CAHMI Projects


The Child and Adolescent Health Measurement Initiative (CAHMI) works in various ways to promote child and adolescent health and encourage improvements in the quality of their health care. The CAHMI is involved with:

  • Developing family-centered health and health care quality measurements and strategies.
  • Providing assistance with the implementation of family-centered strategies within health care.
  • Translating the results of quality measurements in order to be more effective in shaping and driving improvements in policy, practice and outcomes.
  • Writing papers and giving presentations to inspire change in policy, practice and outcomes.

The CAHMI focuses their efforts in areas that are very interconnected. These focus areas are described below, in no particular order.

CAHMI Focus Areas

Family-Centered Quality Measurement and Improvement

Family-Centered care is when families are empowered to make decisions with the provider to ensure the health and well-being of the child and their families. For quality improvement efforts to be family-centered, the CAHMI involves the family in defining, assessing and improving health care quality. The CAHMI develops child health and health care quality measures that are completed by the patient or family in order for their voice to be heard. For Further Information:

  • Engaging Families (and Ourselves) in Quality Improvement: An Optimistic and Developmental Perspective. This article calls for health care professionals to not only do things differently to improve quality of health care, but to be different through fostering mindfulness to better engage patients.

Related Resources and Efforts

  • This “casual conversation” audio recording from the Joint Commission’s “Take 5” discusses the importance of patient-centered communication as a safety issue in health care.
  • Advancing Effective Communication, Cultural Competence, and Patient- and Family-Centered Care: A Roadmap for Hospitals. The Joint Commission created a monograph providing methods for hospitals to support their efforts in ensuring all patients receive high quality of health care.
  • The Institute for Patient and Family Centered Care “provides leadership to advance the understanding and practice of patient- and family-centered care in hospitals and other health care settings”

Actionable Child Health and Quality of Health Care Data

The CAHMI works to advance the effective use of public data on the status of health and health care quality for children, youth and families in the United States. The CAHMI helps analyze quality measurement data so that people will be inspired to use the data to improve policy, practice and outcomes. For Further Information:

  • Data Resource Center for Child and Adolescent Health (DRC). This CAHMI tool provides hands-on access to national, state, and regional data findings from large population-based surveys.
  • Creating Transformative Change: Family-Centered Data Tools pt. 1. This presentation explains how data is useful for the policy makers, grant writers, and advocates as it supplies validity to the proclaimed need for quality improvement.

Preventive Services and Developmental Screening

National health care organizations recommend preventive services and developmental screening. The CAHMI has developed measures assessing whether these recommended services occur in the medical office. The CAHMI has also created tools for well-child care quality improvement efforts. For Further Information:

  • Promoting Healthy Development Survey (PHDS): This CAHMI measurement assesses whether young children under 4 years old are receiving nationally recommended preventive and developmental services.
  • Young Adult Health Care Survey (YAHCS): This CAHMI measurement assesses whether young adults (ages 14 to 18) are receiving nationally-recommended preventive services.
  • Well-Visit Planner (WVP): This CAHMI tool helps parents identify priorities and key issues prior to well-child care visits to improve well-child care for children under 0-6 years old.

Children with Special Health Care Needs

The CAHMI hopes to improve the health and health care quality of ALL children and quality information shows a tremendous need and opportunity for improvement for children with special health care needs. The CAHMI has developed a set of survey-based methods and tools designed to identify children with special health care needs and measure their quality of health care. For Further Information:

  • Children with Special Health Care Needs (CSHCN) Screener. This CAHMI screener identifies children with special health needs based on the definition provided by the federal Maternal and Child Health Bureau (MCHB).
  • The Data Resource Center (DRC), a CAHMI tool, provides easily accessible quality information from the National Survey of Children with Special Health Care Needs (NS-CSHCN).
  • Children with Special Health Care Needs in California: A Profile of Key Issues. This report uses data from the 2009/10 NS-CSHCN to assess how the state is performing compared to other states.
  • What is the Prevalence of Children with Special Health Care Needs? Toward an Understanding of Variations in Findings and Methods Across Three National Surveys

Medical Home

The American Academy of Pediatrics (AAP) believes that every child deserves a medical home, where care is accessible, continuous, comprehensive, family-centered, coordinated, compassionate, and culturally effective. The CAHMI has found ways to report on the presence of a medical home by using existing data from state and national surveys. For Further Information:

  • Measuring and reporting on the presence of a medical home for all children and CSHCN. This 2002 presentation discusses the goal of developing a measure for a medical home by looking at existing surveys and gaining family input from a focus group.
  • Using existing population-based data sets to measure the American Academy of Pediatrics definition of medical home for all children and children with special health care needs. This article concludes that existing surveys may be used to measure the presence of a medical home.

Cultural Competence

National attention has increasingly focused on the need to incorporate the identification and elimination of cultural, racial and ethnic disparities in health care quality into quality measurement and improvement efforts. Respecting a family’s culture and traditions is an integral part of providing family-centered care. The CAHMI has conducted a number of efforts focused on assessing and guiding improvements in the quality of care provided to children of various race/ethnicities. For Further Information:

  • Child Hospitalization Communication, Quality and Safety Survey-Limited English Proficiency (CHCQSS-LEP). This CAHMI measurement assesses the portions of quality and safety of care that are impacted by efficient and effective communication

Related Efforts and Resources

  • The American Cancer Society wrote a short excerpt about the highlights of cultural competency in the Affordable Care Act
  • Think Culture Health (TCH), sponsored by the Office of Minority Health, offers the latest resources and tools to promote cultural and linguistic competency in health care
  • The National Center for Cultural Competence is a cooperative agreement funded by the Maternal and Child Health Bureau
  • US Department of Health and Human Services Cultural Competence Resources for Health Care Providers

Life-Course Perspective

The Life-course perspective seeks to understand an individual’s mental, physical and social health throughout their life span. The life-course perspective requires a health care model focusing on promoting and optimizing health across the life span versus solely on disease management. The CAHMI hopes to address the need for life-course strategies and policies through investigating data on the relationships between child health and various experienced risks and protective factors. For Further Information:

  • Optimizing Health and Health Care Systems for Children with Special Health Care Needs Using the Life Course Perspective. This article summarizes the importance of a life-course approach for children with special health care needs, examines population-based cross-sectional data, and discusses how life course principles can help with integrated care.

Mindfulness & Integrative Pediatrics

The CAHMI works to inspire the incorporation of mindfulness-based methods into health care to promote the well-being of both the provider and the patient, as well as improve the patient encounter and clinical and administrative outcomes. The CAHMI also hopes to inform the health care realm about the implications of integrative pediatrics. For Further Information:

  • Mindfulness and Integrative Care. Learn about the specific work the CAHMI has done in regards to mindfulness and integrative care.

CAHMI Measures

The CAHMI has worked collaboratively with stakeholders and experts to identify priorities for quality measurement and to develop and test new sets of measures in the areas of child and adolescent health care quality. Several of these measures have been implemented nationally, state-wide, and locally for the purpose of:

  • Comparing performance
  • Assessing overall quality of health care for populations
  • Examining program performances and opportunities for quality improvement.

Most CAHMI measures have been endorsed for voluntary use by the National Quality Forum and are included in the National Quality Measures Clearinghouse.

CAHMI Development Process

All of the CAHMI measurements are subject to a uniform six-stage development process that upholds three values:


  • To families
  • To policymakers
  • To providers


  • Data availability
  • Cost and burden
  • Capacity for standardization

Scientific Soundness

  • Empirical evidence for definition
  • Reliable and valid data
  • Valid and accurate scoring method