National Quality Forum Endorses Consensus Standards for Quality of Hospital Care

Patient safety in hospitals focus of 48 NQF-endorsed measures

WASHINGTON, May 15 /PRNewswire-USNewswire/ -- Recognizing that patient safety remains a major hurdle in the United States, the National Quality Forum (NQF) today endorsed 48 voluntary consensus standards focused on measuring the performance of acute care hospitals, including measures addressing pediatric safety, hospital readmission, and prevention and care of venous thromboembolism.

"It has been difficult to make real progress in patient safety in this country, despite the efforts of many highly skilled, committed professionals and innovations in technology and treatment," said Janet Corrigan, president and CEO of the National Quality Forum. "In part, that is because we are all using different yardsticks to measure safety, which makes it difficult to identify and focus efforts on areas most in need of improvement and to measure and quantify progress. NQF-endorsed standards represent consensus of the experts and leaders from all corners of the healthcare industry, and can make a significant difference in helping hospitals measure what matters most to truly improve hospital care."

NQF-endorsed voluntary consensus standards are widely viewed as the "gold standard" for measurement of healthcare quality.

"NQF provides a great service to patients, purchasers, and the hospital community by providing the reference set of standard measures that improve safety, quality, and efficiency.

This set of NQF-endorsed measures will help hospitals identify where there are safety issues in need of system solutions," said Dr. Jonathan B. Perlin, Chief Medical Officer of the Hospital Corporation of America. "NQF-endorsed measures are instrumental in guiding hospitals through the complicated maze of measurement and reporting to ensure that quality is constantly addressed and improved in a way that is efficient and effective."

The set of hospital measures endorsed today will facilitate broad-based quality improvement by targeting numerous safety and quality issues within hospitals. Given the growing concerns with readmissions in America, particularly in the Medicare population, these important measures will help track progress toward improved transitions in care.

Most of the newly endorsed measures, the Quality Indicators, developed by the Agency for Healthcare Research and Quality (AHRQ), specifically offer hospitals an opportunity to pinpoint safety issues with measurement driven by readily available administrative data, rather than medical record reviews. Carolyn Clancy, M.D., director of AHRQ, believes the new measures can have a real impact. "Through public reporting," said Dr. Clancy, "these measures should offer needed guidance to purchasers and consumers seeking information about hospitals, as well as an opportunity for benchmarking to peers in the marketplace."

Six of the measures target the most common preventable cause of hospital death -- venous thromboembolism (VTE). There are 900,000 cases of VTE in the United States every year, and a stunning 300,000 of them are fatal. Annually, over 600,000 of those cases -- and 200,000 of the fatalities -- occur in hospitals, which have access to VTE prophylactic measures and treatments. The need for hospital-focused measures is very clear. All six NQF-endorsed measures on VTE focus on hospitals; with one measure extending the focus to readiness of patients for discharge. These newly endorsed measures further fill out NQF's portfolio of VTE measures and practices, including two previously endorsed Safe Practices.

When a measure is NQF-endorsed(TM), it carries the full weight of formal consensus of more than 375 healthcare providers, consumer groups, professional associations, purchasers, federal agencies, and research and quality improvement organizations. Standards are vetted through NQF's formal Consensus Development Process to achieve special legal standing as voluntary consensus standards and are evaluated against NQF's criteria to ensure they are important, scientifically acceptable, useable, and feasible. When the federal government adopts standards, federal law obligates that they are voluntary consensus standards.

MEASURES ENDORSED BY NQF, MAY 15, 2008

Length of Stay/Readmission
Risk-adjusted average length of inpatient hospital stay

Overall inpatient hospital average length of stay (ALOS) and ALOS by DRG service category

All-cause readmission index

30-day all-cause risk standardized readmission rate following heart failure hospitalization

Severity-standardized average length of stay-routine care
Severity-standardized average length of stay-special care
Severity-standardized average length of stay-deliveries

Patient Safety, Adult
Accidental puncture or laceration
Death in low mortality DRGs
Iatrogenic pneumothorax
Death among surgical inpatients with serious, treatable complications
Bilateral cardiac catheterization rate

Blood cultures performed within 24 hours prior to or 24 hours after hospital arrival for patients who were transferred or admitted to ICU within 24 hours of hospital arrival

Congestive heart failure mortality
Hip fracture mortality rate
Transfusion reaction, age 18 years and older

Patient Safety, Pediatrics
Accidental puncture or laceration
Decubitus ulcer
Iatrogenic pneumothorax in nonneonates
Transfusion reaction, age under 18 years

Pediatrics
PICU severity-adjusted length of stay
PICU unplanned readmission rate
Review of unplanned PICU readmissions
Home management plan of care document given to patient/caregiver
Pediatric heart surgery mortality
Pediatric heart surgery volume
PICU pain assessment on admission
PICU periodic pain assessment
PICU standardized mortality ratio

Surgery and Anesthesia
Abdominal aortic aneurysm volume
Abdominal aortic aneurysm repair mortality rate
Esophageal resection mortality rate
Esophageal resection volume
Incidental appendectomy in the elderly rate
Pancreatic resection mortality rate
Pancreatic resection volume
Post operative wound dehiscence, age under 18 years
Post operative wound dehiscence, 18 years and older
Foreign body left after procedure, age under 18 years
Foreign body left in during procedure, 18 years and older
Failure to Rescue In-hospital Mortality
Failure to Rescue 30-day mortality

Venous Thromboembolism
VTE prophylaxis
Intensive Care Unit (ICU) VTE Prophylaxis
VTE Patients with Anticoagulation Overlap Therapy

VTE Patients Unfractionated Heparin (UFH)Dosages/Platelet Count Monitoring by Protocol (or Nomogram)

VTE Discharge Instructions
Incidence of Potentially Preventable VTE

NQF is a voluntary consensus standard-setting organization. Any party may request reconsideration of the recommendations, in whole or part, by notifying NQF in writing via email no later than June 15, 2008 (appeals@qualityforum.org). For an appeal to be considered, the notification email must include information clearly demonstrating that the appellant has interests that are directly and materially affected by the NQF-endorsed(TM) recommendations and that the NQF decision has had (or will have) an adverse effect on those interests.

Support for the larger portion of these measures was provided by the Agency for Healthcare Research and Quality (AHRQ), with additional funds provided by the Alliance for Pediatric Quality, America's Health Insurance Plans, and Blue Cross Blue Shield Association. Sanofi-aventis provided an unrestricted educational grant in support of the VTE project.

The mission of the National Quality Forum is to improve the quality of American healthcare by setting national priorities and goals for performance improvement, endorsing national consensus standards for measuring and publicly reporting on performance, and promoting the attainment of national goals through education and outreach programs. NQF, a non-profit organization (qualityforum.org) with diverse stakeholders across the public and private health sectors, was established in 1999 and is based in Washington, DC.

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Source: National Quality Forum

CONTACT: Alicia Aebersold of National Quality Forum, +1-202 783 2772,
cell: +1-202-341-8604, aaebersold@qualityforum.org

Web Site: http://www.qualityforum.org/

2008-05-15 18:15:37 0363528 PRNEWSWIRE