AHRQ--Agency for Healthcare Research and Quality: Advancing Excellence in Health Care

NEWS from 2004

December 22 2004 – Release of Agency for Healthcare Research and Quality (AHRQ) Inpatient Quality Indicators Version 2.1, Revision 4

AHRQ is pleased to announce an update of the AHRQ Inpatient Quality Indicators (IQIs), Version 2.1, Revision 4. All updated IQI documentation and software are now available for download or viewing on the AHRQ Quality Indicators website (iqi_download).

Revision 4 incorporates changes to ICD-9-CM codes and DRGs effective October 1, 2004 (Fiscal Year 2005). With this software update, the IQI definitions now include ICD-9 CM codes valid from October 1, 1994 through September 30, 2005.

The IQI software has been enhanced to offer the calculation and reporting of the expected rate at the stratification level selected by the user. The SAS® and SPSS® software syntax now calculates and reports the observed rate, risk-adjusted rate, expected rate and the smoothed rate.

The indicator changes and ICD-9 CM coding updates are detailed in two documents, the IQI Change Log and IQI Indicator Changes, also available on the website. All IQI documents have been updated including the Guide to the Inpatient Quality Indicators, the IQI SAS Software Documentation, and IQI SPSS Software Documentation. These documents incorporate stylistic changes, are available in Microsoft® Word® and PDF format, and include the updated IQI indicator definitions.

AHRQ is committed to continued refinement and enhancement of the QIs based on feedback from users, knowledge gained through direct use, and new scientific evidence. For example, the Support for quality Indicators (SQI-II) contract team is currently reviewing the literature related to each QI to both update the knowledge base underlying the indicators and to identify any evidence that may suggest potential refinement of any indicator. Significant information can be also obtained through user feedback and engaging in applied research and quality improvement efforts.

We welcome your feedback on indicator definitions, the QI software, and related documentation. We also welcome hearing from you about your use of the indicators or "case studies" to assist AHRQ in identifying projects that translate research into practice.

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November 24 2004 – Release of AHRQ Prevention Quality Indicators Version 2.1, Revision 4

AHRQ is pleased to announce an update of the AHRQ Prevention Quality Indicators (PQIs), Version 2.1, Revision 4. All updated PQI documentation and software are now available for download or viewing on the AHRQ Quality Indicators website (pqi_download).

PQI Revision 4 is valid for use with discharges occurring in Fiscal Year 1995 (FY 1995) through Fiscal Year 2005 (FY 2005) or from October 1, 1994 through September 30, 2005. After a complete review of the ICD-9-CM codes and DRGs that were effective October 1, 2004 (FY 2005) it was determined no changes were required to the PQI definitions. The documentation accompanying this release was modified to reflect the timeframe update.

In addition to updating the documentation to reflect the currency of PQI definitions, the four PQIs related to diabetes now have the option of calculating a state and age level condition-specific rate using prevalence data from the National Diabetes Surveillance System at CDC. The PQI software includes a new module in SAS (PQSASC2.SAS) and SPSS (PQSPSC2.SPS) to calculate the state and age level condition-specific observed rates.

All changes included in Revision 4 are detailed in two documents, the PQI Change Log and PQI Indicator Changes, also available on the website. All PQI documents have been updated including new versions of the Guide to the Prevention Quality Indicators, the PQI SAS Software Documentation, and PQI SPSS Software Documentation. The revised documents incorporate several stylistic changes, and reference the new option available for calculating condition-specific rates for each of the four diabetes indicators (PQIs 1, 3, 14, and 16).

Documents are available for download from the AHRQ Quality Indicators Web Site (pqi_download) in Microsoft Word and PDF format.

AHRQ is committed to continued refinement and enhancement of the QIs based on feedback from users, knowledge gained through direct use, and new scientific evidence. For example, the Support for quality Indicators (SQI-II) contract team is reviewing the literature related to each QI to both update the knowledge base underlying the indicators but also to identify any evidence that may suggest potential refinement of any indicator. Significant information can be also obtained through user feedback and engaging in applied research and quality improvement efforts.

