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".
Slide 1
Outline
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. The header and body of the slide are separated by a light blue horizontal line that traverses 80 percent of the slide from the left.
• AHRQ Mission and the
- National Healthcare Quality Report (NHQR)
- National Healthcare Disparities Report (NHDR)
• NHQR/NHDR - Background
• Translating Data Into Change
• A State-led Model for Action
• State Snapshots 2006
Slide 2
AHRQ Mission and Niche
• Mission : Improve the efficiency, effectiveness, quality, safety, and equity of health care
• Niche:
- Developing knowledge through research
- Disseminating the evidence
A bracket stretching from Developing knowledge through research to Measuring quality points to the cover images of the 2006 National Healthcare Quality Report and the 2006 National Healthcare Disparities Report.
Slide 3
Origin of the NHQR / NHDR
Mandated by Congress in Healthcare Research and Quality Act (PL. 106-129)
• "Beginning in fiscal year 2003, the Secretary, acting through the Director, shall submit to Congress an annual report on national trends in the quality of health care provided to the American people."
• To track "prevailing disparities in health care delivery as it relates to racial factors and socioeconomic factors in priority populations"
To the right of the text is a picture of the dome of the Capitol building.
Slide 4
2006 National Healthcare Quality and Disparities Reports
This slide has the cover images of the 2006 National Healthcare Quality Report and the 2006 National Healthcare Disparities Report. A white box in the upper right contains the following text: Released Jan 11, 2007
Slide 5
Why Are These Reports Useful?
• A national overview of healthcare quality
- 42 core (211 total) measures of quality in NHQR
- Reveal "biggest gaps"
• A map with information about healthcare quality in key areas
• A compass on where we are headed
- National and State trends from 1994 forward
• A beacon for measure alignment across public and private quality initiatives
Slide 6
How the NHQR and NHDR Are Related
The body of this slide has a table with two columns.
The column on the left is labeled NHQR and lists: Quality of health care in America ; Quality; Effectiveness, Patient Safety, Timeliness, Patient Centeredness; Variation across time & States.
The column on the right is labeled NHDR and lists: Disparities in health care in America ; Quality + Access; .+ Equity; Variation across time & populations.
Slide 7
Measure Types 2006 NHQR / NHDR
• All Measures (NHQR-211; NHDR- 250)
• Core Measures (NHQR- 42; NHDR- 22)
• Composite Measures (13)
• Alternating Measures
e.g., Breast Cancer, 2005 & Colon Cancer, 2006 (screening & mortality)
• Process & Outcome Measures
Slide 8
Measure Types 2006 NHQR / NHDR (cont'd)
• Setting of Care
- Hospital
- Ambulatory
- Nursing Home/Home Health
• Stages of Care
- Staying healthy
- Getting better
- Living with illness or disability
- Coping with the end of life
Slide 9
Content and Organization 2006 NHQR/NHDR
• Effectiveness
• Cancer
• Diabetes
• End Stage Renal Disease (ESRD)
• Heart Disease
• HIV and AIDS
• Maternal and Child Health
• Mental Health and Substance Abuse
• Nursing Home, Home Health, and Hospice Care
• Patient Safety
• Timeliness
• Patient Centeredness
• Access to Health Care
• Priority Populations
To the right of the text are two brackets. The green bracket, labeled NHQR, stretches from Effectiveness to Patient Centeredness. The orange bracket stretches across all bullet points (from Effectiveness to Priority Populations) and is labeled NHDR.
Slide 10
Data Sources
The cover images of the 2006 National Healthcare Quality Report and the 2006 National Healthcare Disparities Report are located in the center of the slide. There are four text boxes in each quadrant of the slide. Each box has a light blue arrow pointing toward the images of the reports.
