NQF-endorsed measures promote quality care for elderly and acutely ill patients

The National Quality Forum (NQF) has endorsed 12 new quality measures for palliative and end-of-life care.

“As the number of palliative and end-of-life care programs continue to grow across the country, it’s critical that providers have the right measurement tools to help ensure patients receive safe, high-quality and compassionate care,” said June Lunney, in a statement announcing the measures. Lunney serves as the director of research at the Hospice and Palliative Nurses Association and as co-chair of the Palliative Care and End-of-Life Care Endorsement Maintenance Steering Committee at NQF.

The endorsed measures define 12 new measures and two previously endorsed measures. The measures cover pain management, psychosocial needs, care transitions and experiences of care, and include:

  • 1634: Hospice and Palliative Care -- Pain Screening (paired with measure 1637)
  • 1637: Hospice and Palliative Care – Pain Assessment (paired with measure 1634)
  • 1617: Patients treated with an opioid who are given a bowel regimen
  • 1628: Patients with advanced cancer assessed for pain at outpatient visits
  • 1638: Hospice and Palliative Care -- Dyspnea Treatment (paired with measure 1639)
  • 1639: Hospice and Palliative Care – Dyspnea Screening (paired with measure 1638)
  • 1626: Patients admitted to the ICU who have care preferences documented
  • 1641: Hospice and Palliative Care -- Treatment Preferences
  • 1647: Percentage of hospice patients with documentation in the clinical record of a discussion of spiritual/religious concerns or documentation that the patient/caregiver did not want to discuss
  • 0209: Comfortable dying (maintenance)
  • 1625: Hospitalized patients who die an expected death with an ICD that has been deactivated
  • 0208: Family Evaluation of Hospice Care (maintenance)
  • 1632: CARE -- Consumer Assessments and Reports of End of Life
  • 1623: Bereaved Family Survey

“As the number of older adults in this country continues to grow, palliative and end-of-life care services are needed more than ever,” said Janet Corrigan, president and CEO of NQF, in a statement. “This set of measures will help promote the type of high-quality care older people and acutely ill patients deserve.”

For this project, NQF officials said they sought measures focused on care concerns such as managing pain, weight loss and depression. They also sought measures that would directly assess – and improve over time – the experience of patients undergoing palliative and end-of- life care, as well as the experience of their families.

In all, 22 measures were evaluated against NQF's endorsement criteria by a panel of providers, measurement experts and consumer representatives; 14 measures (including 12 new measures) were endorsed.

Because NQF is a voluntary consensus standards-setting organization, officials of the organization said anyone can request a re-evaluation of the endorsed measures by submitting an appeal to NQF by March 14.

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