NQF Releases Surgical Measures 

Washington, DC - The National Quality Forum (NQF) Board of Directors has recently approved for endorsement 21 quality measures concerning surgical care. The measures – part of the Surgery Endorsement Maintenance 2010, Phase 1 and the National Voluntary Consensus Standards for Pediatric Cardiac Surgery projects – address a wide range of surgical procedures and considerations in caring for surgical patients.

The number of surgical procedures, especially those performed outside of hospital settings, continues to rise each year. In 2006, 99 million surgeries were performed in the United States, with 53 million of those surgeries taking place in ambulatory surgery centers.^{1, 2} By 2007, there were 4,964 Medicare-certified ambulatory surgery centers across the country, a 64 percent increase from 2000.³ These endorsed measures will help ensure NQF’s surgical portfolio continues to support a wide variety of care settings and populations.

“With this set of measures, the NQF portfolio of surgical care measures now covers important areas of care quality for pediatric and adult populations, including pediatric cardiac mortality and volume, as well as subspecialty treatments and procedures,” said Janet Corrigan, PhD, MBA, president and CEO of NQF.

The Surgery Endorsement Maintenance and the Pediatric Cardiac Surgery projects were funded by the U.S. Department of Health and Human Services and the Pediatric Cardiac Surgery Coalition, respectively.

NQF is a voluntary consensus standards-setting organization. Any party may request reconsideration of any of the 21 endorsed quality measures listed below by submitting an appeal no later than January 3 (to submit an appeal, go to the NQF Measure Database). For an appeal to be considered, the notification must include information clearly demonstrating that the appellant has interests 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.

SURGERY ENDORSEMENT MAINTENANCE 2010, PHASE 1 QUALITY MEASURES:  

Cardiac-CABG 

• 0114: Risk-adjusted post-operative renal failure (STS)
• 0115: Risk-adjusted surgical re-exploration (STS)
• 0129: Risk-adjusted prolonged intubation (ventilation) (STS)
• 0131: Risk-adjusted stroke/cerebrovascular accident (STS)
• 0119: Risk-adjusted operative mortality for CABG (STS)
• 0113: Participation in a database for cardiac surgery (STS) (reserve status)

Cardiac-CABG: Valve Replacement/Repair 

• 0120: Risk-adjusted operative mortality for aortic valve replacement (AVR) (STS)
• 0121: Risk-adjusted operative mortality for mitral valve (MV) replacement (STS)
• 0122: Risk-adjusted operative mortality MV replacement + CABG surgery (STS)
• 0123: Risk-adjusted operative mortality for aortic valve replacement (AVR) + CABG surgery (STS)
• 1501: Risk-adjusted operative mortality for mitral valve (MV) repair (STS)
• 1502: Risk-adjusted operative mortality for MV repair + CABG surgery (STS)

Esophageal Resection and Transfusion 

• 0360: Esophageal resection mortality rate (IQI 8) (AHRQ)
• 0361: Esophageal resection volume (IQI 1) (AHRQ)

Cardiac-CABG 

• 0116: Anti-platelet medication at discharge (STS)
• 0118: Anti-lipid treatment discharge (STS)
• 0130: Risk-adjusted deep sternal wound infection rate (STS)

Venous Thromboembolism (VTE) 

• 0218: Surgery patients who received appropriate venous thromboembolism (VTE) prophylaxis within 24 hours prior to surgery to 24 hours after surgery end time (CMS)

PEDIACTRIC CARDIAC SURGERY QUALITY MEASURES:  

• 0733: Pre-Operative Mortality Stratified by the Five STS-EACTS Mortality Categories (STS)
• 0732: Surgical Volume for Pediatric and Congenital Heart Surgery: Total Programmatic Volume and Programmatic Volume Stratified by the Five STS-EACTS Mortality Levels (STS)
• 0734: Participation in a national database for pediatric and congenital health surgery (STS)

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. 

1 DeFrances CJ, Lucas CA, Buie VC, et al., 2006 national hospital discharge survey, Natl Health 327 Stat Report, 2008;5:1-20. Available at www.cdc.gov/nchs/data/nhsr/nhsr005.pdf. Last accessed 328 June 2011.

2 Cullen KA, Hall MJ, Golosinskiy A. Ambulatory surgery in the United States, 2006. Natl Health 330 Stat Report, 2009;11:1-28. Available at www.cdc.gov/nchs/data/nhsr/nhsr011.pdf. Last accessed 331 June 2011.

3 DeFrances, Lucas, and Buie.