1. Lessons and Opportunities of Quality Measurement in Serious Illness
Shantanu Agrawal, MD, MPhil
April 17, 2018

2. New Measure Endorsement Process

3. NQF Prioritization Initiative
Model Development
Refinement of Model & Criteria
V1 Pilot Testing (4 Committees)
Proposed Prioritization and Gaps Criteria
Environmental Scan
Prioritization Of Measures
Prioritization Of Gaps
Prioritization of Remaining Committee Measures
Refine Scoring Rubric
V2 Pilot Testing of Rubric (3 Committees)
Draft Prioritization Scoring Rubric
Gaps Analysis
Creation of Driver Diagrams
Assemble Expert Panels for National Priority Areas
Incorporation into NQF Processes

4. NQF Measure Prioritization Criteria
Prioritization Phase 1
Prioritization Phase 2
Outcome-focused (25%)
Outcome measures and measures with strong link to improved outcomes and costs
Improvable (25%)
Measures with demonstrated need for improvement and evidence-based strategies for doing so
Meaningful to patients and caregivers (25%)
Person-centered measures with meaningful and understandable results for patients and caregivers
Support systemic and integrated view of care (25%)
Measures that reflect care that spans settings, providers, and time to ensure that care is improving within and across systems of care
Equity Focused
Measures that are disparities sensitive

5. Measurement Feedback Engage with advisory group and partners
Synthesize and share feedback
Develop methods to optimize and scale measurement feedback efforts
Identify incentives to get frontline feedback
Integrate measurement feedback into NQF processes

6. New National Quality Forum Resources Now Available on the NQF Store
The National Quality Partners (NQP) Playbook™: Opioid Stewardship and the NQP Playbook™: Shared Decision Making in Healthcare are now available on the NQF Store at
To utilize the discount code, individuals should:
Go to the NQF Store (link included in slide)
Add the NQP Playbook: Opioid Stewardship and/or the NQP Playbook: Shared Decision Making in Healthcare to their cart
Enter the discount code AGSUMMIT10 during the checkout process
Complete the checkout

7. Achieving Health Equity
Identify
Disparities and At-Risk
Populations
Achieving Health Equity
Influence
Performance
Measurement
Inspire
Implementation
Best Practices
Inform Payment

8. NQF Serious Illness Initiative*
Quality Measurement Workgroup (w/ CAPC)
4 Measurement Strategy Sessions
Align Measurement & Incentives
Provider Playbook
1 Playbook Strategy Session
Prepare Providers
3 Stakeholder Summits
Engage & Activate Stakeholders
Goals
Activities
Project Start-Up
Quality WG
Strategy Session #1
Playbook Session
Strategy Session #2
Stakeholder Summit #1
Strategy Session #3
Stakeholder Summt #2
Strategy Session #4
Stakeholder Summit #3
Project Wrap-up
Year 1
Year 2
Year 3
*This project is funded by the Gordon and Betty Moore Foundation.

9. Lessons and Opportunities
Leverage existing evidence base
Improvements in symptom burden and patient satisfaction
Reductions in cost & utilization (e.g., ED visits, hospitalizations)
Prioritize involvement of patients & caregivers
Identify patient & caregiver-centric measure concepts during measure development
Obtain patient and caregiver input throughout testing and implementation

10. Lessons and Opportunities
Prioritize outcome measures
Demonstrate change in the outcomes that matter to patient and caregivers
Create a plan around data needs
Short term: What measures can be implemented using data we have now?
Long term: What data do we need? What infrastructure do we need to build to get that data?

11. Moving Forward Identify populations to focus efforts
Areas where evidence already exists
Pilot and build on success
Prioritize measures and gaps
Measurement burden

12. Connect With NQF sagrawal@qualityforum.org @SAgrawalMD
@NatQualityForum
#SupportNQF