NQF Endorses Pulmonary and Critical Care Measures 

JUL 31, 2012

CONTACT: Erin Weireter

NQF Endorses Pulmonary and Critical Care Measures

Washington, DC – the National Quality Forum (NQF) Board of Directors has endorsed 19 measures related to pulmonary conditions and the critical care setting. The measures focus on treatment processes and outcomes for asthma, chronic obstructive pulmonary disease (COPD), and pneumonia.

“Countless individuals suffer from pulmonary and heart conditions in the United States, with critical care units admitting more than five million of them each year,” said Laura J. Miller, FACHE, interim CEO of NQF. “This set of measures will be critical to ensuring these individuals receive the safe, high-quality care they deserve.”

As the third leading cause of death in the United States, chronic lung disease affects close to 33 million Americans. 1 The human and financial burden is significant – asthma affects more than seven million children, accounting for 14 million missed school days and $15 million in healthcare costs each year. 2, 3 COPD and pneumonia are also responsible for close to $50 billion in annual healthcare costs and 1.2 million annual hospital discharges, respectively.4, 5 

“These measures are an important part of the NQF portfolio,” said Stephen R. Grossbart, PhD, senior vice president & chief quality officer at Catholic Health Partners and co-chair of the Pulmonary and Critical Care Steering Committee. “Given the prevalence of chronic lung disease in the United States, it’s more important than ever that providers are able to measure and report on care. These measures will be essential to those quality improvement efforts.”

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 pulmonary/critical care portfolio. In all, 35 measures were evaluated against NQF’s endorsement criteria; 19 received endorsement status. Three were new measures and 16 were maintenance measures. Further harmonization efforts are underway for a sub-set of measures. Three measures are still under review.

“These measures, having undergone a rigorous review by a diverse panel of measurement experts, will help healthcare stakeholders track and improve care for pulmonary conditions and in the critical care setting,” said Kevin Weiss, MD, MPH, senior vice president at the Accreditation Council for Graduate Medical Education and co-chair of the Pulmonary and Critical Care Steering Committee. “I’m confident these measures will put us on a path to safer, more effective care for all patients.”

NQF is a voluntary consensus standards-setting organization. Any party may request reconsideration of any of the 19 endorsed quality measures listed below by submitting an appeal no later than August 30 (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


  • 0036: Use of appropriate medications for people with asthma (NCQA)
  • 0047: Asthma: Pharmacologic therapy for persistent asthma (AMA-PCPI)
  • 1799: Medication management for people with asthma (MMA) (NCQA)
  • 1800: Asthma medication ratio (AMR) (NCQA)
  • 0548: Suboptimal asthma control (SAC) and absence of controller therapy (ACT) (Pharmacy Quality Alliance, Inc.)
  • 0143: CAC-1: Relievers for inpatient asthma (Joint Commission) *reserve status 
  • 0144: CAC-2 Systemic corticosteroids for inpatient asthma (Joint Commission) *reserve status 


  • 0091: COPD: spirometry evaluation (AMA-PCPI)
  • 0102: COPD: inhaled bronchodilator therapy (AMA-PCPI)
  • 0577: Use of spirometry testing in the assessment and diagnosis of COPD (NCQA)
  • 1825: COPD - management of poorly controlled COPD (ActiveHealth Management)


  • 0096: Empiric antibiotic for community-acquired bacterial pneumonia (AMA-PCPI)
  • 0147: Initial antibiotic selection for community-acquired pneumonia (CAP) in immunocompetent patients (CMS)
  • 0231: Pneumonia Mortality Rate (IQI #20) (AHRQ)
  • 0468: Hospital 30-day, all-cause, risk-standardized mortality rate (RSMR) following pneumonia hospitalization (CMS)

Critical Care 

  • 0334: PICU Severity-adjusted length of stay (Virtual PICU Systems, LLC) *paired with 0335 
  • 0335: PICU Unplanned readmission rate (Virtual PICU Systems, LLC) *paired with 0334 
  • 0343: PICU Standardized Mortality Ratio (Virtual PICU Systems, LLC)


  • 0513: Thorax CT: Use of contrast material (CMS)

*reserve status applies only to highly credible, reliable, and valid measures that have high levels of performance due to quality improvement actions. 

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. American Lung Association. Available at www.lungusa.org/assets/documents/publications/lung-disease-data/solddc_2010.pdf. Last accessed October 2011. 
  2. Ibid.
  3. National Heart, Lung and Blood Institute. Available at www.nhlbi.nih.gov/resources/docs/2009_ChartBook.pdf. Last accessed October 2011.
  4. American Lung Association.
  5. Ibid.