Washington, DC – the National Quality Forum (NQF) Board of Directors has approved for endorsement 14 quality measures on palliative and end-of-life care. The measures address a wide range of care concerns, including pain management, psychosocial needs, care transitions, and experiences of care.
"As the number of older adults in this country continues to grow, palliative and end-of-life care services are needed more than ever," said Janet Corrigan, PhD, MBA, president and CEO of NQF. "This set of measures will help promote the type of high-quality care older people and acutely ill patients deserve."
For this project, NQF sought measures focused on care concerns such as managing pain, weight loss, and depression. It also sought measures that would directly assess – and improve over time – the experience of patients undergoing palliative and end-of- life care, as well as the experience of their families. In all, 22 measures were evaluated against NQF's endorsement criteria by a panel of providers, measurement experts, and consumer representatives; 14 measures were endorsed.
"These palliative and end-of-life care measures are a welcome addition to the NQF portfolio," said June Lunney, PhD, RN, director of research at the Hospice and Palliative Nurses Association and co-chair of the Palliative Care and End-of-Life Care Endorsement Maintenance Steering Committee. "As the number of palliative and end-of-life care programs continue to grow across the country, it's critical that providers have the right measurement tools to help ensure patients receive safe, high-quality, and compassionate care."
The endorsed measures include those previously endorsed by NQF and newly submitted measures for initial endorsement. Twelve measures are new. The ongoing evaluation and updating of endorsed measures ensures the currency and relevance of NQF's palliative and end-of-life care portfolio.
"Palliative care teams have been shown to help improve patient care quality throughout the course of treatment," said R. Sean Morrison, MD, director of the National Palliative Care Research Center and co-chair of the Palliative Care and End-of-Life Care Endorsement Maintenance Steering Committee. "This measure set will help support such efforts, such as enhanced treatment of pain and other symptoms, improved communication between providers and patients, fewer admissions to emergency departments, and increased patient satisfaction."
NQF is a voluntary consensus standards-setting organization. Any party may request reconsideration of any of the 14 endorsed quality measures listed below by submitting an appeal no later than March 14 (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.
- 1634: Hospice and Palliative Care- Pain Screening (UNC) (paired with measure 1637)
- 1637: Hospice and Palliative Care – Pain Assessment (UNC) (paired with measure 1634)
- 1617: Patients treated with an Opioid who are given a bowel regimen (RAND)
- 1628: Patients with advanced cancer assessed for pain at outpatient visits (RAND)
- 1638: Hospice and Palliative Care- Dyspnea Treatment (UNC) (paired with measure 1639)
- 1639: Hospice and Palliative Care – Dyspnea Screening (UNC) (paired with measure 1638)
- 1626: Patients admitted to the ICU who have care preferences documented (RAND)
- 1641: Hospice and Palliative Care- Treatment Preferences (UNC)
- 1647: Percentage of hospice patients with documentation in the clinical record of a discussion of spiritual/religious concerns or documentation that the patient/caregiver did not want to discuss (Deyta)
- 0209: Comfortable dying (NHPCO) (maintenance)
- 1625: Hospitalized patients who die an expected death with an ICD that has been deactivated (RAND)
- 0208: Family Evaluation of Hospice Care (NHPCO) (maintenance)
- 1632: CARE- Consumer Assessments and Reports of End of Life (Center for Gerontology and Health Care Research)
- 1623: Bereaved Family Survey (PROMISE Center)
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.