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Beyond measure Quality Comes of Age in American Healthcare

national quality forum1


Let’s think big.

10

the national quality forum celebrates ten years

imagine that all americans have access to affordable healthcare. they can get that care no matter where they live or what their race, age, or income.

Now here’s the rub: What kind of care will they receive? How can we ensure safe, high-quality care for all Americans across our vast, complex healthcare enterprise? How can we support healthcare that reflects the preferences of patients and families, and how will we know good care when we see it? n For 10 years, the National Quality Forum (NQF) has convened stakeholders across the healthcare system to address these urgent questions. Our achievements have helped create a sea change in attitudes and actions that is changing healthcare delivery. n To make a real difference in quality, leaders in both the public and private sectors have embraced a common set of priorities for transforming healthcare. It is now an accepted fact that we must have a standardized set of performance measures born of a respected consensus process. And new opportunities in health information technology will speed quality’s march. n Ultimately, quality goes beyond measurement to a patient’s experience of skilled, compassionate, and appropriate care. We invite you to join us as we work toward this goal for every patient, every time.

“NQF created a process and infrastructure for getting us engaged and talking about how to measure quality. It is no small feat to bring all these different communities together. Hand in hand with that, NQF has pioneered a way for giving consumers and purchasers more of a voice in driving this agenda.”

2

Debra L. Ness, President, National Partnership for Women & Families

1


Let’s think big.

10

the national quality forum celebrates ten years

imagine that all americans have access to affordable healthcare. they can get that care no matter where they live or what their race, age, or income.

Now here’s the rub: What kind of care will they receive? How can we ensure safe, high-quality care for all Americans across our vast, complex healthcare enterprise? How can we support healthcare that reflects the preferences of patients and families, and how will we know good care when we see it? n For 10 years, the National Quality Forum (NQF) has convened stakeholders across the healthcare system to address these urgent questions. Our achievements have helped create a sea change in attitudes and actions that is changing healthcare delivery. n To make a real difference in quality, leaders in both the public and private sectors have embraced a common set of priorities for transforming healthcare. It is now an accepted fact that we must have a standardized set of performance measures born of a respected consensus process. And new opportunities in health information technology will speed quality’s march. n Ultimately, quality goes beyond measurement to a patient’s experience of skilled, compassionate, and appropriate care. We invite you to join us as we work toward this goal for every patient, every time.

“NQF created a process and infrastructure for getting us engaged and talking about how to measure quality. It is no small feat to bring all these different communities together. Hand in hand with that, NQF has pioneered a way for giving consumers and purchasers more of a voice in driving this agenda.”

2

Debra L. Ness, President, National Partnership for Women & Families

1


The first decade…

july 1998 To drive quality improvement, the President’s Advisory

may 1999

NQF is incorporated as a new organization.

Quality grows

june 1999 NQF selects inaugural board members and its first president

ten years ago, when NQF was born, groundbreaking research had called

Commission on Consumer Protection and Quality in the Healthcare Industry recommends the creation of NQF.

and CEO, Kenneth Kizer.

march 2000

NQF welcomes its first 90 charter members.

november 2000 NQF defines the Consensus Development Process for endorsing standards.

june 2002 NQF publishes the first set of endorsed standards to

april 2005 The U.S. Department of Health and Human Services and the

promote safety: A list of serious reportable events (SREs). Hospital Quality Alliance launch hospitalcompare.hhs.gov, using NQF-endorsed® measures to report on hospital performance nationwide.

october 2005

april 2006

Membership tops 200. NQF hires a new president and CEO, Janet Corrigan.

october 2006 NQF expands mission to include setting national priorities and goals.

october 2007

The NQF portfolio of endorsed measures reaches 250.

november 2007 Membership tops 300.

NQF endorses disparities-sensitive measures.

october 2008

The NQF portfolio of endorsed measures reaches 500.

november 2008 The National Priorities Partnership, convened by NQF, releases the first set of National Priorities to transform healthcare.

january 2009 NQF receives contract from the U.S. Department of Health

and Human Services to implement a new congressional mandate around setting national priorities and endorsing performance measures to improve quality and affordability.

2

march 2009 NQF launches its safe practices updates and new webinar

into question clichés about American healthcare being the finest in the world. The Institute of Medicine’s reports, To Err Is Human and Crossing the Quality Chasm, revealed gaping holes in hospital safety and variability in the quality of care. For consumers, healthcare was a gamble, and quality was a nice word without definition. The architects of NQF proposed the radical notion that disparate players could reach consensus on performance standards that would represent their common expectations for safe, high-quality care. The process would engage patients and clinicians, purchasers and providers, communities and industry, health plans and those who are involved in quality measurement and improvement. Performance measures, backed by broad consensus among public and private stakeholders, would galvanize the system to deliver this care more consistently in a way no unilateral action could achieve. In a totally fragmented system, with billions of dollars at stake, NQF’s founding members showed leadership that is now astounding to contemplate. They provided a seat at the table for all stakeholders with particular care to ensure a powerful consumer voice in every decision NQF would make. Our membership is now more than 400 strong. Members have shaped a portfolio of endorsed measures that providers are using to support safer, high-quality care for their patients. NQF has also grown in its role as a neutral convener, bringing together 32 organizations to establish National Priorities and Goals. The collective commitment of the National Priorities Partnership will align resources and focus efforts to speed quality’s progress in the decade ahead. We are grateful for the thousands of individuals who have contributed untold hours to NQF’s innovative work. Dozens of organizational leaders have shaped the oftendifficult processes that have allowed us to join hands. Hundreds of experts brought scientific rigor to the review process leading to endorsement. To all of them, we extend our congratulations and appreciation for an extraordinary body of work.

series to accelerate the spread of safe practices. Thousands of providers from across the nation participate.

may 2009

Membership tops 400.

nqf

william l. roper, md, mph Chair

janet m. corrigan, phd, mba

President and CEO

3


The first decade…

july 1998 To drive quality improvement, the President’s Advisory

may 1999

NQF is incorporated as a new organization.

Quality grows

june 1999 NQF selects inaugural board members and its first president

ten years ago, when NQF was born, groundbreaking research had called

Commission on Consumer Protection and Quality in the Healthcare Industry recommends the creation of NQF.

and CEO, Kenneth Kizer.

march 2000

NQF welcomes its first 90 charter members.

november 2000 NQF defines the Consensus Development Process for endorsing standards.

june 2002 NQF publishes the first set of endorsed standards to

april 2005 The U.S. Department of Health and Human Services and the

promote safety: A list of serious reportable events (SREs). Hospital Quality Alliance launch hospitalcompare.hhs.gov, using NQF-endorsed® measures to report on hospital performance nationwide.

october 2005

april 2006

Membership tops 200. NQF hires a new president and CEO, Janet Corrigan.

october 2006 NQF expands mission to include setting national priorities and goals.

october 2007

The NQF portfolio of endorsed measures reaches 250.

november 2007 Membership tops 300.

NQF endorses disparities-sensitive measures.

october 2008

The NQF portfolio of endorsed measures reaches 500.

november 2008 The National Priorities Partnership, convened by NQF, releases the first set of National Priorities to transform healthcare.

january 2009 NQF receives contract from the U.S. Department of Health

and Human Services to implement a new congressional mandate around setting national priorities and endorsing performance measures to improve quality and affordability.

2

march 2009 NQF launches its safe practices updates and new webinar

into question clichés about American healthcare being the finest in the world. The Institute of Medicine’s reports, To Err Is Human and Crossing the Quality Chasm, revealed gaping holes in hospital safety and variability in the quality of care. For consumers, healthcare was a gamble, and quality was a nice word without definition. The architects of NQF proposed the radical notion that disparate players could reach consensus on performance standards that would represent their common expectations for safe, high-quality care. The process would engage patients and clinicians, purchasers and providers, communities and industry, health plans and those who are involved in quality measurement and improvement. Performance measures, backed by broad consensus among public and private stakeholders, would galvanize the system to deliver this care more consistently in a way no unilateral action could achieve. In a totally fragmented system, with billions of dollars at stake, NQF’s founding members showed leadership that is now astounding to contemplate. They provided a seat at the table for all stakeholders with particular care to ensure a powerful consumer voice in every decision NQF would make. Our membership is now more than 400 strong. Members have shaped a portfolio of endorsed measures that providers are using to support safer, high-quality care for their patients. NQF has also grown in its role as a neutral convener, bringing together 32 organizations to establish National Priorities and Goals. The collective commitment of the National Priorities Partnership will align resources and focus efforts to speed quality’s progress in the decade ahead. We are grateful for the thousands of individuals who have contributed untold hours to NQF’s innovative work. Dozens of organizational leaders have shaped the oftendifficult processes that have allowed us to join hands. Hundreds of experts brought scientific rigor to the review process leading to endorsement. To all of them, we extend our congratulations and appreciation for an extraordinary body of work.

series to accelerate the spread of safe practices. Thousands of providers from across the nation participate.

may 2009

Membership tops 400.

nqf

william l. roper, md, mph Chair

janet m. corrigan, phd, mba

President and CEO

3


measure. report. improve. What gets measured is what gets improved. Across settings and practices, NQF-endorsed measures are spurring changes that save lives, reduce errors, and improve care.

®

Reporting

All told, government entities serving 80 million people now use NQF-endorsed measures as the backbone of their systems for reporting and learning from benchmarks of healthcare performance. Sites such as www.hospitalcompare.hhs.gov rely on NQF-endorsed measures to report on hospital performance nationwide so consumers can make better informed choices in seeking care.

Early gains

The number of states requiring providers to disclose adverse events harming patients increased from five to 28 between 2005 and 2009. All these states use NQF’s list of serious reportable events as a guide or in its entirety in defining errors that should never happen.

“For a given clinical condition, patients want to know, ‘Can I expect and be assured that the care I am receiving is the right care for me?’ Healthcare systems and clinicians are trying to use evidencebased and reliable quality metrics now, precisely because patients, physicians and other clinicians, and payers need this information to be informed about and to improve healthcare quality.” John Tooker, MD, MBA, FACP, Executive Vice President and CEO, American College of Physicians

Incentives

Healthcare plans are using NQF-endorsed measures to help them align payment with performance. Medicare and many private payers now pay more to providers who achieve high levels of performance on measures selected from the NQF portfolio. Informing Practice

Providers nationwide are translating NQF-endorsed measures into systems and processes that result in more consistently safe, high-quality care. Their successes connect measures to practice. NQF’s growing education program takes such successes to thousands of providers, who in turn serve patients in the inner city, suburbs, small towns, and rural communities. Our Safe Practices report and webinar series update clinicians on practices that support a culture of safety.

Florence O’Neill checked into the Hospital of the University of Pennsylvania in Philadelphia with more knowledge than most patients. A veteran of one transplant operation and in line for another, she had learned a lot about the potential for infection. n “I was afraid,” admitted O’Neill from her bed. “But you don’t have to worry here.” Her nurse, masked like her patient, explains her actions to O’Neill as she changes a line dressing. When O’Neill first came into the unit, a physician inserted a central venous line following an NQF-endorsed Safe Practice. Today her team continues a panoply of safe practices that have yielded 19 months without a single bloodstream infection on their unit. n The physician, nurse, and quality director who make up the unit’s Clinical Leadership Team have used performance measures as one tool to focus everyone on common goals. Now they are working to sustain their gains and translate them into still broader achievements in patient safety.

4

5


measure. report. improve. What gets measured is what gets improved. Across settings and practices, NQF-endorsed measures are spurring changes that save lives, reduce errors, and improve care.

®

Reporting

All told, government entities serving 80 million people now use NQF-endorsed measures as the backbone of their systems for reporting and learning from benchmarks of healthcare performance. Sites such as www.hospitalcompare.hhs.gov rely on NQF-endorsed measures to report on hospital performance nationwide so consumers can make better informed choices in seeking care.

Early gains

The number of states requiring providers to disclose adverse events harming patients increased from five to 28 between 2005 and 2009. All these states use NQF’s list of serious reportable events as a guide or in its entirety in defining errors that should never happen.

“For a given clinical condition, patients want to know, ‘Can I expect and be assured that the care I am receiving is the right care for me?’ Healthcare systems and clinicians are trying to use evidencebased and reliable quality metrics now, precisely because patients, physicians and other clinicians, and payers need this information to be informed about and to improve healthcare quality.” John Tooker, MD, MBA, FACP, Executive Vice President and CEO, American College of Physicians

Incentives

Healthcare plans are using NQF-endorsed measures to help them align payment with performance. Medicare and many private payers now pay more to providers who achieve high levels of performance on measures selected from the NQF portfolio. Informing Practice

Providers nationwide are translating NQF-endorsed measures into systems and processes that result in more consistently safe, high-quality care. Their successes connect measures to practice. NQF’s growing education program takes such successes to thousands of providers, who in turn serve patients in the inner city, suburbs, small towns, and rural communities. Our Safe Practices report and webinar series update clinicians on practices that support a culture of safety.

Florence O’Neill checked into the Hospital of the University of Pennsylvania in Philadelphia with more knowledge than most patients. A veteran of one transplant operation and in line for another, she had learned a lot about the potential for infection. n “I was afraid,” admitted O’Neill from her bed. “But you don’t have to worry here.” Her nurse, masked like her patient, explains her actions to O’Neill as she changes a line dressing. When O’Neill first came into the unit, a physician inserted a central venous line following an NQF-endorsed Safe Practice. Today her team continues a panoply of safe practices that have yielded 19 months without a single bloodstream infection on their unit. n The physician, nurse, and quality director who make up the unit’s Clinical Leadership Team have used performance measures as one tool to focus everyone on common goals. Now they are working to sustain their gains and translate them into still broader achievements in patient safety.

4

5


national priorities and goals The more NQF achieved, the more the urgency of an expanded agenda — involving a new partnership — became clear. No one organization could accomplish the vast realignment needed to strengthen the quality of American healthcare. In 2008, NQF convened the National Priorities Partnership, a group of 32 organizations that have committed themselves to a set of National Priorities and Goals. Sharing its partners’ commitment, NQF will focus endorsement and education in the years ahead on realizing the six Priorities:

A new partnership

Patient and family engagement. Patients and families will have a voice, control, and choice in their care. They will find transparency from their providers and support in learning to care for themselves. Their care will account for their individual circumstances, culture, language, and social background.

“The priorities-setting process is really critical. We can’t do everything at once. If we don’t make some clear decisions as a country about where we are driving, we are going to get lost. NQF has demonstrated that by having a vision and continuing to set the priorities, real progress can be made.To NQF, we say congratulations, and keep it up.” Risa Lavizzo-Mourey, MD, MBA, President and CEO, Robert Wood Johnson Foundation

Population health. All Americans will live in communities that foster health. National, state, and local systems of care will help them prevent disease, injury, and disability and reduce the risk and burden of illness. Safety. Patients will receive care grounded in science and provided in

settings that are safe. Their providers will be dedicated to reducing the risks of injury until they achieve zero harm.

Care coordination. Patients and families will be able to move among

providers and procedures with guidance and support in their transitions. They will find consistent attention to their entire healthcare picture, needs, and preferences as a result of strong communications among their providers and with them.

Palliative and end-of-life care. All patients will have access to care that relieves their pain even when cure is not possible. At the end of life, they and their families will receive care that honors their dignity and preferences, comforts them, and offers spiritual support. Overuse. Patients will receive appropriate care that promotes better health. They will benefit from more affordable care through reductions in errors and unnecessary tests and treatments.

Dr. Vicki Montgomery, chief of the Division of Pediatric Critical Care Medicine at Kosair Children’s Hospital in Louisville, KY, walks the talk of continuous improvement. In monthly “walk-rounds,” she and a multidisciplinary team solicit input. “We ask frontline providers what they’re worried about,” says Montgomery. “It helps us create an agenda and priorities to strengthen quality.” n The team also solicits input from parents, giving the hospital key insights into the patient experience — and supporting the National Priority of patient and family engagement. Some things that come up in the tour move to the top of the team’s to-do list. A concern about medication labeling resulted in a new system for getting medications to the bedside with the correct, patient-specific dosing. n The focus on quality starts with Kosair’s parent company, Norton Healthcare System, which publicly reports performance on almost 600 quality indicators and practices. According to Montgomery, “reporting supports a culture where people ask, ‘Gee, what can we do to be even better?’”

