Home > About Us > Leadership > President's Report Archive > October 2004
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No significant changes.
Three new persons have joined the NQF staff: Del Conyers, MPH and Bakeyah Nelson, MPH have been hired as Research Analysts to work across various projects. Angela Miele, MPA, is a new Program Director working primarily on the cancer project. Merilyn Francis, RN, MPP, Assistant Vice President will be leaving NQF later this month for the National Hospice and Palliative Care Organizations. We are currently recruiting for two Program Directors/Senior Program Directors (e.g., RN, PharmD, PhD, MD plus 5-10 years experience).
All Councils continue to meet regularly by conference call and/or e-mail.
Twenty-five abstracts were submitted in response to a call for speaker nominations for the Annual Meeting. Six volunteers from the Member Councils—Joyce Dubow (AARP), Richard Dixon (CDC), Trudy Johnson (New York-Presbyterian), Ellen Severoni (California Health Decisions), Steve Wetzell (Leapfrog), and Dan Wolfson (ABIM Foundation)—identified the format for the presentations and selected the speakers. The Committee gave priority to abstracts focused on implementation of NQF-endorsed products, and then on non-NQF specific quality initiatives with specific results that could translate widely. The Committee also noted it was disappointed in the number of abstracts related to NQF-endorsed products, and agreed with NQF staff’s recommendation that next year’s call for speaker nominations focus solely on implementation of NQF-endorsed consensus standards.
During the Executive Session for this meeting, the Board will discuss by-laws matters related to Board turnover and creation of the Technology Council, which passed the Board by significant margins but for which a few Board members have asked for additional discussion. On reviewing the tenure of Directors (average tenure of a director in the first 5 years = 30 months), what is most striking is how much turn over there has been. Of the 44 persons who have held Director seats, only 8 (18%) have been there since the Board was established. Two current directors have announced their resignation in the past two weeks.
New project funding has come from several sources. We have concluded negotiations with the Delmarva Foundation (the prime contractor to CMS) for three tasks: Endorsement of HCAHPS, endorsement of performance measures in three additional priority areas to supplement the set of hospital voluntary consensus standards, and convening of a pay-for-performance summit. The total award for these three things is $~697,000. Negotiations with Delmarva are also nearing completion for the vehicle that will fund consensus development of the DOQ ambulatory care measures and other tasks; the precise scope of work for the allotted funds is not yet finalized. HCA has agreed to provide funding of about $40,000to support a workshop that examines the state-of-the-art in hospital performance review instruments. Additionally, the Robert Wood Johnson Foundation awarded a grant of $102,500 to convene a workshop on evidence-based practices for substance abuse treatment. CDC has awarded, on a competitive basis, a grant to NQF to establish the Institute for Quality in Laboratory Medicine; first year funding is about $250,000.
Serious Reportable Adverse Events in Healthcare: A Consensus Report
Connecticut recently enacted legislation to make this list of adverse events mandatory reporting events at the state level. Additionally, Saskatchewan, Canada, recently enacted a law to collect data at the province level based largely on NQF’s list of serious reportable events. New Jersey and Maryland also have contacted NQF staff about incorporating the NQF-endorsed events into their systems. Texas has adopted the list, in part.
Voluntary Consensus Standards for Adult Diabetes Care: Update
We anticipate updated specifications as part of the ambulatory DOQ measure set. Once specifications are received, we will conduct a second 30-day review of the updated measures with their detailed specifications.
Safe Practices for Better Healthcare
The Leapfrog Group web site now reports results from its “fourth leap,” a survey that incorporates the 27 NQF safe practices that were not previously part of its initiative. (The first three leaps are for three of the NQF-endorsed safe practices.)
National Voluntary Consensus Standards for Hospital Care (including new areas and HCAHPS)
Ten of the endorsed measures are now being publicly reported on the CMS web site as part of a voluntary hospital reporting initiative; these 10 measures must be reported for facilities to receive maximum payment from the government under the MMA. In 2005, an additional 12 measures from the NQF-endorsed set will be added to the voluntary reporting initiative, along with HCAHPS. CMS has provided funding for HCAHPS and new consensus standards in three additional hospital areas. The areas to be addressed have yet to be finalized. The Catholic Health Association of the U.S. (CHA) written and formally requested to work with NQF on implementing all of the hospital measures (see attached letter). CHA is the first hospital organization to formally commit to implementing all the NQF-endorsed hospital measures.
National Voluntary Consensus Standards for Nursing-Sensitive Care Performance Measurement
The report has just been received from the printer and will be distributed to NQF Members following the Annual Meeting.
Cardiac Surgery Performance Measures
Voting for the 21 proposed consensus standards and attendant recommendations concluded on October 4, 2004. Results of this voting will be discussed during the Open Session of the Board’s meeting on October 7.
Child Healthcare Quality
Proceedings from the workshop were published and distributed in July 2004. The workshop has provided the basis for discussions with CMS about a potential consensus project involving some child healthcare measures.
Home Health Performance Measures
The draft report is out for review and comment. It proposes 28 consensus standards for public reporting of home health care quality. The Member comment period closes on October 12, 2004. Board action should occur at the first meeting of 2005.
