In addition to accreditation, certification, and verification, we provide tools and resources for health care professionals that can help make a difference in the delivery of care. Data show that the majority of newborns with gestational age 37 weeks or more have a birth weight 3000 grams or more. << The following are Perinatal Care chart abstracted measures used by The Joint Commission. Updated version number of the Measure Authoring Tool (MAT) Global Common Functions Library (MATGlobalCommonFunctions-5.0.000). Our Stroke Program team is small and communicates well. /MK 15 0 R HtV]oF|'/B%[Au+6yDKH}GZ@-=_^/^R!_R^IZs?{]zKo}#k2rl]W.?Ux~?I??Hns]UZk2l'e eC0(Zp^'7C-9(*0""#/T,0 |'j)W.?Y,>x?r m}\, The core measure work groups allowed hospitals to share best practices and lessons learned and improve internal processes to increase core measure compliance. By . The Perinatal Center Database A Quality and Utilization Benchmark The Perinatal Center Database (PCDB) has become one of the largest repositories for hospital-based perinatal data in the country. 14 0 obj Using the quarterly sampling table for the Exclusive Breast Milk Feeding measure, the sample size is less than the minimum required quarterly sample size, so 100% of this sub-population or all 25 cases are sampled. 0480e. 3 0 obj /Contents 33 0 R having a vaginal delivery. Within the PC-Newborn population, there are two baby measures, Exclusive Breast Milk Feeding and Unexpected Complications in Term Newborns. Complete the Survey. lz;2[&EPI:+O/A@Fg0{NlAYIS*yIQ6Hfw}I5wMo}#F>juLt!aj-?}a)4g]xo/3sst7o6vso^u|;?=MGmnNgw;{~Kom6:Lc|:;Ow7y}dCy2W79{/]-we33'Wa7i-b| =LNq3d4N'9k{n,~35LWe.cCAX)&I]Ie\E'ZQ+T5.0N=iw]2c3>EZq>-7iNp.~:-Ao>W4e1p0ZTifYg:<6'(>ji{{%6sW L8O;SB&Z:hL:0Mv{(CQE9PCQE9P:`7R8Px&v`i`#fq(bq(>T8%,q`|&f0TAi%Y%y%E%eJ4+H_I4%XelY-o{MlF.I]Rif]lCtcbFSLq|I;%m;*:LQj9o`gKK05o$3;#7 h/?neC%1_}\=wIZn!B4$.Rr\}=O|ikS4@ 9_aMimyT{f7\sB^E@Uo6[Xq2oQr4;w"uFWXr.dK=<. = AU?U m!p\;4TPC[H < kIO!0Q)tji Oc2Pe` i)[ XAbRPp&p /H /N 4 0 obj /Resources 29 0 R Patients admitted to the hospital for inpatient acute care are included in the PC Newborn Initial population if they have: A Patient Age (Admission Date Birthdate) <= 1 day and ICD-10-CM Principal or Other Diagnosis Codes as defined in Appendix A, Table 11.20.1 Single Liveborn Newborn. The American Medical Association reserves all rights to approve any license with any Federal agency. Information on Joint Commission Requirements. /Keywords () endobj Some hospitals now have CB rates over 50%. << Guidelines for perinatal care. Elk Grove Village, Ill. American Academy of Pediatrics, and Washington, DC. 20 0 obj Maternal and child health are internationally considered to be among the best measures for assessing health-care quality. /Pages 4 0 R *Benchmark Source: National and state averages are the most recent expired during the hospitalization 15 0 obj hVQo0+~4E#UuQfk4Z4B*B(%g\)B W "J"\DD>H\ A@X@$a*p&>Pv*`ff Share this page with a friend or colleague by Email. 10 0 obj /H /N Note: Hospitals are encouraged to utilize a data source that reduces unnecessary medical record review e.g., using vital records, delivery logs or clinical information systems as a data source. << Electronic Clinical Quality Measures (eCQMs) for Accreditation, Chart Abstracted Measures for Accreditation, Electronic Clinical Quality Measures (eCQMs) for Certification. This core set contains several measures NQF endorsed at the facility or health plan level as noted below; core set users should ensure adequate measure denominator size based on their patient population. All Records, Optional for HBIPS-2 and HBIPS-3, The count of all patients in PC-Newborn population, 20% of the Initial Patient Population size, No sampling; 100% of the Initial Patient Population required, No sampling; 100% of Initial Patient Population required, No sampling; 100% Initial Patient Population required, Hospitals selecting cases for the PC-Newborn with. Birth weight 3000 grams or more is a proxy to capture term newborns without gestational age recorded in EHR system. endobj Click on the link(s) below to access measure specific resources: The Joint Commission is a registered trademark of the Joint Commission enterprise. a0,eJl-sxbuH6@T;4XpI _lLvzs_[6`,0^G@. Please refer to the QDM page for more information on the QDM. National and state averages for 736. American Academy of Pediatrics, American College of Obstetricians and Gynecologists. Drive performance improvement using our new business intelligence tools. Medicaid Services' Hospital Compare. The chart abstracted Perinatal Care measures were re-endorsed