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01-11-2016 | From the Field

Importance of Performance Measurement and MCH Epidemiology Leadership to Quality Improvement Initiatives at the National, State and Local Levels

Authors: Kristin M. Rankin, Loretta Gavin, John W. Moran Jr., Charlan D. Kroelinger, Catherine J. Vladutiu, David A. Goodman, William M. Sappenfield

Published in: Maternal and Child Health Journal | Issue 11/2016

Abstract

Purpose In recognition of the importance of performance measurement and MCH epidemiology leadership to quality improvement (QI) efforts, a plenary session dedicated to this topic was presented at the 2014 CityMatCH Leadership and MCH Epidemiology Conference. This paper summarizes the session and provides two applications of performance measurement to QI in MCH. Description Performance measures addressing processes of care are ubiquitous in the current health system landscape and the MCH community is increasingly applying QI processes, such as Plan-Do-Study-Act (PDSA) cycles, to improve the effectiveness and efficiency of systems impacting MCH populations. QI is maximally effective when well-defined performance measures are used to monitor change. Assessment MCH epidemiologists provide leadership to QI initiatives by identifying population-based outcomes that would benefit from QI, defining and implementing performance measures, assessing and improving data quality and timeliness, reporting variability in measures throughout PDSA cycles, evaluating QI initiative impact, and translating findings to stakeholders. MCH epidemiologists can also ensure that QI initiatives are aligned with MCH priorities at the local, state and federal levels. Two examples of this work, one highlighting use of a contraceptive service performance measure and another describing QI for peripartum hemorrhage prevention, demonstrate MCH epidemiologists’ contributions throughout. Challenges remain in applying QI to complex community and systems-level interventions, including those aimed at improving access to quality care. Conclusion MCH epidemiologists provide leadership to QI initiatives by ensuring they are data-informed and supportive of a common MCH agenda, thereby optimizing the potential to improve MCH outcomes.

American College of Obstetricians and Gynecologists. (2009). Increasing use of contraceptive implants and intrauterine devices to reduce unintended pregnancy. Obstetrics and Gynecology, 114(6), 1434–1438.CrossRef

Berg, C. J., Harper, M. A., Atkinson, S. M., Bell, E. A., Brown, H. L., Hage, M., et al. (2005). Preventability of pregnancy-related deaths: Results of a state-wide review. Obstetrics and Gynecology, 106, 1228–1234.CrossRefPubMed

Bethell, C. D., Kogan, M. D., Strickland, B. B., Schor, E. L., Robertson, J., & Newacheck, P. W. (2011). A national and state profile of leading health problems and health care quality for US children: Key insurance disparities and across-state variations. Academic Pediatrics, 11(3), S22–S33.CrossRefPubMed

Callaghan, W. M., Creanga, A. A., & Kuklina, E. V. (2012). Severe maternal morbidity among delivery and postpartum hospitalizations in the United States. Obstetrics and Gynecology, 120, 1029–1039.PubMed

CDC & OPA. (2014). Providing quality family planning services: Recommendations of CDC and the US Office of Population Affairs. MMWR Recommendations and Reports, 63(4), 1.

Center for Medicare and Medicaid Services (CMS) Maternal and Infant Health Initiative. (Producer). (2014). Measuring Contraceptive Use in Medicaid and CHIP [Video webinar]. Retrieved from: http://www.medicaid.gov/medicaid-chip-program-information/by-topics/quality-of-care/downloads/contraception-use-webinar.pdf.

Center for Medicare and Medicaid Services (CMS) Center for Medicaid and CHIP Services (2015). Core set of children’s health care quality measures for medicaid and CHIP (Child Core Set): Technical specifications and resource manual for federal fiscal year 2015 reporting. Retrieved from: http://www.medicaid.gov/medicaid-chip-program-information/by-topics/quality-of-care/adult-health-care-quality-measures.html.

Centers for Disease Control and Prevention (CDC). (2015, April 29). Perinatal Quality Collaboratives. Retrieved from: http://www.cdc.gov/reproductivehealth/MaternalInfanthealth/PQC.htm.

Centre for Maternal and Child Enquiries (CMACE). (2011). Saving mothers’ lives: Reviewing maternal deaths to make motherhood safer: 2006–2008. The eighth Report on confidential enquiries into maternal deaths in the United Kingdom. British Journal of Obstetrics and Gynaecology, 118(suppl 1), 1–203.

