Home > About Us > Leadership > President's Report Archive > September 2001
Click here to login to the members area.
The NQF office was relocated from 1875 Connecticut Avenue, NW, Suite 640, to temporary quarters at 601 Thirteenth Street, NW, Suite 500 North, between July 30 and August 1, 2001. Other than a few minor problems generally encountered with moves - i.e., disruption of phone and Internet services - the relocation was uneventful. The NQF will occupy the temporary space, which is adjacent to the permanent space, for approximately 3 months, during which time minor construction, painting, and carpeting will be performed by Robert Edgley Construction.
A Senior Program Director was hired to direct the Hospital Performance Measures project, and a Vice President for Operations was hired to perform a wide range of administrative and substantive duties. A Research Assistant and the Vice President, Communications, departed for graduate studies. A Research Assistant has been hired, and we are considering various options to staff press and legislative functions. We continue to be relatively understaffed.
The Board approved several memberships electronically during July, bringing the number of organizational members to 126. Another slate of proposed members is up for approval at this Board meeting.
On May 30, 2001, the NQF held its second general Membership Meeting in Dallas, Texas. Approximately 70 individuals from 48 organizations attended, and feedback from these members was very positive. Members heard from the SFB (Beth McGlynn, Helen Smits, and Judy Hibbard) about its work, generally, and the national goals work in particular. Attendees also heard from and had the opportunity to dialogue with John Colmers, co-chair of the "Serious Reportable Events" project. During the Member Council break-outs, attendees discussed both these reports, as well as process issues for both the NQF and the Councils, themselves. The Councils were advised of the need to develop agreed upon processes for document review, approval, etc.
AHRQ awarded the NQF a small conference grant ($25,000) for the 2nd Annual Meeting.
Partial funding for the IT Summit has been obtained, with funding received so far from Kaiser Permanente and the Veterans Health Administration. Commitments for funding have also been tendered by the Department of Defense and the Centers for Medicare and Medicaid Services (CMS). The NQF also sought AHRQ funding via a small conference grant for the IT Summit, tentatively scheduled for March 6-7, 2002. AHRQ was unable to fund this initiative via a small conference grant, but we have been informally advised that AHRQ intends to contribute to the meeting via another funding mechanism.
Via its audit firm (Gelman, Rosenberg and Freedman), the NQF has begun the process to negotiate a formal indirect rate with the Department of Health and Human Services.
The National Patient Safety Foundation declined to fund the NQF's grant application to develop and pilot test a standardized instrument for voluntary, confidential reporting of healthcare errors and medical care injuries.
Funding requests are pending for several program initiatives as discussed in the following section.
Serious Reportable Adverse Events
The first consensus document, Serious Reportable Adverse Events, was forwarded to the NQF Member Councils for voting on July 12, 2001; the voting period ended August 29, 2001. 55% of the ballots were returned, with a majority of those voting in all 4 Member Councils approving the report as written. This is now being referred to the Board for final action.
Hospital Performance Measures
The second meeting of the "Hospitals" Steering Committee was held in Arlington, VA, on May 21, 2001. The second meeting focused on establishing a framework for hospital measurement and reporting. The Steering Committee also reviewed candidate measures for the initial core set. As a result of these discussions, the Steering Committee established three working groups:
For the initial measure set, the Steering Committee currently is pursuing measures for: acute myocardial infarction, coronary atherosclerosis, congestive heart failure, perinatal care, and community-acquired pneumonia. Work will focus on evaluating existing measures in each of these areas and determining the differences, similarities, and compatibilities among competing measures. Additional measures for a second set may focus on cross-cutting issues such as pain management and patient safety. The Steering Committee will convene for its third meeting on October 24, 2001 in Detroit.
