Home Health & Hospice Week

Small players aren't exempt from this task.

Oversight and more oversight: That's the role that health care boards of directors should play in providers' formal efforts to improve quality. But many may find themselves playing catch up to avoid enforcement action or other negative consequences.

The good news: Boards now have a guide designed to help them steer quality improvement programs in the right direction, says Peter Leibold of the American Health Lawyers Association in Washing-ton, DC.

Providers should use the report from AHLA and the HHS Office of Inspector General as a tool to guide the boards' oversight, urges Leibold. 

"Oversight of quality is a core fiduciary re-sponsibility of health care organization directors and is a top priority of OIG," said Inspector General Daniel Levinson in announcing the publication.

No exceptions: The call for internal scrutiny applies to all health care providers, including the nation's many small home health agencies.

"This is our attempt to educate boards about their role in the process," says Leibold.

Here's a selection of the kinds of questions boards should be asking:

1. What are the goals of our quality improvement program? If you can't answer that question readily, you may not be using your QI resources wisely. Initiatives such as the Home Health Quality Initiative, administered by quality improvement organization Quality Insights of Pennsylvania, offers HHAs clearly defined goals and benchmarks that can put quality of care goals into context.

2. How are quality improvement goals linked to management accountability? If they aren't, you're spinning your wheels--and it's the board's duty to flag such problems.

Vital: Clinical care benchmarks can facilitate oversight and promote improved quality outcomes, stress the report authors.

3. Do operational policies support clinical quality standards? Clinical professionals should work actively with the board to advance the institution's quality, identify systemic deficiencies and approve recommendations for actions, says the report.

4. Does the board include members with expertise in patient safety and quality improvement issues? If it doesn't it should, says the OIG. "In an era of increasing governance accountability, the boards ... are expected to understand and be involved in the assessment of performance on quality and patient safety initiatives," says the guidance.