The National Quality Forum (NQF) endorsed measures Aug. 10 for care coordination, complication-related patient safety, cancer and disparities and cultural competency. In addition, NQF removed the time-limit endorsement in 13 measures, including a measure for a standardized adverse event ratio for children 18 years of age undergoing cardiac catheterization.
NQF added two patient safety measures with a focus on complications: a measure to address venous thromboembolism prophylaxis and current medication documentation in medical records. These are an addendum to 14 measures endorsed in June.
The 22 cancer quality measures focused on conditions such as leukemia, prostate cancer and multiple myeloma, but also on issues that affect care delivery, including radiation dose limits, hospice readmissions, and care planning. Twelve quality measures have been added on healthcare disparities and culturally competent care for racial and ethnic minority populations.
Lack of coordination and communication across healthcare settings can lead to significant patient complications, including medication errors, preventable hospital readmissions, and emergency department visits, according to officials. The measures are designed to improve patient care quality and safety.
“Care coordination is essential to reducing medical errors, wasteful spending and unnecessary pain and procedures for patients,” said Laura J. Miller, interim CEO of NQF, a voluntary consensus standards-setting organization in Washington, D.C. “We are pleased to endorse this set of measures that will help providers deliver safer, coordinated, and higher-quality care to patients.”
The 12 care coordination measures are:
- Medication reconciliation;
- Acute care hospitalization (risk-adjusted);
- Emergency Department use without hospitalization;
- Advance care plan;
- Medical home system survey;
- Timely initiation of care;
- Care for older adults – medication review;
- Medication reconciliation post-discharge;
- Reconciled medication list received by discharged patients (discharges from an inpatient facility to home/self-care or any other site of care);
- Transition record with specified elements received by discharged patients (discharges from an inpatient facility to home/self-care or any other site of care);
- Timely transmission of transition record (discharges from an inpatient facility to home/self-care or any other site of care); and
- Transition record with specified elements received by discharged patients (emergency department discharges to ambulatory care [home/self-care] or home healthcare).
The measures included those that have been endorsed for at least three years and are now undergoing NQF endorsement maintenance. The ongoing evaluation and updating of endorsed measures ensures they are current and relevant to NQF’s care coordination portfolio. In all, 15 measures were evaluated against NQF’s endorsement criteria, with 12 receiving endorsement status.
NQF time-limited endorsement is applied to measures that meet all of NQF’s endorsement criteria with the exception of field testing and are critical to advancing quality improvement. When measures are granted this two-year endorsement, rather than the traditional three-year period, measure developers must test the measure and return results to NQF within the two-year window.
The statuses of the measures were removed after the board determined field testing results adequately addressed endorsement considerations including reliability and validity, and that there were no unintended consequences or patient harm as a result of measure testing and implementation.
These measures will begin their regular three-year maintenance review in 2013 and 2014. At this time, they will undergo a complete evaluation based on all of NQF’s updated measure criteria.