We welcome your feedback on indicator definitions, the QI software, and related documentation. We also welcome hearing from you about your use of the indicators or "case studies" to assist AHRQ in identifying projects that translate research into practice.

Please submit feedback, questions and comments regarding the AHRQ Quality Indicators to QIsupport@ahrq.hhs.gov.

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November 19 2004 – AHRQ Quality Indicators Patient Safety Indicators (PSI) Version 2.1, Revision 2 Update

The AHRQ Quality Indicators Support Team has posted updated files for the Patient Safety Indicators Version 2.1, Revision 2, originally released on October 22, 2004. NONE OF THE UPDATES IMPACT THE CALCULATION OF PSI RATES.

  1. Output of comma-delimited files. This change pertains to an option provided for PSSASP2.SAS and PSSASP3.SAS to export program output to comma-delimited files that can then be read by EXCEL. The update corrects the syntax for this option in PSSASP3.SAS and corrects a duplicate column heading in both PSSASP2 and PSSASP3. The change does not affect the SPSS syntax.
  2. U.S. Census Data. The SAS and SPSS zip files were changed to exclude the QICTYAxx.TXT census files, which are used in the calculation of risk-adjusted area rates. Because the PSI area indicators are not risk-adjusted, these files are not required for the PSI module.
  3. PSI Covariates Table. The PSI Covariates Table (psi_covariates_rev2.doc and psi_covariates_rev2.pdf) has been updated to include additional columns (i.e. the number of covariates and the odds ratio) and to correct the covariate labels. The change does not affect the covariate values, the risk-adjustment model or the calculation of risk-adjusted rates. The Table is for documentation purposes only.

The updated files are available for download at the AHRQ Quality Indicators Web site: psi_download

Any questions regarding this update may be directed to the AHRQ Quality Indicators Support Team via email: QIsupport@ahrq.hhs.gov

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November 1 2004 – AHRQ Quality Indicator Training from A to Z

This intensive, 6-hour session will be conducted over 2 days by experienced RTI, International and AHRQ Staff; and is intended to help participants understand how: (1) QIs are constructed, (2) resulting data output can be interpreted, and (3) results can be used for surveillance and quality improvement activities. Part of the session will include the opportunity to do some hands on work with the data based on case studies tailored to the needs of hospital association and health system users. All participants will receive a training manual of workshop materials that will serve as a reference tool to support future applications of the QIs.

Session Objectives

By the completion of the 6 hour program participants will:

  • Have a general understanding of the development of the QIs, the purpose of each type of QI, the evidence base for their inclusion as part of the suite of AHRQ quality tools, where to access data and software used to construct the QIs and benefits and limitations of using the QIs for quality improvement or comparative reporting.
  • Have an understanding of select measurement issues that are likely to be encountered when using the QIs.
  • Use activity-based learning experiences related to indicator construction, data output interpretation, and application of results for quality monitoring and surveillance activities.
  • Have an opportunity for an interactive forum for participant Q&A.
  • Leave with a set of reference tools that can be used to support future application.

When and Where

Part I: December 7, 2004 at 3:30-5:30 pm

Part II: December 8, 2004 at 8:00 am - 12:30 pm

Both sessions will be held at the Hyatt Regency Washington on Capitol Hill Washington, DC.

Registration

To reserve a spot please contact NAHDO at nahdoinfo@nahdo.org or call DeAna Clark at 801-587-9104. Attendees can also register by mailing or faxing the attached registration form.

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October 22 2004 – Release of AHRQ Patient Safety Indicators Version 2.1, Revision 2

AHRQ is pleased to announce an update of the AHRQ Patient Safety Indicators (PSIs), Version 2.1, Revision 2.  All updated PSI documentation and software are now available for download or viewing on the AHRQ Quality Indicators website ( psi_download).

