Maintenance of NQF-Endorsed® Performance Measures 


Measure Endorsement

As an endorsing body, NQF is committed to ensuring the performance measures it endorses continue to meet the rigorous NQF measure evaluation criteria. Every three years, endorsed measures are re-evaluated against these criteria and are reviewed alongside newly submitted (but not yet endorsed) measures. This head-to-head comparison of new and previously endorsed measures fosters harmonization and helps ensure NQF is endorsing the best available measures. 

NQF’s measure endorsement - which includes this important three-year review of previously endorsed measures - is standardized in a regular cycle of topic-based measure evaluation. NQF follows a three-year schedule that outlines the review and endorsement of measures in 21 topic areas, such as cardiology, neurology, perinatal, and infectious disease. As the need arises, these topic areas may be revised to account for measures that may require a new or more appropriate topic area.

Each topic-based review of new and previously endorsed measures follows NQF’s Consensus Development Process®, which allows for the submission of new measures, review by an expert Steering Committee, public and Member comment, Member voting, consideration by the Consensus Standards Approval Committee (CSAC), endorsement by the Board of Directors, and an appeals period. At the end of this process, a set of measures around a specific topic area (e.g. cardiology) may be endorsed.

Measure Maintenance

NQF recognizes the need to ensure that the endorsement and maintenance process enables the portfolio of measures to change over time, while continuing to provide consistency and currency for those individuals and organizations implementing the measures. For more information on NQF’s maintenance processes review the policy below.

NQF Endorsement Maintenance Policy (2013) (PDF) 

As part of the maintenance review process, NQF is interested in how endorsed measures are being used. Measure users have the opportunity to submit comments on measures in use via NQF's Quality Positioning System (QPS), a measure search tool. 

NQF is also a facilitator in the ICD-10 coding conversion process. Learn more about our approach here

To review the questions included in the measure submission form, the evidence attachment and/or the testing attachment, Word templates of the online forms are available below:

Annual Update 

In the two years when an endorsed measure is not being re-evaluated for continued endorsement, measure stewards will submit a status report of the measure specifications to NQF. This report will either reaffirm that the measure specifications remain the same as those at the time of endorsement or last update, or outline any changes or updates made to the endorsed measure.

If changes occur to a measure at any time in the three-year endorsement period, the measure steward is responsible for informing NQF immediately of the timing and purpose of the changes. An ad hoc review will be conducted if the changes materially affect the measure’s original concept or logic.

Ad Hoc Review

Ad hoc reviews can be requested at any time by any party, as long as there is adequate evidence to justify the review. When requesting an ad hoc review, requestors should indicate under which criterion they are requesting the ad hoc review and should provide in writing adequate evidence to justify the review. Multiple criterion can be used in the justification. The criterion are: 

  • the evidence supporting the measure has changed
  • implementation of the measure results in unintended consequences
  • material changes have been made to the measure 

Learn more about the ad-hoc review process (PDF).

NQF Resources

The Field Guide is an online resource designed to help you easily access NQF resources.