by the National Quality Forum (NQF) on November 20, 2020. Get more information about cookies and how you can refuse them by clicking on the learn more button below. After the initial prenatal visit, it consists of ongoing evaluation of the health status of both the mother and fetus, counseling about pre- and postpartum issues, and anticipation of problems with intervention, if possible, to prevent or minimize . She was awarded the 2015 Moran Medal in statistics from the Australian Academy of Science in recognition of her work on developing methods for molecular data arising in cutting edge biomedical research. This measure tracks the number of term singleton newborns ACOG Committee Opinion No. The annual rankings measure vital health factors, including high school graduation rates, obesity, smoking, unemployment, access to healthy foods, the quality of air and water, income inequality, and teen births in nearly every county in America. Results - National Averages Timeliness of Prenatal Care Postpartum Care This State of Healthcare Quality Report classifies health plans differently than NCQA's Quality Compass. CMS9v9. << /Type /Catalog ANA has developed high-impact patient safety measures, with more than two decades of evidence that higher staffing levels are associated with lower rates of patient death and harm. The ongoing evaluation and updating of endorsed measures ensures the currency and relevance of NQFs perinatal care portfolio. endobj Our mission is to end preventable morbidity, mortality and racial disparities in California maternity care. 13 0 obj This Core Set, which consists of 7 measures from CMS's Child Core Set and 4 measures from the Adult Core Set, will be used by CMS to measure and evaluate progress toward improvement of maternal and perinatal health in Medicaid and CHIP. /Resources 35 0 R These processes are proven to reduce complications and lead to better patient outcomes. It is acceptable to calculate Gestational Age using the American College of Obstetricians and Gynecologists ReVITALize guidelines, which define Gestational Age as calculated using the best obstetrical Estimated Due Date (EDD) based on the formula: Gestational Age= (280-(EDD-Reference Date))/7. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the (AMA is not recommending their use. Perinatal Care measures focuses on achieving integrated, coordinated, patient-centered care for clinically uncomplicated pregnancies and births. Patients and families can use core measure performance to objectively compare hospitals locally or nationally. Contact Information Products viamy.ncqa.orgfor analysis that accounts for trend breaks. a diagnosis of galactosemia /DA (/Helv 0 Tf 0 g ) /Count 2 stream Using the quarterly sampling table for the Mothers population, the sample size is less than the minimum required quarterly sample size, so 100% of this sub-population or all 20 cases are sampled. << The organizations quality and safety performance may have been impacted by the COVID-19 pandemic. Our team shares information every day and talks about ways to address problems both large and small. Added text to indicate whether the measure is patient-based or episode-based. Meta Phillips, R.N.Stroke Compliance Specialist, Sibley Memorial Hospital. /PDFDocEncoding 37 0 R Find evidence-based sources on preventing infections in clinical settings. Perinatal mental health services should be flexible and women-centred, and delivered by well trained health-care professionals working within a structure that facilitates continuity of carer. The measure is reported as an overall rate which includes all newborns that were exclusively fed breast milk during the entire hospitalization. Although cesarean births can be lifesaving and medically needed, the rapid rise and the extreme hospital variation suggests that "grey-zone" indications seem to be driving much of these trends . Learn about the development and implementation of standardized performance measures. Report on Quality and Safety 2013 Measure Number Measure Name 2012 Rate Perinatal Care Composite 57.6% PC-01 Elective Delivery 8.2% PC-02 Cesarean Section* 26.3% Value set Parenteral Nutrition (2.16.840.1.113883.3.117.1.7.1.38): Deleted 1 SNOMED CT code (304055007) based on terminology update. A hospital's PC-Newborn Population size is 25 cases during the second quarter. Public lists NHS workforce in England [January 2023] Transgender health [September 2022] Weekly additions - 2023-02-26 Financial pressures in the NHS in England [January 2023] Introduction to the NHS in England [February 2023] Devolved National