AHRQ QI Guide to Comparative Reporting AHRQ Annual Conference September 10, 2008 Bethesda, MD Presented by Sheryl Davies.

Slides:

Advertisements

Similar presentations

Adverse Patient Safety Events: Costs of Readmissions and Patient Outcomes Following Discharge Didem M. Bernard, Ph.D. William E. Encinosa, Ph.D.

Advertisements

Variations in Quality Outcomes Among Hospitals in Different Types of Health Systems, Askar Chukmaitov, M.D., M.P.A. Askar Chukmaitov, M.D.,

AHRQ IQI Clinical Validation Panels Sheryl Davies, MA Stanford University.

What Types of Websites and Reports Can MONAHRQ Generate? May 2014 Note: This is one of seven slide sets outlining MONAHRQ and its value, available at

Hospital and Physician Outcomes Reports Presenter: Brian Paciotti, PhD.

Evaluating the AHRQ Inpatient Mortality Indicators for Public Reporting in California AHRQ Users Meeting Joseph Parker, PhD Brian Paciotti, PhD Merry Holliday-Hanson,

Session 3C: Overview of the AHRQ Quality Indicators Thursday, September 27, :30 pm to 5:00 pm ET.

IndicatorGoalHC?JulAugSepOctNovDecJanFebMarAprMayJunYTD % Perfection Worksite Safety Indicators Blood Borne Pathogen Exposures--Sharps0? 3.85 (6) 1.20.

CONTINUOUS QUALITY IMPROVEMENT Continuous Quality Stony Brook Medicine.

The Healthcare Cost and Utilization Project (HCUP) Tools and Products Agency for Healthcare Research and Quality APHA CEI Session  November 2006.

Lessons from the AHRQ PSI Validation Pilot Project AHRQ QI Users Meeting September 10, 2008 Presenter: Patrick S. Romano, MD MPH; Professor, UC Davis Center.

Indun Whetsell March 6, ContributedPotential Gain/At Risk VBP $408,893$1,054,593* RRP $817,786$817,786** HAC $272,595$272,595** BCBS $1.2 million*

Present on Admission. Requirements of Deficit Reduction Act 2005 CMS and CDC choose conditions that are: High Cost, High Volume, or both. Assigned to.

1 Overview of Organization & Comparative Quality Data Ron Spingarn, Deputy Director Healthcare Information Division Phone:

Overview of the AHRQ QI Toolkit for Hospitals Courtney Gidengil, MD MPH Peter Hussey, PhD RAND Corporation.

The AHRQ Quality Indicators Melanie Chansky, MAA, Research Scientist Battelle Memorial Institute December 4, 2008.

AHRQ Quality Indicators Toolkit Tool A.2 Instructions.

Impact of the MS-DRGs on the AHRQ QIs

Comparative Effectiveness of Recombinant Factor VIIa for Off-Label Uses vs. Usual Care in the Hospital Setting Prepared for: Agency for Healthcare Research.

Refinement and Validation of the AHRQ Patient Safety Indicators Developed by UC-Stanford Evidence Based Practice Center Funded by the Agency for Healthcare.

Agency For Healthcare Quality and Research Quality Indicators NH Health Care QA Commission AHRQ Subcommittee Report July 31, 2009.

IndicatorGoalHC?JulAugSepOctNovDecJanFebMarAprMayJunYTD Worksite Safety Indicators Total Recordable Injury Incident Rate Never Occurring 100%?

Seven Leadership Leverage Points for Organization-Level Improvement in Health Care Presented by: Robert L. Colones, MBA President and Chief Executive Officer.

POSITIVE PREDICTIVE VALUE OF AHRQ PATIENT SAFETY INDICATORS IN A NATIONAL SAMPLE OF HOSPITALS AcademyHealth Annual Research Meeting June 9, 2008 Team presenter:

Adapting AHRQ Patient Safety Indicators to QIO Data Jocelyn Andrel, MSPH Charles P. Schade, MD, MPH Patricia Ruddick, RN, MSN.

