Healthcare Quality and Safety Research | Center for Healthcare Policy and Research

Research Themes

Healthcare Quality and Safety Research

Developing and implementing healthcare quality and safety metrics is a critical component of our research portfolio.

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Patrick Romano, M.D., M.P.H., FACP, FAAP

Patrick Romano, professor of internal medicine and pediatrics, is a healthcare quality expert who leads CHPR's quality and safety research. He has developed and evaluated metrics, tools and resources to measure and publicly report patient safety and quality outcomes for a variety of healthcare settings. Romano has played a major role in the development of well-respected and widely employed methodologies in the field. His significant body of work informs influential organizations such as the Centers for Medicare and Medicaid Services (CMS), the Agency for Healthcare Research and Quality (AHRQ), the Joint Commission, the California Department of Health Care Access and Information (HCAI) and Department of Corrections and Rehabilitation (CDCR), the National Committee for Quality Assurance (NCQA), the National Quality Forum and the World Health Organization (WHO).

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Improving Patient Safety

Cal Long Term Care Compare

CHPR's Patrick Romano and Debra Bakerjian lead data analysis for the Cal Long Term Care Compare (CLTCC) website, giving California consumers useful information to compare nursing home quality. CLTCC centralizes publicly available information from federal and state agencies about nursing homes in California, offering metrics covering staffing, quality of facilities, fines and other quality information. 

Learn more about CLTCC
Research highlights

The CHPR quality team is providing clinical and technical expertise to AHRQ and Mathematica, Inc. about the intent, implementation and interpretation of AHRQ quality indicators. This work will be used by public and private payers for contract design, and by healthcare organizations for quality improvement.

The CHPR quality team works with IMPAQ International and the Centers for Medicare and Medicaid Services (CMS) to maintain the Patient Safety Indicator (PSI) 90-composite measure. Rigorous reliability and validity testing of the measure is being conducted by Dan Tancredi and his team of statisticians in preparation for seeking endorsement of the measure from the National Quality Forum (NQF).

Patrick Romano and his CHPR team led the transition of Agency for Healthcare Research and Quality's (AHRQ) Quality Indicators to the ICD-10-CM/PCS diagnosis code sets by mapping more than 228 clinical concepts and 9,000 ICD-9-CM codes. Detailed in the journal HSR, this work has far-reaching implications for national health policy related to reimbursement, public reporting on quality of care, and quality improvement programs for healthcare systems.

CHPR researchers Patrick Romano and Debra Bakerjian are co-editors-in-chief of AHRQ’s Patient Safety Network (PSNet), internationally regarded as an authoritative web-based resource for evidence on improving patient safety. The editorial team curates 20 to 25 recently published studies, tools, news articles and upcoming events weekly, and provides expert commentary on cases describing medical errors and patient harms from hospitals across the US (WebM&Ms). 

In the wake of the COVID-19 pandemic, the editorial team published three primers addressing key patient safety issues:

In partnership with the California Office of Statewide Health Planning and Development (currently the California Department of Health Care Access and Information), teams led by CHPR's Patrick Romano developed and refined the methodology for establishing a state-mandated annual public report card on adverse outcomes and mortality associated with cardiac bypass surgery.

Romano and his team also provided recommendations for the California Department of Corrections and Rehabilitation (CDCR) Healthcare Services Dashboard to improve the validity of the dashboard performance measure.