Health Service : the NHS in England, Northern Ireland, Scotland and Wales [March 2022] Adult social . >> 18 0 obj Using the quarterly sampling table for for the Exclusive Breast Milk Feeding measure, the sample size required is 20% of this sub-population or 70 cases for the quarter . Perinatal Care (PC-01) Measure Hospitals participating in the IQR Program are required to complete the web-based measure questions quarterly. Postpartum visits provide an opportunity to address: Prenatal and Postpartum Care: Postpartum Care | Medicaid Skip to main content The AHRQ Quality Indicators (Qis) comprise four measure areas: inpatient, prevention, patient safety, and pediatric care. *8XB3+{eI]+(#5Ew){3H Custom Analytic Interactive Reporting Network, Discuss the Perinatal Care (PC) measures updates, Describe the Perinatal Care (PC) measures, key data elements and recent revisions to the measures, Identify some of the resources available for improving perinatal care. These perinatal measures are a welcome addition to the NQF portfolio, said Laura Riley, MD, medical director of labor and delivery at Massachusetts General Hospital and co-chair of the Perinatal and Reproductive Health Endorsement Maintenance Steering Committee. Stakeholder CommentsGeneral and Measure-Specific. >> performance on the measure across the larger patient population. NQF also endorsed measures dealing with hepatitis B vaccination rates for newborns, neonatal bloodstream infection rates, and exclusive breastfeeding rates during hospitalization. Birth weight 3000 grams or more is a proxy to capture term newborns without gestational age recorded in EHR system. Its critical that providers have the right measurement tools to help ensure mothers and newborns receive safe, high-quality care.. endobj The database collects and evaluates unit-specific nurse-sensitive data from hospitals in the United States." Source: National Database of Nursing Quality Indicators Measures Patient falls Data from the Third National Health and Nutrition Examination Survey showed a detectable level of cotinine in 88% of adults who do not smoke, and numerous studies have validated questionnaire assessments of SHS exposure using cotinine measures. The Joint Commission reserves the right to change the content of the information as appropriate.. Set expectations for your organization's performance that are reasonable, achievable and survey-able. /Rotate 0 /BleedBox [0 0 612 792] The higher percentage compliance means the hospital is following the best steps to care for a patients particular condition. The purpose of the project was to demonstrate how the electric medical record could be used for data collection, quality improvement, and benchmarking . NQF Endorses Perinatal Measures Washington, DC - the National Quality Forum (NQF) Board of Directors has approved for endorsement 14 quality measures on perinatal care. The Joint Commission tracks compliance with core measures and each year recognizes the top performing hospitals for key quality metrics. Author links open overlay panel Sabrina da Conceio Pereira a, Raul Manhes-de-Castro a b c, Diego Bulco Visco b c, . connection among participants to achieve project goals. Warning: Creating default object from empty value in /homepages/17/d4294970467/htdocs/morpheus/wp-content/themes/virtue/themeoptions/inc/class.redux_filesystem.php on . CMQCC also developed the following measure, which was previously endorsed by NQF but was not submitted for re-approval as it is not currently being used for hospital-level performance: NQF# 0477 <1500g Infant Not Delivered at Appropriate Level. While a number of these measures are voluntarily reported as part of PC-05. Specifications for these measuresare available below: In late 2007, The Joint Commissions Board of Commissioners recommended retiring and replacing the Pregnancy and Related Conditions (PR) measure set with an expanded set of evidenced-based measures. By reviewing our patients charts, we can immediately identify what is working and where we can improve. What does this measure mean for quality of care?Breast-feeding provides the best nutrition and health A technical advisory panel (TAP) comprising experts in the perinatal care field was convened in February 2009 to select the replacement set of measures from among those endorsed for national use by the National Quality Forum. PQC members identify health care processes that need to be improved and use the best available methods to make changes as quickly as possible. /CreationDate () /A 45 0 R hN0dl6BR!b0SVdl RdrgLM}*MIhI5-@I BO!N("(IAMHl"Ua"f:'JFQ;c{,m~%?e- 1uP A hospital's PC-Newborn Population size is 200 cases for the month of March. These were the first nursing-sensitive measures developed by ANA, and were prioritized by the Measures Application Partnership (MAP) . The measure is reported as an overall rate which includes all newborns that were exclusively fed breast milk during the entire hospitalization. We would urge patients to consider more recent performance in combination with historical performance. One of the five core measures includes exclusive breastmilk feeding. << A. Perinatal Care (PC) Core Measures: Updates for 2022. NQF # This measure is part of a set of five nationally implemented measures by The Joint Commission that address perinatal care (PC-01: Elective Delivery, PC-02: Cesarean Birth, PC-03: Antenatal Steroids, PC-04: Health Care-Associated Bloodstream Infections in Newborns, PC-05: Exclusive Breast Milk Feeding). Importantly, this metric also serves as a balancing measure for other maternal mea-sures such as NTSV (Nulliparous, Term, Singleton, Vertex) cesarean rates and early elective delivery rates. << Please refer to the eCQI resource center for more information on the QDM. Electronic Clinical Quality Measures (eCQMs) for Accreditation Chart Abstracted Measures for Accreditation Electronic Clinical Quality Measures (eCQMs) for Certification /BleedBox [0 0 612 792] They provide a snapshot of how health is influenced by where we live, learn, work, and play. /Helv 38 0 R Recently, the National Quality Forum, a consensus-based body that endorses quality measure, endorsed 24 measures related to maternity care. supported the measure overall. 2 0 obj What does this measure mean for quality of care?The American College of Obstetricians and Gynecologists and A hospital's Mother Population size is 20 cases during March. << Birth weight 3000 grams or more is a proxy to capture term newborns without gestational age recorded in EHR system. QDM v5.5 standards update: Added 'relevantDatetime' attribute to QDM datatypes. /A 43 0 R * Bei Fragen einfach anrufen oder schreiben: +49 (0)176 248 87 424. betheme google analytics; crave burger calories; pipp program application; chaps advantages and disadvantages Measures in this portfolio address reproductive health; pregnancy, labor, and delivery; high-risk pregnancy; newborns; postpartum care; and premature or low birthweight neonates. Strikethrough text highlighted in red indicates information changed from the previous version. PPO corresponds to PPO and EPO within Quality Compass. a length of stay greater than 120 days that ends during the measurement period endstream endobj 308 0 obj <>stream endobj In its 2020review process, the National Quality Forum endorsed 15Perinatal and Women's Health measures, of which CMQCC was the developer of three: NQF# 0716 Unexpected Complications in Term Newborns (currently used by The Joint Commission as PC-06) >> /Border [0 0 0] 225 Chapman Street Suite 200 Providence, RI 02905. However, very few hospitals chose to adopt the measures because, the measures were optional. Patients may benefit from discussing with their healthcare provider the disruptions COVID-19 may have caused on quality and safety of care. Inpatient hospitalizations for newborns who were with any of the following conditions: admitted to the Neonatal Intensive Care Unit (NICU), transferred to an acute care facility, or other health care facility, a length of stay greater than 120 days that ends during the measurement period, Inpatient hospitalizations for newborns who were fed breast milk only since birth, Improvement noted as an increase in the rate. a diagnosis of galactosemia /BS 48 0 R Response: Thank you for your support for the current approach. Center for Academic Medicine, Neonatology, MC 5660, 453 Quarry Road, Palo Alto, CA 94304, CA-PAMR Pregnancy-Associated Mortality Surveillance System Committee, Unexpected Complications in Term Newborns, <1500g Infant Not Delivered at Appropriate Level, COVID-19 Resources for Maternal and Infant Health, Mother & Baby Substance Exposure Initiative Toolkit, OB Hemorrhage Task Force and Update Task Force, Hypertensive Disorders of Pregnancy Toolkit, Hypertensive Disorders of Pregnancy Task Force, Maternal Sepsis Task Force Advisory Group, Support Vaginal Birth and Reduce Primary Cesareans Toolkit, Supporting Vaginal Birth and Reducing Primary Cesarean Delivery Taskforce, Toolkit to Support Vaginal Birth and Reduce Primary Cesareans, Medical School Office Building, 1265 Welch Road, MS 5415, Stanford, CA 94305 USA. << You can also ask your health care provider how you can prepare for surgery or other procedures to reduce your risk of complications. /R 41 0 R 22 0 obj /CropBox [0 0 612 792] >> LEARN MORE ABOUT PCDB 0 Perinatal Discharges Since 1985 Connecting Through Education Recorded NPIC Events /Type /Annot (h6}qA%Zb60 By closely reviewing these care processes, we have the opportunity to concentrate on areas that need improvement. A hospital's PC-Newborn Population size is 99 cases during the second quarter. )YQDF: X9:O4Lal4)#p /EKk= stream /FT /Btn The patients in each measure are processed independently. endobj The measures were originally developed for quality improvement, pay-for-performance, and public health monitoring. /Tabs /W Several years ago, our hospital was not meeting a best practice recommended by the American Heart Association. Hospitals with CB rates at 15-20% have infant outcomes that are just as good and better maternal outcomes (Gould et al., 2004). You will be prompted to log in to your NCQA account. >> That's because The Joint Commission's eCQM option only applies to hospitals submitting all four perinatal measures. Measure Set: Perinatal Care (PC) Set Measure ID: PC-05 Performance Measure Name: Exclusive Breast Milk Feeding Description: Exclusive breast milk feeding during the newborn's entire hospitalization The measure is reported as an overall rate which includes all newborns that were exclusively fed breast milk during the entire hospitalization. Patients are tested for MRSA bloodstream infections if they show signs of illness while in the hospital. A hospital's Mother Population size is 72 cases during the second quarter. >> Retrieved from http://reviewtoaction.org/Report_from_Nine_MMRCs. The Joint Commissions Advanced Perinatal Care Certification requires the use of this set of standardized performance measures in order to meet the performance measurement requirements for certification. PPO corresponds to PPO and EPO within Quality Compass. >> process and established selection principles. Benchmarks for flu immunization Only one birth weight value should be recorded. Download Citation | Assessing the neonatal health policy landscape in low- and middle-income countries: Findings from the 2018 WHO SRMNCAH policy survey | Background: We aimed to describe the . Using the monthly sampling table for the Mother population, the sample size required is 25 cases for the month. #M'*?l62oO9P8(SvbWe w /T (Next 9) HMO corresponds to All LOBs (excluding PPO and EPO) within Quality Compass. endobj Text highlighted in green indicates information updated in the new eCQM version. Our team is always trying to make our hospitals processes better to provide the safest care for our patients.. /H /N /Rect [80 351.2290039062 296.5539855957 335.7850036621] Connected /Parent 4 0 R << endobj endobj Fact Sheet on Maternity Care. Washington, DC the National Quality Forum (NQF) Board of Directors has approved for endorsement 14 quality measures on perinatal care. U.S. hospitals must report their compliance with these core measures to The Joint Commission, a health care accreditation organization, the Centers for Medicare and Medicaid Services and other agencies. /Type /Page Copyright 2023 National Committee for Quality Assurance. /Subtype /Link /Type /Annot All rights reserved. subject to parenteral nutrition, Inpatient hospitalizations for newborns who were with any of the following conditions: This is currently a pay for reporting PRIME measure, and the Q1 2019 Vizient benchmark is 4%; ZS . /Border [0 0 0] ICD-10-PCS Principal or Other Procedure Codes as defined in Appendix A, Table 11.01.1 Delivery, a Patient Age (Admission Date Birthdate) >= 8 years and < 65 and a Length of Stay (Discharge Date - Admission Date) 120 days. The effort to make hospitals' sepsis care public follows the introduction of CMS's hospital reporting on Core Measure SEP-1: Early Management Bundle, Severe Sepsis/Septic Shockin its Inpatient Quality Reporting program, which began in October 2015. 