6

7


national priorities and goals The more NQF achieved, the more the urgency of an expanded agenda — involving a new partnership — became clear. No one organization could accomplish the vast realignment needed to strengthen the quality of American healthcare. In 2008, NQF convened the National Priorities Partnership, a group of 32 organizations that have committed themselves to a set of National Priorities and Goals. Sharing its partners’ commitment, NQF will focus endorsement and education in the years ahead on realizing the six Priorities:

A new partnership

Patient and family engagement. Patients and families will have a voice, control, and choice in their care. They will find transparency from their providers and support in learning to care for themselves. Their care will account for their individual circumstances, culture, language, and social background.

“The priorities-setting process is really critical. We can’t do everything at once. If we don’t make some clear decisions as a country about where we are driving, we are going to get lost. NQF has demonstrated that by having a vision and continuing to set the priorities, real progress can be made.To NQF, we say congratulations, and keep it up.” Risa Lavizzo-Mourey, MD, MBA, President and CEO, Robert Wood Johnson Foundation

Population health. All Americans will live in communities that foster health. National, state, and local systems of care will help them prevent disease, injury, and disability and reduce the risk and burden of illness. Safety. Patients will receive care grounded in science and provided in

settings that are safe. Their providers will be dedicated to reducing the risks of injury until they achieve zero harm.

Care coordination. Patients and families will be able to move among

providers and procedures with guidance and support in their transitions. They will find consistent attention to their entire healthcare picture, needs, and preferences as a result of strong communications among their providers and with them.

Palliative and end-of-life care. All patients will have access to care that relieves their pain even when cure is not possible. At the end of life, they and their families will receive care that honors their dignity and preferences, comforts them, and offers spiritual support. Overuse. Patients will receive appropriate care that promotes better health. They will benefit from more affordable care through reductions in errors and unnecessary tests and treatments.

Dr. Vicki Montgomery, chief of the Division of Pediatric Critical Care Medicine at Kosair Children’s Hospital in Louisville, KY, walks the talk of continuous improvement. In monthly “walk-rounds,” she and a multidisciplinary team solicit input. “We ask frontline providers what they’re worried about,” says Montgomery. “It helps us create an agenda and priorities to strengthen quality.” n The team also solicits input from parents, giving the hospital key insights into the patient experience — and supporting the National Priority of patient and family engagement. Some things that come up in the tour move to the top of the team’s to-do list. A concern about medication labeling resulted in a new system for getting medications to the bedside with the correct, patient-specific dosing. n The focus on quality starts with Kosair’s parent company, Norton Healthcare System, which publicly reports performance on almost 600 quality indicators and practices. According to Montgomery, “reporting supports a culture where people ask, ‘Gee, what can we do to be even better?’”

6

7


new platforms. new measures. Whether migrating measures to electronic platforms or assessing more complex performance measures for endorsement, NQF continues to break ground. Health Information Technology

With $40 billion for HIT, the American Recovery and Reinvestment Act of 2009 (ARRA) gives a giant push to innovations that will make timely information available across the healthcare enterprise. The National Priorities and Goals have provided a framework for defining “meaningful use,” one of the criteria for investment of ARRA resources in HIT.

The path forward

NQF’s Health Information Technology Expert Panels have identified the types of data that electronic health records must capture to drive quality improvement. Over the next decade NQF will collaborate with key players to migrate measures and clinical decision support into electronic records that deliver the right information to the right stakeholders in a useful form.

“New investments in health information technology are creating unprecedented opportunities to take quality measurement and quality improvement to the next level. NQF’s groundbreaking work in this area will help ensure that this technology contributes to meaningful, continuous, and positive changes in the health of individuals and the American population.” P  aul C. Tang, MD, MS, Vice President and Chief Medical Information Officer at the Palo Alto Medical Foundation and Consulting Associate Professor of Medicine at Stanford University

An Enduring Portfolio of Measures

In the years ahead, NQF will continually update its portfolio of measures, retiring those that have become obsolete and endorsing new measures to provide additional value. NQF will also work to harmonize measures so they are more useful in assessing care provided at multiple settings and points in time. Additional endorsed measures will support the changes consumers tell us matter most to them: engagement in decisions, coordination in their care, information that helps them care for themselves, and achieving the best possible outcomes. Reducing Disparities

New endorsed measures will help all stakeholders reduce the disparities in care that currently result in poorer health for whole groups of Americans. NQF will work to build standards for cultural competency and measures of performance by patient race, ethnicity, and language into electronic health records. With more accessible data, providers will be able to target disparities, while public reporting will shine a light on their progress.

Electronic medical records are helping Dr. Cliff Fullerton do his job as one of seven Physician Champions in the Baylor Health Care System. n Fullerton devotes two days a week to planning, informing, and encouraging improvements in care. His Garland, TX, primary care practice has been a proving ground for quality improvement initiatives in outpatient settings. n His practice was among the first in Baylor’s 450-physician network to adopt electronic health records. Fullerton put the records to work to improve compliance with national standards, including those endorsed by NQF, among diabetic patients. A pop-up reminder in each patient’s record, letters to patients, and staff training have resulted in significant improvements in compliance. n “NQF endorsement has helped break down barriers to consensus among our clinicians about what metrics to use,” says Fullerton. “And it’s important to us that the measures will evolve and change over time. There’s no one better to manage that process thoughtfully.”

8

9


new platforms. new measures. Whether migrating measures to electronic platforms or assessing more complex performance measures for endorsement, NQF continues to break ground. Health Information Technology

With $40 billion for HIT, the American Recovery and Reinvestment Act of 2009 (ARRA) gives a giant push to innovations that will make timely information available across the healthcare enterprise. The National Priorities and Goals have provided a framework for defining “meaningful use,” one of the criteria for investment of ARRA resources in HIT.

The path forward

NQF’s Health Information Technology Expert Panels have identified the types of data that electronic health records must capture to drive quality improvement. Over the next decade NQF will collaborate with key players to migrate measures and clinical decision support into electronic records that deliver the right information to the right stakeholders in a useful form.

“New investments in health information technology are creating unprecedented opportunities to take quality measurement and quality improvement to the next level. NQF’s groundbreaking work in this area will help ensure that this technology contributes to meaningful, continuous, and positive changes in the health of individuals and the American population.” P  aul C. Tang, MD, MS, Vice President and Chief Medical Information Officer at the Palo Alto Medical Foundation and Consulting Associate Professor of Medicine at Stanford University

An Enduring Portfolio of Measures

In the years ahead, NQF will continually update its portfolio of measures, retiring those that have become obsolete and endorsing new measures to provide additional value. NQF will also work to harmonize measures so they are more useful in assessing care provided at multiple settings and points in time. Additional endorsed measures will support the changes consumers tell us matter most to them: engagement in decisions, coordination in their care, information that helps them care for themselves, and achieving the best possible outcomes. Reducing Disparities

New endorsed measures will help all stakeholders reduce the disparities in care that currently result in poorer health for whole groups of Americans. NQF will work to build standards for cultural competency and measures of performance by patient race, ethnicity, and language into electronic health records. With more accessible data, providers will be able to target disparities, while public reporting will shine a light on their progress.

Electronic medical records are helping Dr. Cliff Fullerton do his job as one of seven Physician Champions in the Baylor Health Care System. n Fullerton devotes two days a week to planning, informing, and encouraging improvements in care. His Garland, TX, primary care practice has been a proving ground for quality improvement initiatives in outpatient settings. n His practice was among the first in Baylor’s 450-physician network to adopt electronic health records. Fullerton put the records to work to improve compliance with national standards, including those endorsed by NQF, among diabetic patients. A pop-up reminder in each patient’s record, letters to patients, and staff training have resulted in significant improvements in compliance. n “NQF endorsement has helped break down barriers to consensus among our clinicians about what metrics to use,” says Fullerton. “And it’s important to us that the measures will evolve and change over time. There’s no one better to manage that process thoughtfully.”

