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Dr. Corrigan officially started in the position of President and CEO and the former National Committee for Quality Health Care (NCQHC) moved their physical offices to NQF on April 3, 2006.
One new Research Assistant joined the staff since the last Board meeting, as well as two employees and a contractor from NCQHC.
If all applications are approved at this meeting, NQF Membership will stand at 330.
All Member Councils continue to meet regularly by conference calls.
The 7th Annual Meeting will be held at the Grand Hyatt Washington, DC, on October 12-13, 2006. We will again work with Member Council leadership and an Annual Meeting Program Committee to develop the program.
David Gifford, Director, MD, MPH, Health Director, Rhode Island Department of Health, has joined the Board; he was approved by the Board at its February 28, 2006, meeting to fill the state seat formerly held by John Agwunobi. David J. Brailer, MD, PhD, recently announced he will be leaving his position as National Coordinator for Health Information Technology.
NQF is finalizing arrangements for a 3-phase project to endorse a comprehensive national framework and set of voluntary consensus standards to evaluate, measure and report a broad view of therapeutic drug management quality.
The field portion of the independent audit took place April 24-28, 2006.
National Framework and Preferred Practices for Palliative and Hospital Care
A revised proposed framework was advanced to NQF Members for voting on April 5, 2006. Ballots are due on May 5, and the results will be presented to the Board at the meeting on May 17.
National Voluntary Consensus Standards for Prevention and Care of Venous Thromboembolism (VTE)
The draft report, “National Voluntary Consensus Standards for Prevention and Care of Venous Thromboembolism: Policy, Preferred Practices, and Initial Performance Measures,” advanced to Members for voting on April 5, 2006; in addition to the framework and practices, two performance measures are under consideration in this report. Results will be presented to the Board at the meeting on May 17.
The VTE TAP was convened on March 21, 2006, in Chicago by the Joint Commission on Accreditation of Healthcare Organizations, which is a subcontractor to NQF on this project. JCAHO is commencing with alpha testing of 10 VTE measures at approximately 25 hospitals; 3 hospitals will be selected for an on-site visit. In September, the TAP will review the results of the alpha testing and recommend which measures should be pilot tested at approximately 55 hospitals begin in January 2007. These results will be reviewed by the TAP and Steering Committee, after which an additional round of review and voting will be performed, as appropriate.
VTE Summit
NQF convened an invitational summit on convened March 24, 2006, to identify a patient-centered national action plan for VTE prevention, treatment, and research. More than 100 research, clinician and consumer leaders participated in the day-long intensive working summit to identify content and plan action steps for consumer messaging and placement, clinical action, and research gaps and opportunities relevant for VTE care. The consumer breakout group recommended a consumer message around which a national awareness campaign would be launched. NQF staff and marketing experts are currently refining the message and summit report.
Cancer Care Quality Measures
The National Cancer Institute is currently working with the American College of Surgeons on pilot testing of a select group of colorectal and breast cancer measures that were considered by the Steering Committee as nearly ready for endorsement for the purpose of accountability. The Symptom Management/End-of-life Care draft report will be available for Member and public review in May. With the delay requested by the government, it is anticipated that the breast and colorectal measures now will be ready for consideration in the latter part of 2006 or early 2007.
Institute for Quality Laboratory Management
As follow-up to the workshop the laboratory medicine workshop held on January 11, 2006, NQF has commissioned a paper to review an existing, targeted set of laboratory medicine quality measures and to discusses proposed implementation strategies from the laboratory’s perspective. The paper is due for delivery to the Centers for Disease Control and Prevention in September 2006.
National Voluntary Consensus Standards for Hospital Care—Additional Priority Areas, 2005
For the second round of voting, the developer withdrew the 15-item care transition measure and forwarded only the 3-item measure with the additional administrative specifications. The revised report and additional specifications were forwarded to Members on April 25, 2006, for a second round of balloting. Ballots are due to NQF on May 11, and results will be discussed by the Board at its meeting on May 17.
