NQF Endorses Care Coordination Measures 

AUG 10, 2012

CONTACT: Erin Weireter

NQF Endorses Care Coordination Measures

Washington, DC –
The National Quality Forum (NQF) Board of Directors has endorsed 12 measures that assess coordination of care – an essential ingredient in efforts to improve care quality and safety.   The measures touch on such critical areas of concern as reconciling patients’ medications, establishing advance care plans, and the timely availability of medical records (to other caregivers and patients themselves) when patients are discharged from hospitals and other in-patient facilities.          

“Care coordination is essential to reducing medical errors, wasteful spending, and unnecessary pain and procedures for patients,” said Laura J. Miller, FACHE, interim CEO of NQF. “We are pleased to endorse this set of measures that will help providers deliver safer, coordinated, and higher-quality care to patients.”

Lack of coordination and communication across healthcare settings can lead to significant patient complications, including medication errors, preventable hospital readmissions, and emergency department visits. The Institute of Medicine has estimated that care coordination initiatives addressing such complications could result in $240 billion in healthcare savings.1 

“These measures are an important part of the NQF portfolio,” said Gerri Lamb, PhD, RN, FAAN, associate professor, Arizona State University College of Nursing and Health Innovation, and co-chair of the Care Coordination Steering Committee. “As the number of older adults with multiple chronic conditions in the United States continues to grow, their treatment needs are often complex and varied. Care coordination measures will help the healthcare community work together to provide more efficient, effective, and high-quality care.”

The measures include those that have been endorsed for at least three years and are now undergoing NQF endorsement maintenance. The ongoing evaluation and updating of endorsed measures ensures they are current and relevant to NQF’s care coordination portfolio. In all, 15 measures were evaluated against NQF’s endorsement criteria, with 12 receiving endorsement status.  

The Committee identified measurement gaps in care coordination with a focused assessment of the role of health information technology in moving toward the next generation of measures. “Even though we currently lack comprehensive quality measurements of effective care coordination , these endorsed measures help set the stage for the future,” said Donald Casey Jr., MD, MPH, MBA, former chief medical officer and vice president of quality for Atlantic Health and co-chair of the Care Coordination Steering Committee.  “Ultimately we want to see measure developers align their efforts with NQF’s Preferred Practices for Care Coordination. The domains of these practices include the healthcare home, developing and implementing a proactive and patient-centered plan of care, effective communication between patients, families and caregivers, efficient information systems that support timely  communication, and transitions of care that promote safe, evidence-based care."  

NQF is a voluntary consensus standards-setting organization. Any party may request reconsideration of any of the 12 endorsed quality measures listed below by submitting an appeal no later than September 10 (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.

Endorsed Measures 

  • 0097: Medication Reconciliation (NCQA)
  • 0171: Acute care hospitalization (risk-adjusted) (CMS)
  • 0173: Emergency Department Use without Hospitalization (CMS)
  • 0326: Advance Care Plan (NCQA)
  • 0494: Medical Home System Survey (NCQA)
  • 0526: Timely Initiation of Care (CMS)
  • 0553: Care for Older Adults – Medication Review (NCQA)
  • 0554: Medication Reconciliation Post-Discharge (NCQA)
  • 0646: Reconciled Medication List Received by Discharged Patients (Discharges from an Inpatient Facility to Home/Self Care or Any Other Site of Care) (AMA-PCPI)
  • 0647: Transition Record with Specified Elements Received by Discharged Patients (Discharges from an Inpatient Facility to Home/Self Care or Any Other Site of Care) (AMA-PCPI)
  • 0648: Timely Transmission of Transition Record (Discharges from an Inpatient Facility to Home/Self Care or Any Other Site of Care) (AMA-PCPI)
  • 0649: Transition Record with Specified Elements Received by Discharged Patients (Emergency  Department Discharges to Ambulatory Care [Home/Self Care] or Home Health Care) (AMA-PCPI)

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. 

 IOM, Roundtable on Value & Science-Driven Health Care: The Healthcare Imperative: Lowering Costs and Improving Outcomes: Workshop Serious Summary, Washington, DC: National Academies Press, 2010.