The National Quality Forum (NQF) Board of Directors has endorsed 12 patient safety measures with a focus on complications. The measures address a range from falls and pressure ulcers to healthcare-associated infections.
The measures were evaluated as part of NQF's patient safety endorsement project, which previously endorsed measures related to medication safety, surgical safety, and care coordination, as well as venous thromboembolism and medication documentation, in June and August 2012, respectively.
"Protecting patients from harm is at the heart of NQF's work to improve healthcare quality," said Helen Burstin, MD, MPH, senior vice president for performance measures at NQF. "These endorsed measures will have a significant impact on national patient safety efforts by helping providers measure, report on, and ultimately improve the care they deliver."
Falls and pressure ulcers are considered high-cost and high-volume adverse events. Falls are the leading cause of injury-related death for individuals aged 65 and older, and it is estimated that patient falls among the elderly will cost over $30 billion by 2020.1,2 Furthermore, there were 257,412 reported cases of Medicare patients who had a pressure ulcer as a secondary diagnosis during hospitalization in 2007, resulting in average healthcare costs of $43,180 per patient.
The measures include those that have been endorsed for at least three years and are now undergoing NQF endorsement maintenance. The ongoing evaluation and updating of endorsed measures ensures they are current, "best in class," address gaps in existing measures, are synchronistic with national priorities, and enhance NQF's patient safety portfolio. In all, 21 measures were submitted for evaluation against NQF's endorsement criteria. Twelve measures - including two new submissions - were endorsed.
"The U.S. healthcare system has made great strides in improving patient safety, yet too many patients still suffer preventable harm," said William A. Conway, MD, senior vice president and chief quality officer at Henry Ford Health System and co-chair of the Patient Safety - Complications steering committee. "These endorsed measures, addressing some of the most prevalent and devastating complications in care, will be critical to ensuring patients receive safe, compassionate, and high-quality care."
The endorsed measures include:
- 0035: Fall risk management (NCQA)
- 0101: Falls: screening, risk-assessment, and plan of care to prevent future falls (NCQA)
- 0266: Patient fall (Ambulatory Surgical Centers Quality Collaborative)
- 0537: Multifactor fall risk assessment conducted in patients 65 and older (CMS)
- 0538: Pressure ulcer prevention and care (CMS)
- 0337: Pressure ulcer rate (PDI 2) (AHRQ)
- 0347: Death rate in low-mortality diagnosis related groups (PSI 2)(AHRQ)
- 0204: Skill mix (Registered Nurse [RN], Licensed Vocational/Practical Nurse [LVN/LPN], Unlicensed Assistive Personnel [UAP], and contract)(American Nurses Association)
- 0205: Nursing hours per patient day (American Nurses Association)
- 0206: Practice Environment Scale - Nursing Work Index (PES-NWI) (composite and five subscales)(The Joint Commission)
- 1716: National Healthcare Safety Network (NHSN) facility-wide inpatient hospital-onset Methicillin-resistant Staphylococcus aureus (MRSA) bacteremia outcome measure (CDC)
- 1717: National Healthcare Safety Network (NHSN) facility-wide hospital-onset Clostridium difficile Infection (CDI) outcome measure (CDC)
With so much emphasis on hospital readmissions and transitions of care, measures that improve quality while reducing the risk of readmission and improving resident life certainly need to be looked at in your care plans.
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