The revised risk adjustment recommendation endorsed by the Board at the December 8, 2005, meeting did not receive any appeals.
Ambulatory Care Quality Measures
The final report for Cycle 1 consensus standards is in the publication process and should be available very soon; the report will be published in electronic format only. The specifications have been available in electronic format since clearing the appeals period.
Phase 3, Cycle 1 of the project encompasses measures for the following priority areas: asthma, coordination of care, hypertension, medication management, obesity, and prevention. The review/comment period for the draft report concluded March 3, 2006. The proposed final report advanced for Member voting on April 5, with ballots due by May 5. The voting results will be presented to the Board at its meeting on May 17.
Phase 3, Cycle 2 was launched on February 22, 2006, with a conference call of the Steering Committee to determine the scope for the five priority areas to be considered in this Cycle. These five areas include diabetes, heart disease, prenatal, behavioral/substance use disorders, and bone care. The following TAP meetings are scheduled: prenatal, May 22; heart disease, May 26; behavioral health, June 9; and, Diabetes, June 14. The Steering Committee will meet July 25-26, 2006 to review the Cycle 2 TAP recommendations.
RWJF has identified the two additional priorities it wishes NQF to address in the ambulatory care project: healthcare disparities and efficiency. The Healthcare Disparities TAP has been appointed, with its initial call planned for later in June. Efficiency measures will be considered in Phase 3, Cycle 3, which will begin in late summer 2006.
Voluntary Consensus Standards for Adult Diabetes Care: 2005 Update
Because the stand-alone diabetes project has been integrated into the larger ambulatory project for Phase 3, Cycle 2 in Spring 2006, the 2005 update report will be available as part of the forthcoming ambulatory care report.
Standardizing a Measure of Patient Experience (HCAHPS)
CMS currently is conducting training for vendor and provider applicants on administering the survey, as well conducting as dry-runs with hospitals and survey vendors. The survey is anticipated to be implemented nationally in the latter part of 2006, with results reported to the public in late 2007.
Pay for Performance Programs: Guiding Principles and Design Strategies
As previously noted, several Members have indicated strong support for NQF to undertake a consensus project on pay for performance program guiding principles and design strategies. NQF is currently seeking funding for this project.
Evidence-based Practices for Substance Use Disorders (SUD)
The SUD Steering Committee and TAP have been appointed, with the initial Steering Committee call planned for mid June and the initial in-person meeting planned for mid July. NQF received 37 practices in response to a “Call for Practices,” and staff is searching for any additional practices appropriate for consideration under the project.
Voluntary Consensus Standards Maintenance Committees (CSMC)
Safe Practices for Better Healthcare
The deliberations of the Safe Practices CSMC are largely complete, and a final document was forwarded to Members for the review phase on May 9. Comments are due by June 29, 2006; the review period was extended because the Spring Membership Meeting is being held during the review period.
Serious Reportable Adverse Events in Healthcare
The “Never Events” CSMC is finalizing its recommendations. A draft report was advanced for review on May 9, and comments are due by June 15, 2006; the review period was extended because the Spring Membership Meeting is being held during the review period.
Pulmonary
The Pulmonary CSMC has been appointed, and the initial conference call was held on April 12, 2006. The “Call for Comments” asked for comments, withdrawals, substitutions and new measures in existing priority areas and was issued on May 1, 2006, with comments due on June 2. (Prior to the call, all measure developers were contacted and asked to report all revisions of NQF-endorsed TM measure specifications, and the measure specifications were redlined to reflect the revisions.) The Committee will meet in Washington, DC in mid-July to review the measure revisions and determine whether the revisions are material changes.
