The National Quality Forum Quality Priorities and Home Care

Size: px

Start display at page:

Download "The National Quality Forum Quality Priorities and Home Care"

Gabriel Lindsey
5 years ago
Views:

1 The National Quality Forum Quality Priorities and Home Care Lisa Hines, BSN, MS Managing Director, Membership & Council Services

2 Objectives Awareness of The National Quality Forum The National Priority Partnership The Consensus Development Process How to participate in NQF activities Common issues around endorsing measures 2

3 Mission of NQF Improve the quality of American healthcare by setting national priorities and goals for performance improvement Endorse national consensus standards for measuring and publicly reporting on performance Promote the attainment of national goals through education and outreach programs. 3

4 About NQF Unique, multistakeholder organization Private, not-for-profit membership organization with more than 400 members representing virtually every sector of the healthcare system Recognized as a voluntary consensus standards-setting body 4

5 National Priorities Partnership Consists of 32 organizations representing virtually every part of the healthcare system Includes the American Health Care Association Have set six National Priorities to transform healthcare 5

6 National Priorities Partnership Goals Engage patients and families in managing health and making decisions about care Improve the health of the US population Improve the safety of America s healthcare system Ensure patients receive well-coordinated care Guarantee appropriate and compassionate care for patients with life-limiting illnesses Eliminate waste while ensuring the delivery of appropriate care 6

7 Setting Priorities NATIONAL PRIORITIES Alignment of public reporting, payment, oversight, and improvement programs with priority areas Performance measures developed around priority areas Multiple actions to make improvements target priority areas Can get us there faster WHERE WE ARE GOING Healthcare that is safe, timely, equitable, effective, efficient, and patient centered National Priorities Partnership

8 CDP Steps 1. Call for intent to submit candidate standards 2. Call for nominations 3. Call for candidate standards 4. Candidate standard review 5. Public and member comment 6. Member voting 7. Review and decision by the Consensus Standards Approval Committee (CSAC) 8. Board of Directors for ratification 9. Appeals 8

9 NQF Homepage

10 Dashboard

11 Project Page

12 STEP 1: Call for Intent to Submit

13 Step 2: Call for Nominations

14 Step 3: Call for Candidate Standards

15 Types of Candidate Standards Candidate Standards Frameworks Practices Measures 15

16 Step 4: Consensus Standards Review

17 Measure Evaluation Criteria Importance to measure and report Scientific acceptability Usability Feasibility 17

18 Step 5: Public and Member Comment

19 Step 5: Submit a Comment

20 Step 7: CSAC Endorsement

21 Step 8: Board Ratification

22 Step 9: Appeals

23 Directory of NQF-Endorsed Standards 23

24 Current NQF projects Outcomes Efficiency Care Coordination Patient Safety Nursing Home Population Health Health Information Technology Conversion to ICD 10 24

25 Home Health Home Health

26 Home Health Steering Committee Jon D. Fuller, MD (Co-Chair) VA Palo Alto Health Care System, Palo Alto, CA Carol Spence, PhD, RN (Co-Chair) National Hospice and Palliative Care Organization, Alexandria, VA Rosa Baier Quality Partners at Rhode Island, Providence, RI Stanley Borg, DO, FAAFP Independent Healthcare Consultant, Chicago, IL Jean DeLeon Baylor Speciality Hospital, Baylor, TX Roger Herr, MPA Outcome Concept Systems, Seattle, WA Robert Krughoff Consumers' Checkbook, Washington, DC Bruce Leff, MD Johns Hopkins University School of Medicine, Baltimore, MD Sandra Lesikar, PhD Booz Allen Hamilton, Rockville, MD Richard MacMillan LHC Group, Inc., Lafayette, LA Katherine Maslow Alzheimer's Association, Washington, DC Tasha Mears Amedisys, Baton Rouge, LA JoAnne Schwartzberg, MD Aging and Community Health, American Medical Association, Chicago, IL Paula Simpson, RN VCU Spine Center, Richmond, IL Sunil Sinha, MBA, MD Pfizer, Columbia, MD Marc Stranz, PharmD, BS Critical Homecare Solutions, Macungie, PA Margaret Terry, MS, PhD MedStar Health Visiting Nurse Association, Calverton, MD Charlotte Weaver, Ph. D Gentiva Health Services, Atlanta, GA Bonnie Westra, PhD, RN University of Minnesota, School of Nursing, Minneapolis, MN Gina Woody WellPoint, Denver, CO 26

27 QI vs. Public Reporting Different levels of information are necessary for: Day-to-day clinical care Quality improvement Public reporting/accountability Example: Day to day functional independence desired 9 individuals ADL measures submitted all QI Only 3individual measures appropriate PR/A Gutman scale: if you can do x, then you can do y 27

28 It is what it says Discharge to community Not under agency control Does not reflect if patient met goals Indicates they were discharged from services could be because benefits max ed out Desired information (return to hospital) is captured in acute hospitalization measure 28

29 Measures cross silos of care Agency level Pain assessment conducted Pain interventions implemented OASIS driven Physician level Measure for ordering pain medications or treatments is in ambulatory measures CPT, pharmacy data, etc. 29

30 Plan of Care Often just a documentation measure Can have a tangible care plan without implementing it Preference is for outcome measure that show care plan was effective Active care coordination and patient engagement measures are also desirable 30

31 Risk adjustment Desire to risk adjust Small samples Numbers too small to report Emergent care - topic specific Dilemma: Remove hospitalizations and risk adjust Numbers too small to report or be meaningful Publicly report overall emergent care-risk adjusted Sub-topics are QI only 31

32 Improvement in behavioral health Not under the agencies control Some interventions can decrease anxiety Assessment and identification often more important than improvement Interventions often controlled by the physician not the agency Could be a disincentive for agencies to accept admissions with behavioral health issues if publicly reported 32

33 Don t jump the gun Potential medication issues identified and timely physician contact during episode medication reconciliation lists not currently received from hospital need better IT programs and coordination in transition of care before publicly reported 33

34 For More Information Lisa Hines, MS,BSN

THE NATIONAL QUALITY FORUM

THE NATIONAL QUALITY FORUM TO: FR: RE: NQF Members NQF Staff Voting draft review for National Voluntary Consensus Standards for Home Health Care: Additional Performance Measures, 2008 DA: January 28, 2009