The National Quality Forum (NQF) Board of Directors has recently approved for endorsement 41 quality measures concerning child health, covering the full spectrum of care from prenatal care to standards designed for adolescents.
The measures are listed in the draft report National Voluntary Consensus Standards for Child Health Quality Measures 2010: A Consensus Report. The full list of standards are available for a 30-day public appeals process closing Sept. 13.
[See also: NQF endorses four new patient quality care measures .]
“With this new set, the NQF portfolio of child health measures now covers important areas of wellness and development for children, including perinatal and neonatal care, chronic illness care, care for hospitalized children, and most recently, child health outcomes,” said Janet Corrigan, president and CEO of the National Quality Forum.
The 2010 Child Health Quality Measures project was designed to enrich NQF’s portfolio of child health standards, at the request of the Centers for Medicare and Medicaid Services. It was completed under a Health and Human Services-funded contract with NQF.
“This list is the result of an increased need for population-health based measures addressing the unique needs of children, from prenatal screenings to adolescent-specific check-ups,” said Marina Weiss, senior vice president for public policy and government affairs of the March of Dimes Foundation and co-chair of the Child Health Quality Measures Steering Committee. “The new measures cover a range of issues important to the healthy development of children, including well-child care, obesity screening, oral health, and mental health.”
For this project, NQF solicited candidate standards suitable for public reporting at the population level and for the following conditions or cross-cutting areas:
- respiratory issues such as asthma;
- overweight/obesity;
- well-child care;
- prevention and screening (e.g., immunizations, developmental delay);
- diabetes;
- prenatal/perinatal care;
- access to care (e.g., well-child care visits, access to primary care practitioners, emergency room utilization);
- oral health (e.g., access to services, dental caries);
- inpatient safety (e.g., pediatric catheter-associated blood stream infection rates);
- mental health (e.g., depression, behavior problems, anxiety, ADHD); and
- patient experience with care.
In all, 75 measures were evaluated for their suitability as voluntary consensus standards for accountability and public reporting using NQF’s standard evaluation criteria. Of these, 41 are now endorsed.
[See also: NQF targets critical need for decision support.]
“These 41 process measures are a timely addition to the portfolio of pediatric and perinatal measures endorsed by NQF. The measures underwent a rigorous review by a panel of providers, measurement experts, and consumer representatives,” said Thomas K. McInerny, MD, associate chair for Clinical Affairs at the Golisano Children's Hospital and co-chair of the Child Health Quality Measures Steering Committee. “They will enable CMS, national organizations interested in child health, states, health plans, and providers to track children’s health quality over time to determine trends and opportunities for improvement.”
NQF is a voluntary consensus standards-setting organization. Any party may request reconsideration of any of the 41 endorsed child health quality measures listed below by submitting an appeal no later than Sept. 13. (To submit an appeal, go to the NQF Measure Database. The new Child Health Quality Measures are at the end of the list. To appeal a measure, click the “appeal this measure” link next to the measure title.)
[See also: NQF adopts six new care standards.]
For an appeal to be considered, the notification must include information clearly demonstrating that the appellant has interests directly and materially affected by the NQF-endorsed recommendations and that the NQF decision has had (or will have) an adverse effect on those interests.
See the next page for a list of quality measures.
Endorsed child health quality measures:
- Frequency of ongoing prenatal care (NCQA)
- Prenatal and postpartum care (NCQA)
- Percentage of low birth weight births (Division of Vital Statistics)
- Sudden Infant Death Syndrome counseling (NCQA)
- Maternal depression screening (NCQA)
- Proportion of infants covered by newborn bloodspot screening (HRSA)
- Newborn hearing screening (NCQA)
- Hearing screening prior to hospital discharge (EHDI-1a) (CDC)
- Outpatient hearing screening of infants who did not complete screening before hospital discharge (EHDI-1c) (CDC)
- Audiological evaluation no later than 3 months of age (EHDI-3) (CDC)
- Intervention no later than 6 months of age (EHDI-4a) (CDC)
- Developmental screening in the first three years of life (MCHB/CAHMI)
- Developmental screening by 2 years of age (NCQA)
- Developmental screening using a parent-completed screening tool (parent report, children 0-5) [from the National Survey of Children’s Health, NSCH] (MCHB/CAHMI)
- Pre-school vision screening in the medical home (American Academy of Pediatrics)
- Blood pressure screening by age 13 (NCQA)
- Blood pressure screening by age 18 (NCQA)
- Chlamydia screening and follow up (NCQA)
- Healthy physical development by 6 years of age (NCQA)
- Healthy physical development by 13 years of age (NCQA)
- Healthy physical development by 18 years of age (NCQA)
- Children age 6-17 years who engage in weekly physical activity [NSCH] (MCHB/CAHMI)
- Immunizations by 13 years of age (NCQA)
- Immunizations by 18 years of age (NCQA)
- Annual dental visit (NCQA)
- Children who received preventive dental care [NSCH] (MCHB/CAHMI)
- Children who have dental decay or cavities [NSCH] (MCHB/CAHMI)
- Primary caries prevention intervention as part of well/ill child care as offered by primary care medical providers (University of Minnesota)
- Depression screening by 13 years of age (NCQA)
- Depression screening by 18 years of age (NCQA)
- Child and adolescent major depressive disorder: Diagnostic evaluation (AMA)
- Risky behavior assessment or counseling by age 13 years (NCQA)
- Risky behavior assessment or counseling by age 18 years (NCQA)
- Child and adolescent major depressive order: Suicide risk assessment (AMA)
- Well child visits in the first 15 months of life (NCQA)
- Well-child visits in the third, fourth, fifth and sixth years of life (NCQA)
- Children with a usual source for care when sick [NSCH] (MCHB/CAHMI)
- Asthma emergency department visits (AL Medicaid Agency)
- Children with inconsistent health insurance coverage in the past 12 months [NSCH] (MCHB/CAHMI)
- Children who receive preventive medical visits [NSCH] (MCHB/CAHMI)
- Children with special health care needs who receive services needed for transition to adult health care [from the National Survey of Children with Special Healthcare Needs, NSCSHCN] (MCHB/CAHMI)
*Note: three measures are still under consideration with the Board.
NQF operates under a three-part mission to improve the quality of American healthcare by building consensus on national priorities and goals for performance improvement and working in partnership to achieve them; endorsing national consensus standards for measuring and publicly reporting on performance; and promoting the attainment of national goals through education and outreach programs.
