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Quality Measurement

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A core component of the OPIP mission is “collaborating in quality measurement and improvement activities across the state,” and “incorporating the patient and family voice into quality efforts.” 

There is an adage that is: “what is measured is what is focused on”. In OPIP’s experience, quality metrics are essential to:

  1. Guide and inform improvements
  2. Evaluate investments
  3. Guide and inform policy- and system-level decision making.

Therefore, in OPIP’s efforts to improve the health of all children, we have developed a number of quality measurement tools.

Some examples include:

CHIPRA Core Measure: Developmental Screening in the First Three Years of Life

  • OPIP’s Director, Colleen Reuland developed the CHIPRA Core Measure on Developmental Screening. Click Here to learn more
  • This metric was an Incentive Metric for Coordinated Care Organizations (CCO) in Oregon between 2013-2019.
    • Prior to being included in the CCO Incentive Metric set, Oregon was in the bottom quartile nationally for developmental screening. After being included, Oregon was one of the top states in the country in 2019.

Coordinated Care Organization (CCO) Incentive Metrics

Office Report Tools:

  • Office report tools are a way to gather standardized information about systems and processes in place.
  • OPIP led the development, implementation steps, and analysis of the Medical Home Office Report Tool (MHORT) used in the Tri-State Children’s Health Improvement Consortium (TCHIC). 
  • OPIP also developed the SBHC Office Report Tool for Adolescents (SORTA) for the project focused on enhancing Adolescent Well-Care Visits. This is a 28-item tool that assesses 55 processes related to adolescent well-care in five domains: (1) Quality Improvement, (2) Billing and Claims aligned with CCO metrics, (3) Education about SBHC services, (4) Content of Adolescent Well-Care Visits, and (5) Care Coordination with Primary Care Providers.
  • OPIP  also developed the PCPCH-specific to Early Childhood Development (PCPCH ECD) tool as part of the Oregon Transforming Pediatrics for Early Childhood cooperative agreement. This looks at office systems and processes specific to the early childhood continuum.

Provider and Office Staff Surveys

  • Prior to every Learning Session, Learning Webinar, or QI effort with participating practices, OPIP administers a survey to the providers and office staff to gather a baseline understanding of their perceptions about the strengths and barriers in their systems related to the topic area of focus. Wherever possible, OPIP strives to utilize items from national surveys for which comparative information is available.  Examples of surveys can be found here.

Consumer or Patient-Surveys

  • OPIP feels it is imperative to gather information from patients and families about the care they receive to get a reliable and valid understanding of the quality of care provided. Particularly for care provided to children and youth, a majority of which is provided in the context of communication between patients and health care providers, surveys are imperative. 
  • OPIP also worked with our partners in the T-CHIC project to administer a version of the CAHPS for patients in the practices involved in the ECHO Learning Collaborative.
  • Data about claims submitted can be useful in developing quality measures about services billed. Through the T-CHIC effort, OPIP was involved in a number of efforts to inform or guide measures by the State Medicaid agency to evaluate quality. 
  • Ms. Reuland, the OPIP Executive Director, has extensive experience working with State Medicaid agencies on developing and using quality measures derived from claims and enrollment data, and understanding how it can compliment and inform other quality measure data. 

Quality Measures Based on Medical Chart Reviews

  • Data obtained from reviews of patient medical charts can be invaluable to understanding specific aspects of care provided and specific patient characteristics. 
  • OPIP staff have experience in developing medical chart review tools and in analyzing the data to inform and evaluate quality improvement efforts. 
  • As part of the ABCD III efforts, OPIP developed a medical chart review tool to assess screening, referral, and care coordination for children at-risk for developmental, behavioral, or social delays. OPIP has done significant work to develop specifications related to follow-up to developmental screening.
  • As part of the Oregon Transforming Pediatrics for Early Childhood cooperative agreement, OPIP has developed specifications for the OR TPEC practice to collect chart review data on screening, referrals, care coordination and issue focused interventions.