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Closing the Quality Gap Series – State of the Science form Systematic Reviews

Primary Author: Kathryn McDonald, MM
Organization Stanford University, Stanford Health Policy

 

Abstract

Purpose

To develop a new Closing the Quality Gap (CQG) series of evidence reports on current priority areas identified by AHRQ, and summarize the state of the science about effective strategies to improve quality of care.

Background

From 2004 to 2007, the Agency for Healthcare Research and Quality (AHRQ) commissioned a collection of evidence reports to bring data to bear on quality improvement (QI) opportunities identified by an Institute of Medicine (IOM) study, Priority Areas for National Action: Transforming Health Care Quality.(1-8)

Materials & Methods

We developed a common protocol for the series outlining guiding principles, key questions and an overarching framework (9) aimed at enabling a summary of commonalities and challenges seen across eight diverse topics (public reporting, bundled payment, medical home, healthcare acquired infection reduction, disabilities measures, disparities reduction, medication adherence, and palliative care). The evidence for each topic was assessed consistent with the AHRQ Methods Guide for Effectiveness and Comparative Effectiveness Reviews. (10)

Results

The following key questions (KQ) launched each report:
KQ1: What is the quality gap(s) targeted by this review, and how might each gap be approached to lead to improvements?
KQ2: Who are the likely stakeholders who could act upon the gap, and what evidence will they need? What are the likely level(s) for implementation of results from the topic report?
KQ 3: From an initial exploration of the potential literature, what is the state of the science for the topic area and gap?
We synthesized findings across the series in an overarching framework about how evidence related to information, incentives, and infrastructure could be used by different target audiences at the micro and macro levels.

Conclusion

The development of a common review method facilitates summarizing the state of the science for closing quality gaps, and results in generating cross-cutting future research themes for the improvement field.

Bibliography

  1. Institute of Medicine (U.S.). Committee on Identifying Priority Areas for Quality Improvement. Adams K, Corrigan J. Priority areas for national action: transforming health care quality. Washington, D.C.: National Academies Press; 2003.
  2. Bravata DM, Sundaram V, Lewis R, et al. Closing the Quality Gap: A Critical Analysis of Quality Improvement Strategies, Volume 5 – Asthma Care. Technical Review 9 (Contract No. 290-02-0017 to the Stanford University-UCSF Evidence-based Practice Center). AHRQ Publication No. 04-005101-5. Rockville, MD: Agency for Healthcare Research and Quality. 2007.
  3. McDonald KM, Sundaram V, Bravata DM, et al. Closing the Quality Gap: A Critical Analysis of Quality Improvement Strategies, Volume 7 – Care Coordination. Technical Review 9 (Contract No. 290-02-0017 to the Stanford University-UCSF Evidence-based Practice Cener). AHRQ Publication No. 04(07)-0051-7. Rockville, MD: Agency for Healthcare Research and Quality. 2007.
  4. Ranji SR, Shetty K, Posley KA, et al. Closing the Quality Gap: A Critical Analysis of Quality Improvement Strategies, Volume 6 – Prevention of Healthcare-Associated Infections. Technical Review 9. (Contract No. 290-02-0017 to the Stanford University-UCSF Evidence-based Practice Center). AHRQ Publication No. 04(07)-005101-6. Rockville, MD: Agency for Healthcare Research and Quality. 2007.
  5. Ranji SR, Steinman MA, Shojania KG, et al. Closing the Quality Gap: A Critical Analysis of Quality Improvement Strategies, Volume 4 – Antibiotic Prescribing Behavior. Technical Review 9. (Contract No. 290-02-0017 to the Stanford University-UCSF Evidence-based Practice Center). AHRQ Publication No. 04-005101-4. Rockville, MD: Agency for Healthcare Research and Quality. 2006.
  6. Shojania KG, McDonald KM, Wachter R, Owens DK. Closing the Quality Gap: A Critical Analysis of Quality Improvement Strategies, Volume 1 – Series Overview and Methodology. Technical Review 9. (Contract No. 290-02-0017 to the Stanford University-UCSF Evidence-based Practice Center). AHRQ Publication No. 04-005101. Rockville, MD: Agency for Healthcare Research and Quality. 2004.
  7. Shojania KG, Ranji SR, Shaw LK, et al. Closing the Quality Gap: A Critical Analysis of Quality Improvement Strategies, Volume 2 – Diabetes Mellitus Care. Technical Review 9. (Contract No. 290-02-0017 to the Stanford University-UCSF Evidence-based Practice Center). AHRQ Publication No. 04-005101-2. Rockville, MD: Agency for Healthcare Research and Quality. 2004.
  8. Walsh J, McDonald KM, Shojania KG, et al. Closing the Quality Gap: A Critical Analysis of Quality Improvement Strategies, Volume 3 – Hypertension Care. Technical Review 9. (Contract No. 290-02-0017 to the Stanford University-UCSF Evidence-based Practice Center). AHRQ Publication No. 04-005101-3. Rockville, MD: Agency for Healthcare Research and Quality. 2005.
  9. Closing the Quality Gap: Revisiting the State of the Science — Series Overview http://effectivehealthcare.ahrq.gov/index.cfm/search-for-guides-reviews-… /?pageaction=displayproduct&productid=715
  10. Methods Guide for Effectiveness and Comparative Effectiveness Reviews. Agency for Healthcare Research and Quality, 2011. Accessed Jan 24, 2011, at http://www.effectivehealthcare.ahrq.gov/index.cfm/search-for-guides-revi….

© Improvement Science Research Network, 2012

The ISRN published this as received and with permission from the author(s).