Behavioral Health
An invitational workshop to explore the dimensions of a project on reaching consensus on a set of performance measures for quality of behavioral health care was held on June 29 at George Washington University. The draft workshop proceedings are in the supplemental Board briefing materials. The publication process will begin in the near future.
Patient Safety Taxonomy
The Steering Committee met twice, and on September 23rd recommended that the Joint Commission on Accreditation of Healthcare Organizations’ taxonomy and the Institute of Medicine’s reporting domains, as well as accompanying recommendations for improvements, be forwarded for consensus. A draft report will be prepared and forwarded to Members for the comment period once the Steering Committee finalizes its recommendations.
Ambulatory Care Quality Measures
More than 100 NQF members from 53 organizations participated in Workgroup meetings in Boston on April 27 and identified 10 priority areas. Related to this project, CMS has asked NQF to consider its Doctor Office Quality (DOQ) measures under expedited consensus, and some or all of these measures should be forwarded to NQF on October 5-6. RWJF also has asked NQF to prepare a proposal for phase II—endorsement of measures—in the 10 priority areas and a roll-up index. As agreed to at the April meeting, the DOQ measures will initially proceed through expedited consensus, but they will be re-evaluated under full consensus (with a call for measures) during phase II.
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. The project will make recommendations about the feasibility and appropriateness of establishing evidence-based safe medication use practices, but will not endorse specific practices per se. The workshop has been scheduled for October 25-26, 2004, in Washington, DC.
Hospital Governance and Quality Improvement
An invitational workshop on hospital governance and quality improvement aimed at defining the role of Boards of Trustees in overseeing hospital quality improvement efforts was held on March 30, 2004. A draft “call to responsibility,” is being circulated to participants for a second round of review, after which it will be forwarded to Members for comment.
Evidence-based Practices for Substance Abuse Treatment Workshop
This project will convene 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. A background paper has been commissioned, in anticipation of a December 2004 workshop.
ACEIs vs ARBs Performance Measure Resolution Workshop
In 2002, NQF endorsed two measures (developed jointly by JCAHO and CMS), addressing use of angiotensin converting enzyme inhibitor (ACEI) drugs for patients with left ventricular systolic dysfunction complicating acute coronary syndrome and heart failure. Ongoing research has identified a new class of drugs, angiotensin receptor blockers (ARBs), with similar effects as ACEIs. This workshop, which is co-sponsored with AHRQ, will examine the current evidence on use of ACEIs and ARBs to address whether the currently endorsed measures should be updated to include broader use of ARBs instead of or as well as use of ACEIs. The workshop will be held in the Washington, DC, area on November 3.
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. This project is funded, in part, by HCA.
DVT Performance Measures
This project is just getting started. It is funded by an unrestricted grant from Aventis.
Cancer Care Quality Measures
The Steering Committee met by conference call to identify the three areas for which measures would be sought under the current government contract. Committee members ultimately settled on breast cancer treatment and diagnosis, colorectal cancer treatment and diagnosis, and symptom management/end-of-life care. The project’s Cancer Data and Methods Panel met in August to make recommendations to the Steering Committee about criteria for measure evaluations. The Steering Committee will meet on October 19 (in Washington, DC), to discuss these recommendations and the framework for evaluation.
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 three “early adopter” collaborating partners completed their self-assessment of implementation of Safe Practice 10, which was followed by site visits and interview by NQF staff. Additionally, 19 non-adopters were interviewed in-depth by phone. 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 now being prepared.
Academic Health Centers Performance Measures Initiative
In addition to Columbia University, interest in this effort to establish performance measures for academic health centers that recognize their special role as teaching and research institutions, as well as disproportionate share providers often, has been expressed by several other universities. An initial planning meeting was convened on May 13, and a follow up meeting was held on September 23, where agreement was reached on 4 areas of focus.
National Commission for Quality Long-Term Care
The majority of Commission members have been identified, and a press conference to formally launch the Commission will be held on October 12th. The first meeting of the Commission is scheduled for December 3, 2004.
Institute for Quality in Laboratory Medicine
NQF has been awarded a cooperative agreement from the Centers for Disease Control and Prevention (CDC) to create the Institute for Quality in Laboratory Medicine as an independent affiliate. IQLM is intended to be the central body for the identification, evaluation, consensus development and dissemination of consensus standards, practice guidelines, performance measures and national reporting on quality for laboratory testing services.
Projects in Development
The Department of Veterans Affairs’ funding of an initial examination of quality of care for HIV/AIDS has been delayed due to uncertainty about which funding vehicle to use. There is no identifiable start date at this time. We have been requested to consider endorsing the framework and preferred practices of the National Consensus Project for Quality Palliative Care. We also have been approached about projects focused on needlestick safety, performance measures for depression, and clinical laboratory quality improvement.
An active outreach effort continues.
The Advisory Committee on Implementation Strategy and Priorities has finalized its initial report, which is provided in the Board’s briefing materials with a recommendation that the Board approve it.
The Advisory Committee on Data Integrity and Availability continued to meet by conference call to discuss its report and also met in person on June 23, 2004. Dr. Iezzoni will discuss the Committee’s report at the October meeting, after which it will be revised and/or forwarded directly to Members for comment.