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Quality Assessment

 

Quality of Care

Americans as Health Care Consumers: The Role of Quality
   Information
Americans as Health Care Consumers: Update on the Role of
   Quality Information
Case Studies from the Quality Improvement Support System
The Challenge and Potential for Assuring Quality Health Care
   for the 21st Century
Expanding Patient-Centered Care To Empower Patients and
   Assist Providers
Improving Health Care Quality: Fact Sheet
National Healthcare Disparities Report: Summary
National Healthcare Quality Report: Summary
National Quality Measures Clearinghouse™
Oregon Consumer Scorecard Project
Partnerships for Quality: Fact Sheet
Q-SPAN: Expanding and Improving Quality of Care Measures
Quality Interagency Coordination Task Force (QuIC): Fact Sheet
Reducing Errors in Health Care
Theory and Reality of Value-Based Purchasing: Lessons from
   the Pioneers
Your Guide to Choosing Quality Health Care

Consumer Assessment of Health Plans (CAHPS®)

CAHPS® Fact Sheet
CAHPS® Overview
CAHPS® 2.0 Questionnaires (Download)
CAHPS® User Stories
From the Pipeline of Health Services Research—CAHPS®

AHRQ Quality Indicators
Technical Reviews

Refinement of the HCUP Quality Indicators
   Summary / Technical Review (File Download) (May 2001)

User Liaison Program Conferences and Workshops

Ensuring Quality Health Care: The Challenges of Measuring
   Performance and Consumer Satisfaction
Workshop Summary, June 4-6, 1997
Health Workforce Shortages: Quality Concerns and Policy Options
Web Conference, April 23 and 30, 2003
Making Quality Count: Tools, Strategies, and Resources
Web Conference, February 10 and 18, 2004

Agency Press Releases
10/27/04 Limiting Medical Interns' Work to 16 Consecutive Hours Can Substantially Reduce Serious Medical Errors in Intensive Care Units
9/30/04 AHRQ Releases Guide to Using Its Quality Indicators for Hospital Quality Reporting and Payment
5/3/04 Studies Show Lower Nurse Staffing Levels Contribute To Poor Patient Outcomes

Speeches and Testimony
3/19/04 Testimony on Health Care Quality Initiatives
4/30/98 AHCPR's Role in Ensuring Americans of Quality Health Care
2/26/98 Testimony on Assessing Health Care Quality
11/18/97 Statement on Health Care Research and Quality Improvement
10/28/97 Testimony on Health Care Quality
Research Findings

Research Activities, May 2004:
QI approaches improved diabetes care in Midwest community health centers in 1 year
Deaf and hearing-impaired patients suggest ways doctors can improve communication to improve care quality and safety
Significant pain is common among hospitalized patients, even those at low risk for pain
Researchers find New York SCHIP improves health care access, continuity, and quality

Research Activities, April 2004:
Researchers examine ways to measure the quality of health services for children and adolescents

Research Activities, March 2004:
Both low- and high-risk patients benefit from undergoing coronary bypass surgery at high-volume hospitals
Updated ICU information systems substantially free nurses from documentation, giving them more time for direct patient care
Nurses' contributions to patient-centred care and care equity are important components of health care quality
Physicians are much less likely to examine patients in contact isolation, compared with nonisolated patients

Research Activities, January 2004:
Racial differences exist in parents' opinions about the quality of primary care provided to their children
Interdisciplinary teamwork is a key to patient safety in the operating room, ICU, and ER
Using chlorhexidine gluconate solution for vascular catheter site care greatly reduces the risk of catheter-related infection
Changing health insurance plans might adversely affect a persons' care as well as increase care costs during the first year
Following an urban hospital closure, remaining hospitals operate more efficiently due to high admissions

Research Activities, December 2003:
Surgical patients fare better at hospitals with a higher proportion of registered nurses who have bachelor's degrees
Hospital isolation policies to prevent spread of infection may inadvertently reduce care quality for isolated patients
People with disabilities are generally satisfied with their care but report poor communication and lack of thorough care
Studies focus on systems for reporting medical errors and quality issues
Researchers focus on diabetes care

Research Activities, November 2003:
Duration of catheterization and other factors increase the likelihood of catheter-related urinary tract infection
California HMOs rely on informal evaluations of quality, not hospital report cards, to select hospitals for contracting

