81 FR 7116 - Request for Measures Assessing Health Care Organization Quality Improvement Activities To Improve Patient Understanding, Navigation, Engagement, and Self-Management

DEPARTMENT OF HEALTH AND HUMAN SERVICES
Agency for Healthcare Research and Quality

Federal Register Volume 81, Issue 27 (February 10, 2016)

The Agency for Healthcare Research and Quality (AHRQ) requests information from the public (including health care delivery organizations, health information developers, payers, quality measure developers, clinicians, and health care consumers) about quality improvement measures designed to help health care organizations monitor initiatives aimed at: <bullet> Improving patient understanding of health information, <bullet> simplifying navigation of health care systems and facilities, and <bullet> enhancing patients' ability to manage their health. Specifically, AHRQ seeks quality improvement measures in four domains: 1. Communication, 2. Ease of Navigation, 3. Patient Engagement and Self-Management, and 4. Organizational Structure, Policy, and Leadership. AHRQ is interested in measures that do not require patient survey data and that health care organizations are currently using, or have used in the past, to guide quality improvement activities designed to address these domains. AHRQ is also interested in information about relevant measures that are under development or are suggested for future development.

[Federal Register Volume 81, Number 27 (Wednesday, February 10, 2016)]
[Notices]
[Pages 7116-7118]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2016-02679]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Agency for Healthcare Research and Quality


Request for Measures Assessing Health Care Organization Quality 
Improvement Activities To Improve Patient Understanding, Navigation, 
Engagement, and Self-Management

AGENCY: Agency for Healthcare Research and Quality (AHRQ), DHHS.

ACTION: Notice of request for measures.

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SUMMARY: The Agency for Healthcare Research and Quality (AHRQ) requests 
information from the public (including health care delivery 
organizations, health information developers, payers, quality measure 
developers, clinicians, and health care consumers) about quality 
improvement measures designed to help health care organizations monitor 
initiatives aimed at:
     Improving patient understanding of health information,
     simplifying navigation of health care systems and 
facilities, and
     enhancing patients' ability to manage their health.
    Specifically, AHRQ seeks quality improvement measures in four 
domains:
    1. Communication,
    2. Ease of Navigation,
    3. Patient Engagement and Self-Management, and
    4. Organizational Structure, Policy, and Leadership.
    AHRQ is interested in measures that do not require patient survey 
data and that health care organizations are currently using, or have 
used in the past, to guide quality improvement activities designed to 
address these domains. AHRQ is also interested in information about 
relevant measures that are under development or are suggested for 
future development.

DATES: Please submit one or more quality improvement measures and 
supporting information on or before March 4, 2016. AHRQ will not 
respond individually to submitters, but will consider all submitted 
measures and publicly report the results of the review of the 
submissions in aggregate.

ADDRESSES: Submissions should follow the Submission Instructions below. 
Electronic responses are preferred and should be addressed to 
[email protected]. Non-electronic responses will also be 
accepted. Please send these by mail to: Cindy Brach, Center for 
Delivery, Organization, and Markets, Agency for Healthcare Research and 
Quality, 5600 Fisher Lane, Rockville, MD 20857, Mailstop: 07W25B.

[[Page 7117]]


FOR FURTHER INFORMATION CONTACT: [email protected] or Cindy 
Brach at the address above.

SUPPLEMENTARY INFORMATION:

Background Information

    The health care system is complex and demanding. Health care 
organizations can help patients to succeed in the health care 
environment by ensuring that patients and caregivers are able to 
understand health information, navigate the health care system, engage 
in the health care process, and take an active and effective role in 
the management of their health.
    This Request for Measures is part of a project that aims to:
     Identify existing measures that organizations use or could 
use to monitor progress related to the four domains described above; 
and,
     Refine and cull identified measures to establish a set of 
measures that reflects patient priorities, has expert support, and will 
be recommended for more formal measure development and testing.
    The project focuses on identifying measures that are not generated 
from patient survey data.
    The project is guided by a conceptual framework that builds on the 
concept of organizational health literacy. As described in the 
Institute of Medicine's Roundtable on Health Literacy, organizational 
health literacy is the ``implementation and monitoring of 
organizational policies, practices, and structures that support 
patients in understanding health information, navigating the health 
care system, and managing their health'' (Brach et al. 2012). The 
conceptual framework identifies four domains as key components of 
organizational health literacy.
    1. Communication (e.g., the quality of verbal and written 
communication with patients, families, caregivers)
    2. Ease of Navigation (e.g., the degree to which an organization's 
physical environment and systems of care are designed in a manner that 
simplifies navigation and use of services)
    3. Patient Engagement and Self-Management (e.g., the degree to 
which an organization encourages patient engagement and provides 
support to enhance the ability of patients to manage their health)
    4. Organizational Structure, Policy, and Leadership (e.g., 
leadership support for organizational health literacy; implementation 
of policies, procedures, and structures that serve to improve 
communication with patients, simplify patient navigation, and enhance 
patient engagement and self-management)
    Quality improvement measures selected for further measure 
development and testing will assess key features of one or more of 
these domains.
    This project is being conducted by AHRQ pursuant to its statutory 
authority to conduct and support research on healthcare and on systems 
for the delivery of such care, including activities with respect to 
quality measurement and improvement. 42 U.S.C. 299a(a)(2).

Submission Guidance

    Submit a measure(s) that is currently in use, in development, or 
for which a need has been identified, in one or more of the four 
domains (i.e., Communication; Ease of Navigation; Patient Engagement 
and Self-Management; and Organizational Structure, Policy, and 
Leadership). For this Request for Measures, AHRQ is specifically 
interested in measures that do not require or use patient reported data 
obtained using a patient survey.
    Your contribution will be very beneficial to AHRQ. The contents of 
all submissions will be made available to the public upon request. 
Materials submitted must be publicly available or can be made public. 
Materials that are considered confidential and marketing materials 
cannot be used by AHRQ. This is a voluntary request for information, 
and all costs for complying with this request must be borne by the 
submitter.
    AHRQ and its contractor, will evaluate all submitted measures and 
supporting documentation. As a set of measures is identified and 
evaluated for further refinement and testing, submissions may be 
included in whole or in part or may be modified for inclusion in the 
measurement set. AHRQ will assume responsibility for the final 
measurement sets as well as any future modifications.

Submission Instructions

    To facilitate handling of submissions, please include the name and 
email address of the measure developer or contact.
    The responses most helpful to the Agency will include all or most 
of the following:
    1. A brief cover letter,
    2. a description of the measure and how it is calculated (e.g., 
who/what is included in the numerator, who/what is included in the 
denominator, who/what is excluded in calculating the measure),
    3. the source of the measure (e.g., publications, organizations 
where measure has been used to guide quality improvement activities),
    4. the domain best aligned with the measure (i.e., Communication; 
Ease of Navigation; Patient Engagement and Self-Management; and 
Organizational Structure, Policy, and Leadership),
    5. the source of data used to calculate the measure (e.g., 
electronic health records, internal monitoring and reporting systems),
    6. a description of data collection strategies (e.g., who is 
responsible for data collection, how is the information needed to 
calculate the measure collected),
    7. a list of health care settings in which the measure has been or 
would be used and characteristics of the patient populations in these 
health care settings,
    8. a description of how the measure has been used to support 
performance improvement (e.g., to whom is the measure reported, what 
actions have been taken based on the measure),
    9. a summary of unintended negative consequences resulting from use 
of the measure (e.g., evidence that implementation of the measure has 
negatively impacted patients, staff, clinical process, or other 
features of the implementing organization), and
    10. evidence that the measure is:
    a. Valid and reliable,
    b. associated with important outcomes,
    c. meaningful to patients, families, clinicians, and/or 
administrators,
    d. feasible to compute with accuracy and without undue cost, 
burden, or delay, and
    e. generalizable across health care settings.
    11. title, author(s), publication year, journal name, volume, 
issue, and page numbers of cited articles.
    12. a statement of willingness to grant to AHRQ the right to use 
and disseminate submitted measures and their documentation to the 
public as part of a set of organizational health literacy measures.
    Submission of copies of existing documentation or reports 
describing the measure and its properties, existing data sources, etc. 
is highly desirable but not required.

Reference Material

Brach, C., Keller, D., Hernandez, L.M., et al. (2012). Ten 
attributes of a health literate health care organization. Washington 
DC: Institute of Medicine.
Kripalani, S., Wallston, K., Cavanaugh, K.L., Osborn, C., Mulvaney, 
S., Scott, A.M., & Rothman, R.L. (2014). Measures to assess a 
health-literate organization.

[[Page 7118]]

Washington DC: Institute of Medicine.

Sharon B. Arnold,
Deputy Director.
[FR Doc. 2016-02679 Filed 2-9-16; 8:45 am]
 BILLING CODE P