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National Accountability Dashboard for Quality

National Accountability Dashboard for Quality enables the Indian Health Service to report key performance data in a succinct and easily viewed display to monitor and improve quality of care.

Background:  The mission of the Indian Health Service (IHS) is to raise the physical, mental, social, and spiritual health of American Indians and Alaska Natives to the highest level. Quality of care is an agency priority, and IHS is committed to continuing our efforts to assure a high-performing health care delivery system for American Indian and Alaska Native people. Quality measurement is an essential part of providing safe and effective, patient-centered care.  Dashboards are a useful tool for easily displaying and monitoring key performance indicators across the organization.

The IHS Strategic Plan FY 2019-2023 details how the IHS will achieve its mission through three strategic goals:

Goal 1: To ensure that comprehensive, culturally appropriate personal and public health services are available and accessible to American Indian and Alaska Native people;

Goal 2: To promote excellence and quality through innovation of the Indian health system into an optimally performing organization; and

Goal 3: To strengthen IHS program management and operations.

In 2016, the IHS assessed options for implementing a system-wide data monitoring process to strengthen quality assurance and improvement activities. The IHS set out to design and implement a quality dashboard to define key areas of performance to support the agency’s oversight and quality management functions. The National Accountability Dashboard for Quality (NAD-Q) supports the agency’s strategic goals and improvement of American Indians and Alaska Natives health outcomes by setting agency-wide standards, improving the oversight of quality of care, enabling the agency to make evidence-based, strategic decisions, and demonstrating transparency to the public.

The NAD-Q is the result of a collaborative process that reflects input from a diverse group of subject matter experts from across IHS in the areas of clinical and public health care, quality improvement, and health informatics.

Dashboard Overview:  The quality dashboard identifies key domains of quality for healthcare systems: 

  • Quality (efficient, effective, and equitable)
  • Accreditation
  • Workforce
  • Patient-centered care
  • Safety
  • Timely care

The dashboard utilizes the following measures within these domains. The measures below also show the alignment with the IHS Strategic Plan goals and objectives:

  • Goal 1 Access
    • Objective (Obj.).1.1: Recruit, develop, and retain a dedicated, competent, and caring workforce
      • Participation in the Federal Employee Viewpoint Survey
    • Obj. 1.3: Increase access to quality health care services.
      • Facilities with an Emergency Preparedness Plan
      • Facilities Reporting on Access to Care in the Emergency Department
      • Facilities with an Opioid Prescribing Policy
  • Goal 2 Quality,
    • Obj. 2.1: Create quality improvement capability at all levels of the organization.
      • Hospital & Ambulatory Accreditation
      • Patient Centered Medical Home Designation
      • Ambulatory facilities with a Quality Improvement program
      • Facilities Improving Safety
  • Goal 3 Management & Operations
    • Obj. 3.2: Secure and effectively manage the assets and resources
      • Employee Influenza Vaccination

Reporting:  These measures require quarterly, semi-annual, or annual reporting. Reporting for all measures is required for IHS-run hospitals, and reporting for a subset of measures is required for ambulatory health centers. Each of the IHS Area Offices with IHS direct service facilities reports and validates data for those sites.

Monitoring: Progress is monitored at the service unit, Area and Headquarters levels. Technical assistance using quality improvement science, principles, and practices is provided by subject matter experts to improve performance.

Communication and Transparency: The NAD-Q went live on February 20, 2018 with reporting FY 2017 Quarter 4 (October 1, 2016-September 30, 2017). The NAD-Q is published quarterly on the IHS website. The reports are available for public viewing and are located at:


For referral to the appropriate spokesperson, contact the IHS Public Affairs Staff at 301-443-3593.

June 2019

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