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2007 Physician Quality Reporting Initiative (PQRI) Tool Kit
The Centers for Medicare & Medicaid Services (CMS) has
developed a Tool Kit for the 2007 Physician Quality Reporting Initiative
(PQRI) that will assist eligible professionals with successful
reporting. This Tool Kit consists of some existing educational resources
plus new measure-specific worksheets designed to walk the user
step-by-step through reporting for each measure.
Agency for Healthcare Research and Quality (AHRQ), Hospital Survey on Patient Safety Culture
This survey tool can be used to assess the safety culture of a hospital as a
whole, or for specific units within hospitals, as well as to track changes in
patient safety over time and evaluate the impact of patient safety
interventions.
AHRQ Releases
Toolkits to Help Providers and Patients Implement Safer Health Care
Practices
The 17 toolkits, developed by AHRQ-funded experts who
specialize in patient safety research, are free, publicly available, and
can be adapted to most health care settings. The toolkits range from
checklists to help reconcile medications when patients are discharged
from the hospital to processes to enhance effective communication among
caregivers and with patients to toolkits to help patients taking
medications.
AMA has developed educational materials to help you get your hospital involved in the Strides in Saftey campaign
This article from the American Medical Association provides quick tips about
how to improve overall patient safety in your facility. It briefly describes
six different programs designed by the Institute for Healthcare Improvement
that can be implemented in your hospital to attain the highest quality patient
safety standards.
CAH Financial Indicators Report
This report can be used to track your CAH's performance across time in
relation to other similar institutions.
Introduction to Physician Performance Measurement Sets: Tools Developed by Physicians for Physicians
This manual was developed by the Physician Consortium for Performance
Improvement. The primary purpose of these sets is to encourage physicians to
improve patient care and maintain clinical excellence by ensuring that they
receive standardized, useful information describing their current practice
patterns compared with a minimum set of clinical recommendations.
Key Informant Interview and Assessment
Process
This document provides information for planning and preparing for face-to-face
interviews.
Subject areas are suggested for the development of specific questions.
Developed by the Center for Rural Health, University of North Dakota,
School of Medicine and Health Sciences.
Measuring Rural Hospital Quality
This paper, from the Rural Health Research Center, presents a model for rural
hospital quality measurement as well as the relevancy and issues of quality
measures for rural hospitals. The paper also explains how rural hospitals can
implement quality measurements into their organization.
Mobilizing for Action through Planning and Partnerships
Four MAPP Assessments, Community Health Status Assessment - The CHSA provides
a list of core indicators (data elements) for 11 broad-based categories.
Communities may also select additional indicators. By gathering data for each
of the categories and assessing changes over time or differences among
population subgroups or with peer, state, or national data, health issues are
identified.
New AHRQ Tools
Help Pharmacies Better Serve Patients With Limited Health Literacy
The pharmacy assessment tool can help raise pharmacy staff awareness of
health literacy issues, detect barriers that may prevent individuals
with limited literacy skills from using and understanding health
information provided by a pharmacy, and may help identify opportunities
for improving services. This tool includes a pharmacy assessment tour to
be completed by trained, objective auditors; a survey to be completed by
pharmacy staff; and a guide for focus groups with pharmacy patients. The
three parts are complementary and are designed to form a comprehensive
assessment.
Patient Safety Tools: Improving
Safety at the Point of Care
These 17 toolkits were produced under AHRQ's Partnerships
in Implementing Patient Safety (PIPS) grant program. The projects have
produced a variety of evidence-based tools, including training
materials, medication guides and checklists, that are easily adapted to
other institutions and care settings. The tools were developed in the
field and are designed to be implemented by multidisciplinary users.
Quality Indicator Project - Indicator Sets and Services
The QI Project's on-line Data Center allows participants to manage every
aspect of the performance measurement process - from data collection and
management to transmission and comparative analysis to utilizing a robust set
of SPC and charting tools. Because the Data Center is web-based, it's
easy-to-use and accessible from multiple points within a facility. Plus,
participants can use the same tool to satisfy multiple initiatives - such as
the CMS' 7th Scope of Work and the AHA's National Quality Initiative. By
streamlining the entire data collection and analysis process, participants
can focus on actually using their data to achieve performance goals.
Top 10 Cost Reporting Errors, Stroudwater Associates
This manual is designed to help you prepare an accurate cost report. The cost
report is a critical element for critical access hospitals (CAHs) as it is the
sole determiner of how mush the hospital will be paid by Medicare. The cost
report is also important for general acute hospitals under 100 beds while the
outpatient hold harmless is in effect. A well-completed cost report can also
be used to facilitate decision-making, with one important caveat: investment
decisions should be made on a variable/marginal cost basis.
Transforming Hospitals: Designing for Safety and Quality
Can the design of a hospital affect the quality of your care? Does noise
reduction improve patient satisfaction? Will better lighting decrease
medical errors? The evidence says yes. HHS. Agency for Healthcare
Research and Quality has just released a new DVD that provides evidence
to help hospital officials and architects design safer, high quality
hospitals. This new two-part DVD illustrates the value of evidence-based
hospital design . a phrase used to describe how the physical design of
health care environments affects patients and staff.
Use of Sub Acute Care
This performance aid was designed for rural distinct part skilled and swing
bed coordinators to provide: Clarification on the transfer rule and expanded
list of affected DRGs; specify transfer rule payments for each provider;
provide comparisons for payments under the transfer rule vs skilled PPS; and
identify possible transfer day based on the expected need for subacute
care.
Organizations
AHRQ Patient Safety Network (PSNet)
On the site, in "What's New", you'll find an annotated, carefully selected
compilation of the most recent and important news, research, tools, and
conferences in patient safety.
American College of Medical Quality (ACMQ)
The specialty medical association for physicians and other professionals in
the fields of clinical quality improvement, quality assessment and medical
quality management.
The American Health Quality Association: Advancing Quality of Care & Patient
Safety Nationwide
The American Health Quality Association represents Quality Improvement
Organizations (QIOs) and professionals working to improve the quality of
health care in communities across America. QIOs share information about best
practices with physicians, hospitals, and nursing homes. Working together with
health care providers, QIOs identify opportunities and provide assistance for
improvement.
American Medical Association - Pay-for-Performance Principles
This Web site is made available by the AMA and provides information,
principles, and guidelines on pay for performance plans. Topics covered
include Patient Registries, Evaluating Incentive Plans, and Physician
Pay-for-Performance Initiatives.
American Society for Healthcare Risk Management
Established in 1980, the American Society for Healthcare Risk Management is a
personal membership group of the American Hospital Association with more than
4,600 members representing health care, insurance, law and other related
professions. ASHRM promotes effective and innovative risk management
strategies and professional leadership through education, recognition,
advocacy, publications, networking and interactions with leading health care
organizations and government agencies.
American Society for Quality, Healthcare Division (ASQ)
A world leader in providing resources, training, and networking possibilities
to quality professionals in nearly every industry. ASQ is working with leading
healthcare organizations, such as the Institute for Healthcare Improvement and
the American Hospital Association, to enhance the use of quality improvement
theories, methods, and tools in health care.
California Health Care Foundation's Quality Initiative, The
The Quality Initiative coordinates quality measurement and outreach projects
in the Health Care Quality program area. The Initiative serves as a catalyst
in improving healthcare quality.
Center for Health Care Strategies, Inc. (CHCS)
CHCS strives to continuously improve the quality of health and health related
services for beneficiaries of our nation's health coverage safety net
-Medicaid and the State Children's Health Insurance Program.
The
Commonwealth Fund Hospital Performance Improvement E-Forum
This site features synched audio and slides from presentations by the lead
authors of two new Fund reports on hospital improvement, as well as an
introduction by Tony Shih, M.D., M.P.H., the Fund's senior program officer
for quality improvement and efficiency, and two expert commentaries.
ECRI (formerly the Emergency Care Research Institute)
An independent nonprofit health services research agency. ECRI's mission is
to promote the highest standards of safety, quality, and cost-effectiveness
in healthcare to benefit patient care through research, publishing,
education, and consultation.
Group Practice Improvement Network (GPIN)
A nonprofit organization founded by the Institute for Healthcare Improvement
that helps its members achieve and sustain performance excellence by sharing
knowledge of best practices.
HCUP QI On-Line, Healthcare Cost Utilization Project
Gives you on-line information about HCUP hospital measures. It is designed to
allow policy makers, public health professionals and the public to do
interactive searches of national rates of hospital utilization, access and
quality.
Hospital Quality Initative (HQI)
Centers for Medicare and Medicaid Services, these initatives build up upon
previous CMS and QIO strategies to identify illnesses and / or clinical
conditions that affect Medicare beneficiaries in order to promote the best
medical practices associated with the targeted clinical disorders; prevent or
reduce further instances of these selected clinical disorders; and prevent
related complications.