Research Activities, October 2003:
Increasing the excision margins around melanoma to recommended widths could substantially reduce mortality rates
Managed care patients with glaucoma are receiving recommended care, but care could be improved in a few areas
Patient and practice socioeconomic status are independently associated with care among privately insured patients
Nursing home facility characteristics and quality-of-care factors may contribute to unnecessary hospitalization of residents

Research Activities, September 2003:
Physician-led, low-key quality improvement efforts can improve care for patients undergoing coronary bypass surgery
Quality improvement initiatives can improve health care for minorities
Organizational culture and leadership, as well as medical informatics, play important roles in quality improvement
U.S. hospitals have become greatly overcrowded, resulting in overloaded ERs and diverted ambulances
Physicians are likely to remain influential in certain areas of health policy reform
Generalist physicians experienced in HIV/AIDS care can provide care comparable to that of HIV/AIDS specialists

Research Activities, August 2003:
Physicians are more likely to intensify therapy for diabetes when they get unfavorable blood-sugar test results during visits

Research Activities, July 2003:
Physicians exhibit certain behaviors when treating patients who are in pain
Patients who receive stem cell transplants at high-volume transplant centers are less likely to die or fail treatment
Common physician medication errors could be prevented by linking laboratory and pharmacy information systems
Disclosure to patients of in-hospital medical errors has increased, but there is room for improvement
Financial consequences for doctor referrals to specialists affect patient satisfaction but not outcomes

Research Activities, June 2003:
Patient safety problems in hospitalized children are substantial
Physicians have an important role to play in improving patient safety and quality of care

Research Activities, May 2003:
Medical errors affect 2 to 3 percent of hospitalized children and are more common in those with special medical needs
Both low- and high-risk patients fare better when they undergo cardiovascular procedures at high-volume hospitals
Reading a large volume of mammograms is only one factor influencing radiologists' accuracy
Quality of the primary care doctor-patient relationship has eroded, even for a doctor's long-time patients
Better access to quality outpatient care for sickle cell disease could reduce patients' heavy reliance on expensive ER care

Research Activities, April 2003:
Certain factors increase the likelihood that sponges or instruments will be left inside a surgical patient
Adequate nurse staffing and managerial support foster better patient care and reduce nurse dissatisfaction and burnout

Research Activities, March 2003:
Whenever possible, heart attack patients at high risk of death should receive angioplasty, not thrombolytic therapy
Four AHRQ-funded studies focus on health care quality

Research Activities, February 2003:
New report provides an overview of children's insurance coverage, health care use and expenditures, and quality of care
More than half of all Medicaid-insured children with chronic conditions receive generalist-only care
Higher primary care density is associated with fewer preventable hospital admissions
Studies focus on the quality of hospital emergency care
Researchers examine access to care and quality for Medicaid MCO enrollees who have disabilities

Research Activities, January 2003:
Patients undergoing hip replacement surgery fare better when their surgeons perform 10 or more of these surgeries per year
Many doctors lack basic knowledge about venous thromboembolism and how to treat it
Researchers identify characteristics and training of complementary and alternative medical providers

Research Activities, December 2002:
Community radiologists vary widely in how they interpret the same screening mammograms
Patient satisfaction seems to lead to higher quality of care for depression
Physicians' involvement in patient safety and quality of care may be pivotal to maintaining medicine's credibility

Research Activities, November 2002:
Practice sites and medical groups may be more meaningful sources for measuring health care quality than health plans

Research Activities, September 2002:
Consumers may be willing to accept restrictions on provider access in exchange for high quality of care
Health plan report cards may have limited relevance for certain vulnerable patient groups

Research Activities, August 2002:
Fewer registered nurses in hospitals linked to more cases of postoperative pneumonia
Both hospital characteristics and board certification of anesthesiologists affect patient outcomes

Research Activities, July 2002:
Fee-for-service Medicare plans offer better quality care than Medicare HMO plans, but costs are higher
Cancer patients' satisfaction with primary care pain management hinges on the doctor-patient relationship

Research Activities, June 2002:
Obese patients have a greater illness burden than other patients and usually are less satisfied with their health care
Accreditation of managed care health plans does not necessarily ensure high quality care or higher enrollment rates
Collaborations between medical informatics and health services reseach are a natural bridge to improved health care quality

