Home > About Us > Leadership > President's Report Archive > December 2005
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Dr. Kizer announced his resignation.
One Senior Program Director resigned recently for family reasons.
If the applications that are pending Board action are approved, NQF organizational membership will increase to 300.
All Member Councils continue to meet regularly by conference calls.
The Annual Meeting was held on October 6-7, 2005, at the Grand Hyatt in Washington, DC. The meeting was attended by more than 350 individuals and based on the feedback was very well-received as a resource for high-level briefings on healthcare quality improvement activities and for the networking opportunities. Of particular interest to attendees were those panels that showcased implementation of NQF-endorsed measures for use in public reporting, pay-for-performance programs, and the measurement of efficiency.
The 7th Annual Meeting will also be held at the Grand Hyatt Washington, DC, on October 12-13, 2006. As the time draws closer, we will again work with Member Council leadership and an Annual Meeting Program Committee to develop the program.
Texas Medical Institute of Technology has forwarded NQF $100,000 and pledged an additional $300,000 for a national voluntary consensus standards project for the public reporting of healthcare-associated infections data in the United States. Additional funding for the project has been contributed by the Association for Professionals in Infection Control and Epidemiology ($25,000), individual state APIC chapters, with other contributions pending.
The Robert Wood Johnson Foundation (RWJF) has awarded the NQF ~$93,000 for a project to track the nursing sensitive measure users and their experiences, including barriers and opportunities encountered.
CMS has forwarded measures for end-stage renal disease quality of care, in anticipation of funding a consensus development project in this area once it identifies a funding vehicle.
We continue to discuss the scope of a project with AHRQ related to its patient safety/quality indicators. This is likely to be a slightly narrower scope than AHRQ’s entire quality indicators set as previously requested and approved by the Board for expedited consensus in October 2004.
Sanofi-aventis has awarded NQF an unrestricted conference grant of $300,000 to convene a separate invitational conference on venous thromboembolism (VTE) as an ancillary activity to the project to develop measures for prevention and care of VTE. The target date for this activity is March 2006. sanofi-aventis also has awarded NQF an unrestricted grant (~$167,000) to convene a small workshop on “metabolic syndrome."
We hope to hear from RWJF in the near future on a grant for a follow-up project to the workshop on evidence-based substance use disorders treatments. This project would seek consensus on practices in the seven areas identified by the workshop participants.
National Framework and Preferred Practices for Palliative and Hospital Care
The Review Committee has concluded its work and a proposed draft framework and preferred practices is in the final stage of preparation for the review phase of the Consensus Development Process. We anticipate it will be launched in late December or early January.
VTE Performance Measures and Conference
The Steering Committee will meet on December 19, 2005, to finalize its recommendations for practices and policies for prevention and care of VTE; measures also will be reviewed and some, such as those forwarded by CMS, may advance depending on the Committee’s review and recommendations. JCAHO’s measure development work is ongoing and additional measures will be considered by the Steering Committee next year. As noted earlier, the target date for the VTE conference is March 2006.
Cancer Care Quality Measures
Although the target launch for the breast cancer draft report had been shortly after the Annual Meeting, additional discussion with the National Cancer Institute and AHRQ have lead to the request that NQF consider delaying the launch until early 2006. Such a delay would permit NCI to work with the American College of Surgeons on its final data analysis, which might then permit measures judged by the Steering Committee as nearly ready for endorsement to advance. Because of the staggering of the colorectal cancer and symptom management/end-of-life care priority areas yet to come, the delay in advancing the breast cancer report will not extend the total life of the project.
The Steering Committee met on December 1-2, 2005, to consider the recommendations of the Colorectal Cancer Technical Panel and the Symptom Management/End-of-life Care Technical Panel. Some follow-up work by conference call will be required to finalize the research agenda, but a draft report with proposed consensus standards should advance in QI 2006.
