How Endorsement Happens 


For more than a decade, the National Quality Forum has crafted and continually improved a process to make sure endorsed standards (measures) have cleared NQF’s bar for rigor and balance. The process is designed to produce consensus from a broad spectrum of stakeholders in America's healthcare.

 NQF has adopted a regular schedule for measure endorsement in 22 areas, such as cardiology, neurology, perinatal care, and infectious disease. To respond to new developments that signal a need for updated standards for patient care, NQF also has a process to consider "ad-hoc" endorsement projects outside of the schedule.

For each Consensus Development Process project, NQF follows a careful process that ensures transparency, public input, and discussion among representatives across the healthcare spectrum.

  1. Call for Nominations allows anyone to suggest a candidate for a given standing committee that will oversee a project. Committees are diverse, often encompassing experts in a particular field, providers, scientists, and consumers. After selection, NQF posts committee rosters on its website to solicit public comments on the composition of the panel and makes adjustments as needed to ensure balanced representation.
  2. Call for Standards starts a minimum 30-day period for developers to submit a measure through NQF’s online submission form.
  3. Standing Committee Review applies a five-part criteria to submitted measures to ensure they reflect sound science, will be useful to providers and patients, and will make a difference in improving quality. The expert standing committee conducts this detailed review in open sessions, each of which includes a public comment period.
  4. Public Comment solicits input from anyone who wishes to respond to a draft report that outlines the standing committee’s assessment of measures for possible endorsement. The standing committee may request a revision to the proposed measures as a result of public comment.
  5. Member Vote asks NQF members to review the draft report and cast their votes on the measures recommended for endorsement.
  6. CSAC Review marks the point at which the NQF Consensus Standards Approval Committee (CSAC) makes endorsement decisions, after deliberating on the merits of the measure and the issues raised during the review process. The CSAC includes consumers, purchasers, healthcare professionals, and others. It ensures that standards are consistently assessed from project to project.
  7. Appeal opens a period when anyone can appeal a CSAC measure endorsement decision. All appeals are submitted and reviewed by NQF's Appeals Board under a new appeals process