Future Directions for the National Healthcare Quality and Disparities Reports

Chapter 7: Implementing Recommended Changes (continued)

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.
Assess what types of analyses are most actionable.
Examine why AHRQ products may not be used by their targeted audiences.
Determine ways in which the reports could provide better and more actionable information.
Evaluate how the results associated with the products justify the investment in them.

Regular, formal reviews of AHRQ's portfolio of products should consider how to produce the most relevant information possible for policy makers, the public, and individuals and entities responsible for implementing quality improvement interventions, including organizations representing and serving communities of color. The committee does not want to convey the idea that just producing more fact sheets or other derivative products is an end in and of itself. The relevance of these various products should be assessed to assist AHRQ in determining priorities for the continuation of existing products or the development of future ones given available resources. Thus,

Recommendation 10: AHRQ should regularly conduct an evaluation of its products to determine if they are meeting the needs of its target audiences and to assess the degree to which the information in the AHRQ products is leveraged to spur action on quality improvement and the elimination of disparities.

Timeline for Implementing Recommendations

Although the IOM Future Directions committee recognizes that the transformation of the NHQR and NHDR and related products will not happen overnight, action steps can begin with the 2010 reports. The 2010 NHQR and NHDR are under development during calendar year 2010 and planned for release in early 2011. The committee's suggested timeline for action steps is presented in Figure 7-1; any one step in the timeline could be performed earlier than suggested.

Figure 7-1. Suggested timeline for implementing recommended activities

Calendar Year 2010		Calendar Year 2011		Calendar Year 2012
AHRQ upgrades presentation aspects of NHQR, NHDR, and State Snapshots; begins consultation with graphics and presentation experts (go to Chapters 2 and 6)	→	AHRQ continues to refine presentation (NHQR, NHDR, State Snapshots, NHQRDRnet) by consulting graphics, statistical, communication, and technology/Web site experts	→	AHRQ continues refinements in presentation as recommended by experts
AHRQ maps measure and data needs to national priority areas; incorporates available measures (go to Chapters 2 and 3)	→	AHRQ incorporates new measures and data that support priority areas as they become available either nationally or subnationally; notes where measure and data needs remain	→	AHRQ incorporates new measures and data that support priority areas; notes where measure and data needs remain
AHRQ plans for development of fact sheets and other derivative products, and for expanded dissemination (go to Chapter 6)	→	AHRQ begins developing NHQRDRnet capabilities that allow users to customize reports AHRQ develops user guide on accessing primary data and how to apply findings in action	→	AHRQ upgrades online presentation of NHQRDRnet to allow customization of reports and utilization of fact sheets and derivative products to support data
AHRQ forms the Technical Advisory Subcommittee for Measure Selection to NAC that Plans for analysis of current core measures and additional measures for relative health care quality impact Issues call for suggested additions and deletions to core measure set Begins to identify measure and data gaps (go to Chapter 4)	→	Technical Advisory Subcommittee Releases findings on relative rankings of its current measures and on some additional quality measures Recommends to NAC/AHRQ areas for funding research on measures and data acquisition	→	Technical Advisory Subcommittee Releases additional findings on relative ranking of quality measures Continues analysis of measures as needed Recommends to NAC/AHRQ areas for funding research on measures and data acquisition
AHRQ contracts for evaluation of current user groups' practices and how change would affect the reports' utility for these users (go to Chapter 7)	→	AHRQ evaluates user groups' application of report findings to affect change	→	AHRQ incorporates updates to the reports based on user group evaluations and reexamines effectiveness of dissemination and partnership efforts
AHRQ seeks additional funding (go to Chapter 7)	→	AHRQ funds development/evaluation of measures and data sources	→	AHRQ continues to fund development and evaluation of measures and data sources

Conclusion

The committee recognizes the excellent work that has been done by AHRQ with regard to the publication of the NHQR and NHDR despite some resource constraints. The committee believes that these reports can be made more forward-looking and action-oriented, offering diverse audiences a picture of what constitutes desired health care, where shortcomings in care now lie, and what policies and practices may spur overall improvement in U.S. health care quality and disparities elimination. Sufficient additional resources will be required to support the role that the committee envisions the NHQR and NHDR playing in the future of U.S. quality improvement efforts.

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Internet Citation: Chapter 7: Implementing Recommended Changes (continued). Content last reviewed October 2014. Agency for Healthcare Research and Quality, Rockville, MD. https://archive.ahrq.gov/research/findings/final-reports/iomqrdrreport/futureqrdr7a.html

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