Institute for Quality Laboratory Management
As previously noted, CDC has provided additional funding of approximately $144,000 for the second year of the cooperative agreement. On January 11, 2006 NQF will convene the first of two invitational workshops requested by the CDC on how to define quality for laboratory medicine.
National Voluntary Consensus Standards for Hospital Care—Additional Priority Areas, 2005
At the October 7, 2005, meeting the Board endorsed two 30-day mortality measures; one for heart failure and one for acute myocardial infarction. No appeals were lodged. The two care coordination measures and one recommendation were proposed for a second ballot, subject to development of detailed administrative specifications for the care coordination measures. Following additional staff discussion with the developer of the care coordination measures, only the accompanying recommendation advanced on the second ballot. The Board will continue the results of this ballot at the meeting on October 7, 2005.
Ambulatory Care Quality Measures
All four Member Councils approved 36 physician-focused consensus standards on the first ballot, and the Board subsequently endorsed these during its conference call on August 3, 2005. Six of eight measures had their specifications adjusted by the developer, the National Committee for Quality Assurance, and were endorsed by the Board on October 7, 2005, following a second round of voting; no appeals were filed. The final report is in the publication process and will be completed by the February 28, 2006, Board meeting.
Phase 3, Cycle 1 of the project has commenced. Cycle 1 encompasses measures for the following priority areas: asthma, coordination of care, hypertension, medication management, obesity, and prevention. Since the Steering Committee meeting on August 15, 2005, the Technical Advisory Panels (TAPs) for Cycle 1 have all conducted in-person and conference calls to evaluate candidate consensus standards. The Steering Committee will meet on December 14-15, 2005, to consider the TAPs’ recommendations and a draft consensus report for the Cycle 1 measures will be available in early 2006.
Voluntary Consensus Standards for Adult Diabetes Care: 2005 Update
Because diabetes will cease to be a project in and of itself and will merge with the larger ambulatory project for Phase 3, Cycle 2 in Spring 2006, the 2005 update report will be published in an electronic format only, by the February 28, 2006, Board meeting.
Patient Safety Taxonomy
One appeal was received from the Department of Veterans Affairs and considered and denied by the Board at the meeting on October 7, 2005 when the taxonomy was endorsed by the Board. The final report is in the publication process and should be completed by the end of the year. A Call for Nominations for the Patient Safety Taxonomy Consensus Standards Maintenance Committee (CSMC) was issued, and the CSMC will begin its work in the near future.
Implementation of NQF-Endorsed Voluntary Consensus Standards: National Conference
NQF has endorsed performance measure sets for the hospital, nursing home, and home health care settings, and has underway a major project to endorse consensus standards for ambulatory care. On May 9, 2005, NQF convened, at the behest of the CMS, a conference to identify opportunities and barriers to implementation of NQF-endorsed consensus standards. A conference summary is in the final publication process and will be completed prior to the February 28, 2006 Board meeting.
Standardizing a Measure of Patient Experience (HCAHPS)
As follow-up to the Board meeting, a letter was sent to CMS Administrator Mark B. McClellan, MD, PhD, urging him to implement HCAHPS immediately. Additionally, a similar letter was sent to OMB in response to its Federal Register notice asking for comment on final preparations to launch HCAHPS.
Home Health Performance Measures
The report was released at the Annual Meeting.
Pay for Performance Programs: Guiding Principles and Design Strategies
The report was released at the Annual Meeting.
Several Members have indicated strong support for NQF to undertake a consensus project on pay for performance program guiding principles and design strategies. The potential need for this is underscored by the now multiple different sets of guiding principles for pay for performance programs promulgated by various organizations and our awareness of several more in development. We continue to explore funding opportunities for such a project.
Improving Safe Use of Prescription Medications
This project, funded by the California Endowment, identified a “safe medication use framework” aimed at increasing the effectiveness of prescription medication use by patients, especially those with low health literacy and/or limited English proficiency. The report was released shortly after the Annual Meeting and an informational briefing of California-based stakeholders was held at the Endowment’s office in San Francisco on October 25, 2005.
