National Priorities Partnership and Implementation of the National Quality Strategy
The National Priorities Partnership is another national collaborative effort, initially including 28 national health care organizations, convened in 2008 as an initiative of the NQF. Its role is to join stakeholders from both public and private sectors to influence policy encompassing every aspect of the health care system. Stakeholder groups include consumer groups, employers, government, health plans, health care organizations, health care professions, scientists, accrediting and certifying bodies, and quality alliances. Today the National Priorities Partnership includes three main areas of collaboration: the Measures Application Partnership (MAP), National Quality Partners (NQP), and the Measure Incubator.
Nursing was represented only by ANA in the initial stakeholder group, but the Nursing Alliance for Quality Care (NAQC) was added as the group expanded. The partnership took the early step of identifying a set of national priorities and goals to coalesce efforts toward achieving performance improvement by stakeholders on high‐leverage areas with the potential to make the most substantial contributions in the near term to the health care delivery systems of the nation and ultimately to consumers. In 2011 the National Priorities Partnership expanded its focus. Significantly, the full list of priorities and goals, consistent with the Quality and Safety Education for Nurses (QSEN) competencies identified in Chapter 1, had substantial impact on the final recommendations of the National Quality Strategy.
Measure Applications Partnership Driving Selection of Measures
The NQF has been named as a consensus endorsement agency, as required by Section 3014 of the ACA. In the habit of convening multistakeholder groups, it is expected to provide input to HHS, through federal government appointment, on the selection of performance measures for public reporting and performance‐based payment programs. In 2010, MAP was designed to service this purpose by an NQF board work group. MAP was designed as a two‐tiered structure that includes a standing multistakeholder coordinating committee to provide direction to and synchronize with the second tier of advisory work groups. The coordinating committee establishes the strategy for the partnership. The work groups identify measurement gaps across settings, prioritize measures, and recommend areas for realignment. NQF through the coordinating committee recommends to HHS measures for use in public reporting, performance‐based payment, and other programs.
MAP reviews standardized performance measures and makes recommendations to HHS for 18 federal programs that use measures for public reporting or payment purposes, including MIPS. NQF reported that in 2018 it updated its measures portfolio by reviewing and endorsing or re‐endorsing 38 measures and removing 40 measures. NQF also worked to remove measures from the portfolio for a variety of reasons, such as measures no longer meeting endorsement criteria; harmonization between similar measures; replacement of outdated measures with improved measures; and lack of continued need for measures where providers consistently perform at the highest level. This continuous refinement of the measures portfolio through the measures maintenance process ensures that quality measures remain aligned with current field practices and health care goals. Measure set refinements also align with HHS initiatives, such as the Meaningful Measures Initiative at CMS (https://www.federalregister.gov/documents/2019/06/26/2019‐13626/secretarial‐review‐and‐publication‐of‐the‐national‐quality‐forum‐2018‐activities‐report‐to‐congress).
MAP includes more than 150 healthcare leaders and experts representing 100 private‐ and public‐sector organizations. MAP volunteers represent consumers, purchasers, employers, health plans, clinicians and providers, communities and states, suppliers, and federal agency liaisons. At least one nursing organization, the ANA, has been a member of the coordinating committee, and several nursing organizations have representatives. Individual nursing leaders and content experts have been appointed through a nominations process to the various work groups. (https://www.qualityforum.org/MAP_Initiates_Review_of_Performance:Measures_for_Federal_Programs.aspx).
National Quality Partners
NQP is an NQF initiative under the National Priorities Partnership that provides an active forum for NQF members to connect, collaborate, and provide thought leadership on quality improvement strategies for achieving national health and health care goals. NQP provides practical, action‐oriented initiatives to drive meaningful and lasting change for patients and their families in the areas of safety and quality. NQP is guided by an NQP Leadership Consortium, which, in concert with the larger NQF structure, works to identify, prioritize, and seek strategies to address some of the high‐priority and complex health care issues. The Leadership Consortium and its NQP Action Teams include representation from the Nursing Alliance for Quality Care, and other nurses and field experts, along with consumers and patients, clinicians, and other stakeholders. These individuals are appointed to grapple with problems and, over a period of months rather than years, develop high‐level strategies, action plans, tool kits, and other resources to assist those on the front lines to improve quality in their organizations. The 2020 NQP Priorities for Action included improving medication safety, promoting high‐quality home‐based care, and preventing maternal mortality (https://www.qualityforum.org/National_Quality_Partners.aspx#:~:text=National%20Quality%20Partners%20(NQP)%2C,health%20and%20healthcare%20quality%20goals). Textbox 2.1 illustrates recent examples of NQP efforts that have involved nursing.
Textbox 2.1 NQP Efforts Involving Nursing
NQP Issue Brief to Co‐Design Patient‐Centered Health Systems provides recommendations for assessing and supporting improved patient, family, and caregiver involvement and engagement in direct care experiences, involving these critical stakeholders as partners in health system co‐design.
NQP Playbook: Supporting Shared Decision Making for Individuals with Chronic Kidney Disease and End‐Stage Renal Disease provides practical guidance to health care providers and organizations on how to use shared decision‐making to address the unique decision‐making needs of individuals with chronic kidney disease and end‐stage renal disease.
NQP Playbook: Improving Access to High Quality Care for Individuals with Serious Mental Illness provides concrete strategies, implementation examples, and resources for health care delivery organizations and clinicians committed to improving access to care and outcomes for individuals living with serious mental illness.
NQP Playbook: Antibiotic Stewardship in Post‐Acute Care and Long‐Term Care is an essential tool for post‐acute and long‐term care facilities seeking to implement, improve, and sustain antibiotic stewardship programs and improve the safety and quality of care for their residents and their families.
NQP Playbook: Antibiotic Stewardship in Acute Care provides a roadmap for US hospitals to strengthen antibiotic stewardship programs and helped spur national standards requiring that hospitals have robust antimicrobial stewardship programs in place to address antibiotic overuse and misuse.
NQP Playbook: Opioid Stewardship provides essential guidance for health care organizations and clinicians across care settings committed to appropriate pain management strategies and opioid stewardship.
NQP Playbook:
