Chapter 7. Strategic Goals and Performance Planning at AHRQ
Portfolios of Work
The Agency's internal structure and activities are organized under a series of portfolios
that contribute to AHRQ's overarching strategic goals and reflect our priorities and
those of the health care system. These portfolios are combinations of activities that
reflect the broad spectrum of the Agency's work. Our goals are to capitalize on the
research strengths and expertise throughout the Agency, communicate the focus of
our research clearly, and ensure that our focus stays on moving research from idea
generation to strategies that can be adopted into practice. The portfolios clarify our
research investments and assure that the continuum of research from conception to
generation is applied in practice and policy.
AHRQ has developed 11 standard portfolios of work:
Quality/Safety of Patient Care
The quality/safety of patient care portfolio works to improve health care outcomes by
increasing the levels of safety and quality in the health care system, especially
through partnerships with public- and private-sector groups to speed the adoption of
research findings into both practice and policy. This portfolio includes quality and
patient safety research that is designed to:
- Develop innovative approaches to collecting, analyzing, and reporting patient
safety information.
- Transform that research into improving the quality and safety of care provided by
doctors, nurses, and other health professionals.
- Foster the use of information technology to reduce medical errors.
Health Information Technology
The Institute of Medicine has identified health information technology (health IT) as
one of the most significant tools that could help to improve health care quality. The
health IT portfolio works to improve health care outcomes through research and the
development, diffusion, and adoption of health information technology that
improves the quality, safety, and efficiency of health care.
Since the late 1960s, AHRQ has been providing the research base for the use of health IT and decision-support systems to improve the quality of care. Within this portfolio, AHRQ sponsors
research, programs, and initiatives that focus on reducing medical errors, increasing
health information sharing, helping patients transition between health care settings,
and increasing our knowledge and understanding of the clinical, financial, and
organizational value and benefits of health IT, as well as its contributors to patient
safety and quality of care.
Data Development Portfolio
Comprehensive data on health care use, quality, costs, and payment systems in the
United States provide AHRQ customers with timely information for use in evaluating
and making decisions about health care services. The data development portfolio
develops and maintains tools that measure and enhance quality, efficiency, and
effectiveness and helps transform research into practice by providing data and
information that can be used by health care decisionmakers to make informed
choices. This portfolio encompasses AHRQ's expanding family of databases, software,
quality indicators, and other evidence-based research tools.
Cost, Organization, and Socio-Economics
How services are organized and financed has a significant impact on the health care
an individual receives. The cost, organization, and socioeconomics portfolio provides
public and private decisionmakers with the information, tools, and assistance they
need to organize, finance, pay for, and regulate health care. Research conducted as
part of this portfolio responds to the information needs of Federal, State, and local
policymakers; public and private purchasers; and health care system leaders.
Long-term Care
The need for long-term care services is expected to increase dramatically in this
country as the population ages. By 2025, the number of Medicare beneficiaries is
expected to reach almost 70 million, or about 20 percent of the U.S. population.
Long-term care refers to care provided for people of all ages who need assistance with
basic activities of daily living and role functioning who are living in the community
or in residential care settings such as assisted living facilities or nursing homes. The
long-term care portfolio develops processes and tools supported by evidence-based
research and helps integrate them into the practice of care. In addition the portfolio provides consumers of long-term care with tools and evidence-based information to
help them make informed decisions.
Pharmaceutical Outcomes
Understanding which medications work for which patients and at what cost is
important in managing the selection of pharmaceutical therapies and services in a
changing health care environment. The pharmaceutical outcomes portfolio develops
and disseminates evidence on the safe and effective use of pharmaceuticals. This
portfolio addresses many of today's most critical health care issues including:
treatment effectiveness, patient safety, cost and quality of care, development of tools
to support evidence-based practice, racial and ethnic disparities, management of
chronic conditions, disease prevention, and the special needs of vulnerable
populations.
