AHRQ Quality Indicators Fact Sheet
AHRQ Quality Indicators ToolkitFact Sheet on Inpatient Quality IndicatorsWhat are the Inpatient Quality Indicators?The Inpatient Quality Indicators (IQIs) include 28 provider-level indicators established by theAgency for Healthcare Research and Quality (AHRQ) that can be used with hospital inpatientdischarge data to provide a perspective on quality. They are grouped into the following four sets: Volume indicators are proxy, or indirect, measures of quality based on counts ofadmissions during which certain intensive, high-technology, or highly complex procedureswere performed. They are based on evidence suggesting that hospitals performing more ofthese procedures may have better outcomes.Mortality indicators for inpatient procedures include procedures for which mortality hasbeen shown to vary across institutions and for which there is evidence that high mortalitymay be associated with poorer quality of care.Mortality indicators for inpatient conditions include conditions for which mortality hasbeen shown to vary substantially across institutions and for which evidence suggests thathigh mortality may be associated with deficiencies in the quality of care.Utilization indicators examine procedures whose use varies significantly across hospitalsand for which questions have been raised about overuse, underuse, or misuse.Mortality for Selected Procedures and Mortality for Selected Conditions are compositemeasures that AHRQ established in 2008. Each composite is estimated as a weighted average,across a set of IQIs, of the ratio of a hospital’s observed rate (OR) to its expected rate (ER), basedon a reference population: OR/ER. The IQI-specific ratios are adjusted for reliability before theyare averaged, to minimize the influence of ratios that are high or low at a specific hospital bychance. Users may select from among several weighting options. The composite indicators areintended to be used primarily to monitor performance in national and regional reporting, and alsofor comparative reporting and quality improvement at the provider level. They are not intended toreflect any broader construct of quality, beyond that reflected in the component indicators.A Snapshot of the IndicatorsThe current provider-level IQIs are listed in Table 1, along with information on their annual ratesof incidence and status regarding endorsement by the National Quality Forum. A detailed Guide toInpatient Quality Indicators, software for calculating the measures, and software documentation areavailable on the AHRQ QI Web site: www.qualityindicators.ahrq.gov/modules/iqi resources.aspx.The guide includes a summary assessment for each of the individual indicators.Each year, AHRQ updates the IQIs to reflect changes to the International Classification ofDiseases, 9th Revision, Clinical Modification and Diagnosis-Related Group coding specifications,specifications of the indicators themselves, data elements reported in the Uniform Billing form, andother technical changes. Other revisions also are made to the indicators from time to time, asdetermined by continued analysis of the indicators and review by expert panels. All the changesmade are described in an online change log on the AHRQ QI Web pages.Tool A.1a
AHRQ Quality Indicators ToolkitTable 1. The 2013 Provider-Level Inpatient Quality Indicators, With 2011 Rates and National QualityForum Endorsement StatusNQF EndorsementIQI IndicatorVolume Indicators1 Esophageal resection2 Pancreatic resection4 Abdominal aortic aneurysm (AAA) repair5 Coronary artery bypass graft (CABG)6 Percutaneous coronary intervention (PCI)7 Carotid endarterectomy (CEA)Mortality Rates for Inpatient Procedures8 Esophageal resection9 Pancreatic resection11 AAA repair12 CABG13 Craniotomy14 Hip replacement30 PCI (not used in public reporting)31 CEA (not used in public reporting)Mortality Rates for Inpatient Conditions15 Acute myocardial infarction (AMI)32 AMI, without transfer cases16 Heart failure (CHF)17 Acute stroke18 Gastrointestinal hemorrhage19 Hip fracture20 PneumoniaUtilization Rates21 Cesarean delivery, uncomplicated33 Primary cesarean delivery, uncomplicated22 Vaginal birth after cesarean (VBAC), uncomplicated34 VBAC, all23 Laparoscopic cholecystectomy24 Incidental appendectomy in the elderly25 Bilateral cardiac catheterizationRate 