Background: Over the last two decades, health care research has demonstrated that quality of care cannot simply be assumed because of a provider’s good intentions. An understanding of the science of quality care has emerged. Operating under a new payment system that underscores the need to provide the highest quality care as efficiently as possible, the home health care field is now poised to embrace innovative, science-based quality improvement strategies.

Purpose: The Effort for Quality Improvement and Performance in Home Health Care initiative seeks to promote quality improvement in home health care by assessing and improving the current knowledge base. A major component of this project is ongoing collaboration among home health care stakeholders who are committed to improving quality performance in home health care.

Study Design: EQUIP is a national quality improvement initiative that aims to focus attention and resources on the state of quality information and performance in home health care and therefore advance the home care quality agenda.

EQUIP engages in two distinct activities:

1. The first activity is the convening of meetings and conferences to focus attention on critical quality and performance issues and identify strategic priorities. In July 2003, more than 50 people participated in a National Meeting entitled Charting the Course for Home Health Care Quality. The focus of this meeting was to set an agenda for quality improvement in home health care. Two Steering Committees have resulted from the National Meeting. Small groups of meeting participants comprise these two committees and are working in the areas of best practices and practice guidelines and organizational changes.
   
   Another important aspect of this first activity is the commissioning of synthesis and discussion papers to summarize what is known about quality improvement methods and to explore the implications for home health care. Six background papers were commissioned to inform the National Meeting. Paper topics included data, information, and quality indicators; improving patient satisfaction; strengthening evidence-based practice; learning from operational failures; promoting patient safety through informatics; and building a home health care workforce to meet quality.
   
   
2. The second activity is an evidence-based practice consortium to assess the practicality, viability, and potential replicability of a model involving home care stakeholders in collaborative performance improvement activities.
   
   This initiative, in conjunction, with the Partnership for Quality Homecare (PAQH) initiative, supports and tests the model of collaborating home care agencies to improve patient care. Currently, eight home care agencies from around the nation are working to improve care for their patients with diabetes. At the conclusion of this 12-month process, a detailed evaluation of the project will be conducted to determine if this model will be replicable by other home care agencies.

Publications: The six background papers distributed at the National Meeting were featured in the May/June 2004 issue of the Journal for Healthcare Quality, published by the National Association for Healthcare Quality. The executive summaries of these papers can be found below:

Promoting patient safety and enabling evidence-based home health care through informatics.

Data, information, and quality indicators for home health care.

Improving patient satisifaction in home care.

Strengthening condition-specific evidence-based practice.

Building a home health care workforce to meet the quality imperative.

Learning from operational failures in home health care.

Click here to download a single copy for personal research and study. Posted with permission by Lippincott Williams & Wilkins.

A follow-up conference entitled "Advancing the Agenda for Home Healthcare Quality" was convened in April 2005. The conference proceedings and findings for this meeting were published in the May 2006 issue of Home Healthcare Nurse and the commissioned papers were published in the January/February 2006 issue of the Journal for Healthcare Quality. Links to the executive summaries of the commissioned papers are listed below:

Lessons from the Science of Improving Function: Implications for Home Care.

Organizational Climate: Implications for the Home Healthcare Workforce.

Transitional Care: A Critical Dimension of the Home Healthcare Quality Agenda.

Effective Pain Management: Lessons from a Nursing Home Research Project.

Knowledge Transfer and Utilization: Implications for Home Health Care.

Click here to download a single copy for personal research and study. Posted with permission by Lippincott Williams & Wilkins.

Policy Brief: Home health care quality conferences: Promoting change through dialogue.

Sponsor: Robert Wood Johnson Foundation (RWJF)