Agency for Healthcare Research and Quality April 4, 2006 – Federal Register Recent Federal Regulation Documents

The Agency for Healthcare Research and Quality (AHRQ) is seeking nominations for members of an AHRQ-convened Quality Indicators Workgroup on Composite Measures for the Inpatient Quality Indicators (IQIs) and the Patient Safety Indicators (PSIs) as part of a general workgroup on composite measures. The AHRQ QI Composite Measures General Workgroup and subsequent IQI and PSI sub-workgroups are being formed as part of a structured approach for developing composite measures from the IQI and PSI software tools for public reporting of quality of hospital care at the national and state level. The purpose of this project is to obtain input from interested organizations and individuals on the development of composite quality measures based on hospital discharge data, specifically using the IQI and PSI measures. The Workgroups will evaluate appropriate technical and methodological approaches currently available and will discuss and suggest strategies as to what composite measure methodology would best fit QI user needs. As part of this effort and using the AHRQ PSIs and IQIs, the Workgroup members will be addressing several key issues for the development of composite measures, including but not limited to: Identifying and defining the quality concept that each composite is intended to measure; Suggesting and considering the individual quality indicators that should be included in the composite; The manner of weighting with which individual quality indicators could or should be combined; Evaluation of using condition-specific quality of care composites (e.g., for cardiovascular disease, or diabetes) or population-specific composites (e.g., pediatrics, women, or geriatrics) or domain specific composites (e.g., surgical, or infections); and Discussion of the methodological considerations which are appropriate or important when combining quality indicators and the considerations when composites are used for publicly reporting data. For additional information about the AHRQ Quality Indicators, please visit the AHRQ Quality Indicators Web site at https:// www.qualityindicators.ahrq.gov. Specifically, the AHRQ QI Composite Measures General Workgroup will consist of up to 15 individuals who have expertise in one or more of the following areas: Statistical methods, hospital quality improvement and patient safety, health services research, and administrative data. To the extent possible, this Workgroup will represent a variety of stakeholder perspectives, specifically including(1) Consumers, (2) healthcare purchasers, (3) quality improvement organizations, (4) researchers, (5) healthcare professionals, (6) state-based organizations, and (7) Federal health care provider organizations. The Workgroup will be further divided into two sub-workgroups to focus on the IQIs and the PSIs separately. Each sub-workgroup will have a series of conference calls to share perspectives, discuss the technical and policy issues surrounding composite measures for each module and will then summarize their discussions for presentation to the AHRQ QI Composite Measures General Workgroup. The AHRQ QI Composite Measures General Workgroup will provide responses to the sub-workgroups' findings. AHRQ will then develop a summary of the discussion in a technical report. This report will be made available for public comment.