Q-METRIC Implementation and Quality Improvement

项目总结 到目前为止，卫生保健质量运动中缺乏对儿童的关注是值得注意的。存在质量差距 已经确定了提供儿科保健的许多领域；然而，对于几乎所有这种情况， 目前还没有适当的儿科质量措施。为响应征求关于 合作研究示范和传播项目，我们介绍了Q度量的实现 和质量改进项目，在3个不同的测量集合中测试和实施6项措施。每套都是 重点关注儿童护理中的一个重要问题：镰状细胞病，过度使用成像治疗头痛和 癫痫发作，以及哮喘的门诊治疗。总的来说，这些措施提供了巨大的改进潜力。 儿科医疗质量。所有这些都是由Q-Medium团队在最初的儿科 质量测量计划(PQMP)授权期，使用严格且经过验证的流程。几乎所有这些 已将措施提交并批准纳入国家质量测量信息交换中心 (NQMC)，其中一项措施已得到国家质量论坛的认可并建议纳入 在医疗补助核心指标集中。重要的是，选定的措施都是基于索赔的，不需要 昂贵且耗时的图表查看；这使它们更易于实施和使用。Q-度量 实施和质量改进小组由来自儿童健康评估和 密歇根大学研究部，2个州医疗补助计划，3个医疗计划，3个医疗系统，1 临床联盟，以及几个测量和改进方面的国家领导者，他们是我们的专家 咨询委员会。为该项目发展的合作伙伴关系将为 通过以下方式传播和实施质量措施：(1)我们在以下方面创造协同效应的能力 广泛的方法论、分析和测量测试场景，以及(2)开发的机会 跨州、医疗计划和医疗系统实施的多种质量改进(QI)干预措施 级别。这种方法将侧重于评估这些新技术的可行性和可用性 在确定的三个级别上制定了措施。项目工作将围绕以下方面的开发进行组织 两个队。每个团队将处理FOA：Team A：field中陈述的两个关键目标的具体组成部分 测试、改进、数据收集和报告新的测量方法，以及团队B：使用性能数据 从措施中定义QI目标并测试多层次改进策略。这两支队伍将是 组织并行和协同工作，以完成项目目标。我们将重点关注以下几个方面 目标：1)持续评价这些项目的定期业绩评分和可靠性评估 国家一级的措施；2)实地测试，以确保健康计划和健康的科学可接受性 系统一级，然后评估这些级别的定期业绩得分；以及3)探索 规范作为电子计量的可行性。

PROJECT SUMMARY To date, the lack of focus on children in the health care quality movement has been notable. Quality gaps in many areas of pediatric health care delivery have been identified; however, for almost all such conditions, appropriate pediatric quality measures have not been available. In response to the call for proposals for the Cooperative Research Demonstration and Dissemination Projects, we present the Q-METRIC Implementation and Quality Improvement project to test and implement 6 measures in 3 distinct measure sets. Each set is focused on a significant issue in the care of children: sickle cell disease, overuse of imaging for headaches and seizures, and outpatient care of asthma. Collectively, these measures offer great potential for improving pediatric health care quality. All were developed and tested by the Q-METRIC team during the initial Pediatric Quality Measure Program (PQMP) grant period, using a rigorous and validated process. Nearly all of these measures have been submitted and approved for inclusion in the National Quality Measure Clearinghouse (NQMC), and one measure has been endorsed by the National Quality Forum and recommended for inclusion in the Medicaid Core Measure Set. Importantly, the selected measures are all claims-based and do not require costly and time-intensive chart review; this makes them easier to implement and use. The Q-METRIC Implementation and Quality Improvement team consists of investigators from the Child Health Evaluation and Research Unit at the University of Michigan, 2 State Medicaid programs, 3 health plans, 3 health systems, 1 clinical consortium, and several national leaders in measurement and improvement, who populate our expert advisory committees. The partnerships developed for this project will bring remarkable innovation to the dissemination and implementation of the quality measures through (1) our capacity to create synergy across a wide range of methodologic, analytic, and measurement testing scenarios, and (2) the opportunity to develop multiple quality improvement (QI) interventions for implementation across state, health plan, and health system levels. This approach will focus on the key goals of assessing the feasibility and useability of these newly developed measures at the three identified levels. Project efforts will be organized around the development of two teams. Each team will address specific components of the two key goals stated in the FOA: Team A: field testing, refinement, data collection, and reporting on the new measures, and Team B: use of performance data from the measures to define QI goals and test multilevel improvement strategies. These 2 teams will be organized to work both in parallel and in tandem to accomplish project goals. We will focus on the following objectives: 1) continued appraisal of regular performance scores and reliability assessments of these measures, at the state level; 2) field testing to ensure scientific acceptability at the health plan and health system level, followed by appraisal of regular performance scores at these levels; and 3) exploration of the feasibility of specification as e-measures.