The June 6 issue of the Journal of the American Medical Association (JAMA) featured an article entitled Quality of Care and Patient Outcomes in Critical Access Rural Hospitals. Many who have had the opportunity to review the article conclude that it unfairly calls into question the quality of care in Critical Access Hospitals (CAHs). The article reported that when compared with non-Critical Access Hospitals, CAHs had fewer clinical capabilities, worse measured process of care, and higher mortality rates for patients with AMI, CHF or Pneumonia.
The Flex Monitoring Team has prepared a detailed analysis of the JAMA report on quality of care at CAHs. The team is funded by HRSA, and is comprised of the nation's leading experts on rural health care quality.
“The report is simply deficient when it comes to understanding the basic role of a Critical Access Hospital within a rural community,” said Alan Morgan, National Rural Health Association CEO. “The current quality measurement systems available do not adequately reflect the core work of what rural hospitals do on a daily basis.” One of the major problems with the JAMA article is the assumption that CAHs would keep the sickest patients. CRHC recognizes that the sick patients a CAH keeps are those refusing to go to a network hospital or wanting only comfort care measures.
CLICK HERE to view the Flex Team's response to the JAMA report. This study highlights the need for CAHs to create their own story. No longer is it acceptable to keep quality improvement data internally, this data must be shared externally to showcase patient safety and quality improvement outcomes. T
Another interesting response to the JAMA report, Measuring Rural Healthcare Health, by Robert Bowman M.D., is available HERE.
Last fall, CRHC kicked off a quality improvement program called iCARE (Improving Communications and Readmissions). The iCARE project focuses on improving data related to heart failure and pneumonia, reducing readmissions, and improving the communications within the hospital and with other community partners such as EMS, the clinics and urban transfer facilities. Participating hospitals have agreed to collect CMS core measure data for heart failure and pneumonia and submit that to “Hospital Compare.”
Beginning in September 2011, the Office of Rural Health Policy (ORHP) will kick off their focused framework for CAHs and State Offices of Rural Health. This is currently a three-year initiative to create a national database for benchmarking purposes and to inform the President as well as other federal officials on how well CAHs perform in quality improvement. With budget concerns at an all-time high, CRHC urges all CAHs to engage and commit by submitting data to Hospital Compare and by agreeing to grant ORHP access to that data. Please visit the MBQIP for a three-minute video that explains these efforts. The consent forms are available here .
CRHC recognizes and congratulates Colorado CAHs for over 10 years of work on quality improvement activities, including the Quality Network, 100,000 Lives Campaign, 5 Million Lives Campaign, Quality Health Indicators (QHi) Benchmarking, and iCARE.
