Transitional care: a critical dimension of the home healthcare quality agenda

ReACH National Demonstration Collaborative: early results of implementation

The Reducing Acute Care Hospitalization (ReACH) National Demonstration Collaborative is a two-year multi-wave initiative using a "virtual" Collaborative Learning Model to reduce acute care hospitalization rates among home care patients. ReACH aims to reduce hospitalization to 23%, as recommended by the Centers for Medicare and Medicaid Services in its 8th Scope of Work for Quality Improvement Organizations. This article reports on the early implementation experience of a sample of 17 of 65 home health agencies participating in Wave I of ReACH. It examines agency challenges in implementing a structured practice improvement initiative, improving hospital to home transitions and focusing appropriate resources on high risk patients. Lessons learned will inform future home health care quality improvement initiatives.

Optimizing reserve in hospitalized elderly

Aging is a multidimensional process that involves the physical, psychosocial, and spiritual domains. The reserves in each of these areas are challenged during the stressful experience of acute and critical care illness and hospitalization. It is imperative that hospital nursing staff recognize the vulnerability of the elderly and take appropriate evidence-based interventions to prevent avoidable decline and deterioration. There are opportunities for nurses to strengthen reserve in the elderly in the areas of practice, research, education, and policy.

Advancing the Agenda for Home Healthcare Quality

On March 31 to April 1, 2005, the Center for Home Care Policy and Research of the Visiting Nurse Service of New York assembled approximately 80 home healthcare stakeholders from across the country to advance the action strategy for measuring, improving, and assuring quality in home healthcare. A specific aim of the conference was to disseminate relevant research on organizational change and evidence-based practices to influence patient safety and quality of care. Attendees worked together to identify high-priority action steps and recommendations at both the organizational and policy levels. This article reports the conference's proceedings and findings.