Cardiovascular
The Cardiovascular CSMC has been appointed, and the initial conference call was held on April 13, 2006. The “Call for Comments” asked for comments, withdrawals, substitutions and new measures in existing priority areas and was issued on May 1, 2006, with comments due on June 2. (Prior to the call, all measure developers were contacted and asked to report all revisions of NQF-endorsed TM measure specifications, and the measure specifications were redlined to reflect the revisions.) The Committee will meet in Washington, DC in mid-August to review the measure revisions and determine whether the revisions are material changes.
The VCS Methods Maintenance Committee is currently in process of being convened. The Committee will be tasked with ensuring consistency of approach and methodology among the various VCS Maintenance Committees. The Committee will comprise one representative from each active VCS Maintenance Committee and two at-large members. The Committee will meet mid-end of June to approve the definition of “material change.”
Hospital Performance Monitoring Systems
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. Funding for this project is being provided, in part, by the Department of Veterans Affairs, Bristol Myers Squibb, and JCAHO. The workshop will be held on May 15, 2006, in conjunction with the Spring Membership Meeting in Miami.
National Commission for Quality Long-Term Care
The Commission met in Executive Session on March 20, 2006, in Washington, DC. The primary contract for the Commission has transitioned from NQF to the Co-Chair’s (former Senator Bob Kerrey) institution, the New School; NQF will continue to be work collaboratively on the project through a subcontract with the New School.
Nursing Sensitive Measures Tracking
Work has commenced on an RWJF-funded project to track users of the nursing sensitive measures and their experiences, including barriers and opportunities encountered. Insights gained will be provided to RWJF, nursing sensitive measures developers and users of the measures to help accelerate the uptake and implementation of the nursing sensitive measures. The Committee met on April 17, 2006, by conference call and is meeting again on May 19 to discuss approaches to identifying, soliciting feedback from users. NQF will be launching a project web page with information about the project and relevant links.
Nurses Educational Preparation and Patient Outcomes in Acute Care: A Case for Quality
As a follow up to nursing-sensitive consensus standards work done in 2003, NQF staff have developed a position paper that summarizes the research in the area of nursing education preparation and its relationship to patient care outcomes. The paper also creates a context for NQF’s associated research and data system recommendations, and articulates the significant effects of nursing education on outcomes of patient safety. The paper was forwarded to NQF Members for review, with comments due by February 7, 2006. The paper underwent revision based on comments received from 12 Members, and will be presented to the Board at the May meeting.
National Voluntary Consensus Standards for the Reporting of Healthcare-associated Infection Data
The Steering Committee and Technical Advisory Panels (TAPs) have been appointed, and a TAP has been appointed for each area to be considered under this project: intravascular catheters and bloodstream infections; surgically implanted devices; indwelling catheters and urinary tract infections; respiratory infections, including those associated with ventilators; gastrointestinal infections; surgical site infections; and pediatric-specific infections. An Implementation/Public Reporting TAP also has been appointed.
A Call for Measures across the continuum of healthcare settings was completed on March 17, 2006, and measures are currently being evaluated; NQF staff also are researching additional measures that may be appropriate for consideration under this project.
A meeting of technical stakeholders was held on April 6, 2006, at NQF offices with the purpose of achieving general agreement on recommended definitions for key healthcare-associated infections to enable a more advanced discussion during the first Steering Committee meeting, where the final decisions about these definitions will be made. Pursuant to the primary funders condition of the contract, the initial Steering Committee meeting is planned for mid July in Los Angeles.
An active outreach effort continues. In addition, Dr. Corrigan has conducted or scheduled meetings and conference calls with many Board members and other key stakeholders to support NQF strategic planning.
The final NQF Compendium 2000-2005 document has been published and will be available at the Spring meetings in both electronic and printed forms.
As previously noted, the Ad hoc Advisory Committee on Evidence Grading met at an in-person meeting on January 12, 2006. The Committee further revised the grading schema, and NQF staff has begun piloting the schema in the ambulatory care project, as recommended by the Committee. Once the pilot is complete, feedback from the users will be incorporated into a revised document, which will be circulated to Members for comment.