PQMP Measure Implementation and Quality Improvement
The second phase of the Pediatric Quality Measures Program (PQMP 2.0) was designed to support and strengthen pediatric quality measurement and quality improvement based on learnings from quality improvement demonstration projects that implemented and evaluated measures in real-world settings. PQMP 2.0 focused on assessing the feasibility and usability of PQMP or existing Child Core Set measures within the Medicaid/CHIP patient populations at the State, health plan, hospital, and provider levels.
PQMP 2.0 activities were intended to support performance monitoring and quality improvement through field testing to inform refinement, data collection, and reporting of measures and use of performance data on measures to define quality improvement goals and test multilevel improvement strategies.
AHRQ awarded grants to six multistakeholder partnership teams to further the implementation of select PQMP measures. The PQMP Learning Collaborative developed the following resources as part of PQMP 2.0 to exhibit and disseminate the learnings of the grantees’ projects:
- Research Foci Lessons from the Field Reports.
- Measure Implementation and Quality Improvement Toolkits.
- Implementation Science Roadmap.
As part of the goal to build the evidence base for quality measurement and improvement in pediatrics, AHRQ and CMS established a set of research foci. These important and ambitious questions outlined key research areas in the quality improvement field where more evidence was needed to facilitate progress. The six PQMP 2.0 grantees established quality improvement demonstration projects that sought to address the research foci.
The PQMP Learning Collaborative gathered data from literature reviews and key informant interviews to augment the findings from the grantee demonstration projects. After identifying a set of key considerations for each of the research foci, the PQMP Learning Collaborative synthesized findings across the three data sources to create an indepth blend of existing evidence and on-the-ground experience. The Lessons from the Field reports describe the findings of this synthesis and lessons learned through the grantees’ data collection efforts, tool development, empirical analyses, and stakeholder engagement.
Learn more and access the Lessons from the Field reports.
Based on their experiences with their quality improvement projects and the implementation process more broadly, the PQMP grantees developed toolkits to assist end users in implementing the PQMP measures and quality improvement initiatives. Each toolkit is tailored to a specific measure or measure set and contains resources such as measure specifications, driver diagrams, strategic roadmaps, screening and communication flow diagrams, and improvement data. The PQMP Learning Collaborative provided technical assistance in developing the toolkits, packaging the toolkits, and creating language to guide users accessing the toolkits online.
Toolkits are currently available for measures related to asthma emergency department use, hospital-to-home transitions, the Child HCAHPS (Hospital Consumer Assessment of Healthcare Providers & Systems) survey, transcranial screening for children with sickle cell anemia, and metabolic monitoring for children on antipsychotics. The toolkits may be useful for State agencies, health plans, hospitals, and providers interested in measure implementation.
Learn more and access the toolkits.
To provide an introduction and overarching guide to measure implementation, the PQMP Learning Collaborative developed an implementation roadmap webpage to support broader dissemination and uptake of the quality improvement toolkits.
The PQMP Learning Collaborative worked closely with two subject matter experts to identify an implementation science framework suitable for analyzing contextual factors across grantee projects. Based on the selected framework, the PQMP Learning Collaborative conducted interviews and developed worksheets to gather information about contextual factors from the grantees.
The data collection effort informed the development of a roadmap to orient stakeholders to the measure implementation process. The roadmap guides potential toolkit users through considering contextual factors to understand how to effectively implement specific measures according to the needs and characteristics of their setting.
Learn more and access the Implementation Science Roadmap.