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Rural Hospital Collaborative for Excellence Using IT
AHRQ UC1 HS15431
Kathy Mechler, MS, RN, CPHQTexas A&M University Health Science
Center Rural and Community Health Institute
Grant Partners
Baylor Health Care System Institute for Health Care Research & Improvement
Dallas-Fort Worth Hospital Council Data Initiative
Texas Medical Foundation Health QualityInstitute
Project Objective
• Improve patient safety and quality of care in rural and critical access hospitals by providing:
• Access to web-based state of the art data processing and analytic tools• Education and training • Ongoing support and encouragement specific to performance measurement and using AHRQ quality and safety indicators in their respective performance improvement efforts
Taught basic concepts of :• patient safety & quality improvement• data analysis & interpretation• required a project from each participating hospital
Education Course
Study Eligibility
• Hospitals in counties with population ‹100,000• General Medical/Surgical (n=129)• Critical Access (n=59)• Eligible hospitals – 188•Funding for 62 hospitals – 66 hospitals in the study • Agree to submit and share administrative data • Agree to abstract and submit CMS Core Measures
Participants – 66 Hospitals
North Runnels HospitalNorth Runnels HospitalNorth Runnels HospitalNorth Runnels HospitalNorth Runnels HospitalNorth Runnels HospitalNorth Runnels HospitalNorth Runnels HospitalNorth Runnels Hospital
Lillian M Hudspeth Memorial HospitalLillian M Hudspeth Memorial HospitalLillian M Hudspeth Memorial HospitalLillian M Hudspeth Memorial HospitalLillian M Hudspeth Memorial HospitalLillian M Hudspeth Memorial HospitalLillian M Hudspeth Memorial HospitalLillian M Hudspeth Memorial HospitalLillian M Hudspeth Memorial Hospital
Palacios Community Medical CenterPalacios Community Medical CenterPalacios Community Medical CenterPalacios Community Medical CenterPalacios Community Medical CenterPalacios Community Medical CenterPalacios Community Medical CenterPalacios Community Medical CenterPalacios Community Medical Center
Memorial Medical CenterMemorial Medical CenterMemorial Medical CenterMemorial Medical CenterMemorial Medical CenterMemorial Medical CenterMemorial Medical CenterMemorial Medical CenterMemorial Medical Center
Winkler County Memorial HospitalWinkler County Memorial HospitalWinkler County Memorial HospitalWinkler County Memorial HospitalWinkler County Memorial HospitalWinkler County Memorial HospitalWinkler County Memorial HospitalWinkler County Memorial HospitalWinkler County Memorial Hospital
Electra Memorial HospitalElectra Memorial HospitalElectra Memorial HospitalElectra Memorial HospitalElectra Memorial HospitalElectra Memorial HospitalElectra Memorial HospitalElectra Memorial HospitalElectra Memorial Hospital
Collingsworth General HospitalCollingsworth General HospitalCollingsworth General HospitalCollingsworth General HospitalCollingsworth General HospitalCollingsworth General HospitalCollingsworth General HospitalCollingsworth General HospitalCollingsworth General Hospital
Ballinger Memorial HospitalBallinger Memorial HospitalBallinger Memorial HospitalBallinger Memorial HospitalBallinger Memorial HospitalBallinger Memorial HospitalBallinger Memorial HospitalBallinger Memorial HospitalBallinger Memorial Hospital
Grimes St. Joseph Health CenterGrimes St. Joseph Health CenterGrimes St. Joseph Health CenterGrimes St. Joseph Health CenterGrimes St. Joseph Health CenterGrimes St. Joseph Health CenterGrimes St. Joseph Health CenterGrimes St. Joseph Health CenterGrimes St. Joseph Health Center
Madison St. Joseph Health CenterMadison St. Joseph Health CenterMadison St. Joseph Health CenterMadison St. Joseph Health CenterMadison St. Joseph Health CenterMadison St. Joseph Health CenterMadison St. Joseph Health CenterMadison St. Joseph Health CenterMadison St. Joseph Health CenterConcho County HospitalConcho County HospitalConcho County HospitalConcho County HospitalConcho County HospitalConcho County HospitalConcho County HospitalConcho County HospitalConcho County Hospital