Research Activities, May 2002:
More than one in three seriously ill people who prefer comfort care over aggressive treatment don't get it
Peer review organizations may need to reconsider the use of physician and nurse reviews of quality of care
Elderly blacks and whites enrolled in Medicare managed care plans do not receive the same quality of care

Research Activities, April 2002:
Directing certain bypass patients from low- to high-volume hospitals could balance clinical benefits with patient choice
Elderly heart attack patients treated in VA and non-VA hospitals are equally likely to receive appropriate medications
Training, feedback on performance, and clinical reminders may encourage doctors to intensify therapy for patients who need it
Certain verbal and nonverbal behaviors by physicians are associated with favorable patient outcomes

Research Activities, March 2002:
Researchers examine ways to assess the quality of care provided by preferred provider organizations

Research Activities, February 2002:
Medicare health plans that provide better access to care and customer service also provide better clinical care
Misunderstandings and miscommunication are hallmarks of a problematic doctor-patient relationship

Research Activities, January 2002:
Researchers examine anemia, dialysis methods, and nephrologist referral among patients with kidney disease

Research Activities, December 2001:
Plain x-rays often do not reveal certain types of cervical spine injuries in victims of blunt trauma
Few doctors take measures to prevent bone loss and related fractures among people on long-term steroid therapy
Office-based quality improvement programs can substantially improve delivery of pediatric preventive services
Even patients with a doctor in the family face challenges in receiving optimal medical care
Medicare fee-for-service patients seem to fare better in areas of higher HMO market penetration

Research Activities, November 2001:
Changes in physician behavior are necessary to improve quality of pediatric care
Researchers examine the impact of the health care workplace on quality of care and patient safety

Research Activities, October 2001:
Increasing Medicaid reimbursement to nursing homes slightly improves quality of care
Large remote rural towns may provide the best conditions for high-quality care of older people with diabetes
England and the United States differ in their approaches to improving cardiac care
Researchers examine the impact of consumer health plan reports on plan choices and quality of care

Research Activities, September 2001:
No-fault approaches to medical injury may improve care quality over the current malpractice litigation environment

Research Activities, July 2001:
Sepsis evaluation in hospitalized infants with lower respiratory tract infections varies greatly
Health care organizations can reclaim dissatisfied patients by developing effective service recovery programs
Doctors' dissatisfaction grew steadily over the last decade

Research Activities, June 2001:
New AHRQ-funded studies focus on quality improvement in diabetes, atrial fibrillation, and end-of-life care
Researchers develop new system for identifying successful hospital quality improvements
Nurses have an important role in improving health care quality

Research Activities, April 2001:
Efforts to improve the quality of health care services for children show positive results

Research Activities, February 2001:
Pain during cataract surgery and postoperative side effects are minor for most patients but vary by type of anesthesia

Research Activities, December 2000:
Rankings of health plans by sicker and healthier patients may differ substantially
AHRQ's Building Bridges Conferences show that health services research can drive improvements in quality of care
Researchers are developing and testing an instrument to examine quality of care for Chinese and Vietnamese Americans

Research Activities, November 2000:
Insurance coverage does not guarantee access to high-quality health care services

Research Activities, October 2000:
Depending on how it's measured, health plan performance may vary by enrollee ethnicity, education, and income

Research Activities, September 2000:
Teaching hospitals provide better care for older heart attack patients
Hospital grades on quality-of-care report cards may not truly reflect actual quality at a specific hospital

Research Activities, June 2000:
Quality of care measures need to account for socioeconomic and racial/ethnic disparities in health care

Research Activities, May 2000:
Race, not sex, limits access to life-saving therapies for heart attack patients
Consumers' assessments of Medicare managed care plans can distinguish different dimensions of quality of care

Research Activities, April 2000:
Researchers assess programs to improve the quality of primary care for depression in managed care

Research Activities, February 2000:
President Clinton announces new actions to improve patient safety and assure health care quality
Total quality management appears to have little impact on outcomes of coronary bypass surgery patients
"Best practices" guidelines can facilitate quality of care improvements in the emergency department
Level of education attained by patients is important when evaluating physician performance

Research Activities, January 2000:
Substantial variations found in spending by U.S. hospitals on quality improvement activities


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