Quality Improvement Tools & Resources

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HRSA and HHS Resources

HRSA Clinical Quality & Performance Measures Toolkit
HRSA recognizes the need for a toolkit of objective educational tools and resources to assist an organization in its quality improvement (QI) efforts. The HRSA Quality Toolkit is equipped with proven strategies and techniques to effectively support an organization's new or existing QI program. The toolkit's wide range of practical, convenient, and useful tools are used for implementing data collection and performance measurement techniques, and the organizations that integrated their use into QI programs effectively improved their deliveries of care. These resources are adaptable and may be used to facilitate the implementation of a new QI program or fine tune an existing one.”

Operating a Health Center: Quality Improvement
A list of technical assistance resources for health centers conducting quality improvement.

Corporate Responsibility and Health Care Quality: A Resource for Health Care Boards of Directors A United States Department of Health and Human Services’ Office of Inspector General resource which seeks to assist directors of health care organizations in carrying out their important oversight responsibilities in the current challenging health care environment.

U.S. Department of Health & Human Services (HHS) Measure Inventory
A comprehensive list of quality measures used by the Department.

Physician Quality Reporting Initiative (PQRI)Tool KitA Centers for Medicare & Medicaid Services tool Kit developed for the Physician Quality Reporting Initiative (PQRI) to assist eligible professionals with successful reporting. This toolkit consists of some existing educational resources plus new measure-specific worksheets designed to walk the user step-by-step through reporting for each measure.

AHRQ State Snapshots
Provides state-specific health care quality information including strengths, weaknesses, and opportunities for improvement. The goal is to help State officials and their public- and private-sector partners better understand health care quality and disparities in their State.

Advances in Patient Safety: From Research to Implementation An Agency for Healthcare Research and Quality resource which describes what federally funded programs have accomplished in understanding medical errors and implementing programs to improve patient safety over the last five years.

AHRQ Patient Safety Network (PSNet)
An Agency for Healthcare Research and Quality resource which includes an annotated compilation of the most recent and important news, research, tools, and conferences in patient safety.

Translating Recommendations Into Reality: Community Voices
A Centers for Disease Control and Prevention resource which examines the importance of integrating voices from all communities, including those with mixed incomes, differing races and ethnicities, and diverse cultures.

Patient Safety Tools: Improving Safety at the Point of Care
An Agency for Healthcare Research and Quality resource which includes toolkits produced for a variety of evidence-based tools, including training materials, medication guides and checklists that are easily adapted to other institutions and care settings. The tools were developed in the field and are designed to be implemented by multidisciplinary users.

Hospital Survey on Patient Safety Culture
An Agency for Healthcare Research and Quality resource which assesses the safety culture of a hospital as a whole, or for specific units within hospitals, as well as to track changes in patient safety over time and evaluate the impact of patient safety interventions.

Community Quality Collaboratives
An AHRQ resource which describes Community-based multistakeholder collaboratives which are on the forefront of implementing cutting-edge ways to transform health care at the local level.

Report to Congress: National Strategyfor Quality Improvement in Health Care
The National Quality Strategy promotes quality health care in which the needs of patients, families, and communities guide the actions of all those who deliver and pay for care. This report incorporates the evidence-based results of the latest research and scientific advances in clinical medicine, public health, and health care delivery.

E-Prescribing and Medication Management
The above links to presentation slides, a transcript, and a WebEx recording of an Agency for Healthcare Research and Quality on the role of health information technology in medication management, from prescribing to adherence.

Critical Access Hospital Year 5 Hospital Compare Participation and Quality Measure Results (March 2010)
This report examines 2008 participation and quality measure results for Critical Access Hospitals (CAHs) in the Centers for Medicare and Medicaid Services (CMS) Hospital Compare public reporting database for hospital quality measures.

Medicare Beneficiary Quality Improvement Project (MBQIP)
The goal of the Flex Medicare Beneficiary Quality Improvement Project (MBQIP) is to improve rural quality care access for Medicare beneficiaries served by critical access hospitals (CAHs). These resources address the challenges of defining and reporting rural-relevant quality measurements and adopting proven clinical delivery models that drive quality and performance-based value. They also provide an overview of the goals, expectations, and measures for MBQIP.

Agency for Healthcare Research and Quality (AHRQ) Quality Indicators
Measures of health care quality that make use of readily available hospital inpatient administrative data.

Transforming Hospitals: Designing for Safety and Quality
An AHRQ resource which provides evidence to help hospital officials and architects design safer, high quality hospitals.

Transforming Hospitals: Designing for Safety and Quality
An AHRQ resource which explains the need for increased information transparency about hospital performance, and reimbursement linked to performance, improving health care environments may be critical to a hospital's survival.

Other Resources

Engaging Hospital Boards in Quality and Safety
This Institute for Healthcare Improvement Webinar explores the relationship between engaged boards and high-quality health outcomes. It also explains the key elements necessary to create and sustain high-performance boards focused on quality and safety.

