[Federal Register Volume 71, Number 64 (Tuesday, April 4, 2006)]
[Notices]
[Pages 16786-16787]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 06-3207]


=======================================================================
-----------------------------------------------------------------------

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Agency for Healthcare Research and Quality


AHRQ Quality Indicators Workgroup on Inpatient and Patient Safety 
Composite Measures

AGENCY: Agency for Healthcare Research and Quality (AHRQ), DHHS.

ACTION: Notice of request for nominations.

-----------------------------------------------------------------------

SUMMARY: 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 http://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.

DATES: Please submit nominations on or before May 4, 2006. Self-
nominations are welcome. Third-party nominations must indicate that the 
individual has been contacted and is willing to serve on one of the 
workgroups. Notification of selected candidates will be contacted by 
AHRQ no later than May 15, 2006.

ADDRESSES: Nominations can be sent in the form of a letter or e-mail, 
preferably as an electronic file with an e-mail attachment and should 
specifically address the submission criteria as noted below. Electronic 
submissions are strongly encouraged. Responses should be submitted to: 
AHRQ Quality Indicators Initiative, Agency for Healthcare Research and 
Quality, Center for Delivery, Organization and Markets, 540 Gaither 
Road, Room 5121, Rockville, MD 20850. E-mail: [email protected].

Submission Criteria

    To be considered for membership on the AHRQ QI Workgroups, please 
send the following information for each nominee:
    1. A brief nomination letter highlighting experience/knowledge 
relevant in the development and use of composite performance measures 
and familiarity with the AHRQ QIs and health care administrative data. 
(See selection criteria below.) Please include full contact information 
of nominee: Name, title, organization, mailing address, telephone and 
fax numbers, and e-mail address).
    2. Curriculum vita (with citations to any pertinent publications).

Nominee Selection Criteria

    Nominees should have technical expertise in health care quality 
measurement development, and a familiarity with statistical methods and 
risk adjustment strategies in the area of composite measure 
development.
    More specifically, each candidate will be evaluated using the 
following criteria:
     Peer-reviewed publications relevant to the development of 
composite measures; performance measures and reporting;
     Expertise in statistical methods relevant to the 
development of composite measures;
     Knowledge of recent composite methodologies published in 
the literature;
     Experience with development of measures based on 
administrative data and its uses;
     Expertise in hospital quality improvement and patient 
safety;
     Familiarity with the AHRQ Quality Indicators and their 
application;
     Experience with application of performance measures for 
public reporting; and,
     Availability to provide written comments and conference 
calls between late April and early August.

Time Commitment

    In an effort to provide for expert input and for recommendations to 
develop a composite measure methodology, we are initiating a review 
process that will require participation in approximately four to five 
conference calls with some

[[Page 16787]]

pre- and post-evaluation time (approximately 10 hours). Results from 
this process will influence the development of composite measures for 
the AHRQ Quality indicators. Beginning in late April/early May through 
early August, selected nominees will be asked to participate in the 
following activities:

IQI/PSI Sub-Workgroup Activities

    1. Provide evaluative comments on current methodology for composite 
indicators (2.0 hours) and participate in subsequent General Workgroup 
call (1.0 hour);
    2. Participate in one Sub-Workgroup conference call to discuss 
suggested changes to the current composite indicator methodology (1.5 
hours);
    3. Provide evaluative comments on AHRQ's new draft or revised 
methodology (1.5 hour);
    4. Participate in second Subgroup call to respond to each others' 
comments and questions or provide additional clarifications regarding 
draft methodology (1.5 hours); and
    5. Participate in second General workgroup call. Provide 
suggestions for summary document for public comment (2.0 hours).
    The Workgroup will conduct business by telephone, e-mail, or other 
electronic means as needed.

FOR FURTHER INFORMATION CONTACT: Mamatha Pancholi, Center for Delivery, 
Organization, and Markets, Agency for Healthcare Research and Quality, 
540 Gaither Road, Rockville, MD 20850; Phone: (301) 427-1470; Fax: 
(301) 427-1430; E-mail: [email protected]; or
    Marybeth Farquhar, Center for Delivery, Organization, and Markets, 
Agency for Healthcare Research and Quality, 540 Gaither Road, 
Rockville, MD 20850; Phone: (301) 427-1317; Fax: (301) 427-1430; E-
mail: [email protected].

SUPPLEMENTARY INFORMATION:

Background

    The AHRQ Quality Indicators (AHRQ QIs) are a unique set of measures 
of health care quality that make use of readily available hospital 
inpatient administrative data. The QIs have been used for various 
purposes. Some of these include tracking, hospital self-assessment, 
reporting of hospital-specific quality or pay for performance. The AHRQ 
QIs are provider- and area-level quality indicators and currently 
consist of four modules: The Prevention Quality Indicators (PQI), the 
Inpatient Quality Indicators, the Patient Safety Indicators (PSI) and 
the Pediatric Quality Indicators (PedsQIs). In response to feedback 
from the AHRQ QI user community, AHRQ is committed to developing 
composite measures in an effort to provide an overall view of quality 
that is complete, useful and easily understandable to consumers and 
others within the health care field.

    Dated: March 29, 2006.
Carolyn M. Clancy,
Director.
[FR Doc. 06-3207 Filed 4-3-06; 8:45 am]
BILLING CODE 4160-90-M