National Voluntary Consensus Standards for Hospital Care 2007: Additional Performance Measures

Purpose

To seek additional voluntary consensus standards for measuring the performance of the nation’s general acute care hospitals, including: 1) morbidity and mortality measures, and 2) anesthesia and surgery measures, and 3) measure for utilization rates for risky or often unnecessary procedures, 4) surgical volume and mortality measures, 5) readmission rates and length of stay (LOS) rates, 6) pain assessment, and 7) pediatric asthma.

Background

To date, the National Quality Forum has endorsed 69 voluntary consensus standards for measuring the performance of acute care hospitals. The first set of endorsed measures (National Voluntary Consensus Standards for Hospital Care: An Initial Performance Measure Set) identified 39 measures in 8 priority areas (acute coronary syndrome; heart failure; patient safety; pediatric conditions; pneumonia; pregnancy/childbirth/neonatal conditions; smoking cessation; and surgical complications). Subsequent consensus projects added 15 measures that are especially sensitive to the quality of nursing care (National Voluntary Consensus Standards for Nursing-Sensitive Care: An Initial Performance Measure Set) and 21 measures specific to cardiac surgery (National Voluntary Consensus Standards for Cardiac Surgery). Most recently, two 30-day mortality measures (National Voluntary Consensus Standards for Hospital Performance: Additional Priority Areas, 2005) were identified for heart failure and acute myocardial infarction. (Some measures were endorsed in more than one project.)

Despite this growing list of endorsed measures, many critical aspects of hospital care are not addressed. The need to fill gaps in the measure sets is noted by various stakeholders including purchasers creating payment incentive programs, consumers seeking information about providers, providers comparing themselves to their peers in the marketplace, and many other stakeholders who want to stimulate overall improvement in the quality of care in hospitals.

Scope

This project will:

• Apply the guiding principles outlined in A Comprehensive Framework for Hospital Care Performance Evaluation to additional areas of performance measurement; and
• Evaluate and endorse additional performance measures to include a broader array of services and care contexts, with particular emphasis on morbidity and mortality measures, anesthesia and surgery related events measures, measures of utilization rates for risky or often unnecessary procedures, surgical volume and mortality measures, readmission rates and LOS, pain assessment, and pediatric asthma. These additional areas of focus will expand the usefulness of NQF-endorsedTM hospital performance measures.
  

Funding

Support for this project has been provided largely by the Agency for Healthcare Research and Quality (AHRQ) with additional funds provided by the Alliance for Pediatric Quality, America’s Health Insurance Plans, and Blue Cross Blue Shield Association.

For more information, please contact Melinda L. Murphy, RN, MS, CNA ( 202.531.0550) or Fatema Salam, MPH (202.783.1300) or e-mail info@qualityforum.org.