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Strengthening the evidence for maternal and child health programs

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Displaying records 1 through 9 (9 total).

ESM 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

Evidence Level: Moderate. Aligns with MCHbest strategy "Transition Care Coordination Services" (https://www.mchevidence.org/tools/strategies/12-4.php). Find other NPM 12 patient-level strategies in MCHbest.

Measurement Quadrant: Quadrant 4: Measuring quality of effect (% of "is anyone better off")

Service Type: Enabling services level of pyramid

Essential Public Health Services: 7. Assure effective and equitable health 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: 2020

Unit Type: Percentage, Unit Number: 100

ESM 12.1 Percent of provider practices that were provided technical assistance on transition and have incorporated the six Core Elements of Transition into their practices (Illinois)

Measure Status: Active

Evidence Level: Moderate. Aligns with MCHbest strategy "Six Core Elements Adaptation with Quality Improvement (QI)" (https://www.mchevidence.org/tools/strategies/12-6.php). Find other NPM 12 practice-level strategies in MCHbest.

Measurement Quadrant: Quadrant 4: Measuring quality of effect (% of "is anyone better off")

Service Type: Public health services and systems level of pyramid

Essential Public Health Services: 8. Build and support a workforce

Service Recipient: Activities related to systems-building

Goal: To increase the number of providers who have incorporated the six Core Elements of Transition into their practices through training, support, and technical assistance offered by DSCC

Numerator: # provider practices receiving technical assistance related to transition who have incorporated the six Core Elements of Transition into their practices

Denominator: # provider practices receiving technical assistance related to transition

Significance: This ESM will measure an output of strategy #6-D: Partner with health care providers to educate and support practice initiatives focused on preparation for transition to adulthood, including providing technical assistance to practices on using the 6 Core Elements of Transition 3.0 Toolkit for Providers, and developing youth- focused educational resources for provider practices. This measure will specifically measure the “success” of the technical assistance provided by DSCC to determine the proportion of provider practices that subsequently adopt six Core Elements of Transition.

Data Sources and Data Issues: DATA SOURCE: UIC Division of Specialized Care for Children

Year: 2020

Unit Type: Percentage, Unit Number: 100

ESM 12.1 Percent of PCP practices of transition age children (12 through 17) receiving Title V CSHCN services that participate in the Six Core Elements of Health Care Transition self-assessment (Arkansas)

Measure Status: Active

Evidence Level: Moderate. Aligns with MCHbest strategy "Six Core Elements Adaptation with Quality Improvement (QI)" (https://www.mchevidence.org/tools/strategies/12-6.php). Find other NPM 12 practice-level strategies in MCHbest.

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

Service Type: Public health services and systems level of pyramid

Essential Public Health Services: 7. Assure effective and equitable health systems

Service Recipient: Activities related to systems-building

Goal: To increase the number of Arkansas Medicaid Pediatric & Family Practice providers who develop a Transition Policy within their practice by implementing the Six Core Elements of Health Care Transition. Related to Disability and Health (DH) Objective 5

Numerator: The number of PCP practices of transition age children (12 through 17) receiving Title V CSHCN services that participate in the Six Core Elements of Health Care Transition self-assessment

Denominator: The number of PCP practices of transition age children (12 through 17) receiving Title V CSHCN services

Significance: Will enable CSHCN providers with the ability to be able to assist and teach families the Six Core Elements of Transition to optimize their ability to assume adult roles & activities to ensure that health care services are available in an uninterrupted manner. 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, the American Academy of Family Physicians, and the 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 health care are cited as two of the major barriers to making successful transitions.

Data Sources and Data Issues: Therap reports of Title V CSHCN PCPs

Year: 2020

Unit Type: Percentage, Unit Number: 100

ESM 12.1 Percent of families of transition age youth with special health care needs receiving professional help with their child’s transition to adulthood (Texas)

Measure Status: Active

Evidence Level: This ESM measures access to/receipt of care, thus doesn’t align with a specific evidence-based strategy. Consider developing an ESM for one of the specific strategies in your state action plan to measure performance. Check MCHbest for examples to connect to the evidence.