Revision 2 incorporates changes to ICD-9-CM codes and DRGs effective October 1, 2003 (Fiscal Year 2004).  With this software update, the PSI definitions now include ICD-9 CM codes valid from October 1, 1994 through September 30, 2004.  In addition to the ICD-9 coding update, several PSIs had minor definitional changes for the purpose of improving the performance of these indicators (PSIs 1, 3, 4, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15 and 16).  AHRQ is also offering three new provider-level PSIs with this release: PSI 27, Obstetric trauma with 3rd degree - vaginal with instrument; PSI 28, Obstetric trauma with 3rd degree - vaginal without instrument; and PSI 29, Obstetric trauma with 3rd degree - cesarean section. 

The PSI software was enhanced to offer the calculation and reporting of the expected rate at the stratification level selected by the user.  The SAS (PSSASP3.SAS) and SPSS (PSSPSP3.SPS) software syntax now calculates the risk-adjusted rate, the expected rate and the smoothed rate. 

All changes to the indicators and the ICD-9 CM coding updates are detailed in two documents, the PSI Change Log and PSI Indicator Changes, also available on the website.  All PSI documents have been updated including new versions of the Guide to the Patient Safety Indicators, the PSI SAS Software Documentation, and PSI SPSS Software Documentation.  The revised documents incorporate several stylistic changes, are available in Microsoft Word and PDF format, and include the updated PSI indicator definitions.  The new software manuals also outline the treatment of missing data by the software. 

AHRQ is committed to continued refinement and enhancement of the QIs based on feedback from users, knowledge gained through direct use, and new scientific evidence.  For example, the Support for Quality Indicators (SQI-II) contract team is reviewing the literature related to each PSI to both update the knowledge base underlying the indicators but also to identify any evidence that may suggest potential refinement of any indicator.  Significant information can be also obtained through user feedback and engaging in applied research and quality improvement efforts. 

We welcome your feedback on indicator definitions, the QI software, and related documentation.  We also welcome hearing from you about your use of the indicators or "case studies" to assist AHRQ in identifying projects that translate research into practice.

Please submit feedback, questions and comments regarding the AHRQ Quality Indicators to QIsupport@ahrq.hhs.gov.

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October 14 2004 – Free Upcoming Web Conferences: The Buy-Right for Health Care Quality Series

Where is the value in health care purchasing? Can hospital quality be measured well enough to link payment to quality? As health care costs continue to escalate and shortfalls remain in health care quality, employers and other purchasers are pursuing “quality-based purchasing” strategies.  The Agency for Healthcare Research and Quality (AHRQ) is sponsoring two interactive web conferences in October that will help purchasers, plans and providers understand the evidence base for quality-based purchasing and public reporting and increase their understanding of an important tool set available to assist with evaluations of health care quality. 

Event #1: “Paying for Performance”

Thursday, October 21, 2004, 3:00-4:30pm, EDT

The first conference in the series features a current look at the evidence base for quality-based purchasing with an emphasis on practical implications for purchasers and providers. 

Event #2:  “Using Quality Indicators for Hospital-Level Public Reporting & Payment”

Wednesday, October 27, 2004, 1:00-2:30pm, EDT

The second conference in the series will provide guidance on the benefits and limitations of using AHRQ’s quality indicators for public reporting of quality or to inform purchasing decisions.

A brochure for these two conferences is available on the AHRQ Quality Indicators Web site at The Buy-Right for Health Care Quality Series, Free Web Conferences.pdf.

Intended Audience

These Web conferences will be of direct value to the following stakeholders:

  • Employers and employer coalitions
  • Health plans, insurers, and other payers
  • State Medicaid Directors
  • Federal purchasers, including CMS, VA, and DOD
  • Federal and State policy makers
  • Health care delivery systems, hospitals, physicians, and other providers
  • Accreditation and other intermediary organizations

Web Conference Format

These interactive Web conferences will last 90 minutes. A panel of experts will discuss various aspects of these topics and engage the audience in a live discussion of their questions and concerns. Participants can connect to the Web conference in three ways – via Internet only, via Internet and phone, or via phone only.

The Buy-Right for Health Care Quality Series will help purchasers make well-informed decisions about whether and how to pursue quality-based purchasing.  The series will also help plans and providers prepare for and participate in quality-based purchasing and public reporting initiatives.  For more information about the web conference series, please open the attached agenda.  To register for the web conferences, please visit the conference series website: www.academyhealth.org/ahrq/valuepurchasing . Registration is free.

