Developing measures for pediatric quality: methods and experiences of the CHIPRA Pediatric Quality Measures Program grantees
Open accessAbstract
Background Monitoring quality is an important way of understanding how the health care system is serving children and families. The Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA) Pediatric Quality Measures Program (PQMP) funded efforts to develop and enhance measures to assess care for children and adolescents. We describe the processes used by the PQMP grantees to develop measures to assess the health care of children and adolescents in Medicaid and the Children's Health Insurance Program.Methods Key steps in the measures development process include identifying concepts, reviewing and synthesizing evidence, prioritizing concepts, defining how measures should be calculated, and measure testing. Stakeholder engagement throughout the process is critical. Case studies illustrate how PQMP grantees adapted the process to respond to the nature of measures they were charged to develop and overcome challenges encountered.Results PQMP grantees used varied approaches to measures development but faced common challenges, some specific to the field of pediatrics and some general to all quality measures. Major challenges included the limited evidence base, data systems difficult or unsuited for measures reporting, and conflicting stakeholder priorities.Conclusions As part of the PQMP, grantees were able to explore innovative methods to overcome measurement challenges, including new approaches to building the evidence base and stakeholder consensus, integration of alternative data sources, and implementation of new testing methods. As a result, the PQMP has developed new quality measures for pediatric care while also building an infrastructure, expertise, and enhanced methods for measures development that promise to provide more relevant and meaningful tools for improving the quality of children's health care.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Byron et al. describe a process of engaging stakeholders at all levels of measure development and implementation for CHIPRA quality measures.
“Byron et al 98 describe a process of engaging stakeholders at all levels of measure development and implementation for Children's Health Insurance Program Reauthorization Act (CHIPRA) quality measures.”
From Measuring and improving the quality of mental health care: a global perspective (2018) · cites this paper as [98]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
The National Committee for Quality Assurance
Iglehart, J. K. (1996) · New England Journal of Medicine · doi:10.1056/nejm199609263351322 · Cited by 1,826 · see citing works
Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents.
Green, M. (1994) · Cited by 1,662 · see citing works
Finding What Works in Health Care: Standards for Systematic Reviews
Eden, J., Levit, L. A., Berg, A. O., & Morton, S. C. (2013) · Cited by 943 · see citing works
The Patient-Centered Outcomes Research Institute
Newhouse, R. P., Barksdale, D. J., & Miller, J. A. (2014) · Nursing Research · doi:10.1097/nnr.0000000000000070 · Cited by 608 · see citing works
Knowing What Works in Health Care: A Roadmap for the Nation
Eden, J., Wheatley, B., McNeil, B., & Sox, H. C. (2008) · University Libraries (University of Maryland) · doi:10.13016/zoku-ylou · Cited by 252 · see citing works
Increasing Demands for Quality Measurement
Panzer, R. J., Gitomer, R. S., Greene, W. H., Webster, P. R., Landry, K. R., & Riccobono, C. A. (2013) · JAMA · doi:10.1001/jama.2013.282047 · Cited by 156 · see citing works
Estabrooks, P. A., Boyle, M., Emmons, K. M., Glasgow, R. E., Hesse, B. W., Kaplan, R. M., Krist, A. H., Moser, R. P., & Taylor, M. V. (2012) · Journal of the American Medical Informatics Association · doi:10.1136/amiajnl-2011-000576 · Cited by 144 · see citing works
