Initially AHCPR was charged with developing standards to reflect good quality medical care.  A major work product was development of standards for management of back pain.  Previously patients with back pain were placed in bed for an extended period of rest, hospitalized and put into traction if the bed rest did not work and finally subjected to extensive back surgery.  The new protocol introduced by AHCPR recommended use of muscle relaxants and then gradual exercise for muscle strengthening.  The recommendations caught many healthcare providers by surprise but they quickly were accepted as the national trend for back pain management.

AHRQ began its existence focusing on geographic variations in medical practice (example:  percentage of women receiving hysterectomies vary greatly by their hometown residence).  The mission of this newly renamed agency is to:

• Support improvement in health outcomes
• Strengthen quality measurement and improvement
• Identify strategies to improve access, foster appropriate use, and reduce unnecessary expenditures

The agency has developed a set of quality indicators which covered three distinct areas of hospital care.  These quality indicators are:

• Potentially avoidable adverse hospital outcomes (such as pulmonary compromise after major surgery)
• Potentially inappropriate utilization of hospital procedures (such as indications for hysterectomy)
• Potentially avoidable hospital admissions (such as pediatric asthma patients requiring hospitalization)

We again have another example of data mining and the power of information in policy making and day-to-day operations of healthcare organizations.

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