Home > About Us > Leadership > President's Report Archive > October 2002
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No significant changes or issues to report.
No changes or issues to report.
NQF membership stands at 156 organizations, if the 5 organizations being considered at the October 2, 2002, Board meeting are included.
We have heard from three Board members about new Member recruitment efforts, one of which resulted in a membership application (Gail Warden-Trinity Health).
The Provider and Health Plan (PHP), Purchaser, and Research and Quality Improvement (RQI) Councils have held 1-2 conference calls each since the July 16, 2002, Board meeting.
The PHP and RQI Councils have written to express concerns about various aspects of the "Hospitals" project (e.g., timing of voting, holding the workshop, review of measures, etc.) and the Consensus Development Process. Copies of those letters and my responses have been provided to the Board.
The 4th NQF Spring Membership Meeting has been scheduled for May 13, 2002, in Los Angeles, CA. The Board meeting will be held on May 14, 2002. Both meetings will be held at a hotel near LAX.
The PHP Council and RQI Council will hold leadership elections this year. The RQI Council has requested the Board's approval to hold separate elections for Chair and Vice Chair. The nominations period closes October 7, 2002. [The Board approved the RQI Council's request.]
Because the seats for four of six Board members of the Governance Committee are expiring on December 31, 2002, and because a Director may not consider his or her own name, the Executive Committee appointed a Special Ad hoc Governance Committee to review the expiring terms and to review the number and assignment of the non-voting Liaison positions. Recommendations on these matters will be discussed during Executive Session of the Board meeting on October 2, 2002.
Following consultation with counsel, we determined that both a change to the by-laws and a filing with the District of Columbia authorities was necessary to change the corporation's legal name from the "National Quality Forum for Health Care Quality Measurement and Reporting" to the "National Quality Forum" (which has been informally discussed on several occasions). An amendment to the by-laws is before the Board for consideration and, if approved, the appropriate legal paperwork will be filed.
The Agency for Healthcare Research and Quality generously awarded a small conference grant of $50,000 to support the NQF's 3rd Annual meeting.
We have been informed that, as of the end of August, the $50,000 previously pledged by AHRQ for a conference related to the "Safe Practices" report release would still be available in early 2003.
The $100,000 in core and dues support from the Department of Veterans Affairs was recently received, as was the $13,000 modification to the existing HHS contract for the purpose of funding the October 17-18 "Hospitals" workshop. The National Health Care Purchasing Institute and the Pacific Business Group on Health had previously pledged $25,000 for the Workshop.
Revenue to date from sales of Serious Reportable Events in Healthcare, Improving Healthcare Quality for Minority Patients, and A National Framework for Healthcare Quality and Reporting is just over $7,500. In pricing the reports, we deliberately opted to err on the low side to encourage purchase and widespread dissemination. (SRE=$12 to general public, Minority Health=$25.50 to general public, Framework=$12 to general public). Now that we have increased experience, we will review the pricing structure to determine whether adjustments should be made upwards and whether we should adjust the discount to NQF members of ~33% plus an additional 10% on orders of more than 10 reports. (NQF members also receive 2-3 complimentary copies and access via the web site.)
The National Cancer Institute recently requested a budget for phase II of the Cancer Care Quality Measures project. Depending on the number of tumor types and/or cross-cutting issues, an 18-month phase II is approximately $1.6-$2.5 million.
The Centers for Medicare and Medicaid Services (CMS) has advised us that it intends to complete the "Nursing Homes" project via a subcontract, although not with Abt (which was the prime contractor under which the original NQF work was done). CMS hopes to conclude contract negotiations so that work to finalize the "Nursing Home" measures can recommence in November 2002.
The largest amount of funding to support the start up and initial operations of the NQF came from a grant from the Robert Wood Johnson Foundation. These funds will expire in 2003. Following discussion with the NQF program officer at the Robert Wood Johnson Foundation, we intend to submit to the Foundation a proposal for renewal of funding that is a mix of both core support and program-specific work.
