Promoting smooth transitions from hospitals and nursing homes to outside care—including professional home healthcare—without triggering readmissions is garnering new attention from the Centers for Medicare and Medicaid Services. Twenty new measures endorsed last week by the National Quality Forum (NQF) may be able to further assist healthcare providers in determining if they are delivering quality care to patients in their homes.
More than 7 million Americans receive professional healthcare services annually in their homes after they are discharged from healthcare facilities or because of acute illness, chronic health conditions, disability, or terminal illness, according to the NQF. In 2007, home healthcare annual expenditures were projected to be $57.6 billion. However, improvements in the quality of home healthcare have been small.
"The committee was very mindful of what was meaningful for the public," said Carol Spence, PhD, RN, director of research at the National Hospice and Palliative Care Organization, Alexandria, VA, and co chair of NQF's Home Healthcare Steering Committee. Continuum of care—and the role of professional home healthcare in that process—was another issue on the table during the committee's discussions.
The 20 new measures focus on eight specific areas of home healthcare: timely initiation of care; patient and caregiver education; preventive services; pain intervention and assessment; improvement and assessment of clinical symptoms; improvement in functional status; assessment of need for emergency room or hospital care; and patient experience of care.
Patient experience of care will be measured using the Consumer Assessment of Healthcare Providers and Systems survey, which lets patients and their families provide details about their home healthcare experiences. In addition, other specific measures address areas including: receipt of flu shots, depression screening, improvements in mobility, pain reduction, medication compliance, improvements in the status of surgical wounds and number of pressure ulcers, and the percentage of home healthcare patients who need rehospitalization.
In addition to endorsing new measures, NQF reviewed 15 other previously endorsed home health measures, many of which have been used by CMS' Home Health Compare, an online tool for consumers to compare the quality of care provided by home health agencies across the country.
The endorsement of measure the quality, safety and patient experience of care in the home aligns with goals set out by the National Priorities Partnership, a group of 28 organizations, convened by NQF to address transformation of the healthcare system. The home healthcare measures work was conducted under a contract from CMS.