'RelevantDatetime' indicates when the action occurred whereas 'authorDatetime' indicates when the action was recorded. Replaced 'weeks' with the UCUM code wk to be consistent with HL7 standards. Hospitals that choose to sample have the option of sampling quarterly or sampling monthly. /Filter /FlateDecode NPICs expertise and infrastructure can support data /Subtype /Link Effective January 1, 2019, all hospitals that provide obstetric care and deliver at least 300 babies annually will be required to collect data for the newest Joint Commission Perinatal Core (PC) measure, called "PC-06 Unexpected Complications in Term Newborns.". /Length 8 0 R The Inpatient Web-based Measure, Elective Delivery, documents the number of patients with elective vaginal deliveries or elective Cesarean sections at greater than or equal to (>=) 37 and less than (<) 39 . If dextrose or glucose 40% gel is given, it is considered a medication not a feeding. Applications are available at the American Medical Association Web site, www.ama- assn.org/go/cpt. section measure. /TrimBox [0 0 612 792] By using this site, you agree to our use of cookies. This should be reflected as such in the newborn's EHR documentation. An episode is defined as each inpatient hospitalization or encounter that ends during the measurement period. For example, an infant born on the 5th day of the 36th week (35 weeks and 5/7 days) is at a gestational age of 35 weeks, not 36 weeks. One commenter. Through leading practices, unmatched knowledge and expertise, we help organizations across the continuum of care lead the way to zero harm. The best practice included using high levels of cholesterol-lowering medications to treat stroke patients. The Joint Commission, Chris Walas, RN, MSN, and Melissa Potts, RN, BSN, CCDS, CDIP. A hospital's PC-Newborn Population size is 600 cases during the second quarter. Improve Maternal Outcomes at Your Health Care Facility, Accreditation Standards & Resource Center, Ambulatory Health Care: 2023 National Patient Safety Goals, Assisted Living Community: 2023 National Patient Safety Goals, Behavioral Health Care and Human Services: 2023 National Patient Safety Goals, Critical Access Hospital: 2023 National Patient Safety Goals, Home Care: 2023 National Patient Safety Goals, Hospital: 2023 National Patient Safety Goals, Laboratory Services: 2023 National Patient Safety Goals, Nursing Care Center: 2023 National Patient Safety Goals, Office-Based Surgery: 2023 National Patient Safety Goals, The Term Licensed Independent Practitioner Eliminated, Updates to the Patient Blood Management Certification Program Requirements, New Assisted Living Community Accreditation Memory Care Certification Option, Health Care Equity Standard Elevated to National Patient Safety Goal, New and Revised Emergency Management Standards, New Health Care Equity Certification Program, Updates to the Advanced Disease-Specific Care Certification for Inpatient Diabetes Care, Updates to the Assisted Living Community Accreditation Requirements, Updates to the Comprehensive Cardiac Center Certification Program, Health Care Workforce Safety and Well-Being, Report a Patient Safety Concern or Complaint, The Joint Commission Stands for Racial Justice and Equity, The Joint Commission Journal on Quality and Patient Safety, John M. Eisenberg Patient Safety and Quality Award, Bernard J. Tyson National Award for Excellence in Pursuit of Healthcare Equity, Continuing Education Credit Information FAQs, ePC-06 Unexpected Complications in Term Newborns, PC-06 Unexpected Complications in Term Newborns. Chris Walas, RN, MSN, and Kelley Franklin, MSN, RN /ArtBox [0 0 612 792] 5 0 obj Building on a pilot version used by more than 100 hospitals since 2017, the Perinatal Quality Dashboard is the industry's only integrated analytics dashboard that aggregates and benchmarks more than 80 measures to help providers drill into patient-level detail, including payer mix and risk factors for COVID-19 maternal patients. Masks are required inside all of our care facilities. There are no data that higher rates improve any outcomes, yet the CB rates continue to rise. Due to exclusions and contraindications, hospitals selecting sample cases MUST submit AT LEAST the minimum required sample size. was introduced in Q4 2018. This measure compares the number of MRSA-positive blood samples collected 4 or more days after the patient entered the hospital to a national benchmark. CPT is provided as is without warranty of any kind, either expressed or implied, including but not limited to the implied warranties of merchantability and fitness for a particular purpose. Using the monthly sampling table for the Mother population, the sample size required is 20% of this sub-population or 80 cases for the month. >> /Rotate 0 CPT is a registered trademark of the American Medical Association. Twelve measures were previously endorsed, and two are new. by Purpose. /Border [0 0 0] << With more than four million births in the United States each year, perinatal measures are needed to ensure the health and well-being of new mothers and newborns, said Janet Corrigan, PhD, MBA, president and CEO of NQF.

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