National Quality Forum

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The National Quality Forum (NQF) is a nonprofit organization dedicated to improving the quality of American healthcare. NQF operates under a three-part mission to improve the quality of American healthcare by:

  • Setting national priorities and goals for performance improvement
  • Endorsing national consensus standards for measuring and publicly reporting on performance
  • Promoting the attainment of national goals through education and outreach programs

Introduction: Why Measure Quality?

Performance measures give us a way to assess healthcare against recognized standards. The measures endorsed by the NQF have become a common point of reference. An NQF endorsement reflects rigorous scientific and evidence-based review, input from patients and their families, and the perspectives of people throughout the healthcare industry. The science of measuring healthcare performance has made enormous progress over the last decade, and it continues to evolve. Measures represent a critical component in the national endeavor to assure all patients of appropriate and high-quality care.


In a report issued in 1998, the President's Advisory Commission on Consumer Protection and Quality in the Health Care Industry proposed creation of NQF as part of an integrated national quality improvement agenda. Leaders from consumer, purchaser, provider, health plan, and health service research organizations met as the Quality Forum Planning Committee throughout 1998 and early 1999 to define the mission, structure, and financing of the National Quality Forum. The National Quality Forum officially launched on September 23, 1999.


NQF receives funding from both public and private sources, including grants from foundations, corporations, and the federal government. In recent years, the Robert Wood Johnson Foundation and the Centers for Medicare & Medicaid Services have provided generous support for NQF. Other funders have included the Agency for Healthcare Research and Quality, the Bristol-Myers Squibb Foundation, the Cardinal Health Foundation, Pfizer Inc., Sanofi-aventis, and the Texas Medical Institute of Technology. Thirty-four percent of the organization’s total funding comes directly from membership dues.

In 2009, the U.S. Department of Health and Human Services (DHHS) awarded a contract to NQF that provides $10 million for fiscal 2009 with the option for renewal each year through 2012, and is being administrated through DHHS’ Centers for Medicare & Medicaid Services and the Assistant Secretary for Planning and Evaluation.

Governance & Leadership

NQF’s work is overseen by its Board of Directors, whose three major Board Committees guide the organization’s actions on matters related to specific elements of NQF’s mission. In addition, eight NQF Member Councils serve in an advisory capacity to the Board of Directors and its standing committees.

Topics & Sample Initiatives

NQF conducts its work around eight topic areas. The first six topics correspond with the priorities identified by the National Priorities Partnership in 2008 as those with the most potential to result in substantial improvements in health and healthcare. The two additional topics, HIT and Disparities, cut across each of the six priorities. Addressing these two additional areas along with the six priorities will be instrumental in improving healthcare quality.

Patient Safety

  • NQF has published a number of reports to encourage providers to adopt best practices and eliminate serious reportable events (SREs).
  • State based reporting has been enacted in 26 states and the District of Columbia to help providers identify and learn from serious reportable events.
  • The Patient Safety Measures project identified and endorsed cross-cutting patient safety measures across conditions, populations, and settings of care.

Population Health

  • NQF undertook an effort to achieve voluntary consensus on performance measures for immunizations to prevent seasonal influenza and pneumococcal disease across healthcare settings in the United States.

Care Coordination

  • NQF's Preferred Practices and Performance Measures for Measuring and Reporting Care Coordination project endorsed a set of preferred practices and performance measures in care coordination that are applicable across all settings of care.
  • With the National Voluntary Consensus Standards For Hospital Care: Outcomes and Efficiency projects, NQF sought to endorse measures of hospital outcomes that reach outside of the hospital walls. These included measures of quality of the hospital transition, improvement in health-related quality of life, palliative care symptom control, and surgical outcomes.

Patient and Family Engagement

  • The National Voluntary Consensus Standards for Home Health Care project resulted in 15 standardized measures to assess the quality of home healthcare in the United States.
  • A 2008 project reviewed the measures for home health performance and added new ones.

Palliative and End-of-Life Care

  • In 2006, NQF endorsed a palliative care and hospice framework which provides a foundation for quality measurement and reporting systems in these areas.
  • NQF identified and endorsed measures for public reporting and quality improvement addressing quality of care for patients receiving palliative and/or end-of-life care. Review of standards relating to end-of-life care undergoing maintenance was also conducted in this project.


  • An Imaging Efficiency Standards project identified and endorsed measures for public reporting and quality improvement related to resource use and care coordination for hospital outpatient imaging.

Health Information Technology (HIT)

  • The Critical Paths for Creating Data Platforms assessed the readiness of electronic data to support selected innovative measurement concepts
  • The Quality Data Model (QDM) provides measure developers with a structure or "grammar" for defining quality measures in a standardized format. With the QDM, measure developers can consistently and uniformly express clinical concepts within quality measures.
  • NQF retooled 113 endorsed quality measures from a paper-based format to an electronic quality measures format. In July 2010, 44 of these 113 eMeasures were published in the Centers for Medicare and Medicaid Services’ Electronic Health Record Incentive Program Final Rule.


  • The Healthcare Disparities and Cultural Competency Consensus Standards project expand previous work on a set of criteria to evaluate disparities-sensitive measures for the ambulatory care setting.
  • The Cultural Competency Measures and Implementation Strategies project identified next steps for cultural competency measures and concepts for the development of a cultural competency practice implementation measure.


  1. National Quality Forum (NQF)

Submitted by Melanie Buehler