Ongoing Projects

National Voluntary Consensus Standards For Hospital Care: Outcomes and Efficiency
There is a growing set of measures on safety and effectiveness, though usually more oriented to process. As we move towards a broader view of hospital-based care, there is a need for measures that specifically address the outcomes and efficiency of care. More

National Voluntary Consensus Standards For Surgical Facilities: Additional Performance Measures
Almost 30 million operations are performed in the United State every year. Peri-operative care -- including pre-operative preparation, intra-operative management and post-operative care – are critical functions within surgical facilities that require coordination among many multi-disciplinary providers within the surgical facility as well as externally. More

National Voluntary Consensus Standards for Outpatient Imaging Efficiency
The cost of imaging studies – approximately $100 billion – is the second largest and the fastest growing item for healthcare payers following prescription medication. A significant portion – as much as $30 billion – is due to inappropriate utilization of imaging or duplication of studies. More

Composite Evaluation Framework
Although NQF has existing criteria for the submission and evaluation of individual measures, there were no such criteria for composite measures.  Working with the Composite Measure Steering Committee, a draft framework and submission criteria was developed.  More

National Voluntary Consensus Standards for Non-Physician Professionals
Providing high-level health care requires a multidisciplinary approach.  By merging the clinical expertise of multiple health care professions, the patient is receiving the best possible care available.  Consensus measures endorsed to date have targeted the physician as the ultimate responsible party, when in fact they are often dependent on other health care professionals for their expertise.  More

National Voluntary Consensus Standards for Clinician Level Peri-Operative Care
NQF has endorsed a number of performance measures applicable to ambulatory care surgical centers, cardiac surgery, and hospital-level surgery and anesthesia measures.  However, significant gaps still exist. This project will focus on: 1) anesthesiology; 2) perioperative management; and 3) general thoracic surgery.  More

National Voluntary Consensus Standards for Clinician Level Cancer Care
NQF has endorsed performance measures for cancer care at the institutional level (e.g., hospitals, health plans) but not at the individual clinician level.  To meet CMS’s need for additional quality measures, cancer care is now being included in this effort to promote accountability, quality improvement and to enable consumers to make informed decisions about where to seek care.  More

National Voluntary Consensus Standards for Clinician Level Infectious Disease
Performance measures around infectious disease prevention, treatment, and management is a large gap within the current landscape of quality measures, specifically in the areas of Hepatitis and HIV/AIDS.  Despite the urgent need, there are very few NQF-endorsedTM performance measures on infectious disease.  More

Health Information Technology Expert Panel
In its March 2001 report, Crossing the Quality Chasm: A New Health System for the 21st Century, the Institute of Medicine (IOM) linked automated information management as a fundamental need to achieve a healthcare system that is re-centered to focus on the patient.  The healthcare quality community has long recognized that such electronic information systems are a critical factor to provide data for measures of healthcare quality.  More

Health Information Technology Structural Measures
Interoperable health information technology (IT) will be required to achieve high quality, patient-centered care.  Evidence suggests that important structural processes, such as physician office and workflow redesign, optimize the impact of health IT on reducing medical errors, reporting quality/performance measurements, advancing patient education, and enhancing communication amongst care providers.  As clinical decision support and performance measurement are further integrated into physician-level health IT tools, there is a need for structural measures of this technology utilization.  More 

Home Health Care Patient Experience of Care Measures
There has been growing recognition of the importance of home health in the continuum of care, especially among those with chronic, co-morbid illnesses.  While there has been a growing movement towards quality measurement in home health care, the voice of the patient has been absent.  A measure of the patient experience of care in home health care is needed to fully understand the quality of home health care in America.  More

Immunization Quality Measures
There are many missed opportunities across the health care system, including physician practices, hospitals, nursing homes, and home care, where immunizations could have prevented serious illness and unnecessary and costly hospitalizations for pneumonia and influenza.  Estimated flu vaccination coverage remains <50% among certain groups for whom routine annual vaccination is recommended.  In order to achieve universal immunization for all those who need them, greater emphasis on adult immunizations across providers and sites of care is needed.  More

