safety event reporting, data integration/usabilityData standards development is ongoing: Supported NQF taxonomy consensus building. Taxonomy approved 2005
2005Redesign PSIRS database system to produce NPSD which includes data specifications, standardized taxonomyDec-06
2004Develop a data warehouse and vocabulary server to process patient safety event dataCompleted
2003Develop reporting mechanism and data structure through the National Patient Safety NetworkCompleted

Educate, Disseminate, and Implement to Enhance Patient Safety/Quality

By 2010, successfully deploy practices such that medical errors are reduced nationwide.

Outcome

200750 participants in the Patient Safety Improvement Corps (PSIC) Train-the-Trainer program will initiate local patient safety training activitiesDec-07
2006Implement and evaluate best practice use of NHQR-DR Asthma Quality Improvement Resource Guide and Workbook for State Leaders in 2 to 5 States

Dec-06

Michigan
Arizona
New Jersey

20055 health care organizations/units of State/local governments will evaluate the impact of their patient safety best practices interventions.Completed: 17 grant awards made for implementing patient safety improvement practices.
2005Implement and evaluate best practice use of NHQR-DR Diabetes Quality Improvement Resource Guide and Workbook for State Leaders in 2-5 States.Completed: Diabetes workbook has been developed and 2 States (Delaware and Vermont) are engaged in using it and setting an action agenda.
20046 health facilities or regional initiatives to implement interventions and service models on patient safety improvement will be in placeCompleted
2003Awards to be made to at least 6 facilities or initiativesCompleted: 6 awards made

Educate, Disseminate, and Implement to Enhance Patient Safety/Quality

By 2010, successfully deploy practices such that medical errors are reduced nationwide.

Outcome

200750 participants in the PSIC Train-the-Trainer program will initiate local patient safety training activitiesDec-07
2007Hold annual patient safety/healthcare information technology conferenceDec-07
200615 additional States/major health care systems will have on-site patient safety experts trained through the PSIC programCompleted: 16 States and 19 hospitals/health care systems participated in the PSIC
200515 additional States/major health care systems will have on-site patient safety experts trained through the PSIC programCompleted: 19 States and 35 hospitals/health care systems participated in the PSIC
200410 States/major health care systems will have on-site patient safety experts trained through the PSIC programCompleted: 15 States
13 hospitals-health care systems
20045 health care organizations or units of State/local government will implement evidence-based proven safe practicesCompleted: 7 organizations received grants to implement evidence-based safe practices
2004Develop 4 NHQR-DR Knowledge Packs on Quality for priority populations and care settingsCompleted: Knowledge Packs were replaced by reports on gender, children, and inpatient care.
2004Conduct annual patient safety conference transferring research findings, products, and tools to usersCompleted: Annual patient safety conference held Sept. 26-28, 2004
2003Established a Patient Safety Improvement Corp (PSIC) training program.Completed
Award to 5 health care organizations or units of State/local government grants to implement evidence-based proven safety practicesCompleted

Maintain vigilance

By 2010, deploy and use measures of safety and quality for improvement in various care settings

Outcome

2007Initiate Network of Patient Safety Databases (NPSD)Dec-07
2007Deliver fifth NHQR-DRDec-07
2007Use NPSD, NHQR, NHDR, PSIs to monitor changes in patient/safety qualityDec-07
2006Deliver fourth NHQR-DR and continue use of NHQR, NHDR, PSIs to monitor changes in patient safety/qualityCompleted: 4th Annual NHQR/DR
2005Develop measures of patient safety culture (ambulatory and longer term care)

Dec-06

Contract award in FY2005

2004Develop measures of patient safety culture (hospital-based)Completed
2003N/AN/A

Data Source: Patient Safety Resource Coordinating Center (PSRCC) databases; NHQR/DR database

Data Validation: Spreadsheets are created and maintained for accepted applications to the program.

Cross Reference: HHS Goals and Objectives: 1.3; HP2010-1/17/23; HHS Priorities: Value-Driven Health Care

Health Information Technology (Health IT)

Long Term Goal: Most Americans will have access to and utilize a Personal Electronic Health Record by 2014.

MeasureFYTargetResult

Hospitals using Computerized Physician Order Entry (CPOE) by 10%. (Retired measure that has exceeded its target).

Outcome

1.3.6

2007Increase to 15%Completed: 27% American Hospital Association (AHA) Report
2006Provider utilization of computerized provider order entry (CPOE) increased to 15%Completed: 21.9% of physician practices use e-prescribing
200510% of hospitals using CPOECompleted: 25% increase in the utilization of CPOE systems
10% of providers using CPOECompleted: 14% of all medical group practices utilize a CPOE3
2004N/AN/A

By 2008, in hospitals funded for CPOE, maintain a lowered medication error rate.

Outcome

1.3.7

2007Decrease preventable adverse drug events (ADEs) by 10%Dec-07
2006Increase rate of detection by 75%Duke hospital implementation completed early; extending work to ambulatory clinics. Funded eRx pilot at Brigham & Women's which focuses on ambulatory ADEs.
2005Increase the rate of detection by 50%Funded implementation study
2004N/AN/A

Data Source: Hospital CPOE usage as documented by the annual Healthcare Information and Management Systems Society (HIMSS) survey; Detection of ADEs noted in recent published articles (JAMA, Archives of Internal Medicine); Medical Group Management Association (MGMA) survey of Health IT uptake in physician offices; Leapfrog annual survey; Health System Change (HSC), Community Tracking Study (CTS).

