The National Quality Forum is setting standards for primary care

A new quality initiative may result in standardizing differing performance measures and creating measures where none exist.

By Andis Robeznieks, AMNews staff. Jan. 12, 2004.

Working on the theory that reducing the underuse, overuse and misuse of medical treatments will result in fewer poor outcomes and unnecessary hospitalizations, the National Quality Forum launched an initiative to standardize performance measures for primary care doctors.

According to NQF, a Washington, D.C.-based organization with 200 members, including the American Medical Association, one goal of the initiative is to streamline the work load of a physician who may belong to several different health plans that all have different performance measures.

Although that may seem like a noble endeavor, NQF President Kenneth Kizer, MD, said his organization is prepared to take some heat for getting involved in promoting performance measures.

"I think they will be controversial because they involve doctors' offices, and that's an area no one has tread in yet," Dr. Kizer said. "There is not uniform acceptance of the use of performance measures among physicians."

Dr. Kizer said that a system in which performance measures are widely accepted and used by physicians and the public "does presage a new era in quality improvement."

"This is a tangible manifestation of the new era of health care in which performance measurement, public reporting, paying for performance and consumer activism are all part of the mill," Dr. Kizer said. "It's not out there in the distant future, it's going to happen before long."

While not commenting specifically on the NQF initiative, the president of the St. Paul, Minn.-based Citizens' Council on Health Care, Twila Brase, RN, expressed concern that performance measures and best practice guidelines "put another person in the exam room" who comes between physicians and patients.