Institute for Clinical Systems Improvement (ICSI)
A collaboration of health care organizations, an objective voice dedicated to
championing health care quality and to helping its members identify and
accelerate the implementation of best clinical practices for their patients.
The ICSI program has four components: improvement commitment, scientific
groundwork for health care, support for improvement, and the Minnesota health
quality agenda.
Institute for Healthcare Improvement (IHI)
A not-for-profit organization driving the improvement of health by advancing
the quality and value of health care. Founded in 1991 and based in Cambridge
Massachusetts, IHI offers comprehensive products and services.
Institute for Medical Quality (IMQ)
A 501 (c) (6) non-profitorganization dedicated to improving the quality of
care provided to patients across the continuum of health care. IMQ offers a
wide range of educational, accreditation, consultation, and certification
programs.
International Society for Quality in Health Care
A non-profit independent organization with members in over 70 countries.
ISQua works to provide services to guide health professionals, providers,
researchers, agencies, policy makers and consumers, to achieve excellence in
healthcare delivery to all people, and to continuously improve the quality
and safety of care.
kaiserEDU.org
This Web site was developed by the Kaiser Family Foundation. kaiserEDU
provides easy access to data, literature, news and developments regarding
major health policy topics and debates. Designed for health care students and
faculty.
Leapfrog
The Leapfrog Group is made up of more than 160 companies and organizations
that buy health care. Leapfrog and its members work together to: reduce
preventable medical mistakes and improve the quality and affordability of
health care; reward doctors and hospitals for improving the quality, safety
and affordability of health care; encourage public reporting of health care
quality and outcomes so that consumers and purchasing organizations can make
more informed health care choices; and help consumers reap the benefits of
making smart health care decisions.
MidMichigan Health Web site
A family of organizations dedicated to providing a quality comprehensive
health care throughout the middle of Michigan and beyond.
Medical Outcomes Trust
A not for profit organization dedicated to improving health and health care
by promoting the science of outcomes measurement, and the development,
evaluation and distribution of standardized, high quality instruments that
measure health and the outcomes of medical care. The Trust supports the use
of these instruments with services and publications.
National Association for Healthcare Quality
Committed to developing and promoting professional expertise in the art and
science of healthcare quality.
National Association for Healthcare Quality Association Journal
Publishes the Journal for Healthcare Quality. NAHQ is a professional forum
that continuously advances healthcare quality practice in diverse and
changing environments. JHQ is the first choice for creative and scientific
solutions in the pursuit of healthcare quality.
National Business Coalition on Health, NBCH
A national, non-profit, membership organization of employer-based health
coalitions. NBCH and its members are dedicated to value-based purchasing of
health care services through the collective action of public and private
purchasers. NBCH seeks to accelerate the nation's progress towards safe,
efficient, high quality health care and the improved health status of the
American population.
National Committee for Quality Assurance (NCQA)
An independent, not-for-profit organization dedicated to assessing and
reporting on the quality of managed care plans, including health maintenance
organizations (HMOs).
National Patient Safety Foundation, (NPSF)
Accomplishes their mission through: Identifying and creating a core body of
knowledge; identifying pathways to apply the knowledge; developing and
enhancing the culture of receptivity to patient safety; raising public
awareness and fostering communications about patient safety; and improving
the status of the Foundation and its ability to meet its goals.
National Safety Council The National Quality Forum
A private, not-for-profit membership organization created to develop and
implement a national strategy for healthcare quality measurement and
reporting. The mission of the NQF is to improve American healthcare through
endorsement of consensus-based national standards for measurement and public
reporting of healthcare performance data that provide meaningful information
about whether care is safe, timely, beneficial, patient-centered, equitable
and efficient.
National Quality Forum (NQF)
A not-for-profit membership organization created to develop and implement a
national strategy for healthcare quality measurement and reporting. A shared
sense of urgency about the impact of healthcare quality on patient outcomes,
workforce productivity and healthcare costs prompted leaders in the public
and private sectors to create the national Quality Forum as a mechanism to
bring about national change.
Patient Safety Institute (PSI)
Combines the power of technology with the strength of patient-provider
relationships to improve care and lower the costs of health care.
Qual-IT
While public and private health care purchasers have
focused on quality measurement and reporting, they do not typically
provide specific incentives for the adoption of HIT as part of an
overall value-based health care plan. As this issue of Qual-IT
describes, however, several policy initiatives focused on employer-based
health plans could provide the needed impetus to dramatically increase
HIT adoption and use.
