Discontinued Performance Measures Table
Performance Budget Submission for Congressional Justification, Fiscal
Patient Safety
Quality/Safety of Patient Care
Long Term Goal: By 2010, prevent, mitigate and decrease the number of medical errors, patient safety risks and hazards, and quality gaps associated with health care and their harmful impact on patients.
| Measure | FY | Target | Result |
|---|---|---|---|
Identify the Threats By 2010, patient safety event reporting will be standard practice in 90% of hospitals nationwide. | 2007 | Initiate network of patient safety databases (NPSD) to identify emerging patient safety threats Dec-07 | 95% event reporting in hospitals |
| 2007 | Continue use of the National Health Quality Report (NHQR), National Healthcare Disparities Report (NHDR), Patient Safety Indicators (PSIs) to monitor and report on changes in patient safety/quality | Complete | |
| 2006 | Use NHQR, NHDR, PSIs to monitor changes in patient safety/quality | 2006 National Healthcare Quality Report 2006 National Healthcare Disparities Report | |
| 2005 | Continue support for data standards and taxonomy development for improved patient safety event reporting, data integration/usability | Data standards development is ongoing: Supported NQF taxonomy consensus building. Taxonomy approved 2005 | |
| 2005 | Redesign PSIRS database system to produce NPSD which includes data specifications, standardized taxonomy | Dec-06 | |
| 2004 | Develop a data warehouse and vocabulary server to process patient safety event data | Completed | |
| 2003 | Develop reporting mechanism and data structure through the National Patient Safety Network | Completed | |
Educate, Disseminate, and Implement to Enhance Patient Safety/Quality By 2010, successfully deploy practices such that medical errors are reduced nationwide. Outcome | 2007 | 50 participants in the Patient Safety Improvement Corps (PSIC) Train-the-Trainer program will initiate local patient safety training activities | Dec-07 |
| 2006 | Implement and evaluate best practice use of NHQR-DR Asthma Quality Improvement Resource Guide and Workbook for State Leaders in 2 to 5 States | Dec-06 Michigan | |
| 2005 | 5 health care organizations/units of State/local governments will evaluate the impact of their patient safety best practices interventions. | Completed: 17 grant awards made for implementing patient safety improvement practices. | |
| 2005 | Implement and evaluate best practice use of NHQR-DR Diabetes Quality Improvement Resource Guide and Workbook for State Leaders in 2-5 States. | Completed: Diabetes workbook has been developed and 2 States (Delaware and Vermont) are engaged in using it and setting an action agenda. | |
| 2004 | 6 health facilities or regional initiatives to implement interventions and service models on patient safety improvement will be in place | Completed | |
| 2003 | Awards to be made to at least 6 facilities or initiatives | Completed: 6 awards made | |
Educate, Disseminate, and Implement to Enhance Patient Safety/Quality By 2010, successfully deploy practices such that medical errors are reduced nationwide. Outcome | 2007 | 50 participants in the PSIC Train-the-Trainer program will initiate local patient safety training activities | Dec-07 |
| 2007 | Hold annual patient safety/healthcare information technology conference | Dec-07 | |
| 2006 | 15 additional States/major health care systems will have on-site patient safety experts trained through the PSIC program | Completed: 16 States and 19 hospitals/health care systems participated in the PSIC | |
| 2005 | 15 additional States/major health care systems will have on-site patient safety experts trained through the PSIC program | Completed: 19 States and 35 hospitals/health care systems participated in the PSIC | |
| 2004 | 10 States/major health care systems will have on-site patient safety experts trained through the PSIC program | Completed: 15 States 13 hospitals-health care systems | |
