National Voluntary Consensus Standards for Emergency Care

Purpose

This NQF project seeks to identify and endorse measures for public accountability and quality improvement related to emergency care at both the facility and practitioner levels.

Background

Emergency care is an integral part of the healthcare delivery system.  In hospitals, the emergency department (ED) accounts for approximately 10% of all ambulatory medical care visits in the United States.   From 1994 through 2004, the number of ED visits increased from 93.4 million to 110.2 million visits annually, an 18% increase.  Yet the number of hospital EDs in the United States decreased by about 12.4 percent during the same period.  Demand and capacity issues have contributed to increased patient wait-time and decreased physician productivity, and they place patients at risk for poor outcomes. A quality initiative that seeks to establish a standardized measurement and reporting system of the performance of emergency care providers and systems will effectively improve the care of patients and reduce excessive healthcare costs.

Scope

The project has been sequenced into several, related phases:

• Phase 1. Measures of Emergency Department Transfer—As a first phase of this project, NQF will consider performance measures in a limited area, emergency department transfers, only. These measures would address the emergency care provided to patients who are transferred from an emergency department to another acute care hospital or emergency department.
• Phase 2. NQF intends to formally solicit measures that address other aspects of hospital-based emergency department that address pressing quality issues such as patient wait-time, overcrowding, boarding, and diversions.
• Proposed Phase 3. Finally, NQF is currently seeking funding to expand the scope of this project to include the full array of emergency-based services (e.g., pre-hospital emergency medical services, urgent care, disaster and all-hazard emergency planning, preparedness, and response) and to result in both endorsed practices and measures that address the quality of emergency care services.

The NQF Process

This project, like all NQF activities, involves the active participation of representatives from across the spectrum of healthcare stakeholders. The project is guided by a Steering Committee. Agreement around the recommendations will be developed through NQF’s formal Consensus Development Process.

Funding

Funding for this project has been provided by the Centers for Medicare & Medicaid Services.
For more information, contact Del M. Conyers or Lisa Hines, at 202.783.1300 or via email, info@qualityforum.org.