Quality Interagency Coordination Task Force (QuIC)
Works to ensure that all Federal agencies that purchase, provide, study or
regulate healthcare services are working in a coordinated way toward the
common goal of improving the quality of care. The QuIC seeks to provide
information to help people make choices, to improve the care purchased and
delivered by the government and to develop the infrastructure needed to
improve the healthcare system.
Rural Assistance Center's Health Care Quality Information Guide
An in-depth information guide that includes FAQs, tools,
funding, documents, journals, organizations, bibliographies, news and
events on health care quality.
Documents
Advances in Patient Safety: From Research to Implementation
Volumes 1-4, AHRQ Publication Nos. 050021 (1-4). February 2005. Agency for
Healthcare Research and Quality, Rockville, MD.
AHRQ State Snapshots
The State Snapshots provide State-specific health care
quality information including strengths, weaknesses, and opportunities
for improvement. The goal is to help State officials and their public-
and private-sector partners better understand health care quality and
disparities in their State.
Aiming
Higher: Results from a State Scorecard on Health System Performance
Developed to follow the National Scorecard on U.S. Health
System Performance, published in 2006, the State Scorecard assesses
state variation across key dimensions of health system performance:
access, quality, avoidable hospital use and costs, equity, and healthy
lives. The findings document wide variation among states and the
potential for substantial improvement "in terms of access, quality,
costs, and lives" if all states approached levels achieved by the top
states.
Chartered Value Exchanges: Local Networks with National Standards
Author(s): Agency for Healthcare Research and Quality (AHRQ)
Chartered Value Exchanges are community-based multistakeholder
collaboratives on the forefront of implementing cutting-edge ways to
transform health care at the local level. Providers, employers,
insurers, and community leaders achieve this special Federal distinction
for their strong commitment to improving quality and value in health care.
Corporate Responsibility and Health Care Quality: A Resource for Health Care Boards of Directors
This resource seeks to assist directors of health care organizations in
carrying out their important oversight responsibilities in the current
challenging health care environment.
First National Report Card on Quality of Health Care in America
Elizabeth McGlynn led a team of experts in the largest and most comprehensive
examination ever conducted of health care quality in the United States.
Called the Community Quality Index Study, it assessed the extent to which
recommended care was provided to a representative sample of the U.S.
population for a broad range of conditions in 12 metropolitan areas.
Health Care Quality: The Rural Context
This report seeks to examine the current state of debate over health care
quality and patient safety and how it affects rural communities.
Hospital Performance Improvement And The Balanced Scorecard, by Terry J.
Hill, Program Director, Rural Health Resource Center
This paper, presented by Terry Hill, Executive Director of the Rural Health
Resource Center, offers a brief overview of the Balanced Score Card as well
as information on comprehensive hospital performance improvement focusing
specifically at the Delta Rural Hospital Performance Improvement Program.
Material used with permission. Source: Press Ganey Associate, Inc.
2005.
Hospital Performance Improvement: Are things getting better?
Interest in improving health care quality has increased palpably in recent
years. We have seen this interest play out in numerous ways, including
greater emphasis on collecting and publicly disseminating performance
data.
Hospital Quality: Ingredients for Success - Overview and Lessons Learned
This study was conducted by the Economic and Social Research Institute in
July by The Commonwealth Fund. How top U.S. hospitals effectively develop and
maintain quality-improvement programs is examined. The study identifies
models for best practices and lays out specific actions that hospitals can
take to emulate them.
The Implementation of Pay-For-Performance in Rural Hospitals: Lessons from the Hospital Quality Incentive Demonstration (HQID) Project
The report found that the conditions for successful participation in
pay-for-performance (P4P) initiatives affect rural health care providers
differently than urban providers. The study calls for future P4P programs to
include a range of incentives independent of patient volume.
Making Performance Work in Rural Hospitals, Terry Hill, Executive Director,
Rural Health Resource Center
Terry Hill, the Executive Director of the Rural Health Resource Center,
provides this Power Point Presentation. The presentation focuses on
Performance Improvement and outlines how the Balanced Score Card approach can
help rural hospitals successfully reach their objectives.
Measuring the Quality of Life in Rural Areas: A Report from the Center of Rural Affairs
From the Center for Rural Affairs. The key to quality of life is the
ability to enjoy it. Few doubt that rural areas provide an enormous
opportunity for quality of life amenities, but are we able to enjoy them
like we should?
Modest Health Care Quality Gains Outpaced by Spending
Author(s): Agency for Healthcare Quality and Research (AHRQ)
The quality of health care improved by an average 2.3 percent a year
between 1994 and 2005, a rate that reflects some important advances but
points to an overall slowing in quality gains, according to annual
reports released in March, 2008 by AHRQ.
