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Strengthening the evidence for maternal and child health programs

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Displaying records 1 through 11 (11 total).

12.1 Percent of youth ages 14 and older receiving services from the DPH Care Coordination Program who receive health transition information and support from their Care Coordinator (Massachusetts)

Measure Status: Active

Measurement Category: Category 2: Measuring quality of effort (% of reach; satisfaction)

Service Type: Bottom level: public health services and systems

Service Recipient: Activities directed to families/children/youth

Goal: All families of youth with special health care needs (YSHCN) ages 14 and older who receive services from the DPH Care Coordination Program will receive the education and support necessary to assist and prepare their youth for successful health transi

Numerator: Number of YSHCN ages 14 and older who received services from the DPH Care Coordination Program that received health transition information and support

Denominator: Number of YSHCN ages 14 and older who received services from the DPH Care Coordination Program

Significance: As stated in the Clinical Report, Supporting the Health Care Transition from Adolescence to Adulthood in the Medical Home, jointly authored by the American Academy of Pediatrics, American Academy of Family Physicians and American College of Physicians, care coordination is part of transition planning for CYSHCN and may be instrumental in supporting the transfer of care from pediatric to adult medical subspecialists. Got Transition’s Six Core Elements cites care coordinators as key members of the collaborative team to support health care transition to adulthood. By providing information and support, DPH Care Coordinators can assist and complement the medical home’s work on transition readiness.

Data Sources and Data Issues: Data will be accessed from the DPH Care Coordination database. Care Coordinators track service delivery and record in the database the types of services provided to each client who received CC services during the reporting period. The database will need to be modified to include a data element on provision of health transition information and support. Systems will need to be put in place to flag youth who should receive these services.

Year: 2018/2020

Unit Type: Percentage, Unit Number: 100

12.1 Percent of CYSHCN who have transition plans to adult health care in place by age 14 (Connecticut)

Measure Status: Active

Measurement Category: Category 4: measuring quality of effect (% of "is anyone better off")

Service Type: Bottom level: public health services and systems

Service Recipient: Activities directed to families/children/youth

Goal: Increase the percentage of CYSHCN with a formal transition plan in place by age 14.

Numerator: The number of CYSHCN 14+ year olds with a transition care plan to adult health care

Denominator: The number of CYSHCN 14+ year olds

Significance: A Census Statement on Health Care Transition for Young Adults with Special Health Care Needs was drafted by the AAP, AAFP and ACPASIM and published in Pediatrics Vol. 110 No. 6 December 2012. It states that all young people with special health care needs have an identified health care provider who attends to the unique challenges of transition and assumes responsibility for current health care, care coordination and future health care planning. This starts with having a written health care transition plan in place by age 14 done together with the YSHCN and family. This is not limited to having appropriate providers in place. It also includes insurance, prescription plan, transportation, office hours, employer co-operation, and hospital of preference. For YSHCN entering college, this will mean assuring that college health services are adequate including: access for filling prescriptions; nutritional requirements; specialists; hospital of preference, if needed; having appropriate legal documents in place so home based providers can communicate with college based providers; and authorizing someone to make healthcare legal decisions if that becomes necessary. A well-timed transition from child-oriented to adult-oriented health care allows young people to optimize their ability to assume adult roles and functioning.

Data Sources and Data Issues: Data Source is MAVEN, the Department’s web-based reporting portal for CYSHCN. This web-based internet platform is an automated system that CT Medical Home Initiative for CYSHCN contractors utilize to enable collection, storage and transmission of data electronically to the Department. This includes data on the development of transition plans. CT School-Based Health Centers with Department Contracts will begin including data on transition plans for medical care after graduation in their 2015-2016 SBHC year-end report. The Department works closely with the State Department of Education (SDE) to encourage inclusion of health care goals and objectives in students’ transition Individual Education Plans. This data is monitored by SDE.

Year: 2018/2020

Unit Type: Percentage, Unit Number: 100

12.1 % of CYSHN that have had a transition planning meeting by their 18th birthday (Vermont)

Measure Status: Active

Measurement Category: Category 2: Measuring quality of effort (% of reach; satisfaction)

Service Type: Bottom level: public health services and systems

Service Recipient: Activities directed to families/children/youth

Goal: Achieve a comprehensive, coordinated, and integrated state and community system of services for children.

Numerator: Number of CSHCN who receive transition meetings before their 18th birthday.

Denominator: Number of CSHCN turning 18

Significance: It is important for all youth to be connected to programs, services, activities, and supports that prepare them to manage their physical, mental and emotional well-being and develop life skills to make informed choices. The ability to manage one's health is a critical factor in success in school and transitioning into employment. This is especially true for youth with life-long health conditions. By assuring that youth working with the state CSHN program receive a transition meeting prior to their 18th birthday, we can better ensure youth are on the path to experience a positive transition.

