The Opportunity

Serious illness is a condition that carries a high risk of mortality and either negatively affects a person’s daily function or quality of life, or excessively strains their caregivers.ⁱ Individuals with serious illness are often identified as those who would benefit from palliative care services.ⁱⁱ As more programs targeting the seriously ill are implemented, measuring quality is necessary to ensure the care provided to an individual meets their needs, aligns with their goals and preferences, and achieves the outcomes that are important to them and their loved ones. Existing quality measures represent a starting point for measuring quality for the seriously ill, but challenges related to measurement gaps and quality measure implementation persist.

Objectives

The NQF Serious Illness Initiative was guided by three objectives:

1. Advance quality measurement by identifying existing serious illness-related quality measures and developing recommendations for addressing measure gaps and overcoming measurement challenges.
   
   
2. Prepare providers to deliver high-quality care to the seriously ill and use quality measures to inform their delivery of care to the seriously ill.
   
   
3. Provide opportunities for expanding and enhancing stakeholder engagement with Initiative activities and other important activities within the field of serious illness.

NQF Process

To meet the Initiative’s objectives, NQF:

• Convened a Serious Illness Quality Measurement Committee. As part of the Serious Illness Quality Alignment Hub, the Committee’s charge was to (1) identify existing quality measures that can assess the quality of care delivered to seriously ill individuals and (2) recommend approaches for addressing measure gaps that exist within the field of serious illness.
  
  
• Hosted a series of Serious Illness Measurement Strategy Sessions. NQF hosted three measurement strategy sessions over the course of the Initiative. For each Strategy Session, a group of experts met in-person to examine a specific measure gap or challenge related to serious illness quality measurement. The group developed recommendations for addressing the measure gap or overcoming the measurement challenge. These recommendations will be published on the Serious Illness Quality Alignment Hub website and the NQF Serious Illness Initiative project page.
  
  
• Developed and released an Issue Brief focused on opportunities for advancing quality measurement in community-based serious illness care. The Issue Brief includes recommendations, preferred tools and approaches, and current measures available for use, in development, or proposed to fill measurement gaps, including several high-priority measure concepts addressing functional assessment and caregiver strain and resilience. The Issue Brief is published on the NQF Store.

Contact Information

For more information, please contact the Serious Illness Project Team at qualityinnovation@qualityforum.org.

Footnotes

ⁱ Kelley AS & Bollens-Lund E. (2018). Identifying the population with serious illness: The ‘”Denominator Challenge”. Journal of Palliative Medicine. 21 (S2), S-7-S-16
ⁱⁱKelley AS & Bollens-Lund E. (2018). Identifying the population with serious illness: The ‘”Denominator Challenge”. Journal of Palliative Medicine. 21 (S2), S-7-S-16