Report Changes in Response to IOM Recommendations

1. Report Changes in Response to IOM Recommendations Ernest Moy Ernest.moy@ahrq.hhs.gov 301-427-1329 http://www.ahrq.gov/qual/qrdr09.htm http://statesnapshots.ahrq.gov

2. Overview • Changes for 2010 - Align with IOM priority areas / updated framework - Add benchmarks • Beyond 2010 - Expand fact sheets / mini-reports - Redesign webtools

3. 2010 Reports: Align with IOM Priorities & Framework

4. 2010 NHQR / NHDR Chapters Single Highlights with new sections on Priority Areasand State Summaries Single Intro/Methods NHQR NHDR With benchmarks, QR highlights, and priority population highlights Effectiveness Safety Timeliness Patient Centeredness Care Coordination Efficiency Health System Infrastructure Access Priority Populations Summaries • With benchmarks, DR highlights, and priority population highlights • Effectiveness • Safety • Timeliness • Patient Centeredness • Care Coordination • Efficiency • Health System Infrastructure • Access

5. IOM Benchmark Recommendation • To the extent that the data are available, the reporting of each measure in the NHQR and NHDR measure set should include routinely updated benchmarks that represent the best known level of performance that has been attained.

6. Benchmark Methods • Setting Achievable Benchmarks • Same in QR and DR • Top 10% States • Year specific • 30+ States with reliable estimates • Exclude Territories • Calculating Time to Benchmark • Linear regression of data points • 4+ data points make a trend (or change in trend)

7. Pneumococcal Vaccine among Elderly by Race/Ethnicity Time to Benchmark 2008 Achievable Benchmark = 63.9% 2 yrs 8 yrs 14 yrs 87 yrs

8. Pneumococcal Vaccine among Elderly by Insurance Time to Benchmark 2008 Achievable Benchmark = 63.9% 3 yrs 8 yrs 3 yrs 22 yrs

9. Benchmark Example of Improvement

10. Benchmark Example of No Improvement

11. Children ages 19-35 months who received all recommended vaccines by household income 2008 Achievable Benchmark = 82%

12. Ongoing Benchmark Challenges • Should benchmarks by updated? When? • What to do when there are no State data? Population benchmark; what population? Provider benchmark? • What about race-specific State-based benchmarks? • Is it appropriate and useful to apply State-based benchmarks to disparities?

13. Beyond 2010: Fact Sheets / Mini-Reports • Focus on Priority Populations • Well-defined audiences • Reduced NHDR Priority Populations chapter • Opportunity to meet user needs better • Every quarter after Report release (3/year) • Sustain interest • Every priority pop covered every other year • Collaboration with • AHRQ Office of Priority Populations • Interagency Work Group

14. Integrated Web Design NHQR • New integrated site will: • Guide users through a cohesive national quality improvement storyline: • National priorities Sub-national targets • Reporting information Taking action • Include enhanced features, such as: • Guiding questions • “Step-by-step” quality improvement tools • Achievable benchmarks • Similar-state-, sub-population-, and payer- comparisons • Easy-to-identify navigational icons • Consistency of detail on NHQR/DR methods • Glossary of terms NHDR State Snapshots NHQRDRnet

15. Integrated Components Detailed tables from Report appendices Meters and dials from State Snapshots Dynamic tables from NHQRDRnet