8

9


how nqf works A private, nonprofit organization, the National Quality Forum derives its strength directly from its members. The breadth of its stakeholders, the power of the consensus process, and complete transparency build trust and credibility that give weight to its actions. Member Councils

Within NQF, stakeholder groups come together in eight member councils to share challenges and solutions within their different sectors. At the same time, cross-council discussions bring all perspectives to a common table. Representatives on each council act as ambassadors to their sectors and serve as listening posts for innovations.

Building trust

First Among Equals

Within NQF, patients are first among equals and the lodestar for all NQF decisions. NQF bylaws require that consumers and those who purchase services on their behalf hold a simple majority of at-large seats on the Board of Directors.

“To get to a place where quality is routinely part of the fabric of healthcare delivery, the interaction of people who come to the table with very different perspectives is invaluable. The National Quality Forum uses this approach to solving problems, and multiple stakeholders have come to count on their expertise in getting the right players together at the right time to make timely decisions on standards and measures of quality care.” carolyn m. clancy, md, Director, Agency for Healthcare Research and Quality

The Consensus Development Process

NQF’s process for endorsing measures results in their wide use and value as catalysts for change. All proposed measures receive rigorous, evidence-based review to make sure they reflect current science. NQF invites public scrutiny through web postings and e-mail alerts, and all member organizations have the opportunity to vote before the Consensus Standard Approval Committee makes the decision on endorsement. Through the ratification process, the NQF Board of Directors provides guidance and oversight. Beyond Endorsement

The considered, careful, and thorough deliberations to evaluate measures yield new insights and information about what prevents or advances quality. Stakeholders mine NQF’s portfolio of endorsed measures as they fashion their own systems for quality improvement. Continuous Improvement

Just as we ask others in healthcare to engage in continuous improvement, we never stop assessing and refining our process. We do what we ask of others.

Stop. Think. Act. Review. A simple technique, STAR training helped a nurse save a baby at Memorial Hermann Sugar Land Hospital in Texas. She double-checked the packaging of a medication dispensed by a computerized system and found that although the external packaging was correct, an adult-sized dose was in the vial destined for an infant in the neonatal unit. That one-second check, matching an NQF-endorsed practice, prevented a terrible error. n Extensive safety training at all levels — from the board room to the operating room — means that improving quality and safety is everyone’s job across the Memorial Hermann Healthcare System. “Exceptional patient care has no room for ‘it’s not my job,’” says Chief Medical Officer Michael Shabot. “Any one of us can prevent a potential hazard.” n “We look to NQF as a kind of lighthouse for its vetting of quality measures,” says Shabot. “We review the references in NQF’s review process, participate in voting on endorsement, and watch what happens very carefully. It’s a huge part of our success.”

10

11


how nqf works A private, nonprofit organization, the National Quality Forum derives its strength directly from its members. The breadth of its stakeholders, the power of the consensus process, and complete transparency build trust and credibility that give weight to its actions. Member Councils

Within NQF, stakeholder groups come together in eight member councils to share challenges and solutions within their different sectors. At the same time, cross-council discussions bring all perspectives to a common table. Representatives on each council act as ambassadors to their sectors and serve as listening posts for innovations.

Building trust

First Among Equals

Within NQF, patients are first among equals and the lodestar for all NQF decisions. NQF bylaws require that consumers and those who purchase services on their behalf hold a simple majority of at-large seats on the Board of Directors.

“To get to a place where quality is routinely part of the fabric of healthcare delivery, the interaction of people who come to the table with very different perspectives is invaluable. The National Quality Forum uses this approach to solving problems, and multiple stakeholders have come to count on their expertise in getting the right players together at the right time to make timely decisions on standards and measures of quality care.” carolyn m. clancy, md, Director, Agency for Healthcare Research and Quality

The Consensus Development Process

NQF’s process for endorsing measures results in their wide use and value as catalysts for change. All proposed measures receive rigorous, evidence-based review to make sure they reflect current science. NQF invites public scrutiny through web postings and e-mail alerts, and all member organizations have the opportunity to vote before the Consensus Standard Approval Committee makes the decision on endorsement. Through the ratification process, the NQF Board of Directors provides guidance and oversight. Beyond Endorsement

The considered, careful, and thorough deliberations to evaluate measures yield new insights and information about what prevents or advances quality. Stakeholders mine NQF’s portfolio of endorsed measures as they fashion their own systems for quality improvement. Continuous Improvement

Just as we ask others in healthcare to engage in continuous improvement, we never stop assessing and refining our process. We do what we ask of others.

Stop. Think. Act. Review. A simple technique, STAR training helped a nurse save a baby at Memorial Hermann Sugar Land Hospital in Texas. She double-checked the packaging of a medication dispensed by a computerized system and found that although the external packaging was correct, an adult-sized dose was in the vial destined for an infant in the neonatal unit. That one-second check, matching an NQF-endorsed practice, prevented a terrible error. n Extensive safety training at all levels — from the board room to the operating room — means that improving quality and safety is everyone’s job across the Memorial Hermann Healthcare System. “Exceptional patient care has no room for ‘it’s not my job,’” says Chief Medical Officer Michael Shabot. “Any one of us can prevent a potential hazard.” n “We look to NQF as a kind of lighthouse for its vetting of quality measures,” says Shabot. “We review the references in NQF’s review process, participate in voting on endorsement, and watch what happens very carefully. It’s a huge part of our success.”

10

11


nqf members consumer council AARP AFL-CIO American Federation of Teachers Healthcare American Hospice Foundation American Sleep Apnea Association Center for Information Therapy Childbirth Connection Coalition for Improving Maternity Services Community Catalyst Community Health Foundation of Western and Central New York Consumer Coalition for Quality Health Care Consumer Health Coalition Consumers Advancing Patient Safety Consumers’ Checkbook DES Action USA Health Care for All International Cesarean Awareness Network Lamaze International National Breast Cancer Coalition National Citizens’ Coalition for Nursing Home Reform National Coalition for Cancer Survivorship National Consumers League National Health Law Program National Partnership for Women & Families The Coordinating Center The Partnership for Healthcare Excellence

health plan council Aetna Alliance of Community Health Plans America’s Health Insurance Plans Arkansas Medicaid BlueCross BlueShield Association CareFirst BlueCross BlueShield

At not-for-profit Hudson Health Plan, where 80 percent of members are Latino or African American, NQF-endorsed measures are helping address healthcare disparities. “We are small, with limited clinical staff,” says Dr. Janet (Jessie) Sullivan, Hudson’s Chief Medical Officer and a founding member of NQF. “We do not have the resources or authority to develop care standards, so following NQF-endorsed standards frees us to concentrate on building programs for excellent care.” n Since 2004, one such program has been a pay-for-performance initiative to strengthen diabetes care. Practices earn up to $300 annually for every diabetic patient whose care complies with standards. To encourage work with all patients, even the most noncompliant, Hudson makes partial payment if key indicators improve but do not reach goals. n The program “has really made a difference,” says Nancy Walter, Vice President of Ambulatory Services at Hudson River Health Care in Yonkers, NY. “If we don’t get every dollar we think we should, we want to know why. The program has reminded us to get information in front of our doctors so that we continually improve.”

