NQF endorses patient outcome measures for high-impact conditions

To improve healthcare quality and give patients and providers more information about the results of care, the National Quality Forum (NQF) has endorsed eight outcome measures for pulmonary and cardiovascular conditions and care provided in the intensive care unit (ICU). This is the first in a set of patient outcome measures NQF is reviewing. Additional measures that will be addressed in the coming months are other high-impact conditions including bone/joint conditions, chronic kidney disease, additional cardiovascular conditions, diabetes, several types of cancers, child health, and mental health.

Patient-centered outcome measures provide important information for patients, clinicians, and healthcare systems about the results of healthcare.  For example, one of the NQF-endorsed measures provides risk-adjusted data on the mortality rate in an intensive care unit.  Another provides information about readmission rates at hospitals.  This information can help consumers make informed choices, and can help pinpoint problems and successes for health professionals providing care.

"These measures help answer important questions about healthcare that get to the heart of the reason patients seek care," said Janet Corrigan, PhD, NQF President and CEO. "Was the patient healthier after receiving care? Did the care have the intended result?  Answering these types of patient-centered outcome questions is a key piece in the whole picture of healthcare quality, and helps clinicians and consumers make informed decisions about care." 

The eight measures endorsed by NQF include two composite measures that address thirty-day post-hospital discharge for patients with acute myocardial infarction and heart failure.  Additional measures address:

• length of stay in the ICU,
• ICU mortality rate,
• readmission rates for percutaneous coronary intervention,
• quality of life for COPD patients following pulmonary rehabilitation,
• functional capacity for COPD patients following pulmonary rehabilitation, and
• complication rates following implantation of implantable cardioverter defibrillator.

NQF's Steering Committee on patient outcome measures was co-chaired by Joyce Dubow, MUP, senior health care reform director at AARP, and Lee Fleisher, MD, professor and chair of anesthesiology at the University of Pennsylvania School of Medicine.

"NQF's focus on health outcomes is critically important," said Dubow.  "Knowledge that we gain from reporting outcomes measures can inform quality improvement efforts and clinical and patient decision making. These measures are especially meaningful to consumers and patients because information on the results of care is intuitively understandable and therefore so useful in selecting clinicians and hospitals."

NQF is a voluntary consensus standards-setting organization. Any party may request reconsideration of the recommendations, in whole or in part, by notifying NQF in writing via e-mail no later than October 20 (appeals@qualityforum.org). For an appeal to be considered, the notification e-mail must include information clearly demonstrating that the appellant has interests that are directly and materially affected by the NQF-endorsed recommendations and that the NQF decision has had (or will have) an adverse effect on those interests.

Endorsed Measures

• Hospital risk-standardized complication rate following implantation of implantable cardioverter-defibrillator (ICD) (Yale University/CMS)
• Hospital 30-day risk-standardized readmission rates following percutaneous coronary intervention (PCI) (Yale University/CMS)
• 30-day post-hospital AMI discharge care transition composite measure (Brandeis University/CMS)
• 30-day post-hospital heart failure (HF) discharge care transition composite measure (Brandeis University/CMS)
• Intensive care unit length-of-stay (Phillip R. Lee Institute for Health Policy Studies, University of California San Francisco). This measure is paired with OT1-024-09 Intensive care: In-hospital mortality rate.
• Intensive care: In-hospital mortality rate (Phillip R. Lee Institute for Health Policy Studies, University of California San Francisco). This measure is paired with OT1-023-09 Intensive care unit length-of-stay.
• Health-related quality of life in COPD patients before and after pulmonary rehabilitation (American Association of Cardiovascular and Pulmonary Rehabilitation) Time-Limited Endorsement
• Functional capacity in COPD patients before and after pulmonary rehabilitation (American Association of Cardiovascular and Pulmonary Rehabilitation) Time-Limited Endorsement