7178.6096.1495.46857.879.5613.70Source: Healthcare Cost and Utilization Project, Nationwide Inpatient Sample, 2011.AHRQ Quality Indicators SoftwareAHRQ provides free software—in both SAS and Windows—for organizations to apply the IQIsto their own data to assist quality improvement efforts in acute care hospital settings. Both versionscontain all the AHRQ QI modules, including the IQIs. Both versions of the software include theIQI composites. Included in the software are data that allow hospitals to compare their measures tonational benchmarks, based on data from the State Inpatient Databases (SID). The most recentrelease of the software uses the most current data available from the SID for computation ofbenchmarks, which is a change from previous versions that had used 3-year averages. Themortality indicators can be risk adjusted, but utilization and volume are not.Tool A.1a
AHRQ Quality Indicators ToolkitFact Sheet on Patient Safety IndicatorsWhat are the Patient Safety Indicators?The Patient Safety Indicators (PSIs) include 18 provider-level indicators established by the Agencyfor Healthcare Research and Quality (AHRQ) that screen for adverse events that patientsexperience as a result of exposure to the health care system. These events may be amenable toprevention by changes at the system or provider level. PSIs are defined on two levels: Provider-level indicators capture potentially preventable complications for patients whoreceived their initial care and the complication of care within the same hospitalization.Provider-level indicators include only those cases where a secondary diagnosis and/orprocedure code flags a potentially preventable complication. These indicators can serve as ascreening tool for hospitals to identify areas for further examination and improvement.Area-level indicators capture all cases of the potentially preventable complication thatoccur in a given population (e.g., metropolitan area, county, or health plan) either duringhospitalization or in a subsequent hospitalization. Area-level indicators are specified toinclude principal diagnoses as well as secondary diagnoses, which adds cases involving acomplication that occurred in a separate hospitalization.Patient Safety for Selected Indicators is a new composite measure that AHRQ established in2009. The composite is estimated as a weighted average, across 11 PSIs, of the ratio of a hospital’sobserved rate (OR) to its expected rate (ER), based on a reference population: OR/ER. The PSIspecific ratios are adjusted for reliability before they are averaged, to minimize the influence ofratios that are high or low at a specific hospital by chance. Users may select from among severalweighting options, including National Quality Forum (NQF)-endorsed weights that omit three PSIsthat have not been individually endorsed by NQF.The composite indicator is intended to be used primarily to monitor performance in national andregional reporting, and also for comparative reporting and quality improvement at the providerlevel. It is not intended to reflect any broader construct of quality, beyond what is reflected in thecomponent indicators themselves.A Snapshot of the IndicatorsThe current provider-level PSIs are listed in Table 1, along with information on their annual ratesof incidence and status regarding NQF endorsement. Some of the PSIs also have area-levelversions, which are noted in the table.A detailed Guide to Patient Safety Indicators, software for calculating the measures, and softwaredocumentation are available on the AHRQ Quality Indicators Web site:www.qualityindicators.ahrq.gov/modules/psi resources.aspx. The Guide includes a summaryassessment for each of the individual indicators.Each year, AHRQ updates the PSIs to reflect changes made to the International Classification ofDiseases, 9th Revision, Clinical Modification and diagnosis-related group (DRG) codingspecifications, specifications of the indicators themselves, data elements reported in the UniformTool A.1b
