A framework for developing healthcare quality measures for children and youth in foster care

• Current guidelines and literature are harmonized to create a foster care framework.
• Sample quality measures throughout the foster care experience are assessed.
• There is great variability and low adherence to recommended healthcare services.
• Nationally standardized measures are needed to improve the quality of care.
• This framework offers a basis to develop a comprehensive set of quality measures.

PurposeTo develop a temporal framework that can be utilized to develop quality measures for children and youth in foster care.MethodsA targeted assessment of published scientific articles, guidelines, evidence reviews, reports, and relevant websites with health recommendations for children in foster care was reviewed to provide supporting documentation for the framework.ResultsNumerous recommendations for quality measures in children are relevant for children in foster care and additional measures have been proposed. From the moment a child enters foster care, through changes in foster home and eventual exit from foster care, the evidence suggests high variability and low adherence to recommended healthcare services.ConclusionsA set of nationally standardized measures are needed to inform child welfare agencies and policy makers about the gaps in care that need to be addressed to improve the quality of care for this population. The framework and domains presented in this manuscript offer a basis by which to develop a comprehensive set of quality measures for foster care children.