Title: Bureaucratic control mechanisms and the implementation of quality improvement programmes in home health agencies

Authors: Diane Brannon, Kathryn H. Dansky

Addresses: Department of Health Policy and Administration, Pennsylvania State University, 115 Henderson Building, University Park, PA 16802, USA. Department of Health Policy and Administration, Pennsylvania State University, 115 Henderson Building, University Park, PA 16802, USA

Abstract: This paper examines the relationship between structural characteristics of home health agencies and the adoption of continuous quality improvement (CQI) technology. Home health services are the fastest growing component of the US healthcare system. Concerns regarding quality management derive from the remote service delivery modality and the heavy reliance on paraprofessional staff. Results of a survey of 361 agency directors indicate that, in contrast to observations in the hospital industry, the implementation of CQI in home healthcare is facilitated by increased formalisation and standardisation of work processes. These bureaucratic mechanisms may provide requisite structural integrity for adoption of inherently decentralising CQI programmes.

Keywords: continuous quality improvement; formalisation; home health aides management; home healthcare; managerial technology adoption; standardisation; structure.

DOI: 10.1504/IJHTM.2001.001108

International Journal of Healthcare Technology and Management, 2001 Vol.3 No.2/3/4, pp.274-287

Published online: 30 Jun 2003 *

Full-text access for editors Full-text access for subscribers Purchase this article Comment on this article