Don't wait for CMS move, EDs are told

With the likelihood that the Centers for Medicare & Medicaid Services (CMS) will adopt some or all of the 10 national voluntary consensus standards for hospital-based ED care recently endorsed by the National Quality Forum (NQF), experts advise ED managers to begin preparing now to be in compliance. Besides, they argue, the new measures will help them improve the efficiency and quality of their departments.

"ED managers should respond to these measures through their own local performance improvement programs, review these measures, and begin to follow them in their own institutions — and be on the lookout for groups like CMS to include them, perhaps as soon as 2010," advises John Moorhead, MD, professor of emergency medicine at Oregon Health & Science University, Portland. Moorhead co-chairs NQF's steering committee on hospital-based ED care. "These measures are not the be-all and end-all, but they are important steps in terms of our long-term goal of ED quality improvement," he says.

Those are good measures that ED managers can begin using now to get a sense of their baseline, particularly with throughput, says Helen Burstin, MD, MPH, NQF's senior vice president of performance measures. They are measures they can use to compare with other hospital EDs and learn from them, Burstin says. "In addition, because NQF has endorsed them, they are now eligible to be used for public reporting, so it's important to get to understand them in advance of CMS potentially using them as part of their outpatient public reporting requirements."

Moorhead says he hopes that in the long run, these measures will not present an additional burden of documentation for EDs. "We hope over a period of time one set of reporting is generated to meet the need of all these programs [i.e., CMS, The Joint Commission], and there is an attempt to minimize the burden on doctors, nurses and department in terms of the reporting process," he says.