Safe Practices
The second meeting of the "Safe Practices" Steering Committee was held on July 18, 2001, in Washington, DC. The primary focus of this meeting was the review of a contract report produced for AHRQ by its University of California San Francisco (UCSF)-Stanford Evidence-based Practice Center (EPC). The Steering Committee decided to expand the list of 73 practices rated by the EPC, which used a narrow definition of "evidence." Instead, the Committee adopted the NQF staff recommendation to use the Strategic Framework Board's definition: "a continuum of scientific information from professional opinion to theory to empirical findings from rigorous studies. The hallmark of an evidence-based quality system is transparency-the ability to clearly link judgments, decisions or actions to the data on which they are based."
Expansion of the list will include five additional areas not sufficiently covered in the EPC report:
The Committee's next meeting has been scheduled for October 29 2001, in Washington, DC, at which time it will review a draft report. We anticipate releasing the final NQF report as part of a large conference, likely to be held in Baltimore, MD, in the summer of 2002, and AHRQ has indicated its willingness to amend the contract to fund this dissemination activity.
Minority Health
On June 28-29, 2001, the NQF convened an group of experts in minority health and healthcare disparities, quality measurement, and consumer reporting. The workshop, undertaken through a grant from the Commonwealth Fund, focused on three commissioned papers:
Discussion focused on 1) the role of measurement and reporting in eliminating health disparities for minority populations, and 2) strategies for incorporating solutions into a national agenda, in particular the NQF "hospitals" project. Workshop proceedings, including recommendations, will be distributed in fall 2001.
IT Summit
A project Steering Committee conferred twice by conference call to focus the scope of the project, which is a joint effort of the NQF and Institute of Medicine. Conference space is being held for March 6-7, 2002, at the Institute of Medicine. Raising funds for the summit has proved more difficult than anticipated.
Nursing Homes
Discussions about a project to identify a core set of quality indicators and measures for nursing homes have continued. Negotiations for a contract are ongoing.
Cancer
A draft proposal for a cancer measures project was submitted to the National Cancer Institute in March 2001, and two follow-up meetings were held at NCI in April and July 2001. Following additional discussion, a budget for a "start-up" initiative in federal fiscal year 2001 was submitted, and we are currently awaiting final disposition of this submission. It is our impression that NCI intends to pursue cancer quality measures for 2-4 sites and/or cross-cutting areas (e.g., pain management or palliative care).
National Quality Measures Clearinghouse
Keystone Peer Review Organization (KePRO), the NQF, Oracle, and IBM submitted a proposal in response to an AHRQ RFP to establish a National Quality Measures Clearinghouse, which also will incorporate in the future the National Guidelines Clearinghouse. An award announcement is expected in mid- to late September.
Standardized Storytelling
With Paul B. Batalden, MD, of Dartmouth Medical School, and William B. Weeks, MD, MBA, of Dartmouth Medical School and the Department of Veteran Affairs' Patient Safety Center of Inquiry (VISN 1), White River Junction, the NQF has submitted a proposal to AHRQ in response to an RFP for patient safety cooperative agreements. The proposed 27-month project will assess whether "standardized storytelling" about healthcare errors and iatrogenic injuries will enhance provider education and facilitate the development of a healthcare culture of patient safety, as reflected by the frequency of error reporting, the quality of adverse event reports and root cause analyses, implementation of policies and procedures to promote patient safety, and an organization's attitudes about reporting. An award announcement is expected in mid- to late September.
Leapfrog
Preliminary discussion has been held with Leapfrog Group representatives about the NQF defining the fourth "leap" that the group will promote.
We continue aggressive outreach efforts to promote the NQF and quality improvement agenda.
The Milbank Quarterly decided against publishing the SFB papers, and an alternative publishing venue is being sought.
The NQF is participating in a working group, along with Chris Queram of the Alliance, Bruce Bradley (representing the Leapfrog Group and General Motors), and several large employers, to discuss "Synchronizing National Health Care Purchasers." At its first meeting on August 3, 2001, in Dearborn, MI, three goals were identified:
A second meeting will be held on September in Minneapolis, MN and a final meeting will be held in November in Washington, DC.