Get Your Customized Online PHDS

How to get your customized Online Promoting Healthy Development Survey (PHDS) website and get a aggregate report to improve quality of care you provide for children and families you serve

The Online Promoting Healthy Development Survey is a validated, Bright Futures Guidelines aligned, family-reported, post-visit assessment of the quality of well child services provided to children 3-72 months. Upon completion of the Online PHDS, families receive a feedback report with educational resources. Providers and care teams can generate an aggregate, quality report with improvement ideas and resources after at least 25 families have completed the Online PHDS.

To prepare to use the Online Promoting Healthy Development Survey (Online PHDS) tool, please review the Cycle of Engagement Account Registration Instructions and Online PHDS Customization Instructions and Worksheet. See below for more information about the Online PHDS.

What is the Online PHDS?

The Online PHDS is a caregiver-reported tool that assesses whether young children 3-72 months of age receive nationally recommended preventive and developmental services recommended by the American Academy of Pediatrics’ Bright Futures Guidelines for Health Supervision for Infants, Children and Adolescents, 4th edition. The Online PHDS can be used in conjunction with an online, parent-completed, coaching and planning tool for well visits, the Well Visit Planner WVP. The WVP along with the Online PHDS, completes the Cycle of Engagement (COE) for early childhood, for assessing and improving the quality of care for children and their families.

Since 1997, the Child and Adolescent Health Measurement Initiative (CAHMI) has developed, tested, and implemented the PHDS. The PHDS was developed and tested using a multistage process including family focus groups, review of the literature, and structured Delphi processes to engage family, expert and provider stakeholders. The PHDS underwent extensive cognitive testing with families, and the psychometric, convergent, divergent, internal and external validity of the PHDS measures was tested based on data from diverse group of families in three managed care organizations as well as through a national implementation of the PHDS through the National Survey of Early Childhood Health (NSECH).

The evidence-based Online PHDS is:

• A family-completed online, mobile-optimized post-visit feedback tool covering the well child visits recommended to occur between 3-72 months of a child’s life
• Specifically assesses whether the quality of services families receive are aligned with the national Bright Futures Guidelines for Health Supervision of Infants, Children and Adolescents
• Available in English and takes about 15 minutes to complete
• Gives the opportunity for caregivers to provide anonymous feedback and partner with their child’s health care providers in providing optimum care for their child
• Can also be used by community organizations, such as family resource centers, health plans, and group provider practices interested in tracking and driving improvements in care.

The PHDS has been used at the national, state, health plan, practice, and provider-level. Throughout it’s development and testing more than 45,000 surveys were completed by parents through 11 Medicaid agencies, 4 health plans and 38 pediatric practices and data were used to improve the quality of health care provided to young children. Additionally, the PHDS was endorsed by the National Quality Forum (NQF) in 2008 and the majority of measures included in the PHDS were included in national surveys such as the National Survey of Early Childhood Health (NSECH) and others included in the National Survey of Children’s Health (NSCH).

What do families and providers get?

• Upon completing the Online PHDS parent tool, families receive a Family Feedback Report and educational resources that help guide them through questions they could ask for their child’s next well-visit
• Once 25 surveys are completed, child health professionals can generate an aggregated, anonymous report that has data findings highlighting areas of excellence as well as improvement opportunities
• Child health professionals can obtain Maintenance of Certification (MOC, Part 4) credit from the American Board of Pediatrics (ABP) and Continuing Medical Education (CME) credit, which will be provided soon (updates are required to meet new ABP reporting criteria).

The PHDS provides a comprehensive, conceptually and psychometrically valid and reliable assessment on how well health care providers and health plans are performing to promote the healthy development of young children. Parents have reported that the tool helped them to learn about what they can and should expect at a well child visit. Studies on the PHDS have also demonstrated improvements in engagement, efficiency and team effectiveness in delivering well child care. Click here to read the peer-reviewed article.

Why was the Online PHDS created?

• National and regional studies have found that recommended preventive and developmental services are not routinely provided and that parents have unmet informational needs.
• Studies have shown that medical chart reviews and claims or billing data do not reliably or validly measure clinical recommendations that providers discuss with their patients. The Online PHDS was designed to measure these communication-dependent aspects of well child care.
• The Online PHDS is important in order to measure the degree to which parents have their informational needs met and whether the care provided is family-centered.
• These important characteristics of a high-quality health system are best measured by asking parents directly.

The Child and Adolescent Health Measurement Initiative (CAHMI) designed the Cycle of engagement model and developed the Online Promoting Healthy Development Survey (PHDS) to assess whether recommended preventive and developmental services are provided, and the degree to which parents' informational needs are met.

More about the Online PHDS

The PHDS was developed and tested through support from The Commonwealth Fund, the Maternal and Child Health Bureau and the American Board of Pediatrics, and with internal resources from the CAHMI. The PHDS has been used in multiple formats including both longer and shorter self-administered paper and telephone versions. The Online PHDS is designed to enable use by individual providers and practices to get real time feedback on quality from the families they serve. The Online PHDS is set up to be used for individual providers but can easily be modified for use by practices and systems.

What is included in the Online PHDS?

The Online PHDS is an online tool for parents with children aged 3-72 months designed to capture quality information about preventive and developmental health care services provided to these young children. The items in the PHDS are aligned with the American Academy of Pediatrics’ Bright Futures Guidelines for Health Supervision of Infants, Children and Adolescents, as well as many Healthy People 2020 goals.

The PHDS collects data in the following domains:

• Anticipatory guidance and education for parents – measures whether caregivers’ information needs were met with regard to age-specific topics based on AAP’s Bright Futures guidelines.
• Developmental surveillance – assesses whether the provider asked about and addressed caregivers’ concerns about their child’s learning, development and/or behavior.
• Developmental screening – determines whether standardized screening tools for developmental and behavioral delays were used.
• Follow up for children at risk – measures whether children at risk were referred and/or received follow-up services.
• Assessment of psychosocial well-being, family behaviors and home safety – assesses whether providers asked about caregivers’ emotional and mental well-being, as well as smoking, alcohol, drug use, and physical safety in the home.
• Family-centered care – measures whether providers show sensitivity to the family’s values and customs, engage the caregiver as a partner in care, and listen to and address parents’ concerns.

The PHDS also gathers information useful for describing the population served and determining their health care needs. This includes measures of:

• Children’s health care utilization – to determine rates of routine or ER visits, office visits.
• Children’s health status – to assess rates of children at risk for developmental and behavioral delays, special health care needs, and overall health status.
• Parenting to optimize development – to assess the proportion of parents reading to young children, applying injury prevention measures, or experiencing depression.
• Access to care and care coordination – to monitor problems with access to pediatric care and coordination among providers.
• Socio-economic status – food insecurity and economic hardship