AHRQ Quality Indicators

Quality Indicators™: Moving Ahead AHRQ Annual Conference 2012 Mamatha Pancholi, MS, Project Officer, Quality Indicators September 11, 2012.

Agency for Healthcare Research and Quality Advancing Excellence in Health Care Improving Administrative Data for Public Reporting Anne Elixhauser.

Preventable Hospitalization Costs and Mapping Tool John Bott Center for Delivery, Organization, and Markets July 21, 2010.

How to facilitate supervision? How to improve quality? How to improve transparency? Dutch hospitals.

Explaining the Volume-Cost Relationship for Cancer Surgery Vivian Ho PhD a Meei-Hsiang Ku-Goto MA a and Thomas Aloia MD b a Rice University and Baylor.

In Hospital Hip Fracture Mortality Colleen McLaughlin, MPH, PhD Division of Quality and Patient Safety.

Comparative Rankings of Hospital Quality – Does the Data Source Matter? Anne Elixhauser, Ph.D. Bernard Friedman, Ph.D. June 26, 2005 AcademyHealth Research.

What do we know about overall trends in patient safety in the USA? Patrick S. Romano, MD MPH Professor of Medicine and Pediatrics University of California,

Day 1: Session I Presenter: Sam Shalaby, General Motors Corporation AHRQ QI User Meeting September 26-27, 2005.

What is Clinical Documentation Integrity? A daily scavenger hunt.

1 1 Survey of Patient Safety Culture in U.S. Hospitals: External Validity Analyses Russ Mardon, Ph.D. Westat 2008 AHRQ Annual Conference Westat 1650 Research.

AHRQ Quality Indicators 2005 AHRQ QI User Meeting September 26, 2005 Marybeth Farquhar, AHRQ.

Day 2: Session III Considerations in Comparative and Public Reporting Presenters: Patrick Romano, UC Davis Shoshanna Sofaer, Baruch College AHRQ QI User.

Use of Outcome Measures in Payment Reform: Rationale Patrick S. Romano, MD MPH UC Davis Center for Healthcare Policy and Research AHRQ Annual Conference.

Hospital-Acquired VTE: What We Have Learned Martha J. Radford, MD Chief Quality Officer NYU Langone Medical Center September 2009.

Going Public Ben Yandell, PhD, CQE Clinical Information Analysis Norton Healthcare, Louisville, KY

AHRQ PSIs and IQIs in National Pay for Reporting September 14, 2009 AHRQ QI Conference Shaheen Halim, Ph.D. Centers for Medicare & Medicaid Services.

AHRQ Quality Indicators NQF Update Marybeth Farquhar, PhD, MSN, RN QI Users Meeting AHRQ 2 nd Annual Conference Rockville, MD September 10, 2008.

Panel Reviews of the AHRQ QIs: AHRQ and NQF panels Sheryl Davies, MA Stanford University.

AHRQ Quality Indicators Software Overview of Changes to v5.0 August 20, 2015.

Hospital Measures Reporting in Ohio Michele Shipp, MD, DrPH AHRQ QUALITY INDICATORS USERS MEETING Wednesday September 9, 2008 AHRQ ANNUAL CONFERENCE 2008.

BlueCross BlueShield of Illinois a Division of Health Care Service Corporation (HCSC), a Mutual Legal Reserve Company Blue Cross Blue Shield of Illinois.

A Profile of Patient Care and Safety in Hospitals with Differing Case-Mix and Financial Condition Sema K. Aydede, PhD Institute for Child Health Policy,

Iowa Healthcare Collaborative - Past, Present, and Future Use of AHRQ Quality Indicators Lance Roberts 2009 AHRQ Annual Conference September 24,

Inpatient Quality Reporting In Colorado Sept HCUP User Group Meeting.

1 Quality of Care and Patient Safety: Impact on Healthcare January 22, 2009 Presenter: F. Lisa Murtha, Practice Leader and Managing Director, Huron Consulting.

Agency for Healthcare Research and Quality,Grant # R01 HS13094 Hospital Financial Distress and Patient Outcome: A Panel Study Mei Zhao, MHA Virginia Commonwealth.

