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Home Health Care
Home Health Care
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 Training
For Better Care:
Quality
Improvement Organizations
(QIOs) are playing
a central role in a
new federal initiative
to help home health
agencies improve the
quality of their care.
The agencies deliver
skilled nursing care,
physical and occupational
therapy, patient and
caregiver education,
and other medical services
to patients at home.
Working
under contract to the
Centers for Medicare
and Medicaid Services
(CMS) at HHS, QIOs
are training agency
caregivers to select
treatment processes
for improvement; to
create and implement
step-by-step plans
designed to improve
care; and to integrate
continuous quality
improvement into ongoing
staff training. CMS
expects QIOs will help
at least 30 percent
of the agencies in
each state improve
care. QIO training—
which is voluntary—is
offered at no cost
to home health agencies.
Increasing
Public Awareness:
The
new HHS initiative
to improve home health
quality combines QIO
quality improvement
training with a new
CMS initiative to publicly
report on eleven measures
of quality of care
provided by every participating
Medicare home health
agency. For each agency,
CMS will report to
the public on the percentage
of patients who have
needed emergency care
or who had to be admitted
to the hospital, as
well as the percentage
of patients with less
pain and confusion.
The data will also
show how well the agencies
helped patients improve
in walking, bathing,
toileting, and taking
medication.
QIOs
will help the public
understand and use
these quality measures
as part of the process
of selecting home health
agency service. CMS
is scheduled to launch
the home health public
reporting initiative
nationally in the fall
of 2003, using lessons
learned in the first
phase of the effort
to begin May 1, 2003
in Florida, Massachusetts,
Missouri, New Mexico,
Oregon, South Carolina,
West Virginia, and
Wisconsin.
Sharing
Effective Methods:
QIOs
are training home health
agencies in a process—known
as Outcome-Based Quality
Improvement (OBQI)—that
depends on collection,
analysis, and feedback
of information on quality
of care and patient
progress that is of
practical value to
clinicians. To participate
in Medicare, home health
agencies are required
to collect and submit
to CMS data on whether
home care has helped
patients improve in
a range of critical
areas such as cognitive
functioning, speech,
mobility, and dealing
with anxiety and pain.
The data also documents
how well each agency
is helping patients
improve grooming, bathing,
dressing, meal preparation,
and other daily activities.
OBQI
provides home health
agencies with methods
for interpreting patient
data, targeting care
processes for improvement,
restructuring care,
and monitoring how
change in care affects
patient recovery and
quality of life. A
recent test in 27 states
showed home health
agencies using OBQI
significantly reduced
hospitalization of
patients. The lead
QIO on the home health
initiative—Delmarva
Foundation of Maryland—has
also created and launched
a website (www.obqi.org)
where home health agencies
can share experiences
and information.
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