A number of projects (see below) are under consideration that, if funded, should generate revenue.
Serious Reportable Adverse Events in Healthcare: A Consensus Report
The final report was printed in March. To date, more than 1,200 reports have been distributed, of which approximately 450 have been from sales. In conjunction with the National Academy for State Health Policy (NASHP) annual meeting in August, representatives from 10 states met with NQF staff to discuss state use of the NQF-endorsed list of serious reportable events (SRE). This joint NQF-NASHP initiative, entitled SAFER (State Alliance for Error Reporting), is exploring ways in which the SRE list might be operationalized. NASHP staff is currently completing an item-by-item "cross-walk" of what is on the NQF list and what is reported in the 20 states having reporting requirements.
Improving the Quality of Healthcare for Minority Patients: Workshop Proceedings
The final workshop proceedings were published and released on June 13, 2002. Various proposals for report language in the HHS-Labor appropriations bills have been drafted and are awaiting action.
A National Framework for Healthcare Quality Measurement and Reporting (formerly referred to as the Strategic Framework Board recommendations)
The initial print supply of 750 copies was exhausted in less than two months (~350 distributed to Members, Board, and SFB and the rest in sales). 500 more copies have been ordered.
IT Summit
A draft of the conference proceedings is being prepared by staff.
Safe Practices for Better Healthcare
A substantially revised document was forwarded to NQF members on September 26, 2002; it was also posted on the NQF web site for member and public review. Comments are due by October 30, 2002.
Hospital Performance Measures
The Steering Committee convened for the 6th time on August 27, 2002. The meeting was the final in-person meeting, and the Committee reviewed a draft comprehensive framework for hospital measurement and reporting. Following additional conference calls to finalize the document, the Steering Committee voted to begin the official review phase of the Consensus Development Process. A review copy of the framework will be forwarded to NQF members on about October 3, 2002, for the 30-day review Member and public period. Attendees at the 3rd Annual Meeting were provided the draft as part of their registration materials.
Member Council voting on group 1 of the Hospital Care National Performance Measures concluded in mid-August. All four Councils passed all measures. A summary of the voting and other issues that arose during the course of balloting has been prepared for the Board's review on October 2, 2002. Of note, several ballots were returned with specific comments that, had they been received, appear as if they could have been accommodated. Regrettably, members casting these ballots did not make the comments during the comment period. We will ask the Council Chairs to emphasize to their members the importance of making comments during the review period.
The "Hospitals" workshop approved by the Board at the July 16, 2002, meeting has been scheduled for October 17-18, 2002, at the Washington Dulles Airport Marriott. The meeting will be open to NQF Members only. Bill Gillespie, PHP Chair and Debra Ness, Consumer Council Vice Chair, are co-chairs for the workshop. A list of the invited workshop participants was included in the Board and Annual Meeting attendees materials Following the workshop and additional staff work, we anticipate consulting the Steering Committee to identify measures for part 2 of the initial measure set, with the goal of achieving consensus on part 2 in late 2002.
Nursing Homes
Except for limited follow-up, the NQF has suspended work on this project pending a new contract from CMS; we hope to have a new funding vehicle in place by the end of November 2002.
Diabetes Measures
The diabetes measures were approved by all NQF Member Councils. They were subsequently unanimously approved by the Board of Directors via electronic balloting. The NQF report National Voluntary Consensus Standards for Diabetes Care will be officially released and available at the Annual Meeting.
Cancer Care Quality Measures
The first meeting of the Steering Committee for this project, which has been previously described, was held in Washington, DC, on September 4-5, 2002. The Committee agreed on a "purpose statement" to guide future deliberations and seven priority "focus areas," including both specific tumor types (i.e., breast, prostate, colorectal) and cross-cutting areas (i.e., symptom management/end-of-life care, prevention/screening, communication and coordination of care, access/cultural competence/clinical trials). The degree to which these priorities will be addressed is subject to additional funding to complete the project.
