From 1988 through 2003, the Robert Wood Johnson Foundation (RWJF) supported the Development and Implementation of a Quality Improvement System for Home Health Care. The effort comprised six projects and was designed to improve the quality of home health, long-term and ambulatory care, and to study methods to improve health care quality in these settings.
(Center for Health Services Research, Colorado Health Sciences Center)
Staff developed and implemented patient outcome measures-the Outcome and Assessment Information Set (OASIS) and an outcome-based quality improvement (OBQI) system for home health care.
As reported by the researchers in the Journal of the American Geriatrics Society (August 2002):
- "It is feasible to integrate the programmatic, data collection, data transmission, and outcome enhancement components of OBQI into the day-to-day operations of home health agencies."
- The findings "suggest that OBQI had a pervasive effect on outcome improvement for home health patients."
Key Results and Findings
(University of Maryland, Baltimore, School of Medicine)
- Researchers developed four sets of clinical practice guidelines on nursing home patients with: new-onset fever, altered mental health status and behavior, significant weight change, and for the terminally ill.
- Findings as reported in the Journal of the American Geriatrics Society (August 1994) on the guidelines for the terminally ill:
- "Appropriate medical management of terminally ill nursing home patients should improve their remaining quality of life."
- "Minimum standards for which 100 percent performance is expected are communication of advance directives, attention to pain control and attention to relief of dyspnea [shortness of breath]."
(Methodist Hospital of Indiana)
- Researchers designed and implemented an organizational structure to support Total Quality Management.
- Researchers revised the HealthNet procedure for measuring blood pressure to reflect the latest recommendations and trained staff in this procedure, including initiating annual retraining.
- Researchers developed a risk model for blood pressure control which identified three measurable factors that influence blood pressure control and could be used in continuous improvement efforts to improve patient outcomes: the degree to which the patient has difficulty in paying for services, the degree to which the patient is overweight, and whether the patient is classified for insurance purposes as self-paying.
(Indiana University School of Law)
As reported in Medical Care (2003):
- "Client-centered quality improvement strategies can be implemented to enable community-based long-term care programs to meet client needs better and increase client satisfaction. Current efforts to computerize quality improvement for public community-based long-term care programs should be supported and promoted."
(State of Vermont Department of Mental Health)
- Software such as the Vermont Medication Graphics program is most likely to be accepted and widely used if it is integrated into an electronic medical record system. This would provide easy, timely access to data.
RWJF provided $4,219,729 in nine grants to support the project.
RWJF Scholar examines neighborhood-based death rates from opiate-based painkiller overdoses, compared with heroin overdose deaths.
Unengaged patients can incur costs of up to 21% higher than patients who are highly engaged in care. This suite of materials from RWJF's AF4...
Adverse working conditions contribute substantially to the risk of depression for working-age adults, according to new research from a team ...
RWJF Nurse Faculty Scholar Jennifer Bellot writes about losing her grandmother to complications from a medical error.
This month the Johns Hopkins Bloomberg School of Public Health published a special issue of its magazine devoted to food.
Learn how The Robert Wood Johnson Foundation is dedicated to building a culture of health in Risa Lavizzo-Mourey's 2014 annual message.
This revolutionary concept gives patients the tools they need improve their own health and health care by transforming the doctor-patient re...
America is not getting good value for its health care dollar. These resources explore issues of cost and value of health care.
CDC: Reducing High-risk Antibiotic Prescriptions Could Also Reduce Deadly Infections - Poorer Women Most Likely to Be Caught in ‘Vicious’ Ca...
The reconvened Commission to Build a Healthier America will provide new guidance in three key areas: early childhood, healthy communities, a...
Team members, grantees, and guests discuss breakthrough ideas that will allow us to move toward solving challenges in health care.
One of the country’s most powerful women, RWJF President and CEO Risa Lavizzo-Mourey contributes a post to a series in which LinkedIn Influ...