Student Nurse Laura

Orem – "creative effort of one human being to help another human being."

ANA Needs your help this week

Posted by Laura on January 8, 2015

Re-post from Tricia Hunter American Nurses Association\California

In December, ANA made significant progress in an effort to add nurse staffing and skill mix along with falls and falls with injury measures to Hospital Compare, CMS’s public reporting and pay for quality site.  This would be the first time that nursing measures would be included on a national public reporting site.  ANA is expecting significant opposition as this moves forward through the NQF and CMS’ Federal Register process.  We need a strong nursing presence during the upcoming NQF comment period.  Please help by submitting comments as noted below! 

ACTION REQUESTED:  Submit comments to NQF’s Measure Application Partnership (MAP) to Improve Patient Safety Outcomes and Transparent Reporting

The deadline for submitting comments is close of business on 1/13/15.

Comments should focus on supporting all four critical NQF-endorsed nursing-sensitive safety measures (nurse staffing, skill mix, falls, and falls with injury).

 

Process

To help support your submission, ANA has drafted the following text that can be personalized to your organization and members for submission.  Please note that there are report errors that need correction prior to the MAP Coordinating Committee meeting scheduled for 1/26-27. Thus, the need for detailed comments.  Please note that you can divide up your comments in the provided comment areas (e.g., General Comments) for each report if you reach the maximum character limits in any one topic area.  For example, you can simply note you are continuing comments in the additional topic areas if you reach the character limits in any one section.

 

  • Nurse Staffing and Skill Mix
    • Enter the following comments into this link for the MAP 2014-2015 Preliminary Recommendations (XLS)  – Measures Voting Results Excel Report at this link:  COMMENT on Recommendations through January 13, 6:00pm
      • The (Organization name) supports the Hospital Workgroup (WG) vote of “conditional support” of the NQF-endorsed measures nurse staffing and skill mix and requests MAP report corrections
      • The MAP report should be amended to accurately reflect the MAP Hospital WG vote that identified only one “condition”, NQF endorsement at the hospital-level reporting, be met
        • Majority of the workgroup (73% vote) for “conditional support” only related to one condition, NQF-endorsement for hospital-level reporting
        • Other conditions listed in the MAP report were not agreed upon by the Hospital Workgroup during voting majority, are incorrectly listed as conditions to be met and should be removed
    • Enter the following comments on the Draft Programmatic Deliverable Report (PDF) – Text Report by Programs at this link: COMMENT ON REPORTthrough January 13, 6:00pm
      • The (Organization name) supports the Hospital Workgroup vote of “conditional support” of the NQF-endorsed measures nurse staffing and skill mix
      • These are high impact safety measures
        • Two decades of research has provided evidence that better nurse staffing and skill mix is associated with lower patient harm rates (e.g., death, falls, infections, pressure ulcers etc.)
        • Wide variance in nurse staffing continues, particularly in medical surgical units
      • The MAP Hospital WG discussion should be reflected accurately by amending the MAP draft report
        • Parsimony and lack of importance of structural measures for inclusion were rejected by the Hospital WG as reasons to exclude these measures with the required majority vote
          • NQF MAP suggested vote and rationale of “Do Not Support” were rejected by the WG
          • MAP’s Measure Selection Criteria includes structural measures to achieve the right mix of high impact measures for accountability
      • The MAP report should also be amended to reflect the broad Hospital WG support for these measures
        • Members noted these measures are essential to improve patient safety and to inform consumers, purchasers and other stakeholders
        • Both co-chairs supported these measures as a floor of safety to transparently report
      • Data is low burden and is already collected by hospitals
  • Falls and Falls with Injury –
    • Enter the following comments into this link for the MAP 2014-2015 Preliminary Recommendations (XLS)  – Measures Voting Results Excel Report at this link:  COMMENT on Recommendations through January 13, 6:00pm
      • The (Organization name) supports the Hospital Workgroup (WG) vote of “conditional support” of the NQF-endorsed measures falls and falls with injury and requests MAP report corrections
      • The MAP report should be amended to reflect the Hospital WG vote accurately to reflect the following
          • The only condition identified by the MAP Hospital WG by the majority vote was NQF-endorsement for hospital-level reporting
          • CMS noted that CMS and AHRQ do not consider the measures as duplicative to any existing measure (no harmonization issue exists)
          • The Hospital WG did not identify under-reporting related to falls with injury
          • Under-reporting was not an agreed upon condition for the falls rate measure
    • Enter the following comments on the Draft Programmatic Deliverable Report (PDF) – Text Report by Programs at this link: COMMENT ON REPORTthrough January 13, 6:00pm
      • The (Organization name) supports the Hospital Workgroup (WG) vote of “conditional support” of the NQF-endorsed measures falls and falls with injury
      • The MAP report should be amended to reflect the broad Hospital WG majority support (73% vote for “conditional support”) for these measures
        • Both these safety outcome measures are critical to improving patient safety
        • They Fill a serious gap in falls measures on Hospital Compare that consumer, purchasers, ANA and other stakeholders have noted
        • Are superior to claims based measures because they are
          • Not subject to known coding issues (server under-reporting with claims driven metrics) and allow for timely reporting
          • Clinically enriched (e.g., clinical assessment data used)
          • Don’t have harmonization issues with other measures per CMS and AHRQ and fill a gap 

BACKGROUND:

  • NQF-convened MAP reviews measures submitted by CMS for prioritization for CMS’s public reporting and pay for quality programs as well as identifies high impact measure gap areas
  • MAP Hospital Workgroup voted “conditional support” for inclusion all four measures in the CMS Inpatient Quality Reporting Program (i.e., public reporting on Hospital Compare)
    • These are the First nursing sensitive measures from the NQF-endorsed Nursing-Sensitive Safety Set of 15 to be advanced by the MAP Hospital Workgroup for CMS’s Inpatient Quality Reporting (IQR) Program (Hospital Compare)
      • Comments are importance since the  MAP Coordinating Committee will review the Workgroup preliminary voting 1/26-27/15 in light of submitted comments to the MAP.

 

THANK YOU for your support of this important effort.

Honorable Tricia Hunter, RN, MN
1121 L Street Suite 508
Sacramento, CA 95814
916-447-0225
916-837-1620 Cell
858-225-0227 Personal Fax

Sorry, the comment form is closed at this time.