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

NEWS from 2005

December 1 2005 – Release of the AHRQ QI Windows Application Version 2.0 and Prevention Quality Indicators FY2006 Update (SAS ONLY)
  1. AHRQ QI Windows Application Version 2.0
    The Agency for Healthcare Research and Quality (AHRQ) is pleased to announce the release of the AHRQ Quality Indicator Windows Application Version 2.0. The software, installation guide and user guide are now available for download from the AHRQ QI web site (www.qualityindicators.ahrq.gov).

    The AHRQ QI Windows Application Version 2.0 incorporates limited enhancements to the performance, features and functionality of application based on recommendations from users. AHRQ plans for future releases of the AHRQ QI Windows Application are included in the AHRQ QI Windows Application Release Notes that is posted on the web site along with the software and documentation.

    The AHRQ Quality Indicator Support team will hold one web-based training session to introduce the updated software and to describe the major features and functionality. The session will be held at 3:00pm ET on Friday, December 9th, 2005. To register send an email to webmeetings@qualityindicators.ahrq.gov with your name, organization, email address. The Support team will send you a meeting invitation that includes a link to the web presentation and a telephone number and access code for the voice presentation. This email confirmation will be sent on Thursday, December 8.

  2. Prevention Quality Indicators FY2006 Coding Update (SAS ONLY)
    AHRQ is pleased to announce an FY2006 coding update of the AHRQ Prevention Quality Indicators (PQIs), Version 3.0. All updated PQI documentation and software are now available for download or viewing on the AHRQ Quality Indicators website (pqi_download).

    PQI Version 3.0 is valid for use with discharges occurring in Fiscal Year 1995 (FY 1995) through Fiscal Year 2006 (FY 2006) or from October 1, 1994 through September 30, 2006. After a complete review of the ICD-9-CM codes and DRGs that were effective October 1, 2005 (FY 2006) it was determined that limited changes were required to the PQI definitions. The documentation accompanying this release was modified to reflect the coding and timeframe update.

    In addition to updating the documentation to reflect the currency of PQI definitions, the two pediatric PQIs were moved to the new Pediatric Indicator Module scheduled for release in January, 2006. Additional exclusion criteria were added to other indicators. All changes included in version 3 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 (Appendix A is now a separate Technical Specifications document) and the PQI SAS Software Documentation.

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

For questions, please contact QIsupport@ahrq.hhs.gov or leave a voicemail at (301) 427-1949.

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November 23 2005 – Call for Nominations

OBJECTIVE: The Agency for Healthcare Research and Quality (AHRQ) is seeking nominations for members of the AHRQ Quality Indicators Workgroup on Composite Measures for the Prevention Quality Indicators (PQIs). The AHRQ QI Workgroup is being formed as part of a structured approach for developing composite measures at the national and state level.  The Workgroups will evaluate appropriate technical and feasible methodological approaches currently available. Their role will be to discuss and suggest strategies as to what composite measure methodology would best fit the AHRQ QI user needs.

As part of this effort, Workgroup members will be addressing several key issues for each composite measure, including:

  • What quality concept is the composite intended to measure?
  • What individual indicators should be included in the composite?
  • How should the individual indicators be combined?
  • Should the composite be condition-specific (e.g., cardiovascular disease, or diabetes) or population-specific (e.g., pediatrics, women, or geriatrics) or by domains?

All nominations MUST be submitted by 6:00 pm EST, December 2, 2005.

BACKGROUND: The AHRQ Quality Indicators (AHRQ QIs) are a unique set of measures of health care quality that make use of readily available hospital inpatient administrative data and have been used for various purposes. Some of these include tracking, hospital self-assessment, reporting of hospital-specific quality or pay for performance. The AHRQ QI are provider- and area-level quality indicators based on hospital discharge data and consist of three modules: the Prevention Quality Indicators (PQI), the Inpatient Quality Indicators and the Patient Safety Indicators (PSI). Additional information on the AHRQ QI can be found on the web site at http://www.qualityindicators.ahrq.gov.

