Washington, DC - The National Quality Forum (NQF) Board of
Directors has recently approved for endorsement 41* quality measures concerning
child health. The measures, listed in the draft report National Voluntary Consensus Standards for Child Health Quality
Measures 2010: A Consensus Report, cover the full spectrum of care from
prenatal care to standards designed for adolescents. The full list of standards
are available for a 30-day public appeals process closing September 13.
“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, PhD, MBA, 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, PhD, 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.
“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 September
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.) 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.
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 (NCQA/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 (Amos Deinard)
- 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)
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.
*Note:
three measures are still under consideration with the Board.
