It also hopes that the development of such programs will be guided not merely by the desire to avoid bad outcomes, but also by the goal of improving the care that individual consumers receive. Clearly, a balance of strong external and internal programs to ensure quality will be needed. Consumers and their families have an obvious role in defining and achieving quality LTC services, and efforts need to be undertaken to ensure that their needs and preferences are at the heart of the evolving quality assurance and improvement system. Yet, families must also be considered in another dimension in their roles as providers of care. Many issues remain unresolved regarding the extent to which government and other official organizations can apply judgements to the quality of the care provided by these informal providers.
Government clearly has a role to play.
In lieu of federal action, some states are moving ahead on their own to develop carefully conceived and comprehensive quality assurance and improvement programs. The committee applauds and encourages their important efforts. At the same time, it recognizes that other states have done relatively little in this area. The study called for in this report will provide a rallying point and blueprint for all of them. The potentially contentious nature and broad scope of the study point to the utility of the IOM model, which employs a study committee composed of experts from a variety of disciplines who hold a range of different perspectives.