42 U.S.C. § 299b–33 — Health care delivery system research

(a) Purpose. This section aims to: (1) Let the Director identify, develop, evaluate, share, and train people in innovative methods and strategies — called "best practices" — for improving the quality, safety, and value of health care delivery. (2) Make sure the Director is accountable for pursuing this research together with other related federal agencies. (b) General functions of the Center. The Center for Quality Improvement and Patient Safety at the Agency for Healthcare Research and Quality (or another agency the Director names) must: (1) Use research from many fields — such as epidemiology, health services, sociology, psychology, human factors engineering, biostatistics, health economics, clinical research, and health informatics. (2) Support work consistent with (a), including finding best practices for care delivery, and practices that change care processes and system design in ways that reliably improve outcomes, patient safety, and reduce errors — such as team-based care skills and rapid-cycle process improvement — and help improve workflow. (3) Identify health care providers — health systems, single institutions, and individuals — that consistently deliver high-quality, efficient care, and use best practices that work well across different settings. (4) Assess research, evidence, and knowledge about what strategies work best to improve care delivery. (5) Find ways to put that knowledge into practice quickly and document whether the improvements last. (6) Build strategies for quality improvement — tools, methods, and interventions — that cut down on variation in how care is delivered. (7) Identify, measure, and improve the organizational, human, and other factors — including an organization's culture and system design — that make quality and safety strategies succeed and last. (8) Help develop best practices that: (A) Have a good chance of working, based on solid evidence review. (B) Are detailed enough — covering the steps, training, skills, and knowledge needed to put them into everyday workflow. (C) Can be readily adapted by providers in different settings. (D) Where relevant, help providers work with each other across the continuum of care and involve patients and families in improving care and outcomes. (9) Fund organizations with proven expertise in improving care delivery — including children's health care — that involve multiple disciplines, health care managers, broad training, patients, caregivers, families, and frontline workers, including work that shares best quality-improvement practices. (10) Build state and community capacity to lead quality and safety work, through education, training, and mentoring, to carry out (1) through (9). (c) Research functions of Center (1) In general. The Center must support — by contract or other means — research on improving health care delivery systems and developing tools to help adopt best practices that improve quality, safety, and efficiency. This can include a Quality Improvement Network Research Program that tests, scales, and spreads these interventions. Funding recipients can include national, state, multi-state, or multi-site quality improvement networks. (2) Research requirements. This research must: (A) Address priorities in the national strategic plan under section 280j. (B) Identify where evidence is too thin to guide strategy, considering gaps already found by the entity with the section 1395aaa(a) contract in its report under section 280j–2. (C) Address concerns raised by health care institutions and providers and passed along through the Center. (D) Reduce preventable illness, death, and their costs by building patient safety research capacity. (E) Support discovering safer, more efficient, and more responsive ways to deliver care, drawing on clinical and comparative effectiveness research. (F) Share findings and turn evidence into practice recommendations adaptable to many settings — which, soon after the Center starts, must include: nationwide Intensive Care Unit improvement projects for adult, pediatric, and newborn patients; practical methods for tackling health care-associated infections like MRSA and VRE and other emerging infections; and practical methods for reducing preventable hospital admissions and readmissions. (G) Expand demonstration projects to improve children's health care quality and use of health information technology, such as through Pediatric Quality Improvement Collaboratives and Learning Networks, consistent with section 1320b–9a where applicable. (H) Identify and reduce hazards by analyzing reports made to patient safety reporting systems and organizations, and using that analysis to build scientific response methods. (I) Include systematic reviews of existing practices that improve quality, safety, and efficiency, plus new research on improving them. (J) Include work on how to measure and evaluate progress on quality and patient safety. (d) Dissemination of research findings (1) Public availability. The Director must share the Center's research findings with the public, using multiple media and formats suited to different providers, consumers, and health literacy levels. (2) Linkage to health information technology. The Secretary must ensure the Center's findings are shared with the Office of the National Coordinator for Health Information Technology, to inform the health IT extension program under section 300jj–32 and relevant standards, certification criteria, and implementation specs. (e) Prioritization. The Director must identify and regularly update a list of processes or systems to focus the Center's research and dissemination on, considering: (1) The cost to federal health programs. (2) How consumers rate their health care experience. (3) How providers rate these processes or systems, and chances to reduce distress and injury to health care workers. (4) The potential effect on patients' health and function, including vulnerable groups like children. (5) The areas of insufficient evidence found under (c)(2)(B). (6) How meaningful use of health information technology (as defined in section 300jj) is evolving. (f) Coordination. The Center must coordinate its work with the Center for Medicare and Medicaid Innovation, established under section 1315a. (g) Funding. Congress may spend up to $20,000,000 for fiscal years 2010 through 2014 to carry out this section.