Endorsing Additional Measures For Home Health Performance and Patient Experience of Care: Addendum
Access theFinal Report: National Voluntary Consensus Standards for Home Health Care — Additional Performance Measures 2008
The Opportunity
There has been growing recognition of the importance of home health in the continuum of care, especially among those with chronic, co-morbid illnesses. Home healthcare services are delivered by approximately 9,284 agencies1 to patients at home who are recovering from care in hospitals or nursing homes; patients who are disabled; the frail elderly; and chronically or terminally ill persons in need of medical, nursing, or therapeutic treatment as well as assistance with the essential activities of daily living. Approximately 7.6 million individuals currently receive care from 83,000 providers because of acute illness, long-term health conditions, permanent disability, or terminal illness.2 In 2007, annual expenditures for home health care were projected to be $57.6 billion.3 As in all areas of healthcare, the quality of home health care provided is a vital concern.
About the Project
This project is an addendum to NQF's Home Health: Additional Measures 2008 project, which began in August 2008. In November 2008, the project Steering Committee decided to consider the pressure ulcer and falls prevention measures originally under the “Home Health: Additional Measures 2008” project, under a different timeline. This allowed the pressure ulcer Steering Committee – convened to develop a pressure ulcer framework in a different project – to review the pressure ulcer measures and provide expertise. The falls prevention measures that are also included in this addendum to the home health project were considered in this amended timeline to allow the measure developer to provide more information about the measures.
ObjectivesThe goal of this NQF project is to evaluate and endorse performance measures for home healthcare, specifically related to fall assessment.
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.
The project Steering Committee originally reviewed two measures related to pressure ulcers during their November 2008 meeting; ultimately, the Committee decided to refer them to the Pressure Ulcer Framework project which began in December 2008. The Pressure Ulcer Steering Committee has since reviewed the measures and recommended these three measures for time limited endorsement.
Funding
Funding for this project is provided by the Centers for Medicare & Medicaid Services.
Related NQF Work
Home Health: Additional Measures 2008
Standardizing Home Health Care Performance Measures
Contact Information
Lisa Hines, BSN, MS, at 202-783-1300 or lhines@qualityforum.org.
Notes1 U.S. Census Bureau, 2002 Economic Census (www.census.gov) (October 2004)
2 Centers for Medicare & Medicaid Services, Office of the Actuary (January 2008)
3 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 NQF project is an addendum to the Home Health: Additional Measures 2008 project. Six measures for falls assessment and pressure ulcers, originally submitted as part of the Additional Measures 2008 project, were split off from the main project and considered by the project Steering Committee under a different timeline.
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.
Steering Committee Roster
For additional information on the Steering Committee formation process, including specific information on conflicts of interest and required time commitment, please refer to the Call for Nominations documents.
Call for Nominations, Nomination Form, Disclosure of Interest Form (MS Word)
The measures reviewed in this project were originally submitted to NQF's Home Health: Additional Measures 2008 project; thus, this project did not issue its own call for measures.
The call for measures for the Home Health: Additional Measures 2008 was issued in September 2008, and closed in October 2008.
Submitted Measures
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.
The Steering Committee met via conference call on October 28, 2008. The purpose of the call was to review the submitted measures.
The Steering Committee met in person in Washington, DC, on November 12 through 13, 2008. The purpose of the meeting was to continue the Committee's review of the submitted measures.
Agenda
Meeting Summary
NQF members were invited to review and vote on the Steering Committee's recommendations. Member voting closed on May 27, 2009.
Voting draft report
Additional information about the CSAC decision, including the agenda, meeting materials, and location of the CSAC meeting, will be posted when available.
The NQF Board of Directors has seven days to ratify the CSAC's endorsement decision.
The public had 30 days to appeal the NQF Board of Directors' decision to endorse a voluntary consensus standard.