AHRQ Quality Indicators ToolkitBilling form, and other technical changes. Other revisions also are made to the indicators from timeto time, as determined by continued analysis of the indicators and review by expert panels.Changes made each year are reported in an online change log on the AHRQ QI Web pages.Table 1. The 2013 Provider-Level Patient Safety Indicators, With 2011 Rates and National QualityForum Endorsement StatusNQF EndorsementIndicator2 Death in low-mortality DRGs3 Pressure ulcer (formerly decubitus ulcer)4 Death among surgical inpatients5 Retained Surgical Item or Unretrieved DeviceFragment Count (formerly foreign body left duringprocedure)6 Iatrogenic pneumothorax7 Central venous catheter-related bloodstreaminfection8 Postoperative hip fracture9 Perioperative hemorrhage or hematomarate(formerly postoperative hemorrhage orhematoma)10 Postoperative physiologic and metabolicderangements11 Postoperative respiratory failure12 Perioperative pulmonary embolism or deep veinthrombosis (formerly postoperative pulmonaryembolism or deep vein thrombosis)13 Postoperative sepsis14 Postoperative wound dehiscence15 Accidental puncture or laceration16 Transfusion reaction17 Birth trauma – injury to neonate18 Obstetric trauma – vaginal with instrument19 Obstetric trauma – vaginal without instrumentArea-LevelIndicatorXRate 133.9321.78Source: Nationwide Inpatient Sample, 2011; rates per 1,000.*Please note that the provider-level PSI 5 is a count (i.e., has no denominator), but the area-level PSI 21 is a rate.AHRQ Quality Indicators SoftwareAHRQ provides free software—in both SAS and Windows—for organizations to apply the PSIsto their own data to assist quality improvement efforts in acute care hospital settings. Both versionsof the software include all the AHRQ QI modules, including the PSIs. Both versions of thesoftware include the PSI composite.Included in the software are data that allow hospitals to compare their measures to nationalbenchmarks, based on data from the State Inpatient Databases (SID). The most recent release of thesoftware uses the most current data available from the SID for computation of benchmarks, whichis a change from previous versions that had used 3-year averages.Tool A.1b
AHRQ Quality Indicators ToolkitMany of the PSIs are calculated using present on admission (POA) codes in the hospital dischargedata. In the latest version of the software, the user has the option to choose whether to use actual orpredicted data for POA. For users with POA data that choose to use it, PSIs are calculated basedon that data element. For users without POA data or those who choose to use predicted data, themodel incorporates the likelihood that the numerator event or the comorbidity was present onadmission.Rates for most PSIs can be risk adjusted except for PSI 17 (Birth Trauma - injury to neonate), PSI18 (OB trauma – vaginal w/instrument) and PSI 19 (OB trauma – vaginal w/o instrument). Thesethree PSIs are not risk-adjusted because materially important risk factors are not available in theState inpatient discharge data. Several other PSIs cannot be risk adjusted because they are very rareand/or treated as sentinel events (PSI 2, PSI 5, PSI 16).Tool A.1b
AHRQ Quality Indicators ToolkitInstructionsINSTRUCTIONSBoard/Staff PowerPoint Presentations on the Quality IndicatorsWhat is this tool?The purpose of the PowerPoint presentation for the board and staff is to help the board members and relevant staffunderstand the importance and financial and clinical implications of the AHRQ Quality Indicators.Who are the target audiences?The key users of this tool are the quality officers and senior management staff who are educating the hospital boardand staff about the Quality Indicators.How can the tool help you?This tool can be a standalone educational resource or serve as a resource to condense key points for presentationto your quality and patient safety committees, boards, organizational leaders, medical and surgical committees andperformance improvement teams.How does this tool relate to others?This tool is part of the Readiness To Change section in the Toolkit Roadmap. It can be related to the selfassessment tool by providing a rich knowledge base on the use of the AHRQ Quality Indicators to identify qualitytopics for monitoring and performance improvement. An organization needs a thorough understanding of theseindicators and their impact to evaluate the organization’s infrastructure to support improvement efforts.Instruction StepsUse and select the following slides to develop a presentation for your board/staff.Tool A.2
AHRQ Quality Indicators ToolkitThe Agency for HealthcareResearch and QualityQuality IndicatorsBackground for Hospital BoardsDateTool A.2