Development and Testing of the AHRQ QI Toolkit for Hospitals Donna O. Farley, PhD Peter Hussey, PhD RAND Corporation.

Minnesota Statewide Quality Reporting and Measurement System Chartbook Section 9.

Future Validation and Improvement of the AHRQ QI AHRQ Annual Conference September 10, 2008 Bethesda, MD Presented by Kathryn McDonald.

Performance Measures: CMS Hospital Inpatient Quality Reporting Program (IQR)Update As of November 2012.

Dr. Rashida Abdelfattah FACULTY OF NURSING SCIENCES University of Khartoum.

Future Validation and Improvement of the AHRQ QI AHRQ Annual Conference September 10, 2008 Bethesda, MD Presented by Kathryn McDonald.

How To Improve Performance on the AHRQ Inpatient Quality and Patient Safety Indicators: Introducing a Toolkit for Hospitals Webinar February 15, :30-4:00.

3 rd Annual Association of Clinical Documentation Improvement Specialists Conference.

The Department of Quality and Risk Management

PATIENT SAFETY AND DOCUMENTATION: Connecting the Dots

The Agency for Healthcare Research and Quality Inpatient Quality Indicator #11 overall mortality rate does not accurately assess mortality risk after.

Quality How is this LOM Metric measured in the LEM?

Inpatient Quality Coding It’s Not Just About What you Get Paid

The AHRQ Quality Indicators Results and Discussion of Data Analysis

The Agency for Healthcare Research and Quality Inpatient Quality Indicator #11 overall mortality rate does not accurately assess mortality risk after.

Presentation transcript:

AHRQ QI Guide to Comparative Reporting AHRQ Annual Conference September 10, 2008 Bethesda, MD Presented by Sheryl Davies

Overview of document User tool to select indicators User tool to select indicators Indicators assigned to four tiers based on evidence Indicators assigned to four tiers based on evidence Gaps assessed for the following areas: Gaps assessed for the following areas: – Importance – Face Validity – Coding/Criterion Validity – Construct Validity – Risk Adjustment

Survey of Evidence Literature Literature – POA, coding validity, preventability, correlation with cost, LOS or other indicators, impact of QI programs AHRQ Validation Activities AHRQ Validation Activities – Chart review of coding validity – Clinical Panel Review National Quality Forum review National Quality Forum review Examination of potential improvements Examination of potential improvements

Tiers Tier 1: Minor or no evidence gaps Tier 1: Minor or no evidence gaps – 1B Serious reportable events Most suitable for comparative reporting/public accountability Most suitable for comparative reporting/public accountability Strongest evidence base Strongest evidence base Established evidence in several areas Established evidence in several areas No substantial evidence against use for comparative reporting No substantial evidence against use for comparative reporting Most endorsed by the National Quality Forum Most endorsed by the National Quality Forum

Tiers Tier 2: Moderate evidence gaps Tier 2: Moderate evidence gaps Users may choose to utilize these indicators for comparative reporting Users may choose to utilize these indicators for comparative reporting Some supporting evidence for use Some supporting evidence for use Some minor evidence gaps Some minor evidence gaps Indicator would be stronger with some additional evidence Indicator would be stronger with some additional evidence Most not currently endorsed by the National Quality Forum Most not currently endorsed by the National Quality Forum

Tiers Tier 3: Significant, but addressable, evidence gaps Tier 3: Significant, but addressable, evidence gaps Not currently suitable for comparative reporting, pending further development Not currently suitable for comparative reporting, pending further development At least one serious evidence gap or concern At least one serious evidence gap or concern Further development and validation work has been identified Further development and validation work has been identified Once further work is completed, indicators will be re-assigned to another tier Once further work is completed, indicators will be re-assigned to another tier Indicators not currently endorsed by NQF Indicators not currently endorsed by NQF

Tiers Tier 4: Significant evidence gaps Tier 4: Significant evidence gaps Substantial gaps in evidence for use in comparative reporting Substantial gaps in evidence for use in comparative reporting Gaps unlikely to be addressed with further development or validation Gaps unlikely to be addressed with further development or validation Not recommended for comparative reporting Not recommended for comparative reporting Indicators are not currently endorsed by NQF Indicators are not currently endorsed by NQF

