Developing measures for pediatric quality: methods and experiences of the CHIPRA pediatric quality measures program grantees
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Published on: February 19, 2021
Sepheen C Byron1, William Gardner2, Lawrence C Kleinman3
1National Committee for Quality Assurance, Washington, DC.
Insights
The Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA) Pediatric Quality Measures Program (PQMP) developed new pediatric quality measures. Innovative methods addressed challenges in evidence, data systems, and stakeholder priorities to improve children's healthcare.
Area of Science:
- Health Services Research
- Pediatric Health
- Quality Improvement
Background:
- Monitoring healthcare quality is crucial for assessing services for children and families.
- The CHIPRA Pediatric Quality Measures Program (PQMP) funded the development of pediatric quality measures.
- This study outlines the processes used by PQMP grantees to create measures for children in Medicaid and CHIP.
Purpose of the Study:
- To describe the processes used by PQMP grantees for developing pediatric quality measures.
- To identify common challenges and innovative solutions in pediatric quality measure development.
- To highlight the importance of stakeholder engagement in the quality improvement process.
Main Methods:
- Key steps included concept identification, evidence synthesis, prioritization, measure calculation definition, and testing.
- Stakeholder engagement was critical throughout the measures development lifecycle.
- Case studies demonstrated adaptations to measure development processes and challenges.
Main Results:
- Grantees employed diverse approaches but encountered shared challenges.
- Common obstacles included a limited evidence base, unsuitable data systems, and competing stakeholder interests.
- Pediatric-specific and general quality measurement challenges were identified.
Conclusions:
- PQMP grantees explored innovative methods to surmount measurement challenges.
- New approaches enhanced the evidence base, stakeholder consensus, data integration, and testing methods.
- The PQMP successfully developed new pediatric quality measures and improved infrastructure for future healthcare quality improvement.
Background:
Monitoring quality is an important way of understanding how the health care system is serving children and families. The Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA) Pediatric Quality Measures Program (PQMP) funded efforts to develop and enhance measures to assess care for children and adolescents. We describe the processes used by the PQMP grantees to develop measures to assess the health care of children and adolescents in Medicaid and the Children's Health Insurance Program.
Methods:
Key steps in the measures development process include identifying concepts, reviewing and synthesizing evidence, prioritizing concepts, defining how measures should be calculated, and measure testing. Stakeholder engagement throughout the process is critical. Case studies illustrate how PQMP grantees adapted the process to respond to the nature of measures they were charged to develop and overcome challenges encountered.
Results:
PQMP grantees used varied approaches to measures development but faced common challenges, some specific to the field of pediatrics and some general to all quality measures. Major challenges included the limited evidence base, data systems difficult or unsuited for measures reporting, and conflicting stakeholder priorities.
Conclusions:
As part of the PQMP, grantees were able to explore innovative methods to overcome measurement challenges, including new approaches to building the evidence base and stakeholder consensus, integration of alternative data sources, and implementation of new testing methods. As a result, the PQMP has developed new quality measures for pediatric care while also building an infrastructure, expertise, and enhanced methods for measures development that promise to provide more relevant and meaningful tools for improving the quality of children's health care.
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