For detailed information on the two conferences such as a list of panelists, content of the conference, and what users should gain by the end of the session, please see the attached Word document, Narrative Agenda of the Conferences for Health Care Purchasers and Providers.   For a general overview of the conferences, including the different ways one can connect to the web conference and the corresponding equipment needed, please see the attached Word document, General Overview of the Conferences for Health Care Purchasers and Providers.

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September 30 2004 – AHRQ Releases Guide To Using its Quality Indicators for Hospital Quality Reporting and Payment

HHS' Agency for Healthcare Research and Quality today announced the availability of a new guide for using the Agency's Inpatient Quality Indicators or Patient Safety Indicators to report on hospital quality or make payment decisions. The Guidance for Using the AHRQ Quality Indicators for Hospital-Level Public Reporting or Payment can be downloaded from AHRQ's Quality Indicators Web site (http://www.qualityindicators.ahrq.gov/resources ).

AHRQ's Quality Indicators are measurement tools that were originally developed by AHRQ and researchers at the University of California at San Francisco and Stanford University to help individual hospitals use their own discharge data to better understand and improve the care they provide. Hospitals and hospital associations have used them extensively for this purpose. More recently, the indicators have been used by state data organizations, employers, health plans and others seeking to improve quality through public reporting and pay-for-performance initiatives. Given the expanding use and interest in the Quality Indicators, AHRQ created the guide to help answer questions about if, when, and how to use them for these new purposes.

"Improving the quality of America's health care system is a key priority for AHRQ, and the new guide will help those designing public reporting and payment initiatives identify measures that fit their local priorities and needs," said AHRQ Director Carolyn M. Clancy, M.D. "While the Quality Indicators aren’t a one-size-fits-all solution and must be used carefully, they can help local hospitals and their communities use data right now to evaluate performance and ultimately provide better care."

The Quality Indicators measure outcomes that consumers care about such as patient safety and complication rates. The indicators are also based on data that hospitals already collect, which makes their use relatively accessible and inexpensive.

This guide is the first in a series of activities that will help users evaluate which individual indicators or groups of indicators they may want to incorporate into their local quality reporting or payment programs. The new guide helps users customize their use of the Quality Indicators, for example, if they wish to place greater or lesser emphasis on cardiac care, if they are in markets with a large or small number of high-volume hospitals, or if hospitals in their area have large variations in the quality of their data. The guide also suggests ways to best use the Quality Indicators, such as pairing data on deaths and volume indicators or using multiple years of data.

"The Quality Indicators are a boon to purchasers, consumers, and providers looking for insight into the quality of care provided in hospitals," said Christopher Queram, CEO of Employer Health Care Alliance Cooperative in Madison, Wis. "In our experience, using the Quality Indicators to compare hospital performance has been a powerful tool to drive health care improvement."

For more information on AHRQ’s Quality Indicators, go to http://www.qualityindicators.ahrq.gov.

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September 27 2004 – AHRQ Quality Indicators From A to Z - Training Opportunity

The Agency for Healthcare Research and Quality (AHRQ) Quality Indicators (QIs) were created to inform health care planning, support evidence-based policy development, and facilitate quality monitoring and surveillance activities. These QIs are constructed using existing hospital discharge data and can be integrated into existing information infrastructures. AHRQ has developed software, which can be used in conjunction with SAS(r) or SPSS(r), to calculate QI rates from inpatient discharge data derived from the Nationwide Inpatient Sample (NIS), the State Inpatient Database (SID) that are part of AHRQ's Healthcare Cost and Utilization Project (HCUP), or any hospital administrative data.

In response to user requests, AHRQ is developing a curriculum to assist current and future QI users. As part of the curriculum development, three training sessions are planned. The first session was held in May 2004 in conjunction with the Annual A2IRNET 2004 Meeting. This message is to announce the availability of the second session November 17 and 18, 2004. A third training session will be held December 2004 in conjunction with the National Association of Health Data Organizations (NAHDO) annual meeting; additional information on that session will be distributed at a later date.

