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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: Shared Decision Making is the go‐to resource for health care organizations and clinicians across care settings to implement and strengthen shared decision‐making—making it a reality for all patients.

       NQP’s Advanced Illness Care Issue Brief provides physicians with tools to discuss complex issues with patients about their preferences and goals for advanced illness care.

       Early Elective Delivery Playbook contributed to a 50% decline in early elective deliveries nationwide over a three‐year period.

      See https://www.qualityforum.org/nqf_store.aspx for all these publications.

      National Quality Forum Measure Incubator

The NQF Measure Incubator is an innovative effort that facilitates efficient measure development and testing through collaboration and partnership. It addresses important aspects of care for which quality measures are underdeveloped or nonexistent. Even though there are hundreds of measures to define various aspects of health and health care quality, there are still gaps where measures are important in driving improvement. Several of these gaps represent work where nurses figure prominently. Some examples of gap areas include palliative and end‐of‐life care, diagnostic accuracy, behavioral health, and care of people with multiple chronic conditions and individuals with Alzheimer’s disease. And while measures of patient satisfaction exist, these and measures of patient‐reported outcomes are still needed. The Measure Incubator connects groups interested in particular measure concepts with measure development experts, financial and technical resources, and continuous sources of data. It is unclear whether nurses are currently engaged in any of the Measure Incubator projects.

      National Database of Nursing Quality Indicators: Capturing the Data

      Even before the release of To Err Is Human (Institute of Medicine, 2000) and Crossing the Quality Chasm (Institute of Medicine, 2001), the nursing profession had begun to speak up about eroding of the quality of care patients received. Not surprisingly, this concern surfaced early at the national nursing policy level. In 1994, the ANA House of Delegates at its annual meeting approved a house resolution that urged ANA leadership to address the problem of declining patient care quality experienced in many institutions, perceived by nurses to be due in part to reductions in staffing levels implemented following declining revenue. ANA, when addressing this problem with its interdisciplinary colleagues, was repeatedly asked to show the evidence that reduced nursing staffing led to such declines in quality care. Nurse leaders determined that not only was there a need for education about principles of quality, but that in fact data were required that would put to rest the criticisms of those claiming that the value of nursing could not be substantiated.

      In the mid‐1990s, ANA began a national effort to educate nurses about the value of data and quality through regional conferences. It simultaneously convened nurse experts Dr. Norma Lang, Dr. Marilyn Chow, and others to identify structural, process, and outcome measures that would support the relationship between staffing levels, skill mix, and the quality of nursing care. Those initial measure definitions became the basis for the NQF‐endorsed nursing‐sensitive measures. As a result of recommendations from this group of experts, ANA funded a contract to develop a national database, with Dr. Nancy Dunton as principal investigator, that could receive and aggregate data collected via these measures. In 1998, ANA awarded grants to seven state nurses associations to encourage hospitals in those states to collect and submit data to this new database, the National Database of Nursing Quality Indicators (NDNQI), a proprietary database of the ANA (Montalvo and Dunton, 2007). Since 1998, the number of acute and specialty hospitals that submit quarterly nursing‐related quality data has grown to 2,000, more than one‐third of all US acute care facilities.

      The impact of NDNQI on policy conversations at the institutional, state, or national level has been far‐reaching. Studies published at the national level utilizing the aggregated data support the impact

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