Measurement Quadrant: Quadrant 4: Measuring quality of effect (% of "is anyone better off")

Service Type: Public health services and systems level of pyramid

Essential Public Health Services: 7. Assure effective and equitable health systems

Service Recipient: Activities related to systems-building

Goal: Assess the provision of transition services to evaluate provider education, outreach and promotion of best practices, and to inform efforts to support providers and families.

Numerator: Number of families of transition-aged youth with special health care needs (12 years+) surveyed who indicated they received professional help with transition services

Denominator: Total number of families of transition-aged youth with special health care needs (12 years+) surveyed

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 providers and families. According to the 2017-2018 NSCH, 87.0% percent of the Texas CSHCN population did not receive the services necessary to transition to adult health care compared to 81.1 percent of CSHCN in the United States. In the Title V CSHCN Parental Outreach Survey, 75% of respondents said that they did not feel prepared for their child’s transition. Only 7.0% of respondents prepared for transition in at least four out of seven transition areas with a professional. Most respondents who indicated that they had prepared for their child’s transition had done so by themselves. The percent of families of transition-age youth who indicate they received professional help with transition services for their child is derived from the CYSHCN Outreach Survey. Data collected reflects the number of survey respondents who indicate that a professional helped them with four or more of the following areas of transition needs: medical, educational, independent living, financial, social, employment, and legal. Successful provider education, outreach, and promotion of best practices, including Got Transition’s Six Core Elements, will lead to increased knowledge, attitudes, and implementation skills for providing transition support. Successful family education, outreach, and support will lead to increased demand for quality transition services.

Data Sources and Data Issues: Data Source: CYSHCN Outreach Survey Responses to the CYSHCN Outreach Survey will be collected on a biennial basis. The survey will be mailed out and dispersed electronically to families served by HHSC CSHCN health care benefits and MCHS contractors in both English and Spanish formats. The survey will be promoted through email communication, newsletters, and webpages. According to the 2019 CYSHCN Outreach Survey as part of the 2020 Title V Five Year Needs Assessment, 15 of 214 respondents with transition-aged youth (7.0%) indicated they received professional help with four or more of the seven areas of transition services. Data Issues: Challenges associated with surveying a convenience sample include the potential to underrepresent subsets of the CYSHCN population in Texas according to geographical location or language spoken. The CYSHCN Outreach Survey seeks to combat these challenges by providing both online and paper access to the survey in English and Spanish. Geographical data is also gathered in order to examine areas of need for additional ongoing needs assessment activities including focus groups and interviews.

Year: 2020

Unit Type: Percentage, Unit Number: 100

ESM 12.1 Employ Health Care Transitions (HCT) Process Measurement tool towards assessing progress on implementation of Six Core Elements of Health Care Transitions statewide (Kentucky)

Measure Status: Active

Evidence Level: Moderate. Aligns with MCHbest strategy "Six Core Elements Adaptation with Quality Improvement (QI)" (https://www.mchevidence.org/tools/strategies/12-6.php). Find other NPM 12 practice-level strategies in MCHbest.

Measurement Quadrant: Quadrant 1: Measuring quantity of effort (counts and "yes/no" activities)

Service Type: Public health services and systems level of pyramid

Essential Public Health Services: 5. Create/champion/implement policy

Service Recipient: Activities related to systems-building

Goal: Measure the implementation of agency-wide improvements as guided by Health Care Transition Process Measurement Tool for Transitioning Youth to Adult Health Care Providers

Numerator: Score on HCT tool, as assessed annually

Denominator: Possible Score on HCT tool

Significance: Statewide HCT improvements shall be guided by research-based instrument conforming to consensus statement of best practice and CYSHCN national standards.

Data Sources and Data Issues: Health Care Transition Process Measurement Tool for Transitioning Youth to Adult Health Care Providers, created by Got Transitions, and scored for Kentucky by OCSHCN.

