New NQF Endorsed Standards Focus on Quality and Patient Experience in Home Health Care 

Washington DC (April 7, 2009) - The National Quality Forum has endorsed 20 new measures to help improve both quality and the patient experience in home health care. The measures can be used to measure and improve the quality of care delivered in the patient's home.

More than 7 million Americans receive professional healthcare in their homes each year after discharge from hospitals or nursing homes or because of acute illness, long-term health conditions, disability, or terminal illness. In 2007 annual expenditures for home health care were projected to be $57.6 billion. Yet improvements in the quality of home health care have been slow--averaging only one percent in 2006 on a limited set of measures.

"Professional home health care is an integral part of the healthcare system and an important step in the continuum of care for millions of patients," said Janet Corrigan NQF president and CEO. "These measures will provide important direction in improving the care patients receive in their homes."

The measures endorsed by NQF focus on eight main areas of home health care: 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 care or hospitalization; and patient experience of care.

Patient experience of care is measured via the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey which allows patients and their families to report their experience of home health care. In addition, other measures address areas such as receipt of flu shots, depression screening, improvements in mobility, pain reduction, and the percentage of home health care patients who need hospital or emergency care.

In addition to endorsing new measures, NQF reviewed 15 previously endorsed home health measures, many of which were used by the Centers for Medicare & Medicaid Services' Home Health Compare, an online tool for consumers to compare the quality of care provided by home health agencies across the country.

Jon Fuller, MD, deputy assistant chief of staff in geriatrics and extended care at the Veterans Affairs Palo Alto Health Care System, and Carol Spence, PhD, RN, director of research at the National Hospice and Palliative Care Organization, co-chaired NQF's steering committee on home health care.

"As our population ages and we experience greater survival of acute events, support and management of chronic conditions is paramount," said Fuller. "A key element for this care is the provision of home care. It is admirable that NQF has identified home care as equal in standing for assuring the quality of care delivered to all patients, regardless of venue. If we are successful in survival of acute events but neglect the events that follow, we have failed."

The endorsement of this set of standards that measure the quality, safety and patient experience of care in the home closely align with the National Priorities set out by the National Priorities Partnership, a group of 28 organizations, convened by NQF, that have come together to transform the healthcare system.

NQF is a voluntary consensus standards-setting organization. Any party may request reconsideration of the recommendations, in whole or in part, by notifying NQF in writing via e-mail no later than April 30 (appeals@qualityforum.org). For an appeal to be considered, the notification e-mail must include information clearly demonstrating that the appellant has interests that are directly and materially affected by the NQF-endorsed recommendations and that the NQF decision has had (or will have) an adverse effect on those interests.

This work was conducted under a contract from the Centers for Medicare & Medicaid Services.

NQF-Endorsed Measures for Home Health Care

The mission of the National Quality Forum is to improve the quality of American healthcare by setting national priorities and goals for performance improvement, endorsing national consensus standards for measuring and publicly reporting on performance, and promoting the attainment of national goals through education and outreach programs. NQF, a non-profit organization (qualityforum.org) with diverse stakeholders across the public and private health sectors, was established in 1999 and is based in Washington, DC.