Data Sources and Data Issues: Data source: Program data

Year: 2018/2020

Unit Type: Percentage, Unit Number: 100

12.1 Number of individuals who have received education and /or training on healthcare transition. (North Dakota)

Measure Status: Active

Measurement Category: Category 1: measuring quantity of effort (counts and "yes/no" activities)

Service Type: Middle level: enabling services

Service Recipient: Activities directed to families/children/youth

Goal: To increase the number of individuals (health professionals, youth/young adults, and families) who receive education and/or training on healthcare transition.

Numerator: Number of individuals who have received education and / or training on healthcare transition. Note: The data is collected based on federal fiscal year (October through September).

Denominator: Not applicable

Significance: The transition of youth to adulthood has become a priority issue nationwide as evidenced by the clinical report and algorithm developed jointly by the American Academy of Pediatrics, American Academy of Family Physicians and American College of Physicians to improve healthcare transitions for all youth and families. Over 90 percent of children with special health care needs now live to adulthood, but are less likely than their non-disabled peers to complete high school, attend college or to be employed. Health and healthcare are cited as two of the major barriers to making successful transitions.

Data Sources and Data Issues: Data Source: List of individuals who have attended care coordination education and / or training opportunities. Data Issues: None Note: The data is collected based on federal fiscal year (October through September).

Year: 2018/2020

Unit Type: Count, Unit Number: 1,000

12.2 Number of organizations that facilitate the dissemination of evidence-informed transition resources to families with CYSHCN and healthcare providers. (Arizona)

Measure Status: Active

Measurement Category: Category 1: measuring quantity of effort (counts and "yes/no" activities)

Service Type: Bottom level: public health services and systems

Service Recipient: Activities related to systems-building

Goal: By 2020, partner with at least five (5) organizations to disseminate evidence-informed transition resources to families with children with special healthcare needs, healthcare providers, and organizational members.

Numerator: Number of organizations for which partnerships have been established to facilitate the dissemination of transitions resources.

Denominator: None

Significance: Medical advances and improved quality of care has enabled the majority of children born with special health care needs (CSHCN) to attain adulthood. The transition of CSHCN to adulthood requires coordinated services and additional resources to facilitate the transition as the CSHCN population is more vulnerable to gaps or instability in the healthcare delivery systems. One way to help facilitate transition is for pediatric primary and specialty care practices to develop and maintain a written health care transition policy.

Data Sources and Data Issues: In-house data from the Office of Children with Special Health Care Needs

Year: 2018/2020

Unit Type: Count, Unit Number: 100

12.2 Number of families/providers who obtain needed support from Neni 311 for a support service. (Guam)

Measure Status: Active

Measurement Category: Category 4: measuring quality of effect (% of "is anyone better off")

Service Type: Bottom level: public health services and systems

Service Recipient: Activities directed to families/children/youth

Goal: Increasing utilization of a medical home by increasing access to resources for providers and/or families of CSCHN or non-CSCHN .

Numerator: Number of families/providers who obtain needed support.

Denominator: Number of families/providers who contact Neni 311.

Significance: Neni 311 is a free help line and community network that connects parents and providers with culturally appropriate resources, health care coordination, services and information to maximize healthy growth and development of children and families. Neni 311 is modeled after Help Me Grow which is an evidence-based system that connects at-risk children with the services they need. Help Me Grow builds collaboration across sectors and improve access by identifying gaps and barriers to access.

Data Sources and Data Issues: Neni 311 log book or database

Year: 2018/2020

Unit Type: Percentage, Unit Number: 100

12.3 Percent of Families that indicate care coordination and family partnerships are working well within their primary or specialty care provide setting (Guam)

Measure Status: Active

Measurement Category: Category 4: measuring quality of effect (% of "is anyone better off")

Service Type: Bottom level: public health services and systems

Service Recipient: Activities directed to families/children/youth

Goal: To increase the number of families that receive effective care coordination, and are able to partner in decision-making within the primary and/or specialty care provider setting.

Numerator: Number of parents, families, or parents that indicate effective care coordination and family partnerships

Denominator: Total number of respondents

Significance: This measure is significant because it allows us to monitor the efficacy of activities to improve care coordination and family partnerships. One of the strongest components of the Medical home model is assisting families with coordination health care among the various providers involved in caring for a child with special health care needs.

Data Sources and Data Issues: CSHCN Survey administered to families and patients within the primary and/or specialty care provider setting. The measure is calculated by comparing the number of favorable responses to survey results questions relating to care coordination and family partnerships to the total number of respondents

Year: 2018/2020

Unit Type: Percentage, Unit Number: 100

12.3 Number of facilities serving CYSHCN using ‘got transition’ resources for establishing transition policies. (Arizona)

Measure Status: Active

Measurement Category: Category 1: measuring quantity of effort (counts and "yes/no" activities)

Service Type: Middle level: enabling services

Service Recipient: Activities related to systems-building

Goal: By 2020, at least eight (8) facilities will have established transition policies to better serve CYSHCN.