In response to feedback from the AHRQ QI user community, AHRQ is committed to developing composite measures in an effort to provide an overall view of quality that is complete and easily understandable to consumers and others within the health care field.

COMPOSITION OF THE COMPOSITE MEASURES WORKGROUP: Each Workgroup, of which there will be three, one for each module, will consist of 7 members from a variety of fields (epidemiology, health services research, medicine, performance measurement etc.). Candidates should have technical expertise in measurement development, and a familiarity with statistical methods and risk adjustment strategies in the area of composite measure development.

COMMITMENT: In an effort to provide for expert input and for recommendations to develop a composite measure methodology, we are initiating a review process that will require participation in one or two conference calls with some pre and post evaluation time (approximately 5 hours). Results from this process will directly influence the development of composite measures for the Quality Indicators. The first set of development activities will focus on the Prevention Quality Indicators.   The schedule for the first review is below.

As a workgroup member, you will be asked to participate in four stages:

  1. mid-December, 2005: Complete a short questionnaire on current methodology (2.0 hour)
  2. early-January, 2006: Participate in one conference call to discuss recommended changes to the methodology (1.5 hours)
  3. January, 2006: Respond to questions or provide additional clarifications after the conference call in early January.
  4. mid-January, 2006: Complete the same questionnaire on new methodology (1.5 hour)

Composite measures workgroup for the Inpatient Quality Indicator and the Patient Safety Indicators will follow a similar process beginning in Spring 2006 and Fall 2006, respectively.  A separate Call for Nominations will be disseminated at  the appropriate times.

The Workgroups will conduct its business by telephone, e-mail, or other electronic means as needed.

SELECTION CRITERIA: Candidates will be selected based upon the following criteria:

  • Familiarity and experience with the relevant methods and literature relating to composite measures, performance measures, and reporting;
  • Familiarity with the AHRQ Quality Indicators and its application;
  • Availability to complete surveys and conference calls during December 2005 and January 2006.

NOTIFICATION: Selected candidates will be contacted by AHRQ no later than December 9, 2005.

MATERIAL TO SUBMIT: Self-nominations are welcome. Third-party nominations must indicate that the individual has been contacted and is willing to serve. To be considered for appointment to the AHRQ QI Workgroups, please send the following information for each nominee:

  1. A 1-page letter of interest (including full contact information of nominee) highlighting experience/knowledge relevant in the development and use of composite performance measures.
  2. Curriculum vitae and/or list of relevant experience (e.g., publications).

Materials can be submitted by fax, U.S. mail, and e-mail.

Agency for Healthcare Research and Quality
AHRQ Quality Indicators Program
ATTN: Mamatha Pancholi, Project Officer
540 Gaither Road
Suite 510
Rockville, MD 20854
FAX: 301.427.1430

DEADLINE FOR SUBMISSION: All nominations MUST be submitted by 6:00 pm EST, December 2, 2005.

QUESTIONS: If you have any questions, please contact Mamatha Pancholi via email mpanchol@ahrq.gov or send an email to QIsupport@ahrq.hhs.gov.

Thank you for your assistance!

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September 8 2005 – Release of the AHRQ QI Windows Application Version 1.0

The Agency for Healthcare Research and Quality (AHRQ) is pleased to announce the release of the AHRQ Quality Indicator Windows Application Version 1.0. The software, installation guide and user guide are now available for download from the AHRQ QI web site (www.qualityindicators.ahrq.gov).

The AHRQ QI Windows Application Version 1.0 replicates the indicator specification and rate calculation of the currently available versions of the SAS and SPSS® syntax for the PQI, IQI and PSI modules. AHRQ plans for future releases of the AHRQ QI Windows Application are included in the AHRQ QI Windows Application Release Notes that is posted on the web site along with the software and documentation.

The AHRQ QI Windows Application Version 1.0 requires Microsoft Windows 2000 or Microsoft Windows XP, with the Microsoft.NET platform and an available Microsoft SQL Server® database. A public-use version of Microsoft .NET and the SQL Server database are included with the software.

