The Agency for Healthcare Research and Quality (AHRQ; pronounced "ark" by initiates and often "A-H-R-Q" by the public) is one of twelve agencies within the United States Department of Health and Human Services (HHS). The agency is headquartered in North Bethesda, Maryland, a suburb of Washington, D.C. (with a Rockville mailing address). It was established as the Agency for Health Care Policy and Research (AHCPR) in 1989 as a constituent unit of the Public Health Service (PHS) to enhance the quality, appropriateness, and effectiveness of health care services and access to care by conducting and supporting research, demonstration projects, and evaluations; developing guidelines; and disseminating information on health care services and delivery systems. History AHRQ's earliest predecessor was the National Center for Health Services Research and Development, established in 1968 within the PHS Health Services and Mental Health Administration. When that administration was split up in 1973, it became the Bureau of Health Services Research within the PHS Health Resources Administration, It was renamed the National Center for Health Services Research in 1975. In 1978 it was transferred to the Office of the Assistant Secretary for Health. In 1985 it was renamed the National Center for Health Services Research and Health Care Technology Assessment. In 1989, the agency became its own operating agency within PHS, and was renamed Agency for Health Care Policy and Research (AHCPR) under the Omnibus Budget Reconciliation Act of 1989 (). During its early years, the Agency for Healthcare Policy and Research implemented large multidisciplinary, multi-institutional projects that focused on patient results in certain medical conditions in an effort to improve clinical practice. This has included basic health IT research, patient safety research on wrong site surgery, medical teamwork, and hospital acquired conditions such as MRSA and VRE. However, AHCPR became controversial when it produced several guidelines that some thought would reduce medical drugs and procedures. This included concern from ophthalmologists on a cataract guideline and concern by the pharmaceutical industry over a reduction in the use of new drugs. When the agency produced a guideline that concluded that back pain surgery was unnecessary and potentially harmful, a lobbying campaign aided by Congressmen whose backs had been operated on changed the name of the agency and scaled back the guidelines program, which existed as the National Guideline Clearinghouse. until it was defunded in 2018. AHCPR was reauthorized December 6, 1999, as the Agency for Healthcare Research