Inventory of Health Care Information Standards. Georgetown University Home Care Project


Home Health Care Classification (HHCC) System

Home Health Care Classification (HHCC) System is a system designed to assess and document home health and ambulatory care using its standardized HHCC nomenclature. Its documentation method tracks home health and ambulatory care. It is based on a conceptual framework using the nursing process to access a patient holistically. HHCC nomenclature consists of six data dictionaries:

  • 20 home health care components to assess and classify care;
  • 145 nursing diagnoses (50 major categories & 95 subcategories);
  • 3 expected outcome goals that modify nursing nursing diagnoses;
  • 160 nursing interventions (60 major & 100 subcategories);
  • 4 nursing action types that modify nursing interventions and converts the dictionary to 640 unique nursing interventions;
  • 3 actual outcomes that evaluate the care process.

A patient/client is also assessed using 20 medical diagnoses and/or surgical procedure categories, and 10 socio-demographic data elements.

HHCC System can be used to identify: (a) care needs in terms of care components and their respective nursing diagnoses and interventions; and (b) resource use in terms of nursing and other health providers (physical, occupational, and speech therapy, medical social worker, and home health aide). The medical assessment categories and socio-demographic data elements are descriptive variables that can be correlated with clinical care data.

HHCC is also designed to record the clinical care pathways for an entire episode of care. The care events can be used to determine care costs, and can provide a payment method for managed care services. HHCC System runs on microcomputer using a portable notebook to facilitate ease of use for data collection and then downloaded to a computer-based workstation for processing.

References are available upon request.

Purpose: The Home Health Care Classification (HHCC) - Nursing Diagnoses and Nursing Interventions was developed by Saba as part of the Georgetown University Home Car Project. It was developed to classify, code for computer processing and analyze study data. The HHCC is being used to document and describe home health nursing care, as well as determine cost and measure outcomes.

Structure: The Home Health Care Classification (HHCC) - Nursing Diagnoses and Nursing Interventions are classified according to 20 Home Health Care Components:

  1. Activity 11. Physical Regulation
  2. Bowel Elimination 12. Respiratory
  3. Cardiac 13. Role Relationship
  4. Cognitive 14. Safety
  5. Coping 15. Self-Care
  6. Fluid Volume 16. Self-Concept
  7. Health Behavior 17. Sensory
  8. Medication 18. Skin Integrity
  9. Metabolic 19. Tissue Perfusion
  10. Nutritional 20. Urinary Elimination

HHCC of Nursing Diagnoses: The scheme consist of 145 nursing diagnoses (50 two digit major categories and 95 three-digit subcategories). Each nursing diagnosis has a modifier to code three possible expected outcomes: 1=improved, 2=stabilized, or 3=deteriorated.

HHCC of Nursing Interventions: It consists of 160 unique nursing interventions (60 two digit major categories and 95 three-digit subcategories). Each nursing intervention has a modifier to code four types of nursing action: 1=access, 2-direct care, 3=teach, and/or 4=manage. The type of action modifier adds the implementation facet to the HHCC of Nursing Intervention Taxonomy expanding it to 640 possible nursing intervention codes.

The HHCC is structured according to the Tenth Revision of the International Classification of Diseases (ICD-10). Each classification label consists of a five character alphanumeric code. The HHCC Care Component is alphabetic and the first character, the Nursing Diagnosis or Nursing Intervention is represented by a second and third digit for major categories, and in some instances a fourth numeric digit for minor subcategories, and the fifth digit is used to represent a modifier for each scheme.

Availability: Virginia K. Saba, EdD, RN, FAAN

Georgetown University

School of Nursing

3700 Reservoir Road, NW

Washington, DC 20007

Tel: (202) 687-46479