The AHRQ Quality Indicator Support team will hold two web-based training sessions to introduce the new software and to describe the major features and functionality. The first session will be held at 3:00pm ET on Friday, September 9th, 2005. The second session will be held at 3:00pm ET on Wednesday, September 14th, 2005. You only need to attend one of the sessions. Attendance will be limited to 75 participants per session. To register send an email to webmeetings@qualityindicators.ahrq.gov with your name, organization, email address and indicate the session you would like to attend. The Support team will send you a meeting invitation that includes a link to the web presentation and a telephone number and access code for the voice presentation.

For individuals attending the AHRQ QI User Meeting on September 26 and 27th, 2005, the Support team will also conduct informal demonstrations of the Windows Application during breaks in the program.

For questions, please contact QIsupport@ahrq.hhs.gov or leave a voicemail at (301) 427 - 1949.

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September 2 2005 – Release of the AHRQ QI Windows Application Version 1.

The Agency for Healthcare Research and Quality (AHRQ) will release the AHRQ Quality Indicator Windows Application Version 1.0 on Wednesday, September 7th. A listserv® announcement will be sent when the software, installation guide and user guide are available for download from the AHRQ QI web site (www.qualityindicators.ahrq.gov).

The AHRQ QI Windows Application Version 1.0 replicates the indicator specification and rate calculation of the currently available versions of the SAS and SPSS syntax for the PQI, IQI and PSI modules. AHRQ plans for future releases of the AHRQ QI Windows Application will be included in the AHRQ QI Windows Application Release Notes that will be posted on the web site along with the software and documentation.

The AHRQ QI Windows Application Version 1.0 requires Microsoft Windows 2000 or Microsoft Windows XP, with the Microsoft.NET platform and an available Microsoft SQL Server database. A public-use version of Microsoft .NET and the SQL Server database are included with the software.

The AHRQ Quality Indicator Support team will hold two web-based training sessions to introduce the new software and to describe the major features and functionality. The first session will be held at 3:00pm ET on Friday, September 9th, 2005. The second session will be held at 3:00pm ET on Wednesday, September 14th, 2005. You only need to attend one of the sessions. Attendance will be limited to 75 participants per session. To register send an email to webmeetings@qualityindicators.ahrq.gov with your name, organization, email address and indicate the session you would like to attend. The Support team will send you a meeting invitation that includes a link to the web presentation and a telephone number and access code for the voice presentation.

For individuals attending the AHRQ QI User Meeting on September 26 and 27th, 2005, the Support team will also conduct informal demonstrations of the Windows Application during breaks in the program.

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August 9 2005 – Meeting Registration

AHRQ QI User Meeting
AHRQ and AHCA State Summit on Public Reporting
2005 User Meeting

The Agency for Healthcare Research and Quality (AHRQ) is pleased to announce that registration is now open for the 2005 AHRQ Quality Indicators User Meeting to be held at the AHRQ Conference Center located in Rockville, Maryland on September 26 – 27, 2005.

The two-day AHRQ Quality Indicators User Meeting is intended both for active users of the AHRQ Quality Indicators (AHRQ QI) and for those interested in how the AHRQ QI might be used in their organizations. The sessions will focus on lessons learned from actual applications on these topics:

  • New Pediatric Indicator Module
  • Applying the AHRQ QI to improve population health
  • Using the AHRQ QI as a catalyst for quality improvement
  • Implications of ICD-9-CM coding practices
  • Use of the AHRQ QI in the National and State Healthcare Quality Reporting
  • Methods for creating aggregate performance indices
  • Considerations in using the AHRQ QI for comparative reporting and pay-for-performance

In addition to presentations by content experts, the AHRQ QI development team and AHRQ QI users, the User Meeting will include an opportunity for open discussion on frequently asked questions, recommendations for future AHRQ QI development, and other considerations related to the use and interpretation of the AHRQ QI. There will be panel discussions on quality improvement, comparative reporting and pay-for-performance with representatives from multiple perspectives, and informal demonstrations of the SAS syntax and new Windows application.

Following the AHRQ QI User Meeting there will be a one-day State Summit on Public Reporting co-sponsored by AHRQ and the Florida Agency for Health Care Administration on Wednesday, September 28, 2005.