Data Validation: Data obtained regarding ADE detection published in peer reviewed journals. HIMSS data verified by other smaller efforts. E-prescribing data validated by other surveys.

Cross Reference: HHS Goals and Objectives:1.2, 1.3, 4.4; HP2010-11/23;

HHS Priorities: Health Information Technology; Departmental Objectives: 7

Long-term Care

Long Term Goal: Improve quality and safety in all long-term care settings and during transitions across settings.

MeasureFYTargetResult

Improve quality and safety in all long-term care settings and curing transitions across settings.

Outcome

1.3.10

2007Develop annual nursing home injurious falls draft measure in partnership with the Centers for Medicare & Medicaid Services (CMS); quantify baseline draft measure.Dec-07
2007Develop partnerships, and access needs and barriers to the adoption of a 2nd generation injurious falls program in nursing homes.Completed: Final report May 2007
2007Initiate dissemination activities for adoption of 2nd generation pressure ulcer intervention.

Dec-07

Completed

2007Implement and evaluate, in at least 30 nursing homes and in partnership with the State's Quality Improvement Organizations (QIOs), 2nd generation nursing home pressure ulcer intervention.Dec-083
2006Synthesize recent research findings on what aspects of nursing home care prevents inappropriate hospitalizations.Completed: Final Report Sep-06
2006Distribute report on implementation of evidence-based protocols for pressure ulcers prevention in nursing homes

Dec-08

Grantee requested a no-cost extension

2006Disseminate findings from AHRQ nursing home (NH) fall prevention program (FPP)

Completed:

  • Journal publication.
  • FPP Manual available in QIO Web site.
  • QIO received FPP training.
2005Partner with a second NH chain that is embarking on fall prevention program.Complete
2004Develop multi-faceted falls prevention program focused on high risk fallers based on evidence-based research and pilot in NH chain.Complete

Improve coordination of formal long-term care with hospital care, primary care, and informal caregivers to facilitate clinical decisionmaking and assure timely transfer of clinical data.

Outcome

1.3.11

2007Complete initial identification of user needs and barriers associated with 2nd generation e-communication tool useCurrently, there is little interest in home care industry to implement the communication tools.
2007Draft contractual award materials for 2008 multiple provider implementation of 2nd generation e-communication tool in diverse geographic settingsCurrently, there is little interest in home care industry to implement the communication tools.
2007Disseminate e-communication user aids and expanded network of provider partnerships to jumpstart use of e-communication tools by multiple provider organizationsE-user aids and tools developed; however, currently there is little interest in home care industry to implement the tools.
2006Initiate dissemination of e-communication tool (i.e., a Web-based tool to improve coordination between hospital, primary care and home care clinicians and patients and their informal care providers to improve care planning and self-care)

Completed:

  • Initiated discussion with CMS.
  • Presentation at professional meetings and with potential adopters.
2005N/AN/A
2004N/AN/A

Improve community-based care to maximize function and community participation, and prevent inappropriate institutionalization and hospitalizations.

Outcome

1.3.12

2007In partnership with CMS, develop annual draft measure of re-hospitalization from long-term care settings of persons receiving formal home health care; quantify baseline draft measure

Dec-07

Partnership with CMS established. Data analysis is in progress

2006New Freedom Initiative: Initiate evaluation plan to assess findings from youth in transition (from pediatric to adult services) projects.Draft Resource Manual
2006Synthesize recent research findings on what aspects of community-based services and care in assisted living can prevent inappropriate institutionalization and hospitalizationsComplete: Final Report on Hospitalizations
2005N/AN/A
2004N/AN/A

Improve information about services and quality so that consumers can make informed choices about the care they receive.

Outcome

1.3.13

2007Initiate cognitive testing on 1st generation of assisted living/residential care consumer tools and resources (1st priority measures)Dec-08
2006Produce report on the state-of-the art instruments and tools available to profile assisted living/residential careReport completed
2006Publish report on how States monitor assisted living/residential care facilities and how States report to consumersReport posted: https://www.ahrq.gov/research/residentcare
2006Determine final sampling methodology and plan of implementation to enhance measurement on the long-term care populationSample design memo completed in June 2006 as a contract deliverable.
2005N/AN/A
2004N/AN/A

Data Source: National Healthcare Quality Report based on CMS's Minimum Data Set and Outcome and Assessment Information Set (OASIS) data.

Data Validation: AHRQ products under go extensive peer review for merit and relevance.

Cross Reference: HHS Goals and Objectives: 1.3; HP2010-1; HHS Priorities: Value drive health care, Health IT, Medicaid Modernization, Personalized Health Care, Prevention

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Page last reviewed February 2008
Internet Citation: Discontinued Performance Measures Table: Performance Budget Submission for Congressional Justification, Fiscal . February 2008. Agency for Healthcare Research and Quality, Rockville, MD. https://archive.ahrq.gov/cpi/about/mission/budget/2009/opa10.html

 

The information on this page is archived and provided for reference purposes only.

 

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