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Advancing the Measurement of Care Coordination in Pediatric Behavioral Health
Maria Jorina1, Ayesha Cammaerts, Janice Singer
1*Center for Patient Safety and Quality Research, Boston Children's Hospital, Boston, MA; †Office of Community Health, Boston Children's Hospital, Boston, MA; ‡Massachusetts Health Quality Partners, Watertown, MA; §Center for Patient Safety and Quality Research, Boston Children's Hospital, Harvard Medical School, Boston, MA; ‖Division of Developmental Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA; ¶Department of Medicine, Integrated Care Program, Boston Children's Hospital, Harvard Medical School, Boston, MA; **Division of General Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, MA.
Insights
Researchers identified and evaluated care coordination measures for children with behavioral health needs. Eight new measures were proposed, alongside one existing measure, to improve pediatric behavioral health care coordination.
Area of Science:
- Pediatric Behavioral Health
- Healthcare Quality Improvement
- Care Coordination Measurement
Background:
- A significant gap exists in pediatric measures for care coordination within behavioral health services.
- The Massachusetts Child Health Quality Coalition recognized the need for improved measurement tools.
Purpose of the Study:
- To outline the systematic process for reviewing and evaluating potential new measures of care coordination.
- To identify and propose candidate measures for children with behavioral health needs.
Main Methods:
- An extensive literature review was conducted.
- The Care Coordination Key Elements Framework guided the evaluation.
- A modified RAND Delphi method was employed for feasibility and validity assessment.
Main Results:
- Thirty-two measures were initially evaluated.
- One existing measure and eight newly developed measures met feasibility and reliability criteria.
- The proposed measures align with the key elements of the Care Coordination Framework.
Conclusions:
- A comprehensive methodology successfully proposed new measures to address identified gaps in pediatric behavioral health care coordination.
- Further testing is required to ensure the scientific validity and widespread applicability of the proposed measures.
Objective:
To describe the measure review and evaluation process used to identify new measures of care coordination for children with behavioral health needs conducted as part of Massachusetts' Children's Health Insurance Program Reauthorization Act Quality Demonstration Grant.
Method:
The Massachusetts Child Health Quality Coalition identified a shortage of pediatric measures of care coordination in behavioral health. After an extensive literature review, the Measure Development Committee applied the Care Coordination Key Elements Framework (Framework), which was designed as part of the grant work, and used a modified RAND Delphi method to conduct feasibility and validity evaluation and propose the new candidate measures for further rigorous testing.
Results:
Thirty-two measures were evaluated. One existing Healthcare Effectiveness Data and Information Set and 8 newly proposed measures met the criteria for feasibility and reliability. These measures represented each of the key elements contained in the Framework. The measures need further testing to ensure scientific acceptability and wide usability.
Conclusion:
A multipronged methodology was used to propose measures of care coordination in the space of pediatric behavioral health to fill the identified gaps in existing measures.
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