Endorsing Additional Clinician-Level Performance Measures
NQF has endorsed over 100 clinician-level performance measures in a variety of areas.  However, to meet CMS’s need for additional quality measures for use in its Physician Quality Reporting Initiative (PQRI), cancer care, infectious disease, non-medical doctor/doctor of osteopathy, surgery and anesthesia are now being included in this effort.  More

National Voluntary Consensus Standards for Perinatal Care
Pregnancy and childbirth is the second most common reason for admission to a hospital, with 4.2 million childbirth-related hospital stays recorded in 2005.  Morbidity and mortality associated with pregnancy and childbirth is substantial, and evidence suggests is to a large extent preventable through high quality perinatal care.  To date, quality measurement in maternal-child care has been limited.  Without appropriate information about perinatal hospital performance at a national level, quality improvement efforts are unfocused and incentives for improvement are limited.  A more complete set of  perinatal performance measures endorsed by NQF would provide the tools for providers, purchasers, and other stakeholders to create a national approach to quality improvement for mothers and babies. More

Endorsing a Framework and Preferred Practices for Measuring and Reporting Culturally Competent Care Quality
In 2002, the Institute of Medicine (IOM) released the report, Unequal Treatment:  Confronting Racial and Ethnic Disparities in Health Care, whichfound that racial and ethnic minorities often receive lower quality of care than their white counterparts, even after controlling for factors such as insurance, socioeconomic status, comorbidities, and stage of presentation.  Efforts to define culturally competent care are already in progress, catalyzed by the Office of Minority Health’s publication of standards for culturally and linguistically appropriate services (CLAS) for health care organizations. More

National Voluntary Consensus Standards for Emergency Care
Emergency care is an integral part of the healthcare delivery system.  In hospitals, the emergency department (ED) accounts for approximately 10% of all ambulatory medical care visits in the United States.  From 1994 through 2004, the number of ED visits increased from 93.4 million to 110.2 million visits annually, an 18% increase.  A quality initiative that seeks to establish a standardized measurement and reporting system of the performance of emergency care providers and systems will effectively improve the care of patients and reduce excessive healthcare costs.  More

Cost-Price Transparency
As the public becomes more informed and engaged in healthcare decision-making, there will likely be greater demand for cost and price information.  A nationwide survey done by the polling firm, Zogby International, found that 84% of those surveyed agreed with the statement “hospitals, doctors, and health plans should publish their prices.”  More

National Voluntary Consensus Standards for End Stage Renal Disease Care
The Balanced Budget Act of 1997 required the Centers for Medicare & Medicaid Services (CMS) to develop and implement a method to measure and report the quality of renal dialysis services provided under Medicare; and CMS funded the development of Clinical Performance measures based on the National Kidney Foundation’s Dialysis Outcomes Quality Initiative Clinical Practice Guidelines.  More

National Voluntary Consensus Standards for Hospital Care: Additional Priorities, 2007
Despite the growing list of NQF endorsed measures, many critical aspects of hospital care are not addressed. The need to fill gaps in the measure sets is noted by various stakeholders including purchasers creating payment incentive programs, consumers seeking information about providers, providers comparing themselves to their peers in the marketplace, and many other stakeholders who want to stimulate overall improvement in the quality of care in hospitals. More

Establishing Priorities, Goals and a Measurement Framework for Assessing Value Across Episodes of Care
The absence of national priorities and goals, and a vision for how to move to a system with  defined accountabilities impedes the efforts of those involved in all facets of performance  measurement and reporting. The NQF has convened a Steering Committee whose primary  charge is to establish national priorities and 3-5 year performance goals for two common  chronic conditions, and to the extent possible, identify measures that can be used to assess progress in meeting each goal.  More