Congress established the PROs in 1983 to look for single case problems. During the 1990s, the PRO system evolved to become a national network of quality improvement experts that systematically evaluate the delivery of health care in a region and institute projects to educate and alter the clinical behavior of institutions, health professionals and patients. QIOs are staffed with clinical experts, communication experts, and data and statistical professionals who work together to analyze and collaborate with the health care system in their communities. Today's PRO system is uniquely qualified to serve as the core of a new national system for improving patient safety. One of the greatest strengths of the PRO system is its extensive infrastructure of relationships in every region of the country.
PROs work individually with hospital staffs and physicians offices.
They are also increasingly engaged with home health care systems, nursing homes, academic health centers, and community groups such as heart associations and cancer coalitions. In addition to technical expertise, they have developed public relations and outreach strategies with professional associations, public health authorities and state officials. This is also critically important for the effectiveness of the PROs' required projects with underserved and disadvantaged populations. These projects often require forms of outreach and communication that are culturally appropriate. The Medicare PRO Program as a Model Error Reduction Program.