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Promoting Continuous Quality Improvement in the Alabama Child Health Improvement Alliance Through Q-Sort Methodology and Learning Collaboratives

Fifolt, Matthew PhD; Preskitt, Julie MSOT, MPH, PhD; Rucks, Andrew PhD; Corvey, Kathryn MPH; Benton, Elizabeth Cason MD, FAAP

doi: 10.1097/QMH.0000000000000124
Setting Priorities for Quality Management

Objective: Q-sort methodology is an underutilized tool for differentiating among multiple priority measures. The authors describe steps to identify, delimit, and sort potential health measures and use selected priority measures to establish an overall agenda for continuous quality improvement (CQI) activities within learning collaboratives.

Methods: Through an iterative process, the authors vetted a list of potential child and adolescent health measures. Multiple stakeholders, including payers, direct care providers, and organizational representatives sorted and prioritized measures, using Q-methodology.

Results: Q-methodology provided the Alabama Child Health Improvement Alliance (ACHIA) an objective and rigorous approach to system improvement. Selected priority measures were used to design learning collaboratives. An open dialogue among stakeholders about state health priorities spurred greater organizational buy-in for ACHIA and increased its credibility as a statewide provider of learning collaboratives.

Conclusions: The integrated processes of Q-sort methodology, learning collaboratives, and CQI offer a practical yet innovative way to identify and prioritize state measures for child and adolescent health and establish a learning agenda for targeted quality improvement activities.

Department of Health Care Organization and Policy in the School of Public Health, University of Alabama at Birmingham (Drs Fifolt, Preskitt, and Rucks and Ms Corvey); and UAB School of Medicine Department of Pediatrics and Alabama Child Health Improvement Alliance, Birmingham (Dr Benton).

Correspondence: Matthew Fifolt, PhD, Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, 330 N Ryals School of Public Health, 1665 University Blvd, Birmingham, AL 35294 (

My coauthors and I have no conflicts of interest to report, and certify that we have adhered to ethical principles in the completion of this manuscript. All of the authors have made substantial contributions in designing, drafting, and approving the final manuscript.

© 2017Wolters Kluwer Health | Lippincott Williams & Wilkins