Coming Soon
- New Q-METRIC Availability of Specialty Services Measures. Look for these measures in NQMC in the near future!
Q-METRIC: Quality Measurement, Evaluation, Testing, Review, and Implementation Consortium
Faculty Contact: Gary L. Freed, MD, MPH
The quality of health care for children in the United States is far from optimal; assessing levels of care is an essential first step to identify areas for change. The Quality Measurement, Evaluation, Testing, Review, and Implementation Consortium (Q-METRIC) at the University of Michigan is devoted to developing quality measures designed to gauge how consistently everyday care for children measures up to established best practices. The Q-METRIC team, led by principal investigator Gary Freed, MD, MPH, has conceptualized and tested more than 50 quality measures, working with expert panels, research clinicians, and data specialists. The resulting measures assess levels of essential care needed by children and their families today in six areas:
- ASTHMA
- AVAILABILITY OF SPECIALTY SERVICES
- HIGH BMI FOLLOW-UP
- OVERUSE OF IMAGING
- SEPSIS SYNDROME
- SICKLE CELL DISEASE
These Q-METRIC measures are among the very few pediatric quality measures in the United States that have been tested for reliability and validity and have adequate measure specifications for implementation. Q-METRIC is a center of excellence (CoE) for the federal Pediatric Quality Measures Program (PQMP), which was established under the Children’s Health Insurance Program Reauthorization Act (CHIPRA) and is funded by the Agency for Healthcare Research and Quality (AHRQ) and the Centers for Medicare & Medicaid Services (CMS).
Asthma
5. Education in proper use of new asthma medication delivery device for children with asthma
Availability of Specialty Services
1. Reporting of CAHPS data regarding availability of specialist care for children on Medicaid
2. Reporting of supplemental CAHPS data regarding availability of treatment or counseling services for children on Medicaid
3. Access to Outpatient Child and Adolescent Psychiatrists, Neurodevelopmental Pediatricians, and Developmental-Behavioral Pediatricians
4. Access to Outpatient Specialty Care for Children
5. Access to Outpatient Dental Care for Children
High BMI Follow-Up
1. Documentation of BMI percentile and weight classification for children
- MEASURE SPECIFICATION
- MEASURE RATIONALE & TESTING
- ABSTRACTION CODEBOOK
- NQMC MEASURE A
- MQMC MEASURE B
2. Communication of weight classification for children who are overweight or obese
3. Hypertension screening for children who are overweight or obese
4. Follow-up visits for children who are overweight with a weight-related comorbidity or obese
5. Parent report of discussion of weight concerns for child
Overuse of Imaging
1. Overuse of imaging for the evaluation of children with simple febrile seizure
2. Overuse of imaging for the evaluation of children with primary headache
3. Overuse of imaging for the evaluation of children with post-traumatic headache
5. Overuse of imaging: Policy for ALARA specific to imaging children
6. Ratio of magnetic resonance imaging scans to computer tomography scans for the evaluation of children with atraumatic headache
7. Ratio of magnetic resonance imaging scans to computer tomography scans for teh evaluation of children with atraumatic seizure
9. Overuse of computed tomography scans for the evaluation of children with a first generalized afebrile, atraumatic seizure
Additional measures are currently under development.
Sepsis Syndrome
1. Protocol for identifying and treating children with sepsis syndrome in the emergency department
2. (Measure discontinued)
3. Timely blood culture for children with sepsis syndrome
4. Timely antibiotics for children with severe sepsis or septic shock
5. Timely fluid bolus for children with severe sepsis or septic shock
6. Documentation of heart rate during fluid resuscitation for children with severe sepsis or septic shock
Sickle Cell Disease
1. Timeliness of confirmatory testing for sickle cell disease
2. Timeliness of antibiotic prophylaxis for children with sickle cell disease
3. Appropriate antibiotic prophylaxis for children with sickle cell disease
- MEASURE SPECIFICATION
- MEASURE RATIONALE & TESTING
- SAS CODE & MEDICATIONS
- NQMC MEASURE A
- NQMC MEASURE B
4. Appropriate outpatient blood testing for children with sickle cell disease
5. Anticipatory guidance for pain management for children with sickle cell disease
6. Anticipatory guidance for prevention and/or management of fever and severe infection in children with sickle cell disease
7. Anticipatory guidance for prevention of stroke in children with sickle cell disease
8. Anticipatory guidance regarding school attendance/performance for children with sickle cell disease
9. Anticipatory guidance for prevention and management of splenic complications in children with sickle cell disease
10. Anticipatory guidance regarding hydroxyurea treatment for children with sickle cell disease
11. (Measure discontinued)
12. Hemoglobin S monitoring prior to chronic transfusion among children with sickle cell disease
13. Transcranial Doppler ultrasonography screening for children with sickle cell disease
14. Appropriate emergency department blood testing for children with sickle cell disease
15. Appropriate emergency department fever management for children with sickle cell disease
16. Appropriate emergency department pain assessment for children with sickle cell disease
17. Appropriate emergency department pain management for children with sickle cell disease
- MEASURE SPECIFICATION
- MEASURE RATIONALE & TESTING
- ABSTRACTION CODEBOOK
- NQMC MEASURE A
- NQMC MEASURE B
18. Satisfaction with care from the hematologist for children with sickle cell disease
19. Satisfaction with care in the emergency department for children with sickle cell disease
For more information, please contact:
Principal Investigator: Gary L. Freed, MD, MPH
Project Manager: Julie McCormick, MA
Child Health Evaluation and Research (CHEAR) Unit
University of Michigan
300 North Ingalls Building, Room 6E08
Ann Arbor, MI 48109-5456
Telephone (734) 615-0616 Fax (734) 764-2599
Principal Investigator: Gary L. Freed, MD, MPH
Project Manager: Julie McCormick, MA
Child Health Evaluation and Research (CHEAR) Unit
University of Michigan
300 North Ingalls Building, Room 6E08
Ann Arbor, MI 48109-5456
Telephone (734) 615-0616 Fax (734) 764-2599
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