Year: 2020

Unit Type: Percentage, Unit Number: 100

ESM 12.1 Degree to which the Title V Children and Youth with Special Health Needs Section promotes and/or facilitates transition to adult health care for Youth with Special Health Care Needs (YSHCN), related to Six Core Elements of Health Care Transition 2.0. (Hawaii)

Measure Status: Active

Evidence Level: Moderate. Aligns with MCHbest strategy 12.6 "Six Core Elements Adaptation with Quality Improvement (QI)" (https://www.mchevidence.org/tools/strategies/12-6.php). Find other NPM 12 practice-level strategies in MCHbest.

Measurement Quadrant: Quadrant 3: Measuring quantity of effect (# of "is anyone better off")

Service Type: Enabling services level of pyramid

Essential Public Health Services: 7. Assure effective and equitable health systems

Service Recipient: Activities directed to families/children/youth

Goal: To increase the degree to which the Title V CYSHNS promotes and/or facilitates transition to adult health care for YSHCN.

Numerator: Total Actual Score from Transition to Adult Health Care Data Collection Form

Denominator: Total Possible Score from Transition to Adult Health Care Data Collection Form (33)

Significance: CYSHNS is addressing Got Transition’s Six Core Elements of Health Care Transition 2.0. Strategy components were adapted for integration as part of CYSHNS services to support youth/families in preparing for transition to adult health care. Health and health care are important to making successful transitions. The majority of YSHCN do not receive needed support to transition from pediatric to adult health care. In addition, YSHCN, compared to those without special health care needs, are less likely to complete high school, attend college, or be employed. The Title V CYSHNS has been addressing these barriers through providing general transition information to families receiving CYSHNS /clinic services or attending transition-related community events, and leading/participating in planning Transition Fairs. The next phase is CYSHNS working to improve its direct services with youth/families related to transition to adult health care, using an evidence-informed quality improvement approach. The Six Core Elements of Health Care Transition is an evidence-informed model for transitioning youth to adult health care providers that has been developed and tested in various clinical and health plan settings. They were developed by the Got Transition/Center for Health Care Transition Improvement, based on the joint clinical recommendations from the American Academy of Pediatrics (AAP), American Academy of Family Physicians (AAFP), and American College of Physicians (ACP). References: Got Transition, “Side-By-Side Version, Six Core Elements of Health Care Transition 2.0”; AAP, AAFP, ACP, “Clinical Report – Supporting the Health Care Transition From Adolescence to Adulthood in the Medical Home”, Pediatrics 2011;128:182-200; McPheeters M et al., “Transition Care for Children With Special Health Needs”, Technical Brief No. 15. Agency for Healthcare Research and Quality (AHRQ) Publication No. 14-EHC027-EF, June 2014.

Data Sources and Data Issues: This is a summary of the Data Collection Form that lists 11 strategy components organized by the Six Core Elements of Health Care Transition: • Transition policy • Transition tracking and monitoring • Transition readiness • Transition planning • Transfer of care • Transition completion. Each item is scored from 0-3 (0=not met; 1=partially met; 2=mostly met; 3=completely met), with a maximum total of 33. Scoring is completed by CSHNP staff, with input from Hilopaa Family to Family Health Information Center. The data collection form is attached as a supporting document.

Year: 2020

Unit Type: Scale, Unit Number: 33

ESM 12.2 Percent of YSHCN enrolled in State CSHCN program who report satisfaction with their transition experience to adulthood. (Alabama)

Measure Status: Active

Evidence Level: No similar strategy found in the established evidence for this NPM. See similar ESMs (https://www.mchlibrary.org/evidence/state-esms-results.php?q=satisfaction&NPM=12&State=&RBA_Category=&MCH_Pyramid=&Recipient=Activities+directed+to+families%2Fchildren%2Fyouth&Status=Active) for this NPM or search for other strategies or promising practices (https://www.mchevidence.org/tools/npm/12-transition.php).

Measurement Quadrant: Quadrant 4: Measuring quality of effect (% of "is anyone better off")

Service Type: Public health services and systems level of pyramid

Essential Public Health Services: 7. Assure effective and equitable health systems

Service Recipient: Activities related to systems-building

Goal: To improve the transition experience.