12

Current as of September 2009

CIGNA HealthCare Highmark, Inc. Horizon Blue Cross Blue Shield of New Jersey Hudson Health Plan Kaiser Permanente Premera Blue Cross UnitedHealth Group Universal American Corp. WellPoint

health professionals council AANAC Academy of Managed Care Pharmacy Academy of Medical-Surgical Nurses AGA Institute American Academy of Audiology American Academy of Dermatology American Academy of Family Physicians American Academy of Hospice and Palliative Medicine American Academy of Neurology American Academy of Ophthalmology American Academy of Orthopaedic Surgeons American Academy of Otolaryngology-Head and Neck Surgery American Academy of Pediatrics American Association of Birth Centers American Association of Cardiovascular and Pulmonary Rehabilitation American Association of Clinical Endocrinologists American Association of Diabetes Educators American Association of Neurological Surgeons

American Association of Nurse Anesthetists American Chiropractic Association American College of Cardiology American College of Chest Physicians American College of Gastroenterology American College of Nurse-Midwives American College of Obstetricians and Gynecologists American College of Physician Executives American College of Physicians American College of Radiology American College of Rheumatology American College of Surgeons American Geriatrics Society American Health Information Management Association American Heart Association American Medical Association American Medical Directors Association American Medical Group Association American Nurses Association American Optometric Association American Organization of Nurse Executives American Osteopathic Association American Pharmacists Association Foundation American Physical Therapy Association American Psychiatric Nurses Association American Society for Gastrointestinal Endoscopy American Society for Radiation Oncology American Society of Anesthesiologists American Society of Breast Surgeons

“When I first knew about NQF, it was focused entirely on quality measures and developing the consensus process. NQF has moved to a much broader remit. Still, even with its expanded objectives — priority setting, endorsement, and education — the organization really has a fourth one: leadership in the quality improvement enterprise.” Dave Domann, MS, RPh, Director, Future Market Strategies, Ortho-McNeil Janssen (Johnson & Johnson Company)

13


nqf members consumer council AARP AFL-CIO American Federation of Teachers Healthcare American Hospice Foundation American Sleep Apnea Association Center for Information Therapy Childbirth Connection Coalition for Improving Maternity Services Community Catalyst Community Health Foundation of Western and Central New York Consumer Coalition for Quality Health Care Consumer Health Coalition Consumers Advancing Patient Safety Consumers’ Checkbook DES Action USA Health Care for All International Cesarean Awareness Network Lamaze International National Breast Cancer Coalition National Citizens’ Coalition for Nursing Home Reform National Coalition for Cancer Survivorship National Consumers League National Health Law Program National Partnership for Women & Families The Coordinating Center The Partnership for Healthcare Excellence

health plan council Aetna Alliance of Community Health Plans America’s Health Insurance Plans Arkansas Medicaid BlueCross BlueShield Association CareFirst BlueCross BlueShield

At not-for-profit Hudson Health Plan, where 80 percent of members are Latino or African American, NQF-endorsed measures are helping address healthcare disparities. “We are small, with limited clinical staff,” says Dr. Janet (Jessie) Sullivan, Hudson’s Chief Medical Officer and a founding member of NQF. “We do not have the resources or authority to develop care standards, so following NQF-endorsed standards frees us to concentrate on building programs for excellent care.” n Since 2004, one such program has been a pay-for-performance initiative to strengthen diabetes care. Practices earn up to $300 annually for every diabetic patient whose care complies with standards. To encourage work with all patients, even the most noncompliant, Hudson makes partial payment if key indicators improve but do not reach goals. n The program “has really made a difference,” says Nancy Walter, Vice President of Ambulatory Services at Hudson River Health Care in Yonkers, NY. “If we don’t get every dollar we think we should, we want to know why. The program has reminded us to get information in front of our doctors so that we continually improve.”

12

Current as of September 2009

CIGNA HealthCare Highmark, Inc. Horizon Blue Cross Blue Shield of New Jersey Hudson Health Plan Kaiser Permanente Premera Blue Cross UnitedHealth Group Universal American Corp. WellPoint

health professionals council AANAC Academy of Managed Care Pharmacy Academy of Medical-Surgical Nurses AGA Institute American Academy of Audiology American Academy of Dermatology American Academy of Family Physicians American Academy of Hospice and Palliative Medicine American Academy of Neurology American Academy of Ophthalmology American Academy of Orthopaedic Surgeons American Academy of Otolaryngology-Head and Neck Surgery American Academy of Pediatrics American Association of Birth Centers American Association of Cardiovascular and Pulmonary Rehabilitation American Association of Clinical Endocrinologists American Association of Diabetes Educators American Association of Neurological Surgeons

American Association of Nurse Anesthetists American Chiropractic Association American College of Cardiology American College of Chest Physicians American College of Gastroenterology American College of Nurse-Midwives American College of Obstetricians and Gynecologists American College of Physician Executives American College of Physicians American College of Radiology American College of Rheumatology American College of Surgeons American Geriatrics Society American Health Information Management Association American Heart Association American Medical Association American Medical Directors Association American Medical Group Association American Nurses Association American Optometric Association American Organization of Nurse Executives American Osteopathic Association American Pharmacists Association Foundation American Physical Therapy Association American Psychiatric Nurses Association American Society for Gastrointestinal Endoscopy American Society for Radiation Oncology American Society of Anesthesiologists American Society of Breast Surgeons

“When I first knew about NQF, it was focused entirely on quality measures and developing the consensus process. NQF has moved to a much broader remit. Still, even with its expanded objectives — priority setting, endorsement, and education — the organization really has a fourth one: leadership in the quality improvement enterprise.” Dave Domann, MS, RPh, Director, Future Market Strategies, Ortho-McNeil Janssen (Johnson & Johnson Company)

13


American Society of Cataract and Refractive Surgery American Society of Clinical Oncology American Society of Colon and Rectal Surgeons American Society of Health-System Pharmacists American Society of Hematology American Society of Pediatric Nephrology American Society of Plastic Surgeons American Urological Association Association for Professionals in Infection Control and Epidemiology Association of periOperative Registered Nurses Association of Rehabilitation Nurses Association of Women’s Health, Obstetric and Neonatal Nurses Australian & New Zealand Society of Palliative Medicine Council of Medical Specialty Societies Heart Rhythm Society Hospice and Palliative Nurses Association Infectious Diseases Society of America Infusion Nurses Society National Academy of Clinical Biochemistry National Association of Certified Professional Midwives National Association of Pediatric Nurse Practitioners National Sleep Foundation New York University College of Nursing Ohio Hospice & Palliative Care Organization Renal Physicians Association Society for Cardiovascular Angiography and Interventions

Society for Healthcare Epidemiology of America Society for Vascular Surgery Society of Critical Care Medicine Society of Hospital Medicine Society of Thoracic Surgeons Wisconsin Medical Society Wound, Ostomy and Continence Nurses Society

provider council Adventist HealthCare Advocate Health Partners Alegent Health Ambulatory Surgery Foundation Amedisys American Health Care Association American Hospital Association AmSurg Corporation Ascension Health Association for Behavioral Health and Wellness Association for the Advancement of Wound Care Association of American Medical Colleges Atlantic Health Aultman Health Foundation Aurora Health Care Baptist Health South Florida Baptist Memorial Health Care Corporation BayCare Health System Baylor Health Care System BJC HealthCare Bon Secours St. Francis Health System Bronson Healthcare Group, Inc. Butler Memorial Hospital Catholic Health Association of the United States Catholic Health Initiatives Catholic Healthcare Partners Cedars-Sinai Medical Center Central Baptist Hospital Child Health Corporation of America

Children’s Hospitals and Clinics of Minnesota CHRISTUS Health Cleveland Clinic Connecticut Hospital Association Crozer-Keystone Health System Detroit Medical Center Duke University Health System Emergency Department Practice Management Association Englewood Hospital and Medical Center Exeter Health Resources Federation of American Hospitals Florida Hospital Gentiva Health Services Good Samaritan Hospital Greater New York Hospital Association Hackensack University Medical Center Harborview Medical Center Health Care Systems, Inc. Health Management Associates, Inc. Healthcare Leadership Council HealthPartners HealthSouth Corporation Henry Ford Health System Hoag Hospital Hospital Corporation of America Hospital for Special Surgery Illinois Hospital Association INTEGRIS Health Intermountain Healthcare Iowa Health System John Muir Health Johns Hopkins Health System Lake Forest Hospital Lakeview Hospital LHC Group, Inc. MaineGeneral Medical Center Mayo Foundation MedStar Health Memorial Hermann Healthcare System Memorial Sloan-Kettering Cancer Center Mercy Medical Center

