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Seven FOTO Functional Status Measures Endorsed by National Quality Forum (NQF)


Standards emphasize measurement gaps and harmonization

Washington, DC – To fill gaps in assessing clinician performance that can promote higher quality health care, the National Quality Forum (NQF) has endorsed 67 clinician–level consensus standards relating to cancer care, infectious diseases, perioperative care, and care provided by thousands of medical professionals who are not MDs, but provide critical services. NQF also endorsed four facility–level measures in surgery and anesthesia, 17 measures addressing prevention and management of stroke across the continuum of care, and three measures for influenza and pneumococcal immunizations, a total of 91 consensus standards.

Nonphysician Professionals

Providing high–level health care requires a multidisciplinary approach. Yet consensus standards endorsed to date have mainly targeted traditional physician practices. Fifteen new NQF–endorsed voluntary consensus standards measure care at a clinician level for non–physician professionals, including podiatrists, clinical social workers, clinical psychologists, dieticians/nutritionists, physical therapists, occupational therapists, and speech–language pathologists.

Anne Deutsch, a clinical research scientist at the Rehabilitation Institute of Chicago, and Carol Wilhoit, MD, quality improvement medical director at Blue Cross Blue Shield of Illinois, co–chaired NQF’s steering committee for clinician–level measures for non–physician professionals.

“NQF endorsement of these measures is important, because patients’ healthcare needs are frequently complex and require treatment from an interdisciplinary team of health care professionals,” said Deutsch. “NQF endorsement of these non–physician measures is an important step forward in performance measurement and public reporting.”

These measures include diabetic foot and ankle care, depression screening and follow–up, current medication verification, pain assessment and follow–up, weight screening and follow–up, and functional status. The measures are evidence–based and have been used to measure quality for many years, but many have not been used as clinician–level performance measures.

“For health plans, NQF–endorsed indicators provide a framework that can be used for measuring performance and then collaborating with providers to improve care,” said Wilhoit. “The new NQF–endorsed measures for non–physician professionals will help expand these activities to a broader group of medical professionals.”

Measures were developed by the American Podiatric Medical Association, Boston University, Centers for Medicare & Medicaid Services, Focus On Therapeutic Outcomes, and Quality Insights of Pennsylvania.

Clinician–Level Nonphysician Professionals Measures Endorsed By NQF

  • Diabetic foot & ankle care, ulcer prevention — evaluation of footwear*
  • Diabetic foot & ankle care, peripheral neuropathy — neurological evaluation*
  • Screening for clinical depression and follow–up*
  • Universal documentation and verification of current medications in the medical record*
  • Pain assessment prior to initiation of patient therapy and follow–up*
  • Adult weight screening and follow–up*
  • Functional status change for patients with knee impairments*
  • Functional status change for patients with hip impairments*
  • Functional status change for patients with foot/ankle impairments*
  • Functional status change for patients with lumbar spine impairments*
  • Functional status change for patients with shoulder impairments*
  • Functional status change for patients with elbow, wrist, or hand impairments*
  • Functional status change for patients with general orthopedic impairments*
  • Change in basic mobility*
  • Change in daily activities*

* Time–limited + Paired

The mission of the National Quality Forum is to improve the quality of American healthcare by setting national priorities and goals for performance improvement, endorsing national consensus standards for measuring and publicly reporting on performance, and promoting the attainment of national goals through education and outreach programs. NQF, a non–profit organization (www.qualityforum.org ) with diverse stakeholders across the public and private health sectors, was established in 1999 and is based in Washington, DC.

Visit the NQF website at www.qualityforum.org to read the full specifications for all of the new NQF-endorsed voluntary consensus standards and read NQF’s research recommendations.