Care Management
Reducing disease and disability by increasing the delivery of effective tests and
treatments for acute and chronic medical problems is the heart of the care
management portfolio. This portfolio helps increase the delivery of evidence-based
treatments for acute and chronic conditions through research and research syntheses,
development of tools, identification of effective implementation strategies, and the
promotion of effective policies. The portfolio encompasses intramural and extramural
work in areas that help create the infrastructure for effective care.
Prevention
Thousands of Americans die prematurely each year as a result of diseases that often
are preventable, such as heart disease, diabetes, some cancers, and HIV/AIDS. AHRQ's
unique contribution to prevention research includes a focus on primary and
secondary prevention within the primary care setting. This portfolio supports research
on preventive care through adoption, delivery, and use of evidence-based clinical
preventive services. This portfolio is helping to develop an evidence-based model for
health care organizations to minimize multi-risk behaviors among patients. The
purpose is to inform, motivate, and support the redesign of primary care delivery
systems to improve delivery of evidence-based preventive services.
Training
Health services researchers focus on some of the most complex and challenging issues currently affecting health care in the United States, and training new investigators is fundamental to producing the next generation of health services researchers. The training portfolio fosters the growth, dissemination, and translation of health services research and encourages growth in the science by nurturing the development of trained scientists. Prime focus is placed on the next generation of researchers by ensuring that the researchers and institutions conducting research are responsive to changes in the delivery of health care services in order to enhance quality, efficiency, and effectiveness of health care and improve patient safety.
The success of these endeavors will be measured in terms of developing productive researchers who in turn develop new knowledge that is ultimately translated into practice or contributes to improvements in health delivery, policy or clinical care at the local, State, and national level.
System Capacity and Bioterrorism
As demonstrated by the attacks of September 11, 2001, and the subsequent use of anthrax as a biological weapon, bioterrorism represents a significant public health threat to the United States. To address this threat, we need to enhance the capacity of Federal, State, and local entities to respond to potential bioterrorism events.
The system capacity and bioterrorism portfolio provides support to empower communities by enhancing their capacity of the health care systems to respond to urgent and emergent situations and needs. Research projects in this portfolio examine an array of issues pertinent to clinicians, hospitals, and health care systems. These include linkages among providers, local and State public health departments, emergency responders, and others preparing to respond to terrorist events and other public health emergencies, as well as regional planning and surge capacity issues.
Organizational Support
This portfolio supports the overall direction and management of the AHRQ, including
the formulation of policies and program objectives and administrative management
and services. The principles which guide the Agency's management structure include:
- An organizational structure that stresses simplified, shared decisionmaking.
- Avoidance of redundancies in administrative processes.
- Ensuring clear lines of communication and authority.
- A strong emphasis on employee involvement in all Agency matters.
- Recognizing and rewarding employee accomplishments and contributions to the
AHRQ's mission.
AHRQ Portfolios of Work and Strategic Goals
AHRQ Portfolios of Work |
AHRQ Strategic Goal Areas |
Safety/Quality—
Improve health care safety and quality for Americans through evidence based research and translation. |
Efficiency—
Develop strategies to improve
access, foster appropriate use, and reduce unnecessary expenditures. |
Effectiveness—
Translate, disseminate, and
implement research findings that improve health care outcomes. |
Organizational Excellence—
Develop efficient and responsive business processes. |
Quality/Safety of Patient Care |
X |
X |
X |
|
Health Information Technology |
X |
X |
X |
|
Data Developments |
X |
X |
X |
|
Cost, Organization, and Socioeconomics |
X |
X |
X |
|
Long-term Care |
X |
X |
X |
|
Pharmaceutical Outcomes |
X |
X |
X |
|
Care Management |
X |
X |
X |
|
Prevention |
X |
X |
X |
|
Training |
X |
X |
X |
|
System Capacity and Bioterrorism |
X |
X |
X |
|
Organizational Support |
|
|
|
X |
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