Evidence for the Management of Adolescent Depression
Lewandowski, R. E., Acri, M. C., Hoagwood, K., Olfson, M., Clarke, G. N., Gardner, W. P., Scholle, S. H., Byron, S. C., Kelleher, K. J., Pincus, H. A., et al. (2013) · PEDIATRICS · doi:10.1542/peds.2013-0600 · Cited by 80 · see citing works
Self-citationThe Effective Health Care Program
Chang, S., Matchar, D. B., Smetana, G. W., & Umscheid, C. A. (2012) · Cited by 42 · see citing works
Medicaid Analytic eXtract (MAX) General Information
(2017) · Cited by 38 · see citing works
Advancing Children's Health Care and Outcomes Through the Pediatric Quality Measures Program
Mistry, K. B., Chesley, F. D., LLanos, K., & Dougherty, D. M. (2014) · Academic Pediatrics · doi:10.1016/j.acap.2014.06.025 · Cited by 35 · see citing works
Quality indicators and quality assessment in child health
Kavanagh, P. L., Adams, W. G., & Wang, C.-H. J. (2009) · Archives of Disease in Childhood · doi:10.1136/adc.2008.137893 · Cited by 31 · see citing works
Gardner, W. P., Morton, S., Byron, S. C., Tinôco, A. D. F., Canan, B. D., Leonhart, K. L., Kong, V., & Scholle, S. H. (2014) · Health Services Research · doi:10.1111/1475-6773.12159 · Cited by 19 · see citing works
Self-citationIMPLEMENTATION CHOICES FOR THE CHILDREN'S HEALTH INSURANCE PROGRAM REAUTHORIZATION ACT OF 2009
Simpson, L., Fairbrother, G., Touschner, J., & Guyer, J. (2009) · Commonweal · Cited by 13 · see citing works
Variations in Measurement of Sexual Activity Based on EHR Definitions
Berlan, E. D., Ireland, A. M., Morton, S., Byron, S. C., Canan, B. D., & Kelleher, K. J. (2014) · PEDIATRICS · doi:10.1542/peds.2013-3232 · Cited by 8 · see citing works
Self-citationWiecha, J. (2001) · doi:10.1367/1539-4409(2001)001
Flagged first, then by citations
Research works printed but not linked: 3
- Agency for Healthcare Research and Quality. Priority setting for the Children's Health Insurance Program Reauthorization Act (CHIPRA) Pediatric Quality Measures Program: a notice by the Agency for Healthcare Research and Quality. Fed Reg. 2010;75:75469-75471.
- Committee on Pediatric Health and Health Care Quality Measures, Board on Children, Youth, and Families, Board on Health Care Ser- vices; Institute of Medicine and National Research Council of the Na- tional Academy. Child and Adolescent Health and Health Care Quality: Measuring What Matters. Washington, DC: National Acad- emies Press; 2011.
- Palmer RH, Miller MR. Methodologic challenges in developing and implementing measures of quality for child health care. Ambul Pe- diatr. 2001;1:39-52.
Cited by
Sorted by citations
Measuring and improving the quality of mental health care: a global perspective
Kilbourne, A. M., Beck, K., Spaeth‐Rublee, B., Ramanuj, P., O'Brien, R. W., Tomoyasu, N., & Pincus, H. A. (2018) · World Psychiatry · doi:10.1002/wps.20482 · Cited by 457 · see citing works
Gleeson, H., Calderón, A., Swami, V., Deighton, J., Wolpert, M., & Edbrooke-Childs, J. H. (2016) · BMJ Open · doi:10.1136/bmjopen-2016-011907 · Cited by 290 · see citing works
Sundaram, C. S., Campbell, R., Ju, A., King, M. T., & Rutherford, C. (2022) · Journal of Patient-Reported Outcomes · doi:10.1186/s41687-022-00524-0 · Cited by 79 · see citing works
Desai, A. D., Popalisky, J., Simon, T. D., & Mangione-Smith, R. M. (2015) · Hospital Pediatrics · doi:10.1542/hpeds.2014-0097 · Cited by 71 · see citing works
Self-citationBentley, N., Hartley, S., & Bucci, S. (2019) · Clinical Child and Family Psychology Review · doi:10.1007/s10567-018-00273-x · Cited by 71 · see citing works
A New Era in Quality Measurement: The Development and Application of Quality Measures
Adirim, T. A., Meade, K. E., Mistry, K. B., Franklin, W. H., Adirim, T. A., Bundy, D. G., Ferguson, L. E., Gleeson, S. P., Leu, M. G., Mueller, B. U., et al. (2016) · PEDIATRICS · doi:10.1542/peds.2016-3442 · Cited by 55 · see citing works
