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AHCPR Awards 5 New Research Projects To Assess Quality Improvement Strategies

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Press Release Date: November 23, 1999

The Agency for Health Care Policy and Research (AHCPR) today announced funding for five new research projects which are aimed at assessing quality improvement strategies. These strategies include: education; the use of information systems; continuous quality improvement; behavioral interventions; academic detailing and use of regulations. These grants are funded under AHCPR's Request for Applications (RFA) entitled "Assessment of Quality Improvement Strategies in Health Care," which was released on January 22, 1999. The goal of the RFA, part of a series of three new calls for research on quality of health care, was to rigorously evaluate strategies for improving health care quality which are currently in widespread use by organized quality improvement systems.

The funding for these new projects is anticipated to total $8.42 million over a 3-year period. The newly funded projects are:

  • Organizational Determinants of HIV Care Improvement. Principal investigator: Paul D. Cleary, M.D., Ph.D. Harvard University, Boston, MA. $2,381,217; 09/30/99-09/29/02. (Grant No.: HS10408).

    This project proposes to assess the use of a rapid cycle quality improvement strategy to improve the care of patients with HIV/AIDS who are being treated in clinics receiving Title-III Ryan White funds. Investigators will assess the quality of HIV care provided by participating clinics, track changes in such care subsequent to quality improvement efforts, and analyze which organizational characteristics and policies were related to such changes.

  • Improving Heart Failure Care in Minority Communities. Principal investigator: Jane E. Sisk, M.A., Ph.D. Mount Sinai School of Medicine, New York, NY. $2,307,609; 09/30/99-09/29/02. (Grant No.: HS10402)

    The objectives of this study are to:

    1. Evaluate the effects of nurse management of congestive heart failure (CHF) on hospitalization rates and functional status of patients, and secondarily, to see how these factors are related to measures of patients' knowledge, attitudes, and behaviors regarding CHF.
    2. Evaluate patient satisfaction, costs, and cost effectiveness of nurse management of CHF.
    3. Disseminate study results throughout New York state via selected organizations.

  • Strategies for Continuous Quality-Improvement (CQI) Efforts: A National Randomized Trial. Principal investigator: T.B. Ferguson, M.D. Society of Thoracic Surgeons, Chicago, IL. $1,416,376; 09/30/99-09/29/02. (Grant No.: HS10403).

    This project proposes to assess the impact of a national cardiac surgery database maintained by the Society of Thoracic Surgery in providing the infrastructure needed to conduct a national program of quality improvement for patients undergoing coronary artery bypass grafting procedures. Investigators will:

    1. Demonstrate that a national voluntary database mechanism can collect and process outcome measures that can be used for large-scale quality improvement initiatives.
    2. Demonstrate that national bypass surgery risk-adjusted benchmarks can be developed from these data and applied in individualized reports to improve quality.
    3. Perform a national randomized trial to determine whether specific surgical care patterns can be influenced via a performance feedback and education intervention aimed at local "opinion leaders."
    4. Determine the incremental value of regional continuous quality improvement (CQI) efforts.

  • Hospital Performance & Beta-Blocker Use After AMI. Principal investigator: Harlan M. Krumholz, M.D. Yale University, New Haven, CT. $1,163,543; 09/30/99-09/29/02. (Grant No.: HS10407).

    This project will focus on efforts to increase the use of beta-blockers after acute myocardial infarction (AMI). The investigators will study hospital characteristics associated with improved performance and attempt to identify hospital-based quality improvement interventions that are most effective in increasing use of beta-blockers for AMIs.

  • Evaluating Quality Improvement Strategies. Principal investigator: Charles J. Homer, M.D. Children's Hospital, Boston, MA. $1,150,949; 09/30/99-09/29/02. (Grant No.: HS10411).

    This study will use a rigorous randomized design to assess the impact of an office-based quality improvement strategy compared with 'usual care' in the management of pediatric asthma in different practices in the same integrated health care delivery system. The investigators aim to:

    1. Establish a practice-based quality improvement program in a large managed care organization.
    2. Determine how this office-based quality improvement strategy affects processes of care, outcomes, and costs for children with asthma.
    3. Assess the cost-effectiveness of this approach.

AHCPR is the lead agency charged with supporting research designed to improve the quality of health care, reduce its cost, and broaden access to essential services. AHCPR sponsors and conducts research that provides evidence-based information on health care outcomes; quality; and cost, use, and access. The information helps health care decisionmakers—patients and clinicians, health system leaders, and policymakers—make more informed decisions and improve the quality of health care services.

For additional information, contact the AHCPR Press Office, (301) 427-1364: Salina Prasad, (301) 427-1864 (

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