The box in the upper left quadrant contains the following:
Provider/facility sample surveys
CDC,NCHS - NAMCS
CDC,NCHS - NHAMCS
CDC,NCHS - NHDS
CMS - ESRD CPMP
CSHSC - Community Tracking Study Physician Survey
The box in the upper right quadrant contains the following:
Surveillance and vital statistics
CDC - NPCR
CDC - HIV/AIDS Surveillance System
CDC - TB Surveillance System
CDC,NCHS - NVSS
NIH - SEER
The box in the lower right quadrant contains the following:
Organizational data systems
AHRQ - HCUP
CMS - Hospital Compare
CMS - Medicare Patient Safety Monitoring System
CMS - OASIS
CMS - Nursing Home Minimum Data Set
CMS - QIO
HIVRN - 2001-2003
HIS - NPIRS
NCQA - HEDIS
NIH - USRDS
SAMHSA - TEDS
The box in the lower left quadrant contains the following:
Population sample surveys
AHRQ - MEPS
AHRQ - CAHPS
CDC - BRFSS
CDC,NCHS - National Asthma Survey
CDC,NCHS - NHANES
CDC,NCHS - NHIS
CDC,NCHS - National Immunization Survey
CMS - MCBS
HRSA - Healthy Schools Healthy Communities User Visit Survey
NHPCO - Family Evaluation of Hospice Care
SAMHSA - NSDUH
U.S. Census Bureau - U.S. Census
Slide 11
NHQR & NHDR Not Enough
• Books "on a shelf" do not make change happen
• "National" policymakers not only audience
• Practice variation across States - important message
• NHQR data for States spread across many tables
- tedious to access
- difficult to summarize
Slide 12
A State-led Framework for Quality Improvement: Why?
• States can play a strategic role -- designing, leading, and assessing
• Existing models focus on providers
• A state-focused model lays out:
A light blue bracket stretches from A leadership role to Steps and is labeled for State action.
Slide 13
The State-led Framework
This slide has an image three concentric circles, which are divided into thirds. The image shows that the strategy for quality improvement rests on planning, doing, and assessing.
The process is as follows:
• Provide leadership to create a vision
• Work in partnership with key stakeholders
• Implement improvement by leading partners to create interventions and assess impact
Slide 14
NHQR/DR Derivative Products for State-led Quality Improvement
• State Snapshots from the:
- 2004 NHQR - print-format on Web for each State
- 2005 NHQR - interactive-format on Web for each State
- 2006 NHQR/NHDR - refinements (e.g., full content PDF)
- http://statesnapshots.ahrq.gov
• Diabetes Care Quality Improvement: Guide & Workbook
• Asthma Care Quality Improvement: Guide & Workbook
• Asthma Care Return on Investment Calculator
- Ask Jeff Brady (AHRQ) or Ginger Carls (TH)
There is a red arrow next to " 2006 NHQR/NHDR - refinements (e.g., full content PDF)"
Slide 15
The State Snapshots
• Online State-by-State data from the NHQR and NHDR:
• Composite measures
• Individual measures
• Focus on managing diabetes
To the right of the text is a screenshot of the State Snapshots tool at:
http://statesnapshots.ahrq.gov/statesnapshots/
strongest_weakest.jsp?menuId=4&state.
Slide 16
Sample Questions for the State Snapshots
• What is Arizona 's healthcare quality overall?
• How does this compare to other states?
• In which areas is Arizona 's healthcare performance the Best? Worst?
• What percentage of Arizonans receive recommended colorectal cancer screening?
• What percentage of diabetic patients in Arizona receive recommended monitoring (HbA1c)?
• What disparities exist in HbA1c testing according to:
Slide 17
Sample Questions for the State Snapshots
• What is Arizona 's healthcare quality overall?
• How does this compare to other states
Overall Health Care Quality
• In which areas is Arizona 's healthcare performance the best? worst?
Strongest and Weakest Measures
• What percentage of Arizonans receive recommended colorectal cancer screening?
All Measures Table / Care by Clinical Area - Cancer
• What percentage of diabetic patients in Arizona receive recommended monitoring (HbA1c)?
• What disparities exist in HbA1c testing according to:
Focus on Diabetes - Quality / Disparities
Slide 18
State Snapshots: Composite Measures
Summary measures - a State's performance compared to their region and the nation for:
• All Available Measures
• Types of Care
• Settings of Care
To the right of the text is an image of a semi-circle labeled "Performance Meter: All Measures." The semi-circle is divided into five even segments of red, orange, yellow, light green, and green with the corresponding labels: very weak, weak, average, strong, and very strong. A dotted arrow is on the left side of the average section and a solid arrow is located at the intersection of the average and strong segments.
Slide 19
Composite Measures: State compared to Region or Nation
This slide contains two screenshots of the State Snapshots tool. There is a red circle around "All" on the left screenshot and "Pacific" on the right screenshot.
