Home > About Us > Leadership > President's Report Archive > February 2005
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No significant changes.
Dianne Feeney, BSN, MSc, joined NQF on December 20, 2004, as a Vice President. We are currently recruiting for two Research Analysts or Research Assistants.
If the applications that are pending Board action are approved, membership will stand at 255 organizations. Unfortunately three consumer organizations have gone out of business in late 2004/early 2005 and will not be renewing.
All Member Councils continue to meet regularly by conference call.
The Spring Membership meeting will be held on May 10, 2005, at the Downtown St. Louis Marriott; the Board meeting will be held on May 11, 2005, at the same facility. As further described below, NQF will convene, at the behest of the Centers for Medicare & Medicaid Services (CMS), a conference on May 9, 2005, re: implementation of NQF-endorsed measures in the hospital, nursing home, home health care, and ambulatory care settings.
The Governance Committee recommended, and the Board approved, the appointment of Janet Olszewki, Michigan Medicaid Director, to a term expiring on December 31, 2006.
The Health Professional, Provider, and Health Plan leadership elections concluded. Janet Sullivan, MD, was re-elected as Chair; following a run off, Frederick Grover, MD, Society for Thoracic Surgeons, was elected Vice Chair. For the Research and Quality Improvement Council, Jeffrey Rich, MD, Virginia Cardiac Surgery Quality Initiative, was elected Chair; following a run off, Jane Brock, MD, American Health Quality Association/Colorado Foundation for Medical Care, was elected Vice Chair.
Negotiations were completed for the vehicle that is funding consensus development of the DOQ/physician-focused ambulatory care measures (phase II), as well as some elements of the build-out of the 10 priority areas (phase III). The Robert Wood Johnson Foundation has formally requested a proposal and budget for additional phase III work in ambulatory care.
Implementation of NQF-Endorsed Voluntary Consensus Standards: National Conference
To date, NQF has endorsed 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 will convene, at the behest of the CMS, a conference to identify opportunities and barriers to implementation of these measure sets. In addition to a plenary session, focused break-out sessions will be held for each care setting—hospital, nursing home, home health care, and ambulatory; pending further discussion with CMS, a separate break-out session on cardiac surgery may be convened. In some respects these break-outs will resemble the “listening sessions,” held by CMS for hospital measures in Spring 2004. The conference will be held in conjunction with the Spring Membership Meeting (May 10) and Board meeting (May 11) at the St. Louis (Downtown) Marriott.
Pay for Performance Programs: Guiding Principles and Design Strategies
Currently, the prevailing methods of paying for healthcare in the United States neither incentivize nor reward providing high quality care. The soaring costs of healthcare, coupled with increasing knowledge of the extent of poor quality care, have made clear the need for a major transformation of the way that healthcare is financed in this country. This conference, to be held March 1-2, 2005, will assess the various types and prevalence of healthcare initiatives in which payment is used to incentivize or reward higher quality of care and determine what design principles or other characteristics of these programs will produce the desired outcomes. The conference also will examine what things are associated with a lack of success and identify the current major gaps in knowledge regarding pay for performance. Initial registration has been very brisk.
National Framework and Preferred Practices for Palliative and Hospital Care
This project will endorse a national consensus framework for discussing and evaluating palliative and hospice care and seek to achieve national consensus on a minimum set of preferred practices for hospice and palliative care based on the framework. The Call for Review Committee Nominations has concluded and the Committee appointments are being finalized.
Standardizing a Measure of Patient Experience (HCAHPS)
The Review Committee, co-chaired by Gerry Shea and Jim Varnum, met on December 1, 2004, and by conference call on December 23, 2004. The Committee recommended a few changes to the current CMS specifications (e.g., the reinstatement of two questions), but overall was pleased with the general structure of the survey’s domains, sampling, administration, and case mix-adjustment methodology. On January 21, 2005, CMS informed NQF it was accepting the recommended changes. Once the Review Committee resolves a final, outstanding issue on public reporting, the draft HCAHPS consensus report will be forwarded to NQF Members and the public for the review period in early February.
