# Presentation: 723332

## Safe Practices Implementation Challenge Grants Technical Assistance  Workshop and Conference Call

- Eisenberg Building
- 540 Gaither Road
- Rockville, MD 20850
- June 12, 2003

## Congressional Mandate for AHRQ

*identify* the causes of preventable health care errors and pat injury in health care delivery;
*develop*, demonstrate, and evaluate strategies for reducing error and improving patient safety; and
*disseminate* such effective strategies throughout the health care industry.

- The director of Agency for Healthcare Research and Quality (AHRQ) shall conduct and support research and build private-public partnerships to:

## AHRQ’s Patient Safety Portfolio

- Identifying risk and hazards
- Reporting system demonstrations (16 projects)
- Working conditions (22 projects)
- Building Capacity
- Centers of excellence in patient safety research (3 centers)
- Developing centers of excellence in patient safety research (18 projects)
- Patient safety improvement corps (PSIC) to be funded in FY 03

## AHRQ’s Patient Safety Portfolio

- Raising awareness
- Dissemination and education (6 grants)
- User liaison program (ULP) conferences and workshops with states
- Identify proven patient safety practices
- System best practices (6 projects)
- Clinical informatics (11 projects)
- Evidence-based practice center (EPC) report on evidence based patient safety practices

## Goals of Implementation Challenge Grants Request for Applications (RFA) 

- Assess risks and known hazards to patient in the process of care and devise intervention strategies
- Implement safe practices that show evidence of eliminating or reducing the known risks and hazards associated with the process of care

## Key Dates

- Letter of Intent:   **June 15, 2003**
- Application Receipt Date:   **July 15, 2003**
- Approximate Peer Review Date:   **First week in September**
- Anticipated award date:   **September 30, 2003**

## Mechanism of Support and Funds Available

- U 18 Cooperative Agreement
- AHRQ will have a substantial involvement in monitoring and evaluating these projects
- One-time solicitation
- Cost sharing  requirement of 50%
- Projected $3 million in total costs in FY 03
- Five to ten new grants
- Half of the awards will be for risk assessment and half for implementation projects

## Eligible Institutions

- For profit or non-profit organization
- Domestic and foreign
- Public and private not profit institutions, such as universities, clinics colleges, and hospitals
- Faith-based or community based organizations
- Tribes and tribal organizations
- Integrated delivery system research networks (IDSRNs) and Primary care based research networks (PBRNs) are encouraged to apply

## Principal Investigator (PI)

- Any individual with the skills, knowledge, and resources necessary to carry out the proposed project is invited to develop an application.
- Individuals from underserved racial and ethnic groups as well as individuals with disabilities are encouraged to serve as PI.

## Two Types of Projects

- Risk Assessment Projects
- 12 months in duration
- Maximum level of federal support $200,000
- 50% cost sharing required
- Implementation Projects
- 24 months in duration
- Maximum level of federal support $500,000
- 50% cost sharing required

## Risk Assessment Grants

- Must identify a priority risk area to be assessed.  The information on risk area should come from the organization's data
- Describe the risk assessment methodology [i.e. Failure mode and effects analysis, Probabilistic risk assessment].  If applicant has limited experience seek outside help
- Must develop a plan for selecting interventions that will reduce or eliminate the target risk

## Implementation Projects

- Must document the risk and hazards to be addressed
- Must specify the safe practice to be introduced and justify selection for dealing with the identified risk
- Must provide an implementation plan
- Introduce known safe practices
- Must assess level of adoption
- Document the impact of the project

## Implementation ProjectsCurrent Safe Practice Recommendations

- Project may expand upon current safe practice recommendations found in the following:
- EPC Report Number 43 – *Making Health Care Safer: A Critical Analysis of Patient Safety Practices*
- The National Quality Forum (NQF) “Safe Practices for Better Healthcare” report
- Joint Commission on Accreditation of Healthcare Organizations (JCAHO) six patient safety priorities

## Cost Sharing is Required

- 50% of total costs of project
- Institutions must document their actual contribution to the project
- 		3 separate budget sheets required:  federal 	support, cost sharing, combined budget
- Provide assurances that the organization is committed to provide funds and resource for its share
- No funds used to calculate indirect costs are part of cost sharing

## Cost Sharing Cannot be Met From

- Costs borne by another federal grant or contract
- Costs or contributions toward another federal grant
- Costs of services or property financed by income earned by contractors and a contract from a recipient

## Submitting an Application

- Applications must be prepared using PHS 398 research grant application and form
- PHS 398 is available at _[http://grants.nih.gov/grants/funding.phs398/phs398.html](http://grants.nih.gov/grants/funding.phs398/phs398.html)_
- For further information contact Grants Info telephone 301-435-0714, Email _[GrantsInfo@nih.gov](mailto:GrantsInfo@nih.gov)_
- Be sure to follow the application directions (especially font requirements).  Failure to follow the directions may result in the proposal being withdrawn from consideration.

## Peer Review Process

- Incomplete, non-responsive applications returned without further consideration
- Must pass technical review of cost-sharing requirement (50%) or application returned without further consideration
- Peer Review panel will discuss and give priority scores to applications of the highest merit

## Review Criteria

- Applications reviewed with consideration of the
- following criteria:
- Significance - important patient safety problem
- Approach - design, method,  and potential problems
- Innovation
- Investigator - training and experience of investigator and personnel or outside partners (especially in safety training)
- Environment - culture of workplace and institution with regards to safety
- Evaluation and Assessment of Impact - plans for evaluation
- Budget – reasonable budget and period of support; evidence
- 	of cost-sharing

## Award Criteria

- Scientific Merit
- Availability of Funds
- Program Priorities
- 	- Institutional systems rather than single institutions
- 	- Geographical distribution may be considered

## Awardees Responsibilities

- Primary responsibility for project as a whole
- Retain custody of rights of data subject to government rights to access
- Must work with AHRQ Coordinating Center and the Program Evaluation Center
- Participate in the annual meeting held in Washington DC area (include funding in the budget)
- Keep ARHQ informed of forthcoming publications

## AHRQ Responsibilities

- AHRQ project officers will have substantial scientific-programmatic involvement in all matters related to the project.
- AHRQ will promote collaboration and comparison of risk assessment approaches and implementation strategies

## Next Steps

- This workshop and conference call is being recorded.  Questions and answers from this workshop and conference call will be posted at www.ahrq.gov by June 20, 2003
- Any questions regarding the RFA and the application process should be directed to:
- 	James B. Battles, Ph.D
- 	Senior Service Fellow for Patient Safety
- 	Center for Quality Measurement and Improvement (CQuIPS), AHRQ
- 	Phone 301-427-1332 	Email: jbattles@ahrq.Gov

## Peer Review and Grant Management Inquiries

- Regarding peer review issues
- 	Michele Hindi-Alexander
- 	Health Scientist Administrator, AHRQ
- 	Phone:  301-427-1547 	E-mail:  _[mhindi@ahrq.gov](mailto:mhindi@ahrq.gov)_
- Regarding financial or grant management issues
- 	Joan Metcalfe
- 	Grants Management Specialist, AHRQ
- 	Phone:  301-427-1450 	E-mail:  jmetcalf@ahrq.gov

## Thank You

- Questions?