| 2004 | 5 health care organizations or units of State/local government will implement evidence-based proven safe practices | Completed: 7 organizations received grants to implement evidence-based safe practices | |
| 2004 | Develop 4 NHQR-DR Knowledge Packs on Quality for priority populations and care settings | Completed: Knowledge Packs were replaced by reports on gender, children, and inpatient care. | |
| 2004 | Conduct annual patient safety conference transferring research findings, products, and tools to users | Completed: Annual patient safety conference held Sept. 26-28, 2004 | |
| 2003 | Established a Patient Safety Improvement Corp (PSIC) training program. | Completed | |
| Award to 5 health care organizations or units of State/local government grants to implement evidence-based proven safety practices | Completed | ||
Maintain vigilance By 2010, deploy and use measures of safety and quality for improvement in various care settings Outcome | 2007 | Initiate Network of Patient Safety Databases (NPSD) | Dec-07 |
| 2007 | Deliver fifth NHQR-DR | Dec-07 | |
| 2007 | Use NPSD, NHQR, NHDR, PSIs to monitor changes in patient/safety quality | Dec-07 | |
| 2006 | Deliver fourth NHQR-DR and continue use of NHQR, NHDR, PSIs to monitor changes in patient safety/quality | Completed: 4th Annual NHQR/DR | |
| 2005 | Develop measures of patient safety culture (ambulatory and longer term care) | Dec-06 Contract award in FY2005 | |
| 2004 | Develop measures of patient safety culture (hospital-based) | Completed | |
| 2003 | N/A | N/A |
Data Source: Patient Safety Resource Coordinating Center (PSRCC) databases; NHQR/DR database
Data Validation: Spreadsheets are created and maintained for accepted applications to the program.
Cross Reference: HHS Goals and Objectives: 1.3; HP2010-1/17/23; HHS Priorities: Value-Driven Health Care
Health Information Technology (Health IT)
Long Term Goal: Most Americans will have access to and utilize a Personal Electronic Health Record by 2014.
| Measure | FY | Target | Result |
|---|---|---|---|
Hospitals using Computerized Physician Order Entry (CPOE) by 10%. (Retired measure that has exceeded its target). Outcome 1.3.6 | 2007 | Increase to 15% | Completed: 27% American Hospital Association (AHA) Report |
| 2006 | Provider utilization of computerized provider order entry (CPOE) increased to 15% | Completed: 21.9% of physician practices use e-prescribing | |
| 2005 | 10% of hospitals using CPOE | Completed: 25% increase in the utilization of CPOE systems | |
| 10% of providers using CPOE | Completed: 14% of all medical group practices utilize a CPOE3 | ||
| 2004 | N/A | N/A | |
By 2008, in hospitals funded for CPOE, maintain a lowered medication error rate. Outcome 1.3.7 | 2007 | Decrease preventable adverse drug events (ADEs) by 10% | Dec-07 |
| 2006 | Increase rate of detection by 75% | Duke hospital implementation completed early; extending work to ambulatory clinics. Funded eRx pilot at Brigham & Women's which focuses on ambulatory ADEs. | |
| 2005 | Increase the rate of detection by 50% | Funded implementation study | |
| 2004 | N/A | N/A |
Data Source: Hospital CPOE usage as documented by the annual Healthcare Information and Management Systems Society (HIMSS) survey; Detection of ADEs noted in recent published articles (JAMA, Archives of Internal Medicine); Medical Group Management Association (MGMA) survey of Health IT uptake in physician offices; Leapfrog annual survey; Health System Change (HSC), Community Tracking Study (CTS).
Data Validation: Data obtained regarding ADE detection published in peer reviewed journals. HIMSS data verified by other smaller efforts. E-prescribing data validated by other surveys.
Cross Reference: HHS Goals and Objectives:1.2, 1.3, 4.4; HP2010-11/23;
HHS Priorities: Health Information Technology; Departmental Objectives: 7
Long-term Care
Long Term Goal: Improve quality and safety in all long-term care settings and during transitions across settings.
