CHPR Research | Healthcare Quality and Safety Research
Healthcare quality and safety research is critical to improving effective and efficient delivery of healthcare services in the US. Since 2005, CHPR has expanded its work on patient safety and quality across multiple levels and sectors of healthcare. Cumulatively this work has improved the accuracy and fairness of quality measurements among healthcare entities and has important implications for not only improving the US healthcare system but also informing healthcare contracting and finance.
Patrick Romano, M.D., M.P.H., FACP, FAAP, a nationally renowned healthcare quality expert, has led the CHPR effort in quality and safety research over the last 15 years. He and his collaborators have developed and evaluated metrics, tools, and resources to measure and publicly report patient safety and quality outcomes for a variety of healthcare settings. Dr. 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 Association of Healthcare Data Organization (NAHDO), the National Quality Forum and the World Health Organization (WHO).
- In 2012 Dr. Romano and his CHPR team led the transition of AHRQ’s 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.
- Currently, 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 also 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 Dr. Tancredi and his team of statisticians in preparation for seeking endorsement of the measure from the National Quality Forum (NQF).
Dr. Romano and Dr. Debra Bakerjian, Ph.D., A.P.R.N., 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). Since October 2019, the team has published 23 commentaries written by UC Davis faculty, fellows, residents, students and staff from over thirteen School of Medicine Departments / Divisions, published brief guides on key patient safety topics, including healthcare team communication through daily huddles and transitions of care. 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, Dr. Romano’s teams developed and refined the methodology for establishing a state-mandated annual public report card on adverse outcomes and mortality associated with cardiac bypass surgery (2005-2019).
The California Department of Corrections and Rehabilitation (CDCR) is in federal receivership due to substandard healthcare for those who are incarcerated. Dr. Romano and his team provided recommendations for the CDCR Healthcare Services Dashboard to improve the validity of the dashboard performance measure.