H. Quality/Satisfaction

V. Key Issues: Population Health >> H. Quality/Satisfaction


Topic Outline

1. Medical errors
2. Patient safety
3. Quality measurement
     a. Structure
     b. Process
     c. Outcomes
4. Quality improvement
     a. General approaches
          1. Evidence-Based Medicine
          2. Pay-for-Performance
          3. Disease Management
          4. Medical Homes

     b.  Health plan quality
     c.  Hospital quality
     d.  Physician quality
     e.  Nursing home quality
      f.  Pharmaceutical quality



Hospital Quality Alliance (HQA)In December 2002, the organizations representing America’s hospitals joined with consumer representatives, physician and nursing organizations, employers and payers, oversight organizations and government agencies to launch the Hospital Quality Alliance (HQA). The HQA is a national public-private collaboration that is committed to making meaningful, relevant, and easily understood information about hospital performance accessible to the public and to informing and encouraging efforts to improve quality. A cornerstone of its collaboration is the Hospital Compare website which publicly reports hospital performance in a consistent, unified manner to ensure the availability of credible information about the care delivered in the nation’s hospitals. The HQA, is committed to expanding Hospital Compare, which is updated quarterly, to include additional measures that will help consumers assess hospital quality and value and make informed decisions about their care. For a list of measures adopted by HQA, please click here.

The Joint CommissionThe Joint Commission seeks to continuously improve health care for the public, in collaboration with other stakeholders, by evaluating health care organizations and inspiring them to excel in providing safe and effective care of the highest quality and value. The Joint Commission evaluates and accredits more than 17,000 health care organizations and programs in the United States. An independent, not-for-profit organization, The Joint Commission is the nation’s oldest and largest standards-setting and accrediting body in health care. To earn and maintain The Joint Commission’s Gold Seal of Approval™, an organization must undergo an on-site survey by a Joint Commission survey team at least every three years.

National Committee for Quality Assurance (NCQA)Since its founding in 1990, NCQA, as a health plan accreditation organization, has been a central figure in driving improvement throughout the health care system, helping to elevate the issue of health care quality to the top of the national agenda. NCQA’s programs and services reflect a straightforward formula for improvement: Measure; Analyze; Improve; Repeat. NCQA makes this process possible in health care by developing quality standards and performance measures for a broad range of health care entities. These measures and standards are the tools that organizations and individuals can use to identify opportunities for improvement.  Today, accredited health plans face a rigorous set of more than 60 standards and must report on their performance in more than 40 areas in order to earn NCQA’s seal of approval. These standards promote the adoption of strategies that we believe will improve care, enhance service and reduce costs, such as paying providers based on performance, leveraging the Web to give consumers more information, disease management and physician-level measurement.

National Quality Forum (NQF)NQF is a multi-stakeholder organization comprised of more than 350 organizations representing consumers, purchasers, health care professionals, providers, health systems, insurers, state governments, and federal agencies. NQF is playing an increasingly important role in evaluating, endorsing and promulgating quality performance measures. In July 2008, Congress overturned a Presidential veto to make law the “Medicare Improvement for Patients and Providers Act of 2008,” which among other things establishes the National Quality Forum as the “gold standard” for measures to be used under Medicare’s Physician Quality Reporting Initiative (PQRI).

Patient-Centered Primary Care Collaborative PCPCCThe Patient-Centered Primary Care Collaborative is a coalition of major employers, consumer groups, and other stakeholders who have joined with organizations representing primary care physicians to develop and advance the patient-centered medical home. The Collaborative believes that, if implemented, the patient-centered medical home will improve the health of patients and the viability of the health care delivery system. NBCH currently serves on the Collaborative’s Advisory Board and also has been working with the Collaborative and the National Business Group on Health to develop guides for employers of all sizes to begin integrating the medical home model into their plans with health benefit companies. The final product is the Health Benefits Purchaser Guide.

Quality Alliance Steering Committee (QASC)QASC, formed in 2006, is a collaborative effort among existing quality alliances (AQA & HQA), government, physicians, nurses, hospitals, health insurers, consumers, accrediting agencies and foundations to dramatically improve the quality of health care across the U.S. Together, all of these stakeholders are working to ensure that quality measures are constructed and reported in a clear and consistent way that informs both consumer and employer decision-making, as well as the efforts of practitioners to improve. Many different private- and public-sector groups have designed models for assessing performance and reporting data. QASC helps to harmonize all of these various initiatives and to build the initial components of an infrastructure to collect health care quality and cost data nationwide.

URACURAC works to promote continuous improvement in the quality and efficiency of health care management through processes of accreditation and education. As an independent, nonprofit organization, URAC is a well-established leader in promoting health care quality through its accreditation and certification programs. URAC offers a wide range of quality benchmarking programs and services that keep pace with the rapid changes in the health care system, and provide a symbol of excellence for organizations to validate their commitment to quality and accountability. Through its broad-based governance structure and an inclusive standards development process, URAC ensures that all stakeholders are represented in establishing meaningful quality measures for the entire health care industry.





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