Washington, D.C.— Quality Improvement Organizations (QIOs) have trained more than 70% of the nation’s Medicare-certified home health agencies in the use of an innovative and effective method for continuously improving care. The voluntary QIO training program—funded by the Centers for Medicare and Medicaid Services (CMS)—is provided at no cost to the agencies. In some states all home health agencies have taken the training.

From mid-2002 through October 2003, QIOs trained nearly 5000 Medicare certified home health agencies in quality improvement techniques. During that time, more than 2500 agencies developed plans of action to improve care processes and are now actively working with QIOs to implement those plans.

The QIO program complements a CMS initiative to publicly report on quality of care provided by individual home health agencies. Following a pilot test of public reporting earlier this year, CMS today unveiled data on its web site that covers home health agencies nationwide.

The data provides the public with a picture of how well each agency is helping patients improve in walking, bathing, toileting, and taking medication, as well as how effectively agencies are helping patients cope with pain and confusion. Home health care typically involves skilled nursing services, home health aide services, therapy, medical social services, and certain medical supplies and equipment.
QIOs are private organizations that work under contract to CMS to improve the quality of care in the nation’s hospitals, doctors’ offices, nursing homes and, more recently, in home health. QIO training shows home health agency staff how to target treatment processes for improvement; how to develop and implement step-by-step plans of action to improve care; and how to integrate continuous quality improvement into day-to-day agency operations. This improvement process—known as Outcome-Based

Quality Improvement (OBQI)—involves collection, analysis, and feedback of information on quality of care and patient progress that is of practical value to clinicians.

“We are seeing overwhelming interest in taking advantage of training offered by QIOs,” said David Schulke, Executive Vice President of the American Health Quality Association, which represents the national network of Quality Improvement Organizations. “The rush to work with QIOs shows that most home health agencies are committed to providing the best possible care and that they recognize that QIO training can help them improve.”

QIOs tested the value of OBQI training during 2001-2002 with the cooperation of 400 home health agencies in Maryland, Michigan, New York, Rhode Island, and Virginia. Participating agencies improving targeted measures of patient care by an average of seven percentage points in one year. Measures not selected for training showed little or no improvement. Another recent test of OBQI involving 54 home health agencies in 27 states resulted in a decline (from 32.5% to 25.3%) in the annual hospitalization rate for patients served by those agencies.
Many agencies participating in the current Home Health Quality Initiative—which began last year—report dramatic improvement among their patients as a result of applying lessons learned in QIO training. Some examples:

“We had been doing long utilization reviews, which didn't really improve patient care. This was a chance to really work on something that really improves patient care and really can make a difference to our patients,” comments Joanne Tallefson, Rogue Valley’s RN Performance Coordinator. “I tell everyone we will be world class at improving pain. I talked to another agency that hadn't gone through this training and I was blown away about how far ahead we are.”

“The Home Health Quality Initiative is off to an excellent start,” said AHQA’s Schulke. “The federal government’s investment in this initiative is having an immediate impact on the quality of life and health of patients all over the country who use home health services”.

FOR MORE INFORMATION: www.ahqa.org/briefing