Tier 1 Indicators IQIs IQIs – Esophageal Resection Volume (#01)* – Pancreatic Resection Volume (#02)* – Abdominal Aortic Aneurysm (AAA) Repair Volume (#04)* – Esophageal Resection Mortality (#08)* – Pancreatic Resection Mortality (#09)* – Abdominal Aortic Aneurysm (AAA) Repair Mortality (#11)* – AMI Mortality (#15 and #32) – CHF Mortality (#16)* – Acute Stroke Mortality (#17)* – Hip Fracture Mortality (#19)* – Pneumonia Mortality (#20)* – Incidental Appendectomy in the Elderly (#24)* – Bi-lateral Catheterization (#25)* *NQF endorsed

Tier 1 Indicators PDIs PDIs – Accidental Puncture or Laceration (#01)* – Decubitus Ulcer (#02)* – Iatrogenic Pneumothorax (#05)* – Pediatric Heart Surgery Mortality (#06)* – Pediatric Heart Surgery Volume (#07)* – Postoperative Wound Dehiscence (#11)* – Blood Stream Infection in Neonates (#02)* PSIs PSIs – Death among Surgical Inpatients with Treatable Serious Complications (#04)* – Iatrogenic Pneumothorax (#06)* – Postoperative Hip Fracture (#08) – Postoperative DVT or PE (#12)* – Postoperative Wound Dehiscence (#14)* – Accidental Puncture or Laceration (#15)* – OB Trauma with and without Instrument (#18 and #19) – Birth Trauma (#17)*

Tier 1B Indicators PSIs PSIs – Death in Low Mortality DRGs* – Transfusion Reaction* – Foreign Body Left in During Procedure* PDIs PDIs – Transfusion Reaction* – Foreign Body Left in During Procedure* *NQF endorsed

Tier 2 Indicators IQI IQI – Hip Replacement Mortality (#14) PDI PDI – Iatrogenic Pneumothorax in Neonates – Postoperative Hemorrhage or Hematoma (#08) – Postoperative Respiratory Failure (#09) – Postoperative Sepsis (#10) PSI PSI – Postoperative Hemorrhage or Hematoma (#09) – Postoperative Physiologic and Metabolic Derangement (#10) – Postoperative Respiratory Failure (#11) – Postoperative Sepsis (#13) *NQF endorsed

Tier 3 Indicators IQIs IQIs – CABG Mortality (#12) – Craniotomy Mortality (#13) – GI Hemorrhage Mortality (#18) PDIs/NQIs PDIs/NQIs – Hospital Acquired Vascular Catheter Related Infections (#12) – Neonatal Mortality PSIs PSIs – Decubitus Ulcer (#03) – Hospital Acquired Vascular Catheter Related Infections (#07)

Tier 4 Indicators IQIs IQIs – CABG Volume (#05) – PTCA Volume (#06) – Carotid Endarterectomy Volume (#07) – Cesarean Delivery (#21 and #33) – VBAC Delivery (#22 and #34) – Laparoscopic Cholecystectomy (#23) – PTCA Mortality (#30) – Carotid Endarterectomy Mortality (#31) PSIs PSIs – Complications of Anesthesia (#01) – OB Trauma-Cesarean Delivery (#20)

Applying Guidance to your Own Report Guidance document is a source of information, users need to weigh their own situation to select indicators Guidance document is a source of information, users need to weigh their own situation to select indicators AHRQ QI Reporting Template AHRQ QI Reporting Template Know your purpose Know your purpose – Tier 2 indicators may be more useful for some purposes than others

Applying Guidance to Your Own Support: Data Know your data Know your data – Potential data checks Rates and variation in POA Rates and variation in POA Procedure dates, Elective vs. Non-elective, E- codes Procedure dates, Elective vs. Non-elective, E- codes “Hospitals Like Mine” Tool – HCUPnet “Hospitals Like Mine” Tool – HCUPnet – AHRQ Tools Medical record review Medical record review u Audit u Individual hospitals

Questions?