Abstract
Organizations are often overwhelmed when faced with a need to develop a comprehensive quality improvement program and use a cross-organizational team to improve outcomes. This article describes the total quality management program implemented in a long-term home health care program in New York State. It describes common issues, such as incidents, multidisciplinary clinical record documentation audits, and staff competency. As a result of this comprehensive performance improvement process, this organization has not only changed the manner in which it operates but also improved its performance.