This one-day meeting will build on the information presented at the AHRQ QI User Meeting, proposing consensus-based cooperation among states on public reporting of healthcare quality information. The morning presentations will frame the difficulties inherent in fulfilling the state's reporting obligation, and the afternoon session will be an open discussion of collaborative steps that can lead to best practices for reporting and ongoing improvement.

Information on how to register, the meeting agendas, location, and hotel accommodations is available on the AHRQ Quality Indicators Web site at: 2005 User Meeting

Space at the meeting will be limited to 100 individuals on a first-come, first-served basis. For questions, please contact QIsupport@ahrq.hhs.gov or call the AHRQ QI voicemail at (301) 427-1949.

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July 11 2005 – Save the Date

The Agency for Healthcare Research and Quality (AHRQ) invites you to attend the first annual AHRQ Quality Indicators User Meeting to be held at the AHRQ Conference Center located in Rockville, Maryland on September 26 - 27, 2005.

The two-day meeting is intended both for active users of the AHRQ Quality Indicators (QIs) and for those interested in how the QIs might be used in their organizations. The sessions will focus on lessons learned from actual applications on these topics:

  • Applying the QI to improve population health
  • Using the QI as a catalyst for quality improvement
  • Impact of ICD-9-CM coding practices
  • Issues in using the QI for comparative reporting
  • Creating aggregate performance indices
  • Training on the new QI Windows Application
  • Training on the new Pediatric Indicator Module

Additional general conference information, hotel accommodations and registration information will be distributed in the coming weeks. Space at the meeting will be limited to 100 individuals on a first-come, first-served basis.

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May 19 2005 – AHRQ Quality Indicators Inpatient Quality Indicators (IQI) Version 2.1, Revision 4a Update

The AHRQ Quality Indicators Support Team has posted to the AHRQ Quality Indicators Web Site updated files for the Inpatient Quality Indicators Version 2.1, Revision 4, originally released on December 22, 2004. THE UPDATE ONLY IMPACTS THE CALCulATION OF THE IQI EXPECTED AND RISK-ADJUSTED RATES.

The update is necessary to correct the calculation of the IQI expected rates. IQI Version 2.1, Revision 4 overestimates the expected rate for individual hospitals based on the 2002 reference population (that is, overestimates the case-mix severity) and (consequently) underestimates the risk-adjusted rate. The Revision 4a update corrects this problem.

The following updated files have been posted to the AHRQ Quality Indicators Web Site.

  1. Parameter Files. The parameter files COVIQP02.TXT, MSXIQP02.TXT (SAS) and MSXIQP_2.TXT (SPSS).
  2. IQI Covariates Table. The IQI Covariates Table (iqi_covariates_rev4a.doc and iqi_covariates_rev4a.pdf).

Users wishing to calculate expected, risk-adjusted and smoothed rates for IQI Version 2.1, Revision 4 based on the 2002 reference population must re-download the iqi_sas_software_rev4a.zip (SAS) or iqi_spss_software_rev4a.zip (SPSS) containing the parameter files listed in item #1 above. Only the iqsasp3.sas (SAS) or iqspsp3.sps (SPSS) module must be re-run.

The update does not impact the observed rates or the FY05 coding updates. The iqsas1.sas, iqsasp2.sas (SAS) or iqsps1.sps*, iqspsp2.sps (SPSS) modules remain unchanged and do not need to be re-run.

*The update also includes a minor correction to the SPSS syntax for Pediatric Heart Surgery Volume (IQI #3) and Mortality (#10) to the exclusion for single procedure of vessel repair or occlusion. The correction impacts less than 0.5% of denominator cases.

The updated files are available for download at the AHRQ Quality Indicators Web site: (iqi_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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April 28 2005 – AHRQ Quality Indicators Inpatient Quality Indicators (IQI) Version 2.1, Revision 4 Advisory Note

The AHRQ Quality Indicators Support Team will be posting to the AHRQ Quality Indicators Web Site updated files for the Inpatient Quality Indicators Version 2.1, Revision 4, originally released on December 22, 2004. THE UPDATE WILL ONLY IMPACT THE CALCulATION OF THE IQI EXPECTED AND RISK-ADJUSTED RATES.

