Future Directions for the National Healthcare Quality and Disparities Reports (2010) / Chapter Skim
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7 Implementing Recommended Changes
7 Implementing Recommended Changes
Pages 137-146
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From page 137... ...
These changes are intended to make the reports more forward-looking and action-oriented by engaging national and state policy makers and other stakeholders in the quest to improve health care quality for the nation. The redesigned NHQR, NHDR, and their related products would continue to fulfill the congressional mandate to report on trends and prevailing disparities, but the focus would be more on driving improvement. Despite the considerable strengths of the national healthcare reports, the committee assessed them as lacking: • a clear set of national priorities on which to focus quality measurement and highlight, through the presenta tion of data, how policies and practices support achievement of these priorities; • an affirmation in both the NHQR and NHDR that achieving equity is an essential part of quality improvement; • an assessment of which measurement areas could have the greatest impact if gaps between current and recommended levels of performance were closed; Health Research and Quality Act of 1999, Public Law 106-129 § 902, 913, 106th Congress, 1st sess.
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From page 138... ...
In previous chapters, the Future Directions committee has recommended a number of steps to address these issues. Specifically, the committee suggests a set of national priority areas for quality improvement and disparities, and recommends that AHRQ ensure the NHQR and NHDR report on progress made toward these national priorities (Chapter 2)
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From page 139... ...
Transforming the report products, engaging national and state policy makers and other actors, strengthening performance metrics, improving data, and supporting the committee's recommended measure selection process are important avenues for improving health care quality for the nation. The Future Directions committee is not able to determine to what extent, if at all, AHRQ might be able to reprogram funds within its existing budget to cover some implementation needs.
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From page 140... ...
For example, the work of the NAC Technical Advisory Subcommittee for Measure Selection will generate ideas for the development of health care quality measures or data sources for high-impact areas that would be tracked nationally; these developmental activities can be quite expensive and are not accounted for in the scenario outlined in the appendix. Upgrading the Reports and State Snapshots In calendar year 2010, with a modest increase in staffing and resources, AHRQ should be able to include numerous upgrades in the 2010 NHQR, NHDR, and State Snapshots (which would be released in early 2011)
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From page 141... ...
Currently the NHQR and NHDR have limited reporting based on Medicare, Medicaid, and private sector data, and the committee urges AHRQ to expand these data in future editions. Upgrading Online Resources, Adding Derivative Products, and Enhancing Dissemination The committee has recommended AHRQ directly or via contracts update the State Snapshots and the NHQRDRnet to: • Include fact sheets, topic-specific derivative products (e.g., expanded mini-reports on priority populations)
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From page 142... ...
11 When existing health care quality measures and data sources are insufficient to track national progress in the identified national priority areas, AHRQ should directly or indirectly support the development of needed measures and the acquisition of relevant data sources. For report purposes, AHRQ tends to pay data use fees but does not pay for infrastructure development (e.g., data collection)
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From page 143... ...
EVALUATION OF THE AHRQ REPORT-RELATED ENDEAVOR Along with its recommendation for an increase in financial support to AHRQ to facilitate transformation of the NHQR, NHDR, and their associated products, the Future Directions committee recommends a rigorous evaluation of the reports so that AHRQ can gain a better understanding of the reports' contribution to quality improvement and disparities reduction. The committee recommends that AHRQ institute an explicit, ongoing program of internal and independent external evaluations of the national healthcare reports and associated products to: • Offer fresh perspectives on how the reports are being used to produce change.
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From page 144... ...
AHRQ develops user guide on accessing products to support data primary data and how to apply findings in action AHRQ forms theTechnical Advisory Subcommittee Technical Advisory Subcommittee Technical Advisory Subcommittee for Measure Selection to NAC that - releases findings on relative rankings of its - releases additional findings on relative - plans for analysis of current core measures and current measures and on some additional ranking of quality measures additional measures for relative health care quality measures - continues analysis of measures as needed quality impact - recommends to NAC/AHRQ areas for funding - recommends to NAC/AHRQ areas for funding - issues call for suggested additions and deletions research on measures and data acquisition research on measures and data acquisition to core measure set - begins to identify measure and data gaps (see Chapter 4) AHRQ contracts for evaluation of current user AHRQ evaluates user groups' application of AHRQ incorporates updates to the reports groups' practices and how change would affect report findings to affect change based on user group evaluations and the reports' utility for these users reexamines effectiveness of dissemination (see Chapter 7)
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From page 145... ...
2008. Committee on Future Directions for the National Healthcare Quality and Disparities Reports: Statement of task.
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