Structured Abstract

Contents

• Preface
• Acknowledgments
• Technical Expert Panel
• Orientation to the Report
• Introduction to the Series Development
  • Problem and Motivation for Series
  • Context: Previous Series
  • Closing the Quality Gap Series Response to the Problem
  • Series Key Questions and Framework
• Cross-Topic Summary
  • Topic Coverage by Quality Lever
  • Patterns Across Reports
• Implications for Future Evidence Reviews
  • Sensible Scoping: Key Questions, Frameworks, and Logic Models for Complex Topics
  • Challenges in Defining Complex Health Care Interventions and Concepts
  • Assessing Individual Study Quality
  • Assessing Strength of the Evidence
  • Meaningful Synthesis and Audiences
  • Methods for Synthesis
• Quality Improvement: Next Steps in an Evolving Field
  • Advancing the Field Through Evidence Synthesis
  • The Challenge of Measurement
  • Improving Study Quality
  • Consistent and Complete Reporting
  • Health Care as a Means to Health
  • Understanding Context
  • Adopting a Common QI Intervention Lexicon
• Conclusion
• References
• Appendix A Topic Findings by Report
• Appendix B Focus on Action: Key Messages for Improving Quality
• Appendix C Advancing the Science: Key Messages for Informing Further Research
• Appendix D Taxonomy of Quality Improvement Strategies

Prepared for: Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services¹, Contract No. 290-2007-10062-I. Prepared by: Stanford-UCSF Evidence-based Practice Center (operating under RAND Evidence-based Practice Center), Stanford, CA

Suggested citation:

McDonald KM, Chang C, Schultz E. Through the Quality Kaleidoscope: Reflections on the Science and Practice of Improving Health Care Quality. Closing the Quality Gap: Revisiting the State of the Science. Methods Research Report. (Prepared by Stanford-UCSF Evidence-based Practice Center under Contract No. 290-2007-10062-I.) AHRQ Publication No. 13-EHC041-EF. Rockville, MD: Agency for Healthcare Research and Quality; February 2013. www.EffectiveHealthCare.ahrq.gov/reports/final.cfm.

This report is based on research conducted by the Stanford-UCSF Evidence-based Practice Center (EPC) under contract to the Agency for Healthcare Research and Quality (AHRQ), Rockville, MD (Contract No. 290-2007-10062-I). The findings and conclusions in this document are those of the authors, who are responsible for its contents; the findings and conclusions do not necessarily represent the views of AHRQ. Therefore, no statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services.

The information in this report is intended to help health care decisionmakers—patients and clinicians, health system leaders, and policymakers, among others—make well-informed decisions and thereby improve the quality of health care services. This report is not intended to be a substitute for the application of clinical judgment. Anyone who makes decisions concerning the provision of clinical care should consider this report in the same way as any medical reference and in conjunction with all other pertinent information, i.e., in the context of available resources and circumstances presented by individual patients.

This report may be used, in whole or in part, as the basis for development of clinical practice guidelines and other quality enhancement tools, or as a basis for reimbursement and coverage policies. AHRQ or U.S. Department of Health and Human Services endorsement of such derivative products may not be stated or implied.

None of the investigators have any affiliations or financial involvement that conflicts with the material presented in this report.

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