Adding to the mix, the AQA Alliance, formerly the Ambulatory Care Quality Alliance, announced it had adopted 31 new surgical and medical quality measures. That brings the total number up to 80 approved by the AQA.
The flurry of activity from various quality improvement organizations underscored a healthcare-heavy week in Washington, where Congress returned with a new majority set to take over in January that promised healthcare reforms, and where Leavitt asked for and received the backing of the countrys largest employers to help force change in the way people seek and receive care.
But even though the quality movement has matured and gotten bigger over the years, patients trust in the healthcare system continued to wane. According to an annual Harris Interactive poll, U.S. adults who perceive hospitals as generally trustworthy and honest fell to 28%, down from 34% in 2005.
Melissa Stegun, a project director with NQF who worked on its expanded list of adverse events, said that the development of measures is a balancing act, where everything from current scientific practices, real-world experience and the patients perspective combine to shape the goal. Quality experts then have to ensure that those goals are achievable and set high enough to really improve healthcare for all Americans.
In the update to its never event list, the NQF added just one new item: artificial insemination with the wrong donor sperm or donor egg. It made marginal changes to six others, but left most of them alone. All told, there are 28 adverse events on the NQF list that are serious, largely preventable and of concern to both the public and healthcare providers for the purpose of public accountability. The NQF also expanded its medication error measure to include drugs that trigger a known patient allergy, Stegun said.
In lockstep with the NQF list, the Leapfrog Group, which counts employers in and out of the healthcare sector as members, said it would ask its membership to follow set criteria if and when major adverse events occur. Through its survey of hospital quality and safety, the Leapfrog Group wants hospitals to apologize to the patient or family, report the event, perform a root-cause analysis and waive costs.
And Leavitt last week reinforced his call for a multipronged effort by patients, large private employers, the federal government and hospitals and physicians to more efficiently change how healthcare is delivered. Leavitt, who addressed the influential Business Roundtable, outlined what he called four cornerstones to a value-based healthcare systemone where patients are rewarded for seeking out quality and cost information, and physicians can track patient care electronically.
The four cornerstones are interoperable records, quality measures, price information and positive incentives.