What is "quality"? In healthcare, quality can encompass the availability of care, the patient’s experience when receiving the care and, perhaps most importantly, the outcome of the care received. As defined by Merriam-Webster’s Dictionary, quality is a “degree of excellence.” According to the Institute of Medicine, quality is “The degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge.”
NICHQ’s view of quality care for children aligns with the Institute of Medicine’s 2001 vision for improving healthcare in "Crossing the Quality Chasm." The IOM publication laid out the six aims for improvement in healthcare, “Safe, Effective, Patient-centered, Timely, Efficient, Equitable.”
NICHQ CEO Charles Homer MD, MPH reframed these aims when laying out NICHQ’s goals in a 2005 speech at the Annual Forum for Improving Children’s Healthcare:
Our goal is to create a healthcare system that enables…
- Children to achieve their greatest potential while causing no needless harm
- Families to better provide for and support their child’s health and well being
- Communities to effectively promote the health of children and families
Society to achieve these results with equality and no waste
Read how far the pediatric quality improvement field has come in two decades in NICHQ's president and CEO's forward to the Pediatric Clinics of North America,"A Great Start and A Long Way to Go."
NICHQ’s Quality Work
The National Initiative for Children’s Healthcare Quality provides tools and methods to improve care - at the practice, hospital, community, state and national level. We help delivery organizations make changes based on the best available evidence and formulate policies that support and accelerate improvement in quality.
Download NICHQ's Model for Quality Improvement here.
NICHQ’s Quality Measures
As NICHQ works on projects to improve quality and the system of care, measures are developed to help experts understand if the changes they make are true improvements.
With input from experts in the field, as well as academic and clinical leaders in healthcare, NICHQ develops appropriate measures for each topic area and designs the measures so that they can be adopted by delivery organizations. There are four types of measures:
Outcome measures tell a team whether the changes it is making are actually leading to improvement — that is, helping to achieve the stated aim.
Process measures tell a team whether a specific process change has been accomplished and whether it is having the intended effect. A team often establishes several process measures in the course of its work. The assumption is that improvement in a process measure will have an eventual impact on the outcome measure.
Structural measures indicate whether the pre-conditions that are established are more likely to result in effective processes and better outcomes for children and families. Structural measures include the level of training of staff and the staff’s characteristics.
Use these measures to make sure that changes to improve one part of the system aren’t causing new problems in other parts of the system.