Cheng, D., Schwarz, E. B., Douglas, E., & Horon, I. (2009). Unintended pregnancy and associated maternal preconception, prenatal and postpartum behaviors. Contraception, 79(3), 194–198.CrossRefPubMed

Finer, L. B., & Zolna, M. R. (2014). Shifts in intended and unintended pregnancies in the United States, 2001–2008. American Journal of Public Health, 104(S1), S43–S48.CrossRefPubMedPubMedCentral

Gemmill, A., & Lindberg, L. D. (2013). Short interpregnancy intervals in the United States. Obstetrics and Gynecology, 122(1), 64.CrossRefPubMedPubMedCentral

Gipson, J. D., Koenig, M. A., & Hindin, M. J. (2008). The effects of unintended pregnancy on infant, child, and parental health: A review of the literature. Studies in Family Planning, 39(1), 18–38.CrossRefPubMed

Health Resources and Services Adminstration (HRSA). Maternal and Child Health Bureau. (2016). Collaborative Improvement & Innovation Network to Reduce Infant Mortality. Retrieved from: http://www.nichq.org/childrens-health/infant-health/coiin-to-reduce-infant-mortality.

Hernandez L. (2014). Pregnancy-Associated Mortality Review: Pregnancy-Related Deaths Due to Hemorrhage, 1999–2012. Florida Department of Health. Retrieved from: http://www.floridahealth.gov/programs-and-services/womens-health/pregnancy/pamr-hemorrhage.pdf.

Langley, G. J., Moen, R., Nolan, K. M., Nolan, T. W., Norman, C. L., & Provost, L. P. (2009). The improvement guide: A practical approach to enhancing organizational performance (2nd ed.). San Francisco, CA: Jossey-Bass.

Lu, M. C., Lauver, C. B., Dykton, C., Kogan, M. D., Lawler, M. H., Raskin-Ramos, L., et al. (2015). Transformation of the title V maternal and child health services block grant. Maternal and Child Health Journal, 19(5), 927–931.CrossRefPubMedPubMedCentral

Lyndon, A., Lagrew, D., Shields, L., Main, E., & Cape, V. (2015). Improving health care response to obstetric hemorrhage. (California Maternal Quality Care Collaborative Toolkit to Transform Maternity Care) Developed under contract #11-10006 with the California Department of Public Health; Maternal, Child and Adolescent Health Division; Published by the California Maternal Quality Care Collaborative, 3/17/15.

Main, E. K., McCain, C. L., Morton Holtby, S., & Lawton, E. S. (2015). Pregnancy-related mortality in California: Causes, characteristics, and improvement opportunities. Obstetrics and Gynecology, 125, 938–947.CrossRefPubMed

MCH Navigator. MCH Training Primer: MCH Training Cycle. (January 2014). Retrieved from: http://mchnavigator.org/trainings/MCH-planning-cycle.php.

National Quality Forum (NQF). (2016a). NQF: About Us. Retrieved from: http://www.qualityforum.org/story/About_Us.aspx.

National Quality Forum (NQF). (2016b). What NQF Endoresement Means. Retrieved from: http://www.qualityforum.org/Measuring_Performance/ABCs/What_NQF_Endorsement_Means.aspx.

Office of Population Affairs (OPA). (2016). Title X family planning. Retrieved from: http://www.hhs.gov/opa/title-x-family-planning.

Provost, L. P., & Murray, S. K. (2011). The health care data guide: Learning from data for improvement. San Francisco, CA: Jossey-Bass.

Public Health Foundation. Turning Point. (2004.) From silos to systems: Using performance management to improve the public’s health. Retrieved from: http://www.phf.org/resourcestools/Documents/silossystems.pdf.

Riley, W. J., Moran, J. W., Corso, L. C., Beitsch, L. M., Bialek, R., & Cofsky, A. (2010). Defining quality improvement in public health. Journal of Public Health Management and Practice, 16(1), 5–7.CrossRefPubMed

Rosenbaum, S. (2011). The patient protection and affordable care act: Implications for public health policy and practice. Public Health Reports, 126(1), 130.PubMed

The Joint Commission. (2015). Statement clarifies Sentinel Event Policy in severe maternal morbidity cases. Joint Commission Online February 4, 2015, pp. 1–2.

Trussell, J. (2011). Contraceptive failure in the United States. Contraception, 83(5), 397–404.CrossRefPubMedPubMedCentral

Ventura, S. J., Curtin, S. C., Abma, J. C., & Henshaw, S. K. (2012). Estimated pregnancy rates and rates of pregnancy outcomes for the United States, 1990–2008. National vital statistics reports: From the Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System, 60(7), 1–21.

Title: Importance of Performance Measurement and MCH Epidemiology Leadership to Quality Improvement Initiatives at the National, State and Local Levels
Authors: Kristin M. Rankin
Loretta Gavin
John W. Moran Jr.
Charlan D. Kroelinger
Catherine J. Vladutiu
David A. Goodman
William M. Sappenfield
Publication date: 01-11-2016
Publisher: Springer US
Published in: Maternal and Child Health Journal / Issue 11/2016
Print ISSN: 1092-7875
Electronic ISSN: 1573-6628
DOI: https://doi.org/10.1007/s10995-016-2105-y

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Springer Medicine

Importance of Performance Measurement and MCH Epidemiology Leadership to Quality Improvement Initiatives at the National, State and Local Levels

Abstract

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Springer Medicine

Abstract

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