About this Review
Requestor of Ad hoc Review
Kidney Care Partners (KCP)
Justification for Ad hoc Review
Criterion 2: KCP has requested an ad hoc review, asserting that implementation of the measure will result in unintended consequences.
0255: Measurement of Serum Phosphorus Concentration
The measure as endorsed calls for monthly measurement of serum phosphorus and the request is to amend the measure specifications to allow for either serum or plasma phosphorus. KCP contends that testing plasma phosphorus concentration is an acceptable alternative to serum phosphorus therefore, performance scores of facilities using plasma testing could inappropriately indicate lower quality.
Although KCP cited unintended consequences as the reason for the request, their position is based on the assertion that plasma testing of phosphorus is an acceptable alternative to serum phosphorus. Therefore, the ad hoc review will necessarily focus on the evidence in regards to plasma testing of phosphorus and NQF’s measure evaluation criteria and guidance for evaluating the evidence for a performance measure will apply.
Associated NQF Project
National Voluntary Consensus Standards for Renal Disease
Reason for Request
An ad hoc review may be conducted on an endorsed measure, practice, or event at any time with adequate justification to substantiate the review. Requests for ad hoc reviews will be considered by NQF on a case-by-case basis and must be justified by one or more of the following specific criteria:
- the evidence supporting the measure, practice or event has changed and it no longer reflects updated evidence,
- there is evidence that implementation of the measure or practice may result in unintended consequences:
- Use of the measure or practice may result in inappropriate or harmful care
- Measure performance scores may yield invalid conclusions about quality of care (e.g., misclassification or incorrect representation of quality)
- material changes have been made to a currently endorsed measure.
Ad hoc reviews can be requested at any time by any party, as long as there is adequate evidence to justify the review.
Process
Requests for ad hoc reviews will be considered by NQF on a case-by-case basis and must be justified by specific criteria. NQF staff review suggests that an ad hoc review is:
A notice of ad hoc review is posted to the NQF web site. NQF will solicit technical experts from previously convened committees and if necessary a call for nominations for experts will be open for no less than 10 business days. The provisional slate of technical advisors will be posted for comment for no less than 10 business days. The selected technical advisors will review the evidence and provide input to the Consensus Standards Approval Committee (CSAC). The ad hoc review requestor and the measure steward are given the opportunity to provide information to the technical advisors and CSAC. Review and comment period for the draft recommendations from the technical advisors will be posted for no less than 10 business days. Review and comment period for the draft recommendations from the technical advisors will be posted for no less than 10 business days. The information will be forwarded to the CSAC (including the assessment of the technical advisors, public and member comments, and input from the measure steward and requester) and CSAC will make a decision on endorsement status and/or specification changes. The CSAC decision is then forwarded to the NQF Board of Directors for ratification followed by a 30-day appeals period. The measures will be subject to a full evaluation/review in its designated maintenance cycle.
Learn more about the NQF ad hoc review process.
Contact Information
For more information, please contact Karen Pace, Ph.D or Ashley Morsell, MPH at 202-783-1300 or via email at measuremaintenance@qualityforum.org.