title: Development and Pilot Testing of Caregiver-Reported Pediatric Quality Measures for Transitions Between Sites of Care.
abstract: Few measures exist to assess pediatric transition quality between care settings. The study objective was to develop and pilot test caregiver-reported quality measures for pediatric hospital and emergency department (ED) to home transitions.
  
  
  
  On the basis of an evidence review, we developed draft caregiver-reported quality measures for transitions between sites of care. Using the RAND-UCLA Modified Delphi method, a multistakeholder panel endorsed measures for further development. Measures were operationalized into 2 surveys, which were administered to caregivers of patients (n = 2839) discharged from Seattle Children's Hospital between July 1 and September 1, 2014. Caregivers were randomized to mail or telephone survey mode. Measure scores were computed as a percentage of eligible caregivers who endorsed receiving the indicated care. Differences in scores were examined according to survey mode and caregiver characteristics.
  
  
  
  The Delphi panel endorsed 6 of 8 hospital to home transition measures and 2 of 3 ED to home transitions measures. Scores differed significantly according to mode for 1 measure. Caregivers with lower levels of educational attainment and/or Spanish-speaking caregivers reported significantly higher scores on 3 of the measures. The largest difference was reported for the measure that assessed whether caregivers received assistance with scheduling follow-up appointments; 92% score for caregivers with lower educational attainment versus 79% for caregivers with higher educational attainment (P < .001).
  
  
  
  We developed 8 new, evidence-based quality measures to assess transition quality from the perspective of caregivers. Pilot testing of these measures in a single institution yielded valuable insights for future testing and implementation of these measures.
authors: Department of Pediatrics, University of Washington, Seattle, WA; Seattle Children's Research Institute, Seattle, WA. Electronic address: arti.desai@seattlechildrens.org.
authors: Arti D
authors: AD
authors: Desai
authors: RAND Corporation, Santa Monica, Calif.
authors: Q
authors: Q
authors: Burkhart
authors: RAND Corporation, Santa Monica, Calif.
authors: Layla
authors: L
authors: Parast
authors: Department of Pediatrics, University of Washington, Seattle, WA; Seattle Children's Research Institute, Seattle, WA.
authors: Tamara D
authors: TD
authors: Simon
authors: Family Voices of Minnesota, Stillwater, Minn.
authors: Carolyn
authors: C
authors: Allshouse
authors: Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
authors: Maria T
authors: MT
authors: Britto
authors: Department of Pediatrics, Tufts University, Boston, Mass.
authors: JoAnna K
authors: JK
authors: Leyenaar
authors: RAND Corporation, Boston, Mass; Harvard Medical School, Boston, Mass; Division of Infectious Diseases, Boston Children's Hospital, Boston, Mass.
authors: Courtney A
authors: CA
authors: Gidengil
authors: Harvard Medical School, Boston, Mass.
authors: Sara L
authors: SL
authors: Toomey
authors: RAND Corporation, Santa Monica, Calif.
authors: Marc N
authors: MN
authors: Elliott
authors: The Commonwealth Fund, New York, NY.
authors: Eric C
authors: EC
authors: Schneider
authors: Department of Pediatrics, University of Washington, Seattle, WA; Seattle Children's Research Institute, Seattle, WA.
authors: Rita
authors: R
authors: Mangione-Smith
mesh_terms: D000293:Adolescent; D000328:Adult; D000359:Aftercare; D000553:Ambulatory Care; D017028:Caregivers; D002648:Child; D002675:Child, Preschool; D003697:Delphi Technique; D004636:Emergency Service, Hospital; D055317:Evidence-Based Practice; D005260:Female; D006760:Hospitalization; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D008297:Male; D010372:Pediatrics / Q000592:standards*; D010865:Pilot Projects; D011177:Postal Service; D011785:Quality Assurance, Health Care; D019984:Quality Indicators, Health Care; D011897:Random Allocation; D011795:Surveys and Questionnaires; D013689:Telephone; D000069341:Transitional Care / Q000592:standards*
keywords: emergency medicine; hospitalists; hospitals; inpatients; pediatrics; quality of care: outcome and process assessment (health care)