Home > About Us > Leadership > President's Report Archive > May 2005
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No significant changes.
Kate Shores recently joined the staff as a Research Assistant, and one Research Assistant, recently departed for an advancement opportunity. Recruitment is under way for an additional Research Analyst/ Research Assistant.
If the applications that are pending Board action are approved, NQF organizational membership will stand at 260. Of note, three Member consumer organizations went out of business in late 2004/early 2005; one purchaser organization also indicated it will not be renewing.
All Member Councils continue to meet regularly by conference calls.
The Spring Membership meeting will be held on May 10, 2005, at the Downtown St. Louis Marriott. As further described below, NQF will convene, at the behest of the Centers for Medicare & Medicaid Services (CMS), a conference on May 9, 2005, regarding implementation of NQF-endorsed measures in the hospital, nursing home, home health care, and ambulatory care settings.
Lisa I. Iezzoni, MD, has resigned from the Board due to the press of her many other commitments.
Janet Corrigan, PhD, has announced her plans to leave the Institute of Medicine to become President and CEO of the National Committee for Quality Health Care; it is expected that the IOM will name someone to this seat, but that has not yet occurred.
The Robert Wood Johnson Foundation (RWJF) has notified us that it will fund a $2.5 million, 46-month project for phase III work on the ambulatory care set. In addition to the build-out of the 10 priority areas, the report will include two additional areas to be named by RWJF, work related to development of an index, and a workshop at the end of the project to identify research and development gaps/priorities.
An application for a small conference grant for the 2005 Annual Meeting, to be held October 6-7, 2005, in Washington, DC, has been submitted to the Agency for Healthcare Research and Quality (AHRQ).
The field portion of the independent audit, conducted by Gelman, Rosenberg, and Freedman, took place April 4-8, 2005.
NQF's insurance underwriter has informed us that it will not be renewing any workers compensation policies in Washington, DC, because of concerns about a large payout in the event of a terrorist attack; other companies contacted are doing the same. Accordingly, NQF will be insured through an assigned risk workers compensation policy at an increased premium of approximately 25%.
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 will convene, at the behest of the CMS, a conference to identify opportunities and barriers to implementation of these measure sets. A meeting summary will be provided to all NQF Members.
National Framework and Preferred Practices for Palliative and Hospital Care
The first meeting of the Review Committee was held on April 18, 2005. The Review Committee made recommendations for refinements to the proposed draft framework. Following further review by the Committee, the framework will move into the review phase of the Consensus Development Project. The Committee will meet again on June 29-30, 2005, to discuss a minimum set of preferred practices for hospice and palliative care quality based on the framework.
Standardizing a Measure of Patient Experience (HCAHPS)
The Member and public review phase for the draft document concluded on March 23, 2005. Comments were reviewed by the Steering Committee during a subsequent conference call. A revised draft was forwarded to NQF Members for voting on April 5, 2005; the voting period will conclude on May 6. The voting results will be available to the Board for discussion at the meeting on May 11.
National Voluntary Consensus Standards for Hospital Care—Additional Priority Areas, 2005
The Steering Committee met on March 17, 2005, to discuss measure identification for the two additional areas: coordination of care and mortality. The next Committee meeting will be held on June 20, at which time it is expected that the Committee will recommend specific measures for additional consideration by NQF Members, as well as make additional recommendations to accompany the set.
Ambulatory Care Quality Measures
At a meeting on March 29-30, 2005, the Review Committee considered 100 measures proposed by CMS, the American Medical Association, the National Committee for Quality Assurance, and the Agency for Healthcare Research and Quality. Fifty measures were recommended for consideration during the NQF Member and public review phase, which concludes on May 23. (The deadline for public comments is May 16.)
The Call for Measures for phase III of this project also was launched; this phase will seek measures in the 10 priority areas identified during phase I, as well as two additional areas to be determined by RWJF.
Voluntary Consensus Standards for Adult Diabetes Care: 2005 Update
The Diabetes Maintenance Committee met twice by conference call to discuss updating the set and the comments received during the review period. The document is now out for a vote, which closes on May 6, 2005. Under consideration are 10 measures for public reporting that may also be used for quality improvement. Based on concerns from some Board members about the advisability of endorsing quality improvement-only measures and the decision of the Ambulatory Care Review Committee to recommend only public reporting/quality improvement measures (i.e., no quality improvement-only measures), the 47 quality-improvement only and community-level measures were not submitted for voting at this time, pending NQF Member and Board discussion at the May 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, is entering the voting phase of the Consensus Development Process. The deadline for voting will be June 9, 2005.