Numerator: Number of facilities serving CYSHCN using ‘got transition’ resources for establishing transition policies

Denominator: None

Significance: Medical advances and improved quality of care has enabled the majority of children born with special health care needs (CSHCN) to attain adulthood. The transition of CSHCN to adulthood requires coordinated services and additional resources to facilitate the transition as the CSHCN population is more vulnerable to gaps or instability in the healthcare delivery systems. One way to help facilitate transition is for pediatric primary and specialty care practices to develop and maintain a written health care transition policy.

Data Sources and Data Issues: In-House from OCSHCN

Year: 2018/2020

Unit Type: Count, Unit Number: 100

12.3 Linkage to community resources: Percent of families served who were connected to a needed resource (Utah)

Measure Status: Active

Measurement Category: Category 4: measuring quality of effect (% of "is anyone better off")

Service Type: Bottom level: public health services and systems

Service Recipient: Activities directed to families/children/youth

Goal: Increase the percentage of families connected to community resources by June 2017.

Numerator: Families who were connected with a community resource

Denominator: Families that allowed a follow-up contact (call, email, etc.) to determine if they were connected with a community resource

Significance: The goal is that CSHCN receive coordinated care and can easily access community based services. Services are available but families may be unaware of the services or unaware of how to access the services.

Data Sources and Data Issues: Program level data The CSHCN Integrated Services Program will collect data in FY2017 based on families referred by the shared resource (Medical Home Portal). The Integrated Services Program will attempt to follow up with families to determine if they were connected with a community service.

Year: 2018/2020

Unit Type: Percentage, Unit Number: 100

12.4 Increase in transition provider education (Texas)

Measure Status: Active

Measurement Category: Category 1: measuring quantity of effort (counts and "yes/no" activities)

Service Type: Middle level: enabling services

Service Recipient: Activities directed to professionals

Goal: To increase the number of providers educated on health care transition best practices.

Numerator: Unduplicated number of users who completed the Texas Health Steps Transition Online Provider Education (OPE) module each fiscal year

Denominator: NA

Significance: The AAP outlined guidelines to promote successful transition from pediatric to adult health care in a 2011 Clinical Report. The Got Transition Six Core Elements operationalized the components of health care transition support by establishing evidence-based tools for use by primary care and specialty care providers. According to the NS-CSHCN 2009/10, 35.4% of Texas children received the services necessary to make the transition to adult health care, compared to 40.0% nationally. In the 2017 CYSHCN Outreach Survey, less than 20% of respondents (18.2%) felt prepared for their child to transition to adult health care. Further, over 40% of respondents indicated that they had not prepared for transition to adult health care. Most respondents who indicated that they had prepared for their child’s transition had done so by themselves. Respondents in Five Year Needs Assessment stakeholder meetings noted that few doctors have the passion or willingness to take on the primary care role and coordinate the many specialists usually seen by young adults whose medical needs are complex. Many adult providers cite lack of training as a barrier to providing care to young adults with special health care needs. In order to increase provider knowledge, MCHS promotes THSteps OPE modules to targeted audiences through web-based communications, conference exhibiting, trainings, webinars, meetings and presentations. After completing the activities of this module providers will be able to: 1. Formulate a strategy to address the health, education, and social needs of children and youth with special health-care needs at key transition points. 2. Differentiate and integrate the functions of health-care professionals involved in transition assistance for youth with special health-care needs. 3. Apply legal requirements and best practices for aiding the transition of children and youth with special health-care needs. Changes in provider knowledge of transition, in combination with support

Data Sources and Data Issues: Data Source: Texas Health Steps OPE module database State fiscal year data will be collected for the Texas Health Steps (THSteps) OPE module “Transition Services for Children and Youth with Special Health-Care Needs”. The goal of this module is to equip Texas Health Steps providers and others to employ transition services for children, adolescents, and young adults with chronic health conditions or disabilities at key transition points. Raw data are available annually and can be sorted by type of provider and date of module completion. Sorting module users by month will allow MCHS to detect increases in module use following targeted provider outreach efforts like conference exhibiting or presentations. Data Issues: Content updates are regularly scheduled for all THSteps OPE modules. The transition module updates might impact trend analysis.

Year: 2018/2020

Unit Type: Count, Unit Number: 7,000

12.5 Percent of consumers and QI clinical teams that report that the Youth Health Readiness Assessment was helpful to transition planning (Wisconsin)

Measure Status: Active

Measurement Category: Category 4: measuring quality of effect (% of "is anyone better off")

Service Type: Bottom level: public health services and systems

Service Recipient: Activities related to systems-building

Goal: Evaluate the efficacy of the Youth Readiness Assessment

Numerator: Consumers and QI clinical teams that report Assessment was helpful

Denominator: Consumers and QI clinical teams that have taken the Youth Health Readiness Assessment

Significance: Promotes the adoption of transition policies and/or practices and enhance education through Care Coordination / Shared Plan of Care (SPoC) Quality Improvement (QI) grants that select Transition as a focus area.

Data Sources and Data Issues: REDCap, Quarterly surveys

Year: 2018/2020

Unit Type: Percentage, Unit Number: 100

   

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.