AHRQ Quality Indicators ToolkitWhy are we here today?The board needs to: Understand the importance of the AHRQ QualityIndicators (QIs) Understand the financial and clinical implications ofthe QIs for our organization Endorse the QIs as a tool for implementing andmonitoring improvement Make the QIs a priority within our organizationTool A.2
AHRQ Quality Indicators ToolkitLeadership is key to improvement Hospital boards are increasingly turning to the QIsas a tool for monitoring performance, particularly onpatient safety To be successful, improvement efforts withinhospitals need to have attention and active supportfrom boards and senior hospital leadership Your active support will demonstrate that thehospital has made it a priority to improve quality andpatient safety This support will help to motivate our staff to engagefully in improvement activitiesTool A.2
AHRQ Quality Indicators ToolkitWhat is AHRQ? The Agency for Healthcare Research and Quality:––––Is part of the U.S. Department of Health and HumanServicesSupports research designed to improve the outcomes andquality of health care, reduce its costs, address patientsafety and medical errors, and broaden access to effectiveservicesSponsors, conducts, and disseminates research to helppeople make more informed decisions and improve thequality of health care servicesActs as the regulator for Patient Safety Organizations thatare certified under the Patient Safety and QualityImprovement ActTool A.2
AHRQ Quality Indicators ToolkitWho developed the QIs? AHRQ contracted with an Evidence-based PracticeCenter (EPC) to develop the QIs The EPC team developed the QIs from 1998 to2002:–––Conducted a review of the evidence related to qualitymeasurement based on administrative dataIdentified candidate indicators using interviews, literaturereview, Web search and other sourcesConducted extensive tests of the validity and reliability of themeasures Pediatric measures were developed laterGeneral Questions About the AHRQ QIs. AHRQ Quality Indicators. July 2004. Agency for HealthcareResearch and Quality, Rockville, MD. www.qualityindicators.ahrq.gov/FAQs Support/default.aspx.Tool A.2
AHRQ Quality Indicators ToolkitWhat are the Quality Indicators? The QIs identify quality topics for monitoring andperformance improvement:––––Use hospital administrative dataHighlight potential quality concernsIdentify areas that need further study and investigationTrack changes over time Because we cannot always measure “quality ofcare” per se, we use certain measures as an“indicator” of qualityGeneral Questions About the AHRQ QIs. AHRQ Quality Indicators. July 2004. Agency forHealthcare Research and Quality, Rockville, MD.www.qualityindicators.ahrq.gov/FAQs Support/default.aspx.Tool A.2
AHRQ Quality Indicators ToolkitWhy were the QIs developed? Because safety is so important, AHRQdeveloped QIs to provide health caredecisionmakers with user-friendly data andtools that will help them:–––Assess the effects of health care program andpolicy choicesGuide future health care policymakingAccurately measure outcomes, community accessto care, and utilizationGeneral Questions About the AHRQ QIs. AHRQ Quality Indicators. July 2004. Agency forHealthcare Research and Quality, Rockville, MD.www.qualityindicators.ahrq.gov/FAQs Support/default.aspx.Tool A.2
AHRQ Quality Indicators ToolkitWhy are the AHRQ QIs important? Some QIs will be publicly reported on CMS’s*Hospital Compare CMS is no longer reimbursing hospitals for somehospital-acquired conditions and safety eventsmeasured by the QIs Fewer resources are available to collect datamanually and develop customized quality metrics thatmay not be accepted by the rest of the field Sciences of quality and safety are maturing: payersand regulators are taking a lead in dictating projectareas* CMS Centers for Medicare & Medicaid Services.Tool A.2
AHRQ Quality Indicators ToolkitHow are the AHRQ QIs structured? Definitions based on:––ICD-9-CM diagnosis and procedure codesOften along with other measures (e.g., DRG, MDC, sex,age, procedure dates, admission type) Numerator number of cases with the outcome ofinterest (e.g., cases with pneumonia) Denominator population at risk (e.g., communitypopulation) Observed rate numerator/denominator Some QIs measured as volume countsICD-9-CM International Classification of Diseases, 9th Revision, Clinical Modification; DRG diagnosis-related group; MDC major diagnostic classification.Source: ions.aspx.Tool A.2
