Improving Effectiveness of Programs Serving Children with Special Health Needs



Maternal and Child Health Bureau (within HRSA)


United States

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To ensure that program goals are met, state agencies are increasingly focusing their efforts on evaluating the effectiveness of their programs. The Division of Services for Children with Special Health Needs (DSCSHN) is committed to building systems of care for children and youth with special health care needs that incorporate six performance outcomes including: partnering with parents in decision making; providing comprehensive and coordinated care through a medical home; ensuring access to adequate insurance coverage; providing for early and continuous screening; assuring access to organized community-based services; and finally transitioning youth with special health care needs to all aspects of adult life, including adult health care, work and independence.

To support this effort, JSI provided training and technical assistance to DSCSHN grantees to strengthen states’ capacity to monitor and improve program outcomes through institutionalizing continuous quality improvement processes. JSI's tasks included:

  • Identify performance measures for program monitoring: JSI developed 7 new data collections forms designed to replace selected Discretionary Grant Information System (DGIS) and The Title V Information System (TVIS) performance measures. The seven data collection forms align with the six core outcomes plus leadership. The DSCSHN incorporated the revised data collection into progress reporting.
  • Evaluate program effectiveness and disseminate lessons learned and best practices: JSI conducted a comprehensive evaluation of the Classes of 2008, 2009 and 2011 to identify strategies that define the effective system of care for CYSHCN. Best practices and lessons learned were organized by leadership and the six core outcomes.
  • Develop a toolkit: JSI reviewed all deliverables of the Classes of 2008, 2009 and 2011 to identify products to be included in a CYSHCN toolkit. High rated products were posted to the CYSHCN website to facilitate access to materials.
  • Provided technical assistance and training: JSI provided opportunities to build capacity of state partners in quality improvement and performance measurement through webinars, individualized consultation, resource development and dissemination, and development of a Learning Community of Improvement Partnership. Specifically, JSI conducted bi-monthly webinars with guest speakers and presentations. Sample topics have included Force Field Analysis, Root Cause Analysis, Plan-Do-Study-Act and Displaying Data to Demonstrate Program Impact. JSI supported an online workspace to allow grantees to access information to support shared learning. Finally, JSI conducted monthly QI coaching calls with grantee QI teams to improve effectiveness of program interventions applying the PDSA cycle.

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