Slide 20
State Snapshots: Individual Measures
• Five Strongest and Weakest Measures for a State compared to all States reporting
• State Rankings for 15 Measures
- Ordinal rank on individual measures of each State's performance out of 51 (States + DC)
• Table of all measures for a State and all measures for all States
Slide 21
State Snapshots: 5 Strongest & Weakest Measures
This slide contains a screenshot of the State Snapshots tool entitled California Strongest and Weakest Measures:
http://statesnapshots.ahrq.gov/stateshapshots/
strongest_weakest.jsp?menuId=4&state=CA.
Slide 22
State Snapshots: Individual Measures
This slide contains a screenshot of the State Snapshots tool entitled California 2006 National Healthcare Quality Report Ranking on Selected Measures:
http://statesnapshots.ahrq.gov/stateshapshots/
staterankings.jsp?menuId=29&state=CA.
Slide 23
State Snapshots: Focus on Diabetes
• Process of care measures
• Outcome of care measures
• Disparities (by income & race/ethnicity)
• Saving costs (for State government employees)
A picture of the aforementioned performance meter is located right of the to the top two bullet points.
Slide 24
Snapshot Focus on Diabetes: Disparities
This slide contains a screenshot of the State Snapshots tool entitled California Focus on Diabetes: Disparities in Treatment: By Income:
http://statesnapshots.ahrq.gov/stateshapshots/
diabetes.jsp?menuId=25&state=CA&level=12.
Slide 25
Snapshots Focus on Diabetes: Lives & $s - State Govt Employees
This slide contains a screen shot of the State Snapshots tool entitled California Focus on Diabetes: Lives and Expenses. There are three red circles around 12.9, $219,000,000 and 30,500 from left to right.
http://statesnapshots.ahrq.gov/stateshapshots/
diabetes.jsp?menuId=27&state=CA&level=11&page=1.
Slide 26
Snapshots Focus on Diabetes: Excess $s - State Govt Employees
This slide contains a screen shot of the State Snapshots tool entitled California Focus on Diabetes: Excess Costs Associated with Diabetes for State Government Employees. There are two red circles around $3,600,000 and $8,200,000 on the screenshot.
http://statesnapshots.ahrq.gov/stateshapshots/
diabetes.jsp?menuId=28&state=CA&level=11&page=2.
Slide 27
AHRQ State Snapshots & Commonwealth Fund State Scorecard
There are two columns on this slide. The left column is entitled AHRQ State Snapshots and contains the following:
• State Summary
• Strongest and Weakest Measures
• Types of Care
• Settings of Care
- Hospital
- Ambulatory
- Nursing Home
- Home Health
• Care by Clinical Area
- Cancer
- Diabetes
- Heart Disease
- Maternal and Child Health
- Respiratory Diseases
• Focus on Diabetes
The right column is entitled CF State Scorecard and contains the following:
• Overall
• Access
• Quality
- Preventive Care (age 50+)
• Avoidable Hospital Use & Costs
• Equity
• Healthy Lives
Slide 28
AHRQ State Snapshots & Commonwealth Fund State Scorecard
This table has two columns from left to right: AHRQ State Snapshots and Commonwealth Fund State Scorecard. The table has five rows, from top to bottom: Content, Trends, Comparisons: National, Regional, and State Ranking.
AHRQ State Snapshots
Content: 129 measures
Trends: Performance Meter Most Recent + Baseline
Comparisons: Includes National and Regional.
State Ranking: Top 5 states for 13 composites; All states for 15 individual measures
Commonwealth Fund State Scorecard
Content: 32 measures
Trends: Point in Time
Comparisons: Includes National
State Ranking: All states for 6 composites; All states for 32 individual measures
Slide 29
State Snapshots
http://statesnapshots.ahrq.gov
This slide also contains an image of the State Snapshots tool on the left and the multi-colored semicircle entitled Performance Meter: All Measures on the right.
Slide 30
NHQR/NHDR Resources
• http://www.ahrq.gov/qual/measurix.htm
• Request Reports: 1-800-358-9295 ahrqpubs@ahrq.gov
• Jeff Brady, Jeff.Brady@ahrq.hhs.gov Acting Director, National Healthcare Reports Lead Staff, NHQR
• Karen Ho, Karen.Ho@ahrq.hhs.gov Lead Staff, NHDR
• Ernest Moy, Ernest.Moy@ahrq.hhs.gov NHQR/NHDR Team
|