Performance Improvement Consultation Data Request Spreadsheet
This document is a spreadsheet designed to capture
specific data elements that have proven effective in the preparation for
the consulting team. It also facilitates completion and reply in
electronic format. It is designed to help the consulting team analyze
information prior to arrival and thus maximize use of time with hospital
administration, leadership, department managers, staff and physicians
while actually on site. First developed by Stroudwater Associates in 2001
for the Delta RHPI Project.
Preventing
Chronic Disease by Translating Recommendations Into Reality: Community Voices
The Centers for Disease Control and Prevention (CDC)
recognizes the importance of integrating voices from all communities,
including those with mixed incomes, differing races and ethnicities, and
diverse cultures.
Physicians Want To Learn from Medical Mistakes but Say Current
Error-reporting Systems Are Inadequate
The perception that U.S. doctors are unwilling to report
medical errors and learn how to prevent them is untrue, according to a
new study funded by the Department of Health & Human Services' (HHS)
Agency for Healthcare Research and Quality (AHRQ).
Quality Improvement Strategies and Best Practices in Critical Access
Hospitals
The purpose of this study is to describe the continuing evaluation and
maturation of CAH QI activities, and to document the best practices of two
CAH's that have developed innovative QI Programs. University of Minnesota
Rural Health Research Center Working Paper #52.
Quality Through Collaboration - The Future of Rural Health
This report assessed the quality of health care in rural areas; developed a
conceptual framework for a core set of services and infrastructure necessary
to deliver those services to rural communities; recommend priority objectives
and changes in policies and programs required to achieve those objectives;
consider implications for federal programs and policy.
To Err Is Human: Building a Safer Health System
Institute of Medicine report brief. November 1999 "Errors are costly in terms
of loss of trust in the health care system by patients and diminished
satisfaction by both patients and health professionals."
Transforming Care at the Bedside
Innovation Series 2004, Institute For Healthcare Improvement To respond to
the urgent need for change on the nation's medical/surgival units, the
Institute for Healthcare Improvement (IHI), in partnership with The Robert
Wood Johnson Foundation (RWJF), has launched an ambitious, expansive
initiative to resesign medical/surgical care. This effort draws on IHI's
experience mobilizing teams of frontline workers to make significant changes
in care processes, as well as its expertise in health system redesign.
Through this work, IHI is developing models of care at the bedside on medical
and surgical units that will result in improved quality of patient care and
service, more effective care teams, improved staff satisfaction and
retention, and greater efficiency.
Trends in
Potentially Preventable Hospitalizations among Adults and Children,
1997-2004
This Statistical Brief presents data from the Healthcare Cost and
Utilization Project on changes in the rates of potentially preventable
hospitalizations.
Quality Indicators
The Premier Hospital Quality Incentive Demonstration: Clinical Conditions and
Measures for Reporting
The CMS/Premier quality measures are based on clinical evidence and industry
recognized metrics.
Agency for Healthcare Research
and Quality (AHRQ) Quality Indicators
The Agency for Healthcare Research and Quality (AHRQ) Quality
Indicators (QIs) are measures of health care quality that make use of
readily available hospital inpatient administrative data.
Healthy People
Leading Health Indicators (LHIs) established by Healthy People 2010 will be
used to measure the health of the Nation over the next 10 years.
Hospital
Quality Alliance (HQA) Hospital Quality Measures 2004-2007
The Hospital Quality Alliance is a private-public cooperation striving
to
improve the quality of care provided by nationwide hospitals through assessing
and publicly reporting on the measurements of hospital care. There are
currently twenty measures on the Hospital Compare chart.
Illinois
Department of Public Health - Health Indicators
This Web site provides leading health indicators and disparities among states
and races/ethnicities.
National Quality Measures
Clearinghouse
This website is a public repository for evidenced-based quality measures and
measure sets.
Centers
for Medicare & Medicaid Services - Health Care Indicators
Contains data and analysis of recent trends in health care spending,
employment, and prices. The National Health Statistics Group tracks trends in
health care related industries and presents this information quarterly.
Quality Indicator Project, The
Formed in 1985 as a voluntary pilot project of seven Maryland acute care
hospitals that wanted to test a handful of clinical performance measures for
data collectability and usefulness in quality improvement activities. Today,
the Project has more than 1,800 participants across four different indicator
sets: Acute care, psychiatric care, long-term care and home care.
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