Meridian Health System Mission Hospital, Inc. National Association of Children’s Hospitals and Related Institutions National Association of Community Health Centers National Association of Public Hospitals and Health Systems National Consortium of Breast Centers National Hospice and Palliative Care Organization National Rural Health Association Nemours Foundation New Jersey Hospital Association New York Presbyterian Healthcare System North Mississippi Medical Center North Shore-Long Island Jewish Health System North Texas Specialty Physicians Northwestern Memorial HealthCare Norton Healthcare, Inc. Park Nicollet Health Services Partners HealthCare System, Inc. Pennsylvania Health Care Association Planetree Premier, Inc. Providence Health System Robert Wood Johnson University Hospital-Hamilton Rockford Health System Roswell Park Cancer Institute Saint Barnabas Health Care System Saint Francis Hospital and Medical Center Sharp HealthCare Sisters of Charity of Leavenworth Health System Sisters of Mercy Health System Sisters of St. Francis Health Services South Carolina Hospital Association SSM Health Care-St. Louis

“If there is any group that has a chance of succeeding, it is NQF. Ken Kizer often referred to NQF as an ‘experiment in democracy’. It is absolutely amazing to see public and private entities at the table working together to approve measures rather than having all different ones. Then it is wonderful to see consumers, health professionals, purchasers, and groups like NCQA and The Joint Commission align their work with these measures.” Norma M. Lang, PhD, RN, Wisconsin Regent Distinguished Professor at the University of Wisconsin, Milwaukee, and Dean and Professor Emerita at the University of Pennsylvania School of Nursing

14

St. Mary’s Hospital St. Vincent’s Health System Stamford Health System Surgical Care Affiliates Tampa General Hospital Tenet Healthcare Corporation Texas Health Resources The Health Alliance of Mid America LLC The National Forum of ESRD Networks The University of Kansas Hospital Thomas Jefferson University Hospital Trinity Health UAB Health System UMass Memorial Medical Group, Inc. United Surgical Partners International University Health Systems of Eastern Carolina University Hospitals of Cleveland University of California-Davis Medical Group University of Michigan Hospitals & Health Centers University of Pennsylvania Health System University of Texas-M.D. Anderson Cancer Center US Department of Defense-Health Affairs UW Health Vanderbilt University Medical Center Vanguard Health Management Veterans Health Administration VHA, Inc. Virtua Health Vitas Healthcare Corporation WellSpan Health WellStar Health System Yale New Haven Health System

public/community health agencies council Aligning Forces for Quality-South Central Pennsylvania Alliance for Health Better Health Greater Cleveland California Office of Statewide Health Planning and Development California Perinatal Quality Care Collaborative Center for Health Care Quality, Department of Health Policy, George Washington University Community Health Alliance Health Improvement Collaborative of Greater Cincinnati Health Resources and Services Administration Healthy Memphis Common Table Illinois Department of Public Health Integrated Healthcare Association Integrated Resources for the Middlesex Area Kansas City Quality Improvement Consortium Maine Quality Forum Minnesota Community Measurement National Academy for State Health Policy National Association of Health Data Organizations New York City Department of Health and Mental Hygiene P2 Collaborative of Western New York Pittsburgh Regional Healthcare Initiative Puget Sound Health Alliance Quality Counts Rhode Island Department of Health State Associations of Addiction Services

“If you are a patient, what you care about is, ‘Will I walk better after I have this hip replacement? Will I be able to breathe better when I get to the top of the stairs? What do other patients like me think about when they go to this provider?’ NQF’s first ten years were really about making measures work for those who deliver care, and the next ten years will be about making them work for the people receiving care.” 

Peter Lee, JD, Executive Director, National Health Policy, Pacific Business Group on Health

15


American Society of Cataract and Refractive Surgery American Society of Clinical Oncology American Society of Colon and Rectal Surgeons American Society of Health-System Pharmacists American Society of Hematology American Society of Pediatric Nephrology American Society of Plastic Surgeons American Urological Association Association for Professionals in Infection Control and Epidemiology Association of periOperative Registered Nurses Association of Rehabilitation Nurses Association of Women’s Health, Obstetric and Neonatal Nurses Australian & New Zealand Society of Palliative Medicine Council of Medical Specialty Societies Heart Rhythm Society Hospice and Palliative Nurses Association Infectious Diseases Society of America Infusion Nurses Society National Academy of Clinical Biochemistry National Association of Certified Professional Midwives National Association of Pediatric Nurse Practitioners National Sleep Foundation New York University College of Nursing Ohio Hospice & Palliative Care Organization Renal Physicians Association Society for Cardiovascular Angiography and Interventions

Society for Healthcare Epidemiology of America Society for Vascular Surgery Society of Critical Care Medicine Society of Hospital Medicine Society of Thoracic Surgeons Wisconsin Medical Society Wound, Ostomy and Continence Nurses Society

provider council Adventist HealthCare Advocate Health Partners Alegent Health Ambulatory Surgery Foundation Amedisys American Health Care Association American Hospital Association AmSurg Corporation Ascension Health Association for Behavioral Health and Wellness Association for the Advancement of Wound Care Association of American Medical Colleges Atlantic Health Aultman Health Foundation Aurora Health Care Baptist Health South Florida Baptist Memorial Health Care Corporation BayCare Health System Baylor Health Care System BJC HealthCare Bon Secours St. Francis Health System Bronson Healthcare Group, Inc. Butler Memorial Hospital Catholic Health Association of the United States Catholic Health Initiatives Catholic Healthcare Partners Cedars-Sinai Medical Center Central Baptist Hospital Child Health Corporation of America

Children’s Hospitals and Clinics of Minnesota CHRISTUS Health Cleveland Clinic Connecticut Hospital Association Crozer-Keystone Health System Detroit Medical Center Duke University Health System Emergency Department Practice Management Association Englewood Hospital and Medical Center Exeter Health Resources Federation of American Hospitals Florida Hospital Gentiva Health Services Good Samaritan Hospital Greater New York Hospital Association Hackensack University Medical Center Harborview Medical Center Health Care Systems, Inc. Health Management Associates, Inc. Healthcare Leadership Council HealthPartners HealthSouth Corporation Henry Ford Health System Hoag Hospital Hospital Corporation of America Hospital for Special Surgery Illinois Hospital Association INTEGRIS Health Intermountain Healthcare Iowa Health System John Muir Health Johns Hopkins Health System Lake Forest Hospital Lakeview Hospital LHC Group, Inc. MaineGeneral Medical Center Mayo Foundation MedStar Health Memorial Hermann Healthcare System Memorial Sloan-Kettering Cancer Center Mercy Medical Center

Meridian Health System Mission Hospital, Inc. National Association of Children’s Hospitals and Related Institutions National Association of Community Health Centers National Association of Public Hospitals and Health Systems National Consortium of Breast Centers National Hospice and Palliative Care Organization National Rural Health Association Nemours Foundation New Jersey Hospital Association New York Presbyterian Healthcare System North Mississippi Medical Center North Shore-Long Island Jewish Health System North Texas Specialty Physicians Northwestern Memorial HealthCare Norton Healthcare, Inc. Park Nicollet Health Services Partners HealthCare System, Inc. Pennsylvania Health Care Association Planetree Premier, Inc. Providence Health System Robert Wood Johnson University Hospital-Hamilton Rockford Health System Roswell Park Cancer Institute Saint Barnabas Health Care System Saint Francis Hospital and Medical Center Sharp HealthCare Sisters of Charity of Leavenworth Health System Sisters of Mercy Health System Sisters of St. Francis Health Services South Carolina Hospital Association SSM Health Care-St. Louis

“If there is any group that has a chance of succeeding, it is NQF. Ken Kizer often referred to NQF as an ‘experiment in democracy’. It is absolutely amazing to see public and private entities at the table working together to approve measures rather than having all different ones. Then it is wonderful to see consumers, health professionals, purchasers, and groups like NCQA and The Joint Commission align their work with these measures.” Norma M. Lang, PhD, RN, Wisconsin Regent Distinguished Professor at the University of Wisconsin, Milwaukee, and Dean and Professor Emerita at the University of Pennsylvania School of Nursing

