附录D: AHRQ QI Toolkit Components

This is a summary of the AHRQ QI Toolkit components, a set of tools available free of charge from the AHRQ website. As noted in Chapter 1, the tools are grouped into six major areas, arranged in logical order of likely use. The full toolkit description, Toolkit for Using the AHQR Quality Indicators: How to Improve Hospital Quality and Safety, is a PDF downloadable from the AHRQ website.

Area 1: Assess Readiness to Change

Survey to self-assess readiness to change

Infrastructure for change management

Readiness to work on the quality indicators

(Your) Role in quality improvement

Case studies of using the QI toolkits for quality improvements Specific tools to support change

Area 2: Apply Quality Indicators to Hospital Data

AHRQ quality indicators

Data requirements

Use

Quality indicator rates

Observed

Expected

Risk adjusted

Smoothed

Interpreting hospital quality indicator rates

Assessing performance of quality indicators (trends and comparators) Preparing to calculate

rates

Area 3: Identify Priorities for Quality Improvement

Prioritization worksheet

Own rate and national comparator

Estimate annual cost and cost to implement

Rate strategic alignment and regulatory mandates

Barrier assessment (staff capability and willingness)

Area 4: Implementation

Project charter

    Quality indicators best practices

    Gap analysis

    Implementation plan

    Implementation measurement

    Project evaluation and debriefing

Area 5: Monitor Progress for Sustainabile Improvement

Ongoing monitoring

Choosing a limited set of indicators

Establish regular reporting schedule

Develop report formats

Establish procedures for acting on problems

Assess sustainability periodically

Area 6: ROI Estimation

Calculating and interpreting ROI

Determine basic ROI design

Calculate ROI

Interpret ROI ratio

Additional guidance

Understand point of view for ROI calculations

Assembling the ROI team

Getting ready to conduct ROI calculation

Using existing literature to estimate ROI calculation

Selecting the time horizon for ROI calculation

Making adjustments for future costs and savings

Determining differences between costs and savings

Using micro costing versus gross costing

Implementation costs worksheet

Net returns worksheet

Case studies

Additional resources

Components of implementation costs ROI calculators

Source: Toolkit for Using the AHRQ Quality Indicators. Content last reviewed March 2017. Rockville, MD: Agency for Healthcare Research and Quality. www.ahrq.gov/professionals/systems /hospital/qitoolkit/index.html