FACCT brings consumers’ wish list to QI table

In September 1997, the Foundation for Accountability (FACCT) of Portland, OR, introduced Consumer Information Framework as an organizing and reporting tool for quality information. For FACCT consultant Ted von Glahn, the framework or template is the foundation’s single most valuable contribution to consumer-based quality reporting.

The framework reflects these competencies that consumers want from health plans and providers:

1. The basics — serving customers with qualified caregivers, and ready access.

2. Staying healthy — health maintenance and disease prevention care, such as well-child check-ups, breast exams, and prostate cancer screening.

3. Getting better — helping people recover from acute problems such as flu or injuries such as an ankle fracture.

4. Living with illness — managing and slowing the progression of chronic disease such as asthma or coronary artery disease.

5. Changing needs — helping people negotiate a major transition in life such as accepting a chronic illness diagnosis or preparing for the end of life.

Typical consumer questions include:

  • Does your provider involve you in decisions about your treatment?
  • Did you get the pertinent education to manage your care?
  • Do you understand what to do?
  • Do you have confidence that you can use what you learned to take care of yourself in regard to your health problems?
  • Does your care help you function in your daily activities?
  • Is the care halting the progression of your disease?

Through its Children’s Health Measurement Initiative, FACCT and the NCQA (National Committee for Quality Assurance) are developing a subset of quality measurements for children’s care. David Bergman, MD, vice president for Quality of Care at Lucile Packard Children’s Health Services at Stanford in Palo Alto, CA, is part of the undertaking. He explains that several distinct issues need to be considered in children’s care. "Families want to be involved in the self-care plans for their kids. They believe they are the experts on their kids and they want to participate in the decisions."

Additional measures will assess providers’ sensitivity to a child’s self-esteem and cultural background. Coordination of care over time matters greatly to families of children with chronic problems, Bergman says. "Those issues go beyond customer service, and they’re not available through the medical records. We have to turn to the family as the source of that data.