Access the Final Report: National Voluntary Consensus Standards for Home Health Care — Additional Performance Measures 2008
The Opportunity
More than 7 million Americans receive professional healthcare in their homes each year (2000). Home healthcare services are delivered at home to patients who are recovering from care in hospitals or nursing homes; patients who are disabled; the elderly; and chronically or terminally ill persons in need of medical, nursing, or therapeutic treatment and assistance with the essential activities of daily living. As in all areas of healthcare, the quality of care provided is of concern to consumers, purchasers, providers and other stakeholders. NQF has previously endorsed 15 home healthcare performance measurers.1
About the Project
This project was completed in April 2009.
Objectives
This project reviewed the existing 15 home healthcare measures as part of NQF's measure maintenance process and endorsed 20 new measures to help improve both quality and the patient experience in home healthcare. The measures can be used to measure and improve the quality of care delivered in the patient's home.
The newly endorsed measures focus on eight main areas of home healthcare:
- timely initiation of care;
- patient and caregiver education;
- preventive services;
- pain intervention and assessment;
- improvement and assessment of clinical symptoms;
- improvement in functional status;
- assessment of need for emergency care or hospitalization; and
- patient experience of care.
Patient experience of care is measured via the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey, which allows patients and their families to report their experience of home healthcare. Other measures address areas including receipt of flu shots, depression screening, improvements in mobility, pain reduction, and the percentage of home healthcare patients who need hospital or emergency care.
Process
The candidate measures were considered for NQF endorsement as voluntary consensus standards. Agreement was developed through NQF's formal Consensus Development Process (version 1.8). This project, like all NQF activities, involved the active participation of representatives from across the spectrum of healthcare stakeholders and was guided by a Steering Committee. Additionally, a special Technical Advisory Panel (TAP) was convened to examine home health patient experience of care. The TAP met in October 2008.
Funding
Funding for this project has been provided by the Centers for Medicare & Medicaid Services.
Related NQF Work
National Voluntary Consensus Standards for Home Health Care: Additional Performance Measures, 2008: Addendum
Standardizing Home Health Care Performance Measures (2005)
Contact Information
For more information on this project, contact info@qualityforum.org or (202) 783-1300.
Notes
1 Medicare Payment Advisory Commission (MedPAC). Report to the Congress: Promoting Greater Efficiency in Medicare. Washington, DC: Medicare Payment Advisory Commission (MedPAC); 2007. National Quality Forum.
This project reviewed the current 15 measures for home health performance, and considered 20 new ones. Measures for public accountability and quality improvement related to the quality of home healthcare.
The project Steering Committee, representing the full range of stakeholder perspectives, was formed following the process set forth in NQF’s Consensus Development Process. Nominations were accepted from August 15 through October 2, 2008. A technical advisory panel also was formed to consider the survey tools to measure the patient experience of home healthcare.
Steering Committee Roster
Technical Advisory Panel
The Steering Committee met in person and by conference call in October and November 2008. They reviewed all submissions and communicated with measure developers as needed to determine the measures to recommend for endorsement. Following this review period, the recommended measures were made available for public and member comment.
October 28, 2008: Technical Advisory Panel Conference Call Agenda
November 12-13, 2008: Steering Committee Meeting Agenda and Summary
Member voting on 20 home health measures was held from January 28 through February 26, 2009.
View draft report.
The CSAC reviewed the measures on March 10, 2009, and considered the member voting results as well as all comments received to date. The committee recommended that 20 measures be endorsed and that 5 measures be retired.
The NQF Board accepted all of CSAC's recommendations, endorsing 20 measures for home healthcare, including a survery tool for patient experience of care.
The public had 30 days to appeal the decision to endorse a voluntary consensus standard. No appeals were submitted.
