What gets measured is what gets done, and to this point there has not been sufficient measurement of the quality of preventive child health care. But progress is being made. For example, the Promoting Healthy Development Survey (PHDS),⁽²⁰⁾ developed with Fund support by Christina Bethell at the Oregon Health & Science University, is becoming the leading global measure of preventive child health care quality, and its use by pediatric practices, health plans, and state Medicaid programs is steadily increasing. Work conducted by Henry Ireys at Mathematica Policy Research, meanwhile, focused on ways to exploit the potential of external quality review and improvement organizations to champion more detailed quality measurement, especially for child developmental services provided through publicly funded care; future Fund-sponsored projects will be exploring this area further.

Other projects will help establish standards for organizing and managing efficient pediatric practices, providing the individual elements of preventive care, formulating recommendations for preventive services, and scheduling children and families for care at those ages that are especially important developmentally. To facilitate measurement of progress, the Fund also is involved in benchmarking the quality of developmental services, through the National Survey of Early Childhood Health, as well as children's developmental status, in partnership with Child Trends.⁽²¹⁾

Although the Child Development and Preventive Care Program does not support clinical research, it has been very involved in evaluating various systems and models of care, most notably the Healthy Steps for Young Children Program. The Healthy Steps model, in addition to the Fund's work with practices in North Carolina through the Assuring Better Child Health and Development (ABCD) initiative, has clearly demonstrated that the quality and use of screening and other developmental services in real-world practices can be improved.^(22),(23)