Ref ugio County Memorial Hospital DistrictRef ugio County Memorial Hospital DistrictRef ugio County Memorial Hospital DistrictRef ugio County Memorial Hospital DistrictRef ugio County Memorial Hospital DistrictRef ugio County Memorial Hospital DistrictRef ugio County Memorial Hospital DistrictRef ugio County Memorial Hospital DistrictRef ugio County Memorial Hospital District
Linden Municipal HospitalLinden Municipal HospitalLinden Municipal HospitalLinden Municipal HospitalLinden Municipal HospitalLinden Municipal HospitalLinden Municipal HospitalLinden Municipal HospitalLinden Municipal HospitalMitchell County HospitalMitchell County HospitalMitchell County HospitalMitchell County HospitalMitchell County HospitalMitchell County HospitalMitchell County HospitalMitchell County HospitalMitchell County Hospital
Jackson County Hospital DistrictJackson County Hospital DistrictJackson County Hospital DistrictJackson County Hospital DistrictJackson County Hospital DistrictJackson County Hospital DistrictJackson County Hospital DistrictJackson County Hospital DistrictJackson County Hospital District
Culberson HospitalCulberson HospitalCulberson HospitalCulberson HospitalCulberson HospitalCulberson HospitalCulberson HospitalCulberson HospitalCulberson HospitalMcCamey HospitalMcCamey HospitalMcCamey HospitalMcCamey HospitalMcCamey HospitalMcCamey HospitalMcCamey HospitalMcCamey HospitalMcCamey Hospital
Titus Regional Medical CenterTitus Regional Medical CenterTitus Regional Medical CenterTitus Regional Medical CenterTitus Regional Medical CenterTitus Regional Medical CenterTitus Regional Medical CenterTitus Regional Medical CenterTitus Regional Medical Center
Ty ler County HospitalTy ler County HospitalTy ler County HospitalTy ler County HospitalTy ler County HospitalTy ler County HospitalTy ler County HospitalTy ler County HospitalTy ler County Hospital
Bowie Memorial HospitalBowie Memorial HospitalBowie Memorial HospitalBowie Memorial HospitalBowie Memorial HospitalBowie Memorial HospitalBowie Memorial HospitalBowie Memorial HospitalBowie Memorial Hospital
Sid Peterson Memorial HospitalSid Peterson Memorial HospitalSid Peterson Memorial HospitalSid Peterson Memorial HospitalSid Peterson Memorial HospitalSid Peterson Memorial HospitalSid Peterson Memorial HospitalSid Peterson Memorial HospitalSid Peterson Memorial Hospital
Starr County Memorial HospitalStarr County Memorial HospitalStarr County Memorial HospitalStarr County Memorial HospitalStarr County Memorial HospitalStarr County Memorial HospitalStarr County Memorial HospitalStarr County Memorial HospitalStarr County Memorial Hospital
Atlanta Memorial HospitalAtlanta Memorial HospitalAtlanta Memorial HospitalAtlanta Memorial HospitalAtlanta Memorial HospitalAtlanta Memorial HospitalAtlanta Memorial HospitalAtlanta Memorial HospitalAtlanta Memorial Hospital
Henderson Memorial HospitalHenderson Memorial HospitalHenderson Memorial HospitalHenderson Memorial HospitalHenderson Memorial HospitalHenderson Memorial HospitalHenderson Memorial HospitalHenderson Memorial HospitalHenderson Memorial Hospital
Knox County Hospital DistrictKnox County Hospital DistrictKnox County Hospital DistrictKnox County Hospital DistrictKnox County Hospital DistrictKnox County Hospital DistrictKnox County Hospital DistrictKnox County Hospital DistrictKnox County Hospital District
El Campo Memorial HospitalEl Campo Memorial HospitalEl Campo Memorial HospitalEl Campo Memorial HospitalEl Campo Memorial HospitalEl Campo Memorial HospitalEl Campo Memorial HospitalEl Campo Memorial HospitalEl Campo Memorial Hospital
