Report Changes in Response to IOM Recommendations (Text Version)

On September 28, 2010, Ernest Moy made this presentation at the 2010 Annual Conference. Select to access the PowerPoint® presentation (1.4 MB).

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Slide 1

Report Changes in Response to IOM Recommendations

Ernest Moy
Ernest.moy@ahrq.hhs.gov
301-427-1329
https://www.ahrq.gov/research/findings/nhqrdr/index.html
http://snapshots.ahrq.gov

Slide 2

Overview

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

Slide 3

2010 Reports: Align with IOM Priorities & Framework

National Priority Area	NHQR/NHDR Chapter&
Population Health	Highlights only
Palliative and End-of-Life Care	Palliative and Supportive Care section of the Effectiveness Chapter
Safety	Patient Safety Chapter
Patient and Family Engagement	Patient Centeredness Chapter
Care Coordination	New Care Coordination Chapter
Overuse	Efficiency Chapter
Access	Access to Health Care Chapter
Health System Infrastructure	New Health System Infrastructure Chapter

Slide 4

2010 NHQR / NHDR Chapters

Single Highlights with new sections on Priority Areas and State Summaries

Single Intro/Methods

NHQR

• With benchmarks, DR highlights, and priority population highlights
• Effectiveness
• Safety
• Timeliness
• Patient Centeredness
• Care Coordination
• Efficiency
• Health System Infrastructure
• Access

NHDR

• With benchmarks, QR highlights, and priority population highlights
• Effectiveness
• Safety
• Timeliness
• Patient Centeredness
• Care Coordination
• Efficiency
• Health System Infrastructure
• Access
• Priority Populations Summaries

Slide 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.

Image: Chart shows the following benchmarks: Health People 2010 target, 90%; National benchmark, 74.3%; National average, 57.3%. High and low points are noted by location, race/ethnicity, and income: Oregon, 74.3%, DC, 52%; White, 59.9%; Black, 36.8; Non-Hispanic White, 61.9%; Hispanic, 33.2%; High income, 60.9%; Poor, 45.1%.

Slide 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)

Slide 7

Pneumococcal Vaccine among Elderly by Race/Ethnicity

2008 Achievable Benchmark = 63.9%

Image: Line graph shows the following data:

Race/ Ethnicity	1999	2000	2001	2002	2003	2004	2005	2006	2007
Total	49.9	53.4	54.2	56.2	55.7	57	56.3	57.3	57.8
Hispanic	28.6	30.5	33	27.6	31.5	34.1	29	33.2	32.4
Black	32.8	30.9	33.8	37.4	37.2	39.2	40.7	36.9	44.7
White	53.2	56.9	57.9	60.4	59.6	60.9	60.5	61.9	62.1

Slide 8

Pneumococcal Vaccine among Elderly by Insurance

2008 Achievable Benchmark = 63.9%

Image: Line graph shows the following data:

Insurance	1999	2000	2001	2002	2003	2004	2005	2006	2007
Total	49.9	53.4	54.2	56.2	55.7	57	56.3	57.3	57.8
Medicare & private	53.9	58.1	59.3	60.8	60	61.9	62.2	61.8	61.6
Medicare & public	37.3	44.6	40.9	49.6	49.5	53.3	53.3	57.1	56.9
Medicare only	44.7	45.3	47.1	49.9	48.4	48.9	45.7	49	51.3

Slide 9

Benchmark Example of Improvement

Images: Two sample benchmarks for adult home health care patients are shown; the percentage of patients approaching the achievable benchmark rises each year.

Slide 10

Benchmark Example of No Improvement

Images: Two sample benchmarks for long-stay nursing home residents who need help with daily activities are shown; the percentage of patients remains approximately the same each year.

Slide 11

Children ages 19-35 months who received all recommended vaccines by household income

Slide 12

Ongoing Benchmark Challenges

Image: Line graph shows the following data:

Income	2000	2001	2002	2003	2004	2005	2006	2007	2008
Poor	67.2	68.0	69.3	75.0	76.8	76.5	76.5	76.5	73.6
Low	70.2	71.0	69.9	77.5	79.1	78.2	79.5	77.8	78.7
Middle	76.1	75.4	77.1	80.9	82.5	82.3	80.6	81.8	79.2
High	78.8	79.3	81.6	86.7	87.6	86.5	86.3	84.1	82.6

Slide 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

Slide 14

Integrated Web Design

• 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

Slide 15

Integrated Components

Images: Detailed tables from Report appendices; Meters and dials from State Snapshots; Dynamic tables from NHQRDRnet.