Quality Measures to Assess Care Transitions for Hospitalized Children
Leyenaar, J. K., Desai, A. D., Burkhart, Q., Parast, L. M., Roth, C. P., McGalliard, J., Marmet, J., Simon, T. D., Allshouse, C., Britto, M. T., et al. (2016) · PEDIATRICS · doi:10.1542/peds.2016-0906 · Cited by 40 · see citing works
Self-citationDevelopment of the Children With Disabilities Algorithm
Chien, A. T., Kuhlthau, K. A., Toomey, S. L., Quinn, J. A., Houtrow, A. J., Kuo, D. Z., Okumura, M. J., Cleave, J. M. V., Johnson, C. K., Mahoney, L. L., et al. (2015) · PEDIATRICS · doi:10.1542/peds.2015-0228 · Cited by 36 · see citing works
Self-citationHospital-Based Quality Measures for Pediatric Mental Health Care
Bardach, N. S., Burkhart, Q., Richardson, L. P., Roth, C. P., Murphy, J. M., Parast, L. M., Gidengil, C. A., Marmet, J., Britto, M. T., & Mangione-Smith, R. M. (2018) · PEDIATRICS · doi:10.1542/peds.2017-3554 · Cited by 36 · see citing works
Self-citationAdvancing Children's Health Care and Outcomes Through the Pediatric Quality Measures Program
Mistry, K. B., Chesley, F. D., LLanos, K., & Dougherty, D. M. (2014) · Academic Pediatrics · doi:10.1016/j.acap.2014.06.025 · Cited by 35 · see citing works
Quality Concerns in Antipsychotic Prescribing for Youth: A Review of Treatment Guidelines
Kealey, E. M., Scholle, S. H., Byron, S. C., Hoagwood, K., Leckman‐Westin, E., Kelleher, K. J., & Finnerty, M. T. (2014) · Academic Pediatrics · doi:10.1016/j.acap.2014.05.009 · Cited by 33 · see citing works
Self-citationLeckman‐Westin, E., Finnerty, M. T., Scholle, S. H., Pritam, R., Layman, D. M., Kealey, E. M., Byron, S. C., Morden, E., Bilder, S. M., Neese‐Todd, S., et al. (2018) · Journal of Managed Care & Specialty Pharmacy · doi:10.18553/jmcp.2018.24.3.238 · Cited by 31 · see citing works
Self-citationBarach, P. R., & Kleinman, L. C. (2018) · Progress in Pediatric Cardiology · doi:10.1016/j.ppedcard.2018.02.010 · Cited by 16 · see citing works
Self-citationBender, M., Spiva, L., Su, W., & Hites, L. (2018) · Journal of Nursing Management · doi:10.1111/jonm.12596 · Cited by 15 · see citing works
A Learning Loop Model of Collaborative Decision-Making in Chronic Illness
Ronis, S. D., Kleinman, L. C., & Stange, K. C. (2019) · Academic Pediatrics · doi:10.1016/j.acap.2019.04.006 · Cited by 13 · see citing works
Self-citationHavers, S. M., Martin, E. K., Wilson, A. J., & Hall, L. (2020) · Journal of Infection Prevention · doi:10.1177/1757177420907696 · Cited by 9 · see citing works
Pediatricians’ Participation in Quality Improvement at the Time of Enrollment in MOC
Freed, G. L., deJong, N. A., Macy, M. L., Van, K. D., & Leslie, L. K. (2018) · PEDIATRICS · doi:10.1542/peds.2018-0712 · Cited by 8 · see citing works
Self-citationThe Challenges of Addressing Pediatric Quality Measurement Gaps
Mangione-Smith, R. M. (2017) · PEDIATRICS · doi:10.1542/peds.2017-0174 · Cited by 8 · see citing works
Self-citationDeveloping a quality measure to assess use of antibiotic medications for respiratory conditions
Melville, B. L., Musser, T., Fishman, E., Rainis, D., & Byron, S. C. (2023) · Antimicrobial Stewardship & Healthcare Epidemiology · doi:10.1017/ash.2022.328 · Cited by 7 · see citing works
Self-citationAdvancing the Science of Measurement in Pediatric Quality of Care
Kuhlthau, K. A., Mistry, K. B., Forrest, C. B., & Dougherty, D. M. (2014) · Academic Pediatrics · doi:10.1016/j.acap.2014.06.016 · Cited by 7 · see citing works
Mackie, T. I., Kovacs, K. M., Simmel, C., Crystal, S., Neese‐Todd, S., & Akıncıgil, A. (2020) · Health Services Research · doi:10.1111/1475-6773.13610 · Cited by 7 · see citing works
Process Metrics and Outcomes to Inform Quality Improvement in Pediatric Hospital Medicine
Desai, A. D., & Starmer, A. J. (2019) · Pediatric Clinics of North America · doi:10.1016/j.pcl.2019.03.002 · Cited by 4 · see citing works