Date and Time: Tuesday, November 16, 2004 from 2:00 p.m. to 6:00 pm and continue on Wednesday, November 17, 2004 from 8:00 a.m. to Noon; adjacent to the National Business Coalition on Health (NBCH) Ninth Annual Conference "Employers Leading by Example: Partnerships for Health Care Value."

Location: Hyatt Regency, Atlanta, Georgia

Registration: Is required. Please see the attached brochure for the NBCH registration information and details on the other exciting opportunities available for you at the NBCH meeting. If you wish to register for just the QI training session and not the entire NBCH meeting, please contact Asta Sorenson, RTI, by e-mail at asorensen@rti.org.

The training sessions are made possible through a contract with RTI, International. The November training program will be a 8-hour session conducted over 2 days; and is intended to help participants understand how: (1) QIs are constructed, (2) resulting data output can be interpreted, and (3) results can be used for surveillance, comparative reporting, and to drive quality improvement activities. Part of the session will include the opportunity to do some hands on work with the data based on case studies tailored to the needs of business coalition and employer representatives. All participants will receive a training manual of workshop materials that will serve as a reference tool to support future applications of the QIs.

Program Objectives: By the completion of the 8 hour program participants will:

  1. Have a general understanding of the development of the QIs, the purpose of each type of QI, the evidence base for their inclusion as part of the suite of AHRQ quality tools, where to access data and software used to construct the QIs and benefits and limitations of using the QIs for quality improvement, comparative reporting or pay for performance.
  2. Have an understanding of select measurement issues that are likely to be encountered when using the QIs.
  3. Use activity-based learning experiences related to indicator construction, data output interpretation, and application of results for quality monitoring and surveillance activities.
  4. Have an opportunity for an interactive forum for participant Q&A.
  5. Leave with a set of reference tools that can be used to support future application.

Who Should Attend? Current or future QI users. Case studies will be tailored to the purchaser and business coalition audiences.

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July 23 2004 – Quality Indictor's Web Site Redesign and Release of AHRQ Inpatient Quality Indicators Version 2.1, Revision 3

The Agency for Healthcare Research and Quality (AHRQ) announces the redesign of the AHRQ Quality Indicators (QIs) Web site. Features of the new QI Web site include:

  • More intuitive navigation
  • Related topics grouped together
  • Cleaner layout and presentation of content
  • Frequently Asked Questions section is now classified by topic and lists all questions at the beginning to make it easier for users to review
  • Messages sent from the Quality Indicators Listserv® since 2002 can be viewed

Along with the redesign, the Inpatient Quality Indicators (IQIs) software has been updated and is now available on the QI Web site. This IQI release, Version 2.1 Revision 3, includes updates related to new FY 2004 ICD-9-CM coding guidelines as well as enhancements to the indicators based on new evidence and user feedback. Notably these changes include three new indicators, which provide alternative information regarding AMI mortality, Cesarean delivery, and Vaginal Birth After Cesarean (VBAC).

The AHRQ Quality Indicators Web site ( http://www.qualityindicators.ahrq.gov) offers providers, state data organizations, hospital associations, researchers and many others easy access to the AHRQ Quality Indicators (QIs), documentation and user support. The AHRQ QIs use readily available hospital administrative data to highlight potential quality concerns, identify areas that need further study and investigation, and track changes over time. They include three modules-- the Inpatient Quality Indicators (IQIs), Prevention Quality Indicators (PQIs), and Patient Safety Indicators (PSIs). The AHRQ QI software is available free of charge in SAS and SPSS format.

The Web site, user services and research and development on the indicators are maintained and enhanced by the Support for Quality Indicators team led by Denise Remus (AHRQ) and Kathryn McDonald (Stanford University) along with Sheryl Davies and Jeffrey Geppert at Stanford; Patrick Romano and colleagues at University of California Davis; Mark Gritz, Gregory Hubert, Rajin Mangru and colleagues at Battelle Memorial Institute. User support is available through the website or by emailing QIsupport@ahrq.hhs.gov.

