Chapter 34 – Quality Assurance in Home Health

What is the role of Quality Assurance in Home Health? What do the outcomes look like?What is a quality outcome? Why is it important? How can a home health agency use it to make improvements? What are the benefits of a quality outcome?

Knowledge development

The challenges of QA in the home care setting are unique because of multiple goals, limited provider control, and unique roles of family members. The project has examined the importance of selected outcomes indicators, such as physical functioning, satisfaction with care, and freedom from exploitation. In addition, all stakeholders agreed that focusing on the “enabling” characteristics of care is key. The project also examined the role of the paraprofessional workforce.

In addition to promoting knowledge development in quality assurance, they can also encourage demonstration programs and research. Demonstrations and research in this area should focus on improving existing systems and establishing new ones. Knowledge development must be coupled with knowledge transfer activities such as conferences, workshops, and publications. The QA can establish a Federal commitment to quality assurance in home care.

While home health QA may be similar to hospital QA, there are many differences. Home health stay is generally longer and indefinite, which makes it difficult to define quality outcomes. Further, the patient’s stay is punctuated by hospital care. Thus, it becomes feasible and morally important to monitor quality in the home care setting.

Knowledge transfer

The key to knowledge transfer is to measure the effectiveness of the process and whether the desired outcomes were achieved. To measure the success of a knowledge transfer process, the selected person must organize the team, determine the appropriate processes, and document the results. The methods used may vary depending on the complexity, volume, and number of participants. Here are some tips for knowledge transfer success:

First, a good knowledge transfer process should include the appropriate use of research evidence. The information collected in research must be relevant to practice and policy. It is critical to understand the context in which the knowledge will be applied. However, there are several risks and challenges to consider. Improving knowledge transfer processes should be undertaken with the involvement of all relevant stakeholders, including policy makers, various administrators, and researchers.

The main barriers to knowledge transfer include individual, organizational, and institutional factors. Knowledge transfer activities in health care settings are more successful when knowledge about the process is shared with appropriate audiences.

The transfer of research results involves the development of user-friendly materials. These materials should reinforce the key messages of the research. To facilitate effective knowledge transfer, the workbook includes several key activities. It includes creating and synthesising new knowledge. The process also involves analysis of the context in which knowledge is produced. Knowledge transfer also involves the actual activities involved in the process. And the evaluation of these activities is critical. Knowledge transfer is crucial for the successful implementation of new research in the healthcare setting.

The Federal Government

The Federal government has a critical role in home health quality assurance. However, efforts to achieve this goal differ significantly among state programs and agencies. This is because home care programs are fragmented, and there is no federal or state agency that focuses exclusively on quality assurance. It is important to provide a focal point for quality assurance, and promote knowledge development and demonstration programs. Knowledge development activities would include research and testing the effectiveness of existing home care quality assurance efforts and developing new systems. The QA could promote knowledge transfer and stimulation activities, including conferences, workshops, and publications.

In home health, quality assurance processes involve all employees of the agency. The agency is tasked with determining which areas need improvement. A quality assurance process includes all employees of the home health agency, as well as the patient. Continuous implementation of QAPI will result in improved patient care, increased employee pride, and greater job satisfaction. These benefits make it worthwhile to implement a Quality Assurance program. The effectiveness of the program will be measured against measurable outcomes.

The Federal Government imposes limited requirements on home care funding by Titles III and XX. However, states have developed their own standards. Title XX programs generally have higher standards than Title III. The monitoring and enforcement mechanisms are similar to those of Medicaid home health quality assurance programs. In short, QAPI improves the care of patients and agency revenue. But how can an agency ensure its services meet these standards? It can begin with benchmarking results against a national standard.

The QA process must take into account multiple goals and the unique roles of the family. It should also take into account the limited control of the provider agency and the unique nature of the home care setting. It is important to recognize that the overall program for quality assurance recognizes the differences in care programs, the intimacy of the setting, and the diversity of the constituent groups. Involving these groups in the quality assurance process can reveal possible differences in outlook and desired outcomes based on roles and client characteristics.

Measures of quality

A measure of quality can be a number of things, but one of the most important is the degree to which evidence-based treatment guidelines are followed. In addition to strengthening accountability, this type of measure can also support performance improvement efforts. Here are some examples of quality measures.

The process measures in this type of quality measure are derived from data submitted by home health agencies to the OASIS database. They are calculated based on the quality episode that begins when a patient is admitted to the home health agency and ends when that patient is discharged, transferred to an inpatient facility, or dies. While these are not risk-adjusted, they are considered appropriate for all patients and settings.

Other quality measures are based on patient or provider satisfaction. These can be quantitative, or qualitative. The process quality measure may be qualitative, or it can be a combination of both. Process quality measures may also include the frequency and type of services provided. These data should be documented in a binder for quality assurance. These measures should be recorded in the minutes of meetings and QAPI binders. The federal government may adopt standardized quality assurance measures to ensure high quality home health care.

Outcomes are often the most important aspect of quality, but they are the most difficult to quantify. The outcomes are the results of care and the satisfaction of the patient. Outcome measures are also helpful in determining the effectiveness of home health care. In addition to quality, they help identify whether the home health agency is meeting patient needs and improving overall health. So, if your home health agency is not meeting patient satisfaction expectations, it might be time to seek additional training or improve the quality of care provided to the patients.

Data sources

The HH QRP uses a wide range of data sources for calculating its quality measures. These include medical records, patient surveys, and administrative databases used for billing and care management. Although these sources have other primary uses, they may also be useful for quality measurement. There are three data sources for HH QRP quality measurements, which was mentioned in a previous section. However, OASIS documentation is among the best factor for home health agencies to positively influence their quality measures as the agencies themselves are entering the data for the OASIS documentations.

OASIS Data Outcomes and Assessment Information Set (OASIS) is an standardized data set that facilitates the measurement of patient outcomes and is the basis for reimbursement. It was originally developed to measure care quality for Medicare beneficiaries. It includes core data items for all adult home health patients. In addition, OASIS data are updated regularly. The OASIS data is a valuable tool for determining how well home health care services are performing. This is why OASIS documentation is a critical factor in home health agency success.