National Voluntary Consensus Standards for Hospital Care—Additional Priority Areas
As previously noted, CMS had provided funding for a project to review possible consensus standards for hospital care in three additional areas—coordination of care, rural sensitive measures, and mortality (acute myocardial infarction [AMI], pneumonia, and heart failure [HF]). On January 24, 2005, Steering Committee members had been appointed, and the Technical Advisory Panels were being appointed when CMS contacted NQF and requested that only two areas be pursued at this time: coordination of care and mortality. CMS and NQF will further discuss a third area, that would involve a Call for Measures and evaluations only at this time, given the funding and time constraints CMS had under the current contracting vehicle.
Ambulatory Care Quality Measures
The CMS request (via Delmarva subcontract) to consider its physician-focused measure (often referred to as the Doctor Office Quality (DOQ) measures, but which also include measures from the American Medical Association and the National Committee for Quality Assurance) was finalized. As agreed to at the April 2004 planning meeting in Boston, the DOQ+ measures initially will proceed through expedited consensus (phase II), but they will be re-evaluated under full consensus (with a Call for Measures) during phase III. CMS is also providing year 1 funding for the build-out of the set in the 10 priority areas identified in phase II; discussions are being held with RWJF on its contributions to the phase III work. A Call for Nominations for the Steering Committee and TAPs was conducted, and the bodies have been appointed. The first Steering Committee meeting will be held on March 29-30, 2005, at a site to be determined.
Cardiac Surgery Performance Measures
The printed report will be available at the Board meeting and distributed to NQF Members, as usual.
Home Health Performance Measures
NQF Members voting concluded on January 4, 2005. The Board will consider the results at this meeting.
Behavioral Health
The workshop proceedings have been printed; copies will be available to Board members at the meeting. NQF Member contacts will sent via usual means just after the meeting.
Patient Safety Taxonomy
The draft report recommending the JCAHO taxonomy and the Institute of Medicine’s reporting domains, as well as accompanying recommendations for improvements, expected to be available for Member review in December, is still pending the outcome of intellectual property discussions with JCAHO.
Improving Safe Use of Prescription Medications
This project, funded by the California Endowment, will establish a “safe medication use framework” aimed at increasing the effectiveness of prescription medication use by consumers, focusing especially on low-literacy and limited English proficiency populations. A workshop was held October 25-26, 2004, in Washington, DC, and the framework and recommendations are being drafted.
Evidence-based Practices for Substance Abuse Treatment Workshop
On December 13, NQF convened a workshop 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 is being drafted. This workshop was funded by RWJF.
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. A commissioned paper will review current knowledge about the broad hospital quality/performance reporting tools and be discussed by workshop participants, with an eye toward recommending the domains that these tools should encompass, as well as data categories or elements and reporting formats. Finalization of the agreement with HCA, which will fund the project in part, is underway.
DVT Performance Measures
The subcontract with JCAHO was finalized, and the joint NQF-JCAHO Call for Nominations for the Steering Committee and TAP has been issued. The deadline for nominations is February 7, 2005.
Cancer Care Quality Measures
The project’s Colorectal Cancer Technical Panel (TP) met on December 10, and the Symptom Management/End-of-life care TP met on December 17. The Call for Measures for breast cancer has concluded; the Breast Cancer TP will meet to review measures on April 7-8, 2005. The Call for Measures for colorectal cancer and symptom management/end-of-life care will close on March 21, 2005.
Informed Consent and Patient Safety
This project, funded by the Commonwealth Fund, is exploring the implementation of the NQF-endorsed “safe practice” (#10) relating to informed consent for low literacy/limited English proficient patients. The workshop to discuss the case studies, results of interviews of non-adopters, and draft user’s guide for implementation was held on September 10, 2004. The proceedings and user’s guide are in the publication process.
National Commission for Quality Long-Term Care
An Executive Session-only organizational meeting for the Commission to organize was held on December 3, 2004; the next meeting will be held on February 24, 2005.
An active outreach effort continues.
Member responses to the report of the Advisory Committee on Data Integrity and Availability were discussed in a Committee conference call on January 19. The further course of the report is being discussed with the Committee Chair.