Background
In early 1999, The Joint Commission solicited input from a wide variety of stakeholders (e.g., clinical professionals, healthcare provider organizations, state hospital associations, healthcare consumers, performance measurement experts and others) about potential focus areas for core measures for hospitals. In May 2001, The Joint Commission announced the four initial core measurement areas for hospitals, which were acute myocardial infarction (AMI), heart failure (HF), pneumonia (PN), and pregnancy and related conditions (PR).
Simultaneously, The Joint Commission worked with the Centers for Medicare & Medicaid Services (CMS) on the AMI, HF and PN sets that were common to both organizations. CMS and The Joint Commission worked together to align the measure specifications for the Quality Improvement Organizations (QIO) contracts and for the Joint Commission accredited hospitals that began collecting these measures for patient discharges beginning July 1, 2002.
In November of 2003, CMS and the Joint Commission began to work to precisely and completely align these common measures so that they were identical. This resulted in the creation of one common set of measure specifications documentation known as the Specifications Manual for National Hospital Quality Measures to be used by both organizations. The Manual contains a common (i.e., identical) data dictionary, measure information forms, algorithms, etc. The goal is to minimize data collection efforts for these common measures and focus efforts on the use of data to improve the health care delivery process.
In the fall of 2003 an additional measure set was added: Surgical Infection Prevention (SIP). The SIP set subsequently transitioned to the Surgical Care Improvement Project (SCIP) effective July 1, 2006.
Additionally in 2003, The Joint Commission launched project activities to examine Children’s Asthma performance measures for inclusion in the ORYX® performance measurement initiative. This work was conducted in collaboration with national children’s health care organizations, particularly, the National Association of Children’s Hospitals and Related Institutions (NACHRI), Child Health Corporation of America (CHCA), and Medical Management Planning, Inc.
(MMP).
An advisory panel was convened to advise project activities including recommendations for measures for further development and testing. This resulted in the identification of a set of candidate measures addressing aspects of children's asthma care (CAC) in the hospital setting. Following a period of public comment and pilot testing, the CAC Advisory Panel and The Joint Commission recommended that three CAC measures move toward national implementation.
The three measures were introduced for implementation effective April 1, 2007:
CAC - 1 Use of Relievers for Inpatient Asthma
CAC - 2 Use of Systemic Corticosteroids for Inpatient Asthma
CAC - 3 Home Management Plan of Care Given to Patient/Caregiver
Data collection for the measure set began with April 2007 discharges. CAC-3 was implemented as a test measure pending National Quality Forum (NQF) endorsement. Although included on the hospital’s ORYX Performance Measure Report, data analysis for CAC-3 was not used in the accreditation process or publicly reported on Quality Check.
The CAC-3 measure has now been endorsed by the NQF and will be implemented as a production measure effective with July 1, 2008 discharges.
Important Information
Where to find the Children's Asthma Care Core Measure Set
The Children's Asthma Care measures can be found in the Specification Manual for National Hospital Quality Measures