Harnessing electronic clinical data to report adult and prenatal immunization quality measures
Byron, S. C., Roth, L., Acton, R. M., & Shen, A. K. (2021) · Journal of the American Medical Informatics Association · doi:10.1093/jamia/ocab125 · Cited by 4 · see citing works
Self-citationImproving the Quality of Written Discharge Instructions: A Multisite Collaborative Project
Desai, A. D., Tolpadi, A. A., Parast, L. M., Esporas, M., Britto, M. T., Gidengil, C. A., Wilson, K. M., Bardach, N. S., Basco, W. T., Brittan, M. S., et al. (2023) · PEDIATRICS · doi:10.1542/peds.2022-059452 · Cited by 3 · see citing works
Self-citationMehl, C., Müller, T., Nau, T., Bachmann, C., & Geraedts, M. (2024) · Zeitschrift für Evidenz Fortbildung und Qualität im Gesundheitswesen · doi:10.1016/j.zefq.2024.03.002 · Cited by 3 · see citing works
A Primer on Understanding Pediatric Health Care Quality Measurement
Heuer, B., Rankin, A. N., Reyes, I., & Dihigo, S. (2019) · Journal of Pediatric Health Care · doi:10.1016/j.pedhc.2019.02.001 · Cited by 3 · see citing works
Challenges to Measuring the Quality of Low-Risk Newborns
Lorch, S. A. (2017) · PEDIATRICS · doi:10.1542/peds.2016-4025 · Cited by 2 · see citing works
Peruzzo, E., Vainieri, M., & Rosis, S. D. (2025) · The International Journal of Health Planning and Management · doi:10.1002/hpm.3912 · Cited by 2 · see citing works
Characteristics and outcomes associated with two asthma quality of care measures
Blackburn, J. L., Sharma, P., Liu, Y., Morrisey, M. A., Menachemi, N., Sen, B., Sanders, T., & Becker, D. J. (2021) · Journal of Asthma · doi:10.1080/02770903.2021.1996602 · Cited by 2 · see citing works
Homology Modeling of the Squalus Acanthias AHR1 To Locate Structural Determinants of FunctionPreprint
Bock, T. (2019) · doi:10.28971/562019dw97 · Cited by 1 · see citing works
Havers, S. M. (2019) · Queensland University of Technology · doi:10.5204/thesis.eprints.134261
- Authors
- Byron, S. C., Gardner, W., Kleinman, L. C., Mangione-Smith, R., Moon, J., Sachdeva, R., Schuster, M. A., Freed, G. L., Smith, G., & Scholle, S. H.
- Affiliations
- National Committee for Quality Assurance (US)
- Dalhousie University (CA)
- Icahn School of Medicine at Mount Sinai (US)
- Seattle Children's Research Institute (US)
- Children's Hospital of Philadelphia (US)
- American Academy of Pediatrics (US)
- Boston Children's Hospital (US)
- University of Michigan (US)
- Illinois Department of Healthcare and Family Services (US)
- Corresponding author
- Byron, Sepheen C.
- ORCID
- Venue
- Academic Pediatrics
- Publisher
- Elsevier BV
- Published
- 2014-09
- Volume
- 14
- Issue
- 5
- Pages
- S27-S32
- ISSN
- 1876-2859 (ISSN-L)
- OpenAlex
- W1990503058
- Cited by
- 31
- References
- 16
- Citations by year
- 2025: 1 · 2024: 1 · 2023: 2 · 2022: 1 · 2021: 2 · 2020: 2 · 2019: 6 · 2018: 6 · 2017: 2 · 2016: 3 · 2015: 2 · 2014: 3
- FWCI
- 6.08
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Academic Pediatrics (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Agency for Healthcare Research and Quality
- U.S. Department of Health and Human Services
- Topics
- Health Sciences › Health Professions › Health Information Management › Healthcare Quality and Management
- Health Sciences › Health Professions › General Health Professions › Primary Care and Health Outcomes
- Social Sciences › Sociology and Political Science › Delphi Technique in Research
- Keywords
- Medicaid, children's health care, stakeholder engagement, evidence synthesis, alternative data, pediatric care quality
- MeSH terms
- Adolescent, Child, Child Health Services, Child Welfare, Humans, Insurance, Health, Quality Assurance, Health Care, United States, Adolescent Health Services, Quality Indicators, Health Care, Quality Improvement
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review