critical practice areas in which home care providers should focus their efforts to improve quality of care and quality of life: Care Coordination, Management and Transitions; Medication Management; Cognitive Function; Physical Function; Chronic Pain Management; and Palliative Care and Advanced Illness Management. An “evidence brief” for each practice area was prepared in which a large body of geriatric and chronic care research was synthesized and applied to the home health setting—an innovation for the field.

Dr. Feldman explained, “There is still a dearth of research conducted specifically in home care so the evidence that underpins the best way to practice home care must be adapted from research conducted in hospitals, nursing facilities, or out-patient settings.” Each evidence brief explains why each practice area was selected as a priority for home care for older adults, contains a summary of evidence on effective practice and describes the implications for current home care practice.

BUILDING THE FRAMEWORK
The Framework Initiative also established a set of important principles for achieving excellence in home care for older adults that cut across all six practice areas. These cross-cutting principles are common to all the best practices and provide a vision to spur home care providers’ quality improvement efforts. They state that home care providers should offer services that are:

Relationship-centered, engaging the older person, and emphasizing familial, social, helping and caring relationships

Team-based, interdisciplinary, and collaborative

Based on the best available evidence from the fields of aging and home care

Individualized for each patient and culturally sensitive

Focused on communication among all individuals involved in care

Organized to facilitate monitoring, evaluation and revision of care as needed over time

To assist home care providers in