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Quality Forum Recommends Measurements on Cancer, Care Coordination, and Disparities

By Rebecca Adams, CQ HealthBeat Associate Editor

August 10, 2012 -- The National Quality Forum recently endorsed several quality measures on cancer treatment, care coordination, and health care disparities. The standards on disparities are the first comprehensive set of measures targeting the problem of health disparities among different populations.

The forum is a voluntary consensus standards-setting organization. Medicare officials consider NQF-endorsed measures when setting federal policies.

Individuals or groups that disagree with any of the standards can request reconsideration of them by submitting an appeal no later than Sept. 10.

The organization decided to take on the issue of racial and ethnic disparities in the wake of research from the Institute of Medicine that shows that minorities often get lower quality care than white patients. That problem is worsened by the fact that minorities often have a harder time getting care and are not as well-versed in health conditions and treatments as white people. NQF officials said they got a grant from the Robert Wood Johnson Foundation in February 2011 to think about structuring quality measures that would affect health care disparities between different groups of people.

The group considered 16 measures and ended up endorsing 12 of them.

"Measures evaluating patient engagement and experience are essential to eliminating disparities and supporting culturally competent care for all patients," said Denice Cora-Bramble, professor of pediatrics at The George Washington University and co-chair of the Healthcare Disparities and Cultural Competency Steering Committee. "These measures will give providers the tools they need to support the high-quality care that all patients deserve."

The standards are evaluations of actions that include efforts to increase patients' health literacy, ensure that patients who have trouble speaking English get translations of information they need to make medical decisions, and that medical professionals communicate with patients in ways that respect cultural differences.

"Accurate and meaningful metrics to measure care quality for populations adversely affected by disparities are critically needed," said Laura J. Miller, the interim CEO of NQF. "These endorsed measures will be instrumental in promoting equitable, high-quality and compassionate care for all populations across the health care delivery system."

For cancer care, the NQF released 22 standards that build on previous recommendations. They are focused on specific conditions, such as leukemia and prostate cancer, and also on issues that affect care, such as radiation dose limits, hospice readmissions and care planning.

"Cancer care is often complex, with many patients facing complicated treatment regimens, individualized therapies, and rapidly changing evidence for existing treatments," said Stephen Lutz, radiation oncologist at Blanchard Valley Regional Cancer Center and chair of the Cancer Steering Committee. "This measure set will help address those complexities and promote the delivery of high-quality cancer care."

NQF also endorsed 12 measures that evaluate the coordination of care among medical professionals. The metrics assess issues such as reconciling patients' medications, establishing advance care plans and the ability of patients and caregivers medical records when patients leave hospitals and other in-patient facilities.

"Care coordination is essential to reducing medical errors, wasteful spending and unnecessary pain and procedures for patients," said Miller, the interim CEO of NQF. "We are pleased to endorse this set of measures that will help providers deliver safer, coordinated, and higher-quality care to patients."

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