A Roadmap for Improving the Quality of Care in Critical Access Hospitals
This document details six recommendations to improve the quality of care in Critical Access Hospitals.

Four Performance Management Tools: An Overview of Balanced Scorecard, Baldrige, Lean and Studer
This document outlines four performance management tools: Balanced Scorecard, Baldrige, Lean, and Studer. These tools have been identified by the National Rural Health Resource Center as effective methods for managing performance improvement with small rural hospitals. Each management tool can be used independently or in combination to fit the uniue challenges and culture of rural health organizations.

The American Health Quality Association: Advancing Quality of Care & Patient Safety Nationwide
Contains links to best practices published by Quality Improvement Organizations (QIOs) and professionals working to improve the quality of health care in communities across America.

Pennsylvania's Lean Outreach
The final report of a collaboration between the Pennsylvania Flex Program and Pennsylvania State University Industrial Engineering to bring Lean technologies and operational improvement to critical access hospitals.

Challenges for Improving Health Care Access in Rural America: A Compendium of Research and Policy Analysis Studies of Rural Health Research and Policy Analysis Centers
A resource that presents relevant research studies in six sections: health insurance and its financing; access to care for rural populations; the impact of the economic downturn; issues in rural health workforce, covering the crisis situation for primary care physicians; general surgeons, registered nurses, and dentists; and, health system challenges with an emphasis on rural impacts of financing and quality initiatives.

Balanced Scorecards for Small Rural Hospitals: Concept Overview and Implementation Guidance
A publication which describes the process of implementing a Balanced Scorecard (BSC) initiative in a small rural hospital setting, including how to identify if an organization is ready for the implementation phase, what the various steps are in the process, what key principles need to be considered that are common to rural hospitals, and what a rural hospital Balanced Scorecard would look like.

Critical Access Hospital Year 3 Hospital Compare Participation and Quality Measure Results (September 2008)
Details the third year of participation, and quality measure results, for CAHs in the CMS Hospital Compare public reporting database for hospital quality measures.

National Association for Healthcare Quality
An organization committed to developing and promoting professional expertise in the art and science of healthcare quality. The National Association for Healthcare Quality also publishes the Journal for Healthcare Quality, which is the first choice for creative and scientific solutions in the pursuit of healthcare quality.

New Hampshire Critical Access Hospital (CAH) Quality Improvement Network (QIN) Adds Value and Credibility
A document which outlines the collaborative performance/quality improvement activities of the thirteen New Hampshire critical access hospitals (CAHs) participating in the Small Rural Hospital Improvement Grant Program (SHIP).

Quality Through Collaboration - The Future of Rural Health
A resource which assesses the quality of health care in rural areas; develops a conceptual framework for a core set of services and infrastructure necessary to deliver those services to rural communities; recommends priority objectives and changes in policies and programs required to achieve those objectives; considers implications for federal programs and policy.

Quality Improvement Strategies and Best Practices in Critical Access Hospitals
A resource which describes the continuing evaluation and maturation of CAH QI activities, and documents the best practices of two CAH's that have developed innovative QI Programs.

Health Care Quality: The Rural Context
A resource which seeks to examine the current state of debate over health care quality and patient safety and how it affects rural communities.

Rural Assistance Center's Health Care Quality Information Guide
An in-depth information guide that includes FAQs, tools, funding, documents, journals, organizations, bibliographies, news and events on healthcare quality.

Hospital Quality: Ingredients for Success - Overview and Lessons Learned
A resource which describes how top U.S. hospitals effectively develop and maintain quality-improvement programs is examined. It identifies models for best practices and lays out specific actions that hospitals can take to emulate them.

The Implementation of Pay-For-Performance in Rural Hospitals: Lessons from the Hospital Quality Incentive Demonstration (HQID) Project
A resource examining the conditions for successful participation in pay-for-performance (P4P) initiatives which affect rural health care providers differently than urban providers.

Hospital Performance Improvement: Are things getting better?
Commonwealth Fund reports on “Hospital Performance Improvement: Trends in Quality and Efficiency” and “Hospital Quality Improvement: Strategies and Lessons from U.S. Hospitals”.

Aiming Higher: Results from a State Scorecard on Health System Performance
A Commonwealth Fund report which assesses state variation across key dimensions of health system performance: access, quality, avoidable hospital use and costs, equity, and healthy lives. The findings document wide variation among states and the potential for substantial improvement "in terms of access, quality, costs, and lives" if all states approached levels achieved by the top states.

Making Strides in Safety
An American Medical Association resource which provides quick tips about how to improve overall patient safety in your facility. It briefly describes six different programs designed by the Institute for Healthcare Improvement that can be implemented in your hospital to attain the highest quality patient safety standards.