DRGs and the measurement of quality in home care.

The definition of quality is conceptual. In reality, the true definition of quality depends on the perspective of the definer. Community health nurses need an alternative to the traditional medical definition of quality. In spite of medical DRGs, when the concept of outcome measurement is presented appropriately to nurses, the opportunity is created for them to quantify the effects of nursing care provided positively, not as another paper exercise for Medicare reimbursement. In addition, the ability to quantify outcome indicators now will establish the framework for developing more specific outcome measures in the future. Client-oriented program objectives provide a structure for evaluating the quality of your agency's services and to demonstrate accountability to the consumers of your services. Nurses are encouraged to take a proactive stance and to examine their major service programs in light of the client outcomes their home care services are intended to achieve. Development of one or two major COPOs for each service program can be easily managed by using the steps outlined in this article.