Agency for Healthcare Research and Quality

The Agency for Healthcare Research and Quality (AHRQ) (formerly known as the Agency for Health Care Policy and Research) is one of 12 agencies within the United States Department of Health and Human Services (HHS). AHRQ is one of three organizational focuses for HHS along with the National Institutes of Health and the Centers for Disease Control. AHRQ's mission is to improve the quality, safety, efficiency and effectiveness of healthcare for Americans. Led by Director Carolyn M. Clancy, M.D., AHRQ sponsors, conducts, and disseminates research to aid in informed decision-making and improve the quality of health care services.

Working with the public and private sectors, AHRQ research evaluates the effectiveness of health care interventions and aims to translate this knowledge into everyday practice and policymaking.

Medical cost-effectiveness research

AHRQ's patient-centered outcomes research aims to improve health care quality by providing patients and physicians with evidence-based information on which medical treatments work best for a given condition. Comparisons of drugs, medical devices, tests, surgeries, or ways to deliver health care can be used to help patients and their families understand and evaluate treatments options and risks. AHRQ initiatives include:

• The John M. Eisenberg Center for Clinical Decisions and Communications Science that translates comparative effectiveness reviews and research reports created by AHRQ's Effective Health Care Program into guides and tools for consumers, clinicians, and policymakers.
• Evidence-based Practice Centers that review and synthesize scientific evidence for conditions or technologies that are costly, common, or important to the Medicare or Medicaid programs.
• The Centers for Education and Research on Therapeutics (CERTs) that conduct research and provide education to advance the optimal use of drugs, biologicals, and medical devices.
• The Developing Evidence to Inform Decisions about Effectiveness Network (DEcIDE), research-based health organizations that conduct practical studies about the outcomes, comparative clinical effectiveness, safety, and appropriateness of health care items and services.

Quality improvement and patient safety

AHRQ funds and disseminates research that identifies the root causes of threats to patient safety, provides information on the scope and impact of medical errors, and examines effective ways to make system-level changes to help prevent errors. AHRQ initiatives include:

• Preventing healthcare-associated infections.
• Medical liability reform.
• Patient Safety Organizations, which collect and analyze patient safety events that health care providers report and provide feedback to help clinicians and health care organizations improve health care quality. AHRQ administers the provisions of the Patient Safety and Quality Improvement Act of 2005 and the Patient Safety Rule dealing with PSO operations.
• TeamSTEPPS® (Team Strategies and Tools to Enhance Performance and Patient Safety), an evidence-based teamwork system designed to improve communication and teamwork skills among health care professionals.
• Patient safety culture assessment tools that hospitals, nursing homes, and medical offices use to assess their patient safety culture, track changes in patient safety over time, and evaluate the impact of specific patient safety interventions.

Health information technology (health IT)

AHRQ's Health IT initiative is part of the Nation's strategy to put technology to work in health care. AHRQ provides support to promote access to and encourage the adoption of health IT.

The Agency has focused its health IT activities on the following three goals:

• Improve health care decisionmaking.
• Support patient-centered care.
• Improve the quality and safety of medication management.

Prevention and chronic care

AHRQ translates evidence-based knowledge into recommendations for clinical preventive services to improve the health of all Americans. AHRQ initiatives include:

• The Patient-Centered Medical Home, a model to improve health care by transforming how primary care is organized and delivered that ensures care is patient-centered, comprehensive, and accessible, coordinated across the health care system, and uses a systems-based approach to quality and safety.
• The Primary Care Practice-Based Research Networks that rapidly develop and assess methods and tools to ensure that new scientific evidence is incorporated into real-world practice settings.
• Administrative support for the U.S. Preventive Services Task Force, an independent panel of nationally renowned, non-Federal experts in prevention and evidence-based medicine that assesses the benefits and harms of preventive services and makes recommendations about which preventive services should be incorporated routinely into primary care practice.

Health care value

AHRQ looks for ways to achieve greater value in health care by producing the measures, data, tools, evidence, and strategies that health care organizations, systems, insurers, purchasers, and policymakers need to improve the value and affordability of health care. AHRQ initiatives include:

• The Medical Expenditure Panel Survey (MEPS), a family of surveys that gathers information about families and individuals, their medical providers, and employers across the United States. It is the only national source of annual data on the specific health services that Americans use, how frequently services are used, the cost of services, and the methods of paying for services.
• The Healthcare Cost and Utilization Project (HCUP), a family of health care databases and related software tools and products developed through a Federal-State-industry partnership that serves as a national information resource of patient-level health care data.
• Quality Indicators (QIs) that highlight potential quality concerns; identify areas that need further study; and track changes over time in prevention, inpatient care, patient safety, and pediatric care. QIs measure health care quality based upon readily available hospital inpatient administrative data.
• The annual National Healthcare Quality Report and National Healthcare Disparities Report that measure trends in effectiveness of care, patient safety, timeliness of care, patient centeredness, and efficiency of care.
• State Snapshots that provide, via a Web site, State-specific health care quality information, including strengths, weaknesses, and opportunities for improvement.
• The CAHPS program develops surveys to help improve the quality of health care from the perspective of consumers and patients. The surveys include ones on home health care, dental plans, and nursing homes.
• The National Guideline Clearinghouse™, a Web-based resource for information on more than 2,300 evidence-based clinical practice guidelines.
• The National Quality Measures Clearinghouse™, a database and Web site for information on specific evidence-based health care quality measures and measure sets.

Political history

The agency originally began as the Agency for Health Care Policy and Research and was tasked with producing guidelines. However, it became controversial when it produced several guidelines which would reduce lucrative medical drugs and procedures. This included concern from ophthalmologists on a cataract guideline and concern by the pharmaceutical industry over a reduction in the use of new high-margin drugs. When the agency produced a guideline which concluded that back pain surgery was unnecessary and potentially harmful, a lobbying campaign aided by Congressmen whose backs had been operated on changed the name of the agency and "wound down" the guidelines program.

Related links

• AHRQ Data and Surveys
• AHRQ’s Health Care Innovations and Exchange program
• AHRQ’s Prevention and Chronic Care Program

External links

• Agency for Healthcare Research and Quality Web site
• U.S. Department of Health and Human Services Web site