Preskitt Julie, Fifolt Matthew, Ginter Peter M, Rucks Andrew, Wingate Martha S
Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham.
J Public Health Manag Pract. 2016 Mar-Apr;22(2):E12-20. doi: 10.1097/PHH.0000000000000192.
The purpose of this article was to describe a methodology to identify continuous quality improvement (CQI) priorities for one state's Maternal, Infant, and Early Childhood Home Visiting program from among the 40 required constructs associated with 6 program benchmarks. The authors discuss how the methodology provided consensus on system CQI quality measure priorities and describe variation among the 3 service delivery models used within the state.
Q-sort methodology was used by home visiting (HV) service delivery providers (home visitors) to prioritize HV quality measures for the overall state HV system as well as their service delivery model.
There was general consensus overall and among the service delivery models on CQI quality measure priorities, although some variation was observed. Measures associated with Maternal, Infant, and Early Childhood Home Visiting benchmark 1, Improved Maternal and Newborn Health, and benchmark 3, Improvement in School Readiness and Achievement, were the highest ranked.
The Q-sort exercise allowed home visitors an opportunity to examine priorities within their service delivery model as well as for the overall First Teacher HV system. Participants engaged in meaningful discussions regarding how and why they selected specific quality measures and developed a greater awareness and understanding of a systems approach to HV within the state. The Q-sort methodology presented in this article can easily be replicated by other states to identify CQI priorities at the local and state levels and can be used effectively in states that use a single HV service delivery model or those that implement multiple evidence-based models for HV service delivery.
本文旨在描述一种方法，用于从与6项项目基准相关的40项所需构建要素中，确定某州母婴及幼儿家访项目的持续质量改进（CQI）优先事项。作者讨论了该方法如何就系统CQI质量衡量优先事项达成共识，并描述了该州使用的3种服务提供模式之间的差异。
家访（HV）服务提供方（家访员）使用Q分类法，对全州HV系统及其服务提供模式的HV质量衡量指标进行优先级排序。
尽管观察到一些差异，但总体上以及在服务提供模式之间，对于CQI质量衡量优先事项存在普遍共识。与母婴及幼儿家访基准1（改善孕产妇和新生儿健康）和基准3（提高入学准备和成绩）相关的指标排名最高。
Q分类活动使家访员有机会审视其服务提供模式以及整个“第一教师”HV系统内的优先事项。参与者就他们如何以及为何选择特定质量衡量指标展开了有意义的讨论，并对该州HV的系统方法有了更强的认识和理解。本文介绍的Q分类法可被其他州轻松复制，以确定地方和州层面的CQI优先事项，并可有效地用于采用单一HV服务提供模式的州或实施多种基于证据的HV服务提供模式的州。
