NQF will convene a multi-stakeholder committee to direct an environmental scan of chief complaint-based measures and concepts, data sources, and approaches to standardizing nomenclature focused for documenting chief complaints. Read more

Description

The Opportunity

Emergency physicians are playing an increasingly important role in the delivery of acute, unscheduled care, with approximately one-quarter of all acute care visits in the U.S. take place in hospital emergency departments (ED). The majority of ED care is based on diagnosing and treating a patient’s chief complaint rather than the treating of a specific disease or condition, because patients present to the ED with chief complaints rather than definitive diagnoses. In the ED, a patient’s chief complaint describes their most significant symptoms or signs of illness (e.g. chest pain, headache, fever, abdominal pain, etc.) that caused him or her to seek health care.

Current measurement approaches are primarily based on discharge diagnoses, and do not address the variability in practice required to establish the diagnosis from a chief-complaint. Moreover, there is a lack of standard nomenclature to define how chief-complaints are organized, categorized, and assigned. In addition, a reliance on diagnosis-based administrative claims for quality measurement creates barriers to establishing valid and reliable patient groups. Currently, there is no national guidance to overcome these barriers to use chief complaints in quality measurement for patients presenting to the ED.

About the Project

NQF will convene a multi-stakeholder committee to direct an environmental scan of chief-complaint-based measures and concepts, data sources, and approaches to standardizing nomenclature focused for documenting chief complaints. The committee will also assess the strengths and weaknesses of potential data sources to describe chief complaints. The scan, which will inform the development of a conceptual framework and other recommendations for chief complaint-based quality measurement.

Objectives

The Committee will:

  • Provide guidance on the environmental scan for measures of chief complaint diagnosis
  • Identify measurement gaps
  • Develop a conceptual framework, addressing issues such as data source suitability and standardized nomenclature

NQF Process

Over a 12 month period of performance, NQF will conduct an environmental scan to identify measures and gaps, and develop a framework to measure related to the diagnosis of chief complaints. A multistakeholder committee of experts will provide input on the environmental scan and framework, using relevant elements of the NQF’s Consensus Development process to receive and review comments; however, the process will not involve voting or the endorsement of any product. Throughout this project, NQF will solicit input from the Committee, including NQF membership and public stakeholders at key points in the project.

Funding

This project is funded under a contract with the Department of Health and Human Services. For information about the availability of auxiliary aids and services for NQF’s federally funded projects, please visit http://www.medicare.gov/about-us/nondiscrimination/nondiscrimination-notice.html

Related NQF Work

Contact Information

For more information, please contact Jean-Luc Tilly at 202.783.1300 or via email at chiefcomplaint@qualityforum.org.

NQF will convene a multi-stakeholder committee to direct an environmental scan of chief complaint-based measures and concepts, data sources, and approaches to standardizing nomenclature focused for documenting chief complaints. Read more

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