Measuring quality care for kids in public health clinics in Philadelphia

The Philadelphia Department of Public Health (PDPH) Ambulatory Health Services (AHS) has oversight of the City's 8 publicly-funded Federally Qualified Look-Alike health centers. The health centers care for almost 21,000 pediatric patients accounting for over 66,000 visits in FY2008. The patients served are an inner city medically underserved population, with close to 45% of the children being uninsured, and nearly 47% being covered by Medicaid. AHS has a Pediatric and Adolescent Quality Care Committee that works to help ensure the quality of services delivered at the sites. In January 2008 this group embarked on a Continuous Quality Improvement (CQI) initiative, with key activities focused on 1) adopting industry recognized HEDIS (Healthcare Effectiveness Data and Information Set) and CAHPS (Consumer Assessment of Healthcare Providers and Systems program) performance indicators to create a baseline performance scorecard, 2) refining provider evaluation tools, and 3) rewriting clinical practice guidelines. The presentation will highlight a baseline performance scorecard developed for pediatrics and the strategy implemented to continue refining performance documentation. We will share key lessons learned regarding some issues inherent in adopting industry acceptable indicators (e.g., issues created by data systems, paper record reliance, and documentation practices), and possible ways to address those challenges. Next steps will be presented revealing the opportunities that the CQI initiative offers for effecting change in provider practice and public health clinic operations.