NQF Endorses Healthcare Disparities and Cultural Competency Measures 

AUG 10, 2012

CONTACT: Erin Weireter

NQF Endorses Healthcare Disparities and Cultural Competency Measures

Washington, DC – the National Quality Forum (NQF) Board of Directors has endorsed 12 quality measures focused on healthcare disparities and culturally competent care for racial and ethnic minority populations.    

“Accurate and meaningful metrics to measure care quality for populations adversely affected by disparities are critically needed,” said Laura J. Miller, FACHE, interim CEO of NQF. “These endorsed measures will be instrumental in promoting equitable, high-quality, and compassionate care for all populations across the healthcare delivery system.” 

Research from the Institute of Medicine shows that racial and ethnic minorities often receive lower- quality care than their white counterparts, even after controlling for factors such as insurance coverage, socioeconomic status, and comorbidities.1 Several factors have been found to contribute to healthcare disparities, including inadequate resources, poor patient-provider communications, lack of culturally competent care, and a lack of access to language services. Healthcare systems need to improve across all of these areas to start addressing disparities; putting meaningful metrics in place to measure such disparities is an important first step.   

“Measures evaluating patient engagement and experience are essential to eliminating disparities and supporting culturally competent care for all patients,” said Denice Cora-Bramble, MD, MBA, acting senior vice president, ambulatory services, senior vice president of the Goldberg Center for Community Pediatric Health at Children’s National Medical Center, professor of pediatrics at The George Washington University, and co-chair of the Healthcare Disparities and Cultural Competency Steering Committee. “These measures will give providers the tools they need to support the high-quality care that all patients deserve.”   

These measures are the first endorsed by NQF that specifically address healthcare disparities and cultural competency. A commissioned paper on measurement concepts for healthcare disparities, completed in September 2011, served as the foundation for measure development in the field. In all, 16 measures were evaluated against NQF’s endorsement criteria, with 12 receiving endorsement status.

“These measures are sure to become an important part of the NQF portfolio,” said Dennis Andrulis, PhD, MPH, senior research scientist, Texas Health Institute, associate professor, University of Texas School of Public Health, and co-chair of the Healthcare Disparities and Cultural Competency Steering Committee. “They have undergone a rigorous evaluation by a panel of experts in cultural competency, disparities measurement, research and medicine, and public and community health, and will help the healthcare community better measure, understand, and eliminate disparities across the care spectrum.”

NQF is a voluntary consensus standards-setting organization. Any party may request reconsideration of any of the 12 endorsed quality measures listed below by submitting an appeal no later than September 10 (to submit an appeal, go to the NQF Measure Database). For an appeal to be considered, the notification must include information clearly demonstrating that the appellant has interests directly and materially affected by the NQF-endorsed recommendations and that the NQF decision has had (or will have) an adverse effect on those interests.

Endorsed Measures 

  • 1888: Workforce development measure derived from the workforce development domain of the Communication Climate Assessment Toolkit (CCAT) (American Medical Association)
  • 1901: Performance evaluation measure derived from the performance evaluation domain of the Communication Climate Assessment Toolkit (CCAT) (American Medical Association)
  • 1905 Leadership commitment measure derived from the leadership commitment domain of the Communication Climate Assessment Toolkit (CCAT) (American Medical Association)
  • 1892: Individual engagement measure derived from the individual engagement domain of CCAT (American Medical Association)
  • 1894: Cross-cultural communication measure derived from the cross-cultural communication domain of the CCAT (American Medical Association)
  • 1896: Language services measure derived from the language services domain of CCAT (American Medical Association)
  • 1898: Health literacy measure derived from the health literacy domain of CCAT (American Medical Association)
  • 1902: Clinicians/Groups’ Health Literacy Practices Based on the CAHPS® Item Set for Addressing Health Literacy (AHRQ)
  • 1904: Clinician/Group’s Cultural Competence Based on the CAHPS® Cultural Competence Item Set (AHRQ)
  • 1821: L2: Patients receiving language services supported by qualified language services providers (Department of Health Policy, The George Washington University)
  • 1824: L1A: Screening for preferred spoken language for health care (Department of Health Policy, The George Washington University)
  • 1919: Cultural Competency Implementation Measure (RAND)

NQF operates under a three-part mission to improve the quality of American healthcare by:  

  • building consensus on national priorities and goals for performance improvement and working in partnership to achieve them;  
  • endorsing national consensus standards for measuring and publicly reporting on performance; and  
  • promoting the attainment of national goals through education and outreach programs. 

Institute of Medicine (IOM). Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. Washington, DC: National Academies Press, 2003. Available at http://www.nap.edu/openbook.php?isbn=030908265X. Last accessed August 2012.