Numerator: Number of youth that indicate satisfaction regarding their transition experience.

Denominator: Total number of youth surveyed.

Significance: The Standards for Systems of Care for Children and Youth with Special Health Care Needs Version 2.0 System Domain Transition to Adulthood indicates the system should contact the young adult/caregiver confirming transfer of care and eliciting feedback on experience with the transition process. Ensuring the successful transition of youth and young adults with special health care needs is essential to individual self-determination and self-management. Young Adult/Caregiver perception of satisfaction with their transition to adult health care will help determine quality improvement measures to drive program development that supports the achievement of successful outcomes.

Data Sources and Data Issues: Survey based on the Six Core Elements of Health Care Transition 2.0 Health Care Transition Feedback Survey for Youth. A potential issue when collecting data using a survey format is a limited number of respondents which could impact the outcome.

Year: 2020

Unit Type: Percentage, Unit Number: 100

ESM 12.2 Increase in transition provider education (Texas)

Measure Status: Active

Evidence Level: Emerging. Aligns with MCHbest strategy "Professional Training/Workforce Development" (https://www.mchevidence.org/tools/strategies/12-1.php). Find other NPM 12 professional/provider-level strategies in MCHbest.

Measurement Quadrant: Quadrant 1: Measuring quantity of effort (counts and "yes/no" activities)

Service Type: Public health services and systems level of pyramid

Essential Public Health Services: 8. Build and support a workforce

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 NSCH 2017/18, 13.0% of Texas children received the services necessary to make the transition to adult health care, compared to 18.9% nationally. In the 2019 CYSHCN Outreach Survey, a quarter of respondents (25.1%) felt prepared for their child to transition to adult health care. Further, 45.8% of respondents indicated that they had not prepared for transition to adult medical 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.

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: 2020

Unit Type: Simple Count, Unit Number: 7,000

ESM 12.3 Decrease percent of families of transition-age youth who have not prepared for medical transition to adulthood (Texas)

Measure Status: Active

Evidence Level: This ESM measures access to/receipt of care, thus doesn’t align with a specific evidence-based strategy. Consider developing an ESM for one of the specific strategies in your state action plan to measure performance. Check MCHbest for examples to connect to the evidence.

Measurement Quadrant: Quadrant 4: Measuring quality of effect (% of "is anyone better off")

Service Type: Enabling services level of pyramid

Essential Public Health Services: 7. Assure effective and equitable health systems

Service Recipient: Activities directed to families/children/youth

Goal: Decrease percent of families of transition-age youth who have not prepared for medical transition to adulthood.

Numerator: Number of families of transition-aged youth with special health care needs (12 years+) surveyed who indicated they have not prepared for transition to adult health care.

Denominator: Total number of families of transition-aged youth with special health care needs (12 years+) surveyed.

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 providers and families. In the 2019 CYSHCN Outreach Survey, a quarter of respondents (25.1%) felt prepared for their child to transition to adult medical care. Furthermore, 98 of 214 respondents with transition-aged youth (45.8%) indicated they have not prepared for medical needs as an adult. Provider education, outreach, and promotion of best practices, including Got Transition’s Six Core Elements, will lead to increased knowledge, attitudes, and implementation skills for providing transition support. Family education, outreach, and support will lead to increased planning for transition to adult health care.

Data Sources and Data Issues: Data Source: CYSHCN Outreach Survey Responses to the CYSHCN Outreach Survey will be collected on an biennial basis. The survey will be mailed out and dispersed electronically to families served by the HHSC CSHCN health care benefits program and MCHS contractors in both English and Spanish formats. According to the 2019 CYSHCN Outreach Survey as part of the 2020 Title V Five Year Needs Assessment, 98 of 214 respondents with transition-aged youth (45.8%) indicated they have not prepared for medical needs as an adult. Data Issues: Challenges associated with surveying a convenience sample include the potential to underrepresent subsets of the CYSHCN population in Texas according to geographical location or language spoken. The CYSHCN Outreach Survey seeks to combat these challenges by providing both online and paper access to the survey in English and Spanish.

Year: 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.