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Improving the Quality of Care Delivered to Children Served by State Agencies

Child Health Toolbox


Margaret Schmid, Ph.D., Health Quality Consultant, Chicago, IL.

The Child Health Toolbox is a downloadable, online resource available on AHRQ's Web site ( The Toolbox is designed for policymakers, program decisionmakers, and others concerned with Medicaid, Title V, State Children's Health Insurance Program (SCHIP), and other child health-related programs. It has seven major sections:

  • Understanding Performance Measurement helps in thinking strategically about the uses of performance measures by examining such questions as: What is performance measurement all about? What does it tell us? What doesn't it tell us?
  • Uses of Performance Measurement answers the questions: How can this program use performance measurement for program management, accountability, and quality improvement? This section includes guidance for effectively reporting performance measure results and examples of how various States have used performance measurement.
  • Why Child Health Measures? includes measurement discussions specific to the Early and Periodic Screening, Diagnosis and Treatment Program (EPSDT) and children with special health care needs (CSHCN).
  • Established Child Health Measures provides an introduction to widely used performance measures appropriate for child health programs, such as CAHPS®, HCUP, Health Plan Employer Data and Information Set (HEDIS®), and Title V measures.
  • Measures In Testing provides a survey of measures being designed, such as the Experience of Health Care and Outcomes Survey (a CAHPS®-based survey focused on behavioral health) and Promoting Healthy Development Survey (a survey designed to measure the effectiveness of parent-physician interaction).
  • Choosing Performance Measures assists identifying performance measures most appropriate for the program. Included are such factors as desired usage of the evaluation, types of service delivery systems, and evaluation cost.
  • Develop Your Own? identifies critical challenges for those desiring to develop their own measures.

Special features of the Toolbox include:

  • Measuring Services for CSHCN.
  • Can We Measure EPSDT?
  • Links to State reports.
  • Information on data issues, measure specifications, validity and reliability, and field-testing.
  • Links to related background research.

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