In an attempt to gain in-depth feedback about the most commonly used performance measures around the country, the National Quality Forum (NQF) recently contracted with the RAND Corporation to conduct an independent study of healthcare end-users to better understand how these measures are being used and more importantly, how to improve the systems and processes responsible for the reporting of these measures.
To conduct their research, RAND surveyed 70 healthcare end-users (i.e. hospitals, physicians and health plans) over a six month period.
The study divided the use of performance measures into four categories: 1) public reporting, 2) quality improvement (QI), 3) payment applications, and 4) accreditation, certification, credentialing, or licensure. The most commonly reported uses of the NQF endorsed measures were QI at 69% followed by public reporting requirements at 64%. Conversely, uses for payment and accreditation, certification, credentialing, or licensure were much less used at 33% and 16% respectively.
The study revealed that the single most important factor cited as either facilitating or impeding the use of measures was the “availability of data to construct performance measures”. Factors noted for impeding the use of the NQF endorsed measures were lack of measure prioritization across all reporting agencies often resulting in “measure fatigue” due to lack of alignment. End users also noted lack of timely data, the cost of measurement, and the challenge of measuring individual physician performance as additional barriers to effectively using the performance measures.
Many end-users cited the increasing use of electronic health records (EHRs) as a better means to improve the efficiency and effectiveness of capturing and reporting these important measures yet few reported that they had conducted formal studies of their own to document the results or R.O.I. on the use of their measures.
“I’m pleased to see this sort of formal monitoring conducted by the NQF,” said Hugh Morgan, director of quality assurance for Somnia, Inc. “It clearly shows their commitment to the basic QI principle that we can only improve upon what we can measure.
“This study is a solid first attempt by the NQF to help us all better understand how and why we have been using the vast array of performance measures so that hopefully the agencies responsible for the measures will better align and prioritize the measures for more relevant and value-add purposes.”