Community health centers: Incorporating a performance scorecard to improve service delivery

In 2008 the Philadelphia Department of Public Health's Ambulatory Health Services (AHS), which operates the City's 8 publicly funded health centers, implemented a Continuous Quality Improvement (CQI) initiative to strengthen its Quality Assurance (QA) activities. The initiative revisited and strengthened CQI activities and QA committee structure, and focused attention on formalizing a set of clinical performance indicators to support the scope of clinical services offered in the health centers. The objectives were to adopt industry recognized performance measures for key clinical services, and create an AHS scorecard incorporating the key components of quality care set forth by the Institute of Medicine. This presentation focuses on the core activities involved in developing the performance scorecard, including identifying relevant industry recognized measures, understanding indicator specifications, identifying data sources, and documenting baseline and target statistics. The presentation will highlight the various issues and challenges encountered in developing the scorecard, e.g., issues inherent in a non-managed care provider effectively using HEDIS measures, and challenges relevant to using paper medical records. Also revealed are the opportunities that such an initiative has had for supporting a continuous quality improvement environment. The information shared in the presentation will be of interest to public health leaders interested in CQI and/or developing a performance scorecard for either the health centers within their purview or their public health programs.