Toolbox Contents

Understanding Quality Measurement

What Is Quality?

• Quality Domains
• Consumer Perspectives

What Is Quality Measurement for Children?
How Is Quality Measurement Used?
What Does Quality Measurement Require?
What Do Quality Measurement Results Tell Us?
What Types of Measures Can We Use?

• Categories of Measures
• Multiple Measures

How Can We Interpret Results?
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Uses of Quality Measurement

Program Management

• Strategy Development Questions
• Resources for Program Management

Accountability

• Strategy Development Questions

Quality Improvement

• Strategy Development Questions
• Quality Improvement Tools

Reporting Results

• Know Your Audience
• Consider a Pilot Year
• Involve Your Stakeholders
• Consider Focus Groups
• Plan Your Dissemination Strategy

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Why Child Health Measures?

Developmental Status and Change
Differential Epidemiology
Dependence
Demographic Patterns
Children with Chronic Health Conditions
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Established Child Health Care Quality Measures

Overview: Existing Measurement Sets
Advantages of Using Established Measures
Quality Measures in State Reports

CAHPS®: Consumer Assessment of Health Plans

• Expanded CAHPS® 3.0 Child Survey
• Children with Chronic Conditions
  • Screener Questions
  • CCC Supplemental Questions
• Availability
• Users
• Comparisons and Trends
• Benchmarking and Databases
• Service Delivery and Units of Analysis
• Length-of-Enrollment Requirements
• Data Issues
• Small Numbers
• Resource and Burden Issues
• Development Process
• Criteria Used
• More Information and User Support

AHRQ QIs: AHRQ Quality Indicators

• Child Indicators Included
• Availability
• Users
• Comparisons and Trends
• Service Delivery and Units of Analysis
• Length-of-Enrollment Requirements
• Data Issues
• Development Process
• Criteria Used
• More Information and User Support

HEDIS®: Health Plan Employer Data and Information Set

• Child Measures Included
• Users
• Comparisons and Trends
• Benchmarking and Databases
• Service Delivery and Units of Analysis
• Length-of-Enrollment Requirements
• Data Issues
• Sample Sizes
• Resource and Burden Issues
• Development Process
• Criteria Used
• More Information and User Support

Title V Maternal and Child Health Programs

• Child Measures Included
• Users
• Comparisons and Trends
• Benchmarking and Databases
• Service Delivery and Units of Analysis
• Length-of-Enrollment Requirements
• Data Issues
• Resource and Burden Issues
• Development Process
• Criteria Used
• More Information and User Support

Child and Adolescent Health Measurement Initiative (CAHMI): Promoting Healthy Development Survey (PHDS)

• Availability
• Child Measures Included
• Users
• Comparisons and Trends
• Benchmarking and Databases
• Service Delivery and Units of Analysis
• Length-of-Enrollment Requirements
• Data Issues
• Sample Sizes
• Resource and Burden Issues
• Development Process
• Criteria Used
• More Information and User Support

Child and Adolescent Health Measurement Initiative (CAHMI): Young Adult Health Care Survey (YAHCS)

• Availability
• Child Measures Included
• Users
• Comparisons and Trends
• Benchmarking and Databases
• Service Delivery and Units of Analysis
• Length-of-Enrollment Requirements
• Data Issues
• Sample Sizes
• Resource and Burden Issues
• Development Process
• Criteria Used
• More Information and User Support

Examples of How States Use Quality Measures

• Arizona
• Michigan
• Minnesota
• New York
• North Carolina
• Ohio
• Rhode Island
• Vermont
• Washington State
• Wisconsin

Mental Health Quality Measures

• Overview
• Experience of Care and Health Outcomes Survey (ECHO™)
• National Inventory of Mental Health Quality Measures

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Emerging Measures

Child and Adolescent Health Measurement Initiative (CAHMI)

• Ambulatory Care Sensitive Hospitalization Measurement Project
• Medical Home for Children with Special Health Care Needs (CSHCN)
• Mental and Behavioral Quality Measures for Children and Adolescents

ORYX™

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Choosing Quality Measures

Some Planning Suggestions

• Think Long Term
• Consider All Available Measurement Tools
• Think Fewer Measures
• Develop a Plan

Factors to Consider

• Making Comparisons
• Databases and Benchmarks
• Trends Over Time
• Service Delivery Systems
• Unit of Analysis
• Staff Experience and User Support
• Costs

Reviewing Some Selected Measures

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Develop Your Own?

Before You Begin

• Have You Identified the Significant Health Problems of Your Target Population(s)?
• Do Measures Already Exist that Accurately Assess Quality in Your Area of Interest?
• Have You Clearly Defined the Anticipated Uses of the Resulting Quality Information?
• Are There Other Methods of Obtaining Comparable Information?
• Have You Examined Your Assumptions About Causality?

Developing Detailed Specifications
Data Issues to Keep in Mind

• Push the Envelope—But Not Too Hard
• Learn and Use the "Typical" Data Sources
• Consider Using Encounter or Claims Data—Very Carefully

Sampling
Reliability and Validity
Field Testing
An Alternative to Consider: Customizing Existing Measures
State-Designed and State-Negotiated Quality Measures
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Resources

Federal Interagency Forum on Child and Family Statistics
Summary Health Statistics for U.S. Children
Advancing State Child Indicators Initiatives

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Internet Citation:

Child Health Care Quality Toolbox: Toolbox Contents. July 2004. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/chtoolbx/toolcon.htm

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