# Presentation: 707103

## 12th Annual NRSA Trainees Research ConferenceSeattle, Washington 

-  Carolyn M. Clancy, M.D.
- Director
- Agency for Healthcare Research and Quality
- June 24, 2006

## AHRQ’s Mission

*        *

-    To improve the quality, safety, efficiency, and effectiveness of health care for all Americans.

## AHRQ is Recognized!

- National Patient Safety Foundation Distinguished Advisors
- Nathan Davis Award

**AHRQ is Recognized!**

## AHRQ: 	NEWSCASTS

- First HHS Agency to provide a regular podcast
- Hear about AHRQ research at any time
- AHRQ “Healthcare411” site registered with major podcast directories
- Site is promoted to medical schools, health professional organizations, large self-insured companies, and others
- 22 organizations linking to site or promoting AHRQ podcasts
- Listen on your computer as well!
- www.healthcare411.org

## AHRQ Research Focus:

- Patient-centered, not disease-specific
- Dual Focus -- Services + Delivery Systems Effectiveness research focuses on actual daily practice, not ideal situations (“efficacy”)
- AHRQ mission includes production ***and*** use of evidence-based information

## Research at HHS:Where Does AHRQ Fit In?

- NIH -- basic biomedical, lab bench research and “efficacy” clinical trials
- CDC -- the public health system, community-based interventions
- AHRQ -- “effectiveness” of health care services and the health care delivery system

**Notes:**
To further help differentiate AHRQ’s research from CDC’s and  NIH’s research, I’ll use an example related to diabetes--a condition that occurs with great frequency within the African American population.. NIH research identifies what can work to improve patient health.  NIH’s primary orientation is laboratory bench science, which seeks to broaden our understanding of basic biology and the biological mechanisms of disease, and clinical trials, designed to establish the potential usefulness of new interventions under ideal conditions (“efficacy”).  For example, how does type A and B diabetes differ and what treatments might be instituted to cure the disease. CDC evaluates health behaviors and tests community interventions that might be used to reverse unhealthy behaviors or reinforce healthy ones.  For example, programs to increase exercise or improve diet.
By contrast, AHRQ develops evidence to help clinicians and patients select the best interventions for that individual.  For example, do multiple medications control the patient’s diabetes or does it work better to combine medication therapy with support from team made up of doctors, nurses, and exercise coaches?  AHRQ research then helps providers develop measures to evaluate what works best.  This research relates to quality improvement efforts.
In its clinical research, AHRQ assesses the effectiveness in daily practice of promising new interventions, compares their benefits, costs, and side-effects with existing approaches, and when effective interventions are not being used, identifies options for overcoming barriers to their widespread use.   AHRQ’s clinical research is unique in two other ways: its focus on the interaction between patients and their care-givers and patient-centered research (rather than treating each disease in isolation), recognizing that the number of individuals with multiple chronic conditions is growing and the care for their different conditions must be coordinated.
AHRQ’s research on the health care delivery system reflects the belief that health care services are not delivered in a vacuum.  The outcomes, effectiveness, and quality of health care interventions are influenced by who delivers the service, the extent to which the systems in which clinicians work support or frustrate their efforts, and the financial incentives or barriers to provide the right service at the right time in the right way.  For example, research related to the development of effective disease management strategies and improved coordination of care draws upon both clinical and health systems research.  

## AHRQ BudgetFY 2005 - 2007

- FY 2007 Request = 	$318,695,000
- FY 2006 Appropriation = $318,695,000
- FY 2005 Appropriation = $318,695,000

## 2006 AHRQ Research Education Budget

- *Totals $18 million

## AHRQ’s Training Goal

- 	    Continue to foster the growth, dissemination, and** translation** of the field and science of Health Services Research to achieve AHRQ’s mission and address Departmental priorities geared toward the **transformation** of health care.”

## Training Objectives 

- _Goal 1:  __**Individuals**_:  Foster the growth of the next generation of researchers and knowledgeable users of research
- _Goal 2:  __**Diversity**_: Foster the institutional and individual diversity in the field of health services research
- _Goal 3:  __**Science**_**:** Foster the development of an integrated science of health services research and refine its foundation

## HSR Core Competencies

- AHRQ supported a small conference grant to John Hopkins  to bring consensus to the field of HSR
- Dr. Christopher Forrest (JHU) and Dr. Diane Martin (UWA) facilitated the event
- As a result of this meeting, a draft set of core competencies is being disseminated and reviewed.
- HSR Core Competency session will take place today at 11:00- 12:30 pm in Room **** to discuss this process in more detail
- All are invited to participate and comment on these competencies
- Aimed to define the field of health services research and bring identity to the profession

## HSR Core Competencies Summary

*Breadth of HSR theoretical an conceptual knowledge*
*In-depth disciplinary knowledge and skills*
*Application of HSR foundational knowledge to health policy problems*
*Pose innovative HSR questions*
*Interventional and Observational Study Designs*
*Primary data collection methods*
*Secondary data acquisition methods*

## HSR Core Competencies Summary

*Conceptual models and operational measures*
*Implementation of research protocols*
* **Responsible conduct of research*
*Multi-disciplinary teamwork*
* **Data analysis*
* **Scientific communication*
*Stakeholder collaboration and knowledge translation*

## Looking to the Future

- Fostering the “*next generation of researchers*” who actively engage in workforce and knowledge production
- Continue to produce “S*tars*”
- Emphasizing the importance of research that makes a difference

## Looking To the Future

- Encouraging researchers  to be involved in research translation and adoption
- Engaging in internal continuous quality improvement to ensure that future researchers are prepared to work in emerging areas:
- Quality improvement research
- Evidence-based medicine
- Translation of research into practice and policy

## Continue to Produce “Stars”

**Continue to Produce “Stars”**

## 12th Annual NRSA Trainees Research Conference

**12****th**** Annual NRSA Trainees Research Conference**

** ****Questions?**
- _[http://www.ahrq.gov](http://www.ahrq.gov/)_