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National Quality Forum

Health Care

Company News: NQF Endorses Framework for Public Reporting of Patient Safety Events

Framework provides seven guidelines for reporting safety events and health care errors

Published: Sunday, October 10, 2010 - 09:38

(National Quality Forum: Washington, D.C.) -- To improve health care safety, the National Quality Forum (NQF) has endorsed a framework for the public reporting of patient safety events. The framework provides guidance that will standardize an approach to capture and present information about a range of adverse events, from infections and medical complications to errors and accidents during the care process. The goal is to improve health care quality and safety through clear, easy-to-use public reports for consumers, providers, and health care systems.

“Clear, focused, consumer-oriented public reporting of safety events is vital to truly improve the safety of patient care,” says Janet Corrigan, NQF president and CEO. “This framework helps us focus not only on what should be reported, but also on how it should be reported. Collecting safety data isn’t enough—it also needs to be compiled and presented in a way that helps consumers make informed decisions about their care and helps clinicians and health care systems learn from their experiences.”

The framework provides seven guidelines that address issues to consider in patient safety-event reporting such as how to convey low-frequency events, ways to protect patient confidentiality when reporting errors, and guidance on using data from trusted sources. The framework also offers guidance on designing and implementing public reports and provides strategies for displaying publicly reported data in a consumer-friendly way. Specific guidelines address the measures used in a public report, for example, measures used in a report should be meaningful to consumers, have transparent methodology, and meet rigorous, widely accepted criteria.

NQF’s Steering Committee on Public Reporting of Patient Safety Event Information was co-chaired by Dr. Eliot Lazar, vice president and chief quality officer at New York Presbyterian Healthcare System; and Ann Monroe, president of the Community Health Foundation of Western and Central New York.

“The framework and guidelines provide important steps in providing meaningful and relevant information to assist patients in making informed decisions about their health care and give providers important information about the care they provide,” says Lazar.

“While consumers use a wide range of health information, they especially value information about how well health care organizations perform on improving patient safety and reducing adverse events,” says Monroe. “This framework provides guidance on how to communicate the complexity of these important data, and how to portray sensitive data in an informative and accurate way. It also provides context for consumers to better understand safety events, medical errors, and the quality of care they receive.”

The endorsed framework builds on NQF’s previous endorsement of guidelines for reporting the quality of hospital care and works in concert with NQF’s ongoing work to improve safety in health care, which includes maintaining safe practices, documenting serious reportable events, and endorsing additional patient safety measures.

NQF is a voluntary consensus standards-setting organization. Any party may request reconsideration of the recommendations, in whole or in part, by e-mailing NQF at appeals@qualityforum.org no later than Nov. 8. For an appeal to be considered, the notification e-mail must include information clearly demonstrating that the appellant has interests that are directly and materially affected by the NQF-endorsed recommendations, and that the NQF decision has had or will have an adverse effect on those interests.


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National Quality Forum

The National Quality Forum (NQF) operates under a three-part mission to improve the quality of American health care: setting national priorities and goals for performance improvement, endorsing national consensus standards for measuring and publicly reporting on performance, and promoting the attainment of national goals through education and outreach programs. In 2008, NQF convened the National Priorities Partnership, a collaborative effort of 32 major national organizations that collectively influence every part of the health care system. By focusing on high-leverage priorities and goals and taking collective action to reach them, the partnership strives to transform health care from the inside out, where it has the best chance to succeed.