Issuing durable medical equipment to patients for use at home is a costly and complex process. Selection, delivery, setup, and maintenance of home care equip ment and the education of patients in its use are currently included in Joint Commission on the Ac creditation of Healthcare Organizations (JCAHO) ac creditation surveys for those health care organiza tions that issue equipment. In this Department of Veterans Affairs teaching hospital, the process was complicated by eligibility regulations and frequently rotating housestaff. We organized a team who studied the process and identified opportunities for improve ment in three areas: the selection of equipment items ordered, management of equipment-related data, and standardization of equipment delivery contracts. We produced a reference manual for staff, developed a simple database, and incorporated JCAHO home care equipment management standards into equipment de livery vendor contracts. The results of the team's efforts were an increase in efficiency, a decrease in discharge delays, and improved continuity of care. We chose to use the FOCUS-PDCA model to illustrate our approach to improving these processes.
