Bright Futures Preventive Services Quality Improvement Measures

Bright Futures provides a set of materials and measures to track and document preventive care activities and services. These resources facilitate engagement of pediatric health care professionals in performing QI activities at the practice level or in partnership with others at the state or community level that will improve preventive care and achieve outcomes related to the Bright Futures goals of disease prevention, risk and disease detection, and health promotion.

Measurement is a critical step in "translating" the Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents into quantifiable components through chart audit and/or office systems inventory. The list below combines nationally endorsed measures and measures tested in, or adopted from, previous QI preventive services projects. To be included, the measures must reflect an important component of Bright Futures Guidelines and be appropriate for practice change over time. This list is designed to be dynamic and will be updated as new components of high-quality care preventive service visit are identified and tested. See the Clinical Practice section of this site for tips on how to use the core tools in Bright Futures Guidelines.

A PDF of the Bright Futures Preventive Services Quality Improvment Measures listed is available for download.​

Infancy & Early Childhood

• Elicit and address patient/family concerns
• Perform developmental and autism screening and follow-up
• Elicit and discuss patient/family strengths
• Perform age-appropriate risk assessment and medical screening
• Measure and plot weight for length until 24 months and body mass index (BMI) at 24 months
• Perform maternal depression screening and follow-up
• Perform oral health risk assessment
• Provide anticipatory guidance

Middle Childhood & Adolescence

• Elicit and address patient/family concerns
• Perform developmental surveillance/identification of youth strengths
• Perform risk assessments and medical screening (vision, hearing, TB, anemia, dyslipidemia, alcohol/substance use, STIs, and measure and plot BMI% based on age and gender)
• Perform chlamydia screening and follow-up
• Perform HIV screening and follow-up
• Perform adolescent depression screening and follow-up
• Perform cholesterol screening and follow-up
• Provide anticipatory guidance

6 Office-Based System Measures (for both age groups)

• Use a preventive services prompting system
• Use a recall/reminder system (to address immunizations and well-child visits)
• Use a system to track referrals (paper based or electronic)
• Use a system to identify children with special health care needs
• Link families to appropriate community resources
• Use a strength-based approach and a shared decision-making strategy