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The Expert Within:
Making Quality Care Good Business

By Sandra Raup, RD, CNSD

Many solutions for streamlining the delivery of home care have been discussed recently within the industry and in the consumer literature. All aspects of health care are being scrutinized as "reform" is on the national agenda. Many solutions may evolve from successful applications in acute care settings. Other solutions come from recognized experts or research conducted in an academic setting. Many new and exciting solutions and applications are generated from these sources which allow higher quality care and more types of services to be provided.

But in addition to these, your own expert care givers can be a source of innovative and effective solutions as well. A system of internal quality improvement may allow an expansion of service, confidence, and cost-effectiveness in an agency. An individual agency or a group of agencies can generate accurate data for the following purposes:

1. Identify the most effective interventions within a set of conditions. Areas where either the number of clients or the cost of care is high could be significantly impacted if outcomes could be more accurately predicted.

2. Define the cost of care for an intervention or diagnosis. Key data collection could allow documentation of effective care for different types of clients. Defining cost effectiveness of interventions will help agencies handle reimbursement issues related to prospective payment.

3. Expand and standardize expertise of nurses providing care. As documentation allows more complete, accurate data collection, problems can be more quickly identified and remedied. Any standardized procedure, for testing or implementation, can be scripted into the documentation system to allow detailed instructions to be available on site.

The most effective solutions are often within your own agency. The goal of CareFacts is to provide accurate data in a standardized language that is easy to retrieve. Your experts can use your own data to define the best possible care for your clients.

Citation: Raup, S. (1994). The Expert Within: Making Quality Care Good Business. The Quality Messenger, 1(2),

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