November 2, 2001

Quality Forum's Hospital Measures Steering Committee Discusses Candidate Measures and Framework

The Hospital Quality Measures Steering Committee of the National Forum for Health Care Quality Measurement and Reporting met on Oct. 24 to discuss the Forum's two-part hospital quality measures project. The project stems from the Quality Interagency Task Force's (QuIC) February 2000 report to the President on patient safety initiatives in the federal government. The Agency for Healthcare Research and Quality (AHRQ) and the Center for Medicare and Medicaid Services (CMS) are jointly sponsoring the project.

The first part of the project will consist of a review of current measures used by the Joint Commission on the Accreditation of Health Care Organizations (JCAHO), peer review organizations and others. The steering committee will use the review of measures to develop an initial set of quality performance measures for the nation's acute care hospitals. The Forum hopes to complete this aspect of the project by December 2001. The second part of the project involves developing a framework to review new measures and update the initial set. The Forum's goal is to complete this work by October 2002.

Forum staff briefed the steering committee on findings from the Minority Healthcare Quality Measurement and Reporting Workshop the Forum held in June. Findings raised during this discussion included, among others, the need to have a standardized format for collecting race and ethnicity data and collecting it routinely and consistently with hospital performance measures.

The steering committee reviewed an augment list of candidate measures, which reflected their comments from the May meeting [see Washington Highlights, May 25]. The list consisted of 29 measures in 7 priority areas including: Acute Myocardial Infarction, Cebrovasular disease, Congestive Heart Failure, Coronary Artherosclerosis, Gastrointestinal disease, Pneumonia, and Pregnancy/childbirth/maternal/ neonatal care. The steering committee and Forum staff discussed several aspects of the candidate measures including the reporting burden, the length of the list, and additional measures for each priority area. They agreed to eliminate gastrointestinal disease because there was only one measure and an inadequate risk adjustment mechanism to account for variations. There was also significant discussion about these conditions and others as they relate to other specialties such as pediatrics.

At the May meeting the steering committee broke into three working groups: Priorities and Scope, Implementation and Measurement System, and Reporting. Representatives from each of these groups presented their recommendations to the steering committee on the set of hospital measures. Several issues were raised during these presentations including the measures' applicability to small hospitals, criteria for evaluating the measures, terminology, and methods for measuring patient perception of care.

Information: Jeff Patyk, AAMC Division of Health Care Affairs, 202-828-0498.