Measuring Performance

Pulmonary Endorsement Maintenance 

Project Status: Completed

Pulmonary and Critical Care Consensus Standards Maintenance and Endorsement

Access the Endorsement Summary (PDF) | Access the Full Report 

The Opportunity

At least 33 million Americans have chronic lung diseases such as asthma, chronic obstructive pulmonary disease (COPD), and pneumonia. Lung disease is the third leading cause of death in the United States.1 The human and financial burden is enormous:

  • In 2008, 23.3 million Americans suffered from asthma. Asthma afflicts people of all ages, races, genders, and socioeconomic status; however, it occurs at disproportionately higher rates among some ethnic and racial populations. Asthma affects an estimated 7 million children and accounts for more than 14 million lost school days every year.2 The annual direct healthcare cost of asthma is $15.6 million.3 
  • COPD is the third leading cause of death in the United States, costing the nation nearly $49.9 billion in 2010.4 
  • In 2006, an estimated 1.2 million hospital discharges were attributable to pneumonia.5 

More than 5 million patients are admitted annually to critical care units in the United States, treating patients with respiratory insufficiency/failure, postoperative management, ischemic heart disorder, sepsis, and heart failure. There are approximately 6,000 ICUs in the United States, caring for 55,000 critically ill patients each day.6 

NQF has endorsed a large number of consensus standards to evaluate the quality of care for pulmonary conditions and the critical care setting over the past decade. As quality measurement has matured, better data systems have become available, electronic health records are closer to widespread adoption, and the demand for meaningful performance measures has prompted development of more sophisticated measures of healthcare processes and outcomes for pulmonary conditions. An evaluation of the NQF-endorsed® pulmonary and critical care measures and consideration of new measures will ensure the currency of NQF’s portfolio of voluntary consensus standards.

About the Project

This project began in November 2011.


To ensure the currency of NQF’s portfolio of voluntary consensus standards for pulmonary conditions and critical care, both newly submitted measures and consensus standards for maintenance review will undergo the consensus development process together, including review against the most recent NQF evaluation criteria. In addition to ensuring currency of specifications and evidence for the focus of the measure, endorsement maintenance provides the opportunity to harmonize specifications and to ensure that an endorsed measure represents the “best in class.”

NQF Process 

Measures will be considered for NQF endorsement as national voluntary consensus standards. Consensus on the recommendations developed through NQF’s formal Consensus Development Process (CDP, Version 1.9). This project involves the active participation of representatives from across the spectrum of healthcare stakeholders and will be guided by a Steering Committee.


This project is supported under a contract provided by the Department of Health and Human Services.

Related NQF Work 

Contact Information 

For further information, contact 202-783-1300 or email Kathryn Streeter, MS at, or Reva Winkler, MD, MPH at


1. American Lung Association. Available at Last accessed October 2011.
2. Ibid.
3. National Heart, Lung and Blood Institute. Available at Last accessed October 2011.
4. American Lung Association.
5. Ibid.
6. Society of Critical Care Medicine. Available at Last accessed October 2011.

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