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June 22 2004 – National Benchmarks for PSI's Now Available on HCUPnet

National benchmarks for the Patient Safety Indicators (PSIs), indicators of potentially avoidable complications and adverse events, are now available on the HCUPnet Web site at http://hcup.ahrq.gov/hcupnet.asp. In addition, the description and definition for each indicator of the PSIs are available. These PSIs were calculated using Version 2.1, Revision 1 of the PSI software and the Nationwide Inpatient Sample (NIS), 2000. For details, see the Guide to the Patient Safety Indicators on the AHRQ Quality Indicators Web site <psi_download.

Benchmarks for the Prevention Quality Indicators (PQIs), Version 2.1, Revision 2, continue to be available. Benchmarks for the Inpatient Quality Indicators (IQIs) are forthcoming.

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June 14 2004 – AHRQ Makes Access to Hospital Data Easier

The Agency for Healthcare Research and Quality has redesigned its interactive HCUPnet software tool (available on the Web at http://www.ahrq.gov/hcupnet) to make it easier to obtain hospital care trend data for the nation and for individual states. The data represent 90 percent of all hospital stays in the nation and are drawn from 36 states.

HCUPnet's databases include statistics on the conditions for which patients were hospitalized, the diagnostic and surgical procedures they underwent, patient death rates, hospital charges, hospital costs, length of stay, and other aspects of inpatient care. The data are for all patients, regardless of type of insurance or whether they were insured.

For example, using HCUPnet to research the impact of the obesity epidemic on hospital care and costs shows that more than 58,000 surgical procedures for obesity were performed in 2001.

In addition, the data show that between 1993 and 2001:

The number of patients admitted for treatment of diabetes with complications-a condition often linked to obesity-rose 23 percent, from 373,666 to 461,161.

  • The number of lower extremity amputations, a diabetic complication, increased 14 percent from 99,522 to 113,379, and the average hospital charge for this procedure increased 38 percent, from $24,332 to $33,562.
  • Admissions for heart attack-which obese persons have a higher risk of suffering-rose 13 percent, from 682,763 to 773,871, and charges increased 61 percent-from an average of $19,178 per hospital stay to $30,875 per stay.
  • Knee replacements, also more common among obese patients, increased roughly 29 percent, from 282,177 to 363,536, and the average hospital charge rose 38 percent, from $18,352 to $25,309.

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May 4 2004 – Training Opportunity - Learn More about the AHRQ Quality Indicators!

The Agency for Healthcare Research and Quality (AHRQ) Quality Indicators (QIs) were created to inform health care planning, support evidence-based policy development, and facilitate quality monitoring and surveillance activities. These QIs are constructed using existing hospital discharge data and can be integrated into existing information infrastructures. AHRQ has developed software, which can be used in conjunction with SAS or SPSS, to calculate QI rates from inpatient discharge data derived from the Nationwide Inpatient Sample (NIS), the State Inpatient Database (SID) that are part of AHRQ's Healthcare Cost and Utilization Project (HCUP), or any hospital administrative data.

In response to user requests, AHRQ is developing a curriculum to assist current and future QI users. As part of the curriculum development, three training sessions will be offered in 2004. Details on the first session are noted below and registration information is available at the A2IRNET Web site under "AHRQ"   (http://www.aairnet.com). The first session is designed to provide an overview of the QIs then more detail on application and interpretation. The May program is structured for healthcare providers and others involved with hospital quality improvement programs. Additional programs will be offered in November and December 2004 (when the session details are finalized information will be posted on the QI Web site and another notice will be sent to the QI liSTSERV).

Date and Time: Tuesday, May 25, 2004 from 1p.m. to 4:30pm and continue on Wednesday, May 26, 2004 from 8:30 a.m. to Noon; adjacent to the Annual A2IRNET 2004 Meeting.

Location: Snow King Resort in Jackson Hole, Wyoming

The training sessions are made possible through a contract with RTI, International. The May training program will be a 6-hour session conducted over 2 days; and is intended to help participants understand how: (1) QIs are constructed, (2) resulting data output can be interpreted, and (3) results can be used for surveillance and quality improvement activities. Part of the session will include the opportunity to do some hands on work with the data based on case studies tailored to the needs of hospital association and health system users. All participants will receive a training manual of workshop materials that will serve as a reference tool to support future applications of the QIs.

