Developing Quality Metrics from Patient-Reported Outcomes for Medical Rehabilitation

The goal of this application is to develop quality metrics that incorporate patient-reported outcomes (PRO) and foster improved services for medical rehabilitation inpatients. Medical rehabilitation utilization has increased substantially, but the development of metrics for evaluating the quality of rehabilitation services has lagged far behind. Medical rehabilitation providers are expected to implement evidence-based practice and increasingly are pressed to document the outcomes of their services. This proposal builds on previous quality measure development efforts by identifying items and instruments that can be used to create quality measures that meet the criteria set forth by the National Quality Forum (NQF), the leading organization responsible for endorsing quality measures. Quality measures were first used to report quality-of-care in inpatient medical rehabilitation in October 2012. In order for quality measures to be effective, they must be tailored to medical rehabilitation practice. This project engages stakeholders in the selection and development of measures that could be used to document quality of care for patients receiving medical rehabilitation services. This project will lead to improvements in the quality of patient outcomes by providing IRFs with feasible, reliable and valid items and instruments that they can utilize efficiently to monitor and improve the quality of their services. This application extends our on-going work in developing outcome monitoring and reporting tools to measure and improve rehabilitation outpatients’ outcomes. This application will operationalize the JCAHO facility accreditation standards, which are designed to enhance quality healthcare delivery and are required for Medicare reimbursement. This project will identify and validate a set of quality measures based on PRO instruments. We will design the specifications for their inclusion in the National Institutes of Health (NIH) Assessment Center, a publicly-available test platform developed as part of NIH’s Patient-Reported Outcomes Measurement and Information System (PROMIS). In summary, there is a pressing need and critical opportunity to develop PRO-based quality measures that can be used to evaluate the quality of care provided to medical rehabilitation inpatients. Thus, the specific aims (A) and tasks (T) of this application are to: