Th he e A AH HR RQ Q Q Qu ua al li it ty y T In nd - - PDF document

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Th he e A AH HR RQ Q Q Qu ua al li it ty y T In nd - - PDF document

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AHRQ Quality Indicators Toolkit Th he e A AH HR RQ Q Q Qu ua al li it ty y T In nd di ic ca at to or rs s I Re es su ul lt ts s a an nd d D Di is sc cu us ss si io on n o of f D Da at ta a R

slide-1
SLIDE 1

AHRQ Quality Indicators Toolkit

T Th he e A AH HR RQ Q Q Qu ua al li it ty y I In nd di ic ca at to

  • r

rs s

R Re es su ul lt ts s a an nd d D Di is sc cu us ss si io

  • n

n

  • f

f D Da at ta a A An na al ly ys si is s

1 Tool B.3b

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SLIDE 2

AHRQ Quality Indicators Toolkit

I IN NS ST TR RU UC CT TI IO ON NS S F FO OR R U US SI IN NG G T TH HI IS S T TO OO OL L – – D DE EL LE ET TE E T TH HI IS S S SL LI ID DE E B BE EF FO OR RE E P PR RE ES SE EN NT TA AT TI IO ON N

  • Use this PowerPoint presentation

as a template for your presentation.

  • Replace the charts with charts that

you create with your data (use the Excel workbook for guidance) and replace the red text with your hospital’s information.

2 Tool B.3b

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SLIDE 3

AHRQ Quality Indicators Toolkit

H Ho

  • w

w c ca an n t th he e A AH HR R Q Q Q QI Is s b be e u us s e ed d i in n q qu ua al li it ty y a as s s s e es s s s m me en nt t? ?

  • Can be used to:
  • Flag potential problems in quality
  • f care
  • Assess performance and

compare against peer hospitals

  • Observe your hospital’s

performance over time

Source: www.qualityindicators.ahrq.gov and AHRQ Quality Indicators Toolkit Literature Review

3 Tool B.3b

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SLIDE 4

AHRQ Quality Indicators Toolkit

Y Y o

  • u

ur r H Ho

  • s

s p pi it ta al l' 's s P P e er rf fo

  • r

rm ma an nc ce e R R e el la at ti iv ve e t to

  • N

Na at ti io

  • n

na al l B B e en nc c h hm ma ar rk ks s

13 14 15 16 17 18 19 20 21 22 23 24 32 34

  • 100
  • 50

50 100 150 200

When the individual hospital rate = 0, the percent difference is shown as -100%

Inpatient Quality Indicators Percent Difference in Rates

Relative to a national sample of hospitals, Your Hospital has similar or better performance on most of the IQIs.

Notes: This chart comes from the Excel worksheet (compare-IQI-rates-benchmark).

4 Tool B.3b

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SLIDE 5

AHRQ Quality Indicators Toolkit

Y Y o

  • u

ur r H Ho

  • s

s p pi it ta al l' 's s P P e er rf fo

  • r

rm ma an nc ce e R R e el la at ti iv ve e t to

  • N

Na at ti io

  • n

na al l B B e en nc c h hm ma ar rk ks s

2 3 4 6 7 8 9 12 14 15 18 19

  • 100
  • 80
  • 60
  • 40
  • 20

20 40 60 80

When the individual hospital rate = 0, the percent difference is shown as -100%

Patient Safety Indicators

Percent Difference in Rates

Relative to a national sample of hospitals, Your Hospital has similar or better performance on many of the PSIs. However, Pressure Ulcers (PSI 3) occur at higher rates than the national sample – this may be an area where Your Hospital should focus quality improvement efforts.

Notes: This chart comes from the Excel worksheet (compare-PSI-rates-benchmark).

5 Tool B.3b

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SLIDE 6

AHRQ Quality Indicators Toolkit

D DE EL LE ET TE E T TH HI IS S S SL LI ID DE E B BE EF FO OR RE E P PR RE ES SE EN NT TA AT TI IO ON N

  • In this example, we will examine the

rates of Pressure Ulcers (PSI 3) and how this particular hospital performed over time.

  • Determine which indicator(s) you

would like to focus on, and fill in these slides based on that indicator and your hospital’s data.

  • Based on the information that you

would like to present, you may choose not to use all of the slides available here.

6 Tool B.3b

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SLIDE 7

AHRQ Quality Indicators Toolkit

I In nd di ic c a at to

  • r

rs s T T h ha at t R R e eq qu ui ir re e A At tt te en nt ti io

  • n

n

  • Based on a review of Your

Hospital’s performance on the IQIs and PSIs, we have decided to focus

  • n the following indicators:

– Pressure Ulcer (PSI 3) – – – –

7 Tool B.3b

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SLIDE 8

AHRQ Quality Indicators Toolkit

D DE EL LE ET TE E T TH HI IS S S SL LI ID DE E B BE EF FO OR RE E P PR RE ES SE EN NT TA AT TI IO ON N

  • You may want to include

information about the indicator as background information.