Home Health Performance Measures
An all-Council conference call was held on March 23, 2005, for Members to share their views on the three measures being considered for a second round of voting. Round 2 voting closed on April 12, and the Board will consider the results at the May 11 meeting.
Institute for Quality Laboratory Medicine
Discussions with CDC continue about the scope of NQF's activities regarding the IQLM.
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. This conference, held March 1-2, 2005, assessed 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. There was significant interest in the conference, which was oversubscribed a week after registration opened. A meeting summary is being produced.
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 7 different sets of guiding principles for pay for performance programs promulgated by various organizations and our awareness of several more in development.
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 in the process of being published.
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 is being drafted.
DVT Performance Measures
The subcontract with JCAHO was finalized, and the Steering Committee and Technical Advisory Panel (TAP) appointments have been made. The first Steering Committee meeting will be held on June 9, 2005, in Washington, DC. JCAHO also is finalizing plans for the first TAP meeting, which will be held in Chicago.
Cancer Care Quality Measures
The project's Breast Cancer Technical Panel (TP) met for the second time on April 7-8, 2005, and reviewed 25 candidate consensus standards for accountability, quality improvement, and surveillance. The TP's recommendations are being finalized in a report, which will be reviewed by the Steering Committee at its meeting on June 29-30, 2005, after which any proposed measures and attendant recommendations will enter the review phase of the Consensus Development Process (CDP).
The Call for Measures for the colorectal cancer and symptom management/end-of-life care priority areas closed on March 21. Very few measures resulted from these calls, and the literature reviews also have yielded few candidates. Staff is discussing this development with the funders and Steering Committee.
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.
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; funding also is being provided by the Department of Veterans Affairs.
Cardiac Surgery Performance Measures
The printed report has been distributed to the Board and NQF Members. To date, no significant follow-on activities have occurred.
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.
Safe Practices for Better Healthcare
The Safe Practices Maintenance Committee has been appointed, and will meet by conference call in Summer 2005.
Serious Reportable Adverse Events in Healthcare
Identification of individuals to serve on the Serious Reportable Adverse Events Maintenance Committee is nearly complete. It is anticipated that the Committee will be able to meet by conference call this summer.
As follow-up to the Board meeting, where a concern was raised about difficulties Minnesota was having implementing the list, a "users" conference call was held on March 15, 2005, with representatives from Minnesota, New Jersey, and Connecticut, and it was decided to establish a "User's Work Group". Each state is currently compiling its implementation issues.
The Department of Defense/TRICARE will present and update on its contract directive that all TRICARE vendors report data on the events as part of the Implementation Conference on May 9, 2005.
NQF is participating on a RAND External Advisory Panel to create detailed specifications and identify appropriate data elements related to state-based collection and reporting of adverse events.
While we do not have all relevant details, we are advised that the states of Washington, Oregon and Georgia are moving to implement the SRE list by regulation; we are trying to get additional information.
The Missouri legislature had under consideration a bill to adopt the NQF-endorsed list, but this did not occur before the end of their legislative session. It is anticipated that this will be re-visited in the next session.
National Commission for Quality Long-Term Care
The Commission's second meeting was held on February 24, 2005. At that meeting, Commissioners agreed to form three working groups (quality of care, systems/regulatory/financing, and future vision), which are meeting by conference call, to develop recommendations for discussion at its next meeting. The activities of this Commission are being followed very closely by the long-term care community.
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. Due to other staff demands, the desire of some Committee members not to alter its report, and the resignation of the Chair, specific action on the Committee's recommendations has lagged, but is not being ignored. It is expected that this will be focused on more this summer.
The Advisory Committee on Implementation Strategy and Priorities will meet on May 9, 2005, following the CMS-NQF implementation conference.
The second Call for Nomination for the Voluntary Consensus Standard Maintenance Committees did not significantly enlarge the pool of candidates for these Committees, so we anticipate directly recruiting Members to populate these important committees. The activities of the Diabetes, Safe Practices, and Serious Reportable Events committees are noted above.