Abstract
Background The field and practice of equitable measurement and evaluation has advanced greatly through the work of organizations such as the Equitable Evaluation Initiative and We all Count: Project for Equity in Data Science. Organizations such as AIR have demonstrated that shared measurement can be a powerful tool for advancing equity at the systems level. Based on the case example of Rise to Health: A National Coalition for Equity in Health Care, we will share strategies and lessons learned to-date about developing a set of impact measures that are meaningful, sensitive to improvement, and usable for both improvement and evaluation.
Objectives A measurement steering committee guided work of selection of measures that were intended to: Focus the field’s attention and effort on the most important indicators of progress towards vision; Help assess the association between short-term activities and 5–10 year impact; Support the production and sharing of knowledge about what improves health equity; Advance equity through the activity of meaningful, equitable measurement; Align with and reinforce key messages, narratives, and values of the Coalition.
Methods We will describe approaches for measurement development including partnering with interested experts and people with lived experiences of inequity, multi-modal input and feedback processes including a modified Delphi process, and the development and application of measurement criteria and rubrics.
Results Our work resulted in a proposed set of 20 measures across 4 impact areas (Access, Workforce, Quality & Safety, Social & Structural Drivers of Health), including at least four patient-reported items and six concepts for new measures to develop.
Conclusions Challenges that also presented as opportunities for innovation included navigating tension between selecting and spreading existing measures versus championing the development of new ones, and balancing measures relevant to specific audiences versus an initiative overall.
