The Personal and Skilled Care Outcomes (PESO) Data Set

Under contract with the New York State Department of Health the Center for Health Services Research of the University of Colorado's Health Science Center initiated the New York State Outcome-Based Quality Improvement (OBQI) Demonstration in 1996. The objective was testing the effectiveness of the OBQI method for enhancing the quality of home care services provided in New York State. OBQI, which involves the regular collection, analysis and reporting of systematic patient health status data, provides home care agencies with objective information about the outcomes of their patients compared with patients receiving care from other agencies. Agencies use this feedback to target agency-level quality improvement efforts designed to enhance future outcomes.

The first phase of the initiative demonstrated the effectiveness of the OBQI process for improving the quality of services provided by Medicare-certified home health agencies (CHHAs). The second phase expanded the OBQI demonstration to allow an evaluation of the OBQI methodology's effectiveness for licensed home care services agencies (LHCSAs), as well. These agencies provide non-Medicare services including assistance with personal care as well as skilled care services. While this phase provided evidence that OBQI can lead to improved patient outcomes in LHCSAs, the need for a quality improvement system that was more finely tailored to the unique services provided by such agencies was apparent.

As a result, the third and fourth phases of the demonstration focused on developing a data set and OBQI process customized for LHCSAs. The result, the Personal and Skilled Care Outcomes (PESO) data set, allows for the measurement and risk adjustment of outcomes directly relevant to the services provided by and patients served by LHCSAs. These activities have made researchers, policy makers, and representatives of the home care community aware of PESO's value and availability to contribute to the systematic evaluation and improvement of patient outcomes in LHCSAs. Additional information on the demonstration project is available in a recently published article in Home Healthcare Nurse 26, no. 10, (November/December 2008). The article is entitled "Improving the Outcomes of Home Care Services in New York State" by Angela G. Brega, PhD., Kathryn S. Crisler, MS, RN, and Nancy R. Barhydt, DrPH.

The work on the PESO project has now concluded and the Department of Health is pleased to make PESO tools available to all. Below are a set of PESO documents. The first is the complete data set, which includes all versions of all data items. There are five documents that represent data collection forms for specific time points in a client's care: Tracking, Start/Resumption of Care, Follow-up, Transfer, and Discharge. Finally, three additional documents provide description regarding the use of the PESO data items for computation of (1) outcome measures, (2) satisfaction measures, and (3) adverse events.

For more information contact the Bureau of Home Care/Hospice Surveillance and Quality Indicator/Evaluation BML