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Who We Are

The Child and Adolescent Health Measurement Initiative (CAHMI) is a national initiative based out of The Bloomberg School of Public Health at Johns Hopkins University in Baltimore, Maryland. Originally housed at FACCT – Foundation for Accountability, the CAHMI was established in 1998.

The Mission of the CAHMI

To ensure that children, youth and families are at the center of quality measurement and improvement efforts in order to advance a high quality consumer-centered health care system. The CAHMI achieves this mission through the development, testing and strategic implementation nationally, state-wide and locally of valid health care quality and outcomes measures and the effective communication and dissemination of this research to inform and advance improvements in policy and practice.

How the CAHMI Achieves this Mission

The CAHMI has three strategic priorities that are the focus of individual project and leadership activities:

Keep the focus on consumer-centered health care. We do this by participating on a number of national committees and advisory boards to represent valid methods and strategies for ensuring children, youth and families are at the center of quality measurement and improvement efforts. Secondly, we provide assistance in the specification of consumer-centered strategies in national, state, plan and provider quality initiatives. The CAHMI also coordinates stakeholders and other efforts to advance child and adolescent health care quality measurement and improvement.

Build the supply for consumer-centered measurement strategies. We accomplish this goal by developing reliable, valid and consumer-centered health measures and by identifying remaining gaps in consumer-centered health care. Additional information about the tools the CAHMI has developed is provided in the next section.

Build the demand for consumer-centered measurement and improvement. We focus on this goal by designing, testing and demonstrating the impact of consumer-centered tools and strategies to improve health systems. The CAHMI also seeks projects focused on informing and activating consumers as child and adolescent health care quality improvement partners.

Core Values

Four core values guide the goals and strategies for the CAHMI:

Family and consumer empowerment

Families and consumers have a need and right to fully engage in ensuring excellence in their children’s health care. They need to know about the quality of health care provided to children and adolescents and to be fully engaged in assessing and improving the quality of health care for their children and adolescents.

Family and consumer involvement

Families and consumers will be involved at every level of identifying, specifying, deploying and communicating information about child and adolescent health care quality.

Scientific credibility

In order to ensure the scientific credibility of the child health and health care quality data and family engagement tools and strategies, the CAHMI will use an explicitly defined and open development and testing process that incorporates ongoing involvement of expert and stakeholder reviewers. The CAHMI will seek to make available the results of testing and applying quality measure in the professional literature and in other venues.

Collaboration

The CAHMI will initiate and be responsive to collaboration with other efforts in the area of child and adolescent health and family-centered health care quality measurement, reporting and improvement efforts to ensure that the CAHMI compliments and adds value to these other efforts. Collaboration is also essential to effectively navigate the political and strategic challenges inherent in quality measurement and reporting for children and adolescents.

CAHMI Tools

The CAHMI has developed a number of quality measurement tools and strategies that assess the quality of care provided to children and young adults. Many of the tools that the CAHMI has developed are surveys that patients themselves complete.

The CAHMI has developed, tested and implemented measurement strategies that assess preventive and developmental services for young children and adolescents, including:

  • Standardized developmental and behavioral screening;
  • Care provided to children with special health care needs, including how to identify children with special health care needs using a survey that parents and/or teens complete;
  • Avoidable hospitalizations;
  • Whether a child has a medical home, including measures specific to children with special health care needs;
  • Whether care is culturally competent; and
  • Other topic areas.

In addition, the CAHMI has developed the Data Resource Center, a website focused on presenting national data sets in a user-friendly format. The Data Resource Center offers data from the National Survey of Children’s Health and the National Survey of Children with Special Health Care Needs.

CAHMI Funders

The CAHMI is currently funded by grants from the federal Maternal Child and Health Bureau, Heath Resources and Services Administration, The Commonwealth Fund and via contracts for consulting and technical assistance. Past funding to establish the CAHMI was provided by The David and Lucile Packard Foundation. Funding for the development of the original cahmi.org website was received from the Commonwealth Fund.

CAHMI Advisors

The CAHMI has a number of advisory committees that provide input and guidance. These advisory committees incorporate a wide range of stakeholders and expertise in the field of child and adolescent health care quality.

The CAHMI Executive Committee (EC) provides strategic and programmatic guidance to the activities of the CAHMI. The CAHMI EC serves as a vehicle for facilitating involvement and collaboration among key constituencies that influence child and adolescent healthcare delivery, quality measurement and reporting nationally and at the state and local levels.

From 1998-2003, the CAHMI maintained a broad-based national advisory committee and topic-specific task forces cutting across key quality of care domains (e.g. Staying Healthy/Healthy Development, Getting Better, Living with Illness). Through this work, the CAHMI brought together more than 80 consumer organizations, public agencies, researchers, health care plans and providers in a collaborative effort to provide leadership and resources for measuring and communicating information about the quality of health care for children and adolescents. These measurement development task forces maintained a consumer-centered focus and followed a standard six-step measure development and testing process. This process, developed by the CAHMI, abides by criteria of relevance, scientific soundness and feasibility.

The Evolution of the CAHMI

In 1997, the Child and Adolescent Health Measurement Initiative was established at The Foundation for Accountability (FACCT) and is now located at Johns Hopkins University. This non-profit initiative was founded on the belief that our health care system has the responsibility to optimize the potential for the well-being of all children by engaging the patients and their families.

Supporting the healthy development of children through preventive measures, early detection of developmental disorders and treatment of chronic conditions will produce benefits that extend throughout the course of their lifetime. The CAHMI, with the collaborative effort from over 50 organizations, created a national framework to discern the quality goals and health outcomes for children and adolescents. This collective discernment of goals and outcomes, incorporated in the National Healthcare Quality Report, laid the necessary foundation for the development of quality measurements. By 2000, The CAHMI set out to develop standardized and validated quality measurements that engaged patients and their families.

By 2003, the CAHMI began to focus on supporting data-driven changes in policy and practice by making health status and health care quality data of children and adolescents transparent and easily accessible. By 2007 the CAHMI continued to empower changes in practice by developing quality improvement tools that focused on creating a family-centered, outcomes based health care system.

The steps of CAHMI’s evolution complement each other. The discernment of the quality goals and health outcomes determines what should be measured. The data acquired from the quality measurements speak to what needs to be improved. The quality improvement tools help health care systems reach the quality goals and health outcomes. The quality measurements determine the effectiveness of the quality improvement tools and emphasize the gaps persisting in health care quality, which comes full circle by influencing what the goals and health outcomes should be in policy.

Presently, the CAHMI has been able to focus more on stressing that all systems (education, health, the community, etc.) play a role in the promotion of children’s well-being throughout their entire life. While this has been a focus area for the CAHMI since its establishment, now is the opportunity for it to be more widely received due to the transformation in health care that emphasizes health outcomes and population health. The CAHMI is working on embedding accreditation into the measurement and improvement tools to help organizations address what they are being held accountable for. The CAHMI is also currently evolving to empower mindfulness centered quality improvement, which is also reflected in The Joint Commission’s HRO model.

Looking forward, the CAHMI embraces the opportunity to grow, grounded in their commitment to establish family-centered health care and promote the well-being of children throughout the life span. The CAHMI encourages feedback as this work is constantly evolving. Together we can make a difference.