Setting Priorities

Improving Healthcare Quality 

The National Quality Forum (NQF) is one of the many organizations working to improve the quality of healthcare in the U.S.  The quality of the healthcare that Americans receive varies greatly across social, economic, and geographic boundaries. Recent studies have indicated that American adults receive recommended care only about 55 percent of the time; that disparities exist in the way care is delivered to racial and ethnic minorities; and that 30 percent of healthcare spending is wasteful and produces no value to the patient.

To create a national healthcare system that provides efficient, effective care of a consistently high quality to all Americans, regardless of their geographic location, a standardized system of evidence-based performance measurement and reporting must be established be applying the principles of quality improvement to the American healthcare system. Many different organizations work together to apply these principles, including performance measurement, public reporting of the results of those measurements, and constant action to correct deficiencies, within the quality landscape of American healthcare.

The principles of quality improvement are central to the work of NQF. NQF is a private sector standard-setting organization whose efforts center on the evaluation and endorsement of standardized performance measurement.  In collaboration with a diverse group of healthcare stakeholders, NQF works to improve the quality of American healthcare by infusing daily health practices with higher standards and routine measures of how and when patients’ needs are being effectively and efficiently met.

NQF evaluates and endorses tools for standardized performance measurement, including: performance measures that assess structure, process, outcomes, and patient perceptions of care; preferred practices that suggest a specific process that, when executed effectively, lead to improved patient outcomes; and frameworks that provide a conceptual approach to organizing practices. These performance standards can be used by institutions, providers, and healthcare consumers to:

  • Create reliable, comparative performance information on which consumers can rely to make informed decisions about their care;
  • Ensure practitioners and provider organizations are held accountable for the quality and efficiency of their performance; and
  • Support quality improvement activities.

The data gathered by these performance standards can then be used to improve healthcare quality in a variety of ways, including:

  • Public reporting. A healthcare institution (e.g., a hospital) reports the results of a standard to an external body, such as a state or federal agency. The state or federal agency then shares the data with the public so that consumers can compare results across institutions and over time. For example, the Centers for Medicare & Medicaid Services’ Hospital Compare website aggregates data on hospitals’ performance on 26 different measures and allows consumers to compare  individual hospitals’ performances across the nation on these measures.
  • Pay for performance. Healthcare institutions are judged by their performance on certain standards and are rewarded financially based on the quality of care that they provide.  For example, in October 2008, the Centers for Medicare & Medicaid Services stopped reimbursing hospitals for conditions that patients acquired during their hospital stay.  
  • Internal quality improvement. Some standards can help an individual institution monitor its own performance, even if they are not considered suitable for public reporting. Comparisons across institutions based on these standards generally are not possible.