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AHRQ's quality indicators can be used as a screening tool to identify potential quality of care problems

The Agency for Healthcare Research and Quality has developed three sets of health care Quality Indicators (QIs), using State-wide data on hospital inpatient stays. The QIs comprise nearly 80 measures covering a range of medical conditions, procedures, and settings. They can be used as a screening tool to identify potential problems in quality of care both inside and outside the hospital.

The AHRQ QIs currently consist of three modules: the Prevention Quality Indicators (PQIs), Inpatient Quality Indicators (IQIs), and Patient Safety Indicators (PSIs). The PQIs use hospital discharge data to identify conditions (for example, asthma and diabetes) for which good outpatient care can potentially prevent the need for hospitalization or for which early and appropriate intervention can prevent complications or more severe disease. Typical PQI indicators of poor outpatient preventive care in a community include high hospital admission rates for asthma, uncontrolled diabetes, and perforated appendix.

The IQIs include volume indicators (the number of certain procedures performed by a hospital for which there is a link between volume and outcomes), mortality indicators for certain inpatient procedures and conditions, and utilization indicators for procedures whose use rates vary significantly. Examples of IQIs include coronary artery bypass graft volume, in-hospital mortality rate for stroke, and Cesarean section rate.

The PSIs include provider-level indicators of potentially preventable complications due to care at a particular hospital, such as a bed sore or foreign body left in after surgery, and area-level indicators that capture all cases of potentially preventable inpatient and outpatient complications that occur in a given area. The AHRQ QI programs as well as their documentation can be downloaded without charge from http://www.qualityindicators.ahrq.gov.

More details are in "Using the AHRQ quality indicators to improve health care quality," by Anne Elixhauser, Ph.D., Mamatha Pancholi, M.S., and Carolyn Clancy, M.D., in the September 2005 Journal on Quality and Patient Safety 31(9), pp. 533-538. Reprints (AHRQ Publication No. 06-R007) are available from AHRQ Clearinghouse.

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