Standardizing Credentialing for Independent Licensed Practitioners: Workshop
This project has been previously discussed. Planning was deferred while JCAHO and NQCA worked through some issues; that has now occurred. A joint workshop with JCAHO and NCQA is being planned for the first half of 2003.
Incentivizing Implementation of Voluntary Consensus Standards for Hospital Care: Workshop
Together with the National Health Care Purchasing Institute (NHCPI), NQF will be holding an invitation-only workshop of hospital decisionmakers, purchasers, and consumers to address the question, "What would be required to get the NQF-endorsed performance measures implemented and the results disclosed?" The meeting will be held on February 12-14, 2003, at an executive retreat-like facility near Washington, DC. Leonard Marcus of the Harvard School of Public Health will facilitate the discussion.
National Summit on Cardiovascular Healthcare Quality Measurement
The NQF and American College of Cardiology will jointly sponsor this National Summit to establish an action plan that will lead to the implementation of an effective and efficient quality measurement system for cardiovascular disease care by 2006. The objectives of the Summit are to define specific actionable steps that could leverage current efforts and direct "next step" efforts in cardiovascular disease care quality measurement and to gain the commitment of participants to take those steps. The NQF and ACC seek broad collaboration in this effort, and a pre-Summit planning meeting will be held on November 5, 2002, at the ACC's Heart House in Bethesda.
Patient Safety Lexicon
The JCAHO and its corporate sponsors (e.g., AMA and AHA) have been working for well over a year to develop a standard lexicon for patient safety. The lexicon is felt to now be ready for review for consensus and possible endorsement by the NQF. We hope to finalize an agreement with JCAHO on this project in the very near future.
Quality of Nursing Care Performance Measures
Following various meetings and discussions that have occurred since June, the Robert Wood Johnson Foundation has requested that the NQF submit a proposal to identify and endorse quality of nursing care performance measures. The proposal is being developed.
Mammography Screening Performance Measures
The Robert Wood Johnson Foundation has requested that the NQF submit a proposal to identify performance measures for mammography. The proposal is being developed.
Considerable contact with the Hill has occurred since the release of Improving Healthcare Quality for Minority Patients, and we anticipate additional follow-up briefings. Helen Wu, the project director for the report, conducted a poster session at a recent HHS meeting on minority health. NQF also has been invited to participate in a workshop on minority health at the American Osteopathic Association's annual meeting in October.
Draft legislation on quality of care for cancer is being prepared by Senators Kennedy and Frist. Title I of the bill explicitly codifies the NQF's ongoing work for the National Cancer Institute. Depending on the final outcome, funding for the full project may be less uncertain. On June 21, 2002, at the behest of the Committee on Health, Education, Labor and Pensions, I briefed several organizations about the NQF, generally, and the project, specifically. Various follow up meetings were held with organizations not present at the briefing.
In spring 2001, the NQF created a link on our web site for individuals to sign up for e-mail notification of web updates or other NQF news. At the end of 2001 and in early 2002, approximately 100 individuals (non-members) had signed up for the service. (Members who request notification-in particular individuals who are not the primary or secondary contact-also frequently use the service, but they are maintained in another database.) Since Spring 2002, however, interest in the NQF's activities has been significant. Notification requests arrive daily and, increasingly, we also receive change of e-mail address notifications from individuals who have new addresses and do not want to miss information about NQF activities. Currently, the database is nearly 500 individuals. Not surprisingly, the highest rate of sign-up occurs in the immediate aftermath of the publication of an NQF report.
The SFB papers are now slated for publication in January 2003 as a supplement to Medical Care. NQF is working with the National Health Policy Forum to conduct an informational meeting for congressional staff and other interested parties soon after the report is released.
The second meeting of the Strategic Advisory Council will be held on November 20, 2002, in Washington, DC.
The next meeting of the Board of Directors will be December 4, 2002.