Implications for Quality Care in Healthcare
The implementation of quality initiatives to ensure quality healthcare services that foster public disclosure and accountability is one of the Centers for Medicare and Medicaid Services (CMS) priorities. CMS uses quality measures in several quality initiatives, including quality improvement, public reporting, and pay-for-reporting. Quality measures, in this context, refer to tools that aid in measuring and quantifying processes, patient perceptions, outcomes, and healthcare organization systems/structures, all of which are associated with a healthcare organization’s ability to provide high-quality care and relay several quality goals. The objectives are to provide care that is effective, equitable, efficient, patient-centered, safe, and timely. The CMS uses quality measures to improve quality, public reporting, and payments for reporting programs at certain healthcare institutions[Cen17].
The National Quality Forum (NQF), which is supported by CMS, is dedicated to improving healthcare quality through the use of health information technology (IT). When electronic health records (EHRs) and other clinical IT systems capture data required for performance measurement and use this data interchangeably with all IT systems, care services become more affordable, safer, and more harmonized. The data collected is based on performance standards and is used to improve quality healthcare in ways such as public reporting, in which healthcare systems must report their results to external bodies such as federal and state agencies in a standard format. Consumers can then compare these results based on performance metrics. Performance levels determine to pay for healthcare institutions. NQF’s initiatives in health information technology span several distinct but interconnected areas of interest, with the goal of improving an electronic environment based on these ideals and, more importantly, assisting clinicians in improving patient care services. The NQF measures seek to establish and promote accuracy and consistency in the set of values known as electronic clinical quality measures (eCQM). NQF creates a report that offers a broad context for the evaluation of HIT security measurement efforts and practices by bridging the gap between health information technology and patient safety[Nat14].
The National Quality Forum (NQF) established a Health Information Technology Expert Panel (HITEP), which developed nine recommendations concerning standardized EHR data measures[Nat17]. Electronic measures (measures) are standardized performance measures in electronic formats. eMeasures aid in the measurement of improvement and the comparison of performance results. They provide precise requirements for data collection, which drives standardization along the measures and improved self-assurance in comparison of provider performance and outcomes. NQF was mandated by the Department of Human and Health Services to retool 113 quality care measures from paper to eMeasure format. These were first made public in 2010, with 44 of them appearing in the CMS’s Electronic Health Record Incentive Program Final Rule in July 2010. The National Quality Forum released a Measure Authoring Tool (MAT), a web-based tool that allows measure designers to create consistent measures for use across Electronic Health Records Systems and other Information Technology systems. eMeasures developed in collaboration with the MAT are part of a more efficient ERH system. The endorsement maintenance process, which includes three-year annual updates and maintenance reviews, is used to update measures.
References
Centers for Medicare and Medicaid Services. (2017, August 22). Quality Measures. Retrieved from CMS.gov: https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment- Instruments/QualityMeasures/index.html?redirect=/QUALITYMEASURES/
National Quality Forum. (2014). Health Information Technology. Retrieved from National Quality Forum: http://www.qualityforum.org/Health_Information_Technology.aspx
National Quality Forum. (2017). Electronic Quality Measures (eMeasures). Retrieved from National Quality Forum: http://www.qualityforum.org/Projects/e- g/eMeasures/Electronic_Quality_Measures_%28eMeasures%29.aspx
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Question
The Centers for Medicare & Medicaid Services (CMS) formed its no-pay policy based on the growing work of the National Quality Forum (NQF) of “never events.” Meaning, that CMS will no longer pay for certain conditions that result from what might be termed poor practice or events that should never have occurred while a patient was under the care of a healthcare professional.
Discuss specific examples of “never events” and their impact on your workplace.
What issues are you considering for your clinical project and why?