IN BRIEF

Meaningful Improvement of Child Health Requires Core Quality and Outcomes Measures

August 16, 2017
Written by

The seemingly infinite indicators large pediatric systems use to measure children’s health often fall short in determining patient outcomes and quality of care.

In an editorial published in JAMA Pediatrics, Kelly Kelleher, MD, director of the Center for Innovation in Pediatric Practice at Nationwide Children’s Hospital, and co-author William Gardner from the Children’s Hospital of Eastern Ontario, call for a national effort to develop a core set of quality and outcome measures for children.

“The specific health needs of children can change rapidly as they pass through the developmental stages,” notes Dr. Kelleher. “To respond to that, an exclusively pediatric measure set must be used. But the measure set must also be sensitive to development without excessively expanding the number of measures and making use of the set not feasible.”

The goal of health care, namely well-being, has a different meaning across a life span. Children must build the physical, cognitive and social foundations to become healthy adults, in addition to their current health needs. Children also face different health risks; many of the diseases and conditions children experience are influenced by socioenvironmental factors.

As the authors note, “successful efforts to move community measures forward will only be achieved by health care clinicians working with social services agencies, schools, and local governments to change the social determinants of health. This includes partnering on services but also on governance, shared savings, and relevant data.”

Current measure sets are primarily aimed at addressing disorders and processes rather than patient outcomes and quality of life. Comparative studies of institutions without common, standardized measures have proven impossible.

Dr. Kelleher and colleagues have convened a group to begin the effort of constructing a set of more relevant pediatric measures. A conceptual framework developed by the National Academy of Medicine will be adapted to identify a core pediatric health measure set that assesses the most important aspects of pediatric health.

“Work needs to be done on both sides; both within the medical community and the communities those pediatric organizations serve,” adds Dr. Kelleher. “We as health care professionals need to create a core set of measures, and we must connect with the external community to move population health initiatives forward. We already focus on patient outcomes and quality of life, and our measure sets should reflect that.”

 

Reference:

Gardner, W, Kelleher, K. Core quality and outcome measures for pediatric health. JAMA Pediatrics. 10 July 2017. [Epub ahead of print].