The update is necessary to correct the calculation of the IQI expected rates. Currently, IQI Version 2.1, Revision 4 overestimates the expected rate for individual hospitals based on the 2002 reference population (that is, overestimates the case-mix severity) and (consequently) underestimates the risk-adjusted rate. The update will correct this problem.

The following updated files will be posted to the AHRQ Quality Indicators Web Site by MAY 13, 2005.

  1. Parameter Files. The parameter files COVIQP02.TXT, MSXIQP02.TXT (SAS) and MSXIQP_2.TXT (SPSS).
  2. IQI Covariates Table. The IQI Covariates Table (iqi_covariates_rev4a.doc and iqi_covariates_rev4a.pdf).

Users wishing to calculate expected, risk-adjusted and smoothed rates for IQI Version 2.1, Revision 4 based on the 2002 reference population must re-download the iqi_sas_software_rev4a.zip (SAS) or iqi_spss_software_rev4a.zip (SPSS) containing the parameter files listed in item #1 above. Only the iqsasp3.sas (SAS) or iqspsp3.sps (SPSS) module must be re-run.

The update will not impact the observed rates or the FY05 coding updates. The iqsas1.sas, iqsasp2.sas (SAS) or iqsps1.sps, iqspsp2.sps (SPSS) modules will remain unchanged and will not need to be re-run.

A listserv announcement will be posted when the updated files are available for download at the AHRQ Quality Indicators Web site: (iqi_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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February 16 2005 – AHRQ Quality Indicators Patient Safety Indicators (PSI) Version 2.1, Revision 3a Update

The AHRQ Quality Indicators Support Team has posted updated files for the Patient Safety Indicators Version 2.1, Revision 3, originally released on January 17, 2005. THE UPDATE IMPACTS THE CALCulATION OF PSI RISK-ADJUSTED RATES.

  1. Parameter Files. The parameter files COVPSP02.TXT, MSXPSP02.TXT (SAS) and MSXPSP_2.TXT (SPSS) have been updated to the 2002 reference population.
  2. PSI Covariates Table. The PSI Covariates Table (psi_covariates_rev3a.doc and psi_covariates_rev3a.pdf) has been updated to include the coefficients and odds ratios for the 2002 reference population.
  3. SAS and SPSS Software Documentation. The references to the State Inpatient Data (SID) used in calculating the risk-adjusted rates have been updated to 2002 and 35 HCUP participating states.

Users wishing to calculate risk-adjusted, expected and smoothed rates for PSI Version 2.1, Revision 3 based on the 2002 reference population must re-download the psi_sas_software_rev3a.zip (SAS) or psi_spss_software_rev3a.zip (SPSS) containing the parameter files listed in item #1 above. Only the pssasp3.sas (SAS) or psspsp3.sps (SPSS) module must be re-run. The pssasp1.sas, pssasp2.sas (SAS) or psspsp1.sps, psspsp2.sps (SPSS) modules remain unchanged and do not need to be re-run.

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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January 18 2005 – Release of Agency for Healthcare Research and Quality (AHRQ) Patient Safety Indicators Version 2.1, Revision 3

AHRQ is pleased to announce an update of the AHRQ Patient Safety Indicators (PSIs), Version 2.1, Revision 3. All updated PSI documentation and software are now available for download or viewing on the AHRQ Quality Indicators website(psi_download).

Revision 3 incorporates changes to ICD-9-CM codes and DRGs effective October 1, 2004 (Fiscal Year 2005). With this software update, the PSI definitions now include ICD-9 CM codes valid from October 1, 1994 through September 30, 2005.

The indicator changes and 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 the Guide to the Patient Safety Indicators, the PSI SAS Software Documentation, and PSI SPSS Software Documentation. These documents incorporate stylistic changes, are available in Microsoft Word and PDF format, and include the updated PSI indicator definitions. In addition, the ICD-9-CM major operating room procedure codes are now included in a separate, downloadable document.

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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