NQF Endorses Measures for Hospital Psychiatric Care 

Washington, DC - The National Quality Forum has endorsed two inpatient psychiatric measures that focus on quality improvement in psychiatric hospitals and general hospitals with psychiatric units.  The endorsed measures address the use of restraints and seclusion and complement psychiatric medication management measures recently endorsed by NQF.

An estimated 57.7 million people suffer from a diagnosable mental disorder each year in the United States, including 4.5 million who suffer from a serious mental illness like schizophrenia or severe bipolar disorder.  Many receive treatment in a psychiatric hospital or the psychiatric unit of a general hospital during an acute episode. 

The measures endorsed by NQF address the quality of care millions of Americans receive in this setting each year and specifically address the use of seclusion and restraints.  The endorsed standards measure the total number of hours all patients admitted to a psychiatric setting were held in seclusion and the total number of hours physical restraints were used.

In its deliberations, the Steering Committee noted that a goal of both measures is to reduce use of restraints and seclusion. 

NQF’s Steering Committee of hospital experts convened for the hospital outcomes project reviewed these measures in collaboration with psychiatric care technical advisors.  The Steering Committee was co-chaired by Bruce A. Boissonnault, president and CEO of the Niagara Health Quality Coalition and Frank Opelka, vice chancellor of clinical affairs at Louisiana State University.

NQF is a voluntary consensus standards-setting organization. Any party may request reconsideration of the recommendations by notifying NQF in writing via e-mail no later than June 4, 2010 to appeals@qualityforum.org. For an appeal to be considered, the notification e-mail must include information clearly demonstrating that the appellant has interests that are directly and materially affected by the NQF-endorsed^® recommendations and that the NQF decision has had (or will have) an adverse effect on those interests.

Endorsed Measures 

• Hours of Physical Restraint: The number of hours that all patients admitted to a hospital-based inpatient psychiatric setting were maintained in a physical restraint per 1,000 psychiatric hours, overall and stratified by age group

• Hours of Seclusion: hours that all patients admitted to a hospital-based inpatient psychiatric setting were held in seclusion per 1,000 psychiatric hours, overall and stratified by age group 

The mission of the National Quality Forum is to improve the quality of American healthcare by setting national priorities and goals for performance improvement, endorsing national consensus standards for measuring and publicly reporting on performance, and promoting the attainment of national goals through education and outreach programs. NQF, a non-profit organization (www.qualityforum.org) with diverse stakeholders across the public and private health sectors, was established in 1999 and is based in Washington, DC.