AHRQ Quality Indicators ToolkitFour Quality Indicator Modules Patient Safety Indicators (PSIs) reflect quality ofcare inside hospitals but focus on potentiallyavoidable complications and iatrogenic events Inpatient QIs reflect quality of care inside hospitals,including inpatient mortality for medical conditionsand surgical procedures Pediatric QIs reflect quality of care inside hospitalsand identify potentially avoidable hospitalizationsamong children Prevention QIs identify hospital admissions thatevidence suggests could have been avoided, at leastin part, through high-quality outpatient careSource: www.qualityindicators.ahrq.gov/Default.aspx.Tool A.2
AHRQ Quality Indicators ToolkitWhat are the Patient Safety Indicators? The PSIs are a set of indicators for adverse eventsthat patients may experience as a result of exposureto the health care system A composite measure is also available These events are likely amenable to prevention bychanges at the system or provider level PSIs are measured using hospital administrative dataVersion 4.3 technical specifications. Agency for Healthcare Research and Quality, Rockville, MD.www.qualityindicators.ahrq.gov/Modules/PSI TechSpec.aspx.Tool A.2
AHRQ Quality Indicators ToolkitA PSI Example: Pressure Ulcer (PSI 3) Numerator: Discharges with ICD-9-CM code ofpressure ulcer stage III or IV in any secondarydiagnosis field among cases meeting the inclusionand exclusion rules for the denominator. Denominator: All medical and surgical dischargesage 18 years and older defined by specific DRGs orMedicare Severity ssure%20Ulcer%20Rate.pdfTool A.2
AHRQ Quality Indicators ToolkitWhat are the Inpatient Quality Indicators? The Inpatient Quality Indicators (IQIs) are a set of 32indicators of hospital quality of care The IQIs are measured using hospital administrativedata The IQIs include:–––Inpatient mortality for certain procedures and medicalconditionsUtilization of procedures for which there are questions ofoveruse, underuse, and misuseVolume of procedures for which there is some evidence thata higher volume is associated with lower mortalityInpatient Quality Indicators Overview. AHRQ Quality Indicators. February 2006. Agency forHealthcare Research and Quality, Rockville, MD.www.qualityindicators.ahrq.gov/modules/iqi overview.aspx.Tool A.2
AHRQ Quality Indicators ToolkitAn IQI Example: Coronary ArteryBypass Graft Mortality Rate (IQI 12) Numerator: Number of deaths among cases meetingthe inclusion and exclusion rules for the denominator. Denominator: Discharges, age 40 years and older,with ICD-9-CM CABG code in any procedure rtality%20Rate.pdf.Tool A.2
AHRQ Quality Indicators ToolkitHow can the AHRQ QIs be used inquality assessment? QIs can be used to flag potential problems in qualityof care QIs can be used to assess performance andcompare against peer hospitals Examples of hospital use of QIs in the literature haveexamined the impact of:–––Health information technology on quality of careHospital board quality committees on quality of careEvaluation of effectiveness of nurse staffing and caredeliveredSource: www.qualityindicators.ahrq.gov/Default.aspx and AHRQ Quality Indicator ToolkitLiterature Review.Tool A.2
AHRQ Quality Indicators ToolkitIf you already have your currentPSI/IQI data available: use slides 1819If you do not have your PSI/IQI dataavailable: use slides 20-21.DELETE THIS SLIDE
AHRQ Quality Indicators ToolkitCurrent performance on the AHRQ QIs INSERT GRAPHS OR TEXT FROM YOURHOSPITAL’S DATA HERETool A.2
AHRQ Quality Indicators ToolkitNext Steps1. Identify priorities for quality improvement2. Establish goals and performance targets3. Formulate an action plan to develop amultidisciplinary team for Quality IndicatorworkTool A.2
AHRQ Quality Indicators ToolkitAn Example of a Report on HospitalPerformance on the AHRQ QIsTool A.2
AHRQ Quality Indicators ToolkitNext Steps1. Run a QI report with most recent quarter’sdata2. Review QI report at next board meeting3. Identify priorities for quality improvement4. Establish goals and performance targets5. Formulate an action plan to developmultidisciplinary team for QI workTool A.2