Program Objectives: By the completion of the 6 hour program participants will:

  1. Have a general understanding of the development of the QIs, the purpose of each type of QI, the evidence base for their inclusion as part of the suite of AHRQ quality tools, where to access data and software used to construct the QIs and benefits and limitations of using the QIs for quality improvement or comparative reporting.
  2. Have an understanding of select measurement issues that are likely to be encountered when using the QIs.
  3. Use activity-based learning experiences related to indicator construction, data output interpretation, and application of results for quality monitoring and surveillance activities.
  4. Have an opportunity for an interactive forum for participant Q&A.
  5. Leave with a set of reference tools that can be used to support future application.

Who Should Attend? Current or future QI users including health care quality managers, quality improvement staff, data analysts, and administrators.

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April 4 2004 – AHRQ Quality Indicators Frequently Asked Questions Updated

The Agency for Healthcare Research and Quality (AHRQ) Quality Indicators (QI) support team has updated the list of Frequently Asked Questions (FAQs) in response to inquiries submitted to the e-mail support system. The new FAQs are located at http://www.qualityindicators.ahrq.gov//FAQs_Support/Default.aspx and address questions about use of the 3M All-Patient Refined DRGs (APR-DRGs), location of technical support documentation and availability of benchmark data.

Technical support is available by contacting the QI support team. The QI support e-mail address is QIsupport@ahrq.hhs.gov. We are also available by phone at (301)427-1949, if you call this number you will reach our voice mail system, messages are responded to within three business days. The QI support e-mail address may also be used to send AHRQ comments, suggestions, or other feedback related to the QIs and their use. We welcome your input!

Thank you for your continued interest in the AHRQ Quality Indicators!

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January 13 2004 – Release of AHRQ Prevention Quality Indicators Version 2.1, Revision 3

AHRQ is pleased to announce an update of the AHRQ Prevention Quality Indicators (PQIs), Version 2.1, Revision 3. All updated PQI documentation and software are now available for download on the AHRQ Quality Indicators Web site (http://www.qualityindicators.ahrq.gov/archive/software.aspx).

Revision 3 incorporates changes to ICD-9-CM codes and DRGs effective October 1, 2002 (Fiscal Year 2003) and October 1, 2003 (Fiscal Year 2004). With this software update, the PQI definitions now incorporate ICD-9 CM codes valid from October 1, 1994 through September 30, 2004.

In addition to the ICD-9 coding update, a few additional minor changes have been implemented for the purpose of improving the performance of these indicators. All changes to the indicators and the ICD-9 CM coding updates are detailed in two documents also available on the Web site. The documents accompanying the PQI software have been updated including new versions of the Guide to the Prevention Quality Indicators, the PQI SAS Software Documentation, and PQI SPSS Software Documentation. These new documents incorporate several stylistic changes, are available in Microsoft Word and PDF format, and include the updated PQI indicator definitions. The new software manuals also outline the treatment of missing data by the software.

The full log of revisions which summarizes all of the revisions made to the PQIs software, software documentation, the list of ICD-9 coding changes, and the Guide to Prevention Quality Indicators are available for download or viewing on the AHRQ Quality Indicators Web site (http://www.qualityindicators.ahrq.gov/archive/software.aspx).

AHRQ is committed to continued refinement and enhancement of the QIs based on feedback from users, knowledge gained through direct use, and new scientific evidence. For example, the Support for Quality Indicators (SQI) contract team is reviewing the literature related to each PQI to both update the knowledge base underlying the indicators but also to identify any evidence that may suggest potential refinement of any indicator. Significant information can be also obtained through user feedback and engaging in applied research and quality improvement efforts.

We welcome your feedback on indicator definitions, the QI software, and related documentation. We also welcome hearing from you about your use of the indicators or "case studies" to assist AHRQ in identifying projects that translate research into practice.

Feedback, questions and comments regarding the AHRQ Quality Indicators may be submitted to QIsupport@ahrq.hhs.gov.

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