Case Studies

Agency for Healthcare Research and Quality (AHRQ), March 2019 through March 2021

Objective

Provide scientific, analytical, technical assistance, dissemination, and logistical support to AHRQ and the multi-stakeholder grantee teams engaged in the Pediatric Quality Measures Program (PQMP) learning collaborative. The goal of PQMP is to improve the quality of care delivered to children covered by Medicaid and the Children’s Health Insurance Program (CHIP) through the implementation of newly developed measures across state, health plan, and provider levels. During the first year of the contract, L&M provided analytical support to the grantee teams to answer key research questions identified by AHRQ. Ongoing activities include developing quality improvement (QI) toolkits with the grantee teams, documenting contextual factors related to QI efforts using an Implementation Science framework, providing general dissemination support and leading the effort to publish research articles and commentaries in an Academic Pediatrics journal supplement.

Challenges

The heterogeneity of measures, settings of implementation, and approaches across grantee projects pose a challenge to identifying shared learnings, best practices and generalizable findings about implementation and quality improvement efforts. For grantees to focus their time and resources on carrying out measure implementation and assessment of usability at multiple-levels, AHRQ recognized that grantees would benefit from external support to coordinate activities and identify common findings.

Approach

Leveraging its deep understanding, L&M provides wide-ranging support to facilitate collaboration among grantee teams as well as dissemination of findings to end-users. L&M coordinates opportunities for grantees to share their work on measure implementation and assists with the synthesis and delivery of findings across projects. The team engages stakeholders at multiple levels to develop a comprehensive view of the challenges of implementing measures in real-world situations. L&M is also supporting the development of QI toolkits and the production of a journal supplement in Academic Pediatrics to advance the body of knowledge on effective pediatric measure implementation and quality improvement strategies.

Results

Our Team:

• Conducted two literature reviews on the six research foci guiding the grantee teams’ efforts.
• Conducted key informant interviews with nine nationally recognized technical experts in measure development and use and quality improvement at national, state, and local levels.
• Developed four research foci focused reports that synthesize the literature reviews, key informant interview findings and grantees’ experiences addressing the research foci. The reports highlight the successes and challenges of pediatric quality measure implementation at the State, health plan, hospital, and provider levels.
• Organized an in-person meeting for PQMP leadership from AHRQ and the grantee teams.
• Provided technical assistance to grantee teams for the development of QI toolkits designed to promote broad dissemination and use of the measures and associated quality improvement strategies.

AHRQ has exercised the option year for L&M to support activities designed to promote the dissemination and adoption of the PQMP measures.