National Quality Forum Endorses National Voluntary Consensus Standards for Nursing Home Performance Measures


WASHINGTON -- The National Quality Forum (NQF) has announced the endorsement of a set of Nursing Home Performance Measures. This action -- representing the consensus of nearly 200 hospitals and healthcare systems, consumer groups, professional associations, purchasers, federal agencies, and research and quality improvement organizations -- provides a standardized set of performance measures for residents in chronic and post- acute care nursing homes.

The primary purpose of the NQF-endorsed measures is to provide information to facilitate consumers' selection of nursing homes. Additionally, the measures may be used by discharge planners and physicians for placement of patients; nursing home providers for internal quality improvement; and policymakers to oversee quality.

"Patients and their families need as much reliable information as possible when they undertake the very difficult decision of selecting a nursing home," said Kenneth W. Kizer, MD, MPH, president and CEO of the NQF. "This set of NQF-endorsed measures should help consumers at this important time."

The NQF endorsed seven chronic care measures, two chronic care measure pairs (in which one should not be pursued without the other), three post-acute care measures, and two measures that should apply to all facilities. Also endorsed were five recommendations in the areas of: staffing information, measures for post acute care, quality-of-life and satisfaction measures, public reporting, and improving and updating the measure set. One chronic care measure and one measure that should apply to all facilities were referred for additional consideration. All of these were considered through the NQF's consensus development process.

The chronic care measures are:

* Residents whose need for more help with daily activities has increased

* Residents who experience moderate to severe pain

* Residents who were physically restrained during the seven-day assessment


* Residents who spent most of their time in bed or in a chair in their

room during the seven-day assessment period

* Residents with a decline in their ability to move about in their room or

the adjacent corridor

* Residents with a urinary tract infection

* Residents with worsening of a depressed or anxious mood

* Referred for additional consideration: weight loss

The chronic care measure pairs are:

* High-risk residents with pressure ulcers AND average-risk residents with

pressure ulcers

* Residents who frequently lose control of the bowel or bladder (low-risk)

AND residents who have a catheter in the bladder at any time during the

14-day assessment period

The post-acute care measures are:

* Recently hospitalized residents who experienced moderate to severe pain

at any time during the seven-day assessment period

* Recently hospitalized residents with symptoms of delirium

* Recently hospitalized residents with pressure ulcers

The measures that apply to all facilities are:

* Pneumococcal polysaccharide vaccination of residents age 65 or older

* Influenza vaccination for all nursing home residents

* Referred for additional consideration: nurse staffing

The NQF is a voluntary consensus standard-setting organization. Any party may request reconsideration of the recommendations, in whole or part, by notifying the NQF in writing no later than Nov. 3, 2003 (601 13th Street, NW, Suite 500 North, Washington, D.C. 20005; fax 202-783-3434). For an appeal to be considered, the notification letter 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.

The NQF is a private, not-for-profit, public benefit corporation created in 1999 to develop and implement a national strategy for healthcare quality measurement and reporting. Established as a unique public-private partnership, the NQF has broad participation from all sectors of the healthcare industry.

Source: National Quality Forum

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