care programs and identify the elements of success or failure, similar to the retrospective research done by VHA.

Greater coordination would enable the identification of opportunities to include standardized quality measures and data elements in the design of other applied health services research. For example, the CanCORS project demonstrates how standardized quality measures and data elements can be applied in controlled clinical trials. Because of the substantial resources available to NIH and the advantages of building on well-designed trials, the committee concludes that spending should be realigned to encourage NIH to identify fields of clinical research for which the inclusion of development and testing of quality indicators and performance measures would be appropriate. NIH should engage in coordination between its various institutes to shorten the time lag between the development of research findings and their implementation in practice through more effective evaluation and dissemination of its own research. Consistent with recommendation 8, presented at the beginning of this chapter, these research efforts should be coordinated through QuIC with the support of AHRQ to ensure congruence with the efforts of the government health care programs to strengthen and streamline their quality enhancement processes.

Broad recognition of the need for coordination is already reflected in the establishment of QuIC, formed expressly to coordinate quality improvement efforts among the different departmental health programs and improve the consistency of oversight (Eisenberg et al., 2001). As discussed above, QuIC works cooperatively with all departments sponsoring health quality research through focused work groups (Eisenberg et al., 2001). The development of a comprehensive research agenda responsive to the needs of all programs should be coordinated similarly through QuIC as a complement to its implementation functions.

Such coordination would facilitate an ongoing trend. Indeed, it is the need to maximize reliance on core competencies already demonstrated that drives the committee’s recommendation for AHRQ’s role in staffing and housing QuIC. AHRQ already provides administrative support to QuIC, and AHRQ’s director serves as QuIC’s operating chair. AHRQ’s current mission and existing pattern of collaboration ensures that coordination will reside in the entity with the expertise, infrastructure, and operational focus needed to achieve a coherent research agenda useful to all programs. An evaluation should be conducted by QuIC every 3 years to assess the usefulness of the research and the application and effectiveness of the new tools developed through this collaborative process.



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