  • Go

to www.qualityindicators.ahrq.gov/

  • r see the Fact Sheet in this toolkit

(Tool A1) to obtain this information.

8 Tool B.3b

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SLIDE 9

AHRQ Quality Indicators Toolkit

A A P P S S I I E E x xa am mp pl le e: : P P r re es s s s u ur re e U Ul lc c e er r ( (P P S S I I 3 3) )

  • Numerator: Discharges with ICD-9-CM

code of pressure ulcer in any secondary diagnosis field among cases meeting the inclusion and exclusion rules for the denominator

  • Denominator: All medical and surgical

discharges age 18 years and older defined by specific DRGs or Medicare Severity DRGs that do not meet any of the exclusion criteria

  • DELETE THIS TEXT BEFORE

PRESENTATION: Replace this information with information about your chosen indicators. Copy this slide and repeat as necessary.

ICD-9 = International Classification of Diseases, 9th Source: Revision; DRG = diagnosis-related group. www.qualityindicators.ahrq.gov/Modules/PSI_TechSpec.aspx.

9 Tool B.3b

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SLIDE 10

AHRQ Quality Indicators Toolkit

C C o

  • m

mp pa ar ri in ng g P P e er rf fo

  • r

rm ma an nc c e e O Ov ve er r T T i im me e

Examining Observed Rates of Pressure Ulcers (PSI 3)

0.01 0.02 0.03 0.04 0.05 0.06 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010

Notes: This chart comes from the Excel worksheet (trend-observed).

10 Tool B.3b

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SLIDE 11

AHRQ Quality Indicators Toolkit

C C o

  • m

mp pa ar ri in ng g O Ob bs s e er rv ve ed d P P e er rf fo

  • r

rm ma an nc ce e t to

  • E

E x xp pe ec c t te ed d P P e er rf fo

  • r

rm ma an nc c e e

  • v

ve er r T T i im me e

Comparing Observed Rates of Pressure Ulcers (PSI 3) to Expected Rates

0.01 0.02 0.03 0.04 0.05 0.06 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Observed Expected

Notes: This chart comes from the Excel worksheet (trend-observed-expected).

11 Tool B.3b

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SLIDE 12

AHRQ Quality Indicators Toolkit

C C o

  • m

mp pa ar ri in ng g R R i is s k k-

  • A

Ad dj ju us s t te ed d a an nd d S S m mo

  • t

th he ed d R R a at te es s O Ov ve er r T T i im me e

Risk-adjusted and Smoothed Rates of Pressure Ulcers (PSI 3)

0.01 0.02 0.03 0.04 0.05 0.06 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Risk-adjusted Risk-adjusted (Lower Confidence Interval Bound) Risk-adjusted (Upper Confidence Interval Bound) Smoothed

Notes: This chart comes from the Excel worksheet (trend-risk-adjusted-smoothed).

12 Tool B.3b

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SLIDE 13

AHRQ Quality Indicators Toolkit

E E v va al lu ua at ti in ng g C C a as s e e M Mi ix x R R e el la at ti iv ve e t to

  • O

Ot th he er r H Ho

  • s

s p pi it ta al ls s

Comparing Expected Rates of Pressure Ulcers (PSI 3) to the Benchmark Rates in order to Compare Case Mix

0.005 0.01 0.015 0.02 0.025 0.03 0.035 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Expected Benchmark*

Notes: This chart comes from the Excel worksheet (trend-expected-benchmark).

13 Tool B.3b

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SLIDE 14

AHRQ Quality Indicators Toolkit

C C o

  • m

mp pa ar ri in ng g H Ho

  • s

s p pi it ta al l’ ’s s P P e er rf fo

  • r

rm ma an nc c e e t to

  • N

Na at ti io

  • n

na al l P P e er rf fo

  • r

rm ma an nc c e e O Ov ve er r T T i im me e

Comparing Risk-adjusted Rates of Pressure Ulcers (PSI 3) to the Benchmark Rates

0.01 0.02 0.03 0.04 0.05 0.06 2 2 1 2 2 2 3 2 4 2 5 2 6 2 7 2 8 2 9 2 1 Benchmark* Risk-adjusted rate Risk-adjusted (Lower Confidence Interval Bound) Risk-adjusted (Upper Confidence Interval Bound)

Notes: This chart comes from the Excel worksheet (trend-risk-adjusted-benchmark).

14 Tool B.3b