APPENDIX A

Workshop: Envisioning a National Quality Report on Health Care

PURPOSE AND STRUCTURE OF THE WORKSHOP

      The general purpose of the workshop was to provide the Institute of Medicine Committee on the National Quality Report on Health Care Delivery with practical, state-of-the-art information on the definition and reporting of national indicators of health care quality.

      The workshop involved more than 40 participants and was open to the public. The topics were organized in three parts: (1) Lessons to be Learned from Other Experiences; (2) Measuring the Dimensions of Health Care Quality; and, (3) Technical, Data, and Policy Issues.

      Presenters were asked to focus on the practical or applied, rather than the theoretical, aspects of their subject. They were also asked to give their opinion regarding the proposed framework for the National Health Care Quality Report as it referred to the subject they are addressing. Those presenting on specific quality measures were asked to present evidence on why the measures should be included in the Quality Report and to comment on available data sources or data needs for implementing the quality measures proposed.

ISSUES ADDRESSED AT THE WORKSHOP

• The feasibility of measuring patient centeredness, safety, effectiveness, and efficiency as dimensions of quality of care.
• The availability and appropriateness of public and private data sources for national indicators of quality of care.
• The feasibility of translating experiences from other sectors and countries to measure quality of health care in the United States.
• The need for specific measures of quality for particular populations and tracking disparities in health care quality.

WORKSHOP AGENDA

May 22-23, 2000
Holiday Inn Georgetown-Mirage I Conference Room
2101 Wisconsin Avenue, N.W., Washington, D.C.

Monday, May 22, 2000

SESSION 1: Quality Indicators in Other Sectors and Other Countries: Issues of Measurement, Presentation, Process, and Accountability

SESSION 2: Measuring Health Care Safety for the National Health Care Quality Report

SESSION 3: Approaches to Measuring the Efficiency of Health Care for the National Health Care Quality Report 

SESSION 4: Measuring Effectiveness and Appropriateness of Care for the National Health Care Quality Report 

SESSION 5: Measuring Patient Centeredness for the National Health Care Quality Report 

SESSION 6: General Discussion on Measures for the National Health Care Quality Report 

 Tuesday, May 23, 2000 

SESSION 7: Issues to Be Considered in Selecting and Defining Measures for the National Health Care Quality Report 

SESSION 8: Available and Needed Data for the National Health Care Quality Report 

SESSION 9: Technical and Data-Related Barriers to Producing a National Health Care Quality Report 

SESSION 10: Roundtable-What Do Policy Makers Want from the National Health Care Quality Report? 

Moderator: Robert Rubin, M.D., The Lewin Group

WORKSHOP SPEAKERS

IRMA E. ARISPE, Associate Director for Science, Division of Health Care Statistics, National Center for Health Care Statistics, Hyattsville, Maryland 

DAVID W. BATES, Chief, Division of General Medicine, Brigham and Women's Hospital, Boston, Massachusetts 

CHRISTINA BETHELL, Senior Vice President, Research and Policy, Foundation for Accountability (FACCT), Portland, Oregon 

CYBELLE BJORKLUND, Deputy Staff Director, Senate Committee on Health, Education, Labor and Pensions, Washington, D.C. 

ROBERT H. BROOK, Vice President and Director, RAND Health and Corpo- rate Fellow, The RAND Corporation, Santa Monica, California 

PEGGY G. CARR, Associate Commissioner, Assessment Division, National Center for Education Statistics, Washington, D.C. 

SUZANNE F. DELBANCO, Executive Director, Leapfrog Group, Washing- ton, D.C. 

CLAES G. FORNELL, Donald C. Cook Professor of Business Administration and Director, National Quality Research Center, University of Michigan School of Business Administration, Ann Arbor, Michigan 

NANCY FOSTER, Project Officer and Coordinator of Quality Activities, Agency for Healthcare Research and Quality, Rockville, Maryland 

MARSHA GOLD, Senior Fellow, Mathematica Policy Research, Inc., Washington, D.C. 

JESSIE GRUMAN, Executive Director, Center for the Advancement of Health, Washington, D.C.

SHERRIE H. KAPLAN, Co-director, Primary Care Outcomes Research Insti- tute, Tufts University School of Medicine, New England Medical Center, Boston, Massachusetts

JASON LEE, Health Policy Counsel, U.S. House of Representatives, Commit- tee on Commerce, Washington, D.C. 

MARK B. McCLELLAN, Assistant Professor, Department of Economics, Stanford University, Stanford, California 

ELIZABETH A. McGLYNN, Senior Researcher, The RAND Corporation, Santa Monica, California 

GREGG MEYER, Director, Center for Quality Measurement and Improve- ment, Agency for Healthcare Research and Quality, Rockville, Maryland 

MICHAEL L. MILLENSON, Principal, William M. Mercer, Inc., Chicago, Illinois 

R. HEATHER PALMER, Director, Center for Quality of Care Research and Education, Harvard School of Public Health, Boston, Massachusetts 

LEE PARTRIDGE, American Public Human Services Association, Washing- ton, D.C. 

ROBERT J. RUBIN, President, The Lewin Group, Falls Church, Virginia 

BARBARA STARFIELD, University Distinguished Professor, The Johns Hopkins University, Baltimore, Maryland 

ORA STRICKLAND, Professor, Neil Hodgson Woodruff School of Nursing, and Director, Research on Special Populations of Veterans, Atlanta VA Medical Center, Atlanta, Georgia 

JACK E. TRIPLETT, Visiting Fellow, Brookings Institution, Washington, D.C. 

JOHN E. WARE, JR., President and Chief Scientific Officer, QualityMetric, Inc., Lincoln, Rhode Island 

JOHN E. WENNBERG, Director, Center for Evaluative Clinical Sciences, Dartmouth Medical School, Hanover, New Hampshire 

DAVID R. WILLIAMS, Senior Research Scientist, Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan 

DONALD YOUNG, Chief Operating Officer and Medical Director, Health Insurance Association of America, Washington, D.C.