National Quality Forum recently endorsed four behavioral health quality measures. The measures address maximum hours of physical restraint use or seclusion, and separately address timeliness of follow-up after an emergency department visit for an alcohol or other drug abuse or dependence, and timeliness of follow-up after an emergency department visit for mental illness or intentional self-harm. The latter two measures had previously been a single measure.
The endorsed measures are:
- 0640 HBIPS-2 Hours of Physical Restraint Use: This process measure for facilities was recommended for continued endorsement. It refers to the total number of hours that all individuals admitted to a hospital-based inpatient psychiatric setting were maintained in physical restraints. The data comes from electronic and paper medical records. The measure is reported as the number of times that physical restraints are used for more than two hours divided by the number of psychiatric inpatient days.
- 0641 HBIPS-3 Hours of Seclusion Use: This process measure for facilities was recommended for continued endorsement. It refers to the total number of hours that all individuals admitted to a hospital-based inpatient psychiatric setting who are held in seclusion. The data comes from electronic and paper medical records. The measure is reported as the number of events divided by the number of psychiatric inpatient days.
- 3488 Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence: This process measure for health plans was recommended for continued endorsement. It is a maintenance measure because it was previously part of an endorsed measure that combined mental health and addiction disorder emergency department follow-up visits. Data for this measure comes from claims for members ages 13 and older who have an emergency department visit with a principal diagnosis of alcohol or other drug (AOD) abuse or dependence and who have a follow-up outpatient visit for AOD. Two rates are reported: the percentage of emergency department visits for which the member receives a follow-up visit within seven days and the percentage of follow-up visits within 30 days of the emergency department visit.
- 3489 Follow-Up After Emergency Department Visit for Mental Illness: This process measure for health plans was recommended for continued endorsement. It is a maintenance measure because it was previously part of an endorsed measure that combined mental health and addiction disorder emergency department follow-up visits. Data for this measure comes from claims for members ages 13 and older who have an emergency department visit with a principal diagnosis of mental illness or intentional self-harm who have a follow-up visit for mental illness. Two rates are reported: the percentage of emergency department visits for which the member receives a follow-up visit within seven days and the percentage of follow-up visits within 30 days of the emergency department visit.
The recommendations were issued in “Behavioral Health and Substance Use, Spring 2019 Review Cycle: CDP Report” by National Quality Forum (NQF). During the spring 2019 project cycle, the Behavioral Health and Substance Use Standing Committee evaluated six measures. The following two measures were not endorsed during this cycle: NQF 0560 HBIPS-5 Patients Discharged on Multiple Antipsychotic Medications with Appropriate Justification; and NQF 1922 HBIPS-1 Admission Screening for Violence Risk, Substance Use, Psychological Trauma History and Patient Strengths Complete. Each Behavioral Health and Substance Use project cycle aims to endorse measures of accountability for improving the delivery of behavioral health care in the United States.
NQF is a consensus-based healthcare organization created in 1999 that works with all members of the healthcare community to drive measurable health improvements. Its mission includes promoting and ensuring consumer protections and healthcare quality through evidence-based measurement and public reporting. NQF-endorsed measures are used by the federal government (Medicare and Medicaid), states, and private-sector organizations to evaluate performance and to share information with consumers. To endorse measures, NQF committees evaluate the evidence-base for measures submitted by measure developers. NQF reconsiders endorsed measures and considers new measures during project cycles. Previously endorsed measures relevant to the project are reconsidered to assess their ongoing importance, validity, reliability, feasibility, and utility .
The full text of “Behavioral Health and Substance Use, Spring 2019 Review Cycle: CDP Report” was published in February 2020 by National Quality Forum. A free copy is available online at http://www.qualityforum.org/Publications/2020/02/Behavioral_Health_and_Substance_Use_Final_Technical_Report_-_Spring_2019_Cycle.aspx (accessed March 30, 2020).
OPEN MINDS last reported on this topic in “National Quality Forum Endorses Four Behavioral Health & Addiction Disorder Safety Measures,” which published on June 13, 2018. The article is available at https://www.openminds.com/market-intelligence/bulletins/national-quality-forum-endorses-four-behavioral-health-addiction-disorder-safety-measures/.
For more information, contact: Information Office, National Quality Forum, 1099 14th Street Northwest, Suite 500, Washington, District of Columbia 20005; 202-783-1300; Fax: 202-783-3434; Email: info@qualityforum.org; Website: http://www.qualityforum.org/.