Measuring Performance

Efficiency Measurement Projects 

Project Status: Current

Efficiency Measurement Projects

About the Projects

NQF's work in Efficiency will take place in two projects:

Efficiency: Imaging Efficiency seeks to identify imaging efficiency measurement domains.

Efficiency: Resource Use (Phase I and II)
      Phase I - Understanding & Evaluating Resource Use Measureswill identify issues before measures are evaluated. 
      Phase II - Endorsing Resource Use Standardswill evaluate and endorse resource use measures.

Project 1 Efficiency: Imaging Efficiency
This project seeks to identify specific imaging efficiency measures in several domains, which include:

  • Duplication
  • Overlap
  • Screening
  • Negative studies
  • Non-contrast imaging of the same body part using the same imaging modality followed shortly thereafter but on separate occasions with contrast imaging
  • Imaging of adjacent body parts
  • Coordination of care for hospital outpatient imaging

Project 2  Efficiency: Resource Use (Phase I and II)

Phase I Understanding & Evaluating Resource Use Measures will focus on identifying the difficult methodologic issues that require clarification before resource use measures across episodes are evaluated.  To undertake this step, NQF will commission two white papers focused on:

  • Criteria for determining the appropriateness of episode-based resource use measures
  • Identification of quality and efficiency measures that could be applied at the geographic-level (This paper has been removed from the Scope of Work as of June 2010).

These papers will be commissioned simultaneously and used as the foundation for Phase II of this effort.

Phase II Endorsing Resource Use Standards will evaluate and endorse resource use measures for reporting at multiple levels, including the individual and group physician level. This consensus development project will specifically include evaluation of episode-based and per capita resource use measures for 18 specific diseases and conditions across two review cycles.  


Review Cycle 1 

Review Cycle 2 

  • Congestive Heart Failure
  • Coronary Artery Disease
  • Acute Myocardial Infarction
  • Stroke/TIA
  • Hypertension
  • Diabetes
  • Chronic Kidney Disease
  • Asthma
  • Chronic Obstructive Pulmonary Disease
  • Cholecystitis/Cholelithiasis
  • Breast Cancer
  • Prostate Cancer
  • Colorectal Cancer
  • Urinary Tract Infection
  • Pneumonia
  • Hip Fracture
  • Osteoarthritis
  • Spine/Low Back Pain


Candidate measures will be considered for NQF endorsement as voluntary consensus standards. Agreement around the recommendations will be developed through NQF’s Consensus Development Process (CDP, Version 1.8). These projects involve the active participation of representatives from across the spectrum of healthcare stakeholders.


This project is funded under NQF's contract with the Department of Health and Human Services, Consensus-based Entities Regarding Healthcare Performance Measurement.

Related NQF Work

Contact Information

For further information, contact Ashlie Wilbon, RN, MPH or Sally Turbyville, MA, MS at 202-783-1300 or via e-mail at

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