Assuring quality in home care programs is difficult and requires continual and systematic attention to quality assurance mechanisms . Although program officials generally expressed satisfaction with their programs' quality assurance systems, they also consistently expressed a professional awareness of the need to constantly monitor and upgrade those efforts. The lack of a standardized framework for defining and measuring quality is a major barrier to understanding and ensuring quality of home care services . Although some standardization exists in home health services, the field of home care, as a whole, has no universally accepted standards of care. It will be difficult to evaluate the quality of home care received by consumers of public home care programs or to effectively implement home care quality assurance systems until generally accepted models of service definitions, standards, and measures are developed.
Officials are open and candid in discussing their home care quality programs .
The vast majority of officials contacted during the course of this study were interested and willing to participate in discussions of their home care service delivery and quality efforts. These officials demonstrated an openness about their programs and seemed to recognize and be willing to discuss shortcomings as well as strengths. Officials are not well-informed about home care quality mechanisms in other states . With some exceptions, program officials are unfamiliar with home care services and quality assurance programs outside their state. These officials demonstrated an interest and desire to learn from the experiences of other programs.