AHRQ Quality Indicators ToolkitINSTRUCTIONSBoard/Staff PowerPoint Presentations on the AHRQ Quality IndicatorsWhat is this tool? The purpose of the PowerPoint presentation for the board and staff is to helpthe board members and relevant staff understand the importance and financial and clinicalimplications of the Agency for Healthcare Research and Quality (AHRQ) Quality Indicators.Who are the target audiences? The key users of this tool are the quality officers and seniormanagement staff who are educating the hospital board and staff about the Quality Indicators.How can the tool help you? This tool can be a standalone educational resource or serve as aresource to condense key points for presentation to your quality and patient safety committees,boards, organizational leaders, medical and surgical committees, and performance improvementteams.How does this tool relate to others? This tool is part of the Readiness To Change section in theToolkit Roadmap. It can be related to the self-assessment tool by providing a rich knowledgebase on the use of the AHRQ Quality Indicators to identify quality topics for monitoring andperformance improvement. An organization needs a thorough understanding of these indicatorsand their impact to evaluate the organization’s infrastructure to support improvement efforts.Instruction StepsUse and select the following slides to develop a presentation for your board/staff.1Tool A.2
AHRQ Quality Indicators ToolkitThe Agency for HealthcareResearch and Quality(AHRQ)Quality IndicatorsBackground for HospitalBoardsDate2Tool A.2
AHRQ Quality Indicators ToolkitWhy are we here today?The board needs to: Understand the importance of the AHRQQuality Indicators (QIs) Understand the financial and clinicalimplications of the QIs for our organization Endorse the QIs as a tool for implementingand monitoring improvement Make the QIs a priority within ourorganization3Tool A.2
AHRQ Quality Indicators ToolkitLeadership is key toimprovement Hospital boards are increasingly turningto the QIs as a tool for monitoringperformance, particularly on patientsafety To be successful, improvement effortswithin hospitals need to have attentionand active support from boards andsenior hospital leadership Your active support will demonstrate thatthe hospital has made it a priority toimprove quality and patient safety This support will help to motivate our staffto engage fully in improvement activities4Tool A.2
AHRQ Quality Indicators ToolkitWhat is AHRQ?The Agency for Healthcare Research andQuality Is part of the U.S. Department of Healthand Human Services Supports research designed to improvethe outcomes and quality of health care,reduce its costs, address patient safetyand medical errors, and broaden accessto effective services Sponsors, conducts, and disseminatesresearch to help people make moreinformed decisions and improve thequality of health care services Acts as the regulator for Patient SafetyOrganizations that are certified under thePatient Safety and Quality ImprovementAct5Tool A.2
AHRQ Quality Indicators ToolkitWho developed the QIs? AHRQ contracted with an Evidence-basedPractice Center (EPC) to develop the QIs The EPC team developed the QIs from1998 to 2002:– Conducted a review of the evidencerelated to quality measurement basedon administrative data– Identified candidate indicators usinginterviews, literature review, Websearch and other sources– Conducted extensive tests of thevalidity and reliability of the measures Pediatric measures were developed later All the indicators were updated annuallyGeneral Questions About the AHRQ QIs. AHRQ Quality Indicators. July 2004. Agency forHealthcare Research and Quality, Rockville, MD.www.qualityindicators.ahrq.gov/FAQs Support/default.aspxNotes:Additional background information ces/Presentations/2010/QI 101 2011-03-02current.pdf6Tool A.2
AHRQ Quality Indicators ToolkitWhat are the QualityIndicators? The QIs identify quality topics formonitoring and performance improvement:– Use hospital administrative data– Highlight potential quality concerns– Identify areas that need further studyand investigation– Track changes over time Because we cannot always measure“quality of care” per se, we use certainmeasures as an “indicator” of qualityGeneral Questions About the AHRQ QIs. AHRQ Quality Indicators. July 2004. Agency forHealthcare Research and Quality, Rockville, MD.www.qualityindicators.ahrq.gov/FAQs Support/default.aspx7Tool A.2
