Private duty agency seeks same to benchmark

What do you do when you truly stand alone?

In 1990, Emerald Health Care Services of Pompton Lakes, NJ, was among the first agencies in its area to become certified by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). But ever since then, the agency’s president, Judy Earley, RN, has searched for data that would be useful in benchmarking.

"We are private-pay and Medicaid," she says. "Most of our patients are not the type who are going to get better. They have chronic conditions like Alzheimer’s. What can I measure, and how can I find someone to measure against?"

The New Jersey home care industry is divided, Earley says. "You are either Medicare or you are private-duty," she explains. "You aren’t both. Our goals and measurements are very different. We can’t measure if a patient gets better, because 90% of the time they don’t." Agencies that are private-pay, such as hers, are unwilling to part with what they consider to be proprietary information.

Any benchmarking data that Earley has found do not relate to the things she can measure — rehospitalization, stress levels in families, placement in long-term care facilities, retention of educational material, and improvements in nutrition and personal care.

She measures these items for her own agency’s use. "But without comparison, it is of limited value," she says. "And the other agencies in our area are measuring different things. National data banks and software also look at things that apply to the 10% who will get better, not chronic cases."

Her on-line searches — "I look every day," she says — and e-mail missives to news groups searching for assistance have drawn blanks. "Every meeting I go to, this is a topic, but no one is doing anything." Earley faces a Joint Commission survey in September and is concerned that her efforts won’t be viewed as either valid or as going far enough.

Not to worry, says Maryanne Popovich, RN, MPH, director of home care accreditation services at JCAHO. "She already has the measures in place," says Popovich. "All she needs to do is get on the phone and start some networking in New Jersey. The state association, Home Health Staffing Association, should be able to put her in touch with others who are like her."

If the association is not already gathering data that is of use, Earley and the other agencies in her situation should encourage it to start acting as a clearinghouse for aggregating data so proprietary information is not an issue.