Home and Community-Based Service Organizations’ Capacity for and Experiences With Quality Improvement Initiatives

Few studies have examined quality improvement (QI) initiatives among home and community-based service (HCBS) providers. Study objectives were to (1) examine HCBS organizations’ QI capacity, (2) explore organizational differences in providers’ QI experiences, and (3) explore the impact of a state’s QI initiatives on providers’ efforts. A survey assessing HCBS providers’ experiences and QI capacity was administered. Overall, respondents reported a moderate amount of previous QI experience. In terms of QI capacity, smaller and rural organizations were more likely to report inadequate support for project implementation (p < .05). Larger organizations were more likely to report challenges with staffing. Smaller organizations reported less of a perceived impact of the state’s initiative (p < .05). Smaller and rural providers need individualized support to overcome lack of QI experience and resources.