NQF Endorses Voluntary Consensus Standards for Ambulatory Care: Emergency and Urgent Care 

Washington DC - To improve healthcare quality and give patients and providers more information about the results of care, the National Quality Forum (NQF) has endorsed 16 ambulatory care measures, with a particular focus on emergency and urgent care.

“The implementation and reporting of quality measures pertaining to emergency and urgent care builds on previous efforts in the ambulatory and inpatient area,” said Janet Corrigan, PhD, MBA, president and CEO of NQF. “Ultimately, this information will provide stakeholders with an improved picture of the quality of care delivered in the United States.”

Suzanne Stone Griffith, RN, MSN, CNAA, assistant vice president of ED and EMS services for the Continental Division of the Hospital Corporation of America, co-chair of the Ambulatory Care Steering Committee, echoed Dr. Corrigan’s sentiments: “With an increasing number of ambulatory care centers delivering emergency and/or urgent care in the United States, it is imperative that the endorsed measures be put into practice to ensure adherence to appropriate standards of care.”

NQF has previously endorsed a wide variety of performance measures for assessing the quality of care provided in outpatient settings, including hospital outpatient departments, emergency departments (EDs), urgent care facilities, ambulatory surgery centers, community health centers, and clinician offices. Endorsement of measures is intended to encourage hospitals and clinicians to improve the quality of care and to empower consumers with quality information to make informed decisions about their healthcare.

Demand and capacity issues have contributed to increased wait time for emergency and urgent care, placing patients at risk for poor outcomes. Hospital emergency departments provide a sizable share of emergent and urgent care. From 1996 through 2006, the number of ED visits increased by 32 percent, while the number of hospital EDs in the United States decreased by about 12.4 percent.

NQF is a voluntary consensus standards-setting organization. Any party may request reconsideration of the recommendations, in whole or in part, by notifying NQF in writing via its web-based form no later than February 15.  Access the appeals form. For an appeal to be considered, the notification 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: 

• ACP-009-10: Acute otitis externa topical therapy (time-limited endorsement) (© American Medical Association)
• ACP-011-10: Acute otitis externa: systemic antimicrobial therapy—avoidance of inappropriate use (time-limited endorsement) (© American Medical Association)
• ACP-012-10: Otitis media with effusion: antihistamines or decongestants—avoidance of inappropriate use (time-limited endorsement) (© American Medical Association)
• ACP-013-10: Otitis media with effusion: systemic corticosteroids—avoidance of inappropriate use (time-limited endorsement) (© American Medical Association)
• ACP-015-10: Otitis media with effusion: systemic antimicrobials—avoidance of inappropriate use (time-limited endorsement) (© American Medical Association)
• ACP-002-10: Ultrasound determination of pregnancy location for pregnant patients with abdominal pain (time-limited endorsement) (American College of Emergency Physicians)
• ACP-003-10: Rhogam for Rh negative pregnant women at risk of fetal blood exposure (time-limited endorsement) (American College of Emergency Physicians)
• ACP-016-10: Endoscopy/polyp surveillance: appropriate follow-up interval for normal colonoscopy in average risk patients (time-limited endorsement) (© American Medical Association)
• ACP-017-10: Endoscopy/polyp surveillance: colonoscopy interval for patients for history of adenomatous polyps—avoidance of inappropriate use (time-limited endorsement) (© American Medical Association)
• ACP-019-10: Troponin results for emergency department acute myocardial infarction (AMI) patients or chest pain patients (with probable cardiac chest pain) received within 60 minutes of arrival (time-limited endorsement) (Optimal Solutions Group)
• ACP-021-10: Head CT or MRI scan results for acute ischemic stroke or hemorrhagic stroke who received head CT or MRI scan interpretation within 45 minutes of arrival (time-limited endorsement) (Optimal Solutions Group)
• ACP-023-10: Median time to pain management for long bone fracture (time-limited endorsement) (Optimal Solutions Group)
• ACP-032-10: Patient(s) two years of age and older with acute otitis externa who were NOT prescribed systemic antimicrobial therapy (Ingenix, Inc.)
• ACP-035-10: Patient(s) with an emergency medicine visit for syncope that had an ECG (Ingenix, Inc.)
• ACP-036: 10: Patient(s) with an emergency medicine visit for non-traumatic chest pain that had an ECG (Ingenix, Inc.)
• ACP-043-10: Ultrasound guidance for internal jugular central venous catheter placement (time-limited endorsement) (American College of Emergency Physicians)

The National Quality Forum (NQF) operates under a three-part mission to improve the quality of American healthcare by: 

• Building consensus on national priorities and goals for performance improvement and working in partnership to achieve them;  
• Endorsing national consensus standards for measuring and publicly reporting on performance; and 
• Promoting the attainment of national goals through education and outreach programs.