14

St. Mary’s Hospital St. Vincent’s Health System Stamford Health System Surgical Care Affiliates Tampa General Hospital Tenet Healthcare Corporation Texas Health Resources The Health Alliance of Mid America LLC The National Forum of ESRD Networks The University of Kansas Hospital Thomas Jefferson University Hospital Trinity Health UAB Health System UMass Memorial Medical Group, Inc. United Surgical Partners International University Health Systems of Eastern Carolina University Hospitals of Cleveland University of California-Davis Medical Group University of Michigan Hospitals & Health Centers University of Pennsylvania Health System University of Texas-M.D. Anderson Cancer Center US Department of Defense-Health Affairs UW Health Vanderbilt University Medical Center Vanguard Health Management Veterans Health Administration VHA, Inc. Virtua Health Vitas Healthcare Corporation WellSpan Health WellStar Health System Yale New Haven Health System

public/community health agencies council Aligning Forces for Quality-South Central Pennsylvania Alliance for Health Better Health Greater Cleveland California Office of Statewide Health Planning and Development California Perinatal Quality Care Collaborative Center for Health Care Quality, Department of Health Policy, George Washington University Community Health Alliance Health Improvement Collaborative of Greater Cincinnati Health Resources and Services Administration Healthy Memphis Common Table Illinois Department of Public Health Integrated Healthcare Association Integrated Resources for the Middlesex Area Kansas City Quality Improvement Consortium Maine Quality Forum Minnesota Community Measurement National Academy for State Health Policy National Association of Health Data Organizations New York City Department of Health and Mental Hygiene P2 Collaborative of Western New York Pittsburgh Regional Healthcare Initiative Puget Sound Health Alliance Quality Counts Rhode Island Department of Health State Associations of Addiction Services

“If you are a patient, what you care about is, ‘Will I walk better after I have this hip replacement? Will I be able to breathe better when I get to the top of the stairs? What do other patients like me think about when they go to this provider?’ NQF’s first ten years were really about making measures work for those who deliver care, and the next ten years will be about making them work for the people receiving care.” 

Peter Lee, JD, Executive Director, National Health Policy, Pacific Business Group on Health

15


purchaser council Buyers Health Care Action Group Caterpillar Inc. Centers for Medicare & Medicaid Services Colorado Business Group on Health Employer Health Care Alliance Cooperative Employers’ Coalition on Health Florida Health Care Coalition General Motors Corporation Greater Detroit Area Health Council Health Action Council Ohio Health Services Coalition HealthCare 21 Business Coalition Lehigh Valley Business Conference on Health Maine Health Management Coalition Microsoft Corporation National Association of State Medicaid Directors National Business Coalition on Health National Business Group on Health New Jersey Health Care Quality Institute Niagara Health Quality Coalition Pacific Business Group on Health St. Louis Area Business Health Coalition The Leapfrog Group Virginia Business Coalition on Health Washington State Health Care Authority

qmri council AAAHC Institute for Quality Improvement ABIM Foundation ACC/AHA Task Force on Performance Measures ACS-MIDAS+ Agency for Healthcare Research and Quality American Academy of Nursing American Association of Colleges of Nursing American Board of Medical Specialties American College of Medical Quality

16

American Data Network American Medical Association– convened Physician Consortium for Performance Improvement American Medical Informatics Association American Psychiatric Association for Research and Education American Society for Quality– HealthCare Division AYR Consulting Group Betsy Lehman Center for Patient Safety and Medical Error Reduction BoozAllenHamilton California HealthCare Foundation California Maternal Quality Care Collaborative Case Management Society of America Center to Advance Palliative Care Center for Health Improvement Community Health Accreditation Program Coral Initiative, LLC Core Consulting, Inc. Dallas-Fort Worth Hospital Council Education and Research Foundation HealthGrades Health Level Seven, Inc. Health Services Advisory Group Institute for Clinical Systems Improvement Institute for Safe Medication Practices Iowa Foundation for Medical Care Iowa Healthcare Collaborative IPRO Jefferson Health System, Office of Health Policy and Clinical Outcomes Kidney Care Partners Louisiana Health Care Quality Forum MHA Keystone Center for Patient Safety & Quality Milliman Care Guidelines National Association for Healthcare Quality National Center for Healthcare Leadership National Committee for Quality Assurance National Consensus Project for Quality Palliative Care National Council of State Boards of Nursing National Institute for Quality Improvement and Education National Patient Safety Foundation Neocure Group Next Wave

board of directors

North Carolina Center for Hospital Quality and Patient Safety Northeast Health Care Quality Foundation Ohio KePRO Partnership for Prevention Pharmacy Quality Alliance Press Ganey Associates Resolution Health, Inc. Texas Medical Institute of Technology The Commonwealth Fund The Joint Commission Thomson Reuters United Hospital Fund University HealthSystem Consortium University of Kansas School of Nursing University of North CarolinaProgram on Health Outcomes URAC Virginia Cardiac Surgery Quality Initiative West Virginia Medical Institute

Current as of September 2009 William L. Roper, MD, MPH (Chair) Dean, School of Medicine, Vice Chancellor for Medical Affairs and CEO, UNC Health Care System, University of North Carolina at Chapel Hill John C. Rother, JD (Vice Chair) Executive Vice President for Policy and Strategy, AARP Gerald M. Shea (Treasurer) Assistant to the President for External Affairs, AFL-CIO Lawrence M. Becker Director, HR Strategic Partnerships, Xerox Corporation Carolyn M. Clancy, MD Director, Agency for Healthcare Research and Quality Francis S. Collins, MD, PhD Director, National Institutes of Health

supplier/industry council Abbott Laboratories Advanced Medical Technology Association AMGEN Inc. Arrowsight, Inc. AstraZeneca Baxter Healthcare Bristol-Myers Squibb Company C.R. Bard Cardinal Health, Inc. CareFusion Dialog Medical eHealth Initiative Eli Lilly and Company Elsevier Clinical Decision Support Epstein Becker & Green, P.C. GE Healthcare GlaxoSmithKline Greenway Medical Technologies Hoffmann La-Roche Inc. Hospira Johnson & Johnson Health Care Systems Inc. MedAssets MedeAnalytics, Inc. Merck & Co., Inc. Olson Consulting Pfizer PhRMA sanofi-aventis Schering-Plough Siemens Healthcare, USA Sodexo Health Care Services ViPS, Inc. Zynx Health

Janet M. Corrigan, PhD, MBA President and CEO, National Quality Forum Helen Darling President, National Business Group on Health Charlene Frizzera Acting Administrator, Centers for Medicare & Medicaid Services Frederick L. Grover, MD The Aragón/Gonzalez-Giusti Chair, University of Colorado at Denver and Health Sciences Center, Department of Surgery Wade Henderson, Esq. President and CEO, Leadership Conference on Civil Rights Karen Ignagni, MBA President and CEO, America’s Health Insurance Plans Chris Jennings President, Jennings Policy Strategies, Inc. Charles N. Kahn, III, MPH President, Federation of American Hospitals

SteegeThomson Communications

Substance Abuse and Mental Health Services Administration The HOPE of Wisconsin Washington State Department of Health Wisconsin Collaborative for Healthcare Quality

Norma M. Lang, PhD, RN Wisconsin Regent Distinguished Professor at the University of Wisconsin, Milwaukee, and Dean and Professor Emerita at the University of Pennsylvania School of Nursing

Peter V. Lee, JD Executive Director for National Health Policy, Pacific Business Group on Health Mark B. McClellan, MD, PhD Director, Engelberg Center for Healthcare Reform, Senior Fellow for Economic Studies, and Leonard D. Schaeffer Chair in Health Policy Studies, The Brookings Institution Debra L. Ness President, National Partnership for Women & Families Nancy H. Nielsen, MD, PhD Immediate Past President, American Medical Association

“At 10 years old, NQF has just entered the rapid growth of adolescence. Most of our impact remains in the future. NQF is a much more robust organization now, capable of having a real impact in the field.” John C. Rother, JD, Executive Vice President for Policy and Strategy, AARP

