New Harmonization Horizons: Role of NQF. Helen Burstin, MD, MPH Senior Vice President, Performance Measures TMIT National Test Bed Workshop March 26, 2008. NQF Role in the Quality Landscape. Set voluntary, consensus standards
Helen Burstin, MD, MPH
Senior Vice President,
TMIT National Test Bed Workshop
March 26, 2008
IOM “To Err is Human” – 44,000 to 98,000 Americans die each year from preventable medical errors
Little progress to date - measures of patient safety showed an average annual improvement of just 1 percent (NHQR 2007)
Unclear impact of Patient Safety and Quality Improvement Act and emerging Patient Safety Organizations (PSOs)
Growing movement toward public reporting and non-payment for “never events”
Beginning in FY 2009, cases with these conditions would not be paid at a higher rate unless they were present on admission.
Medicare will no longer pay for the additional costs of certain preventable conditions (including certain infections) acquired in the hospital.
The rule identifies eight conditions, including three serious preventable events (sometimes called “never events”) that meet the statutory criteria.
CMS propose three additional conditions to the list next year (proposed for inclusion: ventilator associated pneumonia, Staphylococcus aureus septicemia, deep vein thrombosis, and pulmonary embolism).CMS Policy on Never Events
Bloodstream infections from using catheters
Objects left in a patient during surgery*
Urinary tract infections from catheters
Air embolism, an air bubble in a blood vessel*
An infection after heart surgery called mediastinitis
Blood incompatibility, giving a dangerously wrong blood type*
Bed sores, or pressure ulcers √
Hospital-acquired injuries, including falls √
*Serious Reportable Event
√ AHRQ PSI
Not everything that counts can be counted, and not everything that can be counted counts.
Fulfilling Needs everything that can be counted counts.
for the NPP
Standards ready now Urgent to develop
Specific Site of Care
Across the Continuum
Short term needs:
Need for measures that focus on potentially preventable admissions, readmissions, and ED visits
Harmonized set of standards for medication reconciliation across sites of care
Longer term needs:
NQF is launching a new project to identify a set of practices and measures to assess and improve performance along each of the dimensions in the NQF Care Coordination Framework:
Proactive Plan of Care & Follow-up
Transitions or Hand-offs