Roundtable: Measuring Service Quality: Lessons From Early Childhood Care and Education, Mental Health, and Primary Care

Saturday, November 10, 2012: 1:45 PM-3:15 PM
McKeldon (Sheraton Baltimore City Center Hotel)

*Names in bold indicate Presenter

Organizers:  Kimberly Boller, Mathematica Policy Research
Speakers:  Stephanie Jones1, Jonathan Brown2, Rosalind Keith3 and Erin Taylor2, (1)Harvard University(2)Mathematica Policy Research(3)University of Michigan
Moderators:  Kimberly Boller, Mathematica Policy Research

Across a range of settings, from early care and education classrooms to social service offices and primary health care practices, improvements in service quality are a focus for achieving targeted outcomes. Increasingly, policy makers and program operators are using quality measures as the basis for providing incentives for quality improvement and high-stakes decision-making related to staff compensation and advancement. This roundtable extends the conference’s cross-cutting theme focused on boosting the quality of teaching by bringing a multi-disciplinary lens to quality measurement, particularly process quality or what the interventionist (teacher, home visitor, medical doctor) actually does in their work with those whose behaviors/outcomes are expected to improve. The primary questions the participants will address include: (1) How is quality measured in your field and how well do the existing measures perform in assessing key processes that predict outcomes? (2) How have quality measures been effectively used to guide and assess quality improvement and provision of training and technical assistance? (3) What are the trends in quality measurement and improvement and where might your field be five years from now? The chair, an expert in quality measurement in early child care and education in the U.S. and abroad, will introduce the topic and provide examples of how quality is assessed in state Quality Rating and Improvement Systems and more recently in early childhood home visiting programs. Child care quality measures include observational ratings of the classroom environment, instruction, and behavior management as well as staff reports of their education and training. The first participant brings an ecological perspective to quality measurement and has conducted research that demonstrates the importance of assessing school contexts and quality at multiple levels (community, school, classroom/teacher). The second participant, a mental health services expert, studies interventions designed to improve processes of care in clinical practice and has published on parent and child outcomes associated with mental health communication skills training for primary care staff that uses standardized patients to measure uptake of skills and quality of care. The third participant, an expert in implementation science, has developed quality measures for use both in assessing fidelity of evidence-based practices and in documenting quality more broadly in a range of health services research settings (including intensive care units and primary care clinics). Data on quality in this area include observation checklists, structured interviews, and assessments of the patient-provider partnership. As part of work to support the implementation of patient-centered medical homes, the fourth participant recently completed a practice facilitation (coaching) how-to guide designed to improve the quality of care provided by staff and increase patient use of a medical home. The practice facilitation guide includes a section on how to evaluate quality. The chair will facilitate a lively discussion among participants and the audience about the shared learning and potential synergies across fields. One goal of the roundtable is to assess the value of developing a joint product (working paper or article) that identifies the unique and shared approaches and issues of quality measurement across disciplines.

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