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Improving the Quality of Care Delivered to Children Served by State Agencies
Workshop Brief for State and Local Policymakers
This workshop was designed for policymakers in the legislative and executive branches
of State and local governments who are interested in children's health, especially those
who manage publicly funded programs that deliver health care to children. The
workshop was held in New Orleans, LA, January 24-26, 2001.
About the Workshop Sponsor.
The objectives for participants in this workshop included developing a better ability to:
- Use defined measures to identify areas that need improvement, set priorities,
and plan the most effective means for achieving improvement.
- Identify and select appropriate measures for specific tasks.
- Describe the benefits to each agency when multiple agencies coordinate
- Design strategies that facilitate change for State agencies, managed care
organizations (MCOs), providers, and consumers.
- Understand the barriers to effective collaboration and identify strategies for
Ensuring quality of care for children is a national, State, and local priority. Policymakers
and others must work together to implement effective strategies to improve care.
Measuring the performance of the health care system is critical to gauging the success
of these improvement strategies.
Scope of Children's Health Problems
Children in the United States are experiencing epidemics in asthma, obesity, diabetes,
and certain mental health conditions. As purchasers and regulators, States have a
powerful ability to address these epidemics and improve the health of children. State
agencies must work together to choose the issues they will address and the
interventions they will implement to achieve the greatest improvement.
Child Health Toolbox
The Child Health Toolbox is a downloadable, online resource to help
policymakers understand and use performance measurement. The Toolbox includes
information on widely used measures and guidance for choosing the measures best
suited to a program's goals.
Quality Improvement Cooperation
Two Massachusetts departments collaborated to develop multiple projects related to
their efforts to improve the quality of care for children. Two examples of this
cooperation are performance measures now used for Title V block grants and
Medicaid-contracted MCOs, and strategies to improve childhood immunization rates.
Motivating Organizational Change
Effectively motivating and managing change involves a coordinated, multifaceted
approach, including effective communication, collaborative experimentation, selecting
target populations, and using measurement and feedback to communicate and adapt.
Coordinated Initiatives Improve Care
Several States have initiated multi-agency efforts to improve the quality of care
provided to children.
- Rhode Island departments created a system to compare health outcomes for
Medicaid beneficiaries against individuals with private insurance or no insurance;
an initiative to improve access and quality of care for children with special health
care needs enrolled in Medicaid; and an integrated system for foster children.
- Missouri departments created a system of health status indicators for MCO
- The Alabama Governor's Task Force on Children's Health Insurance involves
seven State agencies.
Changing Care Delivery
Clinical practices are influenced by many factors; some may impede the quality of care
delivered. Actions that policymakers can take to facilitate clinical practice change
- Form guiding coalitions and engage clinical leadership.
- Use measurement for motivation and improvement.
- Undertake collaborative improvement.
Changing Consumer Thinking
Social marketing can be used to change risky behavior, improve services, or build
social capital. Social marketing involves listening to target populations to learn their
wants and needs, then determining how to beat the "competition" to reach that
Putting Theory into Practice
A series of simulation exercises completed by small groups of participants formed an integral piece of this hands-on workshop. Groups were composed of representatives from multiple State and local agencies.
AHRQ's User Liaison Program (ULP) disseminates health services research findings in easily understandable and usable formats through interactive workshops. Workshops and other support are planned to meet the needs of Federal, State, and local policymakers, and other health services research users, such as purchasers, administrators, and health plans.
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