AHRQ Quality Indicators ToolkitWhy were the QIs developed? Because safety is so important, AHRQdeveloped QIs to provide health caredecisionmakers with user-friendly dataand tools that will help them:– Assess the effects of health careprogram and policy choices– Guide future health care policymaking– Accurately measure outcomes,community access to care, andutilizationGeneral Questions About the AHRQ QIs. AHRQ Quality Indicators. July 2004. Agency forHealthcare Research and Quality, Rockville, MD.www.qualityindicators.ahrq.gov/FAQs Support/default.aspx8Tool A.2
AHRQ Quality Indicators ToolkitWhy are the AHRQ QIsimportant? A number of IQIs and PSIs are publiclyreported on CMS Hospital Compare CMS is no longer reimbursing hospitalsfor some hospital-acquired conditions andsafety events Fewer resources are available to collectdata manually and develop customizedquality metrics that may not be acceptedby the rest of the field Sciences of quality and safety arematuring: payers and regulators aretaking a lead in dictating project areas* CMS Centers for Medicare & Medicaid Services.9Tool A.2
AHRQ Quality Indicators ToolkitHow are the AHRQ QIsstructured? Definitions based on:– ICD-9-CM diagnosis and procedurecodes– Often along with other data elements(e.g., DRG, MDC, sex, age, proceduredates, admission type) Numerator number of cases with theoutcome of interest (e.g., cases withpneumonia) Denominator population at risk (e.g.,community population) Observed rate numerator/denominator Some QIs measured as volume countsICD-9-CM International Classification of Diseases, 9th Revision, Clinical Modification; DRG diagnosis-related group; MDC major diagnostic classification.Source: ions.aspx.10Tool A.2
AHRQ Quality Indicators ToolkitFour Quality Indicator Modules Patient Safety Indicators (PSIs) reflectquality of care inside hospitals but focuson potentially avoidable complicationsand iatrogenic events Inpatient QIs reflect quality of care insidehospitals, including inpatient mortality formedical conditions and surgicalprocedures Pediatric QIs reflect quality of care insidehospitals and identify potentiallyavoidable hospitalizations among children Prevention QIs identify hospitaladmissions that evidence suggests couldhave been avoided, at least in part,through high-quality outpatient careSource: www.qualityindicators.ahrq.gov/Default.aspx.11Tool A.2
AHRQ Quality Indicators ToolkitWhat are the Patient SafetyIndicators? The PSIs are a set of indicators foradverse events that patients mayexperience as a result of exposure to thehealth care system A composite measure is also available These events are likely amenable toprevention by changes at the system orprovider level PSIs are measured using hospitaladministrative dataVersion 4.3 technical specifications. Agency for Healthcare Research and Quality, Rockville,MD. www.qualityindicato
Fact Sheet on Inpatient Quality Indicators . What are the Inpatient Quality Indicators? The Inpatient Quality Indicators (IQIs) include 28 provider-level indicators established by the Agency for Healthcare Research and Quality (AHRQ) that can be used with hospital inpatient discharge data to provide a perspective on quality.
Goals and Scope Goals - Develop two sets of quality indicators that are applicable to the emergency department setting Patient Safety Indicators (PSI) Prevention Quality Indicators (PQI) - Set the stage for future incorporation into publicly available AHRQ QI software Scope - Implement the established AHRQ QI measurement development process
AHRQ Quality Indicators Guide to Patient Safety Indicators Department of Health and
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Then the O/E ratio is multiplied by the indicator rate for the reference population from the SID. 2 Tool B.1 . AHRQ Quality Indicators Toolkit . Smoothed rate. The smoothed rate is a weighted average of the hospital’s risk-adjusted rate and the
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Documenting your plan and tracking progress Document your plan in a way that works for you Tools available online – AHRQ Dissemination Planning Tool – Knowledge Translation Planning Template – CalSWEC Dissemination Planning Tool (modified from AHRQ) AHRQ Dissemination . Planning Tool. Knowledge Transition Planning Template
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