| Measure | FY | Target | Result |
|---|---|---|---|
Improve quality and safety in all long-term care settings and curing transitions across settings. Outcome 1.3.10 | 2007 | Develop annual nursing home injurious falls draft measure in partnership with the Centers for Medicare & Medicaid Services (CMS); quantify baseline draft measure. | Dec-07 |
| 2007 | Develop partnerships, and access needs and barriers to the adoption of a 2nd generation injurious falls program in nursing homes. | Completed: Final report May 2007 | |
| 2007 | Initiate dissemination activities for adoption of 2nd generation pressure ulcer intervention. | Dec-07 Completed | |
| 2007 | Implement and evaluate, in at least 30 nursing homes and in partnership with the State's Quality Improvement Organizations (QIOs), 2nd generation nursing home pressure ulcer intervention. | Dec-083 | |
| 2006 | Synthesize recent research findings on what aspects of nursing home care prevents inappropriate hospitalizations. | Completed: Final Report Sep-06 | |
| 2006 | Distribute report on implementation of evidence-based protocols for pressure ulcers prevention in nursing homes | Dec-08 Grantee requested a no-cost extension | |
| 2006 | Disseminate findings from AHRQ nursing home (NH) fall prevention program (FPP) | Completed:
| |
| 2005 | Partner with a second NH chain that is embarking on fall prevention program. | Complete | |
| 2004 | Develop multi-faceted falls prevention program focused on high risk fallers based on evidence-based research and pilot in NH chain. | Complete | |
Improve coordination of formal long-term care with hospital care, primary care, and informal caregivers to facilitate clinical decisionmaking and assure timely transfer of clinical data. Outcome 1.3.11 | 2007 | Complete initial identification of user needs and barriers associated with 2nd generation e-communication tool use | Currently, there is little interest in home care industry to implement the communication tools. |
| 2007 | Draft contractual award materials for 2008 multiple provider implementation of 2nd generation e-communication tool in diverse geographic settings | Currently, there is little interest in home care industry to implement the communication tools. | |
| 2007 | Disseminate e-communication user aids and expanded network of provider partnerships to jumpstart use of e-communication tools by multiple provider organizations | E-user aids and tools developed; however, currently there is little interest in home care industry to implement the tools. | |
| 2006 | Initiate dissemination of e-communication tool (i.e., a Web-based tool to improve coordination between hospital, primary care and home care clinicians and patients and their informal care providers to improve care planning and self-care) | Completed:
| |
| 2005 | N/A | N/A | |
| 2004 | N/A | N/A | |
Improve community-based care to maximize function and community participation, and prevent inappropriate institutionalization and hospitalizations. 1.3.12 | 2007 | In partnership with CMS, develop annual draft measure of re-hospitalization from long-term care settings of persons receiving formal home health care; quantify baseline draft measure | Dec-07 Partnership with CMS established. Data analysis is in progress |
| 2006 | New Freedom Initiative: Initiate evaluation plan to assess findings from youth in transition (from pediatric to adult services) projects. | Draft Resource Manual | |
| 2006 | Synthesize recent research findings on what aspects of community-based services and care in assisted living can prevent inappropriate institutionalization and hospitalizations | Complete: Final Report on Hospitalizations | |
| 2005 | N/A | N/A | |
| 2004 | N/A | N/A | |
Improve information about services and quality so that consumers can make informed choices about the care they receive. Outcome 1.3.13 | 2007 | Initiate cognitive testing on 1st generation of assisted living/residential care consumer tools and resources (1st priority measures) | Dec-08 |
| 2006 | Produce report on the state-of-the art instruments and tools available to profile assisted living/residential care | Report completed | |
| 2006 | Publish report on how States monitor assisted living/residential care facilities and how States report to consumers | Report posted: https://www.ahrq.gov/research/residentcare | |
| 2006 | Determine final sampling methodology and plan of implementation to enhance measurement on the long-term care population | Sample design memo completed in June 2006 as a contract deliverable. | |
| 2005 | N/A | N/A | |
| 2004 | N/A | N/A |
Data Source: National Healthcare Quality Report based on CMS's Minimum Data Set and Outcome and Assessment Information Set (OASIS) data.
Data Validation: AHRQ products under go extensive peer review for merit and relevance.
Cross Reference: HHS Goals and Objectives: 1.3; HP2010-1; HHS Priorities: Value drive health care, Health IT, Medicaid Modernization, Personalized Health Care, Prevention
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