Multistate Performance Improvement Project

Strengthening our Quality Programs in our Rural Hospitals

•Alaska•Arizona•Kansas•Oklahoma•New Mexico•Virginia•Wyoming

Participating States

Project Purpose To help our small rural hospitals

develop quality programs that will assist them in surviving the challenges that will come with the emerging era of intolerance in ways tailored to the unique needs of their settings.

Project Goals• Streamlining compliance-related activities to promote success while

consuming minimal resources• Assuring Medicare Conditions of Participation survey readiness• Strengthening quality improvement activities to promote sustainable

and timely improvement• Streamlining quality related activities for greater efficiency and

effectiveness• Strengthening systems such as utilization review, infection control,

credentialing, privileging, medical staff bylaws, policies and procedures, leadership development and board education

• Participating in benchmarking activities to establish baseline performance and promote learning through the sharing

• of best practices• Establishing strong systems for strategically managing the hospitals’

future

Project Activities• Survey readiness• On-site consultation• Training webinars• Resource library• Benchmarking with peer group• Telephone and internet support

Project Timeline

QUALITY INITIATIVESQUALITY INITIATIVESARIZONA FLEX ARIZONA FLEX

PROGRAMPROGRAM

Alison Hughes, MPA, Flex Program, Az RHOHRSA Grantee Partnership MeetingWashington, D.C. September, 2009

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Hopi Country, July, 2009Photo by Alison

Quality InitiativesQuality Initiatives• Performance Improvement Summit for

Critical Access Hospital CEOs and CFOs.• Rural Trauma Team Development.• Mock Site Reviews.• Targeted trainings and Webinars.• Multi-State Quality Improvement Project.• EMS First Responder manager training

and budget training.8

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Arizona Critical Access Hospital CEOs, CFO’s and other staff members gather for 2009 Performance Improvement Summit.

Phoenix, June, 2009

10Phoenix Police on Break July 2009Photo by Alison

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ARIZONA CAH-RELATED FIRST RESPONDERSRECEIVE BUDGET TRAINING, 2008

Photo by Alison

• INTRODUCING THE MULTI-STATE PROJECT TO ARIZONA CRITICAL ACCESS HOSPITALS

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• Introducing the Multi-State Project to the CEOs

• Teleconferences with consultant• Teleconferences with Kansas Hospital Association

online Quality Health Indicators project and interested critical access hospitals.

• Contract negotiations. The need for MOAs with participating hospitals.

• Flex Staff site visits to critical access hospitals with Darlene Bainbridge for consultations.

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• Webinar Involvement • In-person Quality Managers meeting.• Ongoing tele-consultations on identified needs.

–Swing bed policies–Observation bed policies–Personnel management challenges

• Useful tools for Quality Managers–Quality calendar concept

• End-of-year assessment underway.

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Introducing the Multi-State Project toHospital personnel in Willcox, Arizona.

Photo by Alison.

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Quality Managers attend in-person training program July, 2008, Phoenix, AZ. Darlene Bainbridge, trainer.Photo by Alison.

Lessons LearnedLessons Learned

• Chief Executive Officer buy-in and personal engagement impacts success.

• Flex staff engagement impacts success.• The importance of Memoranda of

Agreement with the participating hospitals, prior to participation.

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Navajo Land, ArizonaJuly, 2009

Photo by Alison

END

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Hopi Country, July, 2009Photo by Alison

QUALITY INITIATIVESQUALITY INITIATIVESOKLAHOMA FLEX OKLAHOMA FLEX

PROGRAMPROGRAM

Val Schott, Flex Program, OK RHOHRSA Grantee Partnership MeetingWashington, D.C. September, 2009

Quality InitiativesQuality Initiatives• Multi-State Quality Improvement Project• Community assessments• Annual rural health conference• QIO Quality Initiative• EMS First Responder development

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Stronger quality programs are critical to the future of our rural hospitals

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Five Critical Outcomes• Patient satisfaction that drives loyalty to our rural hospitals• New patient acquisition• Patient retention• Patient profitability• Market domination

Critical Activities• Teleconferences with consultant• Participation in Quality Health Indicators project• Flex Staff site visits to critical access hospitals

with Darlene Bainbridge for consultations.• Internet and telephone support• Resource library• Partnership building with Oklahoma Hospital

Association and QIO

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Lessons Learned• Need to keep it simple• It is not a lack of desire that hurts our

hospitals, it’s a lack of knowledge and resources

• This works best when we all work together

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