The Official Journal of the
National Association for Healthcare Quality

Guest Editorial: Focusing on Home Healthcare Quality
Robert J. Rosati

Organizational Climate: Implications for the Home Healthcare Workforce Patricia Stone, Diane K. Pastor, Michael I. Harrison

Abstract: Organizational climate generally refers to staff members’ perceptions of organizational features like decision making, leadership, and norms. This article examines how organizational climate has been defined and measured in health services research and identifies factors most important in home healthcare delivery. Standardization of climate measures will facilitate the ultimate goal of translating results into evidence-based management practices to improve the quality of care delivery.

Knowledge Transfer and Utilization: Implications for Home Healthcare Pain Management Tracey Bucknall

Abstract: Implementation of research evidence into clinical practice is a complex and dynamic process that has become the subject of investigation in the field of “translation science” or “knowledge utilization.” This article summarizes key lessons from translation science and examines the implications for the organization and delivery of home healthcare. The implementation of pain management guidelines is used as an example.

The Science of Improving Function: Implications for Home Healthcare 
Dorothy Baker

Abstract: Since implementation of the Outcome and Assessment Information Set and publicly reported outcome indicators, a focus of home healthcare necessarily includes efforts to improve older patients’ functional abilities. This article presents results from selected home-based research studies providing strategies for evidence-based practice to efficiently and effectively improve functional outcomes. Results suggest that if systems of care are redesigned, the payoff in patient and staff satisfaction and in improved functional and economic outcomes can be substantial.

Exploring the Utility of Automated Drug Alerts in Home Healthcare 
Penny Hollander Feldman, Margaret McDonald, Robert J. Rosati, Christopher Murtaugh, Christine Kovner, Judith D. Goldberg, Lori King

Abstract: Computerized drug utilization review (DUR) can potentially reduce adverse drug events. We examined automated DUR for home healthcare patients with diabetes or hypertension. Sixty-eight percent of diabetes patients and 50.7% of hypertension patients triggered severe, moderate, or duplicative alerts. The relationship between inappropriate alerts and poorer follow-up reinforces the need for more specific alert systems to focus clinicians’ attention on clinically important alerts.

Effective Pain Management: Lessons from a Nursing Home Research Study
Katherine Jones

Abstract: Pain is often underrecognized, underreported, underassessed, and undertreated, and multiple barriers to optimal pain practices exist. This article reviews a study that developed and implemented a multifaceted intervention to improve pain practices in nursing homes and examines the implications of those study findings for the home healthcare setting.

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

Abstract: This article describes the research base for the transitional care of older adults and offers recommendations to advance the science, translate best practices into home healthcare settings, and improve the transitions of high-risk older adults to and from home healthcare.

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