National Voluntary Consensus Standards for Developing a Framework for Measuring Quality for Prevention and Management of Pressure Ulcers
Access the Final Report: National Voluntary Consensus Standards for Developing a Framework for Measuring Quality for Prevention and Management of Pressure Ulcers
The Opportunity
Quality measurement organizations have worked to reduce the prevalence of pressure ulcers in nursing homes, home health, and nursing-sensitive hospital measurement. To date, NQF has endorsed six measures addressing pressure ulcers. The measures use a variety of definitions, specifications, staging, and timeframes such that the results are not comparable among settings of care or for a single patient that moves to different care settings.
However, to understand the impact of pressure ulcers across populations, quality measures addressing prevention, incidence, and prevalence of pressure ulcers must be harmonized and aligned. Establishing this framework requires collaboration among measure developers and other interested stakeholders.
Statistics
Pressure ulcers are both high-cost and high-volume adverse events. In 2006, there were 322,946 reported cases of Medicare patients with a pressure ulcer as a secondary diagnosis—each case had an average charge of $40,381 for an annual total cost of $13 billion.1
About the Project
This project was initiated in October 2008.
ObjectivesIn this project, NQF will perform an environmental scan of performance measures and of evaluation tools pertaining to pressure ulcers in all healthcare settings. In addition, NQF will seek to develop a framework that addresses 1) preventing and healing pressure ulcers; 2) measuring the incidence and prevalence of pressure ulcers and the pros and cons of both; 3) performing analysis at multiple levels, including providers, systems, communities, and geographical areas; 4) determining accountability as the patient moves across settings of care, i.e., present on admission, etc.; 5) measuring and staging of pressure ulcers, including temporarily “unstageable” and scoring systems; 6) multiple lesions and deep tissue injury in evolution; and 7) harmonizing measure specifications across settings of care.
Process
This NQF project, like all consensus development projects, will be conducted according to NQF's Consensus Development Process (version 1.8). The project will be guided by a steering committee.
Funding
Funding for this project has been provided by the Centers for Medicare & Medicaid Services.
Contact Information
For more information, contact Melissa Mariñelarena, RN, BSN, MPA at 202-783-1300 or pressureulcer@qualityforum.org
Notes
- Association of periOperative Registered Nurses, Skin Integrity. Available at www.skinintegrity.com/pdf/WhyItMatters.pdf.
In this project, NQF will perform an environmental scan of performance measures and of evaluation tools pertaining to pressure ulcers in all healthcare settings. NQF will also propose a framework that aligns the existing quality measures.
The project Steering Committee, 18-20 members with technical expertise in the area of pressure ulcer management as well as quality measurement and improvement, consumers and purchasers, was formed following the process set forth in NQF’s Consensus Development Process.
Steering Committee Roster
For additional information on the Steering Committee formation process, please refer to the Call for Nominations documents.
Call for Nominations (PDF)
Nomination Form (PDF)
The Steering Committee met in person and by conference call between December 2008 and February 2009. They analyzed the results of the environmental scan, and identified quality measures and other instruments that evaluate pressure ulcers in health care settings. Then the committee began drafting a framework, independent of health care setting, for measuring pressure ulcer care.
Meeting summaries
Draft Framework
The steering committee met via conference call on June 25, 2009.
Agenda
The member voting period closed on December 15, 2009.
For more information related to this project, please review the full project details.
The CSAC decided to move forward and recommend the framework to the Board.
The public had 30 days to appeal the final decision to endorse a voluntary consensus standard. Any party could have requested reconsideration of the recommendations, in whole or in part, by notifying NQF by November 9, 2011. The appeals period is now closed.
