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Published on GoldenTimes.com on June 20, 2007
Quality Scores – What Do They Really Mean?
By Lynette Loomis

Most of us judge a health care facility by what we see or smell. For instance, if we visit a skilled nursing facility and it doesn’t smell, we assume resident care is fine. If a hospital has shiny floors and looks clean, we assume that the infection rate is low. If a home health aide smiles, we believe she is competent. But there is a better way to judge health care based on measurable criteria.

Although some of us will have a short stay in a hospital or a skilled nursing facility at some point in our life, the majority of us are more likely to have home care. Home care provides support for the “activities of daily living” (ADLS) including bathing, dressing, feeding etc. But how do we pick what’s right for us, or a family member?

IPRO is an independent, not-for-profit corporation committed to assessing and improving the value of health care services received by consumers through the use of innovative methods and technologies. According to its web site, “IPRO’s professional staff includes more than 350 physicians, registered nurses, epidemiologists, health policy analysts, data analysts, biostatisticians, medical records analysts and systems analysts, as well as a network of more than 300 board-certified physician consultants.”

In 2006, Unity Health System, Edna Tina Wilson Living Center, was a Quality Award winner “for commitment to quality improvement and culture change in the nursing home setting.”

This year, HCR (Home Care of Rochester) is being recognized as one of two organizations statewide for the IPRO Quality Award in recognition of its “quality improvement work targeting reduction of avoidable acute care hospitalizations and improvement in oral medication management.”

This puts HCR within the top 15% of all New York State home health agencies for both quality measures. What this means is that HCR helps people avoid going back to the hospital and does a good job at making sure their home care patients take the right medicine at the right time in the right dose.

Another source of information is the Home Health Outcome and Assessment Information Set. Again. Rochester’s HCR outperformed home health care agencies in the nation, state and local area in variety if areas including helping patients improve their walking (and with less pain) , getting out of bed, bathing, bladder control and breathing. And the number of HCR patients who had to go back to the hospital was lower than its local and national counterparts.

A third source of comparative information is an analysis completed by Fazzi Associates of Home Care Compare (compiled by CMS available at medicare.gov), of 5,345 home care agencies all of whom report on ten outcome measures. HCR placed in the top 3% nationally. The U.S. Department of Health and Human Services also offers “Hospital Compare”. At its web site you can “learn about treatments that are known to get the best results for most adult patients with heart attack, heart failure, pneumonia, and surgery. See how often hospitals provided recommended treatments for these medical conditions.”

The point is that as consumers, we need to be more vigilant in how we evaluate medical care in and out of the home. There are tools we can easily turn to for objective advice. Yes, we want a home health aide to be friendly, but we want to know that he or she can help us get better. Yes, we want our surgeon to have a nice bedside manner but we want to know what his or her malpractice history is as well. Before making a choice, a few minutes on your computer or at the library can make if big difference in our life, literally.

Lynette M. Loomis is a former vice president of Preferred Care Gold and is a long-standing advocate of mature consumers.