Evidence-based Practices for Substance Abuse Treatment Workshop
On December 13, 2004, NQF convened a workshop, funded by RWJF, to i) identify a set of evidence-based treatments for substance use disorders that are widely recognized as being important components of effective treatment programs, and ii) recommend a set of program-level descriptors relating to those attributes that indicate that evidence-based substance abuse treatments are being provided by the program to its clients. The workshop summary was released shortly after the Annual Meeting. As noted earlier in this report, we have been discussing a follow-up consensus project with RWJF (at their request) and hope to hear in the next few days whether it will be funded.
Informed Consent and Patient Safety
This project, funded by the Commonwealth Fund, explored the implementation of the NQF-endorsed Safe Practice 10 relating to informed consent for low literacy/limited English proficient patients. A workshop to discuss the case studies and site visits, results of interviews of non-adopters, and draft user’s guide for implementation was held in September 2004. The proceedings and user’s guide were published and disseminated to the Board and NQF Members in early September. The report has been well-received and is being used by the Safe Practices CSMC.
Cardiac Surgery Performance Measures
On August 8, 2005, UnitedHealth Group announced an initiative with the Society of Thoracic Surgeons (STS) and the American College of Cardiology (ACC) that will require hospitals seeking United Health Premium SM to submit data to the STS database and the ACC registry, which both include information on NQF-endorsed measures. A letter was sent to UnitedHealth to encourage them to publicly report information on the NQF-endorsed consensus standards to its enrollees.
Behavioral Health
The workshop proceedings have been printed and disseminated to the Board and NQF Members.
Safe Practices for Better Healthcare
The Safe Practices CSMC held an in-person meeting on September 30, 2005, and meets regularly by conference call. A revised document for Member review is anticipated in February 2006.
Serious Reportable Adverse Events in Healthcare
The "Never Events" CSMC met in person on October 5, 2005, and if finalizing its recommendations. A draft report for consensus is expected in January 2006.
State-of-the-art in Performance Review Instruments Workshop
A comprehensive quality/performance review program is a management tool used by healthcare systems to aggregate and quantify the various aspects of hospital care to enable comparisons of performance. These programs may include a variety of domains, such as external review (e.g., JCAHO survey results), patient safety, liability/risk management, satisfaction (customer, patient, employee, provider), financial performance, efficiency, and personnel development. As noted in the last report, executing an agreement with HCA has proved elusive, and so we are proceeding with the project with the funding being provided by the Department of Veterans Affairs. We anticipate the workshop will be held in Q2 2006.
National Commission for Quality Long-term Care
The Commission held its first public hearing on July 22, 2005, where it heard from federal and state officials, researchers, providers, and consumer advocates. The hearing was well-received, and the Committee met on September 26 and November 18, 2005, in Executive Session to consider the testimony and to discuss its first report, which is currently targeted for delivery in March 2006.
An active outreach effort continues.
The penultimate draft of a compendium of NQF-endorsed consensus standards and other work will be available to the Board at the meeting on December 7, 2005. The document will be available in January 2006 in both electronic and printed forms.
The Ad hoc Advisory Committee on Evidence Grading met twice by conference call in September, and based on those calls an in-person meeting was scheduled for January 12, 2006.
The Ad hoc Advisory Committee on Performance Measure Criteria held a conference call is finalizing its recommendations and a draft will be circulated for Member comment in January 2006.
Again in conjunction with JCAHO, NQF recognized the 2005 recipients of the John M. Eisenberg Patient Safety and Quality Awards. This year, honorees were selected in three of the four Award categories. The honorees are: Individual Achievement/Audrey L. Nelson, PhD, RN; Innovation in Patient Safety and Quality/Maryland Patient Safety Center and Meridian Health; and Sentara Healthcare. The awards were presented at the NQF’s Sixth Annual Meeting in Washington, DC.