Val Verde Regional Medical CenterVal Verde Regional Medical CenterVal Verde Regional Medical CenterVal Verde Regional Medical CenterVal Verde Regional Medical CenterVal Verde Regional Medical CenterVal Verde Regional Medical CenterVal Verde Regional Medical CenterVal Verde Regional Medical Center
North Bay HospitalNorth Bay HospitalNorth Bay HospitalNorth Bay HospitalNorth Bay HospitalNorth Bay HospitalNorth Bay HospitalNorth Bay HospitalNorth Bay Hospital
Brownf ield Regional Medical CenterBrownf ield Regional Medical CenterBrownf ield Regional Medical CenterBrownf ield Regional Medical CenterBrownf ield Regional Medical CenterBrownf ield Regional Medical CenterBrownf ield Regional Medical CenterBrownf ield Regional Medical CenterBrownf ield Regional Medical Center
Palestine Regional Medical CenterPalestine Regional Medical CenterPalestine Regional Medical CenterPalestine Regional Medical CenterPalestine Regional Medical CenterPalestine Regional Medical CenterPalestine Regional Medical CenterPalestine Regional Medical CenterPalestine Regional Medical Center
Uv alde Memorial HospitalUv alde Memorial HospitalUv alde Memorial HospitalUv alde Memorial HospitalUv alde Memorial HospitalUv alde Memorial HospitalUv alde Memorial HospitalUv alde Memorial HospitalUv alde Memorial Hospital
Paris Regional Medical Center - SouthParis Regional Medical Center - SouthParis Regional Medical Center - SouthParis Regional Medical Center - SouthParis Regional Medical Center - SouthParis Regional Medical Center - SouthParis Regional Medical Center - SouthParis Regional Medical Center - SouthParis Regional Medical Center - South
HoustonHoustonHoustonHoustonHoustonHoustonHoustonHoustonHouston
El PasoEl PasoEl PasoEl PasoEl PasoEl PasoEl PasoEl PasoEl Paso
AustinAustinAustinAustinAustinAustinAustinAustinAustin
Corpus ChristiCorpus ChristiCorpus ChristiCorpus ChristiCorpus ChristiCorpus ChristiCorpus ChristiCorpus ChristiCorpus Christi
Brownsv illeBrownsv illeBrownsv illeBrownsv illeBrownsv illeBrownsv illeBrownsv illeBrownsv illeBrownsv ille
BeaumontBeaumontBeaumontBeaumontBeaumontBeaumontBeaumontBeaumontBeaumont
AmarilloAmarilloAmarilloAmarilloAmarilloAmarilloAmarilloAmarilloAmarillo
AbileneAbileneAbileneAbileneAbileneAbileneAbileneAbileneAbilene
McallenMcallenMcallenMcallenMcallenMcallenMcallenMcallenMcallen
LubbockLubbockLubbockLubbockLubbockLubbockLubbockLubbockLubbock
LaredoLaredoLaredoLaredoLaredoLaredoLaredoLaredoLaredo
PECOSPECOSPECOSPECOSPECOSPECOSPECOSPECOSPECOS
TXTXTXTXTXTXTXTXTX
Hospital Discharge Data, CMS and AHA Quality Measures
Technology Implementation
Market Data
Financial Data
Operational Data
Patient Safety & Quality Data
QualityImprovement
Process
StrategicPlanningProcess
ImprovedPatient Quality
andStrategic Planning
Technology Model for Improvement
How the data being used…
What have we learned?
• Data exports were challenging for rural hospitals• Education and Support is critical to success • Exceeded budgetary expectations• Small numbers have been an issue• Limited resources: Budget and Equipment• Limited human resources Manpower, financial• Independent, have a tendency to resist outside influence• Short term view is focused on revenue to survive• Different problems with patient safety• Knowledge is broad but superficial• Some of the hospitals do not take the time to code self paying patients due to no change or impact on their reimbursement
What are the hospitals saying?
How are the hospitals using the data?
68.75
50
18.75
12.5
0 10 20 30 40 50 60 70 80
Analyzing your patientdata
Making reports
Informing boardmembers with reports
Other
Types of Assistance Used
Quality of Experience
30
36.7
30
3.3
0
5
10
15
20
25
30
35
40
Neutral Good Excellent No response
Next Steps
• Evaluation• Technology evaluation ongoing (qualitative & quantitative)• Measurably improved data integrity
• Sustainability plan underway• Additional funding for ambulatory data and other data initiatives
