Background

In January 2004, the National Quality Forum (NQF) endorsed a compilation of 15 nursing-sensitive care performance measures. The measures were identified through the NQF consensus development process within a framework that organized the measures into categories and provided a structure to define the scope of the full set of measures including future additions.

In 2005, with funding from the Robert Wood Johnson Foundation (RWJF) and working with the guidance of an advisory panel which included measure developers, the Joint Commission took the lead role in the development of uniform, standardized technical specifications for the measure set.  This resulted in the creation of the Implementation Guide for the National Quality Forum (NQF) Endorsed Nursing-Sensitive Care Performance Measures.  After development, the guide was made publicly available on the Joint Commission’s web site. (NOTE: Current testing may result in updates to the 2005 Implementation Guide. However, any specification changes will not be finalized and publicly available until early 2009, after study completion).

In January, 2007 the RWJF funded a proposal to test the NQF endorsed nursing-sensitive care measure set for reliability, feasibility and impact on quality of care in a group of volunteer test hospitals.  A call for participation, followed by the random selection of a diverse group of test sites, was conducted in spring 2007.  Final analysis of the test results and recommendations will be completed in December, 2008.

Important Information

Testing of the complete measure set is currently underway. Volunteer test sites began collecting data for all 15 measures in the set in August, 2007. Reliability assessment involving on-site visits by Joint Commission staff to a randomly selected subset of participating sites is currently underway. 

Technical Advisory Panel Member List

Marilyn P. Chow, RN, DNSc, FAAN (Co-Chair) Vice President, Patient Care Services Kaiser Permanente Oakland, CA	Nancy E. Donaldson RN, DNSc. FAAN Director, Center for Research & Innovation in Patient Care, Department of Physiological Nursing UCSF School of Nursing San Francisco, CA
Marybeth Farquhar, RN, MSN Senior Advisor, Quality Indicators Initiative, Center for Delivery, Organization & Markets Agency for Healthcare Research & Quality Rockville, MD	Lillee S. Gelinas RN, MSN, FAAN Vice President and Chief Nursing Officer VHA, Inc. Irving, TX
Ann Hendrich, RN, MSN, FAAN Vice President, Clinical Excellence Operations Ascension Health St.  Louis, Mo	Teresa C. Horan, MPH Captain, US Public Health Service, Leader Performance Measurement Team, Healthcare Outcomes Branch, Division of Healthcare Quality Promotion Centers for Disease Control and Prevention Atlanta, GA
Gail Keenan, RN, PHD Associate Professor of Nursing and Director of the Nursing Informatics Initiative, College of Nursing University of Illinois at Chicago Chicago, Il	Ellen T. Kurtzman, MPH, RN Assistant Research Professor, Department of Nursing Education, School of Medicine and Health Sciences The George Washington University Washington, DC
Eileen Lake, PhD, RN Assistant Professor, School of Nursing University of Pennsylvania Philadelphia, Pennsylvania	Arnold E. Mattis, RN, MS, EdD (Co-Chair) Dover, DE 19901
Jack Needleman, PhD Associate Professor, , Department of Health Services UCLA School of Public Health Los Angeles, CA	Karen Pace, PhD, RN Senior Program Director National Quality Forum Washington, DC
Mary Jean Schumann, MSN, RN, MBA,CPNP Director, Department of Nursing Practice & Policy American Nurses Association Silver Spring, MD	Michael T. Rapp, MD, JD Director, Quality Measurement and Health Assessment Group Centers for Medicare and Medicaid Services Baltimore, MD
Cathy Rick, RN, CNAA, FACHE Chief Nursing Officer, Office of Nursing Services Department of Veterans Affairs Washington, DC