Home Health & Hospice

Sharing results, good and bad

Homecare Insider, November 30, 2015

Editor's note: This week's Inside Story was adapted from one of HCPro’s best-selling home health & hospice titles, Quality Care in Home Health: Improving Patient Outcomes and Agency Scores. For more information or to order, call customer service at 800-650-6787 or visit www.hcmarketplace.com

While all agencies have every intention of providing high-quality care to their patients, they want to see concrete evidence of their efforts. It is important to remember to stay positive when presenting the reports to a group of clinicians, even if the outcomes are not as positive as desired. It is important not to lay blame but to devise the best method for improvement.

Many agencies use the terms quality assurance and quality improvement interchangeably. Quality assurance is retrospective and often is used to determine who is at fault. An example is determining who did not complete a certain task, such as an incident report. Quality improvement, however, involves prospective and retrospective reviews. It is aimed at improvement, determining where an agency is, and how to get better. In this process, there is no blame, and its goal is to create systems to prevent errors from happening again. Quality improvement consists of continuous actions that lead to measurable improvement.

The first thing an agency needs to understand is its key processes. The concept behind quality improvement is to recognize that both resources and processes are addressed simultaneously to improve quality of care. It is also important to remember that quality improvement is a team process and cannot be completed by an individual. Differing views of the same process are important for perspective. An effective team harnesses the knowledge, skills, experience, and perspective of the individual team members. To form an effective team, all members need to be active and contributing and have a positive attitude that embraces change, if indicated. All members should be asking themselves “How are we doing?” and “Can we do it better?”

Collection of data is the cornerstone of quality improvement. It separates the thoughts of what is happening from what is actually happening. It establishes a starting point or a baseline and reduces ineffective solutions. Both qualitative and quantitative methods of data collection are helpful. Quantitative methods involve numbers and frequency and are easy to measure and analyze. Qualitative methods collect data with descriptive characteristics. This data is observable, but not measurable, and provides important information about patterns and relationships between systems; it is also used to provide context for needed improvements.

Common strategies for collecting qualitative data in a healthcare setting are:

  • Patient and staff satisfaction surveys
  • Focus group discussions
  • Independent observations