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June 20, 2012

National Quality Forum: New Quality Measures

Quality measures 2
The National Quality Forum (NQF) has been releasing a number of new quality measures over the past few months.  In a recent announcement, NQF endorsed a measurement framework for individuals with multiple chronic conditions.  “Performance measurement is critical to improving the health and well-being of individuals with multiple chronic conditions,” NQF President and CEO Janet Corrigan said in a recent statement. 

Making up one-quarter of the population, multiple chronic condition patients are more likely to have adverse outcomes, see multiple clinicians, take several medications and receive fragmented care. As the population continues to age, that percentage is expected to grow. This population is at significantly higher risk of adverse outcomes and complications, and is more likely to see multiple clinicians, take several medications, and receive fragmented, incomplete, and ineffective care. Yet despite wide recognition of this problem from the healthcare community, existing quality measures largely do not address multiple chronic conditions. 

As a result, NQF convened a multi-stakeholder Steering Committee to develop this measurement framework under contract with the Department of Health and Human Services.  Specifically, the framework: 

  • Establishes a definition for multiple chronic conditions in order to achieve a common understanding and a shared vision for effectively measuring the quality of care for affected individuals;
  • Identifies high-leverage measurement areas for the multiple chronic conditions population in an effort to mitigate unintended consequences and measurement burden;
  • Presents a conceptual model that serves as an organizing structure for identifying and prioritizing quality measures; and
  • Offers guiding principles to address methodological and practical measurement issues.  

The standards-setting organization this month also released nine surgical measures performed in hospitals and in outpatient facilities, 19 quality measures for preventative care on population health and two nursing home measures that expand the setting to include inpatient rehabilitation facilities and long-term acute care hospitals. Statement 

“As the healthcare community looks to implement new care delivery models, we must consider how individuals with multiple chronic conditions will be affected,” said Caroline Blaum, co-chair of the Multiple Chronic Conditions Steering Committee. “This framework outlines a potential path for new models that thoughtfully takes into account the needs of this population.” In addition, the report identifies several timely strategic opportunities for applying the framework that are relevant to current policy context. These include: 

  • A coordinated approach for filling measure gaps;
  • Building a common data platform to consistently and seamlessly collect information, including patient reported data;
  • Opportunities to apply the core tenets of the framework as new delivery models are implemented and tested; and
  • Transparency through public reporting to enable consumer decision-making.  

“Supporting individuals with multiple chronic conditions requires a patient-centered approach,” said Barbara McCann, co-chair of the Multiple Chronic Conditions Steering Committee. “This framework will be vital in helping public and private sector quality improvement initiatives shift from a disease-specific model and ultimately improving care for this population.”

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