In spring 2006 SHM leadership agreed that there was a need to develop a coordinated approach to working with external organizations in the performance and standards quality arena, while collaborating with public policy and educational efforts in this area. To this end, I was hired as the SHM Senior Advisor for Quality Standards and Compliance. At around the same time, leaders from the Public Policy Committee (PPC) and Health Quality Patient Safety (HQPS) Committee joined to form a Performance and Standards Task Force (PSTF).
Purpose of the Task Force
Chaired by Patrick Torcson, MD, the PSTF works with staff to monitor the performance and quality landscape at national organizations charged with the measure development and consensus-building processes, as well as to outreach and develop liaison relationships with other professional medical societies and organizations. Ultimately, the task force wants to create a performance framework unique to and reflective of hospitalists.
Since its inception in the late spring, the PSTF has had several meetings to discuss which organizations SHM should engage with and at what level. In several cases, task force members agreed that an official member liaison should be appointed to serve as SHM’s representative to a particular organization. This serves the purpose of having a clinical expert resource available to staff with regard to the particular activities of each organization, as well as to create a consistent and reliable “SHM face” for a particular organization.
Performance Measures
SHM joined the AMA Physician Consortium for Performance Improvement (PCPI), which works with medical specialty organizations to develop physician-level performance measures. As a new member of the PCPI, SHM submitted feedback during the public comment period on perioperative care measures, the development of which was led by the American College of Surgeons, along with input from other medical specialties. SHM also participated in two expert workgroups this past summer, one on emergency medicine, focusing on treating MI and pneumonia, and another on geriatrics, which focused on falls, urinary incontinence, advanced-care planning as part of end-of-life care, and medication reconciliation as part of care coordination. Both the geriatrics and the emergency medicine measures have been released for public comment. At least through 2006, the PCPI is focusing on measures that fall under the Centers for Medicare and Medicaid Services (CMS) contract and will be included in the Physician Voluntary Reporting Program (PVRP).
The PSTF is actively recruiting leaders to participate in expert workgroups that were convened in November for both outpatient parenteral antimicrobial therapy and anesthesiology topics: perioperative normothermia and critical care. The task force will continue to evaluate the PCPI workgroups to determine which ones it should appoint members to participate in, depending on the topic area.
SHM has also become an organizational member of the National Quality Forum (NQF), a nonprofit organization that Congress, in early July, charged with endorsing consensus-based national standards for measurement and public reporting of healthcare performance data. At around the same time, NQF was seeking nominations for members of the steering committee and technical advisory panels that will oversee the work on the development of new consensus standards for hospital care. This project, sponsored by the Agency for Healthcare Research and Quality (AHRQ), will address patient safety, pediatrics, and inpatient care. The Society hopes to be fully engaged in this initiative.
In mid-October, NQF will hold its 7th Annual Meeting, a National Policy Conference on Quality, at the Grand Hyatt in Washington, D.C. This meeting will feature plenary sessions that focus on issues at the forefront of policy discussions, including incentivizing healthcare quality improvement, the role of policymakers, ways to lead professional and trade associations in improving healthcare quality, and efforts presently underway in the federal government to foster healthcare improvements. Mark Williams, MD, editor in chief of the Journal of Hospital Medicine and SHM member, will attend the policy conference as the SHM representative.