Samuel R. Nussbaum, MD Executive Vice President and Chief Medical Officer, WellPoint, Inc. Janet Olszewski, MSW Director, Michigan Department of Community Health Bernard M. Rosof, MD Chair, Board of Trustees, Huntington Hospital John Tooker, MD, MBA, FACP Executive Vice President and CEO, American College of Physicians Richard J. Umbdenstock President and CEO, American Hospital Association Andrew Webber President and CEO, National Business Coalition on Health

“I am very optimistic about quality’s future in America. I often describe this in the political context as being sacred space. We have these very difficult discussions about money, but everybody is agreed to restructure the delivery system to make it higher quality. You are not talking minor things here. It’s revolutionary.” Gerald Shea, Assistant to the President for External Affairs, AFL-CIO

EX OFFICIO Bruce Bagley, MD Chair, Consensus Standards Approval Committee, Medical Director for Quality Improvement, American Academy of Family Physicians Curt Selquist Chair, Leadership Network, Johnson & Johnson Health Care Systems Inc. (Retired)

To hear and see NQF leaders, visit our 10 year anniversary site: BeyondMeasure.qualityforum.org


purchaser council Buyers Health Care Action Group Caterpillar Inc. Centers for Medicare & Medicaid Services Colorado Business Group on Health Employer Health Care Alliance Cooperative Employers’ Coalition on Health Florida Health Care Coalition General Motors Corporation Greater Detroit Area Health Council Health Action Council Ohio Health Services Coalition HealthCare 21 Business Coalition Lehigh Valley Business Conference on Health Maine Health Management Coalition Microsoft Corporation National Association of State Medicaid Directors National Business Coalition on Health National Business Group on Health New Jersey Health Care Quality Institute Niagara Health Quality Coalition Pacific Business Group on Health St. Louis Area Business Health Coalition The Leapfrog Group Virginia Business Coalition on Health Washington State Health Care Authority

qmri council AAAHC Institute for Quality Improvement ABIM Foundation ACC/AHA Task Force on Performance Measures ACS-MIDAS+ Agency for Healthcare Research and Quality American Academy of Nursing American Association of Colleges of Nursing American Board of Medical Specialties American College of Medical Quality

16

American Data Network American Medical Association– convened Physician Consortium for Performance Improvement American Medical Informatics Association American Psychiatric Association for Research and Education American Society for Quality– HealthCare Division AYR Consulting Group Betsy Lehman Center for Patient Safety and Medical Error Reduction BoozAllenHamilton California HealthCare Foundation California Maternal Quality Care Collaborative Case Management Society of America Center to Advance Palliative Care Center for Health Improvement Community Health Accreditation Program Coral Initiative, LLC Core Consulting, Inc. Dallas-Fort Worth Hospital Council Education and Research Foundation HealthGrades Health Level Seven, Inc. Health Services Advisory Group Institute for Clinical Systems Improvement Institute for Safe Medication Practices Iowa Foundation for Medical Care Iowa Healthcare Collaborative IPRO Jefferson Health System, Office of Health Policy and Clinical Outcomes Kidney Care Partners Louisiana Health Care Quality Forum MHA Keystone Center for Patient Safety & Quality Milliman Care Guidelines National Association for Healthcare Quality National Center for Healthcare Leadership National Committee for Quality Assurance National Consensus Project for Quality Palliative Care National Council of State Boards of Nursing National Institute for Quality Improvement and Education National Patient Safety Foundation Neocure Group Next Wave

board of directors

North Carolina Center for Hospital Quality and Patient Safety Northeast Health Care Quality Foundation Ohio KePRO Partnership for Prevention Pharmacy Quality Alliance Press Ganey Associates Resolution Health, Inc. Texas Medical Institute of Technology The Commonwealth Fund The Joint Commission Thomson Reuters United Hospital Fund University HealthSystem Consortium University of Kansas School of Nursing University of North CarolinaProgram on Health Outcomes URAC Virginia Cardiac Surgery Quality Initiative West Virginia Medical Institute

Current as of September 2009 William L. Roper, MD, MPH (Chair) Dean, School of Medicine, Vice Chancellor for Medical Affairs and CEO, UNC Health Care System, University of North Carolina at Chapel Hill John C. Rother, JD (Vice Chair) Executive Vice President for Policy and Strategy, AARP Gerald M. Shea (Treasurer) Assistant to the President for External Affairs, AFL-CIO Lawrence M. Becker Director, HR Strategic Partnerships, Xerox Corporation Carolyn M. Clancy, MD Director, Agency for Healthcare Research and Quality Francis S. Collins, MD, PhD Director, National Institutes of Health

supplier/industry council Abbott Laboratories Advanced Medical Technology Association AMGEN Inc. Arrowsight, Inc. AstraZeneca Baxter Healthcare Bristol-Myers Squibb Company C.R. Bard Cardinal Health, Inc. CareFusion Dialog Medical eHealth Initiative Eli Lilly and Company Elsevier Clinical Decision Support Epstein Becker & Green, P.C. GE Healthcare GlaxoSmithKline Greenway Medical Technologies Hoffmann La-Roche Inc. Hospira Johnson & Johnson Health Care Systems Inc. MedAssets MedeAnalytics, Inc. Merck & Co., Inc. Olson Consulting Pfizer PhRMA sanofi-aventis Schering-Plough Siemens Healthcare, USA Sodexo Health Care Services ViPS, Inc. Zynx Health

Janet M. Corrigan, PhD, MBA President and CEO, National Quality Forum Helen Darling President, National Business Group on Health Charlene Frizzera Acting Administrator, Centers for Medicare & Medicaid Services Frederick L. Grover, MD The Aragón/Gonzalez-Giusti Chair, University of Colorado at Denver and Health Sciences Center, Department of Surgery Wade Henderson, Esq. President and CEO, Leadership Conference on Civil Rights Karen Ignagni, MBA President and CEO, America’s Health Insurance Plans Chris Jennings President, Jennings Policy Strategies, Inc. Charles N. Kahn, III, MPH President, Federation of American Hospitals

SteegeThomson Communications

Substance Abuse and Mental Health Services Administration The HOPE of Wisconsin Washington State Department of Health Wisconsin Collaborative for Healthcare Quality

Norma M. Lang, PhD, RN Wisconsin Regent Distinguished Professor at the University of Wisconsin, Milwaukee, and Dean and Professor Emerita at the University of Pennsylvania School of Nursing

Peter V. Lee, JD Executive Director for National Health Policy, Pacific Business Group on Health Mark B. McClellan, MD, PhD Director, Engelberg Center for Healthcare Reform, Senior Fellow for Economic Studies, and Leonard D. Schaeffer Chair in Health Policy Studies, The Brookings Institution Debra L. Ness President, National Partnership for Women & Families Nancy H. Nielsen, MD, PhD Immediate Past President, American Medical Association

“At 10 years old, NQF has just entered the rapid growth of adolescence. Most of our impact remains in the future. NQF is a much more robust organization now, capable of having a real impact in the field.” John C. Rother, JD, Executive Vice President for Policy and Strategy, AARP

Samuel R. Nussbaum, MD Executive Vice President and Chief Medical Officer, WellPoint, Inc. Janet Olszewski, MSW Director, Michigan Department of Community Health Bernard M. Rosof, MD Chair, Board of Trustees, Huntington Hospital John Tooker, MD, MBA, FACP Executive Vice President and CEO, American College of Physicians Richard J. Umbdenstock President and CEO, American Hospital Association Andrew Webber President and CEO, National Business Coalition on Health

“I am very optimistic about quality’s future in America. I often describe this in the political context as being sacred space. We have these very difficult discussions about money, but everybody is agreed to restructure the delivery system to make it higher quality. You are not talking minor things here. It’s revolutionary.” Gerald Shea, Assistant to the President for External Affairs, AFL-CIO

EX OFFICIO Bruce Bagley, MD Chair, Consensus Standards Approval Committee, Medical Director for Quality Improvement, American Academy of Family Physicians Curt Selquist Chair, Leadership Network, Johnson & Johnson Health Care Systems Inc. (Retired)

To hear and see NQF leaders, visit our 10 year anniversary site: BeyondMeasure.qualityforum.org

Beyond Measure | National Quality Forum  
Beyond Measure | National Quality Forum  

Beyond Measure report for National Quality Forum

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