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Envisioning the National Health Care Quality Report (2001)

Chapter:Appendix A: Workshop: Envisioning a National Quality Report on Health Care

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Suggested Citation:"Appendix A: Workshop: Envisioning a National Quality Report on Health Care." Institute of Medicine. 2001. Envisioning the National Health Care Quality Report. Washington, DC: The National Academies Press. doi: 10.17226/10073.
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APPENDIX A

Workshop: Envisioning a National Quality Report on Health Care

PURPOSE AND STRUCTURE OF THE WORKSHOP

The general purpose of the workshop was to provide the Institute of Medicine Committee on the National Quality Report on Health Care Delivery with practical, state-of-the-art information on the definition and reporting of national indicators of health care quality.

The workshop involved more than 40 participants and was open to the public. The topics were organized in three parts: (1) Lessons to be Learned from Other Experiences; (2) Measuring the Dimensions of Health Care Quality; and, (3) Technical, Data, and Policy Issues.

Presenters were asked to focus on the practical or applied, rather than the theoretical, aspects of their subject. They were also asked to give their opinion regarding the proposed framework for the National Health Care Quality Report as it referred to the subject they are addressing. Those presenting on specific quality measures were asked to present evidence on why the measures should be included in the Quality Report and to comment on available data sources or data needs for implementing the quality measures proposed.

ISSUES ADDRESSED AT THE WORKSHOP

  • The feasibility of measuring patient centeredness, safety, effectiveness, and efficiency as dimensions of quality of care.

  • The availability and appropriateness of public and private data sources for national indicators of quality of care.

Suggested Citation:"Appendix A: Workshop: Envisioning a National Quality Report on Health Care." Institute of Medicine. 2001. Envisioning the National Health Care Quality Report. Washington, DC: The National Academies Press. doi: 10.17226/10073.
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  • The feasibility of translating experiences from other sectors and countries to measure quality of health care in the United States.

  • The need for specific measures of quality for particular populations and tracking disparities in health care quality.

  • WORKSHOP AGENDA

    May 22–23, 2000

    Holiday Inn Georgetown—Mirage I Conference Room

    2101 Wisconsin Avenue, N.W., Washington, D.C.

    Monday, May 22, 2000

    9:00 a.m.–9:05 a.m.

    Welcome

    William L. Roper, M.D., M.P.H.

    Chair, IOM Committee on the National Quality

    Report on Health Care Delivery

    9:05 a.m.–9:15 a.m.

    Introduction to the Workshop

    Mark Smith, M.D., M.B.A.

    Member, IOM Committee

    SESSION 1: Quality Indicators in Other Sectors and Other Countries: Issues of Measurement, Presentation, Process, and Accountability

    9:15 a.m.–9:30 a.m.

    Measuring Consumer Satisfaction with Quality Across Industries—The American Customer Satisfaction Index

    Claes Fornell, Ph.D.

    University of Michigan School of Business Administration

    9:30 a.m.–9:45 a.m.

    Indicators of Educational Quality—The National Education Report Card (NAEP)

    Peggy Carr, Ph.D.

    National Center for Education Statistics

    9:45 a.m.–10:00 a.m.

    International Experiences in the Definition of National Indicators of Health Care Quality

    R. Heather Palmer, M.B., B.Ch., S.M.

    Harvard School of Public Health

    Suggested Citation:"Appendix A: Workshop: Envisioning a National Quality Report on Health Care." Institute of Medicine. 2001. Envisioning the National Health Care Quality Report. Washington, DC: The National Academies Press. doi: 10.17226/10073.
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    Page 161

    10:00 a.m.–10:30 a.m.

    Discussion: Lessons for the Designers of the National Quality Report on Health Care

    Moderator: Michael Millenson

    William M. Mercer, Inc.

    10:30 a.m.–10:45 a.m.

    Break

    SESSION 2: Measuring Health Care Safety for the National Health Care Quality Report

    10:45 a.m.–11:00 a.m.

    Update on Federal Initiatives on Error Measures and Databases

    Nancy Foster, Ph.D.

    Gregg Meyer, M.D., M.Sc.

    Agency for Healthcare Research and Quality

    11:00 a.m.–11:15 a.m.

    Assessing and Reducing Errors in Health Care: The Purchaser Perspective

    Suzanne Delbanco, Ph.D.

    Leapfrog Group

    11:15 a.m.–11:30 a.m.

    Using Information Technology to Ensure and Assess Safety in Health Care

    David Bates, M.D., M.Sc.

    Harvard Medical School

    SESSION 3: Approaches to Measuring the Efficiency of Health Care for the National Health Care Quality Report

    11:30 a.m.–11:45 a.m.

    Efficiency, Productivity in Medical Care, and Medical Cost Increases

    Jack Triplett, Ph.D.

    The Brookings Institution

    11:45 a.m.–12:15 p.m.

    Potential Measures of Efficiency of Health Care

    Mark McClellan, M.D., Ph.D.

    Stanford University

    Discussant: José Escarce, M.D., Ph.D.

    IOM Committee

    Suggested Citation:"Appendix A: Workshop: Envisioning a National Quality Report on Health Care." Institute of Medicine. 2001. Envisioning the National Health Care Quality Report. Washington, DC: The National Academies Press. doi: 10.17226/10073.
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    Page 162

    12:15 p.m.–12:45 p.m.

    Discussion: Measuring Safety and Efficiency for the National Quality Report

    Moderator: John Ware, Jr., Ph.D.

    QualityMetric Inc.

    12:45 p.m.–1:45 p.m.

    Lunch

    SESSION 4: Measuring Effectiveness and Appropriateness of Care for the National Health Care Quality Report

    1:45 p.m.–2:00 p.m.

    Measuring the Appropriateness of Nursing Care

    Ora Strickland, Ph.D., R.N., F.A.A.N.

    Emory University School of Nursing

    2:00 p.m.–2:15 p.m.

    Considerations on the Use of Health Outcomes as Measures of Effectiveness

    John Ware, Jr., Ph.D.

    QualityMetric Inc.

    2:15 p.m.–2:45 p.m.

    Potential Measures of Effectiveness and Appropriateness of Health Care for the National Health Care Quality Report

    Elizabeth McGlynn, Ph.D.

    Robert Brook, M.D., Sc.D.

    RAND

    Discussant: Sheldon Greenfield, IOM Committee

    SESSION 5: Measuring Patient Centeredness for the National Health Care Quality Report

    2:45 p.m.–3:00 p.m.

    Measuring the Patient's Role in Collaborative Chronic Disease Care and Its Link to Quality of Care and Outcomes

    Jessie Gruman, Ph.D.

    Center for the Advancement of Health

    3:00 p.m.–3:15 p.m.

    Measuring the Quality of Interpersonal Care and Patient Involvement in Care

    Sherrie Kaplan, Ph.D., M.P.H.

    Primary Care Outcomes Research Institute, New England Medical Center

    Suggested Citation:"Appendix A: Workshop: Envisioning a National Quality Report on Health Care." Institute of Medicine. 2001. Envisioning the National Health Care Quality Report. Washington, DC: The National Academies Press. doi: 10.17226/10073.
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    Page 163

    3:15 p.m.–3:30 p.m.

    What Lies Ahead? Quality Measurement and the Future Role of the Consumer in Care

    Michael Millenson

    William M. Mercer, Inc.

    3:30 p.m.–4:00 p.m.

    Developing Potential Measures of Patient Centeredness for the National Health Care Quality Report

    Christina Bethell, Ph.D., M.B.A., M.P.H.

    Foundation for Accountability

    Discussant: Judith Hibbard, Dr.P.H., IOM Committee

    4:00 p.m.–4:15 p.m.

    Break

    SESSION 6: General Discussion on Measures for the National Health Care Quality Report

    4:15 p.m.–5:30 p.m.

    Discussion

    Moderator: Arnold Epstein, M.D., M.A.

    IOM Committee

    5:30 p.m.

    Adjourn

    Tuesday, May 23, 2000

    SESSION 7: Issues to Be Considered in Selecting and Defining Measures for the National Health Care Quality Report

    9:00 a.m.–9:15 a.m.

    Defining Indicators and Indices to Track the U.S. Health Care System

    Robert Rubin, M.D.

    The Lewin Group

    9:15 a.m.–9:30 a.m.

    Quality of Care Assessments: New Paradigms

    Barbara Starfield, M.D., M.P.H.

    Johns Hopkins University

    9:30 a.m.–9:45 a.m.

    Variability as a Measure of Quality: The Influence of Patient Preferences and Provider Practice

    John Wennberg, M.D., M.P.H.

    Dartmouth Medical School

    Suggested Citation:"Appendix A: Workshop: Envisioning a National Quality Report on Health Care." Institute of Medicine. 2001. Envisioning the National Health Care Quality Report. Washington, DC: The National Academies Press. doi: 10.17226/10073.
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    Page 164

    9:45 a.m.–10:00 a.m.

    Monitoring Racial, Ethnic, and Socioeconomic Disparities in Health Care: Conceptual Issues and Practical Considerations

    David Williams, Ph.D.

    University of Michigan

    SESSION 8: Available and Needed Data for the National Health Care Quality Report

    10:00 a.m.–10:15 a.m.

    Public Sources of Data and Possible Indicators for the National Health Care Quality Report

    Irma Arispe, Ph.D.

    National Center for Health Statistics

    10:15 a.m.–10:45 a.m.

    Potential Quality Indicators Using Private Data Sources and Future Data Needs for the National Health Care Quality Report

    Marsha Gold, Sc.D.

    Mathematica Policy Research

    Discussant: William Stead, IOM Committee

    SESSION 9: Technical and Data-Related Barriers to Producing a National Health Care Quality Report

    10:45 a.m.–11:30 a.m.

    Discussion

    Moderator: R. Heather Palmer, M.B., B.Ch., S.M.

    Harvard School of Public Health

    11:30 a.m.–11:45 a.m.

    Break

    SESSION 10: Roundtable—What Do Policy Makers Want from the National Health Care Quality Report?

    Moderator: Robert Rubin, M.D., The Lewin Group

    11:45 a.m.–12:30 p.m.

    Congress

    Cybele Bjorklund, M.P.H.

    Senate Committee on Health, Education, Labor and

    Pensions

     

    Jason Lee, Ph.D.

    House Committee on Commerce

    Suggested Citation:"Appendix A: Workshop: Envisioning a National Quality Report on Health Care." Institute of Medicine. 2001. Envisioning the National Health Care Quality Report. Washington, DC: The National Academies Press. doi: 10.17226/10073.
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    Page 165

     

    The States

    Lee Partridge

    American Public Human Services Association

    John Colmers, M.P.H.

    Maryland Health Care Commission

     

    Other Policy Makers: Insurers

    Donald Young, M.D.

    Health Insurance Association of America

    12:30 p.m.–1:00 p.m.

    Discussion: How to Produce a Report Useful to

    Policy Makers and Understandable to the Public

    1:00 p.m.–1:15 p.m.

    Closing Comments

    Mark Smith, M.D., M.B.A., IOM Committee

    1:15 p.m.

    Adjourn

    WORKSHOP SPEAKERS

    IRMA E. ARISPE, Associate Director for Science, Division of Health Care Statistics, National Center for Health Care Statistics, Hyattsville, Maryland

    DAVID W. BATES, Chief, Division of General Medicine, Brigham and Women's Hospital, Boston, Massachusetts

    CHRISTINA BETHELL, Senior Vice President, Research and Policy, Foundation for Accountability (FACCT), Portland, Oregon

    CYBELLE BJORKLUND, Deputy Staff Director, Senate Committee on Health, Education, Labor and Pensions, Washington, D.C.

    ROBERT H. BROOK, Vice President and Director, RAND Health and Corporate Fellow, The RAND Corporation, Santa Monica, California

    PEGGY G. CARR, Associate Commissioner, Assessment Division, National Center for Education Statistics, Washington, D.C.

    SUZANNE F. DELBANCO, Executive Director, Leapfrog Group, Washington, D.C.

    CLAES G. FORNELL, Donald C. Cook Professor of Business Administration and Director, National Quality Research Center, University of Michigan School of Business Administration, Ann Arbor, Michigan

    NANCY FOSTER, Agency for Healthcare Research and Quality, Rockville, Maryland

    MARSHA GOLD, Senior Fellow, Mathematica Policy Research, Inc., Washington, D.C.

    JESSIE GRUMAN, Executive Director, Center for the Advancement of Health, Washington, D.C.

    Suggested Citation:"Appendix A: Workshop: Envisioning a National Quality Report on Health Care." Institute of Medicine. 2001. Envisioning the National Health Care Quality Report. Washington, DC: The National Academies Press. doi: 10.17226/10073.
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    Page 166

    SHERRIE H. KAPLAN, Co-director, Primary Care Outcomes Research Institute, Tufts University School of Medicine, New England Medical Center, Boston, Massachusetts

    JASON LEE, Health Policy Counsel, U.S. House of Representatives, Committee on Commerce, Washington, D.C.

    MARK B. McCLELLAN, Assistant Professor, Department of Economics, Stanford University, Stanford, California

    ELIZABETH A. McGLYNN, Senior Researcher, The RAND Corporation, Santa Monica, California

    GREGG MEYER, Director, Center for Quality Measurement and Improvement, Agency for Healthcare Research and Quality, Rockville, Maryland

    MICHAEL L. MILLENSON, Principal, William M. Mercer, Inc., Chicago, Illinois

    R. HEATHER PALMER, Director, Center for Quality of Care Research and Education, Harvard School of Public Health, Boston, Massachusetts

    LEE PARTRIDGE, American Public Human Services Association, Washington, D.C.

    ROBERT J. RUBIN, President, The Lewin Group, Falls Church, Virginia

    BARBARA STARFIELD, University Distinguished Professor, The Johns Hopkins University, Baltimore, Maryland

    ORA STRICKLAND, Professor, Neil Hodgson Woodruff School of Nursing, and Director, Research on Special Populations of Veterans, Atlanta VA Medical Center, Atlanta, Georgia

    JACK E. TRIPLETT, Visiting Fellow, Brookings Institution, Washington, D.C.

    JOHN E. WARE, JR., President and Chief Scientific Officer, QualityMetric, Inc., Lincoln, Rhode Island

    JOHN E. WENNBERG, Director, Center for Evaluative Clinical Sciences, Dartmouth Medical School, Hanover, New Hampshire

    DAVID R. WILLIAMS, Senior Research Scientist, Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan

    DONALD YOUNG, Chief Operating Officer and Medical Director, Health Insurance Association of America, Washington, D.C.

    Suggested Citation:"Appendix A: Workshop: Envisioning a National Quality Report on Health Care." Institute of Medicine. 2001. Envisioning the National Health Care Quality Report. Washington, DC: The National Academies Press. doi: 10.17226/10073.
    ×
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    Suggested Citation:"Appendix A: Workshop: Envisioning a National Quality Report on Health Care." Institute of Medicine. 2001. Envisioning the National Health Care Quality Report. Washington, DC: The National Academies Press. doi: 10.17226/10073.
    ×
    Page160
    Suggested Citation:"Appendix A: Workshop: Envisioning a National Quality Report on Health Care." Institute of Medicine. 2001. Envisioning the National Health Care Quality Report. Washington, DC: The National Academies Press. doi: 10.17226/10073.
    ×
    Page161
    Suggested Citation:"Appendix A: Workshop: Envisioning a National Quality Report on Health Care." Institute of Medicine. 2001. Envisioning the National Health Care Quality Report. Washington, DC: The National Academies Press. doi: 10.17226/10073.
    ×
    Page162
    Suggested Citation:"Appendix A: Workshop: Envisioning a National Quality Report on Health Care." Institute of Medicine. 2001. Envisioning the National Health Care Quality Report. Washington, DC: The National Academies Press. doi: 10.17226/10073.
    ×
    Page163
    Suggested Citation:"Appendix A: Workshop: Envisioning a National Quality Report on Health Care." Institute of Medicine. 2001. Envisioning the National Health Care Quality Report. Washington, DC: The National Academies Press. doi: 10.17226/10073.
    ×
    Page164
    Suggested Citation:"Appendix A: Workshop: Envisioning a National Quality Report on Health Care." Institute of Medicine. 2001. Envisioning the National Health Care Quality Report. Washington, DC: The National Academies Press. doi: 10.17226/10073.
    ×
    Page165
    Suggested Citation:"Appendix A: Workshop: Envisioning a National Quality Report on Health Care." Institute of Medicine. 2001. Envisioning the National Health Care Quality Report. Washington, DC: The National Academies Press. doi: 10.17226/10073.
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    Next: Appendix B: Designing a Comprehensive National Report on Effectiveness of Care: Measurement, Data Collection, and Reporting Strategies »
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    How good is the quality of health care in the United States? Is quality improving? Or is it suffering? While the average person on the street can follow the state of the economy with economic indicators, we do not have a tool that allows us to track trends in health care quality. Beginning in 2003, the Agency for Healthcare Research and Quality (AHRQ) will produce an annual report on the national trends in the quality of health care delivery in the United States. AHRQ commissioned the Institute of Medicine (IOM) to help develop a vision for this report that will allow national and state policy makers, providers, consumers, and the public at large to track trends in health care quality. Envisioning the National Health Care Quality Report offers a framework for health care quality, specific examples of the types of measures that should be included in the report, suggestions on the criteria for selecting measures, as well as advice on reaching the intended audiences. Its recommendations could help the national health care quality report to become a mainstay of our nation’s effort to improve health care.

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