Review of the National Quality Forum's Measure Endorsement Process

Area of Science:

• Healthcare quality measurement
• Health services research
• Performance assessment

Background:

• The National Quality Forum (NQF) is a key organization for evaluating healthcare performance measures.
• Endorsement by the NQF signifies that a measure meets rigorous standards for healthcare quality assessment.

Purpose of the Study:

• To analyze the characteristics and evaluation criteria of healthcare performance measures reviewed by the NQF.
• To identify trends in measure stewardship, classification, and statistical methods used.
• To assess the extent of stakeholder involvement and the rigor of validity and reliability testing.

Main Methods:

• Data extraction from NQF technical reports (Spring 2018 - Spring 2019).
• Analysis of measure characteristics: stewardship, maintenance status, classification (outcome/process), and risk adjustment methods.
• Review of evaluation criteria, including validity and reliability testing approaches and committee member support levels.

Main Results:

• Most measures were stewarded by federal agencies, evaluated for maintenance, and classified as outcome or process measures.
• A majority of measures utilized statistical models for risk adjustment, and patient advocates were present on most reviewing committees.
• While 91.56% of measures were endorsed, committee members often provided moderate support for critical criteria like validity, reliability, and feasibility.

Conclusions:

• The NQF's Consensus Development Process involves diverse input and thorough evaluation.
• There is a need for enhanced methods to ensure measure reliability and validity.
• Further research should focus on representative stakeholder input and incorporating social factors into risk adjustment.