Phase 2: Gap Analysis Between NQF Framework and Existing Measures

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The goal of this phase of the project is to locate, catalog, and examine existing data collection instruments used to assess HCBS outcomes for people with different types of disabilities (IDD, TBI, PD, MH, and ARD). These instruments, their measures, and items are being mapped onto the domains and subdomains of the National Quality Forum’s (NQF) HCBS Outcome Measurement Framework. Instruments used widely at the state level as well as those developed for research and other specific projects are targeted. Although the initial instrument search is complete, the database will be routinely updated as additional instruments are developed and/or identified.

RTC/OM staff have utilized their expertise and that of collaborating partners to identify relevant instruments currently used in the field that focus on the personal outcomes experienced by persons who are recipients of HCBS and characteristics of the service system itself. Each instrument has been carefully reviewed and coded for a number of different characteristics that groups of stakeholders have indicated would be useful including:

  • Purpose
  • Respondent (i.e., source(s) of data)
  • Administration method
  • Administration mode
  • Developer
  • Item count
  • Target population(s)
  • HCBS domains and subdomains covered
  • Psychometric properties (reliability, validity)
  • Geographic coverage area; and
  • Person-centeredness of items

The measures across these instruments are organized into a relational database based upon the domains and subdomains included in the draft NQF outcome measurement framework. RTC/OM staff identified over 200 instruments for review.  Over 130 of these tools were determined to be relevant to HCBS outcomes and were subsequently coded using the NQF framework and categories noted above.

A crosswalk and gap analysis between existing instruments, measures and items, and the NQF framework was conducted based on this review. This analysis was designed to identify the domains and subdomains for which there are promising measures available and those that require additional measure development. As the existing instruments and measures are being mapped onto the NQF domains and subdomains a relational database for organizing these instruments by domain and subdomain was developed. Included in this database is a description of the basic characteristics of existing tools (e.g. respondent type, target population, data sources, and person-centeredness).  When available, the psychometric properties of instruments are also included.

The findings of this phase of RTC/OM activities have been used to identify measures most in need of further development. The focus of measure development efforts during phases 4 and 5 of Center activities will be on those domains and subdomains of the NQF framework that are not adequately covered and/or lack psychometric data to attest to their reliability and validity.

RTC/OM staff are prepared to answer questions about the extent to which reviewed instruments and measures cover NQF domains and subdomains, the similarities and differences in coverage among instruments as well as any other queries pertaining to this subject.