A just-the-facts approach to quality

At the helm of the Agency for Healthcare Research and Quality, Carolyn Clancy, MD, works to encourage doctors and others to make sure strategies for quality care and patient safety are followed.

By Joel B. Finkelstein, AMNews staff. Feb. 24, 2003.

The Nation is their Patient
Doctors serve America at all levels of government. This occasional series explores how their medical background influences what they do.

Carolyn M. Clancy, MD, newly appointed director of the Agency for Healthcare Research and Quality, aims not only to build an evidence base for improving health care quality but also to help physicians incorporate that information into their practices.

Dr. Clancy, who had served as the agency's acting director since the middle of last year, keeps her hand in practice by supervising residents once a week at George Washington University. She spoke with AMNews recently about the agency's activities.

Question: Why does the agency no longer develop practice guidelines?

Answer: When the agency was first created in late 1989, we supported the development of clinical practice guidelines and developed about 20 in all. In 1996, we changed our process. We changed it for a number of reasons, partly because there was some controversy about practice guidelines when you got to that part of clinical decision-making for which there was no good evidence.

Q: How is the agency involved in this process, and what is its new focus?

A: What we did is shift gears and now support 13 evidence-based practice centers across North America that conduct systematic reviews. These reviews look at hundreds and sometimes thousands of articles on a